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Ochsner-Sherren regimen is used for:September 2009, 2010
Ans. C: Appendicular mass
3
Appendicular abscess
Pelvic abscess
Appendicular mass
Acute appendicitis
Surgery
null
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single
'Routine care' in Neonatal resuscitation consists of all of the following steps EXCEPT:
Suction airway of all babies- not recommended. 'Routine care' consists of : Provide warmth to all babies Proper positioning of baby Suction airways only if necessary Dry the baby Ongoing evaluation of vital parameters of all babies
2
Provide warmth to all babies
Suction airway of all babies
Dry the baby
Ongoing evaluation of vital parameters of all babies
Pediatrics
Neonatal Resuscitation
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multi
Which of the following is the rate limiting enzyme of bile acid synthesis
Microsomal 7 α hydroxylase (cholesterol 7 α hydroxylase) is the rate limiting enzyme of bile acid synthesis. This enzyme is expressed only in liver.
3
Mitochondrial 17 α hydroxylase
Cytoplasmic 7 α hydroxylase
Microsomal 7 α hydroxylase
Mitochondrial 7 α hydroxylase.
Biochemistry
null
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single
Diphyllobothrium latum causes anemia by:
Diphyllobothrium latum, also known as the fish or broad tapeworm, is the biggest worm and can reach 10 m in size. Humans acquire the infection by eating raw fish containing the larvae of the tapeworm. The worm attaches to the small intestine and causes abdominal discomfo. Nausea, diarrhea, weight loss, and pernicious anemia can result. The anemia is induced by the tapeworm's tendency to compete with humans for vitamin B12, which it easily accumulates from the intestinal contents. Ref: Levinson W. (2012). Chapter 54. Cestodes. In W. Levinson (Ed), Review of Medical Microbiology & Immunology, 12e.
3
Its blood sucking activities
The Production Of A Toxin That Affects Hematopoiesis
Competition with the host for vitamin B12
Occlusion of the common bile duct
Medicine
null
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multi
Amyl nitrate is most commonly administered
null
2
Intravenously
By inhalation
Sub lingually
Orally
Pharmacology
null
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multi
A 63-year-old man presents to the emergency department because of transient symptoms of vertigo, slurred speech, diplopia, and paresthesia. He is symptom-free now, and clinical examination is entirely normal. His past medical history is significant for osteoarthritis, hypertension, and dyslipidemia. Which of the following is the most likely cause for symptoms?
Posterior circulation TIA is suggested by the constellation of symptoms (vertigo, dysarthria, and diplopia and the transient episode of his symptoms. The basilar artery is formed by the two vertebral arteries and supplies the pons, the midbrain, and the cerebellum with vertebrobasilar TIAs, tinnitus, vertigo, diplopia, ataxia, hemiparesis, and bilateral visual impairment are common findings. This patient does not have occlusion of the middle cerebral artery since it results in cortical symptoms of motor and sensory loss on the contralateral side. This is also not hypertensive encephalopathy since it causes confusion, headache, nausea, vomiting, and focal neurologic signs.
1
posterior circulation transient ischemic attack (TIA)
anterior communicating artery aneurysm
hypertensive encephalopathy
pseudobulbar palsy
Medicine
C.N.S.
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single
Which of the following is not a ototoxic drug -
Ans. is 'a' i.e., Paracetamol Important ototoxic drugso Aminoglycosideso Cisplatino Furosemideo Deferoxamineo Quinineo Chloroquineo Interferonso Eiythromycino Bleomycino Aspirin
1
Paracetamol
Cisplatin
Quinine
Erythromycin
Pharmacology
Adverse Drug Effect
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single
Which of the following is NOT a component of t RNA?
Component Function Acceptor stem Hydroxyl group of adenosyl nucleotide forms an ester bond with the carboxyl group of aminoacid. DHU arm (DiHydroUridine) or D arm Recognition by specific aminoacyl tRNA synthetase Anticodon arm Base pairs with the codon of mRNA TpsC arm (RiboThymidine, Pseudouridine (ps), Cytidine) Ribosomal recognition Variable loop Unique sequences that are specific for that paicular tRNA.
3
D-loop
TpsC loop
Codon arm
Variable loop
Biochemistry
Translation
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RC-prep is a combination of?
null
4
EDTA with carbamide peroxide
EDTA with hydrogen peroxide
EDTA with sodium hypochlorite
EDTA with urea peroxide and glycol based Glyde
Dental
null
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single
Normal pregnancy can be continued in aEUR'
Wolf Parkinson-While syndrome Marfan's syndrome Ideally, a patient with Marfan's syndrome contemplating pregnancy should have a preconceptional echocardiography to determine the diameter of the aoic root risk depends upon the diagmeter of aoic root. If it is greater than 4.0 cm, she is at significant risk for aoic dissection and she should be offered surgery. If the patient is in early pregnancy, she should be informed that termination of pregnancy is an option. Eisenmengher syndrome & Pulmonary hypeension Pulmonary vascular disease whether secondary to a reversed large left to right shunt such as VSD, Eisenmenger's syndrome or lung or connective tissue disease (e.g., scleroderma) or due to primary pulmonary hyeension is extremely dangerous in pregnancy and women known to have significant pulmonary vascular disease should be adviced from an early age to avoid pregnancy and be given appropriate contraceptive advice. Arias says "Pregnancy is deleterious to patients with primary pulmonary hypeension. The maternal moality is approximately 40% and the fetal outcome is also poor with frequent spontaneous aboions and fetal demises secondary to maternal deaths." According to Dutta, Absolute indications for termination of pregnancy are:? a) Primary pulmonary hypeension b) Eisenmengers syndrome c) Pulmonary veno-occlusive disease Relative indications are a) Parous woman with grade HI and grade IV cardiac lesions. b) Grade I or II with previous history of cardiac failure in early month or in between pregnancy. The termination should be done within 12 weeks by suction evacuation (MVA) or by conventional D & E.
2
Primary pulmonary hypeension
Wolf-Parkinson-White syndrome
Eisenmenger syndrome
Marfan syndrome with dilated aoic root
Gynaecology & Obstetrics
null
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Alpha 1 antitrypsin deficiency mechanism of transmission -
Ans. is 'a' i.e., Autosomal recessiveAutosomal recessive disordersMetabolicHematologicalEndocrineSkeletalNarvouso Cystic fibrosiso Phenylketonuriao Galactosemiao Homocystinuriao Lysosomal storage diso a1-antitrypsin deficiencyo Wilson diseaseo Hemochromatosiso Glycogen storage disorderso Sickle cell anemiao Thalassemiaso Congenital adrenal hyperplasiao Albinismo EDS (some variants)o Alkaptonuriao Friedreich ataxiao Spinal muscular atrophyo Neurogenic muscular atrophies
1
Autosomal recessive
Autosomal dominant
X linked recessive
X linked dominant
Pathology
Obstructive Lung Diseases
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single
Which of the following is not an intracellular enzyme?
Intracellular enzymes: Cytoplasm: Enzymes of glycolysis (conversion of glucose and glycogen to pyruvic and lactic acid). Mitochondria: Enzymes of citric acid cycle and oxidative phosphorylation. Lysosomes: Hydrolytic enzymes.
2
Enzymes of oxidative phosphorylation
Salivary amylase
Glycogen synthase
None of the above
Biochemistry
null
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multi
Which of the following is not a feature of chronic progressive external ophthalmoplegia
Chronic Progressive External Ophthalmoplegia No diplopia since it is bilaterally symmetrical No neurological involvement. Progressive generalized muscular disorder. Stas with bilateral ptosis, is symmetrical. Finally ocular motility palsy followed by paralysis occurs.
4
Stas with bilateral ptosis
May be associated with hea block.
Finally ocular motility palsy
Significant diplopia
Ophthalmology
Squint
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multi
Division of zygote took place on 5th day after fertilization. What is the type of twinning:
Ans. (b) Monochorionic, DiamnioticRef: Dutta 8th ed. 233Division of zygote and types of TwinningDivision of Zygote on/ afterTypes of Twining72 hours/3 daysDichorionic, DiamnioticBetween 4-8 daysMonochorionic, DiamnioticBetween 8-12 daysMonochorionic, Monoamniotic> DaysSiamese, Conjoined TwinsAlso Know* Most common type of twinning is dizygotic twins: 69%* Monozygotic twins in: 31%* MC TYPE OF TWIN GESTATION: Diamniotic Monochorionic (70-75%)* Least common type of twin gestation: Conjoined twins (<1%)* Hellin rule is associated with multiple pregnancyas per which chance of twins is al in 80 pregnancies, triplets 1 in 802 and so on. It can result in complications;* Prematurity is the commonest fetal complication* Post partumhemorrhage is the commonest maternal complication.
2
Monochorionic, Monoamniotic
Monochorionic, Diamniotic
Dichorionic, Diamniotic
Dichorionic, Monoamniotic
Gynaecology & Obstetrics
Multiple Pregnancy
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Lines of Blaschko represent:
Ans. (d) Lines of developmentBlaschko's lines reflect cell migration during embryogenesis of the skin. Nevi cluster along these lines
4
Lines along lymphatics
Lines along blood vessels
Lines nerves
Lines of development
Surgery
Plastic & Reconstructive Surgery
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single
Commonest cause of colonic obstruction in neonates is -
Ans. is 'b' i.e., Aganglionic colon i) Option 'a & c' are causes of small bowel obstruction not colonic obstruction ii) Most common cause of Intestinal obstruction in a neonate is Intestinal atresia - p. 1133, 1232 Nelson
2
Meconium ileus
Aganglionic colon
Heal atresia
Volvulusd) Hernia
Surgery
null
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Cantrell pentology include all except ?
Ans. is d i.e., Trisomy 21 o Pentalogy of Cantrell is named after James R. Cantrell, a pediatric surgeon . The pentalogy of Cantrell is an extremely rare phenomenon with an incidence estimated at around 6 per million live bihs. o It encompasses the following 5 main features. i) Pericardial or distal sternal cleft ii) Supraumbilical omphalocele iii) Diaphragmatic hernia iv) Defect in apical pericardium causing ectopia cordia (Abnormal location of hea). v) Congenital intracardiac defects (VSD, ASD, Tetralogy of fallot, Left ventricular diveiculum).
4
VSD
ASD
TOF
Trisomy 21
Pediatrics
null
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multi
Not true about Ribozyme is:
RIBOZYME - Ribozymes are RNA molecules with catalytic activity At least five distinct species of RNA that act as catalysts have been identified. Three are involved in the self processing reactions of RNAs while the other two are regarded as true catalysts (RNase P and rRNA). (1) rRNA- 23S RNA (prokaryotes) - 28s RNA (eukaryotes) - peptidyl transferase / transpeptidase - catalyzes peptide bond formation on the ribosome. (2) splicing - After transcription, during RNA processing, introns are removed and the exons are ligated together to form the mature mRNA that appears in the cytoplasm; this process is termed RNA splicing. * - ribozyme Sn RNA having role in removal in introns . (3) RIBONUCLEASE P - It cleaves tRNA precursors to generate mature tRNA molecules.
1
It is a protein
Involved in transesterification
Involved in peptide bond formation
Catalyst RNA
Biochemistry
DNB 2018
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Under Vision 2020, to check visual acuity, teacher will refer school child to
Under Vision 2020, to check visual acuity, teacher will refer school child to Vision Centre Vision 2020 Right to Sight Major aim - eliminate avoidable blindness by 2020. They are Global India 1. Cataract 1. Cataract 2. RE + Low vision 2. RE + Low vision 3. Childhood blindness 3. Childhood blindness 4. Trachoma 4. Trachoma 5. Onchocerciasis (not present in India) 5. Diabetic Retinopathy 6. Glaucoma 7. Corneal Blindness Number of Authorised bodies Population Norms 2 (APEX) 1/500 million 20 (Centre of Excellence) 1/50 million 200 (Training Centre) 1/5 million 2000 (Service Centre) 1/500000 20000 (Vision Centre) 1/50000 Rajendra prasad institute of Ophthalmic sciences, AIIMS, Delhi: Services offered at Vision centre - vision testing - PMOA Service centre - cataract surgery - ophthalmologist Training centre - Training - opthal depament of medical college
4
Service centre
Training centre
Centre for excellence
Vision centre
Social & Preventive Medicine
NCDs: CHD, HTN, DM, RF, Cancers, Obesity, Blindness
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single
Chemoattractants among the following are?
Ans. is 'b' i.e., Leukotriene B4 and C5a o Chemoattractant:- C5a (most potent), IL-8, LTB4, PAF, bacterial products, Lymphokine, Kallikrein.o C5a is the most potent chemoattractant
2
Histamine
Leukotriene B4 and C5a
Leukotriene C4 and C3a
Bradykinin
Pathology
Chemical Mediators and Regulators of Inflammation
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single
In humans, where does depolarisation of cardiac ventricular muscle stas from?
In humans, depolarization of the ventricular muscle stas at the left side of the interventricular septum and moves first to the right across the mid poion of the septum. The wave of depolarization then spreads down the septum to the apex of the hea. It then returns along the ventricular walls to the AV groove, proceeding from the endocardial to the epicardial surface. The last pas of the hea to be depolarized are the posterobasal poion of the left ventricle, the pulmonary conus, and the uppermost poion of the septum.
2
Posterobasal pa of ventricle
Left side of inter ventricular septum
Uppermost pa of interventricular septum
Basal poion of ventricle
Physiology
null
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All are true about hypertrophic obstructive cardiomyopathy except
null
3
Assymetrical septal hypertrophy
Systolic ventricular dysfunction is absent
Anterior leaflet movement is delayed
Cardiac output is diminished
Medicine
null
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multi
When preparing a 3/4th crown on maxillary incisor tooth, the proximal grooves should generally be parallel to the
null
3
Long axis of the tooth
Gingival 2/3rd of the labial surface
Incisal 2/3rd of the labial surface
Short axis of the tooth
Dental
null
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Gluconeogenesis enzyme stimulated in starvation
In starvation, there is excessive breakdown of fatty acids resulting in the formation of Acetyl CoA in the liver. They ensure the conversion of pyruvate to oxaloacetic acid. It acts as allosteric activator of the enzyme pyruvate carboxylase and inhibits pyruvate dehydrogenase of Glycolysis.
1
Carboxylase
Pyruvate dehydrogenase
Pyruvate kinase
Glucokinase
Biochemistry
Metabolism of carbohydrate
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What is false regarding wandering spleen?
Wandering spleen- when position is not fixed due to laxity of ligaments or previous surgery - twisting of vascular pedicel - splenic congestion . Wandering Spleen Wandering spleen is an unusual condition with normal spleen having a long loose & vascular splenic pedicle but lacks ligamental attachments. Clinical Features: Intermittent abdominal pain, splenomegaly resulting from venous congestion & severe persistent pain. May lead to splenic torsion & infarction. Chronic torsion typically causes venous congestion & splenomegaly. Splenectomy or splenopexy is treatment of choice.
2
Chronic torsion leads to splenomegaly
Treatment of choice is splenectomy only
Infarction & torsion are common
It is encapsulated with long vascular pedicle
Surgery
Spleen
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Age group for concrete operational stage:
According to Piaget Cognitive theory, the sequence of development has been categorized into 4 major stages. • Sensorimotor stage (0 to 2 yrs) • Pre-operational stage (2 to 6 yrs) • Concrete operational stage (7 to 12 yrs) • Formal operational stage (11 to 15 yrs)
3
0-2 yrs
2-6 yrs
7-12 yrs
11-15 yrs
Dental
null
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Culex mosquito spreads all of the following disease except: March 2008
Ans. C: Yellow fever The yellow fever mosquito, Aedes aegypti (= Stegomyia aegypti = Aedes (Stegomyia) aegypti), is a mosquito that can spread the dengue fever, Chikungunya and yellow fever viruses. The mosquito can be recognized by white markings on legs and a marking in the form of a lyre on the thorax.
3
Viral ahritis
West Nile fever
Yellow fever
Bancroftian filariasis
Social & Preventive Medicine
null
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Organism associated with fish consumption and also causes carcinoma gallbladder:
• Clonorchis sinensis is a liver fluke, acquired by ingestion of raw or inadequately cooked freshwater fishes. • In human body, it lives within bile ducts and causes inflammatory reaction leading to cholangiohepatitis and biliary obstruction. • It is a well known risk factor for cholangiocarcinoma. • It is a rare, but mentioned risk factor for carcinoma gallbladder.
3
Gnathostoma
Anglostrongyloidosis cantonensis
Clonorchis sinensis
H. dimunata
Surgery
null
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Which of the following statements about Recommended Dietary Allowances (RDA) is true
A i.e. RDA is statistically defined as two standard detions (SD) above Estimated Average Requirement (EAR)
1
RDA is statistically defined as two standard detions (SD) above Estimated Average Requirement (EAR)
RDA is defined as being equal to the Estimated Average Requirement (EAR)
RDA is defined as being equal to Adequate Intake (AI)
RDA is defined as the recommended minimum requirement
Physiology
null
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Third tubercle of femur provides attachment to?
Ans. (a) Gluteus maximusRef: Gray's anatomy 39th ed. H433
1
Gluteus maximus
Gluteus medius
Gluteus minimis
Piriformis
Anatomy
Osteology of Lower Extremity
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Genu of internal capsule carries -
Desending (efferent) fibers passing through genu of internal cpsule are corticonuclear fibers.
4
Optic radiation
Corticospinal
Corticorubral tract
Corticonuclear tract
Anatomy
null
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FIGLU Test is used for deficiency of -
Ans. is 'd' i.e., Folic acid Assessment of folate deficiencyo Following tests are used for assessment of folate deficiency.Blood levelNormal level in scrum is about 2-20 nanogram/mJ and about 200 micorgram.'ml of packed cells.Histidine load test or FIGLU excretion test :- Histidine is normally metabolized to formimino glutamic acid (FIGLU) from wrhich formimino group is removed by THF. Therefore in folate deficiency, FIGLU excretion is increased in urine.AICAR excretion In purine nucleotide synthesis the 2nd last step is the addition of C2 with the help of N10-formyl THF. This step is blocked in folate deficiency and the precursor, i.e., amino imidazole carboxamide ribosyl-5-phosphate (AICAR) accumulates and is excreted in urine.Peripheral blood picture Macrocytosis, tear drop cells, hvpersegmented neutrophils, anisopoikilocvtosis.
4
Vitamin B ,
Riboflavin
Niacin
Folic acid
Biochemistry
Vitamins
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Which is not found in CNS in a case of AIDS
Ref Robbins 9/e p250-255 Pathogenesis of CNS Involvement The pathogenesis of the neurologic manifestations in AIDS deserves special mention because, in addition to the lymphoid system, the nervous system is a major target of HIV infection. Macrophages and cells belonging to the monocyte-macrophage lineage (microglial cells) are the predominant cell types in the brain that are infected with HIV. The virus is most likely carried into the brain by infected monocytes (thus, brain HIV isolates are almost exclusively of the R5 type). The mechanism of HIV-induced damage of the brain, however, remains obscure. Because neurons are not infected by HIV, and the extent of neuro- pathologic changes is often less than might be expected from the severity of neurologic symptoms, most expes believe that the neurologic deficit is caused indirectly by viral products and soluble factors (e.g., cytokines such as TNF) produced by macrophages and microglial cells. In addition, injury from nitric oxide induced in neuronal cells by gp41 and direct damage of neurons by soluble HIV gp120 have been postulated. This all results in perivascular giant cells,vacuolisation
3
Perivascular giant cells
Vacuolization
Inclusion bodies
Microglial nodules
Anatomy
General anatomy
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The term 'id' was coined by -
Structural theory of mind (the id, ego and superego) was given by Sigmund freud.
1
Freud
Skinner
Wayker
Blueler
Psychiatry
null
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'Maltese Cross' is a characteristic feature of:
Babesia Microti is a parasitic blood-borne disease transmitted by deer tick (Ixodes scapularis) does not infect liver cells. Its clinical symptoms is similar to malaria, so diagnosis is really confusing. Under the microscope, the merozoite form of the microti lifecycle in red blood cells forms a cross-shaped structure, often referred to as a "Maltese cross", whereas malaria forms more of a diamond ring structure in red blood cells. Ref: Medical Microbiology By Jawetz, 24th Edition, Page 680; 'Clinical Hematology' By Turgeon, 4th Edition, Page 108; 'Blood Cells' By Bain, 3rd Edition, Page 137
2
Cryptococcus Neoformans
Babesia Microti
Blastomycosis
Penicillium Marneffei
Microbiology
null
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30 year old female presents with a painful, red, warm nail fold since last 7 days. Patient is applying various home remidies like turmeric powder , warm saline compressions with out any relief .The most probable diagnosis is
Paronychia is inflammation around a finger or toenail. Paronychia is a nail disease that is an often tender bacterial or fungal infection of the hand or foot, where the nail and skin meet at the side or the base of a finger or toenail. The infection can sta suddenly (acute paronychia) or gradually (chronic paronychia) signs and symptoms: The skin typically presents as red, itchy, and hot, along with intense pain. Pus is usually present, along with gradual thickening and browning discoloration of the nail plate. Causes: *Acute paronychia is usually caused by bacteria. Paronychia is often treated with antibiotics, either topical or oral or both. Chronic paronychia is most often caused by a yeast infection of the soft tissues around the nail but can also be traced to a bacterial infection. If the infection is continuous, the cause is often fungal and needs antifungal cream or paint to be treated. Risk factors include repeatedly washing hands and trauma to the cuticle such as may occur from repeated nail biting. In the context of baending, it is known as bar rot. Prosector's paronychia is a primary inoculation of tuberculosis of the skin and nails, named after its association with prosectors, who prepare specimens for dissection. Paronychia around the entire nail is sometimes referred to as runaround paronychia. Painful paronychia in association with a scaly, erythematous, keratotic rash (papules and plaques) of the ears, nose, fingers, and toes may be indicative of acrokeratosis paraneoplastica, which is associated with squamous cell carcinoma of the larynx. Paronychia can occur with diabetes, drug-induced immunosuppression,or systemic diseases such as pemphigus. Treatment: When no pus is present, warm soaks for acute paronychia are reasonable, even though there is a lack of evidence to suppo its use.Antibiotics such as clindamycin or cephalexin are also often used, the first being more effective in areas where MRSA is common.If there are signs of an abscess (the presence of pus) drainage is recommended. Chronic paronychia is treated by avoiding whatever is causing it, a topical antifungal, and a topical steroid. In those who do not improve following these measures, oral antifungals and steroids may be used or the nail fold may be removed surgically Ref Harrison 20th edition pg 1234
2
Ingrowing finger nail
Acute paronychia
Chronic paronychia
Onychomycosis
Dental
miscellaneous
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ECG was performed on a total of 700 subjects with complaints of acute chest pain. Of these, 520 patients had myocardial infarction. Calculate the positive predictive value of ECG is: MYOCARDIAL INFARCTION ECG PRESENT ABSENT TOTAL POSITIVE 416 9 425 NEGATIVE 104 171 275 TOTAL 520 180 700
Positive predictive value=true positive/(true positive+ false positive) 416/425 x 100= 98% Ref: Medical biostatistics, 1st edition pg: 201
4
40%
55%
95%
98%
Social & Preventive Medicine
null
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Hemiplegia is commonly associated with infarction of the area of distribution of the -
null
2
Anterior cerebral artery
Middle cerebral artery
Posterior cerebral artery
Anterior communication artery
Medicine
null
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All of the following statements are true about Congenital Rubella, EXCEPT:
The first trimester of pregnancy is the most disastrous time for the foetus as the organs are developing. Infection in the second trimester may cause deafness but those infected after week 16 suffer no major abnormalities. Ref: Textbook of Obstetrics By Dutta, 6th Edition, Page 299; Park's Textbook Of Preventive And Social Medicine By K. Park, 18th Edition, Page 128
4
It is diagnosed when the infant has IgM antibodies at bih
It is diagnosed when IgG antibodies persist from more than 6 months
Most common congenital defects are deafness, cardiac malformations and cataract
Infection after 16 weeks of gestation results in major congenital defects
Social & Preventive Medicine
null
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multi
Extra intestinal manifestations associated with inflammatory bowel disease are all except
null
3
Uveitis
Sclerosing cholangitis
Osteoarthritis
Skin nodules
Medicine
null
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Rectum is inflated with air, pain occurs in right iliac fossa. Which sign
an obsolete sign: in chronic appendicitis, pain and tenderness in the right iliac fossa on inflation of the colon with air. The definition information forBastedo sign is provided by Stedman&;s.
3
Aaron sign
Battle sign
Bastedo sign
Meburney sign
Surgery
G.I.T
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single
Which of the following OPV ls are usable?
Rules for VVM use in India Rules 1: If the inner square is lighter than the outer circle, the vaccine may be used (Vials 1, 2) Rules 2: If the inner square is the color as, or darker than, the outer circle, the vaccine must not be used (Vials 3, 4).
2
Only 1
Only 1, 2
Only 1, 2, 3
Only 3, 4
Social & Preventive Medicine
Cold Chain in India
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In leprous neuritis, there is a) Intracutaneous thickening of the nerve b) Facial palsy c) Occurs in warm and moist areas d) Palpable peripheral nerves are present e) > 10 lesions may be found
null
1
abde
abd
abcd
acd
Medicine
null
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single
Major carbohydrate store in body is:
Major carbohydrate store in the body is Hepatic glycogen, Hepatic glycogen maintains blood glucose concentration. No glycogen is stored in adipose tissue. In % glycogen stored in muscles> liver Body stores energy in the form of carbohydrates (glycogen) and not in form of fats because : Fats cannot be metabolized anaerobically. Mobilization of glycogen is faster than fats Fats can never be conveed to glucose Fatty acids cannot cross Blood Brain Barrier (BBB)
1
Hepatic glycogen
Blood glucose
Glycogen in adipose tissue
None of the above
Biochemistry
Glycogen
955a031c-8c68-49a7-8591-ea5bad580d8b
multi
Difference between post burn rupture & incised wound -
Reff: The synopsis of forensic medicine& Toxicology 28th edition pg: 167 Heat ruptures: These are produced by splitting of soft pas at the joints. They may be confused with the incised or lacerated wounds. Can be differentiated from them by the absence of bleeding; presence of intact vessels and nerves; irregular margins and absence of bruising and other vital reactions.
2
Seen in front of the thigh
Intact blood vessels & nerve at floor of the wound
Bleeding from the wound
Small and multiple
Forensic Medicine
Thermal injury
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multi
All are true regarding typhoid ulcer except ?
Ans. is 'b' i.e., Placed transversely along the ileumo Typhoid ulcers are placed longitudinally along the ileum.o On the other hand. Tubercular ulcers are placed transversely along the ileum (Mnemonic: (neck) tie lies longitudinal on body).Features of Tvhoid ulcer ?Salmonella typhi primarily affects the ileum and colon, the terminal ileum is affected most often. o The peyer's patches show ovoid ulcers with their long axes along the axis of the ileum (remember that in intestinal tuberculosis, the ulcers are transverse to the axis of the bowel).o The margins of the ulcer are slightly raised, and the base of the ulcers is base black due to sloughed mucosa.o Though the enteric fever is an example of acute inflammation neutrophils are invariably absent from cellularinfiltrate and this is reflected in leucopenia with neutropenia and relative lymphocytosis in peripheral blood. Thecellular infiltrates in typhoid consists of phagocytic histiocytes, lymphocytes and plasma cells.Complications of Typhoid ?The most common complications of Typhoid are perforation and hemorrhage.There is never significant fibrosis in case of typhoid, hence stenosis seldom occurs in healed typhoid lesions. (strictures are common features of intestinal Tuberculosis).
2
Perforation is less common in children below 5yrs
Placed transversely along the ileum
Multiple ulcer found in terminal ileum
Perforation occurs in 3rd week
Pathology
null
29331269-e524-4837-9799-1532d555141e
multi
The Study of postmoem process of a dead body and their interpretation is
Forensic taphonomy is the interdisciplinary study and interpretation of postmoem processes of human remains. Thanatology is the study that deals with death in all its aspects. Entomology is the study of the form and behaviour of insects. Myiasis is a condition caused by infestation of the body by fly maggots. Putrefaction is the process of gradual dissolution and liquefaction of the tissues.
3
Thanatology
Putrefaction
Taphonomy
Entomology
Forensic Medicine
Thanatology
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single
The most common nerve damaged during open hernia repair -
Ans. is 'a' i.e., Ilioinguinal nerve o All the three nerves ie genifotemoral, ilioinguinal & iliohypogastric are branches of the lumbar plexus and all may be injured in op. for hernia.Ilioinguinal-Nerveo Enters the inguinal canal by piercing the internal oblique muscle (not through the deep ring),o It then emerges from the superficial inguinal ring to supply skin of:Proximomedial skin of the thigh.Skin over the penile root.Upper part of the scrotumIliohypogastric nerveso Divides into two branches - lateral cutaneous and anterior cutaneous,o Lateral cutaneous supplies - posterolateral gluieal skino Anterior cutaneous supplies - suprapubic skinGenitofemoral nerveo Divides into two branches :GenitalFemoralo Genital br of Genitofemoral nerve - enters the inguinal canal at its deep ring and suppliesThe CremasterThe scrotal skino Femoral br of genitofemoral nervePasses behind the inguinal ligament, enters the femoral sheath lateral to femoral artery; pierces the ant layer of the femoral sheath and fascia lata and supplies the skin anterior to the upper part of femoral triangle.o From these descriptions it is obvious that the nerve likely to be injured is ilioinguinal nerve.
1
Ilioinguinal nerve
Iliohypogastric
Genitofumoral
null
Unknown
null
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multi
In diagnosis of retinitis pigmentosa ERG is:
Ans. Less sensitive than the EOG
2
More sensitive than the EOG
Less sensitive than the EOG
Equally sensitive as EOG
None of the above
Ophthalmology
null
47979134-412a-4a97-a8f2-30cf6343e3b0
multi
In which one of the following conditions is gas under diaphragm not seen
After spontaneous rupture, the pressure in the oesophagus rapidly increases and burst at its weakest point in lower one-third, sending a stream of material into the mediastinum and often into the pleural cavity. Thus pneumomediastinum is formed Reference: Bailey and Love edition: 24 page no: 996
4
Perforated duodenal ulcer
Typhoid perforation
After laparotomy
Spontaneous rupture of oesophagus
Surgery
G.I.T
b53c338c-ee25-4e1e-a179-2128253d1803
single
Positive Acute phase reactants are all except :
Acute phase reactants - Plasma proteins which are either increased or decreased during inflammation. Proteins which are increased are called as Positive Acute phase reactants and which are decreased are know as Negative Acute phase reactants.
2
Serum Amyloid A protein
Transthyretin
Fibrinogen
Hepcidin
Biochemistry
Classification and metabolism of amino acids
00db36d3-7ad3-46b9-a884-e6ff24eb54ce
multi
Which of the following phase is characterized by presence of δ waves?
C represents NREM 3 phase which is characterized by presence of δ waves. NREM 3 is also called as "deep sleep".
3
A
B
C
D
Psychiatry
null
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single
True statement(s) regarding feeding of HIV-infected child is/are -
Ans. is 'c' i.e., Exclusively top feeding o HIV infection can be transmitted from infected mother to fetus by breast feeding (though this is the least common mode of veical transmission for HIV). o It seems reasonable for women to substitute infant formula (top feeding) for breast milk if they are known to be HIV infected or are at risk for ongoing sexual or parenteral exposure to HIV. o However, the WHO recommends that developing countries where other diseases (diarrhea, pneumonia, malnutrition) substantially contribute to a high infant moality rate, the benefit of breat feeding outweighs the risk for HIV transmission, and HIV infected women in developing countries should breast feed their infants for lst 6 months of life followed by rapid weaning. For HIV infected mother Developed countries Substitute top feeding for breast feeding Developing counteries Breast feed for 6 months followed by rapid weaning
3
Breast feeding for 4-6 months then sta weaning
Breast feeding for 1 year then sta weaning
Exclusively top feeding
All
Pediatrics
null
22059021-ff43-4f27-8c9c-fe13983eb72a
multi
The modified class III preparation uses a dovetail on the lingual side in:
Lingual dovetail is required for large preparations in maxillary canines.  It is prepared only after completion of proximal portion, because otherwise tooth structure needed for isthmus between proximal portion and dovetail might be removed when the proximal outline form is prepared. Nisha Garg, Amit Garg. Textbook of Operative Dentistry.  Edition 3. Page:337
1
Maxillary canine
Mandibular canine
Mandibular central incisor
Mandibular lateral incisor
Dental
null
5b1a1289-b252-4650-af9c-882567db9658
single
The child rolls over by -
Ans. is 'b' i.e., 5 months Age Milestone 3 Month Neck holding 5 Month Rolls over 6 Month Sit with support 8 Month Sit without support 9 Month Stand with support 12 Month Stand without support Walk with support 15 Month Walk alone, creep upstair
2
3 months
5 months
7 months
8 months
Unknown
null
69378c11-c9f8-4ba0-996b-43d4a16f6f8f
single
Krabbe’s disease caused by deficiency of
null
3
Sphingo myelinase
Alpha galactosidase
Galacto cerebrosidase
Aryl sulfatase A
Biochemistry
null
f3dc145a-9af5-46a5-a688-27dbe27b2fc2
single
Beta agonist which is used for stopping premature labor is:
null
2
Carvedilol
Terbutaline
Pindolol
Nadolol
Pharmacology
null
9fb68698-0716-4133-b474-651e3b41da71
single
Which of the following lesions is NOT an infection from human papilloma virus?
null
4
Verruca vulgaris
Focal epithelial hyperplasia
Condyloma acuminatum
None of the above
Microbiology
null
ddea84f5-d4d2-45e6-88a0-9059512a60a8
multi
Which of the following is a debranching enzyme:
Debranching enzyme is a Bifunctional enzyme with two activities Glucan transferase Amylo a-1,6-glucosidase breaks the alpha (1-6) glycosidic bond present at the branch point of glycogen in glycogen breakdown. Other Options: Glycogen synthetase transfer glucose from UDP-glucose to glycogenin. Glycogen branching enzyme (also known as amylo-a(1,4)-a(1,6) trans glycosylase) make glycogen branches by transferring the end of the chain onto an earlier pa a-1,6 glycosidic bond. Glucose-6-phosphatase dephosphorylates glucose-6-phosphate to free glucose.
3
Glycogen synthetase
Glucose-6-phosphatase
Amylo alpha-1,6-glucosidase
Amylo (1,4)-(1,6) trans glycosylase
Biochemistry
Glycogen
d37b9109-671a-4456-b955-a2e4155b54b4
single
Which of the following synaptic transmitter is NOT a peptide, polypeptide or protein
D. i.e. (Serotonin) (95 - 96- Ganong 22nd) (1081-82- A.K. Jain 3rd)* Dopamine, Norepinephrine, Epinephrine, Serotonin. Histamine are AMINES* Polypeptides are - Substance P*, other tachykinins, Vasopressin, oxytocin, CRH, TRH, GRH,Somatostatin, GnRH, Endothelins, /3-Endorphin*, Endomorphins Enkephalins*, Dynorphins,Cholecystokinin (CCK-4 and CCK-8). VIP, Neurotensin, Gastrin releasing peptide, Gastrin, Motilin,Secretin, Glucagon derivatives, Calcitonin gene related peptide - a, Neuropeptide y, Activins, Inhibins,Angiotensin II. FMRF amide, Galanin, ANP, BNP,* Substance P - is transmitter for afferent neurons that relay sensory information into the CNS and is though to be invoved in the transmission of nociceptive (pain producing) stimuli.* Enkephalins and Endorphins - role in regulating pain, in eating and drinking behaviour, in central regulation of the CVS, and in cell development
4
Substance P
Met-enkephalin
b-Endorphin
Serotonin
Physiology
Nervous System
58d23dee-8bc2-4364-8afd-77e71e67e0ed
single
At which level of heat stress index it is not possible to work comfoably causing threat to health:
HEAT STRESS INDEX(HSI): HSI% Consequence of 8 hour exposure 0 No thermal strain 10-30 Mild-Moderate heat stress, Minimal impairement in work 40-60 Severe heat stress, Threat to health if not fit 70-90 Very severe heat stress, only few can sustain it 100 Maximum heat stress, only young fit acclimatized can sustain it >100 Varying degrees of stress due to hypehermia Ref: Park 25th edition Pgno: 784
2
20-40
40-60
60-80
80-100
Social & Preventive Medicine
Environment and health
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single
Rosiglitazone mechanism of action is ?
Ans. is 'a' i.e., Acts as PPAR gamma agonist Rosiglitazone It is oral antidiabetic drug They are selective agonists for nuclear peroxisome proliferator activator receptor gamma (PPAR gamma) expressed in the fat and muscle cells. It enhances transcription of several insulin responsive genes. Reverse insulin resistance by enhancing GLUT 4 expression and translocation.
1
Acts as PPAR gamma agonist
Inhibitor of alpha glucosidase
Acts as amylin analogue
Acts as dipeptidyl peptidase inhibitor
Pharmacology
null
f27d0008-ecb3-4524-b5c9-734f0870df62
single
A person was brought by police from the railway platform. He is talking irrelevant. He is having dry mouth with hot skin, dilated pupils, staggering gait and slurred speech. The most probable diagnosis is:
Features of dhatura poisoning: (All Datura plants contain tropane alkaloids such as scopolamine, hyoscyamine, and atropine) Dilatation of pupils Dryness of mouth Difficulty in speech Dysphagia Dilatation of cutaneous blood vessels Dry, hot skin Drunken gait Delirium Drowsiness Reference The Synopsis of FORENSIC MEDICINE and Toxicology 29th Edition
4
Alcohol intoxication
Carbamates poisoning
Organophosphorous poisoning
Dhatura poisoning
Forensic Medicine
Miscellaneous
72c5bae5-7b8a-4ed6-b835-368a8f5c9b7b
single
Which of the following layers of epidermis is known as "prickle layer"?
Ans. B. Stratum spinosumStratum spinosum is also called as the prickle cell layer.* Stratum spinosum consists of intercellular attachments, also called desmosomes.* These desmosomes appear like spines on microscopy; hence, it is called as the prickle layer.* Their spiny (Latin, spinosum) appearance is due to the shrinking of the microfilaments between desmosomes that occurs when stained with H&E.
2
Stratum basale
Stratum spinosum
Stratum granulosum
Stratum corneum
Skin
Anatomy of Skin
7fd11a8c-c207-453d-bbb8-7f756e5d8858
single
Energy currency of the cell is
Cellular energy can be stored in high-energy phosphate compounds, including adenosine triphosphate (ATP). This ubiquitous molecule is the energy storehouse of the body. On hydrolysis to adenosine diphosphate (ADP), it liberates energy directly to such processes as muscle contraction, active transpo, and the synthesis of many chemical compounds. Loss of another phosphate to form adenosine monophosphate (AMP) releases more energy.(REF: GANONG'S REVIEW OF MEDICAL PHYSIOLOGY -23rd EDITION. Page No-8)
2
Nucleotide diphosphate
Nucleotide triphosphate
Deoxynucleotide diphosphate
Nuceotide monophosphate
Physiology
General physiology
5b18a115-44eb-4877-b8fe-937b67ce0748
single
Commonest type of cong. cyanotic hea disease is
Most common cyanotic hea disease is tetrology of fallot encountered beyond the age of 1 yr constituting almost 75% of all blue patient. Ref : Ghai essential pediatrics,eighth edition, P.no:420
3
ASD
VSD
TOF
PDA
Pediatrics
C.V.S
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single
CRF with anemia best treatment -
Ans. is 'b' i.e., Erythropoietin o Chronic kidney disease leads to normocyih normochronic anemiaThe kidney is the primary' site of erythropoietin production in the adult. Erythropoietin enhances the growth and differentiation of erythropoietin progenitors.With increasing renal dysfunction decreased level of erythropoietin are produced resulting in progressive anemia,o The primary therapeutic options for anemia of chronic kidney disease areo Red blood cell transfusionso Erythropoietin stimulating agentso Androgen (to a much lesser degree)o Erythropoietin administration is considered the mainstay of the treatment of anemia of chronic disease in renal failureThe administration of erythropoietin stimulating agent is particularly attractive because they have substantially reduced the need for red cell transfusion with an attendant decrease in and for risk for transfusion related complications.# The erythropoietin deficiency can be corrected by the exogenous administration of erythropoietin stimulating agentsTwo such agents available in the united statesEpoetin afla (recombinant human erythropoietin)Darbepoetin alfaEpoetin alfa (recombinant human erythropoietin E.P.O.)o Provides effective treatment for anemia in patients, when administered, once weekly Has become standard care.o However, one problem with epoeitin alfa is that the need for the weekly dose can place a considerable burden on both patients and healthcare staff.Darbepoetin alfao Another erythropoiesis stimulator i.e.darbepoeitin alfa can provide an alternative as it has three fold longer half life.o The dose of darbepoeitin can be scheduled once weekly or twice weekly or may be monthly.Peginasatideo It is a synthetic peptide that activates EPO receptor. Peginesatide stimulates erythroid colony growth, reticulocyte count and hematocriiRed blood cell transfusionso RBC transfusion are universally sussessful in raising hemoglobin levels.o Transfusions often can ameliorate the patient s symptoms and improve health related quality of life .o However they may be associated with significant complications that include transfusion transmitted infection, immunological sensif cation, iron overload syndromes volume overload! transfusion reactionsAndrogenso Prior to the availability of erythropoietin stimulating agents, androgens were used regularly in the treatment of anemia in dialyses patients. Androgens may increae endogenous erythorpoietin production sensitivity of erythroid progenitors and red blood cell sunivat. However the role of androgen was limited because of side effects which was virilisation, priapism, peliosis hepatic, liver function and risk of hepatocellular Ca
2
Iron
Erythropoietin
Blood transfusion
Folic acid
Medicine
Anemia and RBC Disorders
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single
A 32-year-old woman was admitted to the hospital with a complaint of pain over her umbilicus. Radiographic examination revealed acute appendicitis. The appendix was removed successfully in an emergency appendectomy. One week postoperatively the patient complained of paresthesia of the skin over the pubic region and the anterior portion of her perineum. Which of the following nerves was most likely injured during the appendectomy?
The ilioinguinal nerve, which arises from the L1 spinal nerve, innervates the skin on the medial aspect of the thigh, scrotum (or labia majora), and the mons pubis. It has been injured in this patient. The genitofemoral nerve splits into two branches: The genital branch supplies the scrotum (or labia majora) whereas the femoral branch supplies the skin of the femoral triangle. The subcostal nerve has a lateral cutaneous branch that innervates skin in the upper gluteal region, in addition to distribution over the lower part of the anterior abdominal wall. The Iliohypogastric nerve innervates the skin over the iliac crest and the hypogastric region. Spinal nerve T9 supplies sensory innervation to the dermatome at the level of T9, above the level of the umbilicus.
2
Genitofemoral
Ilioinguinal
Subcostal
Iliohypogastric
Anatomy
Abdomen & Pelvis
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single
A 70–year–old man presents with deterioration of vision 3 weeks after cataract extraction and IOL implantation. Slit lamp examination shows honeycomb maculopathy and Fluorescein angiography (FA) shows 'flower petal' hyperfluorescence. The most likely diagnosis is –
Unexpected visual loss, 3 weeks after cataract surgery with 'honey comb maculopathy' and 'flower petal' hyperfluorescence on Fluorescin Angiography is characteristic of Cystoid macular Edema.
4
Age related macular degeneration (ARMD)
Central serous Retinopathy (CSR)
Macular Dystrophy
Cystoid Macular Edema
Ophthalmology
null
ec2b5a31-2e03-4f9c-8484-2ca175c39ef7
single
All of the following statements about Trientine are true, EXCEPT:
Trientine is a copper chelating agent. It is the second line of therapy in the treatment of Wilson's disease. It is less potent than penicillamine. It is used in patients intolerant to penicillamine. it can produce gastric disturbance, iron deficiency anemia due to iron chelation and sideroblastic anemia. Ref: Mitochondrial Function And Dysfunction By Anthony Henry Vernon Schapira, Page 185; Goodman And Gilman's Manual of Pharmacology And Therapeutics, 2007, Page 1130; Sleisenger And Fordtran's Gastraintestinal And Liver Diseases, 8th Edition, Page 1609.
1
More potent than penicillamine and orally absorbed
Alternative to penicilliamine in non tolerant
Not given with iron within two hours of ingestion
May cause iron deficiency anemia
Pharmacology
null
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multi
RET gene mutation is associated with which malignancy -
Ans. is 'b' i.e., Medullary carcinoma thyroid o RET p ratoon cumene is a growth factor receptor (receptor tyrosine kinase)o The RET protein Is a receptor for the glial cell lined derived neurotrophic factor and structurally related proteins that promote cell survival during neural development.
2
Pheochromocytoma
Medullary carcinoma thyroid
Lymphoma
Renal cell carcinoma
Pathology
Thyroid and Parathyroid
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single
Most reabsorption out of
Glucose is maximumly reabsorbed in normal condition.Ref: Ganong&;s review of medical physiology; 24th edition; page no; 682
1
Glucose
Urea
Na+
HCO3
Physiology
Renal physiology
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single
The tumour exclusively found in parotid gland:
Wahin tumour/papillary cystadenoma lymphomatosum is viually restricted to parotid gland. Occur more commonly in male than female.
1
Wahin tumour
Adenocarcinoma
Pleomorphic adenoma
Acinar cell tumour
Surgery
null
bfd177c1-04d8-47a7-8d3b-022294de55b9
single
Which of the following finding on MR imaging distinguishes vaginal atresia from mullerian agenesis
Presence of cervix distinguishes vaginal atresia from mullerian agenesis.
2
Amount of upper vaginal dilatation
Presence of cervix
Length of atresia
Hymeneal ring
Gynaecology & Obstetrics
null
97a1e331-0c6a-4b42-9b6e-5a3bfe31ade9
single
A 40 year old female patient complains of swelling on both the legs. Patient is pregnant (3rd trimester). Which type of thrombosis is most likely to be present in this patient?
null
1
Venous
Arterial
Mural
Saddle
Pathology
null
38693871-6b17-4aa3-944e-b073e1170207
multi
Wire loop lesions are often characteristic for the following class of lupus nephritis:
Answer is C (Diffuse Proliferative Glomerutonephritis) Wire loop lesions are most charachteristic of diffuse proliferative glomerulonephritis (Class IV WHO) but may also be seen in focal proliferative glomerulonephritis (Class III WHO). Most characteristic of: Lupus Nephritis Class IV (Diffuse Lupus Nephritis) Also seen in: Lupus Nephritis Class III (Focal) > Lupus Nephritis Class V (Membranous)
3
Mesangial proliferative glomerulonephritis(WHO class II)
Focal proliferative glomerulonephritis (WHO class III)
Diffuse proliferative glomerulonephritis (WHO class IV)
Membranous glomerulonephritis (WHO class V)
Medicine
null
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single
All are zoonotic disease EXCEPT
[Cl (Rabies) (642- Park 19th) (692-Park 20th)LISTS OF ZOONOTIC DISEASES IN MANA. Bacterial InfectionsAnthrax, Brucellosis, Ornithosis, Q-fever, Leptospirosis, Tuberculosis, PlagueB. Viral InfectionsCow pox, Monkey pox, Eastemequine encephalitis, Ross-river fever, Yellow fever, JE, Lassa fever, RabiesC. Protozoal InfectionsLeishmaniasis, Toxoplasmosis, Trypanosomiasis, BabesiosisD. Helminthic InfectionsClonorchiasis, Fasciolopsis, Schistosomiasis, Echinococcosis, Taeniasis, Trichinellosis
3
Brucellosis
Leptospirosis
Scabies
Rabies
Social & Preventive Medicine
Communicable Diseases
565f6449-e896-4704-90ae-eaf1fc325956
multi
Wasting of the intrinsic muscles of the hand can be expected to be due to injury which nerve ?
- Ulnar nerve innervates 15 of 20 intrinsic muscles of hand.Hence, its injury results in wasting of intrinsic muscles of hand - Musculocutaneous, radial, ulnar & median nerves are all impoant to hand function. - Musculocutaneous and radial nerves allow forearm supination; the radial nerve alone innervates the extensor muscles. - Median nerve is the "eye of the hand" because of its extensive contribution to sensory perception; it also maintains most of the long flexors, the pronators of the forearm & thenar muscles.
1
Ulnar nerve
Radial nerve
Brachial nerve
Axillary nerve
Surgery
Miscellaneous
dd32ae13-9422-4315-ac6b-a4b4f8caae20
single
Which drug is used for Achalasia cardia-
null
1
Nifedipine
Propranolal
Atenolol
Bethnecol
Surgery
null
cab11d26-38f0-45d5-9a83-b66204ebe0f6
single
Wilm's tumor is associated with all the following except :
Warn' s tamer : Wilm's tumor, also known as nephroblastoma, is the most common malignant tumor of kidney in children. Etiology. Most of the tumor are sporadic. 1- 2% may have family history. Familial predisposition to wilm's tumor is inherited in an autosornal dominant manner. Mutation of the following genes are seen in wilms tumor. Wilms tumor gene (WT 1) on chromosome 11. CTNNB I gene encoding the protooncogene beta - ca ten in. p53. Wilm's tumor is associated with three distinct syndromes. WAGR syndrome Beck with Wiedemnn syndrome Denys - Drash syndrome Wilm's tumor Aniridia Genital abnormalities Mental Retardation Enlargement of body organs Hemihypertrophy Renal medullary cysts Adrenal cytomegaly : abnormal large cells in adrenal cortex Gonadal dysgenesis (Male pseudo - hermaphrodite) Nephropathy leading to Renal failure
3
Aniridia
Beckwith syndrome
Polycystic kidney
Hemi – hypertrohy
Pediatrics
null
2aa016b1-ce90-4e4b-b688-bd02feac7f95
multi
Which of the following conditions is associated with maximum hearing loss?
Maximum hearing loss occur when there is ossicular interruption with intact tympanic membrane (54dB). Ossicular interruption with perforation result in 38dB hearing loss, hearing loss in ottitis media with effusion averages about 26-30 dB. Paial or complete fixation of the stapes results in conductive hearing loss that ranges from 5dB to 60dB.
3
Otitis media with effusion
Paial fixation of the stapes footplate
Ossicular disruption with intact tympanic membrane
Disruption of malleus and incus as well tympanic membrane
ENT
null
b56a553c-15c3-46b3-b1c4-4904eb304f71
multi
Mucopolysaccharide hyaluronic acid is present in which among the following:
Hyaluronic acid is a sulphate free mucopolysaccharide. It is present in vitreous humor of the eye. It is also present in skin, synol fluid, umbilical cord, hemolytic streptococci and in rheumatic nodule. It occurs both free and salt like combination with proteins and forms ground substance of the mesenchyme, an integral gel like ground substance of connective tissue and other tissues. It is composed of repeating units of N acetyl glucosamine and D glucuronic acid. Functions: It acts as a cementing substance and contribution to tissue barriers which permits metabolites to pass through but resist penetration by bacteria and other infective agents. In joints it acts as a lubricant and shock absorbent. Ref: Textbook of Medical Biochemistry By M. N. Chatterjea, page 38. Textbook of Biochemistry for Dental/Nursing/Pharmacy Students By Chatterjea page 15
1
Vitreous humor
Cornea
Blood vessels
Lens
Ophthalmology
null
319b1b70-b7e3-4104-bbc6-d34c7b67398e
single
The development of resistance to conventional treatment has led WHO to recommned the use of combination therapies containing aemisinin derivative (aemisinin-based combination therapies also known as ACTs). All of the following combination therapies are recommended if such resistance is suspected, except -
Ans. is 'b' i.e. Aesunate plus quinine The WHO recommended ACTs (aemisinin-based combination therapies) o Aemether + lumefantrine o Aesunate + sulfadoxine-pyrimethamine o Aesunate + amodiaquine o Aesunate + mefloquine o Dihydroaemisinin + piperaquine.
2
Aemether plus lumefantrine
Aesunate plus quinine
Aesunate plus pyrimethamine-sulfadoxine
Aesunate plus mefloquine
Pharmacology
null
99f19799-d809-436e-ac13-7594ad820153
multi
A 66-year-old man presents with a sudden onset of diabetes, anorexia, weight loss, epigastric pain with radiation to back. Next best investigation for this patient is?
Ans. B CT abdomenRef: Bailey and Love: 26th ed. page 1137* The clinical history of epigastric pain radiating to back points to pancreatic etiology. This patient may have developed pancreatic cancer. Sudden onset of diabetes in the elderly is also suggestive. The best imaging modality to image chronic pancreatitis or pancreatic malignancy is CT abdomen.* Choice A is ruled out as gas shadows of stomach obscure ultrasound view of pancreas.* Choice C is fluoroscopic intubation-infusion small- bowel examination which is used to evaluate for small bowel pathology while this patient has pancreatic lesion* Choice D is ruled out as it used for large bowel evaluation.
2
Ultrasound of abdomen
CT abdomen
Enteroclysis
Triple contrast barium enema
Physiology
Misc.
7437be19-31e0-4922-a64d-05046be19976
single
3M-mix antibiotic paste includes the following as intracanal medicament
null
1
Ciprofloxacin, Metronidazole, Minocycline
Norfloxacin, Metronidazole, Minocycline
Ciprofloxacin, Cefixime, Minocycline
Norfloxacin, Metronidazole, Cefixime
Dental
null
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single
The labiodental sounds are
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1
f,v,ph
s,z,c
f,z,s
f,v,z
Dental
null
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single
Kwashiorkor is similar to marasmus in that both diseases have __________
Both marasmus and kwashiorkor are associated with anemia. Marasmus is characterized by a low calorie intake. Dietary deficiencies are compensated for by the breakdown of protein and fats. Key findings include: Growth failure, Aleness, Hunger, Monkey-like appearance , Broomstick extremities , Muscle wasting, Mild anemia Kwashiorkor is characterized by a normal total caloric intake but a decreased intake of protein (minimum protein intake is 8% of the total calories). Key findings are as follows: Growth failure Apathy and irritability with difficulty in feeding Hepatomegaly (fatty liver)- apoprotein deficiency Pitting edema Flaky paint dermatitis (looks like paint coming off a building) Areas of depigmentation Diarrhea due to the loss of brush border enzymes ("use it or lose it") and parasitic diseases Flag sign in hair (alternating dark and light areas) Protuberant abdomen (fatty liver from decreased apoproteins, ascites, bowel distention with air) Reference: GHAI Essential pediatrics, 8th edition Nutrition chapter
4
A normal total caloric intake
A fatty liver
An apathetic affect
Anemia
Pediatrics
Nutrition
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RD k diagnosed by:
Ans. All
4
+90 D
Hurby lens
3 mirror contact lens
All
Ophthalmology
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The process of primary colonizing bacteria adhering to tooth surface providing new receptors for attachment other bacteria is known as
null
3
Attachment
Translocation
Co-adhesion
Biofilm
Dental
null
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'Chancre redux' is a clinical feature of:
Chancre redux : Recurrence of the primary sore at its original site during the first two years of the disease (Relapsing stage of syphilis). Pseudochancre redux : Gummatous (teiary stage) recurrence at the site of the primary chancre.
1
Early relapsing syphilis
Late syphilis
Chancroid
Recurrent herpes simplex infection
Dental
Sexually Transmitted Infections
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Gettlers test is for -
Ans. is 'd' i.e., Drowning Gettler testo Gettler test is done for drowning. It estimates chloride content of blood from both sides of heart. Normally the chloride content is equal in the right and left chambers of the heart (600 mg/100 ml). In fresh water drowning due to hemodilution the chloride content is decreased and in salt water drowning due to hemoconcentration the chloride content is increased in left side of heart. A 25% difference in chloride is significant but the test is of doubtful value.o Limitations of gettler test:-1. No value in atypical drowning; congenital cardiac defects as shunts and patent foramen ovale; and if drowning medium contains same amount of chloride.2. There is progressive loss of Cl- from blood after death. Therefore the test has to be made within a reasonably short time after death.
4
Hanging
Strangulation
Bums
Drowning
Forensic Medicine
Biological Materials & Stains
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single
Which of the following organelles is the major site for anaerobic metabolism?
Oxidative phosphorylation occurs in the mitochondria. The TCA cycle occurs in the mitochondrial matrix. The electron transpo chain occurs on the inner mitochondrial membrane. Anaerobic metabolism occurs in the cytoplasm of most cells. The mitochondria are the site of aerobic metabolism. The Golgi apparatus is responsible for packaging of material for intra- and extracellular use. The nucleolus is the site with in the nucleus of active transcription a gene to mRNA. Centrioles are cytoskeletal elements responsible for nuclear division during cell division. Ref: Bender D.A., Mayes P.A. (2011). Chapter 18. Glycolysis & the Oxidation of Pyruvate. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e.
4
Centrioles
Mitochondria
Golgi apparatus
Cytoplasm
Biochemistry
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single
Mc Naughten's rule :
A i.e. Section 84
1
Section 84
Section 85
Section 86
Section 87
Forensic Medicine
null
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single
Soft water has hardness levels of -
Level of hardness is expressed in terms of milliequivalents per litre where one milliequivalent is equal to 50mg calcium carbonate in one litre of water. The level of hardness of hard water is equal to 3-6mEq/L or 150-300 mg/L. CLASSIFICATION LEVEL OF HARDNESS (mEq./L) LEVEL OF HARDNESS (mg/L) soft water <1 <50 moderately hard 1-3 50-150 hard water 3-6 150-300 very hard >6 >300 Park's Textbook of Preventive and Social Medicine, 25th edition, Page No.787
1
<50
100
150
>200
Social & Preventive Medicine
Environment and health
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In Krebs cycle, which of the following catalyses the step in which the first CO2 is released?
null
2
Aconitase
Isocitrate dehydrogenase
Succinate thiokinase
Succinate dehydrogenase
Biochemistry
null
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multi
Which of the following variant of CAH presents with mineralocoicoid deficiency?
Deficiency in CAH Glucocoicoid Mineralocoicoid Androgens 21 hydroxylase Reduced Reduced Increased 3 b hydroxyl-steroide dehydrogenase Reduced Reduced Increased 11 b hydroxylase Reduced Increased Increased 17 a hydroxylase Reduced Increased Decreased P450 oxidoreductase Reduced Increased Decreased
4
11b hydroxylase deficiency
17a hydroxylase deficiency
P450 oxidoreductase dehydrogenase
3b hydroxyl-steroid dehydrogenase
Medicine
Disorders of Adrenal Gland
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Indicator used in autoclave is -
Ans: b (Bacillus stearothermophilus) Ref: Ananthanarayan, 7th ed,p. 78 Autoclaving: (Moist heat) (121degC X 15 min under 15 lb/sq.inch pressure) - dressings, gloves, glass syringes, culture media, suture materials except catgut. Sterilizing control is by bacillus stearo thermophilus. Hot air oven: (Dry heat) (160degCX 1 hr)-glasswares, glass syringes, oil, grease, liquid paraffin, dusting powder. Sterilization control is by spores of non toxigenic strains of Clostridium tetani.
2
Clostridium tetani
Bacillus stearothermophilus
Bacillus pumilis
Bacillus subtilis Var Niger
Microbiology
General
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All of the following are done in behavior therapy to increase a behavior except:
A i.e. Punishment Punishment & frustrative-non reward lead to decrease in resultant behavior, whereas both positive & negative reinforcements increases (reinforces) the frequency of a paicular response. Operant conditioning describes how consequences of a behavior lead to an increase or decrease in that behavior. Behavior is increased when it is followed by reward (Positive reinforcement) or removal of unpleasant stimulus (negative reinforcement) and reduced by taking away a positive stimulus (frustrative-non reward) or adding a negative stimulus (punishment).
1
Punishment
Operant conditioning
Negative reinforcement
Reward
Psychiatry
null
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multi
The cough response caused while cleaning the ear canal is mediated by stimulation of-
“Irritation of the auricular branches of the vagus in the external ear (by ear wax, syringe, etc.) may reflexly cause cough, vomiting, or even death due to sudden cardiac inhibition.” Auricular branch of the vagus nerve is also known as Arnold’s nerve or Alderman’s nerve. Also Know Similarly irritation of recurrent laryngeal nerve by enlarged lymph nodes in children may also produce a persistent cough.
3
The V cranial nerve
Innervation of external ear canal by C1 and C2
The X cranial nerve
Branches of the VII cranial nerve
ENT
null
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O2 dissociation curve is shifted to right in all except-
Ans. is 'd' i.e., Metabolic alkalosis o Hypercapnea (raised CO2), rise in temprature and increased 2, 3 DPG cause righward shift of O2 dissociation curve,o Metabolic alkalosis causes leftward shift.o Alkalosis (increased pH), increased HbF, and hypothermia (decrease in temperature) cause a leftward shift of oxygen dissociation curve, i.e. increase oxygen affinity to hemoglobin,o Hypoxia (with decrease PaO,) causes a rightward shift of the curve, i.e. decreased oxygen affinity to hemoglobin.Ox Veen dissociation curveShifted to rightShifted to lefto Decreased oxygen affinity' to hemoglobino Increased P50o Increased oxygen delivery to tissueso Causes :y Decreased pH (Acidosis)y Increased temperaturey Increased PCO,y Increased 2,3 DPG (BPG)i) Growth hormone. Androgen, thyroid hormoneii) Exerciseiii) Tissue hypoxiaiv) High altitudev) Anemiavi) Alkalosisvii) Cyanotic CHDviii) Pregnancyix) Chemicals : E no sine, Pyruvate, PEP, phosphateySickle hemoglobin (HbS)o Increased oxygen affinity to hemoglobino Decreased P50o Decrease oxygen delivery to tissueso Causes :y Increased pH (alkalosis)y Decreased temperaturey Decreased PCO,y Decreased 2,3 DPG (BPG)Stored bloody Fetal hemoglobin (HbF)
4
Hypercapnea
Rise in temperature
Raised 2, 3 DPG level
Metabolic alkalosis
Physiology
Principles of Gas Exchange - Respiratory Membrane
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