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A cold nodule in thyroid scintiscan mean
null
3
Nodule which is cold
Hyperactive nodule
Nodule which is nonfunctioning & malignant
Nodule which has no signs of inflammation
Surgery
null
543b141c-025d-4360-9e46-4f4f87894d9b
single
Earliest sensation to be lost in Hansens disease is -
null
2
Pain
Touch
Vibration
Temperature
Social & Preventive Medicine
null
4887adf2-a741-4aab-a401-5a0d9478e00a
single
Who said these words : To study the phenomenon of disease without books is to sail an unchaed sea, while to study books without patients is not to go to sea at all -
Ans. is 'c' i.e., Sir William Osler
3
Hamilton Bailey
Sir Robe Hutchison
Sir William Osler
J.B. Murphy
Surgery
null
d2a74fda-f991-467d-8048-9ff1b10a261c
multi
Which of the following contains highest protein content?
Ans. b (HDL). (Ref. Harper, Biochemistry, 25th ed., 268)PROPERTIES OF PLASMA LIPOPROTEINS LipoproteinMajor lipidElectrophoretic mobilityMajor apoproteinsProtein content1ChylomicronTriglycerideNoneB-48, A-I, IV-2Very low density (VLDL)TriglyceridePre-betaB-100, E, C-I, II, III-3intermediateTriglyceride & density (IDL)cholestery! estersBetaB-100, E-4Low density (LDL)Cholesteryl estersBetaB-100-5High density (HDL)Phospholipids & cholesterolAlphaA-I, IIHighest LIPOPROTEINFUNCTIONSChylomicron- Delivers dietary triglycerides to peripheral tissues and dietary cholesterol to liver. (MH 2003) - Secreted by intestinal epithelial cells. - Levels are classically increased in lipoprotein lipase deficiency (AIIMS 99). - Excess causes pancreatitis, lipemia retinalis, and eruptive xanthomas.VLDLDelivers hepatic triglycerides to peripheral tissues. - Secreted by liver. - Excess causes pancreatitis.LDL- Delivers hepatic cholesterol to peripheral tissues. - Formed by lipoprotein lipase modification of VLDL in the peripheral tissue. - Taken up by target cells via receptor-mediated endocytosis. - Classically increased in familial hypercholesterolemia. - Most atherogenic (MH 2003)HDLMediates centripetal transport of cholesterol (reverse cholesterol transport) - Acts as a precursor for apoC and apoE (which are needed for chylomicron and VLDL metabolism). - Secreted from both liver and intestine. - Aptly known as "good cholesterol"
2
Triglycerides
HDL
LDL
VLDL
Biochemistry
Lipids
bdd45e8b-7a10-45e2-97b2-14e955664bd7
single
During a football game a 21-year-old wide receiver was illegally blocked by a linebacker, who threw himself against the posterolateral aspect of the runner's left knee. As he lay on the ground, the wide receiver grasped his knee in obvious pain. Which of the following structures is frequently subject to injury from this type of force against the knee?
This type of injury can result in the "unhappy triad" (of O'Donahue) injury, with damage to the medial collateral ligament (MCL), anterior cruciate ligament (ACL), and medial meniscus. A blow to the lateral side of the knee stretches and tears the MCL, which is attached to the medial meniscus. The ACL is tensed during knee extension and can tear subsequent to the rupture of the MCL. The remaining answer choices describe structures on the lateral surface of the knee, which are not usually injured by this type of trauma.
2
Fibular collateral ligament
Anterior cruciate ligament
Lateral meniscus and posterior cruciate ligament
Fibular collateral and posterior cruciate ligament
Anatomy
Lower Extremity
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multi
23-year-old medical student complaint of feeling "worried." He fears failing his clinical exam because he feels nervous about presenting a case and performing physical examination in front of examiners. He would skip bedside teaching when it would be his turn to present a case in front of his classmates and tutors. He worries about criticism from his classmates and tutor. The most likely diagnosis is?
Clinical picture of fearing presentation in public, avoidance, fear of criticism is suggestive of social phobia. It is also known as social anxiety disorder. In Generalised anxiety disorder there is free flowing anxiety at all time. In panic disorder there are recurrent panic attacks with feeling of impending doom.
4
Normal shyness
Panic disorder
Generalized anxiety disorder
Social phobia
Psychiatry
Neurotic, Stress Related and Somatoform Disorders
d3dd46c1-b874-4b4d-a853-27b078da2259
single
A 1-year-old female infant is hospitalized for pneumonia. Bacterial cultures of the sputum have grown Pseudomonas aeruginosa. She has had two prior hospitalizations for severe respiratory infections. Her mother has noted that when she kisses her child, the child tastes "salty." The child has had weight loss that the mother attributes to frequent vomiting and diarrhea with bulky, foul-smelling fatty stools. The child is small for her age. Which of the following critical proteins is altered in this condition?
Cystic fibrosis, Most common lethal genetic disease in Caucasian populations. Defect in the cystic fibrosis transmembrane conductance regulator (CFTR) protein Deletion of phenylalanine in position 508 (DF508 mutation). Affected patients often have multiple pulmonary infections and pancreatic insufficiency with steatorrhea and failure to thrive. Death is often due to respiratory failure secondary to repeated pulmonary infections, facilitated by the buildup of thick, tenacious mucus in the airways. Increased concentration of chloride in sweat and tears is characteristic
1
Cystic fibrosis transmembrane conductance regulator
Dystrophin
a-1,4-Glucosidase
a-L-Iduronidase
Pathology
Genetics
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multi
Retinal output is mainly from
(A) Ganglion cell layer # Retina:> Layer of rods & cones: These are the end organs of vision & are also known as photoreceptors> Outer nuclear layer: It consists of nuclei of the rods and cones.> Outer plexiform layer: It consists of connections of rod spherules and cone pedicles with the dendrites of bipolar cells and horizontal cells.> Inner nuclear layer: It mainly consists of cell bodies of bipolar cells.* It also contains cell bodies of horizontal & muller's cells & capillaries of central artery of retina* The bipolar cells constitute the 1 st order neurons> Ganglion cell layer. It mainly contains the cell bodies of ganglion cells (the second order neurons of visual pathway).
1
Ganglion cell layer
Layer of rods & cones
Outer nuclear layer
Outer plexiform layer
Medicine
Miscellaneous
c6a5483b-d9e5-4748-96fd-db67312cb3f7
single
Global warming, which is true:
CO2 is the major green house gas
1
CO2 is the major green house gas
Stratosphere ozone layer is harmful
CFC increases the zone of stratosphere
KYOTO protocol set the target of net reduction of 20 green house gas emission
Social & Preventive Medicine
null
02e3ddc6-35ef-4482-8e3a-ac4b9603597f
multi
Lathryism is due to -
Ans. is 'a' i.e., Khesari Dal Lathvrismo Lathyrism is caused bv lathyrus sativus, commonly known as "Khesari dhal"o The toxin present in lathyrus seeds has been identified as Beta oxalyl aminoalanine (BOAA).o Toxin is water soluble,, this property has been made use of in removing the toxin from the pulse by soaking it in hot wnter and rejecting the soak water.o Blood brain barrier restrict the toxin to enter in the brain - to overcome this barrier the pulse must be eaten in large amounts over a period of time for 2 months or more.o Lathyrism is a paralysing disease of humans and animals,o In humans it affects nervous system - Neurolathyrism.o In animals it affects skeletal system - Osteolathyrism (odoratism).Neurolathyrismo Disease affects young men between 15-45 years,o It is characterized by spastic paralysis of lower limbs.Interventions for prevention and controlo Vitamin C prophylaxiso Banning the cropo Removal of toxin: Steeping method and Parboilingo Educationo Genetic approacho Socio-economic changes
1
Khesari dal
Aflatoxins
Aspergillus
Fluoride
Social & Preventive Medicine
Nutrition and Health
a382164d-8b96-4ac4-933d-540b7968ca22
single
Bone tumors arising from diaphysis -a) Chondrosarcomab) Ewing's tumorc) Osteoclastomad) Chondroblastoma e) Osteid osteoma
Diaphyseal lesions : - Ewing sarcoma, Lymphomas, Fibrous dysplasia, Adamantinoma, Histiocytosis, Osteoid osteoma, Chondromyxoid fibroma, Fibrosarcoma, Fibrous cortical defect. Non ossifying fibroma
4
ab
ad
bc
be
Orthopaedics
null
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single
Vitamin K dependent clotting factor is
Vitamin K dependent clotting factors (VKCF) are clotting factors II (prothrombin), VII (Proconvertin), IX (Christmas factor), X (Stuart Prover Factor), protein C, protein S and protein Z.
1
VII
I
XI
XII
Biochemistry
null
bf51a57c-7701-4b35-824d-64d0798e4a94
single
IPC code related to age for valid consent is?
Ans. is 'c' i.e., 87o Section 87 of the IPC says that a person above 18 years of age can give valid consent and Section 89 of the IPC says that a child under 12 years of age cannot give a valid consent.Other optionso 85 and 86 I PCs are related to drunkenness and criminal responsibility.o 88 IPC: Act not intended to cause death, but can cause death or grievous hurt, done by consent in good faith and for the benefit of that person, e.g., death of a patient caused by surgery done by a surgeon.
3
85
86
87
88
Forensic Medicine
Introduction to Forensic Medicine and Medical Jurisprudence
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single
A patient of 40 years male got a blow on the angle region of mandible and he is asymptomatic. The x-rays of that region shows a radiopaque line with very sharp undercut in the lower border of mandible which may be due to:
null
2
Sutural diastasis
Overlapping sign
Separation sign
Non union sign
Surgery
null
383948b7-bbde-4c78-b992-e507c6a9fa27
single
The dose of Dopamine used for renal vasodilatation is?
Dopamine is used in the treatment of shock - cardiogenic, hypovolemic, and septic shock. It is especially useful when there is renal dysfunction and low cardiac output because dopamine increases renal blood flow and thereby GFR. Dopamine stimulates the hea - increases FOC, CO, BP. It is also sho acting. Its dose is 2-5 mcg /kg/ min for stimulating the hea (beta-1) least does- renal VD. 1-2 mcg /kg/ min- Dopamine receptor stimulation more than 10mcg /kg/ min not to be used as alpha receptors may get stimulated causing vasoconstriction From medical pharmacology Padmaja 4th edition page 97
4
2.5 ug/kg/min
5-10 ug/kg/min
10-20 ug/kg/min
1-2 ug/kg/min
Pharmacology
Autonomic nervous system
ca06d177-cb7e-4b41-be31-1bbb70024a84
single
Smokeless Gun powder contains
SMOKELESS gun powder: Single base: Nitrocellulose Double base: Nitrocellulose + Nitro-glycerine Triple base: Nitrocellulose + Nitroglycerine + Nitroguanidine
1
Nitrocellulose
Charcoal
Potassium
Sulphur
Forensic Medicine
Ballistics
22492e18-1b16-4b47-9535-29e29360ac8a
single
What is the content of ethinyl estradiol in very low dose oral contraceptives ?
Ans. is 'c' i.e., 20 jutg o Very low dose OCPs ---> 20 mg ethinyl estradiol. o Conventional OCPs --> 30-50 mg ethinyl estradiol (mostly 30 g)
3
30 pig
25 ps
20ug
151.tg
Social & Preventive Medicine
null
50e3bd81-d9f2-4f65-90cb-e2200388cfaf
single
True statement about widal test in typhoid is-(
Ans. is 'c' i.e., Previous infection alters widal test . Person who have had prior infection or immunization may develop an anamnestic response during unrelated fever and may show false positive reaction. This may be differentiated by repetition of test after a week. The anamnestic response shows only a transient rise, while in enteric fever the rise is sustained. About other options : . Cases treated with antibiotic (cholermphenicol) may show a poor agglutinin response. . Other than a positive culture, no specific laboratory test is diagnostic - . Both prior vaccination (immunization) or infection can alter the widal test (see above).
3
Widal test is confirmative in endemic areas
Antibiotic treatment does not alter widal test results
Previous infection alters widal test
Widal test does not alter with prior vaccination
Microbiology
null
cc763197-f7c6-4eb8-b8c4-6cb5a8fc46e7
multi
Schizophrenia mostly occurs in -
Schizophrenia starts in late adolescence and early adulthood (15-20 years).
1
Adolescents
Children
Middle age
Old age
Psychiatry
null
ad5476c5-846a-4e03-92aa-21de351fe700
single
ECG of a patient with snake bite is shown below. What is the abnormality seen?
ECG changes typically occur when serum potassium is < 3 mEq/L, and include ST segment sagging, T wave depression, and U wave elevation. With marked hypokalemia, the T wave becomes progressively smaller and the U wave becomes increasingly larger . Ref Davidson 23rd edition pg 370
1
Hyperkalemia
Hypokalemia
Myocarditis
Bigemini
Medicine
Fluid and electrolytes
c5bd1350-d0c4-4af3-af0a-dbb5e1f8ac06
single
The following condition is treated with
The picture and the description are characteristic features of Pyostomatitis vegetans . It is usually treated by corticosteroids
3
Systemic antifungal therapy
Systemic antiviral therapy
Systemic corticosteroids
Systemic antibiotics
Pathology
null
f200b6b4-21bc-4c16-af08-f0b0d01cf944
single
A 72-year-old woman presents with bone pain and tenderness in her lower extremities and left clavicle. Physical examination reveals tenderness to palpation on her lower legs and left midclavicle. Laboratory studies reveal elevated calcium, decreased phosphate, and elevated parathyroid hormone (PTH). X-ray reveals the following. Which of the following is the diagnosis?
Ans. (d) Osteitis fibrosa cystica.The patient in this question has hyperparathyroidism (elevated PTH) and is showing clinical symptoms for osteitis fibrosa cystica, a disease in which cystic bone spaces are filled with brown fibrous tissue. This disease is associated with hyperparathyroidism because PTH first acts on osteocytes and then on osteoclasts, causing calcium to be resorbed from the bone matrix and available in the blood stream (hypercalcemia). PTH also causes decreased phosphate reabsorption in the nephron, which causes decreased blood phosphate levels (hypophosphatemia). Hypercalciuria is yet another sign of hyperparathyroidism, which leads to the formation of calcium oxalate stones. The figure shows osteosclerosis with greater density at the endplates (rugger jersey spine), which can be seen with hyperparathyroidism.Image source- style="font-family: Times New Roman, Times, serif">
4
Paget disease of the bone
Osteomalacia
Osteoporosis
Osteitis fibrosa cystica
Orthopaedics
Hyperparathyroidism
493fcd5d-a3d7-42a1-a531-98cd155e1412
single
For the immediately life-threatening injuries of the chest "Laryngeal obstruction", select the proper intervention. (SELECT 1 INTERVENTION)
Airway obstruction denotes partial or complete occlusion of the tracheobronchial tree by foreign bodies, secretions, or crush injuries of the upper respiratory tract. Patients may present with symptoms ranging from cough and mild dyspnea to stridor and hypoxic cardiac arrest. An initial effort should be made to digitally clear the airway and to suction visible secretions; in selected, stable patients, fiberoptic endoscopy may be employed to determine the cause of obstruction and to retrieve foreign objects. Unstable patients whose airways cannot be quickly reestablished by clearing the oropharynx must be intubated. An endotracheal intubation may be attempted, but cricothyroidotomy is indicated in the presence of proximal obstruction or severe maxillofacial trauma.
2
Endotracheal intubation
Cricothyroidotomy
Subxiphoid window
Tube thoracostomy
Surgery
Trauma
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single
All of the following conditions are associated with systolic thrill in left 2nd and 3rd intercostal space, EXCEPT:
Pink TOF is not commonly associated with a left upper parasternal systolic thrill. It is associated with a systolic thrill in second and third intercostal space. The physiology of TOF depends primarily on the severity of pulmonary stenosis and on the size of the VSD. Pink TOF is said to occur in patients with a large VSD and mild pulmonary stenosis. These patients are initially asymptomatic and gradually develop congestive hea failure over few weeks to months as the pulmonary vascular resistance falls and left to right shunt predominates. They are clinically similar to patients with an isolated large VSD. Ref: Congenital Hea Defects By Diego. F. Wyszynski, Pages 218-220
1
Pink TOF
Subpulmonic VSD
Pulmonic stenosis
Ebstein's anomaly
Medicine
null
da047165-1bc5-42a3-a9e7-cf51843daa75
multi
Which of the following is not example of Pseudopubey?
Ans. is 'd' i.e., All of above
4
Tumor of hypothalamus
Ovarian tumor
Tumor of adrenal gland
All of above
Pediatrics
null
59bf6216-151b-4e33-b1e2-1b29748e9fd9
multi
Angiogenesis is
(Formation of the new blood vessels) (71-72-R) (70-72- Basic pathology 8th)ANGIOGENESIS or neovascularization by which preexisting vessels send out capillary sprouts to produce new vessels.Angiotensis is a critical process in the healing at sites of injury in the development of collateral circulations at sites of ischemia, and in allowing tumours to increase in size beyond the constraints of their original blood supply.* Steps in the process of angiogenesis1. Basement membrane and extracellular matrix degradation2. Endothelial migration3. Endothelial proliferation (mitosis)4. Organisation and maturation including the recruitment of vascular pericytes or smooth muscle cells5. Increased permeability due to intercellular gaps and increased transcytosis.Thrombosis - Formation of the blood clot (thrombus)Fibrosis - Repair by connective tissues
1
Formation of the new blood vessels
Repair by connective tissues
Formation of the blood clot
All of the above
Pathology
Blood Vessels
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multi
In Cushing syndrome, which of the following are seen -
Cushing syndrome is a disorder resulting from increased adrenocoical secretion of coisol, due to any one of several sources: ACTH-dependent adrenocoical hyperplasia or tumor, ectopic ACTH-secreting tumor, or excessive administrations of steroids; characterized by truncal obesity, moon face, acne, abdominal striae, hypeension, decreased carbohydrate tolerance, protein catabolism, psychiatric disturbances, and osteoporosis, amenorrhea, and hirsutism in females; when associated with an ACTH-producing adenoma, called Cushing disease.Ref: Ganong&;s review of medical physiology;24th edition; page no-366
1
|Aldosterone
|Aldosterone
|Epinephrine
|norEpinephrine
Physiology
Endocrinology
d26f2b15-ca73-44ed-a7c6-ba1eb8f16c3a
single
True about chancroid is
Chancroid: Incubation period = 3 to 10 days It lacks systemic reaction and prodrome. Ulcer base is soft.
3
Incubation period is 3 to 10 weeks.
Characterised typically by prodromal symptoms and systemic reaction.
Painful ulcer with irregular erythematous non-indurated margins.
Ulcer base is hard, indurated.
Gynaecology & Obstetrics
null
7d3d2faf-63b7-4dc9-8f00-07017a1d0213
multi
Highest level of health care is
null
2
Primary health care
Tertiary care
Child care
Secondary level care
Social & Preventive Medicine
null
ee776915-2a77-4fcc-a515-dc5221cd3ea1
single
All the following muscles are supplied by Anterior division of Obturator Nerve except
The main nerve supply to muscles of the adductor compament is the obturator nerve. The adductor longus and the gracilis are supplied by the anterior division of this nerve. The adductor brevis is supplied by the anterior division or by the posterior division. The adductor magnus has a double nerve supply. Its adductor pa is supplied by the posterior division of the obturator nerve; while its hamstring pa is supplied by the tibial pa of the sciatic nerve. The pectineus muscle is of double origin so it also has a double innervation: its anterior fibers are supplied by the femoral nerve and its posterior fibers by the anterior division of the obturator nerve. Such muscles are called the hybrid or composite muscles.Reference: Chaurasia Volume II; 7th edition; Page no: 66
4
Pectineus
Adductor Longus
Gracilis
Adductor Magnus
Anatomy
Lower limb
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multi
Pedigree analysis – Analyze the following pedigree and give the mode of inheritance –
This pedigree chart has the following two characteristics: -      The disease is manifesting in both males and females. But, the disease is transmitting to the next generation only by females (mother). Both these are characteristics of mitochondrial diseases. Mitochondrial diseases Mitochondrial DNA is the only non-chromosomal DNA in human cells DNA in humans may be found either in the Nucleus (Nuclear DNA) or in the Mitochondria (Organelle DNA) Mitochondrial DNA is always maternally inherited. Mitochondrial and nuclear DNA is located in different places in the cell. During fertilization, the sperm and egg cell nuclei fuse to form an embryo. The egg cell is very large compared to the sperm, so although the cells' nuclei fuse, the rest of the cell mass in the embryo comes from the egg only. Nuclear DNA is therefore co-inherited but the mitochondrial DNA, which is located outside of the nucleus, is always maternally inherited because all mitochondria in a foetus and later adult are derived from the mitochondria in the mother's egg. All children from affected mother will inherit the disease but it will not be transmitted from an affected father to his children. - Harrison's 16th /e 374
3
Autosomal recessive
Autosomal dominant
Mitochondrial inheritance
X linked dominant
Pediatrics
null
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single
Gracey curettes are area specific instruments because:
null
2
They are used in the specific areas of the US
They adapt to specific areas of the tooth or root
They have more than one angle per cutting edge
They are used for root planning
Dental
null
df3d5830-ab1b-4552-a792-7fdcb57a5393
single
Suspended animation may be seen with :
A i.e. Electrocution Suspended animation (i.e. apparent death) is seen in electrocution & apparently drowned (not drowning)Q
1
Electrocution
Strangulation / hanging
Drowning
Burn
Forensic Medicine
null
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single
A young man underwent surgery for the removal of Glomus tumor. Glomus tumor is seen commonly in:
Glomus tumor is a benign soft-tissue extremity tumors, these lesions arise from dermal neuro myo aerial apparatus (glomus bodies). Glomus tumor more commonly affects the hand. In addition to the severe pain, point tenderness and cold sensitivity are associated with these lesions and subungual glomus tumors typically appear as blue, subungual discolorations of 1 to 2 mm. Tumor excision is the treatment of choice. Ref: Cole P., Heller L., Bullocks J., Hollier L.H., Stal S. (2010). Chapter 16. The Skin and Subcutaneous Tissue. In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews, R.E. Pollock (Eds), Schwaz's Principles of Surgery, 9e.
4
Liver
Adrenals
Pituitary
Finger
Surgery
null
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single
Not a manifestation of anaphylactic shock: CMC (Ludhiana) 11
Ans. Vasoconstriction
2
Hypotension
Vasoconstriction
Bronchospasm
Laryngeal edema
Forensic Medicine
null
ca68969c-14af-437d-8cdb-82fbfade7c4e
single
TOF - include all except ?
Ans. is 'c' i.e., ASD Tetrologv of 'allot Cyanotic hea disease (MC). Defect in infundibular septum leads to : Pulmonary stenosis. VSD (Not ASD) Dextroposition and overriding of aoa. Right ventricular hyperophy (NOT LVH). Pink TOF (Acyanotic TOE) when PS is mild to moderate balanced shunt tnt across the VSD, pt not have cyanosis
3
Pulmonary stenosis
VSD
ASD
RVH
Pediatrics
null
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multi
Which of the following is a MDG ?
Ans. is `a' i.e., Reduce by 2/3" the under five moality by year 1990-2015
1
Reduce by 2/3" the tinder five moality by year 1990-2015
Halve the prevalence of HIV-AIDS by 2015
Reduce maternal moality by 50%
Combat PEM & diarrhoea
Social & Preventive Medicine
null
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single
The blood supply of the Jejunum is through the-
Ans. B. Superior mesenteric arteryArterial supply to the gastrointestinal tract:-a. The arterial supply to the gastrointestinal tract is derived from the anterior midline visceral branches of the aorta. There are usually three anterior branches, the coeliac trunk and the superior and inferior mesenteric arteries. Variants in the origin of the arteries are very rare.b. The most common is a joint origin of the upper two branches as either a coeliac mesenteric trunk or a lienohepaticomesenteric trunk with a separate left gastric artery. Accessory or replaced branches to the upper abdominal viscera are more common. Accessory anastomotic vessels between the origin of the coeliac trunk and superior mesenteric artery are rare.c. The inferior mesenteric artery always arises separately, however, replaced, accessory or anastomotic vessels occasionally arise from the proximal superior mesenteric artery or its branches and contribute to the arterial supply to the proximal territory of the inferior mesenteric artery.d. The coeliac trunk and its branches supplies the gastrointestinal tract from the distal third of the oesophagus to the mid part of the duodenum and all derived adenexae (liver, biliary tree, spleen, dorsal pancreas, greater omentum and lesser omentum).e. The superior mesenteric artery supplies the tract from the mid second part of the duodenum to the distal third of the transverse colon (jejunum, ileum, caecum, appendix, ascending colon and ileal mesentery).f. The inferior mesenteric artery supplies the tract from the distal transverse colon to the upper anal canal.g. Other than accessory arteries, numerous medium calibre arteries form anastomoses between the vascular territories. The most profuse occurs around the head of the pancreas and the duodenum, where anastomoses form between the anterior and posterior superior pancreaticoduodenal arteries and the inferior pancreaticoduodenal arteries; the posterior superior pancreaticoduodenal artery and jejunal arteries; the greater pancreatic artery and jejunal arteries.h. The anastomoses between the territories of the superior and inferior mesenteric arteries are less pronounced and more variable: the most reliable is the pericolic marginal artery, which runs along the transverse colon. Additional anastomotic arcades may exist in the colic mesentery between the transverse and descending colon
2
Inferior mesenteric artery
Superior mesenteric artery
Pancreatico duodenal artery
Ileocolic artery
Anatomy
Blood Vessels of Abdomen and Pelvis
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single
Good prognosis in schizophrenia is indicated by:
Good Prognostic Factors Poor Prognostic Factors (1) Late Onset (1) Younger age of onset (2) Catatonic features (2) Disorganized type (3)Pyknic Built (3) Asthenic built (4) No Family history (4) Family history present (5)Acute onset 5) Chronic type (6) Emotions are preserved (6) Blunting of affect or atypical Feature Present (7)Type I (7) Type II
2
Soft neurological signs
Affective symptoms
Emotional Blunting
Insidious onset
Psychiatry
null
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single
In rabies pathological lesions in CNS are -
Rabies is a severe encephalitis, mainly involves. Rhombencephalon ( rain stem - midbrain and the floor of the fourth ventricle in the medulla). Basal ganglia Spinal cord Dorsal root ganglion.
1
Brainstem encephalitis
Cranial nerve arteritis
Neuronal loss
Neurofibrillary tangles
Pathology
null
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single
Color of postmoem lividity in hypothermic deaths: NEET 13
Ans. Bright pink
4
Purple
Deep red
Cherry red
Bright pink
Forensic Medicine
null
b91ee142-66c1-405c-9c3f-47c450995652
single
Clozapine was the first antipsychotic drug. Which of the following is an indication for the use of Clozapine?
Clozapine has been approved for, Patients with schizophrenia who have failed to respond adequately to typical neuroleptic drugs (treatment-resistant schizophrenia) Patients who are intolerant of typical neuroleptic drugs because of EPS or tardive dyskinesia Patients who are at high risk for suicide Ref: Meltzer H.Y., Bobo W.V., Heckers S.H., Fatemi H.S. (2008). Chapter 16. Schizophrenia. In M.H. Ebe, P.T. Loosen, B. Nurcombe, J.F. Leckman (Eds),CURRENT Diagnosis & Treatment: Psychiatry, 2e.
1
Resistant schizophrenia
Akathesia
First drug to be used for schizpophrenia
Used for schizophrenia with depression
Psychiatry
null
1006257b-c0b6-4b98-b4d3-b97dac082fab
single
All of the following are nonselective beta blockers with additional actions except -
Ans. is 'b' i.e., Betoxalol
2
Carvedilol
Betoxalol
Caeolol
Labetolol
Pharmacology
null
d51af7b6-faa2-4abe-971a-b6b2ab12d46b
multi
Facial nerve palsy is seen in the following fracture
null
2
Anterior cranial fossa
Middle cranial fossa
Cranial vault
Posterior cranial Fossa
Surgery
null
a2c82225-4b8e-4ceb-8770-adeff7cefafc
single
MIC-2 is a marker of-
Ans. is 'a' i.e., Ewing's Sarcoma o MIC 2 (CD 99) is a specific marker for Ewing's sarcoma and peripheral primitive neuroectodermal tumors.
1
Ewing's sarcoma
Osteosarcoma
Dermatofibrous protruberans
Alveolar cell sarcoma
Pathology
null
56206226-b0f9-43f1-9d90-d76b77757a1f
single
Type of speech seen in nasopharyngeal carcinoma -
Nasopharyngeal carcinoma causes denasal speech, i.e. Rhinolalia clausa.
1
Rhinolalia clausa
Rhinolalia aperta
Hot potato voice
Hoarse voice
ENT
null
ffc86f0a-271c-4df4-9a30-e0fff74972dd
single
Cirsoid aneurysms most commonly occur in which of the following vessels?
Cirsoid aneurysms are rare aeriovenous malformations of the scalp and extremities. Cirsoid aneurysms of the scalp are fed by the superficial temporal aery
4
Aoic arch
Splenic aery
Saphenous vein
Superficial temporal aery
Surgery
Cardio thoracic surgery
bea38473-5b3f-4bcb-b990-b86112d3bed2
single
Sinuses are not seen in -
A i.e. Kidney
1
Kidney
Spleen
Endocrine gland
Liver
Anatomy
null
239083f1-487c-4a72-838a-1e416548e2fa
single
Most common pattern of Penumonia seen in Klebsiella infection is
Ans. is 'a' i.e., Lobar Pneumonia
1
Lobar Pneumonia
Bronchopneumonia
Interstitial Pneumonia
Miliary Pneumonia
Medicine
null
678e6f66-4d6a-4934-9a92-73fba01fb004
single
ApoE, ApoC is synthesized by ?
Liver Site of synthesisLiver & intestine A-I ,Liver A-V , B-00, C (C-I, C-11, C-III), EIntestine A-IV, B-48Spleen, brain, testes adrenal --> A- D
1
Liver
Kidney
Intestine
RBCs
Biochemistry
null
10da5a5c-047a-4a45-aa1b-40d9d5781591
single
A 40 year old woman is on treatment for CLL. Over the past few months she noticed swellings in the neck and axilla which was rapidly increasing in size. She complains of feeling feverish and experiences weight loss. Which of the following is responsible?
CLL: Chronic Lymphocytic leukemia (CLL):- Neoplastic proliferation of native B cell; . Transformation to diffuse large B cell Lymphoma is marked by enlarging lymph node or spleen and worsening of symptom. This phenomenon is called Ritcher Transformation. Dx by flow cytometry positive for CD19/20, CD 5/23 Tx: Fludarabine is Drug of choice for management.
1
Richter transformation
Progression of CLL
Development of secondary infections
Immunodeficiency associated hemolytic anemia
Pathology
Chronic Lymphocytic Leukemia
871df950-34b1-439c-b451-9a627e646c55
single
Recurrent oral ulcers with pain and erythematous halo around them, diagnosis is –
Recurrent oral ulcers with erythematous halos suggest the diagnosis of Aphthous ulcer.
1
Apthous ulcer
Herpes
Chicken pox
Measels
Dental
null
da1bcc2f-d0e5-43e4-bc4d-5fb583522a60
single
Following changes are true about pregnancy, EXCEPT:
The blood volume stas to increase from about 6th week,expands rapidly thereafter to maximum 40-50% above the nonpregnant level at 30-32 weeks. The cardiac output stas to increase from 5th week of pregnancy,reaches its peak 40-50% at about 30-34 weeks. Serum LDL and Cholesterol will reach a maximum of 260 mg/100 ml at near term of pregnancy. Dilation of ureter above the pelvic brim with stasis is marked between 20-24 weeks of pregnancy. Ref: Textbook of Obstetrics D.C.Dutta 6th Ed Page 38.
1
Blood volume maximum at 36 weeks
Cardiac output maximum at 30 weeks
Ureter dilates maximum in middle pregnancy
Serum cholesterol is maximum at 32 weeks
Gynaecology & Obstetrics
null
f6c5860a-1cad-4e08-9941-cc15095d6dc0
multi
Which of the following is approved for the treatment of cystic fibrosis with G551D mutation?
Biostrophin is a vehicle for gene therapy in Duchenne and Becker's muscular dystrophyPeginesatide is an erythropoietin analog for anemia of chronic kidney diseaseLumacaftor is a CFTR potentiator for cystic fibrosis with F508 mutationIvacaftor is a CFTR potentiator for cystic fibrosis with G551D mutation
4
Biostrophin
Peginesatide
Lumacaftor
Ivacaftor
Microbiology
All India exam
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single
Cortical blindness
A. i.e. (Normal pupillary light reflexes with complete visual loss) (306 - Khurana 4th)CORTICAL BLINDNESS* Most common cause is bilateral occipital lobe infarction* Unilateral infarction leads to contralateral homonymous congruous hemianopiaClinical features* Vision and visual fields are markedly decreased* Sparing of the macula with preservation of central vision due to dual blood supply*** Complete visual loss with no light perception.* Pupillary responses are normal** (Pupillary light reflex)* ANTON- SYNDROME i.e. denial of blindness by the patients who obviously cannot see* Riddoch - phenomenon - i.e. ability to perceive kinetic but not static targets
1
Normal pupillary light reflexes with complete visual loss
Increased pupillary light reflexes with complete visual loss
Normal pupillary light reflex with partial loss of sight
Increased pupillary light reflexes with partial loss of sight
Ophthalmology
Neuro-Ophthalmology
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single
AML with worst prognosis -
null
4
8/12 translocation
Inversion 16
Normal cytogenetics
Monosomy 7
Pathology
null
d6f97ab8-4c2c-4f77-9990-8a7420dd1651
single
Biological amnesia is -
Biological amnesia:- Head injury (concussion/brain bruises), drugs (Marijuana, alcohol), brain disease (Korsokoff syndrome, Brain tumors, multiple sclerosis, presenile dementia), temporary disturbances in brain blood supply, and transient global amnesia. Psychological amnesia :- Childhood amnesia, dream amnesia, defensive amnesia
2
Lack of interest
Presenile dementia
Opioid addiction
Hypothyroidism
Psychiatry
null
d69eaf10-2504-4ae6-b952-3b8b7feacb4e
single
A 25-year-old woman presents with symptoms of fatigue and weakness. On examination, there is diplopia, ptosis, weakness, and fatigability of muscles on repeated use. Which of the following is the most likely diagnosis?
The distribution of muscle weakness is characteristic with early involvement of the cranial nerves, especially the lids and extraocular muscles. Women are more frequently affected than men (3:2 ratio), and the age for peak incidence in women is in the third or fourth decade.
1
myasthenia gravis
multiple sclerosis
TIAs
muscular dystrophy
Medicine
C.N.S.
69c73554-b26f-4569-b236-88493905cccb
single
Decompression of endolymphatic sac is the treatment for
(A) (Meniere's disease) (104- Dhingra 6th)Surgical Treatment of Meniere's Disease1. Conservative procedures2. Destructive procedures3. IntermittentA. Decompression of Endolymphatic sacB. Endolymphatic shunt operationC. Sacculotomy (fick's operation)D. Section of vestibular nerveE. Ultrasonic destruction of vestibular labyrinthLabyrinthectomyLow pressure pulse therapy (Meniett device therapy)Meniere's Disease TreatmentA. GENERAL MEASURESB. MANAGEMENT OF ACUTE ATTACK1. Reasurance2. Cessation of smoking3. Low salt diet4. Avoid excessive intake of water5. Avoid over- indulgence in coffee, tea and alcohol6. Avoid stress and bring a change in life cycle7. Avoid activities requiring good body balance1. Reassurance - to allay worry and anxiety2. Bed rest with head supported on pillows3. Vestibular sedatives to relieve vertigo* Dimenhydrinate (Dramamine)* Promethazine theoclate (Avomine)* Prochlorperazine (stemetil)* Diazepam given intravenously* Atropine4. VasodilatorsA. Inhalation of carbogen (5% C02 with 95% O2)B. Histamine drip - Histamine diphosphate 2.75 mg dissolved in 500 ml of glucoseC. MANAGEMENT OF CHRONIC PHASE1. Vestibular sedative- prochlorperazine2. Vasodilators- Nicotinic acid, Betahistine3. Diuretics - furosemides4. Propantheline bromide - alone or combination with vasodilators or vestibular sedatives5. Elimination of allergen- food or inhalant allergen6. Hormones - endocrinal disorders such as hypothyroidism- Medical treatment* Intratympanic Gentamicin therapy (chemical Labyrinthectomy)* MICRO WICK - made up of polyvinyl acetate
1
Menier's disease
BPPV
Labyrinthitis
Otosclerosis
ENT
Ear
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single
Subcostal nerve is -
Ans. is 'c' i.e., Ventral rami of T12 o Ventral rami of upper 11th thoracic spinal nerves are known as intercostal nerves and ventral ramus of T12 is known as subcostal nerve.o Upper six intercostal nerves supply thoracic wall whereas lower five intercostal nerves and subcostal nerve supply thoracic and anterior abdominal walls and hence known as thoracoabdominal nerves.o Upper two intercostal nerves also supply the upper limb. Thus only 3rd to 6th are called typical intercostal nerves.
3
Ventral rami of T6
Dorsalrami of T6
Ventralrami of T12
Dorsalrami of T 12
Anatomy
Thorax
9578f748-1e87-4ad9-be94-ceb7a674a204
single
Progesterone is added to estrogens in H to achieve wof effects
Hormone replacement therapy (H) In nonhysterectomised postmenopausal women estrogen therapy is supplemented with a progestin for 10-12 days each month to counteract the risk of inducing endometrial carcinoma. Ref:- kd tripathi; pg num:-318
2
Decrease the estrogen action on the breast
Decrease the occurrence of endometrial cancers
Increase the effectiveness of the estrogens
Inhibit bone resorption
Pharmacology
Endocrinology
59c75220-9b11-48e3-afb7-684f88ec8d33
single
Sedation as an adverse effect is MOST with which of the following atypical antipsychotics?
null
3
Risperidone
Olanzapine
Quetiapine
Aripiprazole
Psychiatry
null
03bf9390-59fb-47e7-83c3-64e0d668b0d4
single
Which of these amino acids will migrate slowest to the anode end at the physiological pH?
At physiological pH basic aminoacid (positive charged a.a) will move slowest towards anode (positively charged electrode).Basic amino acids are: Arginine (Most basic), Lysine and Histidine (Weakly basic)
3
Aspaic acid
Glycine
Lysine
Valine
Biochemistry
null
71284d6b-d978-4521-acc9-bc21413cf691
single
Which of the following is a useful marker to detect autophagy in cells?
Autophagy ("self-eating") is the process in which the starved cell eats its own components in an attempt to reduce nutrient demand to match the supply. Some of the cell debris within the autophagic vacuoles may resist digestion and persist in the cytoplasm as membrane-bound residual bodies. An example of residual bodies is lipofuscin granules as shown in above image. Most impoant gene that we associate with autophagy is ATG-3. Autophagy is a process which is also stimulated by protein called BECLIN-1. Most impoant gene responsible for inhibiting Apoptosis is BCL-2. BCL-2 interacts with BECLIN-1 and forms a complex and this complex is responsible for inhibiting AUTOPHAGY. Inhibition of Autophagy increase the risk of malignancy. Marker for Autophagy is a microtubular protein called LC-3 (Microtubule-associated protein light chain 3). LC-3 plays an impoant role in the closure of the autophagosomal membrane and also in elongation step. BAK, BAX, BID are involved with cellular apoptosis.
3
BAK
BAX
LC3
BID
Pathology
Apoptosis
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single
Non - union is a complication of :
A i.e. Scaphoid Fracture Fracture head & neck femur, fracture body of talus and fractures through waist of scaphoid most commonly leads to nonunion and avascular necrosis due to poor blood supplyQ
1
Scaphoid
Colle's
Inter- trochanteric of hip
Supra condylor of the humerus
Surgery
null
d6d6ce93-fa80-4059-8410-f2f4440170d1
single
A 3-day old baby feeds poorly, vomits on feeding. Urine Benedict's test is +ve. The reducing substance present in the urine is:
Galactosemia: Classic galactosemia is caused by almost total deficiency of galactose-1-phosphate uridyltransferase. Severely deficient neonates present with vomiting, jaundice, and hepatomegaly on initiation of lactose-containing feedings. Renal Fanconi syndrome, cataracts of the ocular lens, hepatic cirrhosis, and sepsis occur in untreated children. Delayed, apraxic speech and ovarian failure occur frequently even with treatment. Developmental delay, tremor, and ataxia occur less frequently. Urine gives positive Benedict's and Seliwanoffs tests. Galactose-1-phosphate is elevated in red blood cells. A galactose-free diet should be instituted as soon as the diagnosis is made. Ref: Thomas J.A., Van Hove J.L. (2012). Chapter 36. Inborn Errors of Metabolism. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e.
4
Glucose
Sucrose
Fructose
Galactose
Pediatrics
null
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single
A 9 year old child disturbs other people, is destructive, interferes when two people are talking, does not follow instructions and cannot wait for his turn while playing a game. He is likely to be suffering from:
This child has symptoms of hyperactivity and impulsivity and the most likely diagnosis would be attention deficit hyperactivity disorder. Symptoms of ADHD: - Inattention - Hyperactivity - Impulsivity - Other symptoms- Destructive behavior, irritability, and aggression.
4
Emotional disorders
Behavioral problems
No disorder
Attention deficit hyperactivity disorder
Psychiatry
Child Psychiatry
e12cd6e4-8b01-47fa-89d7-265c244db3bf
single
Which of the following is a monovalent cation that can reverse a digitalis induced arrhythmia ?
null
4
Digibind antibodies
Lignocaine
Magnesium
Potassium
Pharmacology
null
9403dc8d-1ba1-49e6-8825-b177038d0b67
single
Which of the following aery is not involved in the formation of Kiesselbach's plexus?
Kiesselbach's area or Little's area, is a region in the anteroinferior pa of the nasal septum, where four aeries anastomose to form a vascular plexus called Kiesselbach's plexus. The aeries which forms the plexus are: ? Anterior ethmoidal aery (from the ophthalmic aery) ? Sphenopalatine aery (from the maxillary aery) ? Greater palatine aery (from the maxillary aery) ? Septal branch of the superior labial aery (from the facial aery)
2
Anterior ethmoidal aery
Posterior ethmoidal aery
Greater palatine aery
Sphenopalatine aery
ENT
null
6a755468-08ab-4560-a198-7841c60a7c15
single
Allergic bronchopulmonary aspergillosis is characterized by all EXCEPT
(Not respond to steroid) (241-CMDT-10) (1259-H17th)* High doses of prednisone for at least 2 months is treatment of choice"* ABPA occurs in atopic asthmatic (particularly glucocorticoid dependent) individuals of age 20-40 years and non asthmatic individuals eg cystic fibrosisDiagnostic criteria for Bronchopulmoanry-AspergillosisPrimarySecondaryi. A clinical h/o Asthma**ii. Peripheral eosinophilea**iii. Immediate skin reactivity to aspergillus antigeniv. Precipitating Ab to aspergillus antigenv. |S.IgEvi. Pulmonary infiltrates* (transient or fixed)vii. Central bronchiectasis*** Identification of Asp.antigin sputum* H/o brown flesked sputum* Late skin reactivity to asp.antigen* Patients with corticosteroid dependent may benefited from itraconazole without toxicity* TRANSDATES PLEURAL EFFUSION (283-CMDT-10) causes CHF (90% of cases), cirrhosis with ascites, Nephrotic syndrome, peritoneal dialysis, Myxedema, Acute atlectasis, constrictive pericarditis, SVC obstruction, pulmonary embolism* Pleural tapping in mid-axillary line, muscle NOT pierced is Transversus thoracis (Sternocostalis)**
4
Bronchial asthma
Pleural effusion
Centra bronchiectasis
Not respond to steroid
Medicine
Respiratory
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multi
Most powerful chain breaking antioxidant:
Alpha- tocopherol is most powerful chain breaking anti-oxidants. 2 Classes of antioxidants Chain breaking anti - oxidants : (They interfere with chain propagation) Alpha - tocopherol Beta - carotene Vitamin C Super oxide dismutase (SOD) Uric acid/Urate Polyphenols Preventive antioxidants: (They reduce the rate of chain initiation) Glutathione peroxidase Catalase Ceruloplasmin & transferrin (Chelate metal ions)
2
Vitamin C
Alpha - tocopherol
Catalase
Glutathione peroxidase
Biochemistry
Miscellaneous
19c1563d-b26b-4948-97d4-39158becef3f
single
Acute non-suppurative sialdenitis is seen in:
null
2
Acute bacterial sialadenitis
Mumps
Chronic bacterial sialadenitis
Necrotizing sialometaplasia
Pathology
null
90b750e1-c186-44cb-84b1-1cda994f6801
single
All of the following modalities can be used for in situ ablation of liver secondaries , except
Ultra sonic waves are not described as a method of local Ablative therapy for liver secondaries Local ablative therapy for liver secondaries Crypotherapy Radio-frequency or microwave ablation Ethanol, acetic acid, chemotherapy, hot saline Ref: Sabiston 20th edition Pgno :1464-1465
1
Ultrasonic waves
Cryotherapy
Alcohol
Radio-frequency
Anatomy
G.I.T
5e9ed470-12cd-4b13-a77c-3e8c8dda1daa
multi
Predisposing factors of carcinoma endometrium are all EXCEPT
(Multiparity) (573-74-Shaw's 14th)Multiparity is common in carcinoma cervix, while carcinoma of endometrium women are either nulliparous or of low parityPredisposing Factors in Carcinoma Endometrium* Peak incidence is 55-70 years* An Early menarche and late menopause is characteristic* Unopposed and unsupervised administration of HRT* Chronic non ovulatory cycles as seen in DUB* Familial predisposition - Familial Lynch II syndrome* Tamoxifen given to women with breast cancer increases the risk of endometrial hyperplasia* Combined oral hormonal pills* Obesity hypertension and diabetes* Infertile women and women with polycystic ovarian disease* Feminizing ovarian tumour at the time of diagnosis* The risk of endometrial carcinoma is the highest with the following complex hyperplasia with atypia** histological pattern of endometrial hyperplasia (about 28%)***
3
Obesity
Late menopause
Multiparity
Unopposed administration of estrogen
Gynaecology & Obstetrics
Miscellaneous (Gynae)
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multi
Vagal stimulation of the hea causes:
Increased R-R interval in ECG Vagus is the parasympathetic supply to the hea. Its stimulation causes: - Decreased hea rate - Decreased force of hea contraction - Decreased cardiac output R-R interval is the time interval between consecutive hea beats in the electrocardiogram. So a decrease in hea rate increases the R-R interval Reverse effects on the hea are noted due to sympathetic stimulation.
2
Increased hea rate
Increased R-R interval in ECG
Increased force of hea contraction
Increased cardiac output
Physiology
null
d943a92c-d1c3-456b-90eb-78defc33aed7
single
This surgical blade is used for
This is Number 12 surgical blade. It is used for suture removal.
2
Minor surgical procedures
Suture removal
Abscess drainage
Abdominal incision
Surgery
null
031e44a5-b16c-4eb8-b82a-b6beff3efb5f
single
Type of necrosis in pancreatitis ?
Ans. is 'c' i.e., Fat Fat necrosis is seen most frequently in acute pancreatitis due to leakage of lipase. Fat necrosis Fat necrosis may be of two types : ? 1. Enzymatic fat necrosis This is due to action of lipase on adipose tissue. It occurs most frequently in acute pancreatitis due to leakage of lipase. Depending on the severity of acute pancreatitis, fat necrosis may occur in : - a Adipose tissue contiguous to pancrease, retroperitoneal fat. Adipose tissue in anterior mediastinum. Bone marrow Omental and abdominal fat 2. Nonenzymatic or Traumatic fat necrosis Occurs due to trauma Is seen in subcutaneous tissue of breast, thigh, and abdomen.
3
Fibrinoid
Coagulative
Fat
Caseous
Pathology
null
4734fb95-2116-4921-a6d9-4d40090ef712
single
True about kinematic facebow are all, except
null
4
It locates the true (exact) centre of condylar rotation or transverse horizontal axis.
It is preferred in full mouth reconstruction.
It usually requires a fully adjustable articulator.
None of the above
Dental
null
a33179ad-9af1-4a36-8c24-55eb2aa3a4de
multi
A post partial gastrectomy patient presents with neurological symptoms. Most probable diagnosis is:
Ref: Bailey unci Love's Short Practice of Surgery 25th EditionExplanation:Postoperative complications of gastrectomyLeakage of the oesophagojejunostomy.Leakage from the duodenal stumpParaduodenal collectionsBiliary peritonitisThe presence of septic collections along with a very radical vascular dissection may lead to catastropic secondary haemorrhage from the exposed or divided blood vessels.Long-term complications of surgeryReduced gastric capacityDumping and diarrhoeaNutritional deficiencies may especially vitamin B12 deficiency (Since Intrinsic factor secreted by parietal cell of stomach is necessary for vitamin B32 absorption)Symptoms of Vitamin B12 deficiencyThe main syndrome of vitamin BI2 deficiency is Biermers disease (pernicious anemia).It is characterized by a triad of symptoms:Anemia with bone marrow promegaioblastosis (Megaloblastic anemia).This is due to the inhibition of DNA synthesis (specifically purines and thymidine)Gastrointestinal symptoms.This may also be due to the autoimmune attack on the parietal cells of the stomach in pernicious anemia.Neurological symptoms:Sensory or motor deficiencies (absent reflexes, diminished vibration or soft touch sensation)Subacute combined degeneration of spinal chordDementiaPsychiatric symptoms may be present.
3
Folic acid deficiency
Thiame deficiency
Vitamin B12 de fid ency
Iron deficiency
Surgery
Postgastrectomy Complications
ebbebcea-40e5-4371-aea2-063bf5cff0c7
single
Which antineoplastic agent is an antifolate drug:
Methotrexate
1
Methotrexate
Adriamycin
Vincristine
Cyclophosphamide
Pharmacology
null
05f98cd7-0ecf-4734-8a37-bab796921add
single
A 38-year-old woman shows evidence of early cataracts, hair loss, atrophy of skin, osteoporosis, and accelerated atherosclerosis. This patient has most likely inherited mutations in both alleles of a gene that encodes which of the following types of intracellular proteins?
Helicase. Werner syndrome is a rare autosomal recessive disease characterized by early cataracts, hair loss, atrophy of the skin, osteoporosis, and accelerated atherosclerosis. Affected persons are also at risk for development of a variety of cancers. Unlike Hutchinson-Gilford progeria, patients with Werner syndrome typically die in the fifth decade from either cancer or cardiovascular disease. Werner syndrome is caused by mutations in the WRN gene, which encodes a protein with multiple DNA-dependent enzymatic functions, including proteins with ATPase, helicase, and exonuclease activity. Hutchinson-Gilford progeria is caused by mutations in the human lamin A gene, which encodes an intermediate filament protein that form a fibrous meshwork beneath the nuclear envelope. Mutations in the other choices are not associated with Werner syndrome.Diagnosis: Werner syndrome
2
Deaminase
Helicase
Oxidase
Polymerase
Pathology
Cellular Pathology
a0f9b646-cc92-4fe5-9df8-351a1e4b8fa2
multi
ER-positive status in Ca Breast indicates -
Estrogen receptor (ER) positive breast carcinomas are generally slow-growing and respond well to hormonal treatment. Gene expression profiling, which can measure the relative quantities of mRNA for essentially every gene, has identified five major patterns of gene expression in invasive ductal carcinoma. 1. Luminal A This is the largest group (40-55%) which has characteristics of normal luminal cells. This type is ER-positive and HER2/neu negative. These cancers are generally slow-growing and respond to hormonal treatment. Conversely, only a small number will respond to standard chemotherapy 2. Luminal B These tumors are ER positive, has a higher proliferative rate and overexpresses HER2/neu → Triple - positive cancer. They comprise a major group of ER-positive cancers that are more likely to have lymphnode metastases and may respond to standard chemotherapy. 3. Normal breast line These are ER-positive, HER2/neu negative and characterized by the similarity of their gene expression pattern to normal tissue. 4. Basal line These are ER negative, PR negative, HER2/neu negative → Triple negative. These are characterized by expression of markers typical of myoepithelial cells (e.g., basal keratins, P-codherins, p6.3, or laminin), progenitor cells, or putative stem cells (e.g. cytokeratins 5 and 6). Many carcinomas arising in women with BRAC 1 mutations are of this type. These are aggressive tumors, frequent metastasis to viscera and brain can be seen → have a poor prognosis. 5. HER2 positive These are ER-negative and overexpress HER 2/neu protein.
1
Prognosis
Etiology
Site
null
Pathology
null
3cf70421-5d32-4072-a3d9-c903a111d3e1
multi
Replacement & periodic examination in radiation industary is recommended ?
Ans. is 'b' i.e., Every 2 months Preventive measures in radiation industeriesInhalation, swallowing or direct contact with the skin should be avoided.In case of X-rays, shielding should be used of such thickness and of such material as to reduce the exposure below allowable exposures.The employees should be monitored at intervals not exceeding 6 months by use of the filf badge of pocket electrometer devices.Suitable protective clothing to prevent contact with harmful material should be used.Adequate ventilation of work-place is necessayr to prevent inhalation of harmful gases and dusts.Replacement and periodic examination of workers should be done every 2 months. If harmful effects are found, the employees should be transferred to work not involving exposure to radiation.Pregnant women should not be allowed to work in places where there is continuous exposure.
2
Every month
Every 2 months
Every 6 months
Every year
Social & Preventive Medicine
null
2b0593b3-d3d7-45ea-b605-a6d7e8cf90a5
single
HCV is -
HCV is a 50-60 nm virus with a linear single stranded RNA genome enclosed within a core and surrounded by an envelope carrying glycoprotein spikes. REF:ANATHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO:549
1
Enveloped RNA
Nonenveloped RNA
Nonenveloped positive strand RNA
Enveloped negative strand RNA
Microbiology
Virology
ef0bd6aa-c74b-4356-bcfb-a6e37e2c7971
multi
In Hutchinson's triad in newborn child, what is not seen?
Cataracts REF: Harisson's 18`11 ed chapter 169 Hutchinson's triad is named after Sir Jonathan Hutchinson (1828-1913). It is a common pattern of presentation for congenital syphilis, and consists of three phenomena: interstitial keratitis, Hutchinson incisors, and eighth nerve deafness
4
Interstitial keratitis
Notched incisors
Deafness
Cataracts
Pediatrics
null
5b9fce8f-b048-4367-8f75-7a6d5e61f423
single
ERCP in pancratitis is done to know about – a) Gall stoneb) Associated cholangitisc) Ascitesd) Pancreatic divisume) Annular pancreas
ERCP can be used in pancreatitis to evaluate conditions which can predispose to pancreatitis (e.g. Gall stone, pancreatic divisum, annular pancreas) and associated biliary cholangitis.
2
abcd
abde
acde
ade
Radiology
null
c573307f-a883-49a9-8606-6fc0eb90bf82
multi
A 63-year-old man becomes oliguric 2 days following an open cholecystectomy. Which of the following findings would suggest that prerenal ARF is a major factor in the etiology?
Although evidence of volume contraction cannot confirm prerenal ARF, as this can progress into intrinsic renal failure, it suggests that prerenal factors are contributing. In prerenal ARF, specific gravity is usually > 1.020 and sodium concentration is < 10 mmol/L. The fractional excretion of sodium relates sodium clearance to creatinine clearance and is more sensitive than direct measurements of sodium excretion. In prerenal azotemia, sodium is avidly resorbed from glomerular filtrate, but not in intrinsic renal azotemia because of tubular epithelial cell injury. Creatinine is resorbed less efficiently in both conditions. Therefore, the fractional excretion of sodium is <1% in prerenal azotemia (often much less) whereas it is >1% in intrinsic renal azotemia. Fractional excretion of sodium(%)=UNa/PCrxPNa/UCrx100.
1
postural hypotension
fractional excretion of sodium is 3%
specific gravity is 1.012
the urine sodium is 30 mEq/L
Medicine
Kidney
6a70538e-84dc-4b2f-ac22-9f3d086912ed
single
Grade III intraventricular hemorrhage is
Grade I - Hemorrhage limited to the germinal matrix Grade II - Intraventricular hemorrhage Grade III - Hemorrhage with ventricular dilatation Grade IV - Parenchymal extension of hemorrhage.
3
Intraventricular hemorrhage alone
Hemorrhage limited to germinal matrix
Hemorrhage with ventricular dilatation
Parenchymal extension of hemorrhage
Gynaecology & Obstetrics
null
6200c3c6-7943-4c38-bc10-a6fea4f305e8
single
Motor protein in organ of corti -
Ans. is 'd'i.e.. Myosin o The inner hair cells of organ of corti have 50-200 ciliated structure called stereocilia.o The top of each stereocilium is linked to the side of next adjacent higher stereocilium by means of a thin filamentous strucuture called the tip-link.o Mechanically gated ion channels are located at these attachment points on the sides of stereocilia.o Each stereocilium comprises of several actin filaments encased by a plasma membrane.o The opening and closing of the ion channels is accomplished through the binding and unbinding of proteins at terminal ends of the tip links with a group of channel motor proteins (myosin) which move up and down the actin filaments of stereocilia.
4
Kinesin
Albumin
Dynein
Myosin
Physiology
Special Senses: Hearing and Equilibrium
c47fff66-a500-4de2-b22c-bda36d49ec30
single
In acute pulmonary embolism, the ECG finding may include all except
The most frequently cited abnormality, in addition to sinus tachycardia, is the S1Q3T3 sign: an S wave in lead I, a Q wave in lead III, and an inveed T wave in lead III. This finding is relatively specific but insensitive. RV strain and ischemia cause the most common abnormality, T-wave inversion in leads V1 to V4.Ref: Harrison's 19e pg: 1633
3
S1Q3T3 pattern
P. pulmonale
Sinus tachycardia
T-wave inversion in leads V1 to V4
Medicine
All India exam
f12b9d8b-817b-4959-864e-6d7958f62f71
multi
A baby assessed at 5 minutes after bih is found to be blue with irregular gasping respiration. Hea rate(HR) is 60 beats/min, and a grimace is seen with some flexion of extremities. The Apgar score for this newborn is _______
In this baby: Color: Score 0 Hea rate, < 60 beats/min: score 1 Grimace: score 1 Some flexion of the extremities: score 1 Irregular respiration: Score 1 Thus total score is 4 APGAR SCORING SYSTEM: Appearance 0 points 1 point 2 points Appearance (Skin color) Blue/Pale Pink body, blue extremities Pink Pulse Absent <100 BPM >100 BPM Grimace (reflex irritability) No response Minimal response to stimulation Cough/sneeze when stimualated Activity Floppy Some flexion Well flexed Respiratory effos Absent Slow and irregular Strong cry At 1 minute and 5 minutes after bih of the infant, the 5 objective signs listed here are evaluated and each is given a score of 0,1 or 2 A total score of 10 indicates that the infant is in the best possible condition An infant with a score of 0-3 requires immediate resuscitation Ref: Nelson textbook of pediatrics 21st edition pgno: 872
4
0
2
3
4
Pediatrics
New born infants
db16bb23-bff4-4cb7-bd09-5c6ef652b29e
single
Which of the following is true regarding Fluorescence?
Ans. b. Release of longer wavelength light on absorbing light of shorter wavelength (Ref: Tietz' Fundamentals of Clinical Chemistry 5/e p75; Lehninger 4/447; Harper 29/e p311)In Fluorescence, there is release of longer wavelength of light on absorbing light of shorter wavelength is seen.FluorescenceIt is the emission of light by a substance that has absorbed light or other electromagnetic radiationQ.It is a form of luminescenceQIn most cases, the emitted lights have a longer wavelength and lower energy than the absorbed radiationQ.
2
Spontaneous illumination in dark
Release of longer wavelength light on absorbing light of shorter wavelength
Release of shorter wavelength light on absorbing light of longer wavelength
Continuous emission of lights of different wavelength
Biochemistry
Miscellaneous (Bio-Chemistry)
3799807c-a2ee-499e-b67e-a1f5dbdd7e31
multi
Which immunoglobulin acts as receptor on B cell?
Ig M REF: Jawetz's, Melnick, & Adelberg's Medical Microbiology, 24TH edition chapter 8. Immunology B-cell Receptor for Antigen: B cells express a form of IgM that is located on the cell surface. Cell surface IgM has the same antigen specificity as the secreted IgM antibody molecule. This is achieved by a differential RNA splicing mechanism. The -chain RNA transcript can include a sequence that encodes about 25 hydrophobic amino acids, which enables the IgM molecule to localize in the cell membrane as a trans membrane receptor. Later in development of the B cell, regulation of RNA processing allows expression of a membrane-bound form of IgD, again with the same antigen-binding specificity. Throughout this process, the same V region segment is being expressed with different C region segments.
3
Ig G
Ig A
Ig M
Ig D
Microbiology
null
2bedfa2d-89e6-4b68-a66b-0a09e24d0121
single
All of the following statements are true about the disease where the following rash is noted except:
Ans. B. This disease also known as Roseola infantumThe image depicts the characteristic slap cheek appearance seen in 5th Disease Synonym: Erythema infectiosumParvovirus B19 most classically causes erythema infectiosum (EI), a mild febrile illness with rash. It often occurs in outbreaks among school-aged children, although it can occur in adults as well.EI is also referred to as "fifth disease" since it represents one of six common childhood exanthems, each named in order of the dates they were first described.The illness begins with nonspecific prodromal symptoms, such as fever, coryza, headache, nausea, and diarrhea.Two to five days later, the classic erythematous malar rash appears with relative circumoral pallor (the so-called slapped cheek rash). This facial rash is often followed several days later by a reticulated or lacelike rash on the trunk and extremities Roseola infantum termed as 6th disease is also called exanthem subitum is produced by HHV-6
2
The causative agent is Parvovirus B19
This disease also known as Roseola infantum
Reticulate lacy exanthem may be noted on the trunk and extremities
Clinical features are usually seen in healthy individuals
Skin
Miscellaneous
6d12df2a-58a0-42b0-ab88-ab08f24f23f8
multi
Antibody against tumor cells -
null
1
MHC-I
MHC-II
Anti viral
Differentiated antigen
Pathology
null
4fd176cf-a2a5-4375-90bb-f8b5e2c7789c
single
Chest X-ray findings in tuberculosis associated with HIV are all except: September 2005
Ans. B: Lupus vulgaris Lupus vulgaris is a cutaneous manifestation of tuberculosis.
2
Disseminated tuberculosis
Lupus vulgaris
Pleural effusion
Hilar lymphadenopathy
Medicine
null
2b2a67fe-eb47-44a8-98bd-74fc38f3e98d
multi
Clinical features of nasopharyngeal angiogibroma are -a) 3rd to 4th decadesb) Adolescent malec) Epistaxis and nasal obstruction are the cardinal symptomd) Radiotherapy is the Rx of choicee) Arises from posterior nasal cavity
NFA occurs in adolescent males. Nasal obstruction and epistaxis are the most common presenting symptoms. It arises in the posterior part of nasal cavity near the sphenopalatine foramen. Treatment of choice is surgery.
1
bce
bc
acd
ace
ENT
null
0ea97814-61c9-437d-8b1f-3329f9c3ae64
single
Resistance to zidovudine develops due to-
Ans. is 'a' i.e., Mutations at reverse transcriptase "Resistance to Zidovudine occurs by point mutation which alters reverse transcriptase enzyme. In the past when AZT was used alone, > 50% patients became nonresponsive to AZT within 1-2 years therapy due to growth of resistant mutants" - KDT
1
Mutations at reverse transcriptase
Increased efflux of the drug from inside the cell
Increased metabolism of the drug
Decreased zidovudine 5 triphosphate formation
Pharmacology
null
abc20001-ea11-4125-9424-fbc2227c1090
single
The pulmonary function test done on this patient of asthma would be
The patient is having atopic asthma.Pulmonary function tests in asthma show an obstructive pattern with reduced FEV1,FEV1/FVC ratio.Reversibility is demonstrated by a >12% and 200 ml increase in FEV1 15 minutes after an inhaled sho acting beta2 agonist or in some patients by a 2 to 4 week trial of oral coicosteroids. Ref:Harrison's medicine-18th edition,page no:2109.
2
Non-infarmative
Obstructive pattern
Restrictive pattern
Destructive pattern
Medicine
Respiratory system
8f2472b9-84d1-4132-8d15-3aa051b8169a
single
Macrophages in nervous system is known as:
Microglia are scavenger cells that resemble tissue macrophages and remove debris resulting from injury, infection, and disease (eg, multiple sclerosis, AIDS-related dementia, Parkinson disease, and Alzheimer disease). Microglia arise from macrophages outside of the nervous system and are physiologically and embryologically unrelated to other neural cell types. Ref: Ganong's Review of Medical Physiology 23rd edition, Chapter 4.
4
Schwann cells
Oligodendrocytes
Astrocytes
Microglia
Physiology
null
da8ad635-0037-47a4-a762-fc15e38a3525
single