question
stringlengths
1
1.57k
exp
stringlengths
1
22.5k
cop
int64
1
4
opa
stringlengths
1
287
opb
stringlengths
1
287
opc
stringlengths
1
286
opd
stringlengths
1
301
subject_name
stringclasses
21 values
topic_name
stringlengths
3
135
id
stringlengths
36
36
choice_type
stringclasses
2 values
All are features of somatization disorder except -
Professional patient refers to Munchausen syndrome (factitious disorder).
4
Frequently changing pain sites
Sexual symptoms
Paresthesia
Professional patients
Psychiatry
null
e9ea3745-05f0-4c49-a401-13f1b6007dd0
multi
Most common site for Osteomyelitis:
Ans. (b) MetaphysisRef.: Maheshwari 5th ed. 1168* Hematogenous osteomyelitis is an infection caused by bacterial seeding from the blood.* Acute hematogenous osteomyelitis is characterized by an acute infection of the bone caused by the seeding of the bacteria within the bone from a remote source. This condition primarily occurs in children.* The most common site is the rapidly growing and highly vascular metaphysis of growing bones. The apparent slowing or sludging of blood flow as the vessels make sharp angles at the distal metaphysis predisposes the vessels to thrombosis and the bone itself to localized necrosis and bacterial seeding.Also Know* MC site of OM in child: Lower end of femur * MC site of OM in adults: Thoraco-Lumbar vertebra (Thoracic > Lumbar)* MC site of OM in infants: Hip
2
Epiphysis
Metaphysis
Diaphysis
Sub-chondral growth plate
Orthopaedics
Osteomyelitis
68c8cd1c-2611-4392-8079-3e1100cc711a
single
Release ferroportin store is controlled by?
Ans. (a) Hepsidin(Ref: Robbins 9th/pg 649; 8th/pg 659)Ferroportin which regulates the Iron release from tissue store house is regulated by hepsidin hormone released by liver.
1
Hepsidin
Transferrin
Ferritin
Hepoxin
Pathology
Misc. (R.B.C)
f01146bf-ec9c-4ec9-a726-1a31f8bb3263
single
Which protease inhibitor has boosting effect?
Retroviral protease Inhibitors (Pis): An aspaic protease enzyme encoded by HIV is involved in the production of structural proteins and enzymes (including reverse transcriptase) of the virus. The large viral polyprotein is broken into various functional components by this enzyme. This protease acts at a late step in HIV replication, i.e. maturation of the new virus paicles when the RNA genome acquires the core proteins and enzymes. In case of different Pis, 6-18 tablets are to be taken daily, some on empty stomach, but others with meals; and this has to go on for months and years. Patient acceptability and compliance are often low. One of the strategies adopted to reduce the dose of IDV, LPV and SQV is to combine them with a lowand subtherapeutic dose (100 mg) of ritonavir. By reducing first pass metabolism, ritonavir increases the bioavailability of the companion PI. This &;boosted PI regimen&; permits reduction in the number I frequency of tablets to be taken each day. Lopinavir is marketed only in combination with ritonavir. Nelfinavir is not to be combined with ritonavir. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:772,773
4
Amprenavir
Tenovir
Nelfinavir
Ritonavir
Pharmacology
Chemotherapy
9a1916e3-99ff-4096-8450-753ca328fd6f
single
If a person has visual acuity 6/6. At what distance will he/she be able to read 6/24 lines
Answer- B. 24 metresVisual acuity 616 means that a Person with normal visual acutiy can read the smallest line at a distance of 6 meters.Visual acdty 6124 means that this person can read paicular letters/lines at a distance of 6 meters which a person with normal visual acuity can read from a distance of 24 mm.
2
6 metres
24 metres
36 metres
48 metres
Ophthalmology
null
42d1ea77-4290-49d9-90f3-c668b5101688
single
Which of the following is not a function of gut flora
If the intestinal microbes are eliminated, the intestinal contents become voluminous, the caecum is dilated and the intestine remains thinly walled. Historically, in germ-free animals, the villi are shoer, epithelial cell turnover is reduced and gut-associated lymphoid tissue is atrophic. From a functional point of view, in the absence of flora, mucosal disaccharidase activity is increased and nutrient absorption is more efficient, but gastric and intestinal motility is slower, and immunological defense mechanisms are weaker. Regarding infections, the protective influence of intestinal microflora extends beyond the gut. Through an ill-understood mechanism, normal enteral flora protects also against parenteral infections. Bowel flora has also been given the credit for synthesizing several vitamins. These vitamins include vitamin K, cyanocobalamin, folate, pyridoxine, biotin, pantothenate, and riboflavin. Anaerobic bacterial fermentation of fiber in the colon results in the formation of water, carbon dioxide, hydrogen, and sho-chain fatty acids such as acetic, propionic, and butyric acids.
3
Protection against parenteral infections
Synthesis of vitamin K
Decreased proliferation of epithelial cells
Fermentation of mucin
Physiology
G.I.T
269fb798-5b06-4848-a527-ee75f8f4aa06
single
A well Differenciated follicular carcinoma of thyroid can be best Differentiated from a Follicular Adenoma by
FNAC is is of limited value in the preoperative diagnosis of follicular thyroid cancer. Diagnosis of follicular thyroid cancer requires demonstration of cellular invasion of the capsule or vascular or lymphatic channels. Source : Sabiston 20th edition Pg : 905
3
Huhle cell change
Lining of tall columnar and cuboidal cells
Vascular invasion
Nuclear features
Surgery
Endocrinology and breast
4bfb0267-bfbe-4953-b2e5-82e7b5f3fb5b
multi
True regarding Monteggia fracture is:
: Upper ulnar fracture & dislocated radial head Monteggia fracture-dislocations are classified by the Bado system Bado type I injuries are characterized by a proximal ulnar fracture with anterior dislocation of the radial head. This is due to a forceful pronation injury of the forearm and is the most common type. Bado type II injuries are "reversed" Monteggia fracture-dislocation injuries. Here, there is posterior angulation of the ulnar fracture site and posterior dislocation of the radial head. Bado type III and IV are rare injuries. REF : Maheshwari book of ohopedics 6th Ed.
1
Upper ulnar fracture & dislocated radial head
Upper radial fracture & dislocated ulna
Lower radial fracture & dislocated ulna
Lower ulnar fracture & dislocated radius
Orthopaedics
All India exam
19703614-adc5-4a98-92f9-065da2f0f15b
multi
Vasoconstrictor anong these ?
Ans. is 'c' i.e., Angiotensin-IIImpoant chemical regulator of CVS are :Vasoconstrictors : Noradrenaline, Adrenaline, ADH (vasopressin), angiotension II, Endothelins, PGF2, thromboxane A2.Vasodilators : Kinins (Bradykinin, lysyl-bradykinin), PGE,, PGL (prostacyclin), VIP, ANP, Nitric oxide (NO)
3
NO
PGI2
Angiotensin-II
ANP
Pathology
null
0d1b7cf3-a9d7-41b8-9d3e-02c779855560
single
Most common cause of Foley catheter induced UTI
Ans. (a) E. coliRef Bailey and Love 26th Edition, Page 276* Urinary infection is the most commonly associated infection in postoperative period* Most common organism isolated in catheter related Infections: E. coli
1
E. coli
Klebsiella
Pseudomonas
Staphylococci
Surgery
Urethra & Penis
d1ea3ca3-fc30-4991-80fa-91cbfe3c4c7a
single
A 22-year-old woman experiences a sudden onset of severe lower abdominal pain. Physical examination shows no masses, but there is severe tenderness in the right lower quadrant. A pelvic examination shows no lesions of the cervix or vagina. Bowel sounds are detected. An abdominal ultrasound scan shows a 4-cm focal enlargement of the proximal right fallopian tube. A dilation and curettage procedure shows the only decidua from the endometrial cavity. Which of the following laboratory findings is most likely to be reported for this patient?
Conditions predisposing to ectopic pregnancy include chronic salpingitis (which may be caused by gonorrhea, but a culture would be positive only with acute infection), intrauterine tumors, and endometriosis. In about half of the cases, there is no identifiable cause. Gestational trophoblastic disease associated with a triploid karyotype with partial mole developing outside the uterus is rare. Candida produces cervicitis and vaginitis and is rarely invasive or extensive in immunocompetent patients. Syphilis is not likely to produce a tubal mass with acute symptoms (a gumma is a rare finding).
2
Cervical culture positive for Neisseria gonorrhoeae
Detection of human chorionic gonadotropin in serum
69, XXY karyotype on decidual tissue cells
Pap smear showing pseudo hyphae of Candida
Pathology
Female Genital Tract
a87d6592-2063-49e1-bbbc-dea8027ccb50
multi
Most of the neurons in the Autonomic Nervous System are
Ans: a (cholinergic) Ref: Ganong 22nd ed/ p.226Most of the neurons in ANS are cholinergic.Autonomic Nervous System:Parasympathetic preganglionic fibres have a long course.Parasympathetic postganglionic fibres have a short course. This is because the parasympathetic ganglions are located near the tissues it supplies.Each preganglionic axon diverges to an average of 8 or 9 postganglionic neurons.Preganglionic: Postganglionic = 1:8 or 9.Conduction speed in different fibres:* Autonomic preganglionic axons are B type* Autonomic postganglionic axons are C type* Conduction speed A>B>CPreganglionic fibres are myelinated, whereas, postganglionic fibres are unmyelinated.Cholinergic neuronso All preganglionic neuronso Parasympathetic postganglionic neuronso Sympathetic postganglionic neurons which innervate sweat glands and vessels in skeletal muscles.Remaining sympathetic postganglionic neurons are adrenergic or noradrenergic.Types of nerve fibresFibre typeFunctionsA alphaProprioception; somatic motorA betaTouch, pressureA gammaMotor to muscle spindlesA deltaPain, coId, touchBPreganglionic autonomicC- Dorsal rootPain, temperature, some mechano- reception, reflex responsesC - SympatheticPostganglionic sympathetic Relative susceptibility of nerve fibres Most susceptibleIntermediateLeast susceptibleHypoxiaBACPressureABCLocal anaestheticsCBA
1
Cholinergic
Adrenergic
Noradrenergic
Dopaminergic
Physiology
Nervous System
3b2982df-d351-4c30-b91f-0c5667923076
single
One of the following is not true of International classification of Disease
ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD) Medical classification list by the World Health Organization (WHO); Revised every 10years Consists of 21chapters The ICD-10 consists of: Tabular lists containing cause-of-death titles and codes (Volume 1) Inclusion and exclusion terms for cause-of-death titles (Volume 1) Description, guidelines, and coding rules (Volume 2) and An alphabetical index to diseases and nature of injury, external causes of injury, table of drugs and chemicals (Volume 3) Ref : Park&;s textbook of preventive and social medicine; 23rd edition
2
It is revised once in 10 years
It was devised by UNICEF
The 10th revision consists of 21 major chapters
It is accepted for National and International use
Social & Preventive Medicine
Concept of health and disease
cbf77acb-a5ae-4e8a-a424-371eec5c1961
multi
Expressed breast milk can be stored at room temperature for how many hoursRpt question need to be changed
EXPRESSED BREAST MILK (EBM) STORAGEDURATIONRoom temperature6-8 hoursRefrigerator(4 C)24 hoursFreezer compament(-15 C)2 weeksDeep freezer (-18 C)3-6 months
2
4
8
16
24
Pediatrics
All India exam
4385f9d2-ff17-4069-9b23-d7ad3adad915
single
Autoimmune haemolytic anemia is a feature of?
Causes of Autoimmune Hemolytic Anemias Idiopathic (50%) Drugs - Methyl dopa; CLL, Lymphomas M. Pneumoniae infection. IMN, SLE and other connective tissue disorders.
4
ALL
CML
Burkett's Lymphoma
Lymphoma
Unknown
null
34e4a300-09b2-463c-91c6-8bb18c412698
multi
A patient with oral cancer, had ipsilateral lymph node measuring 2 cm, single in number with capsular spread. According to TNM staging it is included under:
Nx: Nodal status can't be assessed. No: No lymph nodes. N1: Single ipsilateral lymph node <3 cm N2: A: Single ipsilater lymph 3.6 cm B: Multiple ipsilater lymph <6 cm C: Bilateral or contralateral lymph nodes <6 cm. N3: Any lymph node with >6 cm, or Any lymph node with capsular invasion.
4
Nx
N1
N2
N3
Surgery
null
0fa489b4-a12e-40be-a0b6-0a5bf19f076c
single
Tinea unguium effects –
Tinea unguium starts either from distal edge of nail plate or from base of nail. It slowly involves the entire nail plate.
2
Nail fold
Nail plate
Joints
Inter digital space
Dental
null
2d0e223f-ecf4-4948-8045-4ce507b28793
single
Feature of aging periodontium is
null
4
Lacunae in bone and cementum
Increased cell size
Increased cell number
Scalloping of cementum & alveolar bone surface
Dental
null
66e4d56b-257d-4708-a3c8-58b1ab635caa
multi
Regarding severe combined immunodeficiency disease ,which of the following statement is true
Ref Robbins 8/e p234;9/e p239 SCID represent a constellation of genetically distinct syndrome, all having in common defect in both humoral and cell mediated immune response
1
Adenosine deaminase deficiency
Decreased circulating lymphocytes
NADPH oxidase deficiency
C1 esterase deficiency
Anatomy
General anatomy
feeffea3-16aa-4451-a464-622307125a4f
multi
In nasal endoscopy Eustachian tube is examined at?
Ans. is'a'i.e., 1st passNasal endoscopy is done in three passes :-First Pass: Examination of nasal cavity, nasopharynx, opening of eustachian tube, walls of nasopharynx, upper surface of soft palate and uvula, opening of eustachian tube of opposite side opening of nasolacrimal duct and inferior meatus.
1
1st pass
2nd pass
3rd pass
4th pass
ENT
null
9ba348e1-553b-4d8a-984a-ad03e04bfe78
single
Multifocal tumor of vascular origin in a patient of AIDS -
Ans. is 'a' i.e., Kaposi sarcoma Neoplastic disease in AIDS . Kaposi sarcoma (most common tumor) . Non Hodgkin lymphoma - Immunoblastic lymphoma (most common lymphoma) - Primary CNS lymphoma (associated with EBV) - Burkitt's lymphoma . Other less common neoplasm are - Hodgkin's disease - Leukemia - Cervical Ca - Brain tumor - Testicular Ca - Multiple myeloma - Melanoma - Lung Ca - Anal Ca - Oral Ca
1
Kaposi sarcoma
Astrocytoma
Gastric Carcinoma
Primary CNS lymphoma
Microbiology
null
ead6fe56-07de-4eca-9a64-a10320f1a750
single
Urethral and bladder neck supports include all except
Supports of Bladder neck Pubourethral Ligaments Arcus tendineus fascia Levator ani muscles Vagina and its lateral fascial condensations.
4
Pubourethral Ligaments
Arcus tendineus fascia
Levator ani muscles
Uterosacral Ligament
Gynaecology & Obstetrics
null
ddbac0ae-a957-4e45-881d-250d23b3c2ac
multi
The height of a child is double the bih height at the age of-
Ans. is 'd' i.e., 4 years o An infant usually doubles his bih height by the age of 41/2 years Age Bih 3 months 9 months 1 year 2 years 41/2 years Height 50 cm 60 cm 70 cm 75 cm 90 cm 100 cm
4
1 year
2 years
3 years
4 years
Pediatrics
null
3bfc573d-5493-47a5-9329-f16f7198e4b7
single
The most common causative organism for lobar pneumonia is :
Answer is C (Stretptococcus pneumonia): 'Streptococcus pneumonia or pneumococcus is the most common cause of community acquired acute pneumonia -Robbins 7th/748 Lobar pneumonia refers to an acute bacterial infection that results in consolidation of a large poion of a lobe or an entire lobe. Streptococcus pneumonia produces a picture of lobar pneumonia.
3
Staphylococcus aureus
Streptococcus pyogenes
Streptococcus pheumoniae
Haemophilus influenzae
Medicine
null
6b97edfe-91c2-4519-98f5-3f0ecf23458e
single
Familial Renal Cell carcinoma is associated with:
Von Hippel Lindau syndrome
4
Turners syndrome
Alpos syndrome
Peutz-jeghers syndrome
Von Hippel Lindau syndrome
Pathology
null
f1566f4b-b795-431a-98f9-3b397e063415
single
Posterior staphyloma is most commonly seen in: March 2012
Ans: D i.e. Degenerative myopia Staphyloma & causes The usual causes of intercalary staphyloma are perforating injuries of the peripheral cornea, marginal corneal ulcer, anterior scleritis etc. Developmental glaucoma, end stage primary or secondary glaucoma, scleritis & trauma to the ciliary region of the eye are some of the conditions that lead to a ciliary staphyloma The most common cause of anterior staphyloma is a sloughing corneal ulcer which perforates && heals with the formation of a pseudocornea Degenerative high axial myopia is the most common cause of posterior staphyloma
4
Perforating injuries of the peripheral cornea
Developmental glaucoma
Sloughing corneal ulcer
Degenerative myopia
Ophthalmology
null
e49da6bd-f2e8-4581-a858-2d214da01da9
single
Unna boot is used for treatment of
Answer- B. Varicose ulcersIt is named for the dermatologist Paul Gerson Unna.This boot can be used to treat uninfected nonnecrotic leg and foot ulcers that result from such conditions as venous insuftciency (varicose ulcers) and stasis dermatitis.
2
Diabetic foot ulcer
Varicose ulcers
Ankle instability
Calcaneum fracture
Surgery
null
cc95288d-54de-4886-8bfa-101e9c45ae8b
single
Which of the following is not a step of b-oxidation?
4 repetitive steps of fatty acid oxidation : 1. FAD dependent oxidation 2. Hydration 3. NAD dependent oxidation 4. Thiolysis It is NAD dependent oxidation, not NADP dependent
1
NADP dependent oxidation
FAD dependent oxidation
Thiolysis
Hydration
Biochemistry
Beta oxidation of fatty acids
fb55532a-5cfa-4979-835c-9f31d70ea4c7
multi
Reticulocytes are stained with
Reticulocytes are stained in living state in vitro so staining with dyes like brilliant cresyl blue and new methylene blue is referred to as supravital staining.
2
Methyl violet
Brilliant Cresyl blue
Sudan black
Indigo carmine
Pathology
null
cc71e0e7-2fa5-419b-83bd-13328c6270d5
single
Which is NOT TRUE with regards to antibiotic resistance in bacteria?
Plasmid mediated resistance can be transmitted both horizontally and veically. Routes of horizontal transfer of plasmid mediated resistance are conjugation, transduction and transformation. 3 main mechanisms of drug resistance: Production of beta lactamases: Most common mechanism of penicillin resistance in both gram +ve and -ve bacteria. Alteration of PBP (penicillin binding proteins ): Seen in gram +ve bacteria. This is the basis for methicillin resistance in MRSA also basis for penicillin resistance in pneumococci and enterococci. Impaired penetration: Seen only in gram -ve bacteria PBP are localised on outer surface of cell membrane and not on cell wall. PBP are essential for synthesis of cell wall.
3
Most common mechanism is production of antibiotic destroying enzymes
Lack of target binding site may be mechanism of resistance in some enterococci against vancomycin
Plasmid mediated resistance is transmitted only veically
Target binding shifting is the mechanism in some pneumococci
Microbiology
null
e3fa1ebf-55d1-4705-91de-e2a3dcfb96b1
multi
Changes in blood passing through the systemic capillaries are all except
In systemic capillaries pO2<CO2The decrease in O2 affinity of hemoglobin when the pH of blood falls is called the Bohr effect and is closely related to the fact that deoxygenated hemoglobin which occure in systemic capillaries. The pH of blood falls as its CO2 content increases, so that when the PCO2 rises, the curve shifts to the rightIncrease in hematocrit because of chloride shift occurs in capillariesBecause the rise in the HCO3- content of red cells is much greater than that in plasma as the blood passes through the capillaries, about 70% of the HCO3- formed in the red cells enters the plasma. The excess HCO3- leaves the red cells in exchange for Cl-.Note that for each CO2 molecule added to a red cell, there is an increase of one osmotically active paicle in the cell-- either an HCO3- or a Cl- in the red cell. Consequently, the red cells take up water and increase in size. This increase hematocritpH decreases due to the formation of HO3- anion, and H2CO3Ref: Ganong's Review of Medical Physiology Twenty-Third Edition Page No:611
3
Increase in hemotocrit
pH decreases
Shift of oxygen dissociation curve to the left
Increase in protein content
Physiology
Cardiovascular system
0386062e-599e-43fa-89b6-89046b74be56
multi
Aspergillus causes all except:
Ans. is 'c' i.e., Dermatophytosis(Ref: Harrison, 18th/e, p. 1655, 16561)* Dermatophytosis is caused by dermatophytes and Aspergillus is not a dermatophyte. Other options are correct.
3
Bronchopulmonary allergy
Otomycosis
Dermatophytosis
Keratitis
Microbiology
Mycology
e7f6536b-8882-4acf-8f6c-1b7b4e3ef3a2
multi
Which cranial nerve's fibers are myelinated by oligodendrocytes?
The fibers of the optic nerve (CN II) are myelinated by oligodendrocytes. This is an impoant distinction from the Other cranial nerves ( myelinated by Schwann cells) because the optic nerve is considered a tract of the central nervous system
2
I
II
III
VII
Anatomy
Brainstem, cerebellum and ventricles
5771fc3c-6963-4f48-b66d-422b7607224c
single
The antihypeensive which cause decrease libido and impoance is
Diabetics have a maximum risk of causing sexual dysfunction followed by beta blockers Atenolol ,metaprolol and Carvedilol have high risk whereas nevibolol has maximum risk of erectile dysfunction ACE inhibitors decrease the risk Refer kDT 6/e p139
1
Atenolol
Enalapril
Prazosin
Diltiazem
Pharmacology
Cardiovascular system
c9e81c2d-ec7d-400e-a721-f77997d6df7d
single
Which cranial nerve passes through diaphragm?
null
4
6
7
8
10
Anatomy
null
9928c0ed-b40f-47ba-b6ec-011ac05ccaa8
single
Mesosomes in bacteria are the functional unit for -
Mesosomes (chondroid)  Mesosomes are formed by invagination of plasma membrane into the cytoplasm. They are more prominent in gram-positive bacteria. They are the principal sites of respiratory enzymes in bacteria and are analogous to mitochondria of eukaryotes. They coordinate nuclear and cytoplasmic division during binary fission.
3
Lipid storage
Protein synthesis
Respiratory enzymes
null
Microbiology
null
f6ab608e-5b4d-4347-883e-b1c5652e9977
multi
All of the following are true about vagina except
Vaginal mucosa is lined by non-keratinized squamous epithelium.
3
Direction of vagina is parallel to plane of brim of true pelvis.
Posterior wall is 11.5 cm and anterior wall is 9 cm long
Vaginal mucosa is lined by keratinized squamous epithelium
No glands open into vagina
Gynaecology & Obstetrics
null
b86707d7-0465-4762-8b9a-18f3e60506d9
multi
USG is/are based on:
Ans. A. Piezoelectric effectUltrasonography:Ultrasonic image(sonographic/echographic) is based on mechanical oscillations of the crystal excited by electrical pulses (Piezoelectric effect).
1
Piezoelectric effect
Diamagnetic effect
Paramagnetic effect
Ferromagnetic effect
Radiology
null
1cd11a50-c962-4559-a968-9bd10e6d5685
single
Which one of the following is not a symptom of atherosclerotic occlusive disease at the bifurcation of aoa (Leriche syndrome)?
. Ans : (d) Gangrene localised to feet In chronic atherosclerotic occlusive disease usually it is confined to distal abdominal aoa below the renal aeries. Frequently extends to iliac aeries . Claudication characteristically involves buttocks , thighs and calves & may associated with impotence in males (Leriche syndrome ) .
4
Claudication of the buttock and thigh
Claudication of the calf
Sexual impotence
Gangrene localized to the feet
Surgery
Vascular surgery
081090f4-fa5f-4ac5-becf-5f8ceea2ef94
single
A 30-year old male presents with severe pain chest, breathlessness, hypotension and ECG shows ST elevation in V3, V4, V5 and V6 leads. He will be best treated with :
null
4
Streptokinase
t-PA
Heparin
PTCA
Medicine
null
526e053c-7084-4fe9-a687-16050cded94b
single
Prolonged postoperative ileus is best treated by?
Most patients developed transient ileus after a major abdominal operation. Most of these resolve within 3 to 5 days. Condition like extensive operative manipulation, major small bowel injury, heavy narcotic use, intra abdominal infection and pancreatitis- can prolong the ileum to 5 to 7 days. Ileus prolonged beyond this period is viewed with suspicion. Management of postoperative ileus The essence of treatment is prevention, with the use of nasogastric suction and restriction of oral intake until bowel sounds and passage of flatus return. Electrolyte abnormality, if any is corrected. A battery of laboratory tests are conducted to look for primary causes. which, if found is treated. "If paralytic ileus is prolonged and threatens life, a laparotomy should be considered to exclude a hidden cause and facilitate bowel decompression" Ref: Bailey & Love 25/e, Page 1201.
3
Long tube inseion
Calcium pantothenate
Laparotomy and exploration
Peristaltic stimulants
Surgery
null
97b025c6-5b15-4fe1-b9a1-7d313599ec4e
single
A 4-year baby is having a large face, large jaw, large ear and macroorchidism is –
Fragile X syndrome Fragile X syndrome is the prototype of diseases in which the mutation is characterized by a long repeating sequence of three nucleotides. Normally, a codon is triplet (trinucleotide). In these type of disorders, this trinucleotide sequence undergoes amplification and the same sequence is repeated many times in the genome. In most cases, the affected sequences share the nucleotide G and C. Clinical features of fragile - X syndrome Mental retardation                                       Large testis (macroorchidism)                         Large everted ears Hyperextensible joint  Long face with large mandible High arched palate   Mitral valve prolapse
4
Mc Cuneal bright syndrome
Down's syndrome
Cri–du chat syndrome
Fragile X syndrome
Pediatrics
null
875e04dc-6256-4e06-8600-90ef2fcbc089
single
In which of the following procedures sperms are aspirated from the testes?
Aspiration of sperms from testes is done in Testicular sperm aspiration(TESA). In this technique, an aspiration needle is inseed percutaneously to the testis parenchyma to aspirate fluid or small pieces of seminiferous tubules to obtain sperm. Ref: Feility Cryopreservation By Ri-Cheng Chian, Page 52-3; Feility Preservation: Emerging Technologies and Clinical Applications By Emre Seli, page 305.
3
ZIFT
GIFT
TESA
MESA
Gynaecology & Obstetrics
null
d50d9b86-91c1-44d2-b449-037fe3b516e7
single
Female presents with history of color change from pallor to cyanosis on exposure to cold in fingers. This condition is mostly associated with ?
History of color change from pallor to cynosis on cold exposure suggests raynaud's phenomenon. Raynaud's phenomenon is the most common and earliest manifestation of generalized scleroderma (systemic sclerosis).
1
Scleroderma
Leukemia
Lung infections
Hepatosplenomegaly
Dental
null
6cb855d6-ba78-48c7-97a5-29f7b4786ac8
multi
A 5 year old boy presents with leukocoria in the right eye which is diagnosed as diffuse retinoblastoma involving the entire globe. Examination of the left eye revealed a small 2-3mm tumor in the periphery. What will be the ideal management of this patient?
Enucleation remains the treatment of choice for significantly advanced tumors and for tumors with no potential for visual salvage. Focal therapy is used for small tumors usually in patients with bilateral disease and in combination with chemotherapy. Ref: Ophthalmic Oncology - Page 195; Cancer in Children and Adolescents - Page 448.
3
Enucleation of both eyes
Enucleation of right eye and observation for left eye
Enucleation of right eye and focal therapy of the left eye
Six cycles of Chemotherapy
Ophthalmology
null
b077e31d-1870-4d92-ba5e-ce82e565703e
multi
Prolonged thumb sucking directly results in all of the following except:
Effects on Maxilla Proclination of maxillary incisors. Increased arch length. Increased anterior placement of apical base of maxilla. Increase in SNA angle. Increased clinical crown length of maxillary incisors. Increased counter-clockwise rotation of occlusal plane. Decreased width of palate.  Atypical root resorption of primary central incisors. Trauma to maxillary central incisors. Constriction of maxilla. Effects on Mandible  Proclination of mandibular incisors. Increased mandibular intermolar width. More distal position of point B: Mandible is more distally placed relative to the maxilla. Mandibular incisors experience a lingual and apical force. Inter-arch Relationship  Decreased inter-incisal angle Increased overjet Decreased overbite Posterior open bite Anterior open bite Narrow nasal floor and high palatal vault.
1
Deep overbite
Proclination of upper centrals
Anterior open bite
Constriction of maxilla
Dental
null
bffa774d-6d8d-4591-9128-462d3ee935cd
multi
A patient is brought to the emergency as a case of head injury, following a head on collision road traffic accident. Patient is unconscious and his right pupil is dilated. CT scan is not available. Whats the next step in management
Burrhole should be made at the side of dilated pupil.
4
Cranlotomy left side
Craiotomy right side
Burrhole left side
Burrhole right side
Surgery
null
99c69805-a622-46bc-9916-cf1ff4a71631
multi
What is the probable genetic defect in this child with recurrent infections, tetany, oral candidiasis & a hea murmur?
Digeorge syndrome: Caused by 22q deletion C- Cardiac anomaly A- Abnormal facies (hypeelorism, antimongoloid slant, sho philtrum, mandibular hypoplasia. T- Thymic hypoplasia C- Cleft palate H- Hypocalcemia
3
21q deletion
21p deletion
22q deletion
22p deletion
Pediatrics
Primary Immunodeficiency
38ec1aac-851f-484d-84fa-31e8f7d6ffdb
single
Cell cycle specific anti-cancerous drug is?
Ans. b (Vincristine). (Ref. Harrison Principles of Internal Medicine, 16th ed., 469 Fig. 70.3)CYCLE SPECIFIC ANTICANCEROUS DRUGSS-Phase specific drugsM-Phase specific drugsG,Phase specific drugsHydroxyurea,Methotrexate,Dactinomycin,Cytarabine,5-FU,MercaptopurineThiogauanine,ColchicinesVinca alkaloids and taxols (e.g., vincristine, vinblastine, paclitaxel).Vinca alkaloids (vincristine, vinblastine) inhibit mitotic spindle formation while taxels (paclitaxel) stabilize the mitotic spindles. Thus are known as'Spindle poisons'.Intercalaters: Anthracyclines and actinomycin D.By crosslinking between adjacent guanine in DNA: Cisplatin.By DNA breakage: Bleomycin.
2
Cyclophosphamide
Vincristine
Nitrogen mustard
Doxorubicin.
Pharmacology
Anti-Cancer
21597709-3c1f-414d-b7b6-6a2945f49574
single
All are contents of cubital fossa except
Contents of the cubital fossa: Mnemonic: from medial to lateral:MBBR Median nerve Brachial aery Tendon of Biceps Radial nerve. REF:B D Chaurasia 7th edition Page no: 98.
4
Median nerve
Biceps tendon
Brachial aery
Ulnar nerve
Anatomy
Upper limb
7ff98768-e8f8-409e-b22f-45698d43263e
multi
Tautomerization
Tautomerization or enolization The process of shifting a hydrogen atom from one carbon atom to another to produce enediols is known as tautomerization. Sugars possessing anomeric carbon atom undergo tautomerization in alkaline solutions. When glucose is kept in alkaline solution for several hours, it undergoes isomerization to formD-fructose and D-mannose. This reaction- known as the Lobry de Bruyn-von Ekenstein transformatiorr-results in the formation of a common intermediate-namely enediol--$or all the three sugars. The enediols are highly reactive, hence sugars in alkaline solution are powerful reducing agent Ref: Biochemistry by U. Satyanarayana 3rd edition Pgno : 16,17
1
Shift of hydrogen
Shift of carbon
Shift of both
None of these
Biochemistry
Metabolism of carbohydrate
77faa3e8-5a5c-4ec0-8b11-e23838a6150f
multi
Commonest cause of fungal uveitis is:
Ans. Candida
1
Candida
Aspergillus
Fusarium
Mucor mycosis
Ophthalmology
null
bad53b1d-8502-4e62-b646-16224d10470c
single
Barrets esophagus is commonly associated with one of the following:
Ans. is 'a' i.e. Adenocarcinoma Barret's esophagus is the single most important risk factor for adenocarcinoma of esophagus.Barret's esophagus is metaplastic change of distal esophageal mucosa from normal squamous epithelium to columnar epithelium, in response to chronic gastro-esophageal reflux.The junction between squamous esophageal mucosa and gastric mucosa moves proximally.The risk of adenocarcinoma increases with increasing length of columnar-lined epithelium.The adenocarcinoma develops at the squamo-columnar junction (85%) or within 2 cm of the junction.Other complications of Barett's esophagus include : peptic ulcers in the columnar lined seg. of esopahgushigh and long strictures occur at the squamo-columnar junction and move high up as the squamo- columnar junction moves up with progressive injury.
1
Adenocarcinoma
Squamous cell carcinoma
Sarcoma
Gastrointenstinal stromal tumor
Surgery
Esophageal Diseases - Gastroesophageal Reflux Disease, Carcinoma
8dc1d945-42ef-4453-a330-bf835737c711
single
A patient presented with Aldrich-Mee's lines which are characteristic of which heavy metal poisoning?
Aldrich-Mee's lines: Hyperkeratosis of the palms and soles with irregular thickening of the nails and development of bands of opacity in the fingernails. It is seen in prolonged contact of Arsenic. Ref: The essentials of forensic medicine and toxicology by Narayan Reddy, 27th edition, Page 475
3
Lead
Mercury
Arsenic
Copper
Forensic Medicine
null
09139cc0-c0f0-46e2-9643-e2a62ff073cf
single
Lucid interval is a characteristic pathognomonic feature of\
(A) Extradural haemorrhage # Extradural haemorrhage.> It is a period in which person is liable for acts> Lucid interval is a period occurring in insanity, during which all the symptoms of insanity disappear completely. The individual is able to judge his acts soundly and he becomes liable for his acts.> If he commits an offense, he can be held completely responsible.> Because it is very difficult to whether he was suffering from mental aberration at the time of commit the offence.
1
Extradural haemorrhage
Intracerebral haemorrhage
Tumour in the frontal lobe
Intracerebral abscess
Surgery
Miscellaneous
c57ec386-bcdb-4f25-9900-8d69848075b1
single
Placement of a double lumen tube for lung surgery is best confirmed by -
Ans. is 'd' i.e., Bronchoscopy * During thoracic surgery, there is a need for one lung to be deflated and or isolated.This offers the surgeon easier and better access within the designated hemothorax.In order to achieve these double-lumen endobronchial tubes are used that allow the anesthetist to selectively deflate one lung while maintaining standard ventilation of the other.Components of the Double lumen tubeDouble lumen endobronchial tube has two separate color-coded lumens each with its own level.One lumen ends in the trachea and the other lumen ends in either the left or right main bronchus.Each lumen has its own cuff (tracheal a bronchial cuffs) and color-coded pilot balloons.The proximal end of these tubes is connected to a breathing system.Mechanism of actionBecause of the differing anatomy of the main bronchi and their branches, both right and left versions of any particular double lumen tube must exist.Once correctly positioned the anesthetist can selectively ventilate one lung, so for operations requiring that the right lung is deflated, a left-sided double lumen tube would be used that enables selective ventilation of the left lung alone and vice versa.How to confirm the position of the double Lumen tube?The position of the tubes should be checked by auscultation immediately after intubation and after positioning the patient for operation.The auscultatory method for checking the correct placement of tube is lust a clinical method for ensuring correct placement of the tube and the confirmation of correct placement of the tube should be the done by flexible fiberoptic bronchoscopy.What is the use of end-tidal CO2 determination (EtCO2) in intubation?.The EtC02 can be used to confirm the position of the endotracheal tube. (whether the tube is in esophagus or trachea)The persistent detection of CO2 by a capnograph is the best confirmation of tracheal placement of an endotracheal tube (EtCO2).Note: Capnography can detect whether the tube is in trachea or esophagus but cannot differentiate between tracheal intubation and endobronchial intubation because in both these cases there will be the persistent detection of CO2.Double lumen tube
4
EtC02
Airway pressure measurement
Clinically by auscultation
Bronchoscopy
Unknown
null
288ea92a-0aa0-4a10-a572-2c6bc6be09b4
multi
Which of the following microorganism is incriminated in infection after hemodialysis
Hemo-dialysis catheter-related bloodstream infections (CRBSIs) are a major complication of long-term catheter us in HD. Gram positive organism are seen followed by gram negative organisms. Similarly in peritoneal dialysis, the clinical presentation typically consists of pain and cloudy dialysate, often with fever and other constitutional symptoms. The most common culprit organisms are gram-positive cocci, including staphylococcus, reflecting the origin from the skin. Gram-negative rod infections are less common; fungal and mycobacterial infections can be seen in selected patients, particularly after antibacterial therapy. In cases where peritonitis is due to hydrophilic gram negative rods (g.g., Pseudomonas sp.) or yeast, antimicrobial therapy is usually not sufficient, and catheter removal is required to ensure complete eradication of infection. Nonperitonitis catheter-associated infections (often termed tunnel infections) vary widely
1
Gram positive organisms
Chlamydia
Gram negative
Anaerobes
Medicine
null
b29fdee7-9c7c-422b-b429-8fbe5bb03abf
single
Causes of soft S1 include:
Answer is D (All of the above) Long standing severe M.S. (calcified mitral valve), obesity, mitral regurgitation and pleural effusions are all established causes of soft S1.
4
Long standing severe MS
Obesity
Mitral Regurgitation
All of the above
Medicine
null
87cf1ed7-6ba4-4171-95e6-5672aa626244
multi
Myasthenia gravis is which type of hypersensitivity-
In mystenia grevis antibodies are directed against Ach Receptors so this a type 2 hypersensitivity reaction. 1. Type II cytotoxic reaction is mediated by antibodies directed against antigens on the cell membrane that activates complement thereby causing antibody-mediated destruction of cells. The cell membrane is damaged by a membrane attack complex during activation of the complement. eg:-Stimulation- Grave's disase (LATS), Inhibition - Myasthenia gravis (Anti Ach receptor Ab) 2.Type 1 rxn lead to anaphylaxis. 3. Type 3 rxn.is antigen antibody complex mediated rxn. Myasthenia gravis, an autoimmune disease
2
Type I
Type II
Type III
Type IV
Microbiology
Immunology Pa 1 (Immune Response, Antigen-Antibody Reactions, Hypersensitivity, Structure of Immune System, Immunodeficiency Disorders)
c8b54767-4932-4cde-a4c1-839470d899e1
single
Which of the following is the drug of choice for long-term management of panic disorder?
SSRIs are the drugs of choice for long-term management of panic disorder Benzodiazepines are DOC for acute panic attacks
4
Phenothiazine
Azapirone
Beta blocker
Selective serotonin reuptake inhibitor
Pharmacology
Psychiatric Illness
f92e6758-1089-4383-94fd-7a24e079828d
single
Bone tumor arising from epiphyses is
Giant cell tumor refer Robbins page no 1233 Pathogenesis. Current evidence suggests that the neoplas- tic cells of giant cell tumor are primitive osteoblast precur- sors but they represent only a minority of the tumor cells. The bulk of the tumor consists of non-neoplastic osteoclasts and their precursors. The neoplastic cells express high levels of RANKL, which promotes the proliferation of osteoclast precursors and their differentiation into mature osteoclasts RANK expressed by these cells. However, the feedback between osteoblasts and osteoclasts that nor- mally regulates this process during bone remodeling is absent. What results is a localized but highly destructive resorption of bone matrix by reactive osteoclasts. Giant cell tumors arise in the epiphysis but may extend into the metaphysis. The majority arise around the knee (distal femur and proximal tibia), but viually any bone can be involved. The typical location of these tumors near joints frequently causes ahritis-like symptoms. Occa- sionally, they present with pathologic fractures. Most are solitary;
4
Osteogenic sarcoma
Ewings sarcoma
Giant cell tumor
Chondromyxoid fibroma
Anatomy
Musculoskeletal system
bb14ea81-ba6d-4f73-9951-0542c52573e9
single
Which of the following is not true about the autistic specific disorder
Core symptoms of Autism are 1. Persistent deficts in social communication and interaction, 2. Restricted, repititive patterns of behaviour, interests and activities, 3. Associated physical characteristics. Associated behavioural symptoms include- Disturbance in language development and usage, Intellectual disability, Irritability, Instability of mood and affect, Response to sensory stimuli, Hyperactivity and Inattetnion, Precocious skills, Insomnia, Minor infections and GI symptoms. Marked impairment in reciprocal social and interpersonal interaction:i. Absent social smile.ii. Lack of eye-to-eye-contact.iii. Lack of awareness of others existence or feelings; treats people as furniture.iv. Lack of attachment to parents and absence of separation anxiety.v. No or abnormal social play; prefers solitary games.vi. Marked impairment in making friends.vii. Lack of imitative behaviour.viii. An absence of fear in presence of danger.2. Marked impairment in language and non-verbal communicationi. Lack of verbal or facial response to sounds or voices; might be thought as deaf initially.ii. In infancy, an absence of communicative sounds like babbling.iii. Absent or delayed speech (about half of autistic children never develop useful speech).iv. Abnormal speech patterns and content. Presence of echolalia, perseveration, poor aiculation and pronominal reversal (I-You) is common.v. Rote memory is usually good.vi. Abstract thinking is impaired.3. Abnormal behavioural characteristicsi. Mannerisms.ii. Stereotyped behaviours such as head-banging, body-spinning, hand-flicking, lining-up objects, rocking, clapping, twirling, etc.iii. Ritualistic and compulsive behaviour.iv. Resistance to even the slightest change in the environment.v. The attachment may develop to inanimate objects.vi. Hyperkinesis is commonly associated.4. Mental retardation Only about 25% of all children with autism have an IQ of more than 70.5. Other featuresi. Many children with autism paicularly enjoy music.ii. In spite of the pervasive impairment of functions, ceain islets of precocity or splinter functions may remain (called as Idiot savant syndrome). Examples of such splinter functions are prodigious rote memory or calculating ability, and musical abilities.iii. Epilepsy is common in children with an IQ of less than 50. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no.164
4
Impaired communication
Impaired imagination
Language developmental delay
Vision problems
Psychiatry
Child psychiatry
85ce9035-42d5-411d-86b1-f06f45e66783
multi
Which of the following agents is used for day care surgery
Refer Katzung 12th/440 Propofol is drug of choice for day care surgery
1
Propofol
Thiopentone
Diazepam
Ketamine
Pharmacology
Anesthesia
3fab9c1e-18ee-47c8-9f55-1d70ef29b28f
single
A 30-year-old male, Kallu, with a history of sexual exposure comes with a painless indurated ulcer over the penis with everted margins. The diagnosis is
null
1
Syphilis
Chancroid
Lymphogranuloma venerum
Granuloma inguinale
Medicine
null
33fbdee5-585d-42f9-9e9a-6478cb853b32
multi
Phenobarbitone inhibits which complex of ETC?
Ans. A. Complex I(Ref: Harper 31/e page 123)Inhibitors of ETC at Complex I1. An insecticide and a fish Poison Rotenone2. Amobarbital which is a barbiturate.3. Piericidin
1
Complex I
Complex II
Complex III
Complex IV
Biochemistry
Respiratory Chain
c9ba70ff-be70-42dd-8f9f-4f5d6bcaf262
single
Which of the following antitubercular drugs are associated with hypothyroidism?
Ethionamide is thought to prevent organification of iodine in thyroid hormone synthesis, as it is structurally related to other thionamides (propylthiouracil and methimazole). So, it can lead to hypothyroidism.
1
Ethionamide
Streptomycin
PZA
Rifampicin
Pharmacology
null
d110b23f-9c42-4423-8a3c-90fa68619168
single
Osgood Shattiler disease -
Osgood-shaltter disease is osteochondritis of tibial tuberosity (just below the knee joint).
1
Involve the knee joint
Pelvis
Wrist joint
Cervical spine
Orthopaedics
null
e3ed0c08-92f2-4fe8-8888-2555f46e925f
single
For deted nasal septum, surgery is required for:
Indications for Surgery in DNS Persistent unilateral nasal obstruction and recurrent headaches Detion causing recurrent sinusitis or otitis media Recurrent epistaxis from septal spur Access for operation in polypectomy with DNS As a pa of septorhinoplasty for cosmetic correction of external nasal deformities. As a approach to hypophysectomy
4
Septal spur with epistaxis
Marked septal detion
Persistent rhinorrhea
All
ENT
null
9ccdd51f-4c0d-4e05-9ad4-8f2c6fc0a12f
multi
In a given population, total bihs in a year are 4050. There are 50 still bihs. 50 neonates die within first 7 days of life whereas the number of deaths within 8-28 days of life is 150. What is the Neonatal moality rate in the population?
In the given question, Total neonatal deaths = Total early neonatal deaths + Total late neonatal deaths = 50 + 150 = 200 Total live bihs = Total bihs - Total stillbihs = 4050 - 50 = 4000 NMR= Neonatal death/Live bihs*1000 Thus, Neonatal moality rate, NMR = 200/4000 X 1000 = 50 per 1000 live bihs.
2
12.5
50
49.4
62.5
Social & Preventive Medicine
Obstetric Care in RCH: Visits, IFA, TT, MCH Indicators
9c8f1674-1416-4b53-86a1-6219e75240c1
single
Protein requirement of an adult is
Protein requirement of an adult: 0.7 gm/kg/day in terms of Egg protein or 1.0 gm/kg/day in terms of mixed vegetable protein (NEW GUIDELINE: 0.83 g/kg/d) Egg protein has the highest NPU of 96. Indian Council of Medical Research (ICMR) has recommended 1.0 gm protein per kg of body weight for an Indian adult, assuming a NPU of 65 for dietary proteins.
3
0.7 gm/kg in terms of Egg protein & 0.7 gm/kg in terms of mixed vegetable protein
1.0 gm/kg in terms of Egg protein & 1.0 gm/kg in terms of mixed vegetable protein
0.7 gm/kg in terms of Egg protein & 1.0 gm/kg in terms of mixed vegetable protein
1.0 gm/kg in terms of Egg protein & 0.7 gm/kg in terms of mixed vegetable protein
Social & Preventive Medicine
null
e4fd9dc3-9462-4736-9ec5-c58ed6da8daa
single
Lack of insight is not a feature of :
A i.e. Panic disorder
1
Panic disorder
Schizophrenia
Mania
Reactive Psychosis
Psychiatry
null
2c4742d3-476f-434f-9a9d-a128735bacd1
single
Stye is suppurative inflammation of glands of ?
Ans. is 'a' i.e., Zeis
1
Zeis
Meibonian
Wolfring
All the above
Ophthalmology
null
b0fb5f76-d043-45f3-b20f-9ce5742fff7c
multi
Incubation period of syphilis is: September 2006
Ans. C: 9-90 days Acquired syphilis: - Primary syphilis: incubation period 2-3 weeks (range 9-90 days): local infection - Secondary syphilis: incubation period 6-12 weeks (range 1-6 months): generalised infection - Early latent syphilis: asymptomatic syphilis of less than 2 years duration - Late latent syphilis: asymptomatic syphilis of 2 years or longer duration - Late symptomatic syphilis (teiary syphilis): cardiovascular syphilis, neurosyphilis, gummatous syphilis Congenital syphilis: - Early congenital syphilis occurs within the first 2 years of life. - Late congenital syphilis emerges in children older than 2 years.
3
10-14 days
30-60 days
9-90 days
3-6 months
Skin
null
2c88fd28-82ed-4caf-88a6-b5fd04a77b6c
single
A 27-year-old G1P0 female at 36 weeks gestation presents to her obstetrician with a 3-day history of abrupt onset of extremely pruritic and urticarial papules and blisters on the abdomen and trunk. She states that the itching has worsened such that it is interfering with her everyday life.
Ans- D Erythematous urticarial patches and plaques (classically periumbilical) that progress to tense vesicles and blisters in a pregnant woman is herpes gestationis (also known as pemphigoid gestationis). There is no association to the husband's URI. Herpes gestationis is a pruritic blistering dermatologic disorder unique to pregnancy. It is not associated with past or present herpes infection. The onset is generally later in pregnancy (second trimester or later). The distribution involves the abdomen or extremities but may be generalized. It is thought to be an autoimmune condition triggered by pregnancy, with antibodies against hemidesmosomal proteins. It is associated with other autoimmune diseases such as Hashimoto's thyroiditis, Grave's disease, or pernicious anemia. Tunzi et al. describe some of the major pregnancy-specific skin conditions, which include pruritic urticarial papules and plaques of pregnancy, prurigo of pregnancy, intrahepatic cholestasis of pregnancy, pemphigoid gestationis, impetigo herpetiformis, and pruritic folliculitis of pregnancy. The majority of skin conditions resolve postpartum and require only symptomatic treatment. Lipozencic et al. detail the specifics of diagnosing pemphigoid gestationis, which includes the presence of subepidermal vesicles on routine histologic examination and the linear deposition of C3 and IgG along the basement membrane of perilesional skin. Detection of C3 and IgG is accomplished by immunofluorescence microscopy. Figure A displays the classic findings of vesicular skin lesions in a pregnant woman with herpes gestationis. Illustration A displays herpes zoster, note the dermatomal distribution. Illustration B displays bullous pemphigoid. Illustration C displays pruritic urticarial papules and plaques of pregnancy. Incorrect Answers: Answer 1: Herpes zoster is a viral skin condition affecting only one dermatome. Answer 3: Intrahepatic cholestasis of pregnancy involves diffuse burning and itching without visible skin changes. Answer 2: Pruritic urticarial papules and plaques of pregnancy presents with umbilical-sparing abdominal skin wheals.
4
Herpes zoster
Pruritic urticarial papules and plaques of pregnancy
Intrahepatic cholestasis of pregnancy
Herpes gestationis
Unknown
null
028eb157-8e5f-4fa9-ab20-d114d6a39bbb
single
Nucleus pulposis is derived from ?
The nucleus pulposus is the sole remnant of the embryonic notochord, the initial longitudinal skeletal axis of the body. The developing bodies and interveebral discs of the veebral column replace the notochord. NOTOCHORD: The notochordal plate becomes the centrally placed notochord, which acts as a foundation around which the veebral column develops. It extends throughout the entire length of the future veebral column, and reaches as far as the anterior end of the mid-brain, where it ends in a hook-like extremity in the region of the future dorsum sellae of the sphenoid bone. The notochord then undergoes involution and becomes the nucleus pulposus of the interveebral disks. Remnants of the notochord: are located in the nucleus pulposus, clivus, nasopharyngeal notochordal bursa, and sacrum.The most common anomaly due to incomplete resorption of notochord is butterfly veebra. Nucleus pulposis: The nucleus pulposus is 70-90% water although the exact propoion varies with age. Proteoglycans are the next major component, and they constitute about 65% of the dry weight of the nucleus. Type II collagen is seen interspersed in the proteoglycan medium.It functions to distribute hydaulic pressure in all directons of the disc. It is present in the middle of the veebral disc. Ref: Clinical Anatomy of the Lumbar Spine And Sacrum, By Nikolai Bogduk,4th Edition,Page 19
2
Neural crest
Notochord
Sclerotome
None of the above
Anatomy
null
ade663f7-b194-4dcf-a545-54e0bc0b24ec
multi
Oral Factor Xa Inhibitor is
Factor Xa inhibitors * Oral Direct Factor Xa (Stua-Prower factor) Inhibitors are Rivaroxaban, Apixaban, Betrixaban and Edoxaban * Rivaroxaban inhibits free and clot associated Factor Xa AE reducing !rombin generation AE suppressing Platelet aggregation and Fibrin formation. * Other options: * Dabigatran etexilate is an Oral Direct Factor IIa (Thrombin) Inhibitor * Fondaparinux is a parenteral synthetic Heparin derivative anticoagulant * Bivalirudin is a parenteral Hirudin-based Thrombin Inhibitor. * Salient features of Rivaroxaban: Ref:- Goodman & Gilman's the pharmacological basis of therapeutics 13th Edition; Pg num:- 594.
4
Dabigatran etexilate
Fondaparinux
Bivalirudin
Rivaroxaban
Pharmacology
Hematology
9e36f14c-c95f-49c0-bd24-9e121a13f153
single
Death due to cyanide poisoning results from which of the following types of anoxia?
Ans. D. Histotoxic anoxiaHypoxia or Anoxia O2 deficiency at the tissue level Type:a. Hypoxic Hypoxia (anoxic anoxic)i. PO2 of arterial bloodii. Chemoreceptor stimulatedb. Anaemic Hypoxiai. Arterial PO2 is normal but amount of Hb available to carry O2 is reducedii. Chemoreceptors are not stimulated, since dissolved O2 in blood is enough to keep these receptors normal.c. Stagnant or ischemic hypoxiai. Normal PO2 and Hb cone.ii. Blood flow to tissue is so slow that adequate O2 is not deliverediii. Chemoreceptor are strongly stimulated.d. Histotoxic Hypoxia: -i. Caused by Cyanide, that inhibit cytochrome oxidase (cyt aa3), so that tissue cells cannot make use of O2 .ii. O2 delivery to tissue is normal.iii. Chemoreceptor are strongly stimulated.
4
Anoxic anoxia
Anaemic anoxia
Stagnant anoxia
Histotoxic anoxia
Physiology
Respiratory System
ffa601b1-ab92-4780-b3dc-d1c93143d7ed
single
Obsessive Compulsive Disorder is NOT associated with
(B) Thought insertion # THOUGHT INSERTION is more commonly associated with shizophrenia.> OBSESSIVE-COMPULSIVE DISORDER (OCD) is an anxiety disorder characterized by intrusive thoughts that produce uneasiness, apprehension, fear or worry (obsessions), repetitive behaviors aimed at reducing the associated anxiety (compulsions), or a combination of such obsessions and compulsions.> The acts of those who have OCD may appear paranoid and potentially psychotic.
2
Repetitive behavior
Thought insertion
Anxiety
Paranoid behavior
Psychiatry
Miscellaneous
e9d2479e-dfdd-400f-acc5-0abdb0e3476d
single
All are seen in cirrhosis of liver except
(A) (Enlargement of testes) (943- Davidson 22nd)Clnical features of hepatic cirrhosis* Hepatomegaly (although liver may also be small)* Jaundice* Ascites* Circulatory changes spider telangiectasia, palmar erythema, cyanosis* Endocrine changes; loss of libido, hair lossMen; gynaecomastia, testicular atrophy, impotenceWomen ; breast atrophy, irregular menses, amenorrhoea* Haemorrhagic tendency; bruises, purpura, epistaxis* Portal hypertension; splenomegaly, collateral vessels, variceal bleeding* Hepatic (portosystemic) encephalopathy* Other features; pigmentation, digital clubbing, Dupuytren's contractureCommon precipitants of Hepaic Encephalopathy includeA. Increased nitrogen load as in;B. Electrolyte and Metabolic imbalance such as in1. GI bleeding1. Hypokalemia2. Excessive dietary protein intake2. Alkalosis3. Azotemia3. Hypoxia4. Constipation4. HyponatremiaC. Drugs: CNS depressant agents like narcotics, tranquillizers, sedativesD. Miscellaneous conditions like; infection0, surgeryQ, superimposed acute liver disease0* Anaemia may lead to cellular hypoxia at the level of liver cells and thus ppt, encephalopathyQ* Barbiturates are CNS depressant drugs and their injudicious use, therefore may precipitate hepaticQ encephalopathy,* Hypothyroidism, though not mentioned as a diret precipitating, factor, may contribute towards precipitating encephalopathy by causing constipation' or slowing down the intellectual and motor activity* Cause of vasodilatation in spider nevi is - Estrogen* Most common cause of pyogenic liver abscese is Biliary Tract Infections**HIGH YIELD FACTS1. Octreotide / Somatostatin analogue are agents of choice for medical management of variceal bleed. **2. Desmopressin is the drug of choice for central Diabetes Insipidus (Pituitary DI or Neurohypophyseal DI)
1
Enlargement of testis
Gynaecomastia
Absence of pubic and facial hair
Loss of libido
Medicine
G.I.T.
b5efd00f-878a-47d4-b56c-be839eb1025c
multi
Angle formed between mandibular plane and the long axis of mandibular central incisor is:
null
1
90° ± 5°
25°
120°
80°± 2°
Dental
null
2f171692-0eb8-4c10-8584-0eea03c17ee3
single
The Hb-O2 dissociation curve is shifted to left by
2,3-BPG is very plentiful in red cells. It is formed from 3phosphoglyceraldehyde, which is a product of glycolysis the Embden-Meyerhof pathway (Figure 36-4). It is a highly charged anion that binds to the bchains of deoxyhemoglobin. One mole of deoxyhemoglobin binds 1 mol of 2,3-BPG. In effectHbO2 + 2,3-BPG =Hb - 2,3-BPG + O2In this equilibrium, an increase in the concentration of 2,3BPG shifts the reaction to the right, causing more O2 to be liberated. So decrease in 2,3 BPG shift the reaction to leftMetabolic acidosis (or nonrespiratory acidosis) occurs when strong acids are added to blood. If, for example, a large amount of acid is ingested (eg, aspirin overdose) this decrease in pH cause shift to the rightA rise in temperature shifts the curve to the rightThe pH of blood falls as its CO2 content increases so that when the PCO2 rises, the curve shifts to the rightRef: 23rd Edition of Ganong's Review of Medical Physiology 611,615
4
Metabolic acidosis
Increased temperature
Increased PCO2
Decreased 2, 3 DPG
Physiology
Cardiovascular system
a1f3d457-ccc2-4b5a-9be8-edfca004add2
single
Most serious adverse effect of ketoconazole is:
Ketoconazole (KTZ): It is the first orally effective broad-spectrum antifungal drug, useful in both dermatophytosis and deep myc osis. The oral absorption of KTZ is facilitated by gastric acidity because it is more soluble at lower pH. Hepatic metabolism is extensive; metabolites are excreted in urine and faeces. Elimination of KTZ is dose dependent: tlh varies from llh to 6 hours. Penetration in CSF is poor: not effective in fungal men ingitis. However, therapeutic concentrations are attained in the skin and vaginal fluid. Adverse effects Ketoconazole is much less toxic than AMB, but more side effects occur than with itraconazole or fluconazole, that have largely replaced it for systemic use. The most common side effects are nausea and vomiting; can be reduced by giving the drug with meals. Others are-loss of appetite, headache, paresthesia, rashes and hair loss. Ketoconazole decreases androgen production from testes, and it displaces testosterone from protein binding sites. Gynaecomastia, loss of hair and libido, and oligozoospermia may be themanifestations. Menstrual irregularities occur in some women due to suppression of estradiol synthesis. A dose-dependent decrease in serum hydro coisone due to synthesis inhibition has also been noticed, but without any clinical manifestations in normal individuals. Mild and asymptomatic elevation of serum transaminases occurs in -5% patients, but serious hepatotoxicity is infrequent. It is contraindicated in pregnant and nursing women. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:762,763
1
Adrenal insufficiency
Pellagra like skin lesion
Liver injury
Prostate cancer
Pharmacology
Chemotherapy
c9da7744-614b-47e7-a334-412c6837f06c
single
While playing cricket, a child broke his distal end of radius. He was put on POP. Which of the following is the late complication of Colles fracture?
Early complications of Colles fracture include, Median nerve compression Tendon damage Ulnar nerve contusion or compression Compament syndrome Fragment displacement with loss of reduction Decreased range of motion of the wrist Prolonged swelling Late complications of Colles fracture include, Stiffness of the fingers, shoulder, or radiocarpal joint Shoulder-hand syndrome Cosmetic defects Rupture of the extensor pollicis longus Malunion Nonunion Flexor tendon adhesions Chronic pain of the radioulnar joint with supination Ref: Hosey R.G., Nikovits D.A., Rodenberg R.E., Armsey T.D., Black W. (2011). Chapter 38. Common Upper & Lower Extremity Fractures. In J.E. South-Paul, S.C. Matheny, E.L. Lewis (Eds), CURRENT Diagnosis & Treatment in Family Medicine, 3e.
1
Stiffness of wrist joint
Ulnar nerve palsy
Median nerve palsy
None of the above
Surgery
null
0334a920-2530-482f-979e-ebbae4891c85
multi
A 62-year-old patient has been diagnosed with a restrictive pulmonary disease. Which of his following lung measurements is likely to be normal
null
3
FEV1
FVC
FEV1/FVC
FRC
Medicine
null
408d53b0-f06c-4e92-87f2-7f8436040ab8
single
Which of the following cement has most anticariogenic effect used while placing bands on molar to prevent caries?
GIC has fluoride releasing property and it also binds with the tooth chemically. So, it should be the cement of choice.
1
GIC
Polycarboxylate
Zinc phosphate
Silicate
Dental
null
2d02e49e-b28e-4923-ac54-557fc4057fee
single
A very potent and sho acting benzodiazepine was given to a patient Kallu for the purpose of causing hypnosis but the drug caused psychiatric disturbances in him. Which of the following can be the hypnotic used?
(Ref: KDT 7th/405) Triazolam is a very potent BZD with ultra rapid elimination. Some cases of paranoia and psychiatric disturbances have been noted with this drug.
4
Flurazepam
Nitrazepam
Temazepam
Triazolam
Anatomy
Other topics and Adverse effects
bd87728e-1a4d-4e01-a6ec-6d30a7af9e36
multi
Not true about population pyramid -
Ans. is 'b' i.e., India has narrow base o In countries with high birth rates as ours, population pyramid is broad based conical (narrow apex) because of high birth rate and tapering of population with increase in age.o The pyramid of developing country (e.g. India) has a broad base and a tapering top.o In developed countries, the pyramid generally shows a bulge in the middle and has a narrower base (as in figure given in the question).Percentage distribution by age of the population of India and of the population of Sw itzerland
2
India has broad base
India has narrow base
India has narrow apex
Developed countries have bulge in the center
Unknown
null
3b4527ac-13b3-481f-bd7c-6a9096ac95ce
multi
Selegiline is
(B) MAO-B inhibitor # Selegiline is a MAO-B inhibitor.> MAO exist in forms MAO-A & MAO-B.> MAO-A predominates in peripheral adrenergic structures & intestinal mucosa.> MAO-B predominates in brain & Blood platelets. Selegline, along c- levodopa, prolongs its action, & wearing-off effect.> Based on the theory that oxidation of DA or toxin MPTP in the striatum by MAO to free radicals is cause for parkinsonism early therapy c- selegiline night delay progression of disorders.> Non selective MAO inhibitors include: Phenelzinec/lsocarboxazide/Tranylcypromine.> Selective MAO-A are: Clorgiline/ Moclobemidee> Selective MAO-B are: Selegiline (Deprenyl), Rasagline, Periphery, BLood brain barrier
2
Dopa decarboxylase inhibitor
MAO-B inhibitor
COMT inhibitor
MAO-A inhibitor
Pharmacology
Miscellaneous (Pharmacology)
910bbdab-feea-4b56-bc3a-0c15cdfc7d45
single
A female with 20 weeks pregnancy presents with fever and dysuria. A preliminary diagnosis of cystitis was made. Which of the following drugs will be safe to use for this patient?
Antibiotics safe in pregnancy P - Penicillin C - Cephalosporin M - Macrolides Ciprofloxacin causes cailage and bone destruction Gentamycin causes hearing loss in fetus Cotrimoxazole contains sulfonamides which can cause kernicterus in the child
4
Ciprofloxacin
Gentamicin
Cotrimoxazole
Amoxicillin
Pharmacology
Cell Wall Synthesis Inhibitors
1523dcf4-9d03-40ad-a6b7-5f48085616f9
single
Antihelminthic also acting as immunomodulator is-
Ans. is 'b' i.e., Levamizole
2
Albendazole
Levamizole
Mebendazole
Piperazine
Pharmacology
null
c63bbe38-cf93-4dc9-8e69-dbe89f96d170
single
The main controlling agent for respiratory drive is which of the following -
Central chemoreceptors are situated in the deeper pa of medulla oblongata, close to the dorsal respiratory group of neurons. This area is known as a chemosensitive area, and the neurons are called chemoreceptors. Chemoreceptors are in close contact with blood and cerebrospinal fluid. Central chemoreceptors are connected with respiratory centers, paicularly the dorsal respiratory group of neurons through synapses. These chemoreceptors act slowly but effectively. Central chemoreceptors are responsible for 70% to 80% of increased ventilation through chemical regulatory mechanisms. Main stimulant for central chemoreceptors is the increased hydrogen ion concentration. However, if hydrogen ion concentration increases in the blood, it cannot stimulate the central chemoreceptors because the hydrogen ions from blood cannot cross the blood-brain barrier and blood-cerebrospinal fluid barrier. On the other hand, if carbon dioxide increases in the blood, it can easily cross the blood-brain barrier and bloodcerebrospinal fluid barrier and enter the interstitial fluid of the brain or the cerebrospinal fluid. There, carbon dioxide combines with water to form carbonic acid. Since carbonic acid is unstable, it immediately dissociates into hydrogen ion and bicarbonate ion. CO2 + H2O - H2CO3 - H+ + HCO3- Hydrogen ions stimulate the central chemoreceptors. From chemoreceptors, the excitatory impulses are sent to the dorsal respiratory group of neurons, resulting in increased ventilation (increased rate and force of breathing). Because of this, excess carbon dioxide is washed out and respiration is brought back to normal. Lack of oxygen does not have a significant effect on the central chemoreceptors, except that it generally depresses the overall function of the brain. Ref: Sembulingam - physiology 7th edition
1
CO2
Oxygen
NO
HBO3
Anaesthesia
Fundamental concepts
9463eeaf-d1a7-4421-8e8a-885d79459848
single
A seven year old child with recurrent chest infections and exocrine pancreatic insufficiency is suspected of having cystic fibrosis Sweat chloride levels have been observed between 40-60 mmo1/1 on two separate occasions. Which of the following test should be performed next to suppo the diagnosis of Cystic fibrosis:
Answer is B (Demonstrate an abnormal nasal potential difference) Nasal Potential Difference is a sensitive test of electrolyte transpo (CFTR function) that can be used to suppo or refute a diagnosis of cystic fibrosis when sweat chloride levels are normal or border line and two CF mutations cannot be demonstrated by DNA testing. Diagnostic criteria for cystic fibrosis Risk Factor For CF PLUS Laboratory Evidence of CFTR Dysfunction * Presence of one or more typical clinical feature * Positive sweat chloride test (> 1 phenotypic symptom) Plus (>60 mcq/l on two occasions) or Or * History of CF in sibling Plus * Identification of 2 CF mutations or or * Positive Neonatal screening test Plus * Abnormal Nasal Potential Difference The patient in question has typical clinical features of cystic fibrosis; however the sweat chloride levels are border line (between 40-60meq/1) on two separate occasions. To establish the diagnosis of cystic. fibrosis, another laboratory evidence demonstrating CFTR dysfunction is therefore required. This can be achieved by demonstration of abnormal CF mutation by DNA analysis or by demonstrating an abnormal nasal potential difference. The diagnostic criteria for cystic fibrosis requires demonstration of at least two CF mutations and hence demonstration of an abnormal F508 mutation alone is not sufficient to establish the diagnosis of CF An abnormal CFTR nasal potential difference is an established laboratory evidence of CFTR dysfunction and is accepted as a diagnostic criterion to establish the diagnosis of cystic fibrosis.
2
Repeat Sweat chloride levels on a different day
Demonstrate an abnormal nasal potential difference
Demonstrate an abnormal F508 mutation by DNA analysis
Demonstrate an abnormal 72 hour fecal fat
Medicine
null
b1fd2546-bd8f-4e2b-860e-a762ac039f84
single
A patient is found to have sun-sensitive dermatitis, diarrhea, and dementia he must be suffering from the deficiency of which of the following.
The most common symptoms of niacin deficiency involve the skin, the digestive system, and the nervous system. The symptoms of pellagra are commonly referred to as the three "Ds": sun-sensitive dermatitis, diarrhea, and dementia. A fourth "D," death, occurs if pellagra is left untreated
1
Niacin
Riboflavin
Folic acid
Iron
Biochemistry
null
080790bd-d9b2-46bb-9bae-af04b24ca7a4
single
Drugs with high affinity can be used in :
Affinity is the ability of a drug to combine with the receptor.
2
High concentration.
Low concentration.
Moderate concentration.
None.
Pharmacology
null
4e062a23-9da8-4ddb-bcc9-32c376d60ed2
multi
Which hormone stimulates pancreatic secretion that is rich in bicarbonate?
.
2
Somatostatin
Secretin
CCK
Gastrin
Pathology
All India exam
08871182-b3d9-45da-ae2c-f1691fceeabe
single
Which of the following drugs should not be administered concomitantly with warfarin as it decreases the effect of oral anticoagulants
Oral contraceptives Estrogen increases the synthesis of various clotting factors and produce a hypercoagulable state. Thus OCP containing estrogen decrease the effectiveness of warfarin and other oral anticoagulants.
4
Broad spectrum antibiotic
Cimetidine
Aspirin
Oral contraceptive
Pharmacology
null
3d3fc67e-3193-4623-8a01-b19d9ea2741c
single
Best heat test agent for pulp testing:
null
1
GP sticks.
Rubber wheel.
Barlew disk.
Rotation friction heat.
Dental
null
65ea8d84-f7d5-44c4-9dd9-12db881e3249
single
Tonometer with variation in application surface
Ans. d. Maklakov tonometer Indentation tonometry Indentation tonometry was devised by SchiotzQ. Because of its simplicity, reliability, low price and relative accuracy, it is the most widely used tonometer in the world. For repeated use in multiple patients it can be sterilized by dipping the footplate in ether, absolute alcohol, acetone or by heating the footplate in the flame of spirit. The greatest accuracy is attained if the deflection of lever is between 3-4. Its main disadvantage is that it gives a false reading when used in eyes with abnormal scleral rigidity') False low level of 10P are obtained in eyes with low scleral rigidityQ seen in high myopes and following ocular surgery Applanation tonometry The concept of Applanation tonometry was introduced by GoldmannQ is 1954. It is best on lmbe-Fick lawQ. Currently, it is the most popular and accurate tonometerQ
4
Mackey Marg tonometer
Rebound tonometer
Dreger's tonometer
Maklakov tonometer
Ophthalmology
null
4c792e63-310f-41f7-8989-1e460674d570
single
In a lady of 32 weeks pregnancy injection dexa- methasone is to given to prevent:
Administration of dexamethasone before delivery: – Reduces the incidence and severity of intraventricular hemorrhage – Accelerates fetal lung maturation in preterm labour and prevents hyaline membrane disease. It should be given atleast 24 hours before delivery. Its effect lasts for 7 days therefore earlier it was said that repeat injections of betamethasone should be given weekly. Recent trials have shown that repeated injection lead to an increase in incidence of cerebral palsy therefore repeated injections are not given. Steroid of choice for lung maturity is Betamethasone. Dose = 2 doses of 12 mg of steroid (i.e., 3 ampules) are given i/m - 24 hours apart. Adverse effects of Dexamethasone:
1
Respiratory distress syndrome
Neonatal convulsions
Neonatal jaundice
Cerebral palsy
Gynaecology & Obstetrics
null
7bdc8144-4b5f-4ec7-b4ad-68f73e9cf05a
single
Early diastolic notching of uterine aery disappears by which week of gestation?
Diastolic Notching in uterine aery Doppler usually disappears beyond 22 weeks of gestation. Persistence of uterine notch beyond 22 weeks is indicator of preeclampsia.
3
20
21
22
24
Radiology
ULTRASOUND
54e415d9-2edc-4dc0-bc09-678a39aaa046
single