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Which of the following deficiency in alcoholics inhibit pyruvate dehydrogenase?
Arsenite and mercuric ions react with the - SH groups of lipoic acid and inhibit pyruvate dehydrogenase, as does a dietary deficiency of thiamin, allowing pyruvate to accumulate. Many alcoholics are thiamin-deficient (both because of a poor diet and also because alcohol inhibits thiamin absorption), and may develop potentially fatal pyruvic and lactic acidosis. Ref: Harper 28th edition, Chapter 17.
1
Thiamin
Niacin
Riboflavin
Ascorbic acid
Biochemistry
null
5869cee3-fe75-4e5e-8f77-052a6a724546
single
Compared to the other antidepressant drugs mirtazapine has the distinct ability to act as an antagonist of :
null
3
Beta receptors
D2 receptors
Alpha 2 receptors
5-HT receptors
Pharmacology
null
ef08b696-e95c-48d5-92d7-151cd5504a4b
single
Tetracycline injection causes palsy of which nerve?
Ans. is 'c' i.e., Radial
3
Ulnar
Median
Radial
Superficial Radial Nerve injury
Pharmacology
null
c1141cca-a33f-4001-830f-d3c0a7bea1eb
single
Which of the following is key area of nasal septum?
.
2
Anterosuperior pa of nasal septum
Anteroinferior pa of nasal septum
Posterosuperior pa of nasal septum
Posteroinferior pa of nasal septum
Pathology
All India exam
dff710d7-47a5-4f56-a5eb-c85d918d6812
single
An 83-year-old man with Parkinson's disease presents with low-grade fever and cough for several weeks. Lately, he has been experiencing more rigidity and difficulty with his walking. He is on a levodopa/carbidopa combination for treatment for the past 5 years. On examination, his gait is shuffling and slow. He has a tremor in his left hand at rest, and there is cogwheel rigidity of the forearm. There are crackles in the left lower lung field. CXR reveals a lung abscess in the left lower lobe. Which of the following is the most likely bacteriologic diagnosis for the lung abscess?
Most lung abscesses and all anaerobic abscesses involve the normal flora of the oropharynx. Septic embolic usually contain S. aureus. Factors that predispose to Gram-negative colonization of the oropharynx include hospitalization, debility, severe underlying diseases, alcoholism, diabetes, and advanced age. Impaired consciousness, neurologic disease, swallowing disorders, and nasogastric or endotracheal tubes all increase the likelihood of aspiration.
1
oropharyngeal flora
tuberculosis
Staphylococcus aureus
Pseudomonas aeruginosa
Medicine
Respiratory
193bb7c1-ba4e-4928-bcbf-9be0f7878eba
single
A patient with microcytic hypochromic anemia. Hb-9 g%, serum iron-20 microg/dl, ferritin level-800 ng/ml, transferrin percentage saturation is 64%. What is possible diagnosis?
Ans. (a) Atransferrinemia(Ref: Wintrobe's 12th/pg814)This patient with microcytic hypochromic anemia, has high ferritin level (800ng/ml) & increased transferrin percentage saturation (64%). The most possible diagnosis is Atransferrinemia.AtransferrinemiaIt is a rare congenital autosomal recessive condition with low transferrin level in the body.So whatever transferrin is left, is saturated.It presents with hypochromic microcytic anemia, decreased serum levels of iron, TIBC, and increased serum level of ferritin (as iron absorption is markedly increased but iron transfer to eryrthropoetic tissues are reduced)High transferrin saturation (64% in this case) & high ferritin level, excludes Iron deficiency Anemia (option B excluded)In DMT 1 mutation, transferrin saturation is low (hence option C excluded)High transferrin saturation excludes Anemia of chronic disease (option D)
1
Atransferrinemia
Iron deficiency anemia
DMT 1 mutation
Anemia of chronic disorder
Pathology
Misc. (R.B.C)
b2dbe8ac-5af8-4362-9f0f-a9cf94bfedba
single
What does Gettlers test detects -
Reff: The synopsis of forensic medicine & Toxicology 28th edition pg: 194 In 1921, Gettler published a test for drowning from right and left hea chambers, a difference of 25mg/100ml between the chlorides concentrations of the two sides of the hea indicated that the death was due to drowning. In freshwater drowning the chloride level in the blood in the left side of the hea was lower than in the right side; the reverse situation was noted in saltwater drowning. Positive is seen in seawater drowning due to hemoconcentration and negative in fresh water drowning due to hemodilution.
2
Diatoms in drowning
Chloride content of blood in drowning
Weight in drowning
null
Forensic Medicine
Asphyxia
938dae46-070d-4e45-ba68-e4364cb73b7d
multi
Functional unit for implementation of National Mental Health Programme is at which level?
The Government of India has launched theNational Mental Health Programme(NMHP) in 1982, keeping in view the heavy burden of mental illness in the community, and the absolute inadequacy of mental health care infrastructure in the country to deal with it. Principal unit of Health administration in India is District under a collector. All National health programmes in India are implemented district wise.
1
District
Subcentre
PHC
State
Social & Preventive Medicine
Other NHPs
c3cbc758-268b-40a8-8e04-06ee4bad9483
single
To prevent keratoconus what is used –
There are no preventive measures for keratoconus. Some specialists believe that patient with keratoconus should have their eye allergies aggressively treated and should be instructed not to rub their eyes
4
Antibiotics
Cycloplegics
Glasses
null
Ophthalmology
null
477aeeb4-d0b5-499f-b2b2-1cfa88860fcc
multi
Following ultrasound is showing-
Ans. is 'b' i.e., Ectopic pregnancy* Empty endometrial cavity with an extrauterine single gestational sac with yolk sac in left adenexa. Both ovaries are normal. It is indicative of left adnexal, unruptured ectopic pregnancy.
2
Normal pregnancy
Ectopic pregnancy
H. mole
Ovarian cyst
Gynaecology & Obstetrics
Miscellaneous (Gynae)
d3e749dd-9d30-48f9-b050-46138d1376a7
single
What is the structure seen in the given X-ray below?
Plain abdominal X ray showing a stent in the right and left ureter. Ureteric stents,also known as double J stents or retrograde ureteric stents, is a urological catheter that has two "J-shaped" (curled) ends, where one is anchored in the renal pelvis and the other inside the bladder. Stents are used for the free passage of urine from the kidney to the bladder, in adverse conditions such as postoperative urologic procedures, and previously to lithotripsy and ureteral obstructions. Indications Stents may be uses for a sho of long term period depending on the indication: * obstruction from urolithiasis * malignant obstruction (typically pelvic malignancies) * benign strictures * retroperitoneal fibrosis REF : DAVID SUTTON 9TH ED:
1
Stent
Surgical clips
Foley catheter
Intravesical wire
Radiology
All India exam
4dd139ec-8cdb-46c2-97d6-4a37f57701ad
single
Limiting amino acid in wheat are:
Limiting amino acid in various food stuffs Wheat-lysine (the most deficient) and threonine (second limiting amino acid) Rice-lysine Legumes-tryptophan or methionine (or cysteine) Maize-lysine and tryptophan Egg-none; the reference for absorbable protein
3
Lysine, arginine
Threonine, methionine
Lysine, threonine
Lysine, methionine
Biochemistry
null
5457999e-c4e3-4d59-ba60-94c81097022d
single
All of the following are true regarding whooping cough except:
Ans: cRef: Harrison, 16th ed, p. 875, 876
3
Spread by droplet infection
90% of cases occur in children under 5 years of age
The whoop stage is more infectious than catarrhal stage
Blood count shows lymphocytosis
Medicine
Infection
07846002-ed62-4fc4-811e-de10d5e53c34
multi
Maximum density of goblet cells is seen in:
C i.e. Nasal conjunctiva Goblet cells are the chief source of tear mucus Q. These occur throughout the conjunctiva, especially the plica semilunaris.
3
Superior conjunctiva
Inferior conjunctiva
Nasal conjunctiva
Temporal conjunctiva
Ophthalmology
null
70a64eaf-fc06-4396-ae85-abb7829b13c9
single
The histiocytosis X is a spectrum of disorders, which include the following condition
null
4
Eosinophilic granuloma
Hand Schuller - Christian disease
Letterer - Siwe disease
All of the above
Pathology
null
3b78cc65-1321-4a8b-8e97-3852be0044b7
multi
In frey's syndrome, neurotransmitter is:
null
1
Acetylcholine.
Epinephrine.
Norepinephrine.
Serotonin.
Pathology
null
3223ba5c-8db2-40cc-bd7b-c0cc589615a1
single
All of the following are seen in Systemic Juvenile Ahritis except
Rheumatoid factor is negative in systemic onset JIA Ref Ghai pediatrics eighth edition pg no 626
1
Rheumatoid Factor +ve
Hepatosplenomegaly
High fever with rash
Elevated E.S.R
Pediatrics
Musculoskeletal disorders
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multi
A village with 10000 population 250 suffered from malaria out of which 50 dead, another 100 suffered from dengue out of which 30 died in 2013 case fatality rate of dengue is -
Ans. is 'c' i.e., 30 CFR =Total no. of deaths due to a diseaseTotal no. of cases of the same diseasex 100 CFR due to dengue=No. of death due to dengueTotal cases of denguex 100 =30100x 100 = 30
3
40 '
80
30
70
Social & Preventive Medicine
Measurement of Mortality and Morbidity
5420c6b5-7fad-4770-99b0-2fba04a7f72b
single
All are true about mammary gland, except ?
Ans. is 'd' i.e., Nipple is supplied by 6th intercostal nerve Mammary gland Breast (mammary gland) is a modified sweat gland present in the superficial fascia of pectoral region. Veically it extend from 2" to 6' ribs at midclavicular line and horizonal extent is from sternal margin to midaxillary line at the level of 4th rib. Aerial supply of breast Aerial supply of breast includes ? Perforating branches of internal mammary aery in II",Hird, 1 v.-"h intercostal spaces. Thoracoacromial, lateral thoracic and superior thoracic branches of axillary. Mammary branches, from rd, 3rd and 4'h posterior intercostal aeries. Venous Drainage There is an anastomotic circle of veins around the base of nipple-the circulus venosus of Haller. Veins from this and from the glandular tissue radiate to the circumference of the gland and drain into axillary, internal mammary and posterior intercostal veins. Nerve supply Sensory and sympathetic innervation is anterior and lateral cutaneous branches of 4th,5th and 6th intercostal nerves. Nipple is mainly innervated by the 4th intercostal nerve.
1
Is a modified sweat gland
Extends from 2nd to 6th rib veically
Supplied by internal mammary aery
Nipple is supplied by 6th intercostal nerve
Anatomy
null
4468ff64-b65c-4f6b-8b06-b6e84e1cdf51
multi
In diffuse calcification of pancreas calcium lies in?
Ans. is 'd' i.e., Anywhere
4
Acinar tissues
Interstitium
Pancreatic ducts
Any where
Pathology
null
f58d5dd3-6978-422d-bc88-8df4fc1b7404
single
Most common lung cancers in non smokers is
Adenocarcinoma is the most common lung cancers in non smokers.
4
Squamous cell carcinoma
Bronchoalveolar carcinoma
Small cell carcinoma
Adenocarcinoma
Medicine
null
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multi
BCR-ABL fusion gene is detected by?
Ans. (b) FISH(Ref: Robbins 9th/pg 616-618)Flow cytometry: is used for immunophenotyping in Leukemias & LymphomasFISH- used for detecting submicroscopic chromosomal aberrations of BCR-ABL fusionKaryotyping: Used for detecting chromosomal defects of at least 5 mb size (low sensitivity)RT-PCR: used for quantitative DNA estimation
2
Flow cytometry
FISH
Karyotyping
RT-PCR
Pathology
Misc. (W.B.C)
bca7c6ea-da3c-4ae0-be48-4e4d117b7c97
single
In a patient with head injury, unexplained hypotension warrants evaluation of:
High thoracic or cervical cord transection causes hypotension and bradycardia due to functional sympathectomy (sometimes with Horner syndrome). Ref: Harrison's Principles of Internal Medicine, 15th Edition, Page 2441; Surgery: Basic Science and Clinical Evidence By Jeffrey A. Noon, Philip S. Barie, Randall Bollinger, 2008, Page 314
3
Upper cervical spine
Lower cervical spine
Thoracic spine
Lumbar spine
Surgery
null
03e894aa-0c5e-44dd-b240-97bfbf3cabba
single
NOT a mutation in Down's syndrome
(D) VNTR's# A Variable Number Tandem Repeat (or VNTR) is a location in a genome where a short nucleotide sequence is organized as a tandem repeat is associated with major psychiatric disorders.> Trisomy 21 also known by the karyotype 47, XX+21 for females and 47,XY,+21 for males.> The extra chromosome 21 material may also occur due to a Robertsonian translocation in 2-4% cases. In this situation, the long arm of chromosome 21 is attached to another chromosome, often chromosome 14.
4
Mosaicism
Robersonian translocation
Maternal non disjunction
VNTR's
Pathology
Misc.
108cd666-f90d-45a2-939c-830582f4076e
single
Sironemelia is caused due to effect in ?
Gastrulation itself may be disrupted by genetic abnormalities and toxic insults. In caudal dysgenesis (sirenomelia), insufficient mesoderm is formed in the caudalmost region of the embryo. Because this mesoderm contributes to formation of the lower limbs, urogenital system (intermediate mesoderm), and lumbosacral veebrae, abnormalities in these structures ensue. Affected individuals exhibit a variable range of defects, including hypoplasia and fusion of the lower limbs, veebral abnormalities, renal agenesis, imperforate anus, and anomalies of the genital organs Ref: Langman's embryology 11th edition Chapter 5.
2
Endoderm
Mesoderm
Ectoderm
None of the above
Anatomy
null
d8ed37c8-5125-4883-bcf5-ac9e2395e106
multi
Ulcerative colitis starts in :
null
4
Descending colon
Transverse colon
Caecum
Rectum
Surgery
null
a2952605-b6b4-4717-b51f-800ce497b5d5
single
A gastric ulcer is said to be refractory when it fails to heal after therapy for:
A gastric ulcer that fails to heal after 12 weeks and a duodenal ulcer does not heal at 8 weeks of therapy should be considered refractory. Cause of refractory ulcers: Malignancy Zollinger Ellison syndrome Cigarette smoking Ischemia Crohn's disease Lymphoma Eosinophilic gastroenteritis Infections (TB,CMV) Ref: Harrisons principles of internal medicine, 18th edition, Page: 2452
3
6 weeks
8 weeks
12 weeks
14 weeks
Medicine
null
c836f213-8fad-4947-bbc1-4efd2e3cee0e
single
Induction at term is not done in
Preeclampsia is associated with significant maternal and fetal morbidity and moality. No pregnancy complicated by preeclampsia should be allowed to cross 38 weeks and earlier terminations will often have to be considered depending on maternal and fetal status. Refer page no 559 of Textbook of obstetrics, Sheila Balakrishnan, 2 nd edition.
1
Preeclampsia
Diabetes
Hea disease
Renal disease
Gynaecology & Obstetrics
General obstetrics
8845d5fb-1445-492d-877d-68f59ec7c0ab
single
The following are true regarding Lyme's Disease, except -
Borrelia burgdorferi is the causative agent of Lyme’s disease Lyme’s disease is transmitted by ixodid tick Erythema migrans (annular skin lesions) occurs in 1st stage Rodents act as natural hosts.
3
It is transmitted by ixotid tick.
Erythema chronicum migraines may be a clinical feature
Borrelia recurrentis is the aetiological agent
Rodents act as natural hosts
Microbiology
null
196d5107-9b2c-43f4-a7ba-f2dba3ae8041
multi
A child presents with a lesion on the face as depicted on the PLATE. The biopsy from the lesion is also shown. What is the most probable diagnosis?
ANSWER: (C) Indeterminate LeprosyREF: IAL textbook of leprosy P:157CAUSES OF HYPOPIGMENTED WHITE LESION ON FAE OF CHILD* Pityriasis Alba* Vitiligo* Indeterminate Hansen* Albinism* Halo nevus* Post-kala-azar dermal leishmaniasis* Seborrheic dermatitis* Pityriasis Versicolor See PLATE - KEY INTERMEDIATE LEPROSY(A) Morphology: It appears as poorly defined areas of slight hypopigmentation or erythema, without systemic or neural changes. The condition is only likely to be recognized readily in endemic areas where there is a high awareness of leprosy. (B) Microscopy: Scanty superficial and deep lymphohistiocytic infiltrate in the dermis, with some tendency to localization around appendages. Bacilli are infrequent but scantily present in nerves. Perineural & peri appendageal inflammatory infiltrate consisting of lymphocytes and histiocytes.
3
R Alba
Lepromatous Leprosy
Indeterminate leprosy
Pityriasis Rosea
Unknown
null
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The following tests are used to check the efiiciency of pasteurization of mild except -
Methylene blue reduction test is an indirect method for detection of microorganism in milk. REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION. PAGE NO - 606
4
Phosphatase test
Standard plate count
Coliform count
Methylene blue reduction test
Social & Preventive Medicine
Nutrition and health
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multi
All can take split thickness graft except -
"The skin graft must be applied to a well-vascularized recipient wound bed. It will not adhere to exposed bone, cartilage, or tendon devoid of periosteum, perichendrium or peritenon, respectively, or devoid of its vascularized perimembranous envelope." - Sabiston 17/e p 2185
3
Fat
Muscle
Skull bone
Deep fascia
Surgery
null
245603af-6394-429f-9428-2c5afb784bd5
multi
Not a differential Diagnosis for grey white membrane on Tonsil
null
2
Candidiasis
Ludwig's Angina
Vincent's Angina
Malignancy tonsil
ENT
null
1c9ce032-cf70-4271-a044-b50a52d9516e
single
True about gastric stump carcinoma
Usually, after Billroth II operation altered acid level, enterogatric bile reflux is the pathogenesis which increases the peptic activity causing mucosal metaplasia and dysplasia resulting in stump carcinoma Reference SRB edition:5 page:845
1
Enterogastric reflex is the cause
Prognosis good after surgery
It is always adenocarcinoma in nature
Diffuse type is only variety
Surgery
G.I.T
4e6bf53f-f3b2-4d0a-9155-5c45fead1013
multi
Lower 1/3'd of anal canal is derived from?
Ans. is'a'i.e., Proctodaeum(Ref: BDC Sh/eVol. Il p. 415)'The lower third of the anal canal is an ectodermal derivative and is derived from the proctodaeum.'Pa of anal canal above pectinate line develops from dorsal pa of md.odermal cloaca (primitive rectum) and pa of anal canal below pectinate line develops from ectodermal proctodeum.
1
Proctodaeum
Cloaca
Urogenital Sinus
Midgut
Anatomy
null
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single
Treatment for achalasia associated with high rate of recurrence :
Treatment of Achalasia The aim of treatment is to relieve the functional obstruction at the cardio The two main methods to achieve this are Forceful dilatation or Esophageal myotomy (Heller's myotomy) with or without an antireflux procedure 1) Forceful dilatation (pneumatic dilatation) The aim is to weaken or rupture the circular muscle fibres of the LES by a forceful stretch. Perforation and bleeding are potential complications 2) Extramucosal cardiomyotomy (Heller's myotomy) this involves surgical division of the muscle fibres of the lower esophageal sphincter. this procedure can be performed through a laparoscopic or thoracoscopic approach (Open surgical procedure i.e. Laparotomy or thoracotomy can also be done, but the videoscopic procedure is better) major complication is gastro-esophageal reflux. paial fundoplication is done to prevent reflux "modified laparoscopic Heller myotomy is the operation of choice"- Sabiston Other methods of treatment Drugs Nitrates and calcium channel blockers can be used, but are ineffective for long-term use. They can be used for transient relief of symptoms and in patients unfit for surgery and pneumatic dilatation. Botulinum toxin Botulinum toxin is given by endoscopic injection into the LES. It reduces LES pressure by blocking the cholinergic excitatory nerves in the sphincter. Its effect is only sho-lived and repeated injections have to be given. Used only in patients unfit for surgery and pneumatic dilatation. Ref : Bailey & Love 25/e p1036
4
Pneumatic dilatation
Laproscopic myotomy
Open surgical myotomy
Botulinum toxin
Anatomy
G.I.T
dffef730-fa4d-44ec-baaa-ac6a57e3370a
single
Antibiotic treatment of choice for treating cholera in an adult is a single dose of:
Doxycycline - antibiotic of choice for adults only single dose suffices. TMP-SMX - antibiotic of choice for children. Furazolidone - antibiotic of choice for pregnant women. Ref: Park's Textbook Of Preventive And Social Medicine By K. Park, 19th Edition, Page 193; Park's Textbook Of Preventive And Social Medicine By K. Park, 18th Edition, Page 181
3
Tetracycline
Co-trimoxazole
Doxycycline
Furazolidone
Social & Preventive Medicine
null
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single
In treatment of papillary carcinomas thyroid, radioiodine destroys the neoplastic cells predominantly by
I131 is treated by the body just like the ordinary nonradioactive isotope, so that when swallowed it is concentrated in the thyroid gland. It emits mainly β radiation (90%) which penetrates only 0.5 mm of the tissue and thus allows therapeutic effects on the thyroid without any damage to the surrounding structures, particularly the parathyroids. It also emits gamma rays, which are more penetrating. Uses I131is the preferred initial t/t for hyperthyroidism caused by Grave's disease. It is used in combination with surgery in some cases of thyroid carcinoma, especially those in which metastases are sufficiently differentiated to take up iodides selectively. Also know, It is contraindicated in children and pregnant or breastfeeding women, and can induce or worsen ophthalmopathy.
2
X rays
β rays
γ rays
α particles
Surgery
null
7422396e-c847-42cc-af10-6ad261ebfe0a
single
An IgG2 molecule is composed of which of the following?
IgG molecules contain two gamma heavy chains of a given subtype and two light chains (either kappa or lambda). The 2 in IgG2 indicates the subclass to which the molecule belongs. IgG2 contains two gamma2 chains (since a given B cell can only form one type of heavy chain). The IgG molecule will contain either two kappa chains or two lambda chains, but never one of each. A given cell produces immunoglobulin molecules with a single type of heavy chain. IgG molecules with gamma1 chains would be of the IgG1 subclass. Ref: Levinson W. (2012). Chapter 58. Cellular Basis of the Immune Response. In W. Levinson (Ed), Review of Medical Microbiology & Immunology, 12e.
4
One alpha, one gamma, and two kappa chains
One gamma1 chain and two kappa chains
Two gamma1 chains and one kappa and one lambda chain
Two gamma2 chains and two kappa chains
Microbiology
null
50fdbc42-2ea4-4934-b036-09b2aa3becbc
single
Find therapeutic index of drug from the information given below in the graph
TI = LD50/ED50 TI = 128 mg/8 mg = 16
4
128
1024
8
16
Pharmacology
FMGE 2019
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single
Inferior mesenteric vein drains into vein-
Splenic
1
Splenic
Hepatic
Portal
Inf. vena cava
Unknown
null
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single
Pituitary diabetes insipidus is improved by?
CHLORPROPAMIDE : This Anti-diabetic drug was withdrawn from market as it causes SIADH. So theoretically, it can be used in diabetes insipidus. But the DOC for treatment of Central Diabetes Insipidus: Desmopressin
3
Water restriction
Lithium
Chlorpropamide
Chlohiazide
Medicine
Disorders of pituitary gland
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single
General anaesthetic most likely to cause bronchodilation is
null
2
Thiopentone
Ketamine
Propofol
Fentanyl
Pharmacology
null
929eb584-78d3-4865-81de-4b530a5f56f9
single
somatic efferent nerves are all except:
Somatic efferent nerves, also called as general somatic efferent (GSE) nerves, supply skeletal muscle of somatic origin. Somatic efferent nerves are: • Occulomotor (3) • Trochlear (4) • Abducent (6) • Hypoglossal (12)
3
Occulomotor
Trochlear
Trigeminal
Abducent
Anatomy
null
c06bec9b-c2af-4632-b0ff-aa5dc99a5ca0
multi
Which of the following is an ionic channel ?
Ans. is 'c' i.e., Nicotinic cholinergic receptors
3
a -1 receptors
b - 1 receptors
Nicotinic cholinergic receptors
Muscarinic cholinergic receptors
Pharmacology
null
ef9bc893-c0eb-4c1b-9a21-71a6a843270c
single
Na+ – K+ ATPase
In Na+-K+ exchange, 3 Na goes out and 2K goes in to the cell.
1
3 Na+ out/ 2K+ in
3Na+ in/ 2K+ out
2Na+ out/ 3K+ in
2Na+ in/3K+ out
Physiology
null
8d80d19f-8e39-45b9-a512-d26c49606bf2
single
Glycine is useful in all of the following except -
Ans. is 'c' i.e., Spermine synthesis Glycineo Glycine is a nonessential amino acid which is synthesized from serine. Glycine is metabolized by following three pathways -It can be converted to serine, a reaction that require tetrahydrofolate {derivative of folic acidQ) and pyridoxal phosphateQ as coenzyme. Further serine is metabolized by serine dehydratase into pyruvate and NH4+.The major pathway of glycine degradation is oxidative cleavage into CO and NH4' by glycine cleavage complex of liver. H4 folate is required which is converted to N5, N10- methylene H4 folate. Thus folic acid is required forglycine metabolismQ.Glycine may be oxidatively deaminated by glycine oxidase to glyoxylic acid.o Glycine is necessary for the formation of following products:- HemeQ, purine ringQ, bile acids conjugation (formation of glycocholic acidQ, and glyco-chenodeoxycholic acid), creatineQ, glutathioneQ, glucose (by gluconeogenesis).
3
Purine synthesis
Creatine synthesis
Spermine synthesis
Heme synthesis
Biochemistry
Metabolism of Purines and Pyrimidines
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multi
Granulomatosis hepatitis is not caused by:
Granulomatous hepatitis is a cause of pyrexia of unknown origin and granulomas are picked up on CT scan or USG abdomen. It is associated with infections like tuberculosis, cat scratch disease, blastomycosis, histoplasmosis.
2
Blastomycosis
Metastatic carcinoma
Tuberculosis
Cat scratch disease
Medicine
Hepatitis
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single
Apple jelly nodule in Nasal septum
null
3
Syphilis
Leprosy
Lupus vulgaris
Wegener's Granulomatosis
ENT
null
5466afa8-02a3-480b-8269-f6a34433e11c
single
The inner wall of the tubule is highly calcified and termed as
Dentin is made up of dentinal tubules. The dentinal tubules contain the protoplasmic process of the odontoblasts called odontoblastic process. The inner wall of the tubule is highly calcified and is termed as peritubular or intratubular dentin. Between the tubules is the intertubular dentin and it is calcified to a lesser degree than peritubular dentin.
3
Peritubular dentin
Intratubular dentin
Both
Mantle dentin
Dental
null
7627cdba-8054-455d-840c-b3b54b457efb
multi
Duodenal blow out is usually seen at which day of the post operative period?
Ans: a (4th day)Duodenal blow out usually occurs between 2-7 days of surgery, more specifically on the 4th.It presents as abdominal pain, tachycardia, worsening of the general condition of the patient.It usually occurs after Billroth -II gastrectomyManagement:Total parenteral nutrution is given, catheter is placed immediately below the right costal margin and the electrolytes are replenished.Billroth I:Billroth IILower half of the stomach removed and is anastomosed to the Ist part of duodenum2/3rd of the stomach is removed; duodenal stump is closed and stomach is anastomosed to the jejunum.
1
4th
11th
2nd
7th
Surgery
Stomach & Duodenum
eec3a8ae-117a-4fdc-aaa1-5c764d3bec3c
multi
Super carrier of HBV shows following serum markers ?
Ans. is 'c' i.e., HbsAg + HBeAg + HBV DNA In HBV infection, there are two types of carriers : Super Carriers High titre of HBs Ag, HBe Ag, DNA polymerase and HBV in the circulation Highly infective Simple carriers Low titre of HBsAg with negative HBe Ag, DNA polymerase and HBV Have low infectivity
3
HBsAg
HbsAg + HBV DNA
HbsAg + HBeAg + HBV DNA
Anti-HBsAg + HBV DNA
Microbiology
null
fa7ac1e6-a7cd-4fb6-ae6d-eb432a54d80a
single
NNN media used in?
Diagnosis Novy-Macneal-Nicole Medium Laboratory diagnosis of leishmaniasis can include the following: Isolation, visualization, and culturing of the parasite from infected tissue Serologic detection of antibodies to recombinant K39 antigen Polymerase chain reaction (PCR) assay for sensitive, rapid diagnosis of Leishmania species Other tests that may be considered include the following: CBC count, coagulation studies, liver function tests, peripheral blood smear Measurements of lipase, amylase, gamma globulin, and albumin Leishmanin (Montenegro) skin testing (LST) (not FDA approved in the United States) Novy-MacNeal-Nicolle medium (NNN) is a culture medium used to grow Leishmania It consists of 0.6% sodium chloride (NaCl) added to a simple blood agar slope. NNN can also be used to grow Trypanosoma cruzi. REF:Medscape
1
Leishmania
Histoplasma
Trypanosoma
Entamoeba
Microbiology
general microbiology
a3a57d7a-c81d-4cda-be2e-7d28ee29688b
single
How many pairs of flagella does Giardia lamblia possess -
Ans. is 'd' i.e., Four Giardia (review)o Giardia is a flagellate protozoao It is the only common protozoa that inhabits the duodenum and jejunum (upper small intestine) of human.o Infective form - cysto Mode of transmission - Ingestion of cysto Giardia exists in two forms
4
One
Two
Three
Four
Microbiology
Parasitology
4798e068-b663-4127-814f-58927566011e
single
A 27 years old P2L2 has come to OPD for contraceptive advice. She has delivered a male child 3 weeks back and is presently lactating. She has no contraindication of any hormone use. She can be given-
Progestin-only Contraception methods do not impair milk production and are an excellent choice for lactating women. There are no increased risks of genital tract or breast neoplasia MEC 1 However, after the initial 6 weeks of delivery are over, use of IUCDs is equally good. OCP contain estrogens which significantly reduce breast milk production and are therefore contraindicated
2
DMPA
Minipill
Levonorgestrol implants
Combined OCPs
Gynaecology & Obstetrics
Puerperium
48a76a40-bca9-4936-b7b1-f4efaca201ba
single
Endometrial repair after menstrual bleeding is under the influence of which hormone ?
Ans. is 'c' i.e., EstrogenAfter mensturation there is proliferative phase, which is under the control of estrogen.Secretory phase is controlled by progesterone
3
FSH
Progesterone
Estrogen
LH
Gynaecology & Obstetrics
null
68e90803-2748-46c5-b982-84483ab34e16
single
A 18yr old girl comes to gynaec OPD presenting with 6months A amenorrhea with his low grade fever weight loss pain abdomen generalised weakness On clinical examination pelvic mass felt on left side with features of ascites Diagnosis
ref : shaw gynecology
1
TB pelvic with tuboovasion mass
ectopic pregnancy
Granulosa cell tumour
Fibroid with degeneration
Gynaecology & Obstetrics
All India exam
9351ace8-c88c-4536-895a-2afe55eb7e9d
single
A 25 yr old female presented with malaise and generalized weakness since 6 months. Her appetite is reduced and she has giddiness and palpitations on and off. There was no organomegaly. Laboratory study showed normochromic to hypochromic anaemia, RDW=60, and MCV=50. What is the diagnosis ?
null
2
Thalasemia minor
Iron deficiency anaemia
Chronic malaria
Folate deficiency
Medicine
null
1147973b-6b69-4447-ad7a-23ac66cfd08d
single
Radioactive phosphorus is used in the treatment of –
Amongst the given options, Radioactive phosphorus has a well-established role in polycythemia vera. It has also been tried in multiple myeloma, however, its use for this is still debatable.
1
Polycythemia
Thyroid metastasis
Multiple myeloma
Embrynal cell carcinoma
Radiology
null
c3870125-a555-459a-8762-76d5aea29085
single
Vitamin K is a cofactor in
Refer Katzung 10/e p 549 Vitamin K is involved in activition if various clotting factors as well as anticlotting clotting proteins It carries out the final step in activation of these ors I. E, gamma carboxylation of glutamate residues in these factors
1
Carboxylation
Hydroxylation
Deaminatiom
Hydrolysis
Pharmacology
Respiratory system
47718736-f2ae-4566-818b-7f1e88e2fb41
single
Pseudomembranous colitis, all are true except -
Ans. is 'c' i.e., Blood in stools is a common feature
3
Toxin A is responsible for clinical manifestation
Toxin B is responsible for clinical manifestation
Blood in stools is a common feature
Summit lesions is early histopathological finding
Microbiology
null
a42988ae-5dba-4560-89ac-54d4c0174e7f
multi
Amyloid deposit stain positively with all of the following except
Ref Robbins 9/e p262 The Modified Gomori Methenamine-SilverNitrate Stain (GMS Stain) is intended for usein the histologic visualization of fungi, basement membrane and some oppounistic organisms such as Pneumocystis carinii.
3
Congo red
Crystal violet
Methanamine silver
Thioflavin T
Anatomy
General anatomy
05cfec95-b551-488c-83ee-f0f4e15c9496
multi
In an experiment, metabolically active cells are subjected to radiant energy in the form of x-rays. This results in cell injury caused by hydrolysis of water. Which of the following intracellular enzymes helps to protect the cells from this type of injury?
The body has intracellular mechanisms that prevent damage from free radicals generated by exposure to x-rays. Glutathione peroxidase reduces such injury by catalyzing the breakdown of hydrogen peroxide. Endonucleases damage DNA in nuclear chromatin. Lactate dehydrogenase is present in a variety of cells, and its elevation in the serum is an indicator of cell injury and death. Phospholipases decrease cellular phospholipids and promote cell membrane injury. Proteases can damage cell membranes and cytoskeletal proteins.
2
Endonuclease
Glutathione peroxidase
Lactate dehydrogenase
Phospholipase
Pathology
Cellular Pathology
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multi
The definition of Epidemiology as The study of the distribution and determinants of disease frequency in man was given by
null
3
John M. Last
Winslow
MacMahon
Frost
Dental
null
39e0c7e3-f45a-4b51-81c8-cb4b3e759498
single
Which of the following conditions is diagnosed using Cozen's test?
Cozen's test - In this test active extension of wrist against resistance produces pain at the point of common extensor origin. It is considered a positive finding for lateral epicondylitis or Tennis elbow.
2
Little leaguer's elbow
Tennis elbow
Golfer's elbow
Frozen shoulder
Surgery
null
62a6cedf-ba1f-4ca0-a95c-5853454b8383
single
Which of the following is true about cementum
null
4
It forms a part of periodontium and is avascular.
Its function is to attach tooth to PDL.
It provides anchorage to the tooth.
All of the above
Dental
null
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multi
Chronic calcific pancreatitis is associated with all of the following except: September 2005
Ars. A: Hypercalcemia Chronic calcifying pancreatitis is invariably related to alcoholism. The earliest finding is precipitation of proteinaceous material in the pancreatic ducts that forms protein plugs that subsequently calcify. The pancreatic ductal epithelium undergoes atrophy, hyperplasia, and metaplasia at the site of the protein plugs. Chronic pancreatitis is a relapsing condition that presents with abdominal pain. As the disease progresses, the frequency and duration of episodes of abdominal pain increase. Consequently, narcotic addiction is a common problem because of the intractable pain. Weight loss and malabsorption are also common. Diabetes can develop in more than half of patients with chronic calcific pancreatitis. Diabetes tends to be brittle in these patients, probably because of the lack of both insulin and glucagon. However, patients with diabetes associated with chronic pancreatitis are less prone to complications such as retinopathy, nephropathy, atherosclerosis, and ketoacidosis than are patients with primary diabetes. On the other hand, neuropathy and myopathy can occur in one third of patients with chronic pancreatitis-associated diabetes
1
Hypercalcemia
Diabetes mellitus
Malabsorption of fat
Diabetes associated complications are uncommon
Surgery
null
5dd21e15-236d-401e-8d9d-00e0ec553c01
multi
Which of the following artery supplies lower 2/3rd of thyroid lobe, trachea, thymus
Superior thyroid artery is the first anterior branch of external carotid artery. It is intimately related to external laryngeal nerve. The superior thyroid artery supplies upper one third of thyroid lobe and the upper half of isthmus. The inferior thyroid artery is a branch of thyro cervical trunk, which arises from subclavian artery. Its terminal part is related to recurrent laryngeal nerve. The inferior thyroid artery mainly supplies lower 2/3rd' of thyroid lobe and lower half of isthmus, trachea, parathyroid and thymus.
1
Inferior thyroid artery.
Superior thyroid artery.
ECA
All of the above
Anatomy
null
ae81c5d1-b01b-463f-9a7b-45aa6a217de5
multi
The child , Draws triangle from a copy at _______.
Emerging patterns of Adaptive milestones from 1-5years of age 15months Makes a tower of 3 cubes Makes a line with a crayon Inses raisin in a bottle 18months Makes a tower of 4 cubes Imitates scribbling Imitates veical stroke Dumps raisin from a bottle 24months Makes a tower of 7 cubes (6 at 21 mo) Scribbles in a circular pattern Imitates horizontal stroke Folds paper once imitatively 30months Makes a tower of 9 cubes Makes veical and horizontal strokes, but generally will not join them to make cross Imitates circular stroke, forming a closed figure 36months Makes a tower of 10 cubes Imitates construction of "bridge" of 3 cubes Copies circle Imitates cross 48months Copies bridge from model Imitates construction of "gate" of 5 cubes Copies cross and square Draws man with 2-4 pas besides the head Identifies longer of 2 lines 60months Draws a triangle from copy Names heavier of 2 weights Ref: Nelson paediatrics; Table 11-1
4
30 months
36 months
48 months
60 months
Pediatrics
Growth and development
b193a37a-1740-4567-aaa4-0a93ea428a2f
single
Which of the following is not associated with multiple myeloma?
MULTIPLE MYELOMA : Bone pain is the most common symptom in myeloma, affecting nearly 70% of patients. Unlike the pain of metastatic carcinoma, which often is worse at night, the pain of myeloma is precipitated by movement. Persistent localized pain in a patient with myeloma usually signifies a pathologic fracture. The bone lesions of myeloma are caused by the proliferation of tumour cells, activation of osteoclasts that destroy bone, and suppression of osteoblasts that form new bone. The bone lesions are lytic in nature and are rarely associated with osteoblastic new bone formation due to their suppression by dickhoff-1 (DKK-1) produced by myeloma cells. Therefore, radioisotopic bone scanning is less useful in diagnosis than is plain radiography. The bony lysis results in substantial mobilization of calcium from bone, and serious acute and chronic complications of hypercalcemia may dominate the clinical picture. Localized bone lesions may expand to the point that mass lesions may be palpated, especially on the skull, clavicles, and sternum; and the collapse of veebrae may lead to spinal cord compression. Skull X ray may show the typical "punched out" lesions characteristic of multiple myeloma. The lesion represents a purely osteolytic lesion with little or no osteoblastic activity The next most common clinical problem in patients with myeloma is susceptibility to bacterial infections. Ref: Harrison 19e pg: 714. / MAHESWARI 9TH ED
4
Bone pain
Metastatic calcification
Punched out lesion in the skull
Carpopedal spasm
Orthopaedics
Tumors
c4f593ff-e24d-46af-8d60-6a204ef4db74
single
The highest volume overload in a paurient due to maximum cardiac output is seen:
Ans. d. Immediately after delivery The highest volume overload in a paurient due to maximum cardiac output is seen immediately after delivery. "Peripheral vasodilation leading to a decrease in systemic vascular resistance is thought to be the first cardiovascular change associated with pregnancy (induced by progesterone). Cardiac output increases in response to this, by 20% at 8 weeks gestation and by up to 40-50% at 20-28 weeks gestation. Labour leads to fuher increases in cardiac output by 15% in the first stage and 50% in the second stage due to the combination of auto-transfusion of 300-500 ml of blood back into the circulation with each uterine contraction, and sympathetic stimulation caused by pain and anxiety. Cardiac output increases again immediately after delivery due to auto-transfusion of blood uterine contraction and relief of aoocaval compression. This may increase cardiac output by as much as 60-80%, followed by a rapid decline to pre-labour values within 1 houry Physiological Changes in the Cardiovascular System During Pregnancy Peripheral vasodilation leading to a decrease in systemic vascular resistance is thought to be the first cardiovascular change associated with pregnancy (induced by progesterone). Cardiac output increases in response to this, by 20% at 8 weeks gestation and by up to 40-50% at 20-28 weeks gestation. This is achieved predominantly an increase in stroke volume (due to an increase in ventricular end-diastolic volume, wall muscle mass, and contractility) but also by an increase in hea rate Labour leads to fuher increases in cardiac output by 15% in the first stage and 50% in the second stage due to the combination of auto-transfusion of 300-500 ml of blood back into the circulation with each uterine contraction, and sympathetic stimulation caused by pain and anxiety Cardiac output increases again immediately after delivery due to auto-transfusion of blood uterine contraction and relief of aoocaval compression. This may increase cardiac output by as
4
During second trimester
At term
After a heavy meal
Immediately after delivery
Gynaecology & Obstetrics
null
12dffb5b-cb5f-465d-858b-79190c6d5a6d
single
Turcot's syndrome is associated with -a) Duodenal polypsb) Familial adenomatous polyposisc) Brain tumorsd) Villous adenomae) Hyperplastic polyps
Turcot's syndrome is a variant of Familial adenomatous polyposis characterized by - Colorectal polyposis - Brain tumors (Medulloblastoma, Glioblastoma multiforme) The colonic polyps in Turcot's syndrome are fewer and larger than in classic FAP.
3
a
c
bc
ad
Surgery
null
364b074f-caf6-472c-a962-e91382c34ef2
single
Absolute contraindication to thiopentone:
Ans. (b) Acute intermittent phorphyriaMust Know* Thiopentone is C/I in acute intermittent porphyria.* Etomidate is C/I in adrenal insufficiency.* LA which causes meth hemoglobinemia: Prilocaine* Malignant hyperthermia is caused by: Succinylcholine* DOC for malignant hyperthermia: Dantrolene
2
Cardiotoxicity
Acute intermittent phorphyria
Malignant hyperthermia
Methhemoglobinemia
Anaesthesia
Miscellaneous General Anesthesia
1d211ebf-cd7d-4006-a7e9-98aa50eaa11f
single
A small amount of atropine is added to diphenoxylate in order to:
Atropine is intentionally added to diphenoxylate in fixed dose combinations to intentionally produce the adverse effects. - If the person takes diphenoxylate in large doses to get the euphoria, atropine will produce adverse effects and the person will not abuse the drug.
4
Suppress associated vomiting of gastroenteritis
Augment the anti-motility action of diphenoxylate
Block side effects of diphenoxylate
Discourage overdose and abuse of diphenoxylate
Pharmacology
Gastro-Intestinal Tract
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multi
A case of injury to right brow due to a fall from scooter presents with sudden loss of vision in the right eye. The pupil shows absent direct reflex but a normal consensual pupillary reflex is present. The fundus is normal. The treatment or choice is:
A i.e. Intensive intravenous coicosteroids as prescribed for spinal injuries to be instituted within six hours A i.e. Intensive intravenous coicosteroids as prescribed for spinal injuries to be instituted within six hours The first line of management of traumatic optic neuropathy is mega dose IV methyl prednisolone with in 8 hours followed by orbital canal decompression. (if visual function deteriorates or does not improve) Q
1
Intensive intravenous coicosteroids as prescribed for spinal injuries to be instituted within six hours
Pulse methyl Prednisolone 250 mg four times daily for three days
Oral Prednisolone 1.5 mg/kg body weight
Emergency optic canal decompression
Ophthalmology
null
882ebf42-f087-466c-893a-6626280fcaeb
multi
Which of the following prevent extrusion and lateral tooth movement
null
1
Alveolar crest group
Horizontal group
Oblique group
Apical group
Dental
null
c343068d-658f-44b2-8e9a-28f0e0a4005d
single
Chloroquine is used in the treatment of
null
1
DLE
Pemphigus
Psoriasis
Nummular eczema
Pharmacology
null
ff7dd22e-0ecd-4df0-9aa3-a195c0206d0a
single
Which of the following is the site of Venous Thrombosis in Budd Chiari Syndrome?
Budd-Chiari Syndrome (BCS) is an uncommon congestive hepatopathy caused by the obstruction of hepatic venous outflow. Patients may present with acute signs and symptoms of abdominal pain, ascites, and hepatomegaly or more chronic symptoms related to long-standing poal hypeension. The obstruction may be thrombotic or nonthrombotic anywhere along the venous outflow system from the hepatic venules to the right atrium. Ref: Current Medical Diagnosis and Treatment, 2012, Chapter 16 ; Scwaz's Principles of Surgery, 9th Edition, Chapter 31
3
Infrahepatic inferior vena cava
Infrarenal inferior vena cava
Hepatic vein
Poal vein
Medicine
null
755a5d68-a4ef-4bce-ae9c-d34ed0be80ab
single
True about small bowel diverticula-
Small bowel is uncommon site for diverticula. In small bowel, duodenum is the most common site followed by jejunum and then ileum. They are mainly acquired type and are false diverticula i.e. their walls consists of only mucosa or submucosa. They are mainly seen at the mesenteric border. Small bowel diverticula can be associated with bacterial overgrowth, leading to vitamin B12 deficiency, megaloblastic anemia, malabsorption, and steatorrhoea. This is known as 'blind loop' syndrome and can be treated by a course of antibiotics. Mostly small bowel diverticula are symptomless unless some complication arises. Complications occur in 6 to 10% of patients and incldues diverticulitis, hemorrhage, perforation, intestinal obstruction and malabsorption. Duodenal diverticula are mainly seen on the medial border. Small bowel diverticula can be easily diagnosed by barium meal follow through study. Enteroclysis or Small bowel enema is the most sensitive test. Treatment is mainly medical Surgery is indicated only when complication arises
4
Contains all the layers of bowel wall
Common in terminal ileum
Surgical treatment is not required
Seen on the mesenteric border
Surgery
null
cc6e5084-d76b-4877-9012-f0c803f1d70d
multi
Function of Golgi apparatus is
Organization of the Golgi is directed at proper glycosylation of proteins and lipids. There are more than 200 enzymes that function to add, remove, or modify sugars from proteins and lipids in the Golgi apparatus. Membranous vesicles containing newly synthesized proteins bud off from the granular endoplasmic reticulum and fuse with the cistern on the cis side of the apparatus. The proteins are then passed other vesicles to the middle cisterns and finally to the cistern on the trans side, from which vesicles branch off into the cytoplasm.(REF: GANONG'S REVIEW OF MEDICAL PHYSIOLOGY 23rd EDITION page no.42)
2
Synthesis of protein
Maturation of protein
Degradation of protein
Sequencing of protein
Physiology
General physiology
30ba9ad5-f44c-4af8-b386-f0cc0dbbb760
single
In a 40 years old male thrombus in the common femoral aery is because of -
Ans. is 'a' i.e., Atheroma
1
Atheroma
Thrombangits obliterans
Raynauds disease
Abdominal mass
Surgery
null
a2ea05d8-c927-4b53-9678-5d2f84bb613d
single
Treatment of choice in central safe perforation is -
There are 2 schools of thought as far as this question is concerned – Some believe that. TOC of central perforation is myringoplasty. TOC of central perforation is conservative management. But according to Turner 10/e, p 285 - central perforation/ tubo tympanic CSOM are both managed conservatively by antibiotics and by keeping the ear dry. “If there is recurring discharge or if there is deafness sufficient to cause disability, closure of the perforation by myringoplasty should be considered.” According to Scott’s Brown (7/e, vol-3 p 3421) Dry perforations that are symptom free do not require usually require closure. If the only symptom is a hearing impairment, the chances of improving hearing with surgery should be considered carefully, not just the hearing in the operated ear but the overall hearing ability of the patient. In patients with a H/O intermittent activity, surgery to close the perforation is probably indicated to minimize future activity. So from all above discussions it is clear that TOC for central safe perforation is conservative management.
4
Modified mastoidectomy
Tympanoplasty
Myringoplasty
Conservative management
ENT
null
9e939bbd-40e4-44f2-8c4d-7028715e80e7
single
Plasmacytoid lymphomas may be associated with increase in
Lymphoplasmacytic lymphoma is a B-cell neoplasm composed of small lymphocytes, plasmacytoidlymphocytes, and plasma cells, which typically affects older adults. There is maturation to plasmacytoid cells, but lacking the features of other lymphomas (pseudofollicles, neoplastic follicles, monocytoid B cells). lymph nodes; the pattern is diffuse or interfollicular, sparing the sinuses. The infiltrate consists of small lymphocytes,plasmacytoid cells and plasma cells Immunoblasts, epithelioid histiocytes and mast cells may be present. bone marrow; diffuse, nodular or interstitial infiltration. The consensus panel requires bone marrow involvement for the diagnosis of WM4. There may be circulating neoplastic cells, but the count is lower than for CLL
2
IgG
IgM
IgA
IgE
Pathology
Haematology
22362a35-3598-4a88-9ef5-a033c8e05483
single
A woman consumes several tabs of Amitryptilline (case of amitryptiline poisoning). All of the following can be done except -
Ans. is 'd' i.e., Atropine as antidote o This question is straight forward and you can solve this one, even if you don't know the treatment of TCAs poisoning. As you all know that TCAs cause antichlolinergic side effects, atropine (an anticholinergic drug) cannot be used in TCAs poisoning. Treatment of TCAs Poisoning o Treatment of TCAs overdose includes: (i) Assessment and treatment ofABC: Airway protection should be done. (ii) Gastric lavage (gastric decontamination): Gastric lavage may be considered for potentially life threatening TCA overdoses only when it can be delivered within 1 hour of ingestion and the airway is protected. Activated charcol may reduce the absorption of TCAs. (iii) Alkalinization: The use of sodium bicarbonate in TCA poisoning has been shown to have beneficial effects. A lkalinization correct hypotension and arrhythmias. Sodium bicarbonate is indicated when: (i) pH < 7.1; (ii) RS > 0.16 seconds; (iii) QRS > 100 msec; (iv) Arrhythmias; (v) Hypotension. (iv) IVfluids: IV fluids are given for hypotension. In cases refractory to the use of IV fluids inotropic agents may be required. (v) Anticonvulsants: Seizures are usually self limited but where treatment is necessary benzodiazepines are the treatment of choice. (vi) Drug elimination: Tricyclic specific antibody fragments have been developed and their effectiveness at reversing cardiovasular toxicity in animals has been demonstrated by several studies. However, experimental work has shown that extremely large amounts are required and at present the use of Fab fragments is limited by cost and possibility of renal toxicity. Hemodialysis and hemoperfusion are not effective.
4
Sodium bicarbonate infusion
Gastric lavage
Diazepam for seizure control
Atropine as antidote
Pharmacology
null
4ed3f0ba-f7a5-4cd6-a722-c6e187d45578
multi
Best preservative for protozoal cysts is
10 % formalin is ALL - purpose fixative used for preservation of morphology of helminth eggs, larvae, protozoan cysts and coccidian.
1
10 % formalin
Isopropyl alchol
HCL Solution
Naoh solution
Microbiology
null
cef23903-71b8-47dd-a2ca-e49a99b39a45
single
The Ridley -Jopling classification for leprosy is based on which of the following parameters?
Ans. a. Clinical, bacteriological, immunological Ridley-Jopling Classification for Leprosy is based on Clinical (skin and nerve involvement), bacteriological (bacteriological/ morphological index in skin and nasal smears) and immunological criteria (Lepromin test).
1
Clinical, bacteriological, immunological
Histopathological, clinical, therapeutic
Histopathological, epidemiological, therapeutics
Histopathological, clinical, epidemiological
Skin
null
cd4b3186-97d1-4fdd-9108-5052400f1a82
single
Pancytopenia with cellular marrow is seen in all except -
null
4
Megaloblastic anemia
Myelodysplasia
Paroxysmal Nocturnal hemoglobinuria
G6PD deficiency
Medicine
null
a70d307f-4877-4273-8cb8-33276953aac7
multi
By what age a child can make tower of 3 cubes?
15 months - 2 cube tower 18 months - 3 cube tower 24 months - 6 cube tower 36 months - 9 cube tower
2
15 months
18 months
24 months
28 months
Pediatrics
null
b3fd8ae3-c58a-4280-adca-d02122f6918c
single
Which of the following is FALSE regarding breast cancer during pregnancy?
Breast cancer occurs in 1 of every 3000 pregnant women, and axillary lymph node metastases are present in up to 75% of these women. The average age of the pregnant woman with breast cancer is 34 years. Less than 25% of the breast nodules developing during pregnancy and lactation will be cancerous. Ultrasonography and needle biopsy are used in the diagnosis of these nodules. Open biopsy may be required. Mammography is rarely indicated because of its decreased sensitivity during pregnancy and lactation Because of the potential deleterious effects of radiation therapy on the fetus, radiation cannot be considered until the fetus is delivered. A modified radical mastectomy can be performed during the first and second trimesters of pregnancy, even though there is an increased risk of spontaneous aboion after first-trimester anesthesia. Ref: 1. Robinson DS, Sundaram M, et al: Carcinoma of the breast in pregnancy and lactation, in Bland KI, Copeland EM III (eds): The Breast: Comprehensive Management of Benign and Malignant Diseases. Philadelphia: WB Saunders, 1998, p 1433. 2. Hunt K.K., Newman L.A., Copeland E.M., Bland K.I. (2010). Chapter 17. The Breast. In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews, R.E. Pollock (Eds), Schwaz's Principles of Surgery, 9e.
2
Axillary lymph node metastases in 75% of affected women
Mammography is sensitivity during pregnancy
Radiation cannot be considered for treatment
Less than 25% of the breast nodules are cancerous
Surgery
null
df5eba26-f882-4eaa-a0ac-190e4db7b434
multi
Which of the viruses is not commonly implicated in the pathogenesis of Non-Hodgkin's lymphomas?
HTLV-1 is associated with adult T-cell leukemia/lymphoma. EBV is found in a subset of Burkitt lymphoma, 30% to 40% of Hodgkin lymphoma (HL), many B-cell lymphomas arising in the setting of T-cell immunodeficiency, and rare NK-cell lymphomas. In addition to Kaposi sarcoma, HHV-8 is associated with an unusual B-cell lymphoma (primary effusion lymphoma) that presents as a malignant effusion, often in the pleural cavity.
4
Human T-cell leukemia virus-1 (HTLV-1)
Epstein-Barr virus (EBV)
Human herpesvirus-8 (HHV-8)
Cytomegalovirus (CMV)
Pathology
Non Hodgkin Iymphoma
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single
Karlstad studies were held in:
Since artificial fluoridation is not permitted in Sweden a number of other initiatives were introduced in 1971 as part of the "Karlstad studies" to evaluate the separate and combined effects of different plaque control programs.  The efficacy of professional tooth cleaning was extensively investigated for the first time in the so-called Karlstad studies.
3
Netherlands
London
Sweden
Finland
Dental
null
17aecbe9-9c27-4320-9850-82c20087b77e
single
All are true regarding Thrombotic Thrombocytopenia Purpurs (TTP), except ?
Ans. is 'a' i.e., Normal complement levels All the given options are true in relation to TTP. Because red cells are forced to squeeze through abnormally narrowed small vessels because of thrombi. --> Due to consuption of platelets in formation of platelet thrombi. --> Due to presence of thrombi in CNS microcirculation. --> Due to presence of thrombi in renal microcirculation. " height="120" width="390" align="left">Clinical features o TTP is characterized by a pentad of : ? Microangiopathic hemolytic anemia Thrombocytopenia Neurological symptoms Renal dysfunction Fever o Platelet associated IgG and complement levels are usually normal in TTP --> Because red cells are forced to squeeze through abnormally narrowed small vessels because of thrombi. --> Due to consuption of platelets in formation of platelet thrombi. --> Due to presence of thrombi in CNS microcirculation. --> Due to presence of thrombi in renal microcirculation.
1
Normal complement levels
Microangiopathic hemolytic anemia
Thrombocytopenia
Thrombosis
Pathology
null
73508488-6509-45fb-91f8-a8258ec3036e
multi
Urinary retention in child is most commonly caused by -
null
2
Metal scab with ulceration
Post.urethral valve
Urethral stricture
Epispadias
Surgery
null
0667f795-0893-4e1e-b541-fa9fe4688ad1
single
Mutism is a recognised feature of :
> A. i.e. Ganser state; B. i.e. Conversion hysteria; C. i.e. Catatonic schizophrenia
4
Ganser states
Conversion hysteria
Catatonic Schizophrenia
All
Psychiatry
null
daf07b41-4081-4250-a888-595f79ccdab6
multi
In a patient post myocardial infarction developed arrial fibrillation. Subsequently the ECHO showed a mural thrombus. The management is by
(A) Warfarin # Patients with an anterior location of the infarction, severe LV dysfunction, CHF, a history of embolism, two-dimensional echocardiographic evidence of mural thrombus, or atrial fibrillation are at increased risk of systemic or pulmonary thromboembciism.> Such individuals should receive full therapeutic levels of antithrombin therapy (UFH or LMWHs) while hospitalized, followed by at least 3 months of warfarin therapy.
1
Warfarin
Cardioversion
Digoxin
Propranolol
Medicine
Miscellaneous
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single
Not seen in pellagra -
- niacin deficiency results in pellagra. The disease is characterized by diarrhea, dermatitis and dementia. - niacin deficiency is common in maize eating population due to aminoacid imbalance cause by an excess of leucine. - excess of leucine appears to interfere in the conversion of tryptophan to niacin. Reference: Park's textbook of preventive and social medicine, 23rd edition, pg no:619 <\p>
2
Diarrhea
Dyspepsia
Dementia
Dermatitis
Social & Preventive Medicine
Nutrition and health
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single
Isolated hyperbilirubinemia is classically seen as an adverse effect of:
Hepatotoxicity due to rifampin alone is uncommon and often consists of isolated hyperbilirubinemia. Ref: Harrisons Principles of Internal Medicine, 18th Edition, Page 1375
2
INH
Rifampin
Pyrazinamide
Capreomycin
Medicine
null
7dd6bfb1-85df-474a-9770-6044a19f9376
multi
Green coloured urine is seen in:
Ans: d (Phenol) Ref:Reddy, 27th ed, p. 469In phenol poisoning (carbolic acid) green coloured urine is passed which is called carboluria. Il is due lo the presence of oxidized hydroquinone and pyrocatechol in urine. They are derivatives of phenol. The hydroquinone and pyrocatechol cause pigmentation in the cornea and various cartilages - Ochronosis.Brown colored urine is seen in nitric acid poisoning.Appearance of stomach in various poisoningCarbolic acid: Thickened leathery brown stomachOxalic acid: Bleached up appearanceNitric acid: Distended abdomenArsenic: Velvetty stomachAlkali: Chocolate coloured mucosaSulphuric acid: Brown coloured mucosaPotassium: Brown coloured mucosapermanganate BRIDGEAcetic acid produces hemoglobinuriaCarbolic poisoning is the only corrosive acid poisoning where stomach wash can be given.
4
Copper sulphate
Opium
Nitric acid
Phenol
Forensic Medicine
Toxicology
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single
Pseudochylous ascites occurs in-
• Abnormal accumulation in the peritoneal cavity of a milky fluid that resembles chyle. • The turbidity of the fluid is caused by cellular debris in the fluid. • Pseudochylous ascites is indicative of an abdominal tumor or infection. • In some patients the ascitic fluid appears milky because of an excess of chylomicrons (triglycerides)
4
Cirrhosis
Hyperlipidemia
Filariasis
Malignant ascites
Surgery
null
8569f191-3105-4946-9511-0403b00fce58
single
Not true about somnambulism among the following is
* Somnambulism is an arousal parasomnia consisting of a series of complex behaviours that result in large movements in bed or walking during sleep. * Also called sleep walking, in this condition individual arises from bed and ambulates without fully awakening. * Individuals can engage in a variety of complex behaviours while unconscious. * Sleepwalks characteristically begin toward the end of the first or second slow wave sleep episodes (NREM stage III and IV). * Sleepwalking episodes may range from sitting up and attempting to walk to conducting an involved sequence of semi-purposeful actions Ref:- Kaplan & Sadock's Synopsis of Psychiatry 10th edition; Pg num:- 762
1
Low level motor skill/function is present
Sleep walking
Disorder of sleep arousal
Patient consciousness is not preserved
Psychiatry
Sleep disorders and eating disorders
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multi