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All of the following statements regarding hirschsprung disease are TRUE, EXCEPT:
|
Diagnosis Of Hirschsprung's Disease Rectal manometry and rectal suction biopsy are the easiest and most reliable indicators of HD. Rectal suction biopsies are the procedure of choice and should be performed no closer than 2 cm to the dentate line to avoid the normal area of hypoganglionosis at the anal verge. Anorectal manometry measure the pressure of the internal anal sphincter while a balloon is distended in the rectum. In patient with HD, pressure fails to drop or there is a paradoxical rise in pressure with rectal distension. Barium enema examination should be done in unprepared bowel as washout may minimise the dilation of the gut above the obstruction. It is always essential that both AP and lateral view should be taken as narrow sho segment may be overlapped by dilated proximal colon in one of the view's. Ref: Love & bailey 25/e, page 86-87 ; Nelson 18/e, page 1565-67 ; S. Dass Textbook of Surgery 5/e, page 1035-36
| 4
|
Rectal manometry and rectal suction biopsy are the easiest and most reliable indicators of HD
|
Rectal suction biopsies are the procedure of choice
|
In patient with HD, pressure fails to drop or there is a paradoxical rise in pressure with rectal distension on anorectal manometry
|
Bowel should be prepared before barium enema examination
|
Surgery
| null |
8ee5332d-3619-49b7-ab5d-15be4d8f5380
|
multi
|
All are seen in diphtheric outcome except
| null | 3
|
Pseudomembrane formation
|
Cardiomyopathy
|
Endotoxemia
|
Polyneuropathy
|
Medicine
| null |
096700f7-b2ec-4744-8349-bfc3416cda51
|
multi
|
Which among the following is a feature of denervation of smooth muscle?
|
ANSWER: (C) Increased sensitivity to chemical mediatorsREF: Ganong physiology 22nd edition page 111"When the motor Nerve supply to a smooth muscle is cut, the muscle does not atrophy (this is in contrast to skeletal muscle which atrophies on denervation), It becomes hyper responsive to the chemical mediators that normally activate it"
| 3
|
Atrophy of the muscle.
|
Decrease in no of receptors for neurotransmitters
|
Increased sensitivity to chemical mediators
|
Decreased neurotransmitter release At NMJ
|
Physiology
|
Smooth Muscle: Contraction and Excitation
|
bb6045d2-0c83-43c5-9893-8a356b72ef5d
|
single
|
Progression of congenital scoliosis is least likely in which of the following veebra anomalies?
|
Block veebra type of scoliosis has the best prognosis. The progression is slow and it can be corrected easily, whereas unilateral thoracic unsegmented type carries worst prognosis. Ref: Ohopaedic Surgery Essentials in Pediatrics By Kathryn E. Cramer, Susan A. Scherl, 2004), Page 65; Campbell's Ohopaedics, 11th Edition, Page 2607.
| 3
|
Fully segmented Hemiveebra
|
Wedge veebra
|
Block veebra
|
Unilateral unsegmented bar with Hemiveebra
|
Surgery
| null |
bf83869b-611e-4bd1-945b-e97fab2a5272
|
single
|
The proximal pa of the internal carotid aery is derived from which of the following?
|
C. The proximal pa of the internal carotid aery is derived from aoic arch 3.
| 3
|
Aoic arch 1
|
Aoic arch 2
|
Aoic arch 3
|
Aoic arch 4
|
Anatomy
|
Pharyngeal Arches
|
d7bbec2a-afd0-4d2d-8f48-e5cf46d06737
|
single
|
Clitoris develops from -
| null | 4
|
Urogenital sinus
|
Labio scrotal swelling
|
Genital folds
|
Genital tubercle
|
Anatomy
| null |
63f0f5e4-79ba-44bf-9af4-bdc29c634b55
|
single
|
Myocardial contractility is increased by:
|
Option A: Atropine is a muscarinic receptor antagonist that is used to inhibit the effects of excessive vagal activation on the heart, which is manifested as sinus bradycardia and AV nodal block. Effect on contractility is negligible.
Option B: Decrease EDV decreases contractility by Frank Starling law.
Option D: Acidosis, hypercapnoea and hypoxia inhibit myocardium contractility.
Option C: This effect is known as Bowditch Effect (Myocardial tension increases with an increase in heart rate).
| 3
|
Atropine
|
Decreased end diastolic volume
|
Increased heart rate from 70 to 150 beats/min
|
Reduced arterial pH to 7.3
|
Physiology
| null |
bd6f9ddf-7516-4542-a01f-de6fd005ecc4
|
single
|
Therapeutic drug monitoring is advised in all except
|
Metformin Therapeutic drug monitoring is paicularly useful in the following situation (i) As a guide to the effectiveness of the therapy Plasma gentamycin and other antimicrobials against sensitive bacteria. Plasma theophylline for asthma. Blood cyclosporine to avoid transplant rejection. (ii) When the desired effect is suppression of infrequent sporodic events such as: Epileptic seizures (anticonvulsants) Episodes of cardiac arrythmia (antiarryhthmics) (iii) To reduce the risk of adverse drug effect (therapeutic index low) Digoxin Anticonvulsants Antiarrythmics Theophylline TCA Aminoglycoside Lithium (iv) When lack of therapeutic effect and toxicity may be difficult to distinguish Digoxin is both a treatment for and sometime the cause for supraventricular tachycardia, therefore a plasma digoxin measurement will help to distinguish whether an arryhthmia is due to too little or too much digoxin. (v) When there is no quick and reliable assessment of effect Lithium for mood disorder. (vi) To check patient compliance on a drug regimen, when there is a failure of threrpaeutic effect at a dose that is expected to be effective. Antiepilepsy drug (vii) Poisoning and overdose Monitoring of plasma concentration is of no value for (i) Cases where dose can be titrated against a quickly and easily measured effect such as Antihypeensive -9 Blood pressure (B.P. can be easily monitored) Diuretics ---> Body weight Hypoglycemics --4 Blood sugar (blood glucose level can be easily monitored) Oral anticoagutants --> INR (ii) Plasma concentration has no correlation with effect This is the case with drugs that act irreversibly and these have been named hit and rundrugs" because their effect persits long after the drug has left the plasma Such drugs destroy or inactivate target tissue (enzyme, receptor and restoration of effect occurs only after days or weeks).
| 1
|
Metformin
|
Phenytoin
|
Tacrolimus
|
Cyclosporine
|
Pharmacology
| null |
832deb1b-3fde-49c4-871f-0d1a9766e2d2
|
multi
|
Structures at the transpyloric plane include all EXCEPT:
|
Ans. (b) Termination of portal vein* The kidneys occupy the epigastric, hypochondriac lumbar and umbilical regions Vertically they extend from the upper border of twelfth thoracic vertebra to the centre of the body of third lumbar vertebra.* The right kidney is slightly lower than the left and the left kidney is a little nearer to the median plane than the right.* The transpyloric plane passes through the upper part of the hilus of the right kidney; and through the lower part of the hilus of the left kidney.Structures at the Level of Transpyloric Plane* Origin of superior mesenteric artery.* Origin of portal vein.* Hilum of left kidney.* Origin of Renal artery.* Termination of spinal cord.* Level of Duodenojejunal flexure
| 2
|
Fundus of gall bladder
|
Termination of portal vein
|
Hilum of kidneys
|
Pylorus of stomach
|
Anatomy
|
Abdominal Wall
|
f97dd9ac-0157-4a82-9175-578577786de0
|
multi
|
Laryngeal Papillomatosis is caused by
|
Laryngeal papillomata These are rare benign tumours occurring mainly in children, but can also present in adults. They are most commonly found on the vocal folds, but may spread throughout the larynx and tracheobronchial airway (although this is less likely in adults). They are caused by papillomaviruses andneed repeated removal by carbon dioxide laser or microsurgery to maintain a reasonable voice and airway. These patients are best managed in specialist centres, with the appropriate expeise. Antiviral treatment is of doubtful value. Papilloma vaccination is, to date, of unproven benefit. Ref: Bailey and love 27th edition Pgno : 750
| 1
|
HPV
|
EBV
|
CMV
|
HSV
|
Surgery
|
Head and neck
|
420b4e91-20a6-4335-a3a9-6484081d3fce
|
single
|
In modified Pugh's classification score of 8, what shall be the line of management ?
|
Child-Pugh score is calculated by adding the scores of the five factors and can range from 5 to 15. Decompensation indicates cirrhosis with a Child-Pugh score of >7 (class B). This level has been the accepted criterion for listing liver transplantation. Parameters: Bilirubin INR Albumin Ascites Asterixis Grade Points One-year Patient Survival (%) A: well-compensated disease 5-6 100 B: significant function compromise 7-9 80 C: decompensated disease 10-15 45
| 2
|
Conservative management
|
Ohotopic liver transplant
|
Sclerotherapy
|
Shunt surgery
|
Medicine
|
Cirrhosis
|
210c84d1-5fbd-4d28-bf4a-06d2a0e0e4c4
|
multi
|
Unequal division of the conus cordis resulting from anterior displacement of the conotruncal septum gives rise to -
| null | 3
|
Persistent truncus arteriosus
|
Coarctation of aorta
|
Tetralogy of Fallot
|
Transposition of great vessels
|
Anatomy
| null |
f707a689-db7b-4d8d-ba35-251f1adbda98
|
multi
|
A 71-year-old woman is receiving a drug to lower her serum cholesterol. Over the past week, she has developed muscle pain and weakness unrelated to physical activity. On examination, she has diffuse but mild muscle tenderness. Laboratory studies show her serum creatine kinase is 2049 U/L and creatinine is 2 mg/dL. Urine dipstick analysis is positive for blood, without RBCs on urine microscopy. Which of the following drugs is most likely to produce her findings?
|
She has a statin-induced myopathy, with a creatine kinase level more than 10 times normal from rhabdomyolysis (myoglobin released from muscle can be detected by the urine dipstick). Statins are HMG-CoA reductase inhibitors that reduce endogenous cholesterol synthesis in the liver. Cholestyramine binds bile acids in the intestine and disrupts enterohepatic bile acid circulation to increase the conversion of cholesterol to bile acids in the liver. Clofibrate enhances uptake and oxidation of free fatty acids in muscle. Ezetimibe interferes with intestinal lipid absorption. Nicotinic acid inhibits the mobilization of peripheral free fatty acids to reduce hepatic triglyceride synthesis and secretion of VLDL.
| 4
|
Cholestyramine
|
Clofibrate
|
Ezetimibe
|
Lovastatin
|
Pathology
|
Peripheral Nerve & Skeletal Muscles
|
b75249fa-cad3-4620-a558-89265009270e
|
single
|
A 50-year-old male presents with severe refractory hypeension, weakness, muscle cramps and hypokalemia, the most likely diagnosis is:
|
Manifestation of Conn's Syndrome (Primary Hyperaldosteronism) Clinical Laboratory Muscle weakness and fatigue (due to hypokalemia) Hypeension without edema Polyuria and polydipsia Hypokalemia Metabolic alkalosis Hypernatremia Increased Aldosterone Low renin
| 2
|
Hypoaldosteronism
|
Hyperaldosteronism
|
Cushing syndrome
|
Pheochromocytoma
|
Surgery
|
Parathyroid and adrenal glands
|
bff96992-281c-4b17-bb5a-16c22a9c6fb1
|
single
|
Development of Lymphoma in Sjogren's syndrome is suggested by all of the following except-
|
Ans. is 'd' i.e., High C4 complement levels o Lymphoa is a well-known complication of Sjogren s syndrome : Most lymphomas are extra-nodal, low grade marginal B cell lymphomas.o Development of Lymphoma in Sjogren's syndrome is suggested by low C4 complement levels.Lymphoma in Sjogren's syndromeThe development of Lymphomas in patients with Sjogren syndrome is suggested by :-o Persistent parotid gland enlargemento Purpurao Leukopeniao Cryoglobulinemiao Low C4 complement levels
| 4
|
Persistent parotid gland enlargement
|
Cyogtobilinemia
|
Leukopenia
|
High C4compement levels
|
Medicine
|
Immunology and Rheumatology
|
d7ff76be-eccf-4ec8-b290-078ad163c0a0
|
multi
|
Contraindication for laparoscopic cholecystectomy is all except
|
Contraindications to Laparoscopic Cholecystectomy Absolute Unable to tolerate anaesthesia Refractory Coagulopathy Suspicion of carcinoma Relative Previous upper abdominal surgery Cholangitis Diffuse peritonitis Cirrhosis or poal hypeension Chronic obstructive pulmonary disease Cholecystenteric fistula Morbid Obesity Pregnancy Ref: Blumga 5th edition Pg no :514
| 1
|
Shrunken liver
|
Previous laparotomy
|
Emphysema
|
Obese individual
|
Anatomy
|
G.I.T
|
de5301a6-019e-4e87-bda5-f234301dd5aa
|
multi
|
Earliest and common form of reversible cell injury is :
|
Following morphologic forms of reversible cell injury are included under this heading:
Hydropic change (cloudy swelling, or vacuolar degeneration)
Fatty change
Hyaline change
Mucoid change
| 4
|
Cloudy swelling
|
Cellular swelling
|
Albuminous degeneration
|
All of the above
|
Pathology
| null |
eedcbd4c-ff70-49c3-b15d-505dcfc1cf0e
|
multi
|
Which of the following acts as a coenzyme in carboxylation reaction?
|
Ans. C. Biotin. (Ref Harper's Biochemistry 27th/Ch. 44).Vitamin B7 (biotin):Function:-Cofactor for carboxylation enzymes (which add a l-carbon group):- Pyruvate carboxylase: pyruvate (3C)*oxaloacetate (4C).- Acetyl-CoA carboxylase: acetyl-CoA (2C)*malonyl-CoA (3C).- Propionyl-CoA carboxylase: propionyl-CoA (3C)*methylmalonyl-CoA (4C).- 3 methylerotoyl CoA = methyl glutaconyl CoADEFICIENCY: due to antibiotic overuse, ingestion of raw eggs (avidin in egg white AVIDLY binds to biotin).Ch by Dermatitis, alopecia, enteritis.VitaminsVITAMINENZYMES IN WHICH IT ACTS AS COENZYMESDEFICIENCY DISEASE1. Vit. B1 (Thiamine)# Pyruvate dehydrogenase complex# Oxidation decarboxylation of a-keto-acid# Transketolase reaction# Tryptophan pyrolase# Beri-Beri disease# Werinicke encephalopathy2. Vit. B2 (Riboflavin) (heart stable but light sensitive)# FMN and FAD are two coenzymes of this vit.# Constituent of cytochrome -c- reductase# Warburg-yellow enzyme# Fumarate dehydroganase# Cheilosis# Glossitis# Seborrheic3. Vit. B3 (Niacin)# NAD and NADP are it's active forms with operate as hydrogen and electron transfer agents# They are co-enzymes for various types of dehydrogenase like- Alcohol dehyrogenase- Lactate dehydrogenase- Malate dehydrogenase- Pyruvate dehydrogenasePellagra C/B 3 D's:- Diarrhea- Dermatitis- Dementia4. Vit. B6 (Pyridoxine) (In vit.B6 defi Kynureine levels rise, which is converted to xanthurneic acid - a reliable criteria for B6 defi)# Co-transaminase# Co-decarboxylase# Deaminase# Involved in synthesis of Co-A# Coenzyme for Kynureninase# Epileptiform convulsion in infants# Sideroblastic anemia# (It is used in Rx of oxalate stone of kidney and homocytinuria)5. Pantothenic acid# Active form is Co-A# Formation of Acetyl CoA# Formation of succinyl CoA# Oxidation of F. acids# Synthesis of F. acids# G.I symptoms# Changed sleep pattern# Easy fatigue# Burning foot syndrome6. Biotin# Carboxylase enzyme (carboxylation reaction)# Leiner's disease# Exfoliative dermatitis7. Vit. B12 (Cyanocobalamine)# To convert-Methyl malonyl CoA|Homocysteine methionine|Ribonucleotide|DeoxyribounuleotideMethyl malonyluriaHomocystinuriaPernicious anemiaSACD
| 3
|
Riboflavin
|
Niacin
|
Biotin
|
Pantothenic acid
|
Biochemistry
|
Vitamins and Minerals
|
575096a1-0e36-47c4-82b8-c82b3067123f
|
single
|
Hippocampus lesion affects:
|
Answer is D (Explicit memory): Hippocampal lesions primarily affect Declarative or Explicit memory. The Hippocampus is essential to forming new memories for facts and general information (sementic memory) and also for life experiences (episodic memory). But the hippocampus does not appear to play a role in precedural memory, the kind of memory we draw upon while riding bike or using a tool Classification of Memory Based on Anatomy of Temporal Lobe system (Hippocampus) Declarative Memory or Explicit Memory (Episodic/Sementic Memory) Declarative memory also known as Explicit memory, is memory of events, places, facts and people and is dependent on the temporal lobe system (Hipppcampus) Declarative memory can be fuher divided into two classes. Episodic memory Sementic memory Refers to memory of Refers to memory or facts episodic events that that are no longer contain 'what"where' ascribable to any paicular `when' information occasion in life Lesions of the temporal lobe such as hippocampus are known to greatly impair patient's ability to learn new facts, concepts, vacobulary and knowledge about the world. Non-Declarative Memory or Implicit Memory (Procedural memory) Non-Declarative memory is also known as procedural memory and does not depend on the structural integrity of the temporal lobe system. Non-Declarative memory encompasses a variety of perceptual motor learning skills and mental operations Currently the brain regions involved in encoding procedural memory are not clear, atleast in humans (striatum may be engaged)
| 4
|
Implicit memory
|
Procedural memory
|
Non-declarative memory
|
Explicit memory
|
Medicine
| null |
cdc37ffe-1980-449e-b568-4e0087e5db66
|
single
|
Granulomatous mastitis is caused by all except -
|
Inflammatory processes involving the breast are uncommon and are usually associated with pain and tenderness in the affected areas. Included in this category are several forms of mastitis and traumatic fat necrosis, none of which increase the risk of cancer. ref : Robbins Basic Pathology, 9E,page-707 REF OF IMG:
| 3
|
TB
|
Fungus
|
Staphylococcus
|
Antibodies to milk antigens
|
Pathology
|
Breast
|
b43726fd-7031-48e3-83e8-f9f0e6c8417e
|
multi
|
In cholera epidemic which step should be first taken
|
Cholera is an acute diarrheal disease caused by Vibrio cholerae.
I.P.-1-2 days
First step in epidemic of cholera: Verification of diagnosis
First line treatment of choice: water and electrolyte replacement.
In the given question, safe water supply and sanitation should be the 1 st step to decrease mortality from cholera. Also know
Stool appearance of cholera: “Rice watery stool • Chemoprophylaxis of cholera: Tetracycline 500mg BID for 5 days.
Drug of choice for cholera:
Adults: Doxycycline 300 mg stat.
Children: Cotrimoxazole 5mg/kg BID for 3 days
Pregnant female: Furazolidone 100mg QID for 3 days
| 4
|
Vaccination to all individuals immediately
|
Primary chemoprophylaxis
|
Cure with tetracycline
|
Safe water supply and sanitation
|
Social & Preventive Medicine
| null |
edd40e0a-e743-4dcc-9615-2490f0895359
|
multi
|
True about paget's disease -a) Common in young girl 10-16 yr of ageb) ↑ALPc) Associated with hypercalcemia & hypophosphatemiad) More common in femalee) Associated with chondrosarcoma
|
Paget's disease occurs after 40 years of age and is more common in males.
Alkaline phosphatase (ALP) is raised and calcium & phosphate are normal.
The usual malignancy complicating Paget's disease is osteosarcoma. There are some reports of cases of chondrosarcoma as a complication of Paget's disease.
| 3
|
ab
|
ad
|
be
|
ce
|
Orthopaedics
| null |
876d75d2-16ae-4cb5-8773-4753595d5183
|
multi
|
Clutton's joint is seen in ?
|
Ans. is 'd' i.e., Congenital syphilis Syphilic ahritis Syphilic ahritis may be seen in congenital or acquired syphilis. Congenital syphilis The joint may be affected early or late : ? Early congenital syphilis : - Osteochondritis in juxta-epiphyseal region results in breakdown of the bone and cailage. Late congenital syphilis : - Painless synovitis at pubey is called clutton's joint. Most comon site is knee followed by elbow, and often is bilateral Acquired syphilis Joint may be involved in the secondary or teiary stage. Secondary stage : - Transient polyahritis. Teiary stage : - Gummatous polyahritis, Chorcot's (neuropathic) joint
| 4
|
Primary syphilis
|
Secondary syphilis
|
Teiory syphilis
|
Congenital syphilis
|
Surgery
| null |
eac11180-1b84-406c-ad5e-621a6e55751b
|
single
|
All are true of Nephrotic syndrome, except
| null | 1
|
RBC casts in urine
|
Hypo-proteinemia
|
Oedema
|
Hyperlipidemia
|
Medicine
| null |
973a3959-7b00-4154-aa00-c07e3a13f5d9
|
multi
|
A 46-year-old Texan develops a lesion in the vestibule of his mouth that on histological examination is revealed to be verrucouscarcinoma of the upper aerodigestive tract. What is true of this lesion?
|
Verrucous carcinoma is a low grade malignancy and is seen more frequently in the southern pa of the United States. It is found most commonly on the gingival buccal junction in tobacco chewers. It is grayish white and exophytic. wide local excision is Treatment of choice .Radiation may be tried for very large lesions.If not excised, the lesion tends to invade locally
| 1
|
It is most commonly found on the inside of the cheek.
|
It is associated with a high metastatic rate.
|
It is ulcerating in appearance.
|
It is best treated with radiation.
|
Surgery
|
Oral cavity
|
15a0d8fc-f27a-4637-9d99-a03b62fc0266
|
multi
|
For a tooth with open apex, treated with calcium hydroxide for apexification, the most reliable sign before obturation is:
|
Weine recommends that the apexification procedure be completed in two appointments. After instrumentation, irrigation and drying of the canal during the first appointment, he advises sealing a sterile, dry, cotton pellet in the pulp chamber for 1 to 2 weeks. Placing a calcium hydroxide dressing in the canal is optional at the first appointment.
During the second appointment, the debridement procedures are repeated before the canal is filled with a thick paste of calcium hydroxide and CMCP or calcium hydroxide in a methylcellulose paste. Whether the tooth is filled in one or two appointments (or more) should be determined to a large extent by the clinical signs and symptoms present and to a lesser extent by operator convenience.
All signs and symptoms of active infection should be eliminated before the canal is filled with the treatment paste.
Absence of tenderness to percussion is an especially good sign before the canal is obturated.
Because of the wide-open access to periapical tissues, it is not always possible to maintain complete dryness in the root canal.
If the canal continues to weep but other signs of infection seem to be controlled after two or three appointments, the dentist may elect to proceed with the calcium hydroxide paste treatment.
| 4
|
Electric pulp testing
|
Thermal pulp testing
|
Tooth mobility
|
Tenderness on percussion
|
Dental
| null |
1878bfda-cffe-4497-b35f-279517910270
|
single
|
The most common side-effect of chemotherapy administration is -
|
Side effects are unpredictable and depend on the type of chemo drug a person is using. Illness, easy bruising or bleeding, and hair loss are some of the most common side effects. Other common side effects include: nausea and vomiting Ref Harrison 20th edition pg 563
| 1
|
Nausea
|
Alopecia
|
Myelosuppression
|
Renal dysfunction
|
Medicine
|
Oncology
|
7761f18f-e3d2-4b86-b101-6e125ad78966
|
single
|
True about metaplasia is
|
Answer- C. It is a reversible changeMetaplasia is an adaptive change in which one adult (mature) cell type is replaced by another adult (mature) cell.It is reversible.There is no pleomorphism, and cell polarity as well as cell & nuclear size are not altered.
| 3
|
Loss of polarity
|
Nucleus is smaller in size
|
It is a reversible change
|
Immature cells
|
Pathology
| null |
5624ce0e-aa07-4eaa-9fa3-016e08c84c60
|
multi
|
Blood agar is an example of:
|
Blood agar is an example of enriched media. Enriched media are cultural media that are enriched with whole or lysed blood, serum, special extracts, or nutrients to suppo the growth of those bacteria that cannot grow on the basal media. Other examples of enriched media are serum agar and chocolate agar. Selenite F broth is an enrichment media used for the isolation of Salmonella group of bacteria. Selective media are solid media which contain substances that slow or inhibit the growth of micro-organisms other than those for which media are devised. Eg Tellurite medium for diphtheria, Deoxycholate citrate agar for Shigella and Salmonella. Ref: Medical Lab Science: Theory & Practice By Ochei Et Al, page 586
| 2
|
Enrichment media
|
Enriched media
|
Nutrient media
|
Selective media
|
Microbiology
| null |
c55ac8e4-43ef-43c1-b37d-778ffb3cefef
|
single
|
Trans-esophageal echocardiography is better over trans- thoracic echocardiography in?
|
Ans. (b) Evaluation of left atria and left Atrial appendage thrombusRef.: Harrison 19th ed. /270e-2* Trans-esophageal echocardiography is better than trans- thoracic echocardiography as it is better able to evaluate the left Atrial thrombus and left Atrial appendage. Therefore in patients of atrial fibrillation of long standing duration for evaluation of clots in left atrium, trans-esophageal echocardiography is done.
| 2
|
Evaluation of left ventricle
|
Evaluation of left atria and left Atrial appendage thrombus
|
Evaluation of Pericardial fluid
|
Evaluation of commissural fusion
|
Medicine
|
Noninvasive Examination of the Heart
|
6fba02e9-82c9-4852-93ae-434154a7890f
|
single
|
Arsenophagists are :
|
C i.e. Persons tolerating high doses of As after taking arsenic in low doses at frequent intervals.
| 3
|
Criminals using arsenic for homicidal purpose
|
Person using arsenic as aboion stick
|
Person who can tolerate high doses of arsenic after taking arsenic in low doses at frequent intervals
|
Persons using it as cattle poison
|
Forensic Medicine
| null |
03c5fdbb-5e81-47bc-bc91-659aa076400f
|
single
|
Choice of intubation in Bilateral TMJ ankylosis for oral surgeries
|
Intubation is generally done with the help of endotracheal tube (ETT). The internal diameter of ETT used ranges between 3 and 8 mm depending on the age, sex, and size of nares of the patient. Potex north and south polar performed Rae tubes (RAE- right angled ETT) and flexo- metallic tubes are commonly used. Out of them, North Pole Rae tube is preferred in case of ankylosis patient due to the direction of the curve of ETT which favors its placement in restricted mouth opening as in case of ankylosis.
| 1
|
North pole Rae tube
|
South Pole Rae tube
|
Tracheostomy
|
Cricothyrotomy
|
Surgery
| null |
6244829d-bb69-4a7e-88ce-4312ce13ec9d
|
single
|
In Kartagener syndrome, all are seen except:
|
Ans: c (Bronchial asthma) Ref: Robbins, 7th ed,727; Harrison, 16th ed,p. 1542Kartagener's syndrome is characterized by bronchiectasis, situs inversus and sinusitis. It is associated with primary ciliary dyskinesia. Lack of ciliary activity interferes with bacterial clearance, predisposes sinuses and bronchi to infection and affects cell motility during embryogenesis, resulting in situs inversus. Males with this condition will be infertile due to ineffective mobility of sperm tail.
| 3
|
Bronchiectasis
|
Situs inversus
|
Bronchial asthma
|
Sinusitis
|
Pathology
|
Respiration
|
a6c0aa9b-da12-4385-9b3e-712cadad6f47
|
multi
|
Conversion of T4 to T3 is inhibited by all except:
|
Ans. (D) Methimazole(Ref: KDT 8/e p252-253)Methimazole inhibits only thyroid peroxidase whereas propylthiouracil inhibits thyroid peroxidase as well as 5'-deiodinase. Later is involved in peripheral conversion of T4 to T3 (Katzung 12/e p688, Goodman Gilman 12/e p1150)
| 4
|
Propranolol
|
Propylthiouracil
|
Amiodarone
|
Methimazole
|
Pharmacology
|
Anti Thyroid
|
e9e45624-2a6d-4548-98ea-3a6db4253dd3
|
multi
|
Which antineoplastic drug is a peptide?
|
Bleomycin This is a mixture of closely related glycopeptide antibiotics having potent antitumour activity. It chelates copper or iron, produces superoxide ions and intercalates between DNA strands-causes chain scission and inhibits repair . It is highly effective in testicular tumour and squamous cell carcinoma of skin, oral cavity, head and neck, genitourinary tract and esophagus; also useful in Hodgkin&;s lymphoma. Mucocutaneous toxicity and pulmonary fibrosis, but little myelosuppression are the special features. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:826,827
| 1
|
Bleomycin
|
Aspaeme
|
Valinomycin
|
Dactinomycin
|
Pharmacology
|
Chemotherapy
|
979b9e3f-a25a-4cad-9c86-87c07e918e10
|
single
|
All are the characteristics of cellulitis, EXCEPT
| null | 4
|
Acute onset
|
Doughy to indurated consistency
|
Caused by aerobic bacteria
|
Well circumscribed
|
Surgery
| null |
dea23967-536e-4f35-861a-61482f630c09
|
multi
|
Which of these is NOT a grievous hu under Sec 320 of the IPC?
|
Grievous Hu: S 320 IPC defines grievous hu and lists eight kinds of hu which it lables as "grievous". These clauses are not mutually exclusive for there can be injuries which may fall in more than one clause. However, the list is exhaustive in the sense that, the framers of the Code have used the term "only", while listing the type of hus which they designated as "grievous". This positively shows that the list is exhaustive and no hu outside the list given in S. 320 can be termed as 'grievous hu'. The following kinds of hu only are designated as "grievous" Emasculation. Permanent privation of the sight of either eye. Permanent privation of the hearing of either ear Privation of any member or joint. Destruction or permanent impairing of the powers of any member or joint. Permanent disfiguration of the head or face. Fracture or dislocation of a bone or tooth. Any hu which endangers life or which causes the sufferer to be during the space of twenty days in severe bodily pain or unable to follow his ordinary pursuits. Where injury was caused on the abdomen with a sharp edged weapon and the doctor had stated that the injury had penetrated the abdominal cavity but had not involved any vital organs/ impoant structures, but had just touched the stomach, it was held that the accused had caused only simple hu. Similarly, cutting of a tendon or a muscle does not make the injury fall under purview of any clauses of S 320 IPC. Ref: Dr. Dasari Harish, Prof & Head; Dr. K H Chavali, Assoc. prof; Dr. Amandeep Singh & Dr. Ajay Kr, Asst. Profs, Dept. Forensic Medicine & Toxicology, Government Medical College & Hospital, Sector 32, Chandigarh - 160030.
| 4
|
Loss of teeth
|
Loss of hearing of one ear
|
Emasculation
|
Abdominal stab with or without organ damage
|
Forensic Medicine
| null |
9da57665-f190-436b-b1cf-8f93db470086
|
single
|
Increased osmotic fragility is seen in -
|
Ans. is 'd' i.e., Hereditary spherocytosis Osmotic fragility of Red blood cells.o Red blood cell osmotic fragility is the resistance of RBC hemolysis to osmotic changes,o Normally RBC maintains osmotic equilibrium with the surrounding medium i.e., with a serum that has 0[?]9% NaCl.o As the surrounding medium becomes hypotonic fluid will enter into the cell along the osmotic gradient, eventually, under very hypotonic conditions the cell will enlarge to capacity and rupture - Osmotic lysis,o Osmotic fragility is determined by measuring the degree of hemolysis in hypotonic saline.o The normal red cell begins to lyse at 0[?]5% NaCl and the hemolysis is complete at 0[?]3 NaCl.o Red blood cells osmotic fragility is considered to be increased if hemolysis occurs in a NaCl concentration > 0[?]5%.o Osmotic fragility is considered to be decreased if the hemolysis is not complete in a 0[?]3 % of NaCl.Increased osmotic fragilityDecreased osmotic fragility'o Hereditary spherocytosiso Hemolytic anemia (acquired immune)o Malariao Severe pyruvate kinase deficiencyo Hemolytic disease of newborno Iron deficiency anemiao Thalassemiao Liver diseaseo Reticulocytosiso Hemoglobinopathies, HbS, HbC
| 4
|
Alpha thalasemia
|
Beta thalassemia
|
Sickle cell anemia
|
Hereditary spherocytosis
|
Unknown
| null |
cf8deac0-97c8-4aaf-87ce-1c4406bb98e7
|
single
|
Tolazine is used as:
|
Ref; GOODMAN& GILMAN'S The Pharmacological Basis of the Therapeutics 10th edition (page no; 245) Tolazoline is an alpha adrenergic antagonist. used as an aid in visualizing distal peripheral vessels during aeriography and a vasodilator in treating coronary aery stenosis during angio-procedures
| 2
|
A thrombin inhibitor in perpheral angiography
|
A vasodilatol' in treating coronary aery stenosis during angio procedures
|
A vasoconstrictor in treatment of varices
|
antispasmodic during biliary spasm
|
Pharmacology
|
Autonomic nervous system
|
33501538-17d7-4600-b7e3-89a5b66f1a5a
|
single
|
In Community Needs Assessment approach as pa of the Reproductive & Child Health programme, the targets for various health activities are set at the level of-
|
Ans. is d i.e., District o The various activities of Reproductive and child Health Programme (RCH) arc targeted at the district level. "The RCH programme is based on a di iThrential approach. Inputs in all the districts have not been kept uniform. While the care component are the same for all districts, the weaker districts will get more suppo and sophisticated facilities are proposed for relatively advaced districts. On the basis of cude bih rate and female literacy rate - all the districts have been divided into three categories 'A, B, & C' All the districts will be covered in a phased manner over a period of three years."
| 4
|
Community
|
Sub-centre
|
Primary health-centre
|
District
|
Social & Preventive Medicine
| null |
747645fc-c00a-4820-b0c3-86d51cecdccc
|
single
|
Not true about gas gangrene:
|
Ans. is. 'd' i. e. Metronidazole is the drug of choice
| 4
|
Most common cause is Cl perfringens
|
Extensive necrosis of muscles
|
Cl perfringens produce heat-labile spores
|
Metronidazole is the drug of choice
|
Microbiology
| null |
2f9acd5e-f70e-4236-abad-fbf65b0d12a0
|
multi
|
Psoralen-A is used in the treatment of -
|
Psoralen and many of its derivatives are naturally occurring tricyclic furocoumarins. The derivative most widely used in photochemotherapy is 8 - methoxypsoralen (8MOP, methoxsalen, xanthotoxin) which is principally of plant origin but it is available as a synthetic drug. 4, 5, 8-trimethyl psoralen (TMP, trioxsalen) is a synthetic compound which is less phototoxic after oral administration and is primarily used for the treatment of vitiligo. ijdvl journal of dermatology, psoralens.
| 2
|
Pemphigus
|
Vitiligo
|
Pityriasis alba
|
Icthyosis
|
Dental
|
miscellaneous
|
7cb87c84-7285-49ac-823d-cb91e1365f70
|
single
|
Principle used in radiotherapy is
|
B i.e. ionization of molecule
| 2
|
Cytoplasmic coagulation
|
Ionization of molecule
|
DNA damage
|
Necrosis of tissue
|
Radiology
| null |
cb8b5553-6aa6-49aa-94d6-b82206257be4
|
single
|
In direct laryngoscopy which of the following cannot be visualized:
|
(a) Cricothyroid(Ref. Dhingra, 6th ed., 422)In Direct laryngoscopy we are visualising the cavity of the larynx from within so cricothyroid muscle or membrane which lie externally cannot be seen.
| 1
|
Cricothyroid
|
Lingual surface of epiglottis
|
Arytenoids
|
Pyriform fossa
|
ENT
|
Anatomy of Larynx
|
b3cc95bf-bf78-4acf-a402-a854385cbf48
|
single
|
Which of the following is not intracapsular -
|
Ans. is 'd' i.e., Lateral epicondyle o The capsular ligament of the elbow joint is attached to the lower end along a line that reaches the upper limits of the radial and coronoid fossae anterioly; and of the olecranon fossa posteriorly; so that these fossae lie within the joint cavity.o Medially, the line of attachment passes between the medial epicondyle and the trochlea,o On the lateral side, it passes between the lateral epicondyle and the capitulum.Attachments of right humerus: Anterior viewAttachments of right humerus: Posterior view
| 4
|
Coronoid fossa
|
Radial fossa
|
Olecranon fossa
|
Lateral epicondyle
|
Anatomy
|
Joints
|
6df5338d-98d8-41fd-9c6c-b7c9d1a763c7
|
single
|
Action of parathormone on phosphate level ?
|
Ans. is 'a' i.e., Decreases phosphate level
| 1
|
Decreases phosphate level
|
Increases phosphate level
|
No effect
|
Variable effect
|
Physiology
| null |
d122ac78-b9fe-435e-bc56-a8a673aa3ed3
|
single
|
For NRR to be 1, couple protection rate should be?
|
To achieve the demographic goal of NRR 1 the couple protection rate (CPR) should have to be achieved by 60% far beyond the present level. The objective was to assess the contraceptive prevalence rate by different methods and to find out the correlation of different biosocial factors with the use of contraception.
| 3
|
20%
|
40%
|
60%
|
80%
|
Social & Preventive Medicine
| null |
2e226451-d296-4014-9c51-0ad4a7440a89
|
single
|
Period of onset in tetanus refers to the time between:
| null | 2
|
First injury to spasm
|
First symptom to spasm
|
First spasm to death
|
Trismus to laryngeal spasm
|
Surgery
| null |
5aed8bcf-ad8c-4973-b5d2-f775baf9bf1b
|
single
|
Anatomical snuffbox contains -
|
- Boundaries of anatomical snuff box
Anterior/ Lateral wall- Extensor pollicis brevis and abductor pollicis longus tendons.
Posterior/ medial wall- Extensor pollicis longus tendon
Floor- Styloid process of radius, trapezium,scaphoid and base of first metacarpal.
Roof- Skin, fascia, starting of cephalic vein, superficial branch of radial nerve.
Content- radial artery
| 1
|
Radial artery
|
Brachial artery
|
Ulnar artery
|
Interosseus artery
|
Anatomy
| null |
c0619822-c711-4fac-ac75-03673228070d
|
single
|
Tzank smear in a case of pemphigus vulgaris show
|
Cytodiagnosis is of most value in pemphigus and its various forms. Acantholysis is the loss of intercellular connections, such as desmosomes, resulting in loss of cohesion between keratinocytes, seen in diseases such as pemphigus vulgaris. It is absent in bullous pemphigoid, making it useful for differential diagnosis In bulbous pemphigoid, eosinophils are commonly seen. Ref Harrison 20th edition pg 1245
| 1
|
Acantholytic cells
|
Macrophages
|
Fibroblasts
|
Neutrophils
|
Dental
|
All India exam
|
ee6fc4ea-8c0e-4a1d-9f32-695907a93213
|
single
|
The classification proposed by the International Lymphoma Study Group for non - Hodgkin&;s lymphoma is known as -
|
<p>International Lymphoma Study Group (Harris et al) proposed revised European -American classification of lymphoid neoplasms (REAL classification ) .This classification was based on the hypothesis that all forms of lymphoid malignancies represent malignant counterpas of normal population of immune cells present in the lymph node & bone marrow.</p><p>Harsh mohan textbook of pathology 6TH edition pg no 366.</p>
| 2
|
Kiel classification
|
REAL classification
|
WHO classification
|
Rappapo classification
|
Medicine
|
Haematology
|
9d1781ab-b8e5-45fd-9e7a-ca4a264a1fc6
|
single
|
A 37 yr old male brought to emergency room late after road traffic accident . On examination the capillary refilling time is delayed in the left lower limb . All are indications for amputation in this patient, except?
|
Causes of Amputations 'three Ds': (1) Dead, (2) Dangerous (3) Damned nuisance. Dead (or dying) Peripheral vascular disease accounts for almost 90% of all amputations. Other causes of limb death are Severe trauma, burns and frostbite. Dangerous disorders are malignant tumours, potentially lethal sepsis (Gas Gangrene) and crush injury. Damned nuisance: In some cases retaining the limb may be worse than having no limb at all. This may be because of: (1) pain; (2) gross malformation; (3) recurrent sepsis or (4) severe loss of function. Transcutaneous Oxygen Tension (TcPO2)values > 40 mmHg are indicative of healing whereas values < 20 mmHg are indicative of non-healing and impending limb loss. For values between20- 40 mmHg, the clinician needs to consider co-morbidities like vascular disease, diabetes etc and the patient's nutritional status before considering amputation. Ankle-brachial Index (ABI) > 0.9 indicates absence of vascular injury and values < 0.45 indicate severe injury.
| 1
|
Transcutaneous Oxygen Tension - 40mmHg
|
Severe Peripheral Vascular disease
|
Ankle-Brachial Index < 0.45
|
Fulminant Gas Gangrene
|
Orthopaedics
|
Amputations and Spos Injury
|
f133751d-3c4b-4581-996e-cc2240ededfa
|
multi
|
'Syndrome of apparent mineralocoicoid excess' is due to deficiency of
|
Syndrome of apparent mineralocoicoid excess is due to genetic deficiency of 11b-dehydrogenase-2, cause hypokalemia. Liddle's syndrome is caused by autosomal dominant gain-in-function mutations of ENaC subunits, cause hypokalemia. Loss of the transpo functions of the thick ascending loop of Henle and distal convoluted tubule nephron segments causes hereditary hypokalemic alkalosis, Bater's syndrome (BS) and Gitelman's syndrome (GS), respectively. Ref: Harrison 19e pg: 305
| 2
|
11a--hydroxysteroid dehydrogenase
|
11b--hydroxysteroid dehydrogenase
|
12a--hydroxysteroid dehydrogenase
|
12b--hydroxysteroid dehydrogenase
|
Medicine
|
Fluid and electrolytes
|
3b51bbf5-7b38-48c3-b605-3a6241c7274b
|
single
|
Lupus anticoagulants may cause all of the following except:
|
Answer is C or None (Increased PT or None) Prothrombin time Ic usually not affected by Lupus Anticoagulant. The Lupus Anticoagulant typically causes an isolated prolongation of APTT. Prothrombin time is usually normal although slight prolongation in PT may also be observed `Lupus anticoagulant should be suspected in cases of markedly prolonged PTT without clinical bleeding and normal or slightly elevated PT'- CMDT The presence of LA activity may predispose patients to venous and aerial thromboembolism and may cause mid trimester aboions - Harrisons 16`11/685 VDRL tests for syphillis are non specific tests, detecting anticardiolipin antibodies. Lupus anticoagulants are family of antiphospholipid antibodies of the same class and may give a false positive VDRL. Causes of false positive VDRL reactions: Acute false positive (< 6 months) Chronic false positive ( 6 months) Recent viral infection / immunization * Aging Genital herpes * Autoimmune disorders Human immunodeficiency virus * SLE Malaria * RA Parentral drug use * Parentral drug use.
| 3
|
Recurrent aboion
|
False+ve VDRL results
|
Increase prothrombin time
|
Aerial thrombosis
|
Medicine
| null |
4afa1fd9-0cf9-45d7-b085-29777ee2c5dd
|
multi
|
Radical cure of plasmodium vivax is by:
|
Primaquine In contrast to other antimalarial drugs, primaquine is a poor erythrocytic schizontocide: has weak action on P. vivax, but blood forms of P. Jalciparum are totally insensitive. On the other hand, it is more active against the preerythrocytic stage of P. Jalciparum than that of P. vivax. Primaquine differs from all other available antimalarials in having a marked effect on primary as well as secondary tissue phases of the malarial parasite. It is highly active against gametocytes and hypnozoites. The mechanism of action of primaquine is not known. However, it is different from that of chloroquine. Though, resistance among P. vivax against primaquine can be induced, it is not a clinical problem. Essentials of medical pharmacology K D Tripathi Sixth edition Pg no 791
| 3
|
Chloroquine
|
Tetracycline
|
Primaquine
|
Aesunate
|
Pharmacology
|
Chemotherapy
|
046006db-797a-46a9-a9ff-e778ffc04155
|
single
|
The middle meningeal aery enters the cranium through the ?
|
The middle meningeal aery is the largest of the aeries supplying the dura mater. It is a branch of the maxillary aery and enters the cranium through the foramen spinosum.
| 1
|
Foramen spinosum
|
Foramen rotundum
|
Foramen magnum
|
Foramen ovale
|
Anatomy
| null |
e40983b0-00ba-4f3a-9684-b45df6840c12
|
single
|
Sphenoid vomer joint is which type of joint?
|
In fibrous joints the bones are joined by fibrous tissue.these joints are either immovable or permit a slight dgree of movement these can be grouped following three subtypes 1 sutures :these are peculiar to skull and are immovable according to shapre of bony margins the sutures can be Schindylesis;between rostrum of sphenoid and upper border of vomer 2 gomphoses: A joint that binds the teeth to bony sockets (dental alveoli) in the maxillary bone and mandible. 3 syndesmoses :Slightly movable aiculations where the contiguous bony surfaces are united by an interosseous ligament, as in the inferior tibiofibular aiculation. Description Ref BD CHAURASIA S Handbook of General Anatomy Fouh edition Pg no 61 FIBROUS JOINTS
| 1
|
Schindylesis
|
Gomphoses
|
Syndesmoses
|
Synchondrosis
|
Anatomy
|
General anatomy
|
d1da5ed6-94a3-47d1-8235-9568dd91faf4
|
single
|
Mechanism of action of paclitaxel is :
|
Taxanes (paclitaxel and docetaxel) act by increasing the polymerization of tubulin whereas vinca alkaloids (vincristine, vinblastine and vinorelbine) cause inhibition of tubulin polymerization. Both of these drugs act by causing the disruption of mitosis and are active in M-phase of the cell cycle.
| 2
|
Topoisomerase inhibition
|
Increases the polymerization of tubulin
|
Inhibits protein synthesis
|
Alkylation of DNA
|
Pharmacology
| null |
3294783f-447f-45cb-a636-afb8a59078b9
|
single
|
During progression of labor S/D of umbilical artery ratio?
|
Ans. b. DecreasesFeto-placental perfusion assessed with Doppler ultrasound by three methods. Systolic versus end diastolic flow velocity (S/D flow) in the umbilical vessels, middle cerebral artery, and ductus venosus.UMBILICAL ARTERY DOPPLERThis test measures the ratio of systolic and diastolic blood flow in the umbilical artery.The umbilical circulation normally has low resistance, so significant diastolic blood flow is expected.The systolic/diastolic (S/D) ratio normally decreases throughout pregnancy.Umbilical artery S/D ratio is gestational age-dependent.The S/D ratio normally decreases from approximately 4.0 at 20 weeks to 2.0 at term, and it is generally less than 3.0 after 30 weeks.Because of downstream impedance to flow, more end-diastolic flow is observed at the placental cord insertion than at the fetal ventral wall. Thus, abnormalities such as absent or reversed end-diastolic flow will appear first at the fetal cord insertion site.This test is predictive of poor perinatal outcome only in IUGR foetuses.Non-reassuring findings, which may indicate need for delivery, are absent diastolic flow and reversed diastolic flow.Note:-This notch disappears at 24 weeks of pregnancy as the resistance of uterine artery decreases due to trophoblastic invasion. There is no diastolic notch in late second and third trimester. But if this diastolic notch persists beyond 24 weeks, it predicts that female will have PIH during this pregnancy.Extra MileUmbilical artery Doppler waveform patterns vs USG patternsNORMAL UMBILICAL ARTERY DIASTOLIC FLOWABSENT UMBILICAL ARTERY DIASTOLIC FLOWREVERSED UMBILICAL ARTERY DIASTOLIC FLOW
| 2
|
Increases
|
Decreases
|
Persistent diastolic notch
|
Constant
|
Gynaecology & Obstetrics
|
Physiology & Histology
|
fbb8941a-acb2-4867-9054-95bb3f2d50fe
|
single
|
Most common cause ofAcute Intestinal Obstruction in neonates is -
|
Ans. is 'c' i.e., Duodenal atresiao Most common cause of neonatal intestinal obstruction Meconium plug syndrome.o Second most common cause of neonatal intestinal obstruction Duodenal atresia.Impoant causes of intestinal obstruction in newbornMeconium plug syndrome o Duodenal atresia o Jujunoileal atresiaMalrotation of gut o Meconium ileusMeconium plug syndrome --> when meconium plug causes obstruction of colon. It is seen in Hirschsprung disease, maternal DM, maternal preeclampsia, prematurity, sepsis, hypothyroidism.Meconium Ileus --> when meconium plug obstruct ileum. It is seen in cystic fibrosis.Note ?o Intussusception is the most common cause of intestinal obstruction between 3 months and 6 year of age (not in neonate).
| 3
|
Jejuna! atresia
|
Malrotation
|
Duodenal atresia
|
Acute Intussusception
|
Pediatrics
| null |
6158307b-a942-4636-917b-f502310dffba
|
single
|
Most important site for gastrin producing cells-
|
Ans. is 'c' i.e., Pylorus/Antrum * Gastrin is a polypeptide produced by G cells of gastric mucosa in the antrum of the stomach and the TG cells that are present throughout the stomach and small intestine. Gastrin secreting cells are also present in pituitary gland, brain and nerves, and the fetal pancreatic islets. GastrinCholecystokininSecretinSecreted by1. G cells in antral and duodenal mucosa1. Mucosa of upper intestine1. S cells in ileal mucosal2. TG cells in stomach and ileum2. Brain and nervesglands.3. Pancreatic islets in fetus 4. Pituitary 5. Brain and nerves Stimulated by1. Peptides and amino acids in stomach and duodenum1. Peptides and amino acids in small intestine1. Peptides and amino acids in small intestine2. Distension of stomach2. Fatty acids (> 10 C in duodenum)2. Acid in small intestine3. Vagal neurotransmitter GRP 4. Epinephrine Inhibited by1. Acid in duodenum 2. Secretin, GIP, VIP, CCK, somatostatin 3. Glucagon 4. Calcitonin Mode of action1. Group-IIC hormone1. Group-IIC hormone1. Group-IIA hormoneEffects on exocrine secretions1. Gastric acid (+)1. Pancreatic enzymes (+)1. Pancreatic HC03 (+)2. Pepsin (+)2. Enterokinase (+)2. Hepatic bile (+)3. Gastric acid (~)Effects on endocrine secretions1. Insulin (+)1. Insulin (+)1. Glucagon (-)2. Glucagon (+)2. Glucagon (+)2. Potentiates CCK 3. Potentiates secretin Effects on GI motility1. Gastric motility (+)1. Pyloric sphincter tone (+)1. Pyloric sphinter tone (+)2. Gastric emptying (-)3. Gall bladder contraction (+)4. Small intestine, colon motility (+)5. Relaxes LESOther effects1. Trophic effect on the mucosa of stomach, ileum, and colon1. Trophic effect on pancreas 2. Satiety
| 3
|
Body of stomach
|
Funds
|
Pylorus/Antrum
|
All of the above
|
Physiology
|
G.I.T.
|
7e52c1d8-3374-4b1b-920f-8a11a18f179a
|
multi
|
All are useful in knowing the time since death Except
|
Sequential changes after death like the degree of rigor mois, postmoem hypostasis, postmoem cooling and extent of putrefactive changes are assessed. They will help a great deal in asceaining the time since death. Ref - Krishan Vij 5th edition
| 1
|
Cooling of the body
|
Rigor mois
|
Postmoem staining
|
Postmoem bruising
|
Forensic Medicine
|
Identification
|
0e23e7e4-f3bb-4eba-aad3-f0a4efc955dc
|
multi
|
The sac contains only a poion of the circumference of the intestine -
|
Ans. is 'a' i.e., Richter's hernia
| 1
|
Richter's hernia
|
Littre' s hernia
|
Spigelian hernia
|
Lumber hernia
|
Surgery
| null |
ec50b75d-8a2c-4352-b6d8-1c5e91d7abac
|
single
|
Which of the following facial expressions indicate the rest position
|
Facial expression:
The following indicates rest position:
Lips are even anteroposteriorly with slight contact.
Skin around the eyes and chin is relaxed.
Relaxation around the nostrils with unobstructed breathing.
With experience the dentist learns to recognize, these features depicting rest position and will make measurements accordingly.
| 4
|
Lips are even anteroposteriorly with slight contact.
|
Skin around the eyes and chin is relaxed.
|
Relaxation around the nostrils with unobstructed breathing.
|
All of the above
|
Dental
| null |
f21b37f8-313a-4971-8821-d101993d10c5
|
multi
|
The following statement about keloid is true ?
|
Ans. is 'b' i.e., Local recurrence is common after excision
| 2
|
They do not extend into normal skin
|
Local recurrence is common after excision
|
They often undergo malignant change
|
They are more common in whites than in blacks
|
Surgery
| null |
d9672d8b-57a1-41ab-9176-13e09caa76ac
|
multi
|
Breech presentation with hydrocephalus is managed by :
|
Ans. is a, b and c i.e. Cesarean section, Trans-abdominal decompression, PV decompression and Craniotomy of after coming head Management options in case of breech presentation with hydrocephalus Cephalocentesis : In this, excessive fluid is removed thereby reducing the fetal head size, allowing vaginal delivery. It can be done : Per abdomen : A wide bore needle is inseed the maternal abdomen into the fetal head after emptying the bladder. The transabdominal approach is used successfully in both cephalic and breech presentation. ii. Per vaginal : With cephalic presentation, as soon as the cervix is dilated upto 3 - 4cm , ventricles are tapped trans vaginally with a wide bore needle. With breech presentation labour is allowed to progress upto delivery of trunk and shoulders. The needle is inseed transvaginally just below the anterior vaginal wall and into the aftercoming head through the widened suture line. Cesarean Section : recommends all hydrocephalic fetuses should be delivered abdominally, whereas the use of cephalocentesis should be limited to fetuses with severe associated abnormalities. Craniotomy is recommended if the obstetrician is well versed with the technique and is applicable for the forecoming (veex) and the after coming head (breech) in case of hydrocephalus if fetus is dead. Note: In a hydrocephalic fetus if BPD is < 10 cm or if head circumference is < 36 cms, vaginal delivery may be permitted.
| 4
|
Cesarean section
|
Trans-abdominal decompression
|
PV decompression and Craniotomy of aftercoming head both
|
All of the above
|
Gynaecology & Obstetrics
| null |
c2b8b761-b173-4972-bf2e-b6e277d44c18
|
multi
|
A person was diagnosed with Gout. You will suggest the patient to avoid which of the following food product in his diet ?
|
Foods avoided in Gout : Foods rich in Purine are : 1. Vegetarian- Spinach, Peas, Cauliflower, Mushrooms 2. Non-vegetarian- Meat, Liver, Fish (tuna). 3. Alcohol & heavy exercise causes lactic acidosis & hyperuricemia.
| 4
|
Whisky & Beer
|
Spinach & Mushrooms
|
Meat & Fish
|
All
|
Biochemistry
|
Nucleotides
|
a9c6d4a0-171c-4b76-95b1-1c4cd5bd9f90
|
multi
|
Specific gravity of amniotic fluid
|
Specific gravity of the amniotic fluid is 1.010 Fluid is faintly alkaline It becomes highly hypotonic to maternal serum at term pregnancy Ref: Dutta Obs 9e pg 34.
| 2
|
1.213
|
1.01
|
1.51
|
1.1
|
Gynaecology & Obstetrics
|
General obstetrics
|
fed2d236-0b62-4de1-9065-2fa829fecc92
|
single
|
Not a direct branch of arch of aoa ?
|
Branches of arch of aoa are :- i) Brachiocephalic trunk ii) Left common carotid aery iii) Left subclan aery Right common carotid aery and right subclan aery arise from brachiocephalic trunk (Brachiocephalic trunk divides into right common carotid and right subclan aeries).
| 4
|
Left common carotid aery
|
Left subclan aery
|
Brachiocephalic trunk
|
Right common carotid aery
|
Anatomy
| null |
fb8dc07b-dd13-4c4b-9f5f-7737812872fe
|
single
|
Naf inhibits
|
Enolase requires Mg2++, and by removing magnesium ions, fluoride will irreversibly inhibit this enzyme. Thus fluoride will stop the whole glycolysis.Ref: DM Vasudevan, 7th edition, page no: 111
| 1
|
Enolase
|
Glucokinase
|
Hexokinase
|
G-6 PD
|
Biochemistry
|
Metabolism of carbohydrate
|
07cc186e-078f-4eb5-82c8-d426261bb781
|
single
|
Bacterial endocarditis can cause all except -
| null | 4
|
Cerebral infarct
|
Focal glomerulonephritis
|
Meninigitis
|
Subcutaneous nodules
|
Pathology
| null |
e8f0ae66-dc65-4812-b1f0-de854acc0b1f
|
multi
|
Ganser syndrome is a feature of -
|
Ans. is 'c' i.e., Dissociative disorder Dissociative disordero The essential feature of the dissociative disorder is a disruption in the usually integrated functions of consciousness, memory, identity or perception of the environment Dissociative disorder areDissociative (psychogenic) amnesia It is the most common type of dissociative disorder. Dissociative amnesia is characterized by retrograde amnesia (inability to retrieve stored memories and events leading up to onset of amnesia) and absence of antegrade amnesia (inability to form new long term memories).Dissociative fugue A dissociative fugue may be present when a person impulsively wanders or travels away from home and upon arrival in the new location is unable to remember his/her past (i.e., amnesia for early life). There is loss of personal identity and the person assumes a new identity. There is absence of awareness of amnesia during fugue episode, i.e., Patient denies any memory loss during fugue state. On recovery there is amnesia for fugue episodes and recovery of memory of earlier life (i.e., before the episode of fugue).Dissociative identity disorder (multiple personality disorder) More than one personality appears to possess the individuals, Showing their characteristic behavior. At any instance behavior and memories of one personality is exhibited, patient then is unaware of the other's existance.Depersonalization disorder : - Feeling of detachment from self is referred to as depersonalization. Individuals with this disorder will report feeling as if they are living in a dream or watching themselves on movie screen i.e., feeling detached from self and as if one is an outside observer of oneself. People with this disorder feel like they are "going crazy" and they frequently become anxious and depressed.Dissociative disorders not otherwise specified :-These are the disorders that are characterized by dissociative response that do not meet diagnostic criteria for one of the other dissociative disorder. Important ones areDissociative Trance (Possession) disorders There is temporary exchange of person's personality by a new personality usually attributed to a spirit or divine power. Usually the person is aware of the existance of the other, i.e., possessor (unlike dissociative identity disorder).Ganser's syndrome : - Also known as syndrome of approximate answers. This is characterized by giving approximate answers together with a clouding of consciousness, and frequently accompanied by hallucinations and other dissociative, somatoform or conversion symptoms.
| 3
|
OCD
|
Conversion disorder
|
Dissociative disorder
|
Schizoid personality disorder
|
Psychiatry
|
Symptoms & Signs
|
7b37ca1d-7166-46df-b411-06cea03ab88c
|
single
|
patient develops to have malaria smear shows all stages of schizonts 14-20 merozoites, yellowish brown pigment . what is type of malaria
|
p.vivax= yellowish brown pigment = 12-24 = merozoites p.falciparum= dark brown = 18-24 merozoites p.malariae= dark brown = 8 merozoites p. ovale = dark yellow = 8-12 merozoites ref : ananthanaryana 9th ed
| 3
|
p.vivax
|
p.malariae
|
p.falciparum
|
p.ovale
|
Microbiology
|
All India exam
|
388639e4-fa78-40e0-86ec-b51a69bb6081
|
multi
|
The Electron Microscopy is viually diagnostic in renal biopsy study of -
|
Ans. is 'c' i.e., Alpo syndromeo Alpo's syndrome presents with characteristic histological features on electron microscopy. Such changes may present in other diseases, but are most pronounced and widespread in Alpo's syndrome.Features of Alpo's syndrome on electron microscopy :o Alpo's patients early in their disease typically have diffuse thinning of the basement membrane which thickens over time into multilamellous surrounding lucent areas that often contain granules of varying density.o The characteristic electron electron microscopic finding of fully developed disease is that glomerular basement membrane shows irregular foci of thickening alternating with attenuation (thinning) with pronounced splitting and lamination of lamina densa often with distinctive basket weave appearance.
| 3
|
Goodpasture's syndrome
|
Churg-Strauss syndrome
|
Alpo syndrome
|
Wegner's granulomatosis
|
Pathology
| null |
2f9d3172-5199-4d32-b4ff-c7e8e2ade208
|
multi
|
The following is true of anti-H. pylori therapy EXCEPT:
|
Triple drug therapy for H. pylori is indicated in those patients in whom infection is detected by urea breath test. Since H. pylori becomes less virulent in the absence of acid, combination with PPI is more effective. Because resistance can develop to single agents, these are used in combination. Colloidal bismuth subcitrate dislodges H. pylori but produces metallic taste and blackening of tongue.
| 1
|
It is indicated in all patients of peptic ulcer
|
Resistance to any single antimicrobial drug develops rapidly
|
Concurrent suppression of gastric acid enhances the efficacy of the regimen
|
Colloidal bismuth directly inhibits H. pylori but has poor patient Acceptability
|
Pharmacology
|
Kidney, Respiratory, GIT and Autacoids
|
755d6070-f130-4000-8fb6-9a087a5e4128
|
multi
|
An 82-year-old hospitalized patient with creatinine clearance of 25 mL/min has a microbial infection requiring treatment with antibiotics. Which one of the following drugs is least likely to require a dosage adjustment, either a smaller dose than usual or an increased interval between doses?
|
Erythromycin is eliminated largely via biliary excretion and decreases in renal function do not usually require a dosage reduction unless creatinine clearance <10mL/min. All of the other antimicrobial drugs listed are eliminated by the kidney, at rates proportional to creatinine clearance, so major dose reductions would be needed in patients with renal dysfunction to avoid toxicity.
| 2
|
Arnphotericin B
|
Erythromycin
|
Gentamicin
|
Imipenem-cilastatin
|
Pharmacology
|
Anti Microbial
|
b740ca92-3399-4365-b3c2-9194a1a7bbff
|
multi
|
Bih weight of a child doubles at five months of age while the bih length doubles at the age of -
|
Ans. is 'd' i.e., 4 year
| 4
|
1 year
|
2 years
|
3 years
|
4 years
|
Pediatrics
| null |
1a6970e0-fab5-4906-8fc5-27ddfc8185b5
|
single
|
Which of the following drugs can be used for secondary prevention of coronary aery disease?
|
Ans. is'a'i.e., GemfibrozilGemfibrozilThis fibric acid derivative effectively lowers plasma TG level by enhancing breakdown and suppressing hepatic synthesis of TGs.Besides high efficacy in type III hyperlipoproteinemia, gemfibrozil has shown action in subjects with raised blood CH in addition.In the 'Helsinki Hea Study' men without known CAD treated with gemfibrozil had a 34% reduction in fatal and nonfatal MI, though overall moality was not affected.That these benefits extend to secondary prevention of coronary events in men with existing CAD and low HDL CH, has been demonstrated in another trial.
| 1
|
Gemfibrozil
|
Colestipol
|
Temisaan
|
Vitamin E
|
Pharmacology
| null |
33952ca2-8eef-48a7-8f81-f75e24ca0a23
|
single
|
All of the following drugs are effective for cervical ripening during pregnancy except :
|
Ripening of cervix is changing the cervical matrix from sol to gel state by dissolving the collagen bundles making cervix soft. Drugs used for cervical ripening are: Prostaglandin - Dinoprostal gel and Misoprostal tablet Steroid receptor antagonist - Mifepristone, Onapristone Relaxin Glyceryl trinitrite, isosorbide mononitrate Oxytocin Ref: Williams Obs 24e pg 525,Datta Obs 9e pg 486.
| 3
|
Prostaglandin E2
|
Oxytocin
|
Progesterone
|
Misoprostol
|
Anatomy
|
General obstetrics
|
88871c12-2c07-4b12-ad23-8e7e4564dc38
|
multi
|
Uncoupler in ETC
|
Dinitrophenol (DNP) a potent uncoupler is amphipathic and increase the permeability of the lipoid inner mitochondrial membrane to protons (H+), thus reducing the electrochemical potential and sho-circuiting the ATP synthase. In this way, oxidation can proceed without phosphorylation.Ref: MN Chatterjea Textbook of Medical Biochemistry, 8th edition, page no: 146
| 3
|
H2S
|
Antimycin a
|
2, 4-dinitrophenol
|
Barbiturates
|
Biochemistry
|
Respiratory chain
|
2bea30b9-bcfa-4ed4-8657-a528bf894fa5
|
single
|
A 5-year-old unimmunised child presented with sore throat & swelling of neck. On examination of throat, the following was seen. What is the most probable causative organism?
|
A membrane is seen over the tonsil in this child with swelling of neck: suggestive of Diphtheria. Diphtheria typically follows an incubation period of 2-5 days. - Infection is slower in onset with less local discomfo often resembling a typical viral upper respiratory infection (URI) - Localized or coalescing pseudo membrane in diphtheria extends beyond the tonsils, on to the soft palate and is diy grey in colour. It is characterized by the formation of a dense, gray debris layer composed of a mixture of dead cells, fibrin, RBCs, WBCs, and organisms - It is adherent, and its removal leaves a bleeding surface. - Urine may show albumin. - Smear and culture of throat swab will reveal corynebacterium diphtheriae
| 4
|
Streptococcus pyogenes
|
Mycobacterium tuberculosis
|
Staphylococcus aureus
|
Corynebacterium diphtheriae
|
Pediatrics
|
Impoant Bacterial Diseases in Children
|
7b31f5af-d70f-41b5-98ab-e4d25af7d339
|
single
|
Which of the following is viually diagnostic of aoitis on chest X-Ray?
|
B i.e. Calcification of ascending aoa - Saccular aneurysm with pencil - thin (linear) dystrophic calcification most commonly in ascending aoa commencing near the aoic rootQ is charcteristic feature of syphilitic aoitis. - Aoic aneurysm in Marfan's syndrome often involves sinuses of valsalva, & ascending aoa. It can also affect aoic ring resulting in AR. The aneurysm is classically flask shaped with loss of usual indentation at sino -tubular junction. Takayasu's aoitis affects segments of aoa including main aoic branches & pulmonary aeries.
| 2
|
Calcification in descending aoa
|
Calcification of ascending aoa
|
Calcification of pulmonary aery
|
Focal oligemia
|
Radiology
| null |
77ee39f6-ad07-44e5-936f-8218482774d1
|
multi
|
Health promotion includes:
|
Ans: D (Health.....) HEALTH PROMOTION Park 23rd/ 43# It is process of enabling people to increase control over & to improve health# The well known interventions in this area are: health education, environmental modification, nutritional interventions & life style & behavioural changes # Health education: This is one of the most cost-effective interventionsEnvironmental modification: A comprehensive approach to health promotion requires environmental modifications, such as provision of safe water, installation of sanitary' latrines, control of insects & rodents, improvement of housing etcNutritional interventions : These comprises food distributions & nutrition improvement of vulnerable groups, child feeding programmes, food fortifications & nutritional education# Life style & behavioural changes:Specific protection Park 23rd/ 43To avoid disease altogether is the ideal but this is possible only in a limited number of cases.The following are some of the currently available interventions aimed at specific protectionImmunizationUse of specific n utrien tsChemoprophylaxisProtection against occupational hazardsProtection against accidentProtection from carcinogenAvoidance from allergenThe control of specific hazards in the general environment e,g air pollution, noise controlControl of consumer product quality & safety of foods, drugs, cosmetics etcEarly Diagnosis &Treatment Park23rd/ 43# These are main interventions of disease control# Though notas effective & economical as primary prevention may be critically important in reducing in high morbidity & mortality in certain disease such as essential hypertension, cancer cervix & breast cancer. For many others such as T.B, leprosy, & STD, early diagnosis & treatment are the only mode of interventions# Mass treatment approach is used in the control of certain diseases viz. yaws, pinta, bejel, trachoma & filaria
| 4
|
PAS smear
|
Mass treatment
|
Immunization
|
Health education
|
Social & Preventive Medicine
|
Health Education & Communication
|
3c13e5c2-6db6-4c53-bb07-c67f5dc9d027
|
single
|
A 12 year old girl presents with a yellowish "bihmark" on the scalp. Her mother repos that the lesion has progressively become thicker and way. She is asymptomatic but they are concern regarding the cosmetic appearance. Which is the most likely diagnosis?
|
Nevus sebaceous appears usually on the scalp. Made of extra sebaceous glands in the skin. It stas as a flat pink or orange plaque (slightly raised area). Hair does not grow in a nevus sebaceous. During adolescence, they can become very bumpy and wa- like. A nevus sebaceous does not go away on its own. T/t: Surgery Sebaceous hyperplasia: Enlarged sebaceous glands seen on the forehead or cheeks of the middle-aged and elderly. Aplasia cutis: Congenital absence of skin, with or without the absence of underlying structures such as bone. It most commonly affects the scalp.
| 3
|
Sebaceous hyperplasia
|
Congenital was
|
Nevus sebaceous
|
Aplasia cutis
|
Dental
|
Naevi and vessel related disorders
|
e5c69dcf-bdbd-42d3-a3de-6ac770aa9c26
|
single
|
Antidepressant drug used in nocturnal eneuresis is:
|
A i.e. ImipramineAdverse effects ofTCAsl. Anticholinergic - Dry mouth, bad taste, urinary retention, blurred vision, palpitation, constiPation.2. Sedation, mental confusion, weakness.3. Increased appetite and veigfit gain.4. Sweating andfinc tremer.5. Decreased seizure threshold (clomipramine, maprotiline & bupropion).6. Postural hypotension > Marimum by amitripSline - Goodman & Gillman 11/e p. 4j3.7. Cardiac arrythmia; Maximum by amitriptyline and dosulpin.
| 1
|
Imipramine
|
Fluoxetine
|
Trazdone
|
Sealine
|
Psychiatry
| null |
a0c7e108-ee1e-44b1-95ec-0cffe25e7fbd
|
single
|
Iron poisoning in 4 year child, R X includes –a) Stomach lavageb) Desferrioxamine IV 100 mgc) X–ray abdomend) Blood transfusion
|
Iron poisoning
Ingestion of a number of ferrous sulphate tablets may cause acute iron poisoning.
Clinical features
Severe vomiting
GI bleeding
Diarrhea
There may be severe shock, hepatic & renal failure
Treatment of Iron poisoning
Because iron is radio-opaque abdominal radiography may confirm the ingestion. Repeat radiograph may help with assessment of the efficiency of gastric decontamination methods.
Ipecac-induce emesis may be used to remove tablets from the stomach.
Gastric lavage is not recommended in children because of its inefficiency.
Activated charcoal does not adsorb iron and should not be used.
Whole bowel irrigation may be of benefit.
If tablets adhere to gastric mucosa, removal by endoscopy.
Desferrioxamine is a specific shelter of iron and is the antidote of choice.
| 4
|
a
|
c
|
ac
|
bc
|
Pediatrics
| null |
288a504b-52f0-41f2-8081-366707a88dfc
|
single
|
In deep incised wounds, Langer's lines determine?
|
Ans. is 'b' i.e., Gaping Gaping is more when the skin is cut across the Langer's line. Incised wound It is a clean cut through the tissues (usually, skin and subcutaneous tissue), caused by sharp-edged object. which is longer than its depts, when the weapon is struck or pressed and drawn across the body pa, i.e., there is pressure and friction. examples of sharp edged object are knife, blade, razor, scalpel, sword, chopper etc. The characteristic feature of incised wound are : - Length is the greatest dimension (most impoant) Hair, hair bulb, nerve and vessels are cut --> bleeding is profuse as vessels are cut. Width of injury is more than the thickness of blade, due to gaping of wound. Langer's line of skin determines gaping : gaping is more when cut is across these lines Margins are eveed, clear, and clean cut Clean incised wounds heal by primary intention, whereas diy, infected or large wounds heal by secondary intention, with scar formation. Hesitation cuts (Tentative cuts or trial cuts) are characteristic features of suicidal attempt. Incised wound on nose, ear and genital are usually homicidal and are inflicted on account of jealously or revenge in case of adultery, causing disfiguration
| 2
|
Direction
|
Gaping
|
Shelving
|
Healing
|
Forensic Medicine
| null |
6db68f02-eea8-488a-8ee3-07c61f640df1
|
single
|
Which of the following is seen in COPD?
|
Chronic bronchitis: Follicular bronchiolitis: Desquamative pneumonitis: Chemical pneumonitis One type of COPD Inflammed bronchial tubes produce lots of mucus Leads to coughing and difficulty breathing Cigarette smoking is the most common cause Known as hyperplasia of the BALT ( Bronchial associated lymphoid tissue) Characterized by the development of lymphoid follicles with germinal centers in the walls of small airways. Idiopathic interstitial pneumonia Elevated level of macrophages Name derived from the former belief that these macrophages were pneumocytes that had desquamated Inflammation of the lungs ( or ) breathing difficulty due to inhaling chemical fumes Inhaled substance include: Chlorine gas Grain and feilizer dust Fumes from pesticides
| 1
|
Chronic bronchitis
|
Follicular bronchiolitis
|
Desqumative pneumonitis
|
Chemical pneumonitis
|
Pathology
|
Obstructive Lung Disease
|
abc7c799-13bb-4c93-aa5c-8cec6d7c85f8
|
single
|
Most common cause of Croup ?
|
Ans. is `d.' i.e., Parainfluenza virus Croup (Laryngotracheobronchitis) Laryngotracheobronchitis is the most common infectious cause of obstruction in children usually occurring between the ages of 6 months and 3 years. Male children (boys) are characteristically more frequently involved than females (girls) Etiology It is a viral infection most frequently caused by Parainfluenza virus Pathology The most characteristic pathological feature is edema formation in the subglottic area The loose areolar tissue in the subglottic area swells up and causes predominant signs of upper airway obstruction. Presentation Gradual onset with a prodrome of upper respiratory symptoms Hoarseness and barking cough (croupy cough) Stridor (initially inspiratory than biphasic) Fever is usually low grade (or absent) although may occasionally be high grade Droolings is characteristically absent and there is no dysphagia (seen in epiglottitis) Imaging (X ray) Symmetric 'steeple' or 'funnel shaped' narrowing of the subglottic region (steeple sign) Hypopharyngeal widening or distension Normal epiglottis and aryepiglottic folds Treatment Mild symptoms (barking cough but no stridor at rest) Suppoive therapy alone with humified oxygen, oral hydration and minimal handling. Moderate symptoms (barking cough with stridor at rest) Active intervention with humified oxygen, Nebulized racemic epinephrine and glucocoicoids (steroids). Severe symptoms (impending respiratory failure) Require an aificial airway (Intubation with endotracheal tube or tracheostomy may be required). Antibiotics are not routinely indicated in the treatment of Acute Laryngotracheobronchitis. Their use is limited if there is evidence of secondary bacterial infection.
| 4
|
H influenza
|
S pneumoniae
|
Influenza virus
|
Parainfluenza virus
|
ENT
| null |
edb3331e-9e85-44c4-bf4d-16d6b7acad0d
|
single
|
Commonest treatment of Branchial cyst
|
A branchial cyst probably develops from the vestigial remnants of the second branchial cleft, is usually lined by squamous epithelium, and contains thick, turbid fluid full of cholesterol crystals. The cyst usually presents in the upper neck in early or middle adulthood and is found at the junction of the upper third and middle third of the sternomastoid muscle at its anterior border. It is a fluctuant swelling that may transilluminate and is often soft in its early stages so that it may be difficult to palpate. If the cyst becomes infected it becomes erythematous and tender and, on occasions, it may be difficult to differentiate from a tuberculous abscess. Ultrasound and fine-needle aspiration both aid diagnosis and treatment is by complete excision, which is best undeaken when the lesion is quiescent. Although the anterior aspect of the cyst is easy to dissect, it may pass backwards and upwards through the bifurcation of the common carotid. Bailey & Love,5th,727
| 3
|
Cystectomy
|
Aspiration
|
Excision
|
Nothing done
|
Surgery
|
Head and neck
|
5d10159b-1c13-4072-97de-b058a048178f
|
single
|
A 30 yr old female with whose blood routine showed RBC count of 4.5 million, MCV 55fl and TLC 8000. There is no history of blood transfusion. What is your diagnois?
|
. Thalessemia minor
| 3
|
Iron deficiency anemia
|
Thalessemia major
|
Thalessemia minor
|
Megaloblastic anemia
|
Pathology
| null |
749cf443-0ebe-4584-a020-f1802fd34e8b
|
single
|
Murder is punished under
|
Refer the byte "Legal sections".
| 3
|
300 IPC
|
307 IPC
|
302 IPC
|
304 IPC
|
Forensic Medicine
| null |
ca7eea66-7505-46f9-a10a-9ce892505920
|
single
|
Transient acute adrenal insufficiency is seen with which of the following drug.
|
Etomidate causes adrenal gland suppression. It inhibits an enzyme 11 beta hydroxylase on essential enzyme for coisol synthesis. Etomidate has the highest incidence (40%) of post operative nausea and vomiting (PONV) among the intravenous anesthetics. Propofol has antiemetic propeies thereby reducing PONV. Other potential adverse effects of etomidate: Adrenocoical suppression Myoclonus Seizure precipitation Pain on injection
| 1
|
Etomidate
|
Propofol
|
Thiopentone
|
Ketamine
|
Anaesthesia
|
Intravenous Anesthetic Agents
|
bb1e8876-00d9-4bc5-8e31-85618130b522
|
single
|
First rank symptoms of schizophrenia are all except
|
First Rank Symptoms (SFRS) of Schizophrenia 1. Audible thoughts: Voices speaking out thoughts aloud or 'thought echo'. 2. Voices heard arguing: Two or more hallucinatory voices discussing the subject in the third person. 3. Voices commenting on one's action. 4. Thought withdrawal: Thoughts cease and subject experiences them as removed by an external force. 5. Thought inseion: Experience of thoughts imposed by some external force on person's passive mind. 6. Thought diffusion or broadcasting: Experience of thoughts escaping the confines of self and as being experienced by others around. 7. ' Made' feelings or effect. 8. 'Made' impulses. 9. 'Made' volition or acts: In 'made' affect, impulses and volitions, the person experiences feelings, impulses or acts which are imposed by some external force. In 'made' volition, for example, one's own acts are experienced as being under the control of some external force. 10. Somatic passivity: Bodily sensations, especially sensory symptoms, are experienced as imposed on the body by some external force. 11. Delusional perception: Normal perception has a private and illogical meaning. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 55
| 1
|
Ambivalence
|
Running commentary
|
Primary delusion
|
Somatic passivity
|
Psychiatry
|
Schizophrenia and other psychotic disorders
|
76f2791f-fec0-4cf6-ba8a-2f54ce6cd54a
|
multi
|
All of the following are true for anaemic retinopathy except
|
Anaemic retinopathy In anaemia, retinal changes are liable to occur when haemoglobin level falls by 50 percent and are consistently present when it is below 35 percent (5 gm%). Anaemic retinopathy is characterised by pale aerioles and a pale general background of the fundus. Retinal veins are dilated. Superficial retinal and preretinal (subhyaloid) haemorrhages may be seen in posterior half of the fundus. A few haemorrhages have white centres (Roth spots). Rarely, a few soft exudates (cotton-wool patches) may also be present. Ref:- A K KHURANA; pg num:-264
| 3
|
Occurs when haemoglobin level falls below 5 gm%
|
Aerioles become pale
|
Veins are pale and narrow
|
Superficial retinal and subhyaloid haemorrhage are seen
|
Ophthalmology
|
Cornea and sclera
|
11c0e64c-e7db-407c-be60-2081af0fe776
|
multi
|
Which cell is not seen in Hodgkin lymphoma -
| null | 4
|
Reed sternberg cell
|
Lacunar cell
|
L & H cell
|
Langerhan cell
|
Pathology
| null |
7eb9708d-31b5-402e-b838-74b1f8ee69b9
|
single
|
Regarding synthesis of triacylglycerol in adipose tissue, all of the following are true except
|
SYNTHESIS OF TRIGLYCERIDES (TAG) Liver and adipose tissue are the major sites of triacylglycerol (TAG) synthesis. The TAG synthesis in adipose tissue is for storage of energy whereas in liver it is mainly secreted as VLDL and is transpoed to peripheral tissues. The TAG is synthesised by esterification of fatty acyl CoA with either glycerol-3-phosphate or dihydroxyacetone phosphate (DHAP).The glycerol pa of the fat is derived from the metabolism of glucose. DHAP is an intermediate of glycolysis. Glycerol-3-phosphate may be formed by phosphorylation of glycerol or by reduction of dihydroxyacetone phosphate (DHAP). In adipose tissue, glycerol kinase is deficient and the major source is DHAP derived from glycolysis. However, in liver glycerol kinase is active. The fatty acyl CoA molecules transfer the fatty acid to the hydroxyl groups of glycerol by specific acyltransferases. In addition to these two pathways, in the intestinal mucosal cells the TAG synthesis occurs by the MAG pathway. The 2-MAG absorbed is re-esterified with fatty acyl CoA to form TAG (Fig. 11.4). Esterification of fatty acyl CoA with glycerol phosphate to form triacylglycerol occurs at a rapid rate during the fed state. Under conditions of fasting, it is seen that synthesis of triacylglycerol occurs side by side with lipolysis since the free fatty acid level is high in plasma. The glycerol phosphate is derived from the metabolism of glucose in the fed state by channeling dihydroxyacetone phosphate, an intermediate of glycolysis. In the fasting state, the glycerol phosphate is derived from dihydroxyacetone phosphate formed during gluconeogenesis (neoglycerogenesis). The activity of the enzyme PEPCK is enhanced in liver and adipose tissue during conditions of fasting so that glycerol phosphate is available to esterify and store the excess fatty acid mobilized.METABOLISM OF ADIPOSE TISSUE The adipose tissue serves as a storage site for excess calories ingested. The triglycerides stored in the adipose tissue are not ine. They undergo a daily turnover with new triacylglycerol molecules being synthesized and a definite fraction being broken down. 1. Adipose Tissue in Well-fed Condition i. Under well-fed conditions, active lipogenesis occurs in the adipose tissue. ii. The dietary triglycerides transpoed by chylomicrons and the endogenously synthesised triglycerides from liver brought by VLDL are both taken up by adipose tissue and esterified and stored as TAG. The lipoprotein molecules are broken down by the lipoprotein lipase present on the capillary wall. iii. In well-fed condition, glucose and insulin levels are increased. GluT4 in adipose tissue is insulin dependent. Insulin increases the activity of key glycolytic enzymes as well as pyruvate dehydrogenase, acetyl CoA carboxylase, and glycerol phosphate acyltransferase. The stimulant effect of insulin on the uptake of glucose by adipose tissue, on the glycolysis and on the utilisation of glucose by the HMP pathway also enhances lipogenesis. iv. Insulin also causes inhibition of hormone-sensitive lipase, and so lipolysis is decreased2. Adipose Tissue in Fasting Condition i. The metabolic pattern totally changes under conditions of fasting. TAG from the adipose tissue is mobilized under the effect of the hormones, glucagon and epinephrine. ii. The cyclic AMP-mediated activation cascade enhances the intracellular hormone sensitive lipase.The phosphorylated form of the enzyme is active which acts on TAG and liberates fatty acids. iii. Under conditions of starvation, a high glucagon, ACTH, glucocoicoids, and thyroxine have lipolytic effect. The released free fatty acids (FFA) are taken up by peripheral tissues as a fuel.3. Adipose Tissue and Diabetes Mellitus Lipolysis is enhanced and high FFA level in plasma is noticed in diabetes mellitus. The insulin acts through receptors on the cell surface of adipocytes. These receptors are decreased, leading to insulin insensitivity in diabetes. In type 2 diabetes mellitus, there is insulin resistance and the different insulin signaling pathways are affected differently. Hepatic gluconeogenesis occurs uninhibited leading to hyperglycemia. However, increased mobilization of fatty acids from adipose tissue and the persistently high free fatty acid levels in the presence of hyperinsulinemia stimulate synthesis of triacylglycerol. The overproduction of TAG leads to increased release of VLDL from liver causing hyperiglyceridemia. The excess deposition of TAG in adipose tissue accounts for the obesity prevalent in type 2 diabetes patients. 4. Adipose Tissue and Obesity The fat content of the adipose tissue can increase to unlimited amounts, depending on the amount of excess calories taken in. This leads to obesity. Plasma insulin level is high. But the insulin receptors are decreased, and there is peripheral resistance against insulin action. When fat droplets are overloaded, the nucleus of adipose tissue cell is degraded, cell is destroyed, and TAG becomes extracellular. Such TAG cannot be metabolically reutilized and forms the dead bulk in obese individuals.Ref: DM Vasudevan - Textbook of Biochemistry, 8th edition, page no: 139-141
| 2
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Synthesis from Dihydroxyacetone phosphate
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Enzyme Glycerol Kinase plays an impoant role
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Enzyme Glycerol 3 phosphate dehydrogenase plays an impoant role
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Phosphatidate is hydrolyzed
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Biochemistry
|
Metabolism of lipid
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506bb446-441a-4f49-a44b-187a10cc1542
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multi
|
Following an accident a man developed paralytic squint. Regarding Paralytic squint, TRUE is:
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The signs and symptoms of paralysis of any extraocular muscle are: Squint Limitation of ocular movements Diplopia False orientation Abnormal position of the head Veigo Ref: Parsons' Diseases of the Eye By Ramanjit Sihota & Radhika Tandon, 21st edition, Page 425.
| 1
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Diplopia
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Tunnel vision
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Vitreous haemorrhage
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Floaters
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Ophthalmology
| null |
29f3f3f8-64f5-4bf5-8a9d-b3e3192d96a7
|
multi
|
Ultra structure finding of irreversible injury
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Amorphous densities in mitochondria Ref , Robbins 7/e p41-2 ,9/ep42
| 2
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Ribosomal detachment from endoplasmic reticulum
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Amorphous densities in mitochondria
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Formation of phagolysosomes
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Cell swelling
|
Anatomy
|
General anatomy
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9f11e268-f221-40a7-877c-6d7bf873aa66
|
single
|
In a study of lifestyle influences on health, investigators observe that sending children outside to play instead of letting them sit for hours in front of the television can have long-term health benefits. Which of the following tissues is most likely to be in better condition by middle age from this lifestyle change?
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Vitamin D can be synthesized endogenously in the skin with exposure to ultraviolet (UV) light. Together, vitamin D and calcium help build and maintain growing bone. Exercise helps build bone mass, which protects against osteoporosis later in life, particularly in women. Renal function is not greatly affected by the environment. There are some deleterious effects on the eye (cataracts) and the skin (cancer, elastosis) from increased exposure to UV radiation in sunlight. Increased air pollution in many cities has led to an increased incidence of pulmonary diseases, and children are particularly at risk.
| 1
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Bone fractures
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Ocular cataracts
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Urinary tract calculi
|
Pulmonary emphysema
|
Pathology
|
Environment & Nutritional Pathology
|
b25e95f0-40e7-4b5a-aa94-55a547d5ca1f
|
single
|
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