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True about hepatitis A viurs ?
|
Ans. is 'c' i.e., Common cause of hepatitis in children HAV is the most common cause of hepatitis in children. HAV does not cause chronic hepatitis or cirrhosis. HBV (no HAV) helps in HDV replication.
| 3
|
Causes cirrhosis
|
Helps HDV replication
|
Common cause of hepatitis in children
|
Causes chronic hepatitis
|
Microbiology
| null |
ae29e3d1-085f-4e58-935d-893261415feb
|
multi
|
The following tests may be useful in the assessment of a patient with sarcoidosis
|
Investigations in Sarcoidosis Lymphopenia is characteristic and liver function tests may be mildly deranged. Hypercalcaemia may be present (reflecting increased formation of calcitriol - 1,25-dihydroxyvitamin D - by alveolar macrophages), paicularly if the patient has been exposed to strong sunlight. Hypercalciuria may also be seen and may lead to nephrocalcinosis. Serum angiotensin-conveing enzyme (ACE may provide a non-specific marker of disease activity and can assist in monitoring the clinical course. Chest radiography has been used to stage sarcoid . In patients with pulmonary infiltrates, pulmonary function testing may show a restrictive defect accompanied by impaired gas exchange. Exercise testsmay reveal oxygen desaturation. Bronchoscopy may demonstrate a 'cobblestone' appearance of the mucosa, and bronchial and transbronchial biopsies usually show non-caseating granulomas, as may samples from the mediastinal nodes obtained by EBUS. Bronchoalveolar lavage fluid typically contains an increased CD4:CD8 T-cell ratio. Characteristic HRCT appearances include reticulonodular opacities that follow a perilymphatic distribution centred on bronchovascular bundles and the subpleural areas. PET scanning can detect extrapulmonary disease. The occurrence of erythema nodosum with BHL on chest X-ray is often sufficient for a confident diagnosis, without recourse to a tissue biopsy. Similarly, a typical presentation with classical HRCT features may also be accepted. In other instances, however, the diagnosis should be confirmed by histological examination of the involved organ. The presence of anergy (e.g. to tuberculin skin tests) may suppo the diagnosis. Ref - Davidsons 23e p632
| 4
|
Chest X-ray
|
ACE
|
Serum calcium
|
All of the above
|
Medicine
|
Immune system
|
4cf53dd4-1047-472f-877b-cb9a62d360b9
|
multi
|
which of the following SSRI is hea safe
|
SSRI * IMPOANCE Most widely prescribed antidepressant * MECHANISM Specifically acts on serotonin transpoers and increases serotonin in synapse. DRUGS FLUOXETINE FLUVOXAMINE DAPOXETINE CITALOPRAM ESCITALOPRAM ESCITALOPRAM SERALINE PAROXETINE USE FLUOXETINE=============CHILDHOOD DEPRESSION FLUVOXAMINE===========OCD DAPOXETINE==============PME ESCITALOPRAM===========HEA SAFE, PATHOLOGICAL EMOTIONS PAROXETINE=========SEDATING, PANIC DISORDER IMPULSE CONTROL DISORDERS PME PARAPHILIA Ref. kaplon and Sadock, synopsis of psychiatry, 11 th edition, 955
| 1
|
escitalopram
|
clomipramine
|
fluoxetine
|
amitriptilline
|
Psychiatry
|
Pharmacotherapy in psychiatry
|
1d4df690-1700-4b66-8674-1a7b53fdca4c
|
single
|
Choose the appropriate lettered structure in this MRI scan showing a transaxial section through the head. Which structure may be obliterated by a pituitary tumor?
|
(c) The suprasellar cistern can be obliterated by a pituitary tumor.
| 3
|
A
|
B
|
C
|
D
|
Anatomy
|
Head & Neck
|
40a9c6c3-7798-4d54-9c70-45f3f4c4e01f
|
single
|
Pedigree Chart -
|
Ans. is 'c' i.e., Used to see genetic transmission Pedigreeo Provide graphic depiction of a family structure medical history'.o Person providing information is formed as pro band,o Special symbol is used for each designation,o Three generation pedigree should be made.o Closer the relationship of proband to the person, greater is change of shared genetic component.
| 3
|
Used for growth monitoring.
|
To assess side effect during chemotherapy
|
Used to see genetic transmission.
|
To assess developmental delay in infant
|
Pediatrics
|
Genetics And Genetic Disorders
|
6a8aca69-0485-470a-bbde-8f452a4b4674
|
single
|
True about cornea –a) Power is 43 Db) Majority of refraction occur at air – tear interfacec) With the rule astigmatism is present because vertical meridian more steep than horizontal meridiand) Spherical structuree) Refractive index 1.334
|
It has already been explained in this chapter that maximum refraction occurs from the anterior surface of the cornea (at the air-tear interface) because the difference between refractive index of two medium is maximum at this site. The air has a refractive index of 1.00 and cornea has refractive index 1.376, the difference is 0.376 (maximum).
The cornea is not completely circular: Anterior surface (most important surface) is elliptical, while the posterior surface is circular.
The vertical meridian of the cornea is 0.05 D steeper than the horizontal meridian, resulting in astigmatism with the rule.
Refractive power of the cornea is 43-44 D.
| 3
|
ab
|
bc
|
abc
|
bcd
|
Ophthalmology
| null |
d698059f-551e-4984-a760-419061c33ba0
|
multi
|
Following is/ are the clinical feature/ s of lepromatous leprosy -
|
Ans. is 'd' i.e., All the above Important clinical features oflepromatous leprosyo Diffuse erythema, tingling, nasal stuffiness or ep is tax is are earliest manifestations.o Nodules with predeliction for external ears,o Madarosis (loss of eye lashes and eye brow s),o Saddle nose (Collapse of nasal bridge) and perforation of palate.o Testicular involvement results in loss of testicular sensation, loss of libido, impotence & gynaecomastia.o Leonine face (Diffuse dermal infiltration of face).o Symmetrical thickening of peripheral nerve.?o Trophic uicer/neuropathic ulcer/Perforating ulcer develop frequently in lepromatous leprosy because sensory impairment appears before motor weakness and the patient continues to misuse his hands and feet,o Systemic involvementLymphadenopathy, Hepatomegaly, ocular involvement.
| 4
|
Leonine facies
|
Loss of libido and impotence
|
Saddle nose
|
All the above
|
Skin
|
C. Mycobacteria
|
15446fe5-2559-40c2-8fa1-66656fa0991b
|
multi
|
Causes of macrocephaly includes?
|
Causes of Megalencephaly Lysosomal storage diseases: Gangliosidosis, MPS Carbohydrate disorder: Galactosemia Aminoacidurias: Maple Syrup urine disease, Glutaric aciduria type-1 Neurogenerative diseases: Alexander disease, Canavan disease, Metachromatic leukodystrophy Neurocutaneous diseases: Neurofibromatosis, Tuberous sclerosis, Soto's syndrome, Achondroplasia Benign familial Megalencephaly Weaver syndrome: A condition that involves tall stature with or without macrocephaly, a variable degree of intellectual disability & characteristic facial features. Ref: Nelson's edition, 6th edition, page 370.
| 4
|
Galactosemia
|
Weaver syndrome
|
Soto's syndrome
|
All of the above
|
Anatomy
|
General anatomy
|
830eab55-09c4-49dc-9d9e-a48aef8c355e
|
multi
|
The maximum dose of isotretinoin should not exceed
|
Oral isotretinoin duration of treatment varies according to dose but post-therapy relapse is minimized by treatment courses that amount to the total of 120-150 mg/kg Ref Harrison 20th edition pg 1233
| 4
|
30-60mg/kg
|
60-90 mg/kg
|
90-120 mg/kg
|
120-150 mg/kg
|
Dental
|
All India exam
|
cb346e41-7afd-4e14-8a96-779b317a8a5b
|
single
|
Which of the following is feature of reticulocyte?
|
Reticulocytes are non-nucleated spherical cells bigger than normal RBCs and are polychromatic (having a blue color) d/t the presence of free ribosomes & RNA. They are identified with supravital staining. Best stain to identify them is new methylene blue.
| 2
|
Constitute 10% of the red cells
|
No nucleus
|
Smaller in the size than RBCs
|
Mature in lymph nodes
|
Pathology
|
Hematopoeisis: Basic concepts
|
45e01978-7c85-4024-83b1-fb325916e855
|
multi
|
Nanotechnology has found tremendous application in the diagnosis of cancers because of all of following advantages, except
|
Ans'd. Nanocrystals exhibit a narrow difference between their excitation and emission peak spectra
| 4
|
Nanocrystals exibit bright, photostable fluorescence
|
Nonocrystals have a narrow spectrum wavelength
|
Peak spectrum wavelength is tunable
|
Nanocrystals exhibit a narrow difference between their excitation and emission peak spectra
|
Pathology
| null |
d3bd91f7-e48a-4873-9e26-75dc562869c8
|
multi
|
Complications of sphenoid sinus surgery are all except:
|
(d) Orbital emphysema(Ref. Cummings, 6th ed., 778)Orbital complications will follow maxillary, ethmoid and frontal sinus surgeries due to close proximity.
| 4
|
CSF leak
|
Optic nerve injury
|
Lateral rectus palsy
|
Orbital emphysema
|
ENT
|
Nose and PNS
|
24c618da-ec9c-48b1-b8c6-68052496a293
|
multi
|
Erosive ahritis is seen in all, except
|
Ref Semantischolar.org
| 1
|
SLE
|
Gout
|
Osteoahritis
|
Old age
|
Medicine
|
Immune system
|
806d1d4d-a49d-470f-a731-babad4a4d583
|
multi
|
A 9 1/2 -year-old girl presents to your office with an approximately 1 1/4 -cm nodule in her neck, just to the left of the midline and below her cricoid cartilage. It is nontender and moves when she swallows. It has been enlarging over the last several months and was not seen by the pediatrician at her 9-year-old check-up. There is no family history of endocrine disorders. The most likely diagnosis is
|
While reactive lymphadenopathy is by far the most common cause of neck masses in children; a lymph node should not move with deglutition and is more likely to be tender. A branchial cleft syst should be more lateral and the thyroglossal duct cyst should be higher and in the midline (although they can sometimes present off the midline). One might also have expected some prior evidence of both of these congenital cysts, although that is not always the case. The location and characteristics strongly suggest a thyroid nodule. While follicular adenomas are much more common in adults than cancers they are rarer in children and a rapidly growing solitary nodule is likely to be a papillary carcinoma, the most common thyroid cancer in children.
| 2
|
Reactive viral lymphadenopathy
|
Papillary thyroid cancer
|
A brachial cleft cyst
|
A follicular adenoma of the thyroid
|
Surgery
|
Plastic & Reconstructive Surgery
|
b7074fe0-aa45-4419-b2cf-e6449f94eb39
|
multi
|
Site of transplantation in Islet cell transplant for Diabetes mellitus is
|
The islets are then purified from the dispersed tissue by density-gradient centrifugation and can be delivered into the recepient liver (the preferred site for transplantation) by injection into the poal vein Ref: Bailey and love 27th edition Pgno :1552
| 2
|
Skin
|
Injected into the poal vein
|
Liver
|
Pelvis
|
Anatomy
|
General anatomy
|
91ec5518-373b-4a7e-9246-d7a72ba7640c
|
single
|
A young pt presents with jaundice. Total bilirubin is 21, direct is 9.6, alkphosis 84 KA units. Diagnosis is:
|
Answer is D (Obstructive jaundice): Direct bilirubinemia (conjugated birirubin > 15% of total bilirubin) along with high serum alkaline phosphatase (6-7 times normal) suggests the diagnosis of obstructive jaundice. AffirghnfeAre Total bilirubin (mg/di) 0.3 to 1.0 21.0 Direct bilirubin is 45% of total bilirubin Conjugated bilirubin (mg/d1) 0.1 to 0.3 9.6 Direct bilirubinemia Alkaline phosphatase 3-13 KAV 84 KA Alkaline phosphatase is raised by atleast six times:Significant rise Rise in conjugated bilirubin level may be seen Wth both, hepatocellular disease (Viral/ infective Hepatitis) and Obstructive jaundice hut association with significantly elevated ALP limits our diagnosis to obstructive damage. Rise in alkaline phosphatase levels Patient with parenchymal disease of liver i.e. hepatocellular disorders : may show increase in alkaline phosphatase levels but the increase is only slight to moderate and usually not more than two times normal Obstructive lesion: Striking increase in alkaline phosphatase is more suggestive of an obstructive lesion In the given question rise in alkaline phosphatase is about 6 to 7 times normal and thus is more in our of an obstructive cause.
| 4
|
Hemolytic jaundice
|
Viral hepatitis
|
Chronic active hepatitis
|
Obstructive jaundice
|
Medicine
| null |
77586db1-ffb6-446d-aff1-796d79223559
|
single
|
A 20 year old man presents with swelling of left lower limb and hydrocoele. All of the following may be the causative agent EXCEPT:
|
Ans. (d) Onchocerca volvulusRef: Diagnostic medical parasitology 3rd/275, Park 19th /221* Onchocerca volvulus results in river blindness and subcutaneous nodules.* "Lymphatic filariasis" covers infection with three closely related nematode worms - W.Bancrofti, B. Malayi and B. timoria.* All three infections are transmitted to man by the bites of infective mosquitoes.* All three parasites have basically similar life cycles in man- adult worms living in lymphatic vessels whilst their offspring, the microfilariae circulate in peripheral bloodand are available to infect mosquito vectors when they come to feed.Also Know* Diethylcarbamazine (DEC) is the drug of choice for filariasis.* Ivermectin is the drug of choice for Onchocerca volvulus
| 4
|
Brugia malayi
|
Brugia timoria
|
Wuchereria bancrofti
|
Onchocerca volvulus
|
Microbiology
|
Mycology
|
7ef8af5c-38ee-4a77-9663-1be485a9aeaa
|
multi
|
Very high intraocular pressure, veically oval mid-dilated pupil and shallow anterior chamber is seen in:
|
Ans. B: Acute primary angle closure glaucoma
| 2
|
Primary open angle glaucoma
|
Acute primary angle closure glaucoma
|
Malignant glaucoma
|
Pupillary block glaucoma
|
Ophthalmology
| null |
ab157e1b-f77c-4c77-904f-c05e20321dad
|
multi
|
Which of the following vaccines can be used in pregnancy in normal circumstances?
|
Pregnancy is not a contraindication or precaution for Influenza trivalent vaccine. This vaccine is recommended for women who will be pregnant during influenza season. Influenza live attenuated vaccine is contra indicated. Must Know - Principle: Live-virus vaccines are contraindicated during pregnancy because of the possibility that vaccine virus replication will cause congenital infection or have other adverse effects on the foetus. MMR (measles, mumps and rubella virus vaccine) is contraindicated in pregnancy. It is a live attenuated vaccine. It is also contraindicated in gelatine or neomycin hypersensitivity and known severe immunodeficiency. Varicella vaccine is contraindicated in pregnancy. It is a live attenuated vaccine. It is also contraindicated in gelatine or neomycin hypersensitivity and known severe immunodeficiency. Hepatitis A is not contraindicated, but is has to be use with caution in pregnancy. Ref: Schuchat A., Jackson L.A. (2012). Chapter 122. Immunization Principles and Vaccine Use. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.
| 3
|
MMR vaccine
|
Varicella vaccine
|
Influenza trivalent vaccine
|
Hepatitis A vaccine
|
Social & Preventive Medicine
| null |
56a69b5d-6782-4fd2-81a4-bba439c8fcd6
|
single
|
True statement about listeria:
|
Ans. is. 'b' i. e., Motile by peritrichous flagella
| 2
|
Gram negative bacillus
|
Motile by peritrichous flagella
|
Commonest cause of community acquired meningitis
|
Only one serovar is known
|
Microbiology
| null |
5729d11a-d2a9-4340-b3d5-b16a80b99610
|
multi
|
Acute graft rejection occurs within?
|
Hyperacute rejection: type 2 HSR, happens over span of few minutes to hours. Eg: kidney transplant Acute rejection: Few weeks to months(< 6 months) Chronic rejection: After 6 months. Graft vs host disease (Runt Disease): Acute GVH: < 100 days Chronic GVH: > 100 days
| 3
|
Few minutes
|
Few hours
|
< 6 months
|
6-12 months
|
Pathology
|
FMGE 2019
|
4d31c7e1-c3c6-40a4-8b36-0bbbc598757c
|
single
|
The protein that carries iron from the gut to the body tissues is called
| null | 4
|
Ferritin
|
Haemosiderin
|
Myoglobin
|
Transferrin
|
Pathology
| null |
c8ae46e5-eb0a-4864-bc20-5179d0891e92
|
multi
|
After an endoscopy a technician kept the instrument for sterilization. Which of the following agent is used for sterilization of fibre optic instruments?
|
Glutaraldehyde, which has two reactive aldehyde groups, is 10 times more effective than formaldehyde and is less toxic. It denatures proteins and nucleic acids. Both proteins and nucleic acids contain essential -NH2 and -OH groups, which are the main sites of alkylation. In hospitals, it is used to sterilize respiratory therapy equipment, endoscopes, and hemodialysis equipment. Ref: Levinson W. (2012). Chapter 13. Sterilization & Disinfection. In W. Levinson (Ed), Review of Medical Microbiology & Immunology, 12e.
| 1
|
Glutaraldehyde
|
Chlorine
|
Autoclave
|
Phenol
|
Microbiology
| null |
d64a63bf-c476-4043-9b1c-05bf5e2628c1
|
single
|
Cytokinee are secreted in sepsis in and systemic inflammatory response syndrome (SIRS) by:
|
ref Harrison 18/e p2223_2225 , Robbins 7/e p202 Cytokines are the peptide mediators or intercellular messangers which regulate immunological, inflammation,reparative host response.they are produced by widely distributed cells like macrophages ,monocytes, lymphocytes, platelets,fibroblast, endothelium,stromal cells etc.. platelets is also the answer
| 1
|
Neutrophils
|
Adrenal
|
Platelets
|
Collecting duct
|
Anatomy
|
General anatomy
|
be10ec1b-8d6e-43a1-9043-7ab77343f3f2
|
single
|
Necrotizing lymphadenitis is seen in:
|
Kikuchi Fujimoto disease Or histiocytic necrotizing lymphadenitis It is Benign and self-limited disorder in young individuals characterized by regional cervical lymphadenopathy with tenderness Accompanied with mild fever and night sweats Diagnosed on the basis of an excisional biopsy of affected lymph nodes which shows fragmentation, necrosis and karyorrhexis, presenting with posterior cervical lymphadenopathy.
| 2
|
Kimura disease
|
Kikuchi Fujimoto disease
|
Hodgkin disease
|
Castelman disease
|
Pathology
|
Auto Immune Disorders Introduction
|
4f35422d-7907-4a4e-a2e3-43484a81dd9c
|
single
|
Enucleation of the eyeball is contraindicated in
|
Endophthalmities is treated by intravitreal injection of antibiotics. If not managed and removal of eye of eye is indicated.we should go for evisceration. This is because the outer coats of the eyeball are not involved and hence we should not remove it. Also it is more convenient to put aificial eye then orbital implant Refer khurana 6/e 307
| 1
|
Endophthalmities
|
Panophthalmities
|
Intraoccular tumours
|
Painful blind eye
|
Ophthalmology
|
Diseases of orbit, Lids and lacrimal apparatus
|
873a4e24-5786-4626-85a8-14e87015b7a5
|
multi
|
Colostrums has in compared to normal milk -
|
Colostrum contains a high concentration of proteins as compared to normal milk.REF.PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE.Editon-21.Page no.-491
| 3
|
Decreased K
|
Decreased Na
|
Increased proteins
|
Increased calories
|
Social & Preventive Medicine
|
obstetrics,pediatrics and geriatrics
|
3ee93576-d484-4bff-9171-c3375cd5428a
|
single
|
The prognosis of rhabdomyosarcoma is likely to be poor if the site of the tumor is ?
|
Ans. is 'c' i.e. Extremity Rhabdomyosarcomas of the extremities have alveolar histology which is associated with aggressive tumor biology. Also know RMS is the most common malignant tumor of the soft tissues in infants and children. MC site is head & neck region Among head & neck, orbit is the most common site.
| 3
|
Orbit
|
Paratesticular
|
Extremity
|
Urinary bladder
|
Surgery
| null |
cef4da9b-e2e4-4f6e-a3f2-7f3b75916ee3
|
single
|
Pipkin classification is used for
|
COMMON FRACTURES CLASSIFICATION FRACTURECLASSIFICATIONOpen fracturesGustilo & Anderson Supracondylar Humerus Galand ( based on displacement )Proximal Humerus Neer ( 4 pa fractures )Distal Radius Frykman , FermandezPelvis Young & Burgess, TileFemoral head Pipkin's classificationFemoral neck ( Pediatric )Delbet classificationFemoral neck ( Adult )Pauwel ( Based on fracture angle )Garden ( Based on displacement )Interochanteric Boyd & Griffin , Evans Femoral shaft Winquist & Hansen ( Based on degree of communition ) Tibial plateau SchatzkerPilon fracture Ruedi -AllgowerAnkle Lauge -Hansen , Danis- Weber Talar neck Hawkin Calcaneum Essex -Lopresti , Sanders ( Based on CT findings )Physeal injuries Salter - Harris Classification (Refer: Mohindra's Fundamentals of Ohopedics, 2nd edition, pg no. 125)
| 3
|
Acetabular fractures
|
Pelvis ring fracture
|
Femoral head fracture
|
Femoral shaft fracture
|
Orthopaedics
|
All India exam
|
13d1a16b-7679-4da4-9ee1-c2cc3a7ce60b
|
single
|
Osteoarthritis does not affect:
|
Ans: d (Metacarpophalangeal joint)Ref: Maheshwari Ortho, 3rd ed, p. 252 & Harrison, 15thed, p. 1990
| 4
|
Knee joint
|
Hip joint
|
Interphalangial joint
|
Metacarpophalangial joint
|
Orthopaedics
|
Arthritis
|
9baf28d2-adec-4f9c-bdef-818da8763755
|
single
|
Most common viral cause of acquired aqueductal stenosis is ?
|
Out of the given options, only mumps and toxoplasma cause aqueductal stenosis. Toxoplasma is not a virus. Hence, the answer is mumps.
| 2
|
Rubella
|
Mumps
|
Toxoplasma
|
Enterovirus
|
Pediatrics
| null |
69138b67-5fda-4a5b-947e-95923bbc535f
|
single
|
Pulsatile GnRH is used for managing:
|
Ans. is d, i.e. Anovulatory infertilityPulsatile GnRH is used for:* Ovulation induction (in managing anovulatory infertility)* Delayed, puberty
| 4
|
Precocious puberty
|
Fibroid
|
DUB
|
Anovulatory infertility
|
Gynaecology & Obstetrics
|
Physiology & Histology
|
507a0ca8-f93b-4cbe-b970-efb650197231
|
single
|
The regional aerial resistance of the mesentery and kidney vessels is reduced by
|
In hyperdynamic sepsis, the peripheral aeriolar tone and BP are low but the cardiac output is often high; therefore the vasoconstrictor noradrenaline (norepinephrine) is appropriate to restore BP, usually at the price of some reduction in cardiac output.In most cases, a vasoconstrictor such as noradrenaline (norepinephrine) is necessary to increase SVR and BP, while an inotrope (dobutamine) may be necessary to maintain cardiac output. In the later stages of severe sepsis, the essential problem is at the microcirculatory level. Oxygen uptake and utilisation are impaired due to failure of the regional distribution of flow and direct cellular toxicity despite adequate global oxygen delivery. Tissue oxygenation may be improved and aerobic metabolism sustained by reducing demand, i.e. metabolic rate. ref:Davidsson&;s principles and practices of medicine,ed 21,pg no 598
| 3
|
Dopamine
|
Dobutamine
|
Nor adrenaline
|
Isoprenaline
|
Medicine
|
C.V.S
|
32dd536f-b070-4428-af6e-b5925aaa9de6
|
single
|
All true about pisiform, except Manipal 11
|
Ans. Can be seen on newborn X-ray
| 3
|
Last carpal bone to ossify
|
Attached to flexor carpi ulnaris
|
Can be seen on newborn X-ray
|
It is a sesamoid bone
|
Forensic Medicine
| null |
ae63bedc-1ec2-4370-af64-0bf943a003a7
|
multi
|
Which of the following is an indication for using mifepristone?
|
Mifepristone, also known as RU486, is an antiprogestin that has been used for treatment of leiomyomas. Mifepristone diminishes leiomyoma volume by approximately half and it is effective in improving symptoms. Other uses of mifepristone: For termination of early pregnancy For emergency postcoital contraception Endometriosis Cushing's syndrome Breast cancer Other neoplasms such as meningiomas that contain glucocoicoid or progesterone receptors Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 9. Pelvic Mass. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e.
| 2
|
Ectopic pregnancy
|
Fibroid uterus
|
Molar pregnancy
|
Habitual aboion
|
Gynaecology & Obstetrics
| null |
0e7bbb2e-7820-4b9f-bf7c-4445a12a3292
|
single
|
After passing his physical exam, a 19 year old army recruit gives urine and blood samples for fuher testing. Serum analysis yields elevated ALT, HBsAg, Anti-HBc, HBeAg, and bilirubin. All other values are normal. Which of the following is the hepatitis B status of this recruit?
|
The presence of elevated ALT, HBsAg, anti-HBc, HBeAg, and bilirubin all point to active hepatitis B. An asymptomatic carrier does not have elevated ALT and bilirubin. The absence of findings on physical examination rules out fulminant hepatitis B. Recovery from acute self-limited HBV is associated with the presence of anti-HBs and the decrease in HBsAg and HBeAg. Ref: Ray C.G., Ryan K.J. (2010). Chapter 13. Hepatitis Viruses. In C.G. Ray, K.J. Ryan (Eds), Sherris Medical Microbiology, 5e.
| 2
|
Asymptomatic carrier
|
Chronic active carrier
|
Fulminant hepatitis B
|
Recovered from acute self-limited HBV
|
Microbiology
| null |
4a005936-2b64-4b7e-b523-f868f4ec1efb
|
multi
|
Which of the following organs does not show pale infarct?
|
Pale infarcts are typically seen in hea, kidney and spleen. Red infarcts principally occur in organs with dual blood supply such as lungs, or in those organs with extensive collateral circulation such as brain and small intestine. In both types of infarcts, infarcted area shows coagulative necrosis, but in red infarct there is bleeding into the necrotic area from adjacent aeries and veins. Reference: Essentials of Rubin's Pathology edited by Emanuel Rubin, 5th edition page 123.
| 1
|
Lung
|
Hea
|
Kidney
|
Spleen
|
Pathology
| null |
c8398700-b266-44dd-a502-1460e95711c3
|
single
|
Mitochondrial chromosomal abnormality leads to
|
Ref Robbins 8/e p171;9/e p172 Example of mitochondrial inheritance is leber's hereditary optic neuropathy.leigh's disease ,MELAS - Mitochondrial encephalopathy Lactic acid Stroke like syndrome Neuropathy , ataxia, retinitis, Kearns Sayre syndromes, chronic progressive external opthalmoplegia,Pearson syndrome M
| 1
|
Leber's hereditary optic neuropathy
|
Angelman syndrome
|
Prader villi syndrome
|
Myotonic dystrophy
|
Anatomy
|
General anatomy
|
b48da862-312f-4ae1-ba72-346d5c4c2e96
|
single
|
Gestational sac is seen by TVS at-
|
Ans. is 'a' i.e., 5 weeks [Ref: Dutta's Obs 7th/ep. 68}TVS showso Gestational sac & yolk sac - 5th weeko Fetal pole & cardiac activity - 6th weeko Embryonic movements - 7th weeko Fetal gestational age is best determined by CRL between 7th to 12th weeks (variation +/- 5 days)o Doppler effect of ultrasound can pick up heart rate by 10lh week.
| 1
|
5 weeks
|
6 weeks
|
7 weeks
|
8 weeks
|
Gynaecology & Obstetrics
|
Diagnosis of Pregnancy
|
0a3d446a-b19d-464f-b943-07d247aa5046
|
single
|
Mechanism of action of transexaminic acid is?
|
Ans. is 'd' i.e., Prevents fibrinolysis o Tranexamic acid binds to the lysine binding sites on plasminogen and prevents its combination with fibrin and thus prevents fibrinolysis.
| 4
|
Decrease vascular permeability
|
Smooth muscle contraction
|
Activates Plasmin formation
|
Prevents fibrinolysis
|
Pharmacology
| null |
24529115-b874-4602-bac8-c556ae3de80c
|
single
|
Rotator interval is between:
|
(c) Supraspinatus and subscapularis- Rotator interval is a triangular portion of shoulder capsule which lies between supraspinatus and subscapularis tendon and coracohumeral ligament passes through it.
| 3
|
Supraspinatus and teres minor
|
Teres major and teres minor
|
Supraspinatus and subscapularis
|
Subscapularis and infraspinatus
|
Orthopaedics
|
Injuries Around Shoulder
|
74e740a7-f4e9-4b75-a190-3dc560b2f498
|
single
|
Which of the following drug is used as a Transcranial patch for Parkinson's disease
|
Rotigotine is a non-ergot dopamine agonist indicated for the treatment of Parkinson's disease (PD) and restless legs syndrome (RLS). It is formulated as a once-daily transdermal patch which provides a slow and constant supply of the drug over the course of 24 hours. However, it was withdrawn in 2008 because of crystal formation on the patches, affecting the bioavailability and efficacy of this drug.
| 2
|
Levodopa
|
Rotigotine
|
Selegiline
|
Carbidopa
|
Pharmacology
| null |
23a04e1e-6ac1-4851-b0e0-2bc31c2f5840
|
single
|
The treatment of Acute Manic Episodes is
|
Lithium
| 2
|
ECT
|
ECT
|
Diazepam
|
Sodium valproate
|
Psychiatry
| null |
0d0d6c5f-a781-487b-801f-2ab4357e74cc
|
single
|
In cochlear implants electrodes are most commonly placed at -
| null | 2
|
Oval window
|
Round window
|
Horizontal semicircular canal
|
Cochlea
|
ENT
| null |
574099a3-70bd-4d39-b57c-4d761a8e9555
|
single
|
Hypersensitivity vasculitis is most commonly seen in:
|
. Post capillary venules
| 1
|
Post capillary venules
|
Aerioles
|
Veins
|
Capillaries
|
Pathology
| null |
2d58192a-ba7a-41ca-a7de-fbf3b8044d0d
|
single
|
Hill Sach&;s lesion is most commonly seen in
|
HILL-SACH&;S lesion is most commonly seen in recurent shoulder dislocation. It is a posterolateral defect in the head of the humerus.This is produced due to the impact of posterolateral pa of the head of the humerus against the sharp anteraior margion of the glenoid rim. ref:textbook of ohopedics ,john ebnezar,4th edition page no:136
| 1
|
Recurrent shoulder dislocation
|
Posterior shoulder dislocation
|
Fracture neck of humerus
|
Anterior shoulder dislocation
|
Orthopaedics
|
Shoulder and arm injuries
|
29b6eb2c-71dd-4388-bddb-a19f3218a540
|
single
|
Natural killer cell is -
|
Ans. is 'c' i.e., Null cells Null cells (Large granular lymphocytes or LGLIo Null cells are called so because they lack features of surface markers of both B and T lymphocytes. The account for 5 to 10% of peripheral blood lymphocytes.o They are also called "large granular lymphocytes (LGL)"as they contain large azurophilic cytoplasmic granules. They express CD 16 and CD56 markers. They proliferate in response to IL-2.o LGLs arise in both bone marrow and thymic microenvironment. In contrast to T-cells, they are not MHC restricted.o Various types of LGLs are:-1) Antibody dependent cytotoxic cells (ADCC)# These cells kill/lyse target cells which are sensitized with IgG.2) Natural killer cells (NK cells)# These cells possess cytotoxic activity against virus infected cells, tumor cells and transplanted foreign cells.# Cytotoxicity of NK cells is neither antibody dependent nor MHC restricted. Activity is nonimmune as it does not require antigenic stimulation.# NK-cells are positive for CD16 and CD56.# NK cells are usually negative for CD3, but a subset is positive for CD3 called NK/T-cells.# IL-2 acts as a growth factor for NK cells. NK cells activity is augmented by interferon. NK cells secrete peroforin (resembles comlement C9) which causes transmembrane pores through which cytotoxic factors (e.g. TNF-b) enters the cells and induce apoptosis.o Virus infected cells and tumor (cancer) cells are killed by NK cells and cytotoxic T-cells.3) Lymphokine activated killer (LAK) cells# These are NK cells which are activated by IL-2. These cells kill tumor cells more efficiently than unstimulated NK cells.
| 3
|
MHC restricted
|
Antibody dependent
|
Null cells
|
B-lymphocytes
|
Microbiology
|
Immunology
|
455bd18a-8840-415f-b6ba-cdf2dc55df5d
|
single
|
Radionucleide of choice for the assessment of renal function?
|
Ans: b (DTPA) Ref: Bailey, 24th ed, p. 129999Tc DTPA (diethyl triamino penta acetic acid)Useful to assess the functional status of kidney.DTPA behaves like inulin: completely filtered by the glomeruli, and not absorbed by the tubules. On using a gamma camera the dynamic action of kidney can be assessed.Other substances used are -M AG3, DMSA, and hippuran.Radionuclide scans and their uses. * DTPA - dynamic function of kidney.* Tc labeled RBC- splenic diseases* DMSA -cortical function* PET scan-functional brain imaging* Orthohippurate - renal plasma flow.* Tc pyrophosphate-acute MI, hot spots.* 99Tc HID A scan - acute cholecystitis* 99Tc MDP-bone imaging* Selenium+I131 - thyroid* Gallium tumours* Tc-thallium substraction scan-parathyroid* Xenon gas-ventilation-perfusion scan* Selenium - pancreas* 99Tc arcitumumab-colorectal cancer.* I131 I132. -Placenta* MUGA scan-ventriculography.
| 2
|
MIBG
|
DTPA
|
Thallium
|
Sulphur
|
Radiology
|
Genito Urinary System
|
08fbcc61-7de1-4806-9153-048032b3489e
|
multi
|
Best drug for chemoprophylaxis in a pregnant woman who is traveling to chloroquine resistant falciparum malaria endemic zone?
|
Ans. A. Mefloquine. (Ref. H-17th/pg 1292; Table 203-6)Best drug for chemoprophylaxis in a pregnant woman who is traveling to chloroquine resistant falciparum malaria endemic zone is Mefloquine.Regimens for the Rx of MalariaType of Disease or RxRegimen(s)Uncomplicated Malaria Known chloroquine- sensitive strains of Plasmodium vivax, P. malariae, P. ovale, P. falciparumChloroquine (10 mg of base/kg stat followed by 5 mg/kg at 12, 24, and 36 h or by 10 mg/kg at 24 h and 5 mg/kg at 48 h) or Amodiaquine (10-12 mg of base/kg qd for 3 days)Radical Rx for P. vivax or P. ovale infectionIn addition to chloroquine or amodiaquine as detailed above, primaquine (0.25 mg of base/ kg qd; 0.375-0.5 mg of base/kg qd in Southeast Asia and Oceania) should be given for 14 days to prevent relapse. In mild G6PD deficiency, 0.75 mg of base/kg should be given once weekly for 6 weeks. Primaquine should not be given in severe G6PD deficiency.Sensitive P. falciparum malariaArtesunate (4 mg/kg qd for 3 days) plus sulfadoxine (25 mg/kg)/pyrimethamine (1.25 mg/kg) as a single dose or Artesunatec (4 mg/kg qd for 3 days) plus amodiaquine (10 mg of base/kg qd for 3 days).Multidrug-resistant P. falciparum malariaEither artemether-lumefantrinec (1.5/9 mg/kg bid for 3 days with food) or artesunatec (4 mg/kg qd for 3 days) plus Mefloquine (25 mg of base/kg-either 8 mg/kg qd for 3 days or 15 mg/kg on day 2 and then 10 mg/kg on day 3).Second-line Rx/Rx of imported malariaEither artesunatec (2 mg/kg qd for 7 days) or quinine (10 mg of salt/kg tid for 7 days) plus 1 of the following 3: 1. Tetracycline (4 mg/kg qid for 7 days);2. Doxycycline (3 mg/kg qd for 7 days)3. Clindamycin (10 mg/kg bid for 7 days) or Atovaquone-proguanil (20/8 mg/kg qd for 3 days with food).Severe Falciparum Malaria7Artesunate (2.4 mg/kg stat IV followed by 2.4 mg/kg at 12 and 24 h and then daily if necessary) or Artemetherc (3.2 mg/kg stat IM followed by 1.6 mg/kg qd) or Quinine dihydrochioride (20 mg of salt/kg/7 infused over 4 h, followed by 10 mg of salt/kg infused over 2-8 h q8h/) or Quinidine (10 mg of base/kgh infused over 1-2 h, followed by 1.2 mg of base/kg per hour with electrocardiographic monitoring).
| 1
|
Mefloquine
|
Doxycycline
|
Ataquinone/Proguanil
|
Primaquine
|
Medicine
|
Infection
|
2e7b6669-a00d-46ed-b865-4cd2dad058fe
|
multi
|
Most common nerve injured in ligation of superior thyroid aery:
|
The external laryngeal nerve lies in relation to superior thyroid aery. The recurrent laryngeal nerve lies close to inferior thyroid aery.
| 4
|
Recurrent laryngeal nerve
|
Facial nerve
|
Mandibular nerve
|
External laryngeal nerve
|
ENT
| null |
faa5126d-1049-4f06-bf2a-ac2aae7f959f
|
single
|
Antiphospholipid syndrome ( APS) is associated with all of the following except:
|
Indications for APLA testing 3 or more consecutive first trimester losses Unexplained IUGR Early onset severe preeclampsia Unexplained thrombosis Autoimmune connective tissue diseases like SLE False positive serological test for syphilis (refer pgno:333 sheila 2nd edition)
| 1
|
pancytopenia
|
Recurrent aboions
|
Venous thrombosis
|
pulmonary hypeension
|
Gynaecology & Obstetrics
|
General obstetrics
|
f4e8f8a7-6e0b-497c-928e-aa93477d1b11
|
multi
|
Duret hemorrhage seen in -
|
Ans. is 'a' i.e., Brain o Duret - Bernard hemorrhage can be seen with severe compression of the midbrain and other brainstem areas during transtentorial herniation.
| 1
|
Brain
|
Kidney
|
Heart
|
Lung
|
Medicine
|
C.N.S.
|
d7fc3477-6c0e-4054-86e6-5a6532dc949a
|
single
|
Which of the following is/are features of dishpan digit?
|
Dishpan digit
Finger of the child who indulges in sucking habit. On examination, it will provide valuable information about the habits. They are:
Reddened.
Exceptionally clean thumb / nail / finger.
Fibrous rough callus.
| 4
|
Reddened finger
|
Exceptionally clean thumb
|
Fibrous rough callus
|
All of the above
|
Dental
| null |
a4e65b7c-0b67-4c72-801b-f37b57bc365a
|
multi
|
Age limit for HDI?
|
According to previous editions of Park (21st/e) the minimum and maximum established values for life expectancy atbirth was 25 years and 85 years, respectively.
However, Now the minimum established value is 20 years and maximum value is the highest observed value during time series, i.e. the country which has the highest value is taken as reference for maximum value. For example themaximum life expectancy is observed in Japan (83.4 in 2011). Thus 83.4 years is taken as
upper (maximum limit).
That means minimum value is established at 20 years and maximum value is established at 83.4 years.
Human development index (HDI)
o HDI is a composite index combining indicators representing three dimensions –
(i). Longevity (life expectancy at birth)
(ii). Knowledge (Adult literacy rate and mean years ofschooling, i.e. Gross enrolement ratio)
(iii). Income (real GDP per capita in purchasing power parity in US dollars)
The HDI is an index used to rank countries by level of human development.
o According to HDI countries are divided -
(i). Developed countries (High HDI → ≥0.8) →USA, Canada, Norway
(ii). Developing countries (medium HDI → 0.5-0.79)→India
(iii). Underdeveloped countries (Low HDI → ≤0.5)→Seiera, Ethopia
Following information has been added in 22nd/e of Park
Components of human development index have changed. Now it includes expected years of schooling (insteadof adult literacy rate) and GNI per capita (instead of GDP per capita).
| 1
|
25 to 85 yrs
|
25 to 50 yrs
|
15 to 45 yrs
|
50 to 75 yrs
|
Unknown
| null |
60137255-30ef-4f50-ae6c-8adbef9ddf67
|
single
|
35-year-old woman presents to OPD with complains of headache after hitting her head accidentally with the wall while doing household chores . An MRI was ordered which confirmed presence of blood clot in the great cerebral vein of Galen. Obstructed vein is a direct tributary of which of the following venous structures?
|
Veins of the brain are direct tributaries of dural venous sinuses. Emissary veins connect dural venous sinuses with the veins of scalp; Pterygoid venous plexus communicates with cavernous sinus through an emissary vein; Diploic veins lie in channels in the diploe of skull and communicate with dural sinuses, veins of scalp, and meningeal veins.
| 4
|
Emissary veins
|
Pterygoid venous plexus
|
Diploic veins
|
Dural venous sinuses
|
Anatomy
|
Brainstem lesions and blood supply of CNS
|
bcceb61d-71c9-4fe4-98bc-83f4ef1bad78
|
multi
|
Cystocoele is prolapse of
|
Cystocoele is prolapse of the anterior 2/3rd vaginal wall while prolapse of lower 1/3rd of the anterior vaginal wall is called as urethrocele. The anterior wall prolapse or cystocele is the most common form of female pelvic organ prolapse Rectocele is prolapse of lower 2/3rd of the posterior vaginal wall Enterocoele is a bulge in the upper 1/3rd of the posterior vaginal wall. Cystocoele is a central defect and it shows the absence of rugae while lateral vaginal sulci are present The surgery of cystocele is anterior colporrhaphy and pubocervical fascia is repaired
| 1
|
Upper 2/3rd of anterior vaginal wall
|
Lower 2/3rd of anterior vaginal wall
|
Upper 1/3 of anterior vaginal wall
|
Lower 1/3 of anterior vaginal wall
|
Microbiology
|
All India exam
|
21e8bc04-fb23-45b1-b232-38e3a05943fd
|
multi
|
All of the following drugs cause discolouration of urine EXCEPT :
| null | 2
|
Nitrofurantoin
|
Digoxin
|
Azo dyes
|
Rifampicin
|
Pharmacology
| null |
b2b5499b-f29d-4854-ba85-2c56496f021a
|
multi
|
All are true about bulbar urethral rupture, except:
|
Ans. (b) Floating prostate on per rectal examination* Floating prostate is seen in membranous urethral injury* Perineal hematoma seen in Bulbar urethral injury.* Deep Perineal pouch hematoma is seen in Membranous urethral injury.
| 2
|
Perineal hematoma
|
Floating prostate on per rectal examination
|
Collection of urine in perineum
|
Bleeding per urethra
|
Surgery
|
Urethra & Penis
|
71436754-35e2-4c6e-bb25-ca3b6ba8b9c4
|
multi
|
Which of the following is mechanism of action of dapsone?
|
Dapsone is analogue of PABA Competively inhibits dihyropteroate synthase - decreases folic acid synthesis. It can cause mild hemolysis, anemia and psychosis. Uses: Leprosy Malaria Prophylaxis of pneumocystitis Dermatitis herpetiformis
| 4
|
Inhibit the cell wall synthesis
|
Inhibit the sterol of cell wall
|
Inhibit the protein synthesis
|
Compete with PABA in folic acid synthesis
|
Pharmacology
|
Mycobacterial Diseases (TB, Leprosy and MAC)
|
1d004cf3-7beb-498e-a4b9-635a2882edd3
|
multi
|
In a 4-year old boy who has history of pyogenic infections by bacteria with polysaccharide-rich capsules, which of the following investigations should he done?
|
Ans. d. IgA and IgG2 deficiency Recurrent episodes of pyogenic infections by capsulated organisms are most commonly observed in patients with selective IgA deficiency and decreased IgA or IgG subclass levels (especially IgG2). "Specific Antibody Deficiency (SAD) patients generally present with recurrent upper and/or lower respiratory infections due to an encapsulated organisms (Streptococcus pneumonia, Haemophilus influenza, Branhamella catarrhalis, or Staphylococcus aureus). Frequent, recurrent episodes of otitis media are most commonly observed in patients with selective IgA deficiency and decreased IgA or IgG subclass levels (especially IgG2)." Specific Antibody Deficiency (SAD) Antibody deficiency against microbial polysaccharide antigens is a well-established clinical entity and has been referred to as either antigen specific antibody deficiency (ASAD) or specific antibody deficiency (SAD)Q Frequent, recurrent episodes of otitis media are most commonly observed in patients with selective IgA deficiency and decreased IgA or IgG subclass levels (especially IgG2) Q. Frequent nfections were repoed in 92% of patients with SAD (sinusitis, 77%; pneumonia, 42%; otitis media,25%; bronchitis, 28%).
| 4
|
IgA deficiency
|
IgG 1 deficiency
|
IgG2 deficiency
|
IgA and IgG2 deficiency
|
Microbiology
| null |
1085c041-d2db-41fc-ab3f-5ce4daaf78b1
|
single
|
Hurthle cell tumour is:
|
HURTHLE CELL CARCINOMA:
Hurthle cell carcinomas account for approximately 3% of all thyroid malignancies.
Considered to be a subtype of follicular thyroid cancer.
| 2
|
Papillary carcinoma thyroid
|
Follicular carcinoma thyroid
|
Medullary carcinoma
|
None of the above
|
Surgery
| null |
b8b6cd0f-0730-4f26-a57a-8384d20d8bf4
|
multi
|
Rhinophyma is associated with-
|
Rhinophyma is a slow-growing benign tumor due to hypertrophy of sebaceous gland.
| 1
|
Hypertrophy of the sebaceous glands
|
Hypertrophy of sweat glands
|
Hyperplasia of endothelial cells
|
Hyperplasia of epithelial cells
|
ENT
| null |
c4cd0bcf-69dc-4a56-a44a-46ccf0ad0646
|
single
|
Amphotericin B toxicity can be reduced by?
|
New amphotericin B formulations: In an attempt to improve tolerability of i.v. infusion of AMB, reduce its toxicity and achieve targeted delivery, 3 new lipid formulations of AMB have been produced. (a) Amphotericin B lipid complex (ABLC): Contains 35% AMB incorporated in ribbon like paicles of dimyristoyl phospholipids. ( b ) Amphotericin B colloidal dispersion (ABCD). Disc shaped paicles containing 50% each of AMB and cholesteryl sulfate are prepared as aqueous dispersion (c) Lpi osomal amphotericin B (small unilamellar vesicles SUV): Consists of 10% AMB incorporated in uniform sized (60-80 nM) unilamellar liposomes made up of lecithin and other biodegradable phospholipids. The special features of these preparations are: * They, except ABCD, produce milder acute reaction (especially liposomal formulation) on i.v. infusion. * They can be used in patients not tolerating infusion oi conventional AMB formulation. * They have lower nephrotoxicity. * They cause minimal anaemia. * The liposomal preparation delivers AMB paicularh* to reticuloendothelial cells in liver and spleen-----especialh valuable for kala azar and in immunocompromised patients ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:758
| 1
|
Incorporating it in liposomal complex
|
Combining with fluconazole
|
Combining with flucytosine
|
Injecting the drug with dextrose
|
Pharmacology
|
Chemotherapy
|
8d028eef-4996-42d1-ab3c-b34ac7f53ec7
|
single
|
Which of the following sonographic finding confirms intra uterine pregnancy
|
Normal gestational sac implants eccentrically in the endometrium.
Anechoic center surrounded by single echogenic rim = intra-decidual sign.
Two concentric rings echogenic surrounding sac = Double decidual sign.
| 4
|
An echogenic rim along one side of decidua.
|
Two concentric echogenic rings surrounding the sac.
|
A sac positioned eccentrically within endometrium.
|
All of the above.
|
Gynaecology & Obstetrics
| null |
43d1e4bf-9bda-4616-986c-d7a21c8df26c
|
multi
|
Founder members of vision 2020 are A/E
|
B i.e. UNICEF
| 2
|
WHO
|
UNICEF
|
ORBIS
|
International Agency for prevention of blindness
|
Ophthalmology
| null |
0d195b51-2758-4be1-8e4e-ff5e73dcbfab
|
single
|
Which of the following is the auto antibody associated with Rheumatoid arthritis -
|
Anti CCP
| 2
|
Anti DLE
|
Anti CCP
|
Antids DNA
|
Antihistone
|
Unknown
| null |
bb3a09e3-baae-4a02-bd18-aed70635a855
|
single
|
In preterm labour which drug has Neuro-protective role?
|
Ans. (a) MgSO4 Ref: Williams Obstetrics 25th Ed; Page No-730* To prevent convulsions; Administer IV MgSO4 and Continue IV MgSO4 for 24 hours after delivery.* Always avoid Nifedipine and b-blockers, because they cause severe maternal complication.Antihypertensive Drug Therapy Issues* Discontinue medications: This may be done in patients with mild-to-moderate HTN caused by the normal decrease in BP that occurs in pregnancy. Pharmacologic treatment in patients with diastolic BP <90mmHg or systolic BP <140mmHg does not improve either maternal or fetal outcome.* Maintain medications: It may be necessary in the case of patients with severe HTN. The drug of choice is methyl-dopa because less teratogenicity. Labetalol may be acceptable as alternatives. b-blocking agents side effects are intrauterine growth retardation (IUGR).* "Never use" medications: Angiotensin-converting enzyme inhibitors are mostly contraindicate in pregnancy, due to it is associated with some side effects; such as fetal hypocalvaria, renal failure, oligohydramnios, and death. Diuretics are contraindicated during pregnancy due to possible adverse fetal effects which are associated with the plasma volume reduction.* BP target range: Decreases of BP to normal valve in pregnancy may jeopardize Uteroplacental blood flow. Maintain diastolic values between 90 and 100mmHg.Management* Conservative outpatient management is appropriate with uncomplicated mild-to-moderate chronic HTN.# Stop drug therapy: Try to discontinuation of antihypertensive agents. Follow guideline outlined.# Serial sonograms and antenatal testing is appropriate after 30 weeks' gestation to monitor for increased risk of IUGR.# For early identification of superimposed preeclampsia; Serial BP and urine protein assessment are needed.# If the cervix is favorable; Induce labor at 39 weeks* Aggressive prompt delivery is indicated for chronic HTN with superimposed preeclampsia at any gestational age.# To prevent convulsions; Administer IV MgSO4 and Continue IV MgSO4 for 24 hours after delivery.# Try to keep diastolic BP between 90 and 100mmHg with IV hydralazine and/or labetalol.# If mother and fetus are stable; Attempt vaginal delivery with IV oxytocin infusion.
| 1
|
MgSO4
|
Nifedipine
|
Ritoridine
|
Isoxsuprine
|
Gynaecology & Obstetrics
|
Pharmacotherapeutic in Obstetrics
|
e3dee44b-eadc-4bc7-8800-27d4ab477dfb
|
single
|
Dosage of Vitamin–A for children between 1–3 years –
| null | 2
|
1250 IU
|
1333 IU
|
1667 IU
|
2333 IU
|
Pediatrics
| null |
5fbf43d1-5be5-4fb3-a7f7-460b8a6ae23c
|
single
|
Accommodation is brought about by:
|
Ans: d (Ciliary body contraction) Ref:Ganong, 22th ed, p. 154Accommodation is brought about by ciliary muscle contractionAccommodationThe process by which the curvature of the lens is increased is called accommodation.Mechanism: At rest the lens is under tension by lens ligaments & lens is pulled into a flattened state.When the gaze is directed towards a nearby object, ciliary muscle contracts. This decreases the distance between the edges of ciliary body & relaxes lens ligaments so that the lens attains a more convex shape. The change is maximum at the anterior surface of the lens (i.e., radius of curvature changes from 10 mm to 6 mm). The curvature of the posterior surface remains almost the same (i.e., 6 mm). This may add as many as 12 D to the refractive power of eye.
| 4
|
Dilation of iris
|
Dilation of pupil
|
Lens zonules made tense
|
Ciliary body contraction
|
Ophthalmology
|
Elementary Optics
|
c8745cac-94bb-4d0c-90aa-756df9973462
|
single
|
A patient with suspected subarachnoid haemorrhage presents with blood isolated in the fouh ventricle on a CT scan. Aneurysmal rupture is likely to have resulted from
|
*Saccular aneurysm at size of >7mm and at top of basilar aery and at origin of posterior communicating aery are at greater risk of rupture . Ref Harrison20th edition pg 2445
| 3
|
Posterior Inferior Cerebellar Aery Aneurysm
|
Anterior Communicating Aery Aneurysm
|
Posterior Communicating Aery Aneurysm
|
Basilar Aery Tip Aneurysm
|
Medicine
|
C.N.S
|
0fe69853-983a-4e6b-931d-d552f7777928
|
single
|
The term 'disease control' employs all of the following except-
|
Ans. is 'd' i.e., Reducing the prevalence of the disease o The term disease control describes, reducing the i) The incidence of disease ii) The duration of disease and consequently the risk of transmission iii) The effects of infection, including its complications iv) Financial burden to the community
| 4
|
Reducing the complications
|
Reducing the risk of fuher transmission
|
Reducing the incidence of disease
|
Reducing the prevalence of the disease
|
Social & Preventive Medicine
| null |
6242ae15-336b-47ca-b879-60c9f30402a2
|
multi
|
In haemoptysis blood usually comes from
| null | 3
|
Bronchial veins
|
Pulmonary veins
|
Bronchial arteries
|
Pulmonary arteries
|
Medicine
| null |
cce222b4-8997-449a-b425-aa2f31e32eb3
|
multi
|
Internationally quarantinable disease are -
|
Ans. is 'd' i.e., All of the above Quarantinable diseases o Diphtheria o Yellow fever o Infectious TB o SARS o Plague o Small pox o Viral hemorrhagic fever Also Know : Quarantine was first applied for plague. Quarantine period for yellow fever is 6 days. Quarantine has been 'replaced by active surveillance'.
| 4
|
Plague
|
Cholera
|
Yellow fever
|
All of the above
|
Social & Preventive Medicine
| null |
eea5b2b7-6b90-4ee5-9f4b-35c6ea77ec6b
|
multi
|
Projections from substantia nigra pars compacta to striatum releases
| null | 2
|
GABA
|
Dopamine
|
Glutamate
|
Aspartate
|
Physiology
| null |
2e32ec5e-de83-43a2-8083-33c825936ad9
|
single
|
Sublingual nitroglycerin for treatment of acutechest pain can cause ?
|
Ans. is 'b' i.e., Headache Due to vasodilatation there may be tachycardia, palpitation, flushing, headache, dizziness and fainting may occur. Adverse effects Due to vasodilatation tachycardia, palpitation, flushing, headache, dizziness and fainting may occur. Rashes are common paicularly with pentaerythritol tetranitrate. Methemoglobinemia. Sildenafil causes dangerous potentiation of nitrate action (cGMP is increased by nitrates and its breakdown by phosphodiesterase is inhibited by sildenafil - marked accumulation of cGMP) - severe hypotension, MI and death may occur the only contraindications of nitrates use are hypotension or simultaneous use of sildenofil.
| 2
|
Hypeension
|
Headache
|
Bradycardia
|
Sexual dysfunction
|
Pharmacology
| null |
e88c22c4-23f1-44e2-9f26-a430eaaf3f4e
|
single
|
Denominator in dependency ratio ?
|
Ans. is 'b' i.e., Age group 15-65 years Dependency ratio The propoion of persons above 65 years of age and children below 15 years of age are considered to be dependent on the economically productive age group (15-64 years). The ratio of combined age group 0-14 years plus 65 years and above to the 15-65 years age group is known as total dependency ratio.
| 2
|
Age group < 15 years
|
Age group 15-65 years
|
Age group > 65 years
|
< 15 years and > 65 yeas
|
Social & Preventive Medicine
| null |
5bbf4eaa-c62a-4031-ba1a-74c8ce49c6fb
|
single
|
Metal ceramic restorations fail usually due to fracture of
the cervical material. This can be avoided if:
| null | 2
|
Occlusal forces are minimal
|
Casting is so designed as to reduce stress on ceramic material
|
Metal is not more than 0.5 mm thick
|
Ceramic is at least 1.5 mm thick
|
Dental
| null |
b4d58c84-55e0-437a-ad51-d5de19dc2fc6
|
multi
|
Skin lesion in meningococcal meningitidis is due to-
| null | 2
|
Exotoxin
|
Endotoxin
|
Allergic reaction
|
Direct vascular Damage
|
Microbiology
| null |
f1f9342d-8187-48a0-8d52-5e6ab7fa87f2
|
multi
|
Hand and foot syndrome is an adverse effect of:
|
Capecitabine and 5-FU can cause hand and foot syndrome. Diarrhea is the most common adverse effect of 5-FU. 5-FU can also cause bone marrow suppression. Drugs commonly implicated are: Capecitabine 5-Fluorouracil Cytarabine Pemetrexed Doxorubicin
| 1
|
5-Fluorouracil
|
Bleomycin
|
Etoposide
|
Actinomycin D
|
Pharmacology
|
Cytotoxic Anticancer Drugs
|
3c64e4ad-8d9c-4fbc-9065-c5d1bed748ed
|
single
|
Which of the following skin conditions is treated with PUVA therapy?
|
PUVA is used to treat extensive psoriasis and psoriasis that has not responded to other therapies. PUVA stands for psoralens plus UVA. Psoralens are used orally followed by exposure of lesions to measured amount of a type of ultraviolet light-UVA. Sho term side effects of PUVA therapy include tanning, pruritus, nausea, headache and dizziness. Long term side effects include cataracts, lentigines, photoaging, squamous cell carcinoma and melanoma. Ref: Step by Step(r) Psoriasis Management By Khanna Neena, page 283. Manual of Dermatologic Therapeutics By Kenneth A. Arndt page 262.
| 1
|
Psoriasis
|
Tinea versicolor
|
Lichen planus
|
Porphyria cutanea tarda
|
Skin
| null |
5bd7c211-d519-4173-a982-1b501e1943a6
|
single
|
Products of complete hydrolysis of cardiolipin are:
|
3 glycerol, 4 fatty acids , 2 phosphates Cardiolipin is a complex phospholipid, which can be antigenic. The structure is glycerol attached to two phosphatidic acids. Each phosphatidic acid contains one glycerol, 2 FA and one phosphate. So in total 3 glycerol, 4 fatty acids, 2 phosphates are present in cardiolipin.
| 1
|
3 glycerol, 4 fatty acids , 2 phosphates
|
3 glycerol, 4 fatty acids , 1 phosphates
|
3 glycerol, 3 fatty acids , 2 phosphates
|
5 glycerol, 4 fatty acids , 2 phosphates
|
Biochemistry
|
Chemistry of Lipids
|
ea3c1658-c844-4fb8-80ac-62973f93f2ed
|
single
|
All of the following are used for monitoring air pollution except
|
Indicator for air pollution Remarks Sulphur dioxide Best Smoke and soiling index Air filtered through white paper and stained is measured under photoelectric meter Grit and dust measurement Deposit gauzes collect grit dust and others solid Coefficient of haze Amount of smoke and other aerosol in the air Air pollution index Arbitrary index for measurement of pollution by one or more pollutants Instruments Used for Air Parameters Instrument Used for Kata thermometer Low air velocity Hygrometer Air humidity Psychrometer Air humidity Anemometer Air velocity Wind vanes Air direction
| 4
|
SO2
|
Soiling index
|
Coefficient of haze
|
E. coli
|
Social & Preventive Medicine
|
Environment
|
101ffce9-309d-44b3-9728-cc577aa81302
|
multi
|
A newborn with respiratory distress was noted to have marked nasal flaring, audible grunting, minimal intercostal chest retarction. The respiratory rate was 30/min. The Silverman score of this child would be? NOT RELATED- MEDICINE
|
.
| 4
|
1
|
2
|
3
|
6
|
Pharmacology
|
All India exam
|
1201e6c5-5070-45c8-b141-3c3f0c2754d1
|
single
|
The symptoms of Hyperparathyroidism include ?
|
Ans. is 'd' i.e., All of the above
| 4
|
Constipation & muscle weakness
|
Anorexia & weight loss
|
Polydipsia & polyuria
|
All of the above
|
Surgery
| null |
f7a5befc-c9d7-47bf-a625-52b623c87c25
|
multi
|
Main pancreatic duct is derived from ?
|
The pancreas develops from the two endodermal buds, dorsal and ventral, that arise from the pa of the gut that later forms the second pa of the duodenum. The ventral bud forms the lower pa of the head, and the uncinate process of the pancreas, while the upper pa of the head, the body and the tail are formed from the dorsal bud. The main pancreatic duct is formed, in its distal pa, by the duct of dorsal bud, and in its proximal pa by the duct of the ventral bud. The islets of Langerhans are also derived from the primitive duct system. Ref: Textbook of Human Embryology, 6th Ed, Page 184.
| 1
|
Paly from the dorsal pancreatic bud and paly from the ventral pancreatic bud
|
Dorsal pancreatic bud only
|
Ventral pancreatic bud only
|
None of the above
|
Anatomy
| null |
1166931d-79a9-4d69-96b7-83c4aa9c0208
|
multi
|
Ahritis mutilans is seen in:
|
Psoriatic Ahropathy
| 4
|
OA
|
Rheumatoid ahritis
|
Reiters syndrome
|
Psoriatic Ahropathy
|
Surgery
| null |
e82ebf61-292c-4d7f-a01e-8e39008842a7
|
single
|
Which of the following is TRUE about cholera toxin?
|
V cholerae produce a heat-labile enterotoxin. Ganglioside GM1 serves as the mucosal receptor for subunit B, which promotes entry of subunit A into the cell. Cholera toxin catalyzes the ADP ribosylation of the G protein, rendering it unable to dissociate from the active adenylate cyclase complex. This causes persistent activation of intracellular adenylate cyclase, which in turn stimulates the conversion of adenosine triphosphate to cAMP. The net effect is excessive accumulation of cAMP at the cell membrane, which causes hypersecretion of chloride, potassium, bicarbonate, and associated water molecules out of the cell. Ref: Brooks G.F. (2013). Chapter 17. Vibrios, Campylobacters, Helicobacter, and Associated Bacteria. In G.F. Brooks (Ed), Jawetz, Melnick, & Adelberg's Medical Microbiology, 26e.
| 3
|
Increases the levels of intracellular cyclic GMP
|
Acts through the receptor the opiates
|
Causes continued activation of adenylate cyclase
|
Inhibits the enzyme phosphodiesterase
|
Microbiology
| null |
65be5346-6230-4900-be9d-1a598c785997
|
multi
|
Glucose transporters present in the Beta cells of the Islets of Langerhans is:
|
Ans. B. GLUT2GLUTTissue LocationFunctionGLUT 1Brain, Placenta, Kidney, RBCBasal Glucose UptakeGLUT 2Liver, Pancreas, IntestinePancreas-Insulin SecretionGLUT 3Brain (Neurons), PlacentaBasal Glucose UptakeGLUT 4Skeletal Muscle, Adipose Tissue, Cardiac MuscleInsulin stimulated uptake after mealsGLUT 5Small Intestine, TestisFructose TransportGLUT 6WBC, SpleenNot KnownGLUT 7Liver, Endoplasmic ReticulumGlucose transport in ER
| 2
|
GLUT1
|
GLUT2
|
GLUT3
|
GLUT4
|
Biochemistry
|
Carbohydrates
|
b3c251fc-d600-49f0-b005-db8fc46c14cc
|
single
|
Muscular timidity caused by opioids is due to the agonist effect on which receptor
|
Refer Miller 7/ep781 Truncal rigidity caused by highly lipid soluble opioids like Fentanyl is supraspinal in origin. It is mainly caused by stimulation of mu receptors whereas kappa and delta receptors tend to reduce the rigidity
| 1
|
Mu
|
Kappa
|
Delta
|
Sigma
|
Pharmacology
|
Anesthesia
|
4921c86c-9682-4e1a-8d35-3edb40c45a57
|
single
|
Maximum radiopaque shadow in ovary is seen in
|
Teratoma is most radio-opaque because of its calcifications (Ref: Radiology Review Manual by Wolfgang Dahne 6thEtd, 1010)
| 1
|
Teratoma
|
Dysgerminoma
|
Mucinous cyst adenoma
|
Granulose cell tumour
|
Radiology
|
All India exam
|
9e14a61e-9991-453a-a7fb-5b0d7251cea0
|
single
|
Indication for induction of labour is :
|
PIH at term
| 2
|
Placenta pre
|
PIH at term
|
Hea disease at term
|
Breech
|
Gynaecology & Obstetrics
| null |
397a34a4-f6ea-4958-bf79-933cddc691c7
|
single
|
Antibiotic of choice for lymphedema is ?
|
<p> Lymphoedema Accumulation of fluid in extracellular and extravascular fluid compament , commonly in subcutaneous tissue. Classification: 1. Primary - without any identifiable disease. 2. Secondary- acquired due to definitive cause. Primary lymphoedema:- Affects commonly females. Common in lower limb and left side. It can be familial , syndromic ( Turners , Klinefelter&;s , Down&;s, Klipple Trenauy weber) It can be 1. Lymphoedema congenital : present at bih (<2yrs). Familial type is called Nonne- Milroy disease. 2. Lymphoedema praecox- present at pubey (2-35 years). Familial type is called Letessier- Meige&;s syndrome. 3. Lymphoedema tarda- present in adult life after 35 years. Complications: Skin thickening, abscess, maggot formation. Recurrent cellulitis Lymphangiosarcoma Recurrent streptococcal infection. Conservative treatment:- 1. Elevation of limb, exercise , weight reduction. 2. Static isometric activities like prolonged standing or weight lifting should be avoided. 3. Diuretics to reduce edema. 4. Daily wearing of below knee stockings. 5. Daily wearing of below knee stockings. 6. Intermittent pneumatic compression devices. 7. Antibiotics- flucloxacillin, erythromycin, long acting penicillin. 8. Skin care. 9. Complex decongestive therapy {Reference: SRB&;s manual of surgery, 5th edition , page no. 247}
| 1
|
Penicillin
|
Amikacin
|
Metronidazole
|
Ceftazidime
|
Surgery
|
Vascular surgery
|
266c3949-61fc-4dfd-98d4-dec06bc18bcd
|
single
|
What is the content of ethinyl estradiol in very low
| null | 3
|
30µg
|
25µg
|
20µg
|
15µg
|
Social & Preventive Medicine
| null |
fbe76a8e-8638-4bce-824d-b9ad3cf05cdc
|
single
|
The first step in fatty acid synthesis involves:
|
Ans. A. Acetyl-CoA carboxylase(Ref Harper 31/e page 217)Fatty Acid SynthesisBy two enzyme system1. Acetyl-CoA carboxylase2. Fatty acid synthase complexAcetyl-CoA CarboxylaseConverts acetyl-CoA (2C) to malonyl-CoA in the presence of ATP.Acetyl-CoA carboxylase has a requirement for the B vitamin biotin.It is a multienzyme protein.This is the rate limiting stepQ in the fatty acid synthesis.Acetyl-CoA carboxylase is not a part FAS ComplexQ.
| 1
|
Acetyl-CoA carboxylase
|
Hydroxyl-CoA dehydrogenase
|
Acetyl dehydrogenase
|
Pyruvate kinase
|
Biochemistry
|
Lipids
|
99d67a98-3952-49bd-9bee-2e551e245e25
|
multi
|
Maxillary sinus opens into which meatus?
|
Ans. c (Middle meatus). (Ref. Bhargaw, 5th ed.151)THE LATERAL NASAL WALL# It consists anteriorly of the nasal bone, frontal process of maxilla & the lacrimal bone.# Posterior to lacrimal bone, the lateral wall of nasal cavity is formed by ethmoid labyrinth, maxillary & inferior concha.# Perpendicular plate of palatine bone & the medial pterygoid plate form the most posterior portion.# Within the nasal cavity, scrolls of bone on the lateral walls, the conchae, projected medially to divide the cavity into meatuses.# Superior & middle conchae are part of ethmoid bone, but the inferior conchae are separate pair of bones.# A turbinate is a concha, meaning a soft tissue bone complex.# Superior, middle & inferior meatuses that are formed under & lateral to respective conchae, have increased contact with nasal surface to permit effective warming & moistening of inspired air.Superior turbinate meatus- Post ethmoidal air cells drain into it & sphenoid sinus drain via sphenoethmoidal recess.Middle turbinate meatus- Most important area, forms OMC where anterior-middle ethmoid air cells, maxillary & frontal sinuses drain into it.- Anterior to frontal recess & anterior end of middle turbinate is the bony prominence of frontal process of maxilla known as agger nasi, cells in it drains into ethmoid infundibulumInferior turbinate meatus- Largest turbinate. Nasolacrimal duct drains into its anterior part.Osteomeatal unit/complex (OMC)- OMC is the normal aerated channel which provides airflow & mucocilliary clearance for sinuses.- It is the key area for pathogenesis of chronic sinus diseases.- It is the cross road (confluence) for drainage of most paranasal sinuses.- It is the center of interest due to functional endoscopic sinus surgery (FESS).
| 3
|
Inferior
|
Superior
|
Middle
|
All
|
ENT
|
Nose and PNS
|
7fd604f4-2708-4088-94ff-a76e3fd8d966
|
multi
|
Which of the following is not true about Xenon anesthesia?
|
Ans. c. Slow induction and slow recovery Xenon anaesthesia is inert, non-explosive, environment friendly having low blood solubility with minimal cardiovascular side effects. Lower blood gas coefficient of Xenon results in rapid induction and recovery.Xenon Anesthesia* Xenon was isolated by William Ramsay (Nobel prize for chemistry ) in 1904 and 1st used as anesthetic in 1950.* It is one of the noble gases (colourless, odurless, nonirritating, non-flammable, does not support combustion and non-explosive gas)* Heavier than air (4 times) and more viscous than N2 and N2O.* Being extremely unreactive. it does not interact with soda lime, but will diffuse readily through rubber.* Except for cost, xenon would be the most ideal inhaled anesthetic agent because Xenon (MAC of 71%) is more potent than nitrous oxide, can provide anesthesia in 30% O2 is very insoluble (blood-gas partition coefficienct of 0.14) and has positive medical and environmental effects.Characteristic Features of Xenon Anaesthesia* Minimal cardiovascular and hemodynamic side effects* Not known to be metabolized in liver or kidney* Not teratogenic and does not trigger malignant hyperthermia* Neuroprotective and cardioprotective0* Emergence from xenon anesthesia is faster* Xenon is more potent than nitrous oxide with MAC 71%* It is a good analgesic* Blood-gas solubility coefficient of less than one third of N2O, there is still the potential of diffusion hypoxia during recovery.* Lower blood gas coefficient of Xenon results in rapid induction and recovery* It provides good hemodynamic stability with little change in blood pressure.* It inhibits calcium pump in plasma membrane0 and NMDA receptor in dorsal bom neuron.Advantages of Xenon AnesthesiaDisadvantages of Xenon Anesthesia* Inert, non-explosive, environment friendly* Low blood solubility* Not metabolized in the body* Rapid induction and recovery* Eliminated via lungs (can be used in renal and hepatic failure)* Does not trigger malignant hyperthermia* High cost* Less potent* No commercially available anesthesia equipment
| 3
|
Non explosive
|
Minimal cardiovascular side effects
|
Slow induction and slow recovery
|
Low blood gas solubility
|
Anaesthesia
|
Miscellaneous General Anesthesia
|
3338b008-1f10-4104-9408-00daabc3f964
|
multi
|
A male with azoospermia. On examination size of testis normal FSH normal testosterone normal. Most probable cause is:
|
Ans. is d, i.e. VAS obstructionSince all FSH, LH and Testosterone are normal therefore, it has to be an obstructive cause. Amongst the option, VAS obstruction is the only obstructive cause and hence our answer.
| 4
|
MAL descended testis
|
Klinefelter's syndrome
|
Kallmann's syndrome
|
VAS obstruction
|
Gynaecology & Obstetrics
|
Endometriosis and Infertility
|
c7dc25f7-ffd5-4f9b-bd51-eeef47bcc046
|
multi
|
a 40 yr old man underwent renal transplantation two months after transplantation he developed fever and features suggestive of bilateral diffuse interstitial pnuemonitis. what is causative agent ?
|
PERSONS WITH HIGH RISK OF CMV INFECTION : organ transplantation with malignant tumors who are recieving chemotherapy with hiv/aids viral excreation is icreased and prolonged diffuse interstitial pneumonia is common complication ref : ananthanaryana 9th ed
| 2
|
HSV
|
CMV
|
EBV
|
VZV
|
Microbiology
|
All India exam
|
e4012dca-8632-44f1-b40d-a28dd7cf8fe7
|
single
|
Infants acquire adult hemoglobin level at:
| null | 2
|
Birth
|
End of 1st year
|
Puberty
|
4 years
|
Physiology
| null |
dec6e9e4-b194-431f-9fa1-659e4d8dc8c3
|
single
|
A child presented to the emergency depament with seizures. On examination oval hypopigmented macules were noted on the trunk, along with sub-normal IQ. What is the probable diagnosis?
|
Essentials of Diagnosis & Typical Features of Tuberous sclerosis: Facial angiofibromas or subungual fibromas. Often hypomelanotic macules, gingival fibromas. Retinal hamaomas. Coical tubers or subependymal glial nodules, often calcified. Renal angiomyolipomas. Seizures are the most common presenting symptom. Up to 20% of patients with infantile spasms (a serious epileptic syndrome) have tuberous sclerosis. Ninety-six percent of patients have one or more hypomelanotic macules, facial angiofibromas, ungual fibromas, or shagreen patches. Adenoma sebaceum, the facial skin hamaomas, may first appear in early childhood, often on the cheek, chin, and dry sites of the skin where acne is not usually seen. Mental retardation occurs in up to 50% of patients referred to teiary care centers; the incidence is probably much lower in randomly selected patients. Patients with seizures are more prone to mental retardation or learning disabilities. Diagnostic studies: More helpful is MRI or CT scanning; the latter can show the viually pathognomonic subependymal nodular calcifications and sometimes widened gyri or tubers and brain tumors. Contrast material may show the often classically located tumors near the interventricular foramen. Hypomyelinated lesions may be seen with MRI. Ref: Bernard T.J., Knupp K., Yang M.L., Kedia S., Levisohn P.M., Moe P.G. (2012). Chapter 25. Neurologic & Muscular Disorders. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e.
| 3
|
Neurofibromatosis
|
Sturge Weber
|
Tuberous sclerosis
|
Incontinentia Pigmenti
|
Pediatrics
| null |
897920f2-ed35-4fbb-a5fc-bda825e39195
|
single
|
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