falan42/meta_data · Datasets at Hugging Face

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
Involvement of the joints of hand is relatively uncommon in which of following ahritis?	Joints involved in ankylosing spondylitisAnkylosing spondylitis primarily affects the axial skeletonThe disease usually begins in the sacroiliac joints and usually extends upwards to involve the lumbar, thoracic, and often cervical spineIn the worst cases, the hips or shoulders are also affected. The hip joint is the most commonly affected peripheral jointRarely knee and ankle are also involved(Refer: Mohindra's Fundamentals of Ohopedics, 2nd edition, pg no. 302, 426)	1	Ankylosing spondylitis	Reactive ahritis	Psoriatic ahritis	Rheumatoid ahritis	Orthopaedics	All India exam	b3abeea7-7099-43a6-a7a7-511dbc41f7c5	single
The best investigation for colorectal carcinoma -	null	4	Exfoliative cytology	Air contrast barium enema	Ultrasound	Colonoscopy and biopsy	Surgery	null	d7721e32-bf89-4bb7-9a03-67448742bf3d	single
Which of the following is not true about ACE inhibitors?	null	3	Used in asthma	Increase quality of life	Postural hypotension is seen	Na level decrease	Pharmacology	null	0d6277b2-8c3a-4174-82a1-09b4ded897c0	multi
Asymptomatic gonorrhoea in females is due to infections of :	Endocervix	3	Vagina	Urethra	Endocervix	Fundus	Gynaecology & Obstetrics	null	0bd35e48-62db-4c8f-ae9c-64648f045f98	single
Orphan drugs are:-	* Orphan drugs are defined as the medicines which are unlikely to be developed by pharmaceutical industry due to economic reasons but which respond to public health needs. * Orphan drug is developed specifically to treat a rare medical condition (affecting fewer than 200,000 people), the condition itself being referred to as an orphan disease. Ex- deferiprone to treat iron overload in thalassemia patients, N-acetylcysteine to treat paracetamol poisoning etc. * Since the pharmaceutical companies will not like to develop such a drug due to lack of financial benefits, a separate law known as 'The Orphan Drug Act' was passed in 1983. The intent of the Orphan Drug Act is to stimulate the research, development, and approval of products that treat rare diseases. Few examples of the orphan drugs: Liposomal amphotericin B Digoxin antibody Fomepizole	2	Commercially easy to obtain	Drugs to treat rare diseases	Developed with an intention of monetary gain	All of the above	Pharmacology	Pharmacodynamics	5df9ef5c-32ce-407f-9604-c87a2e83373d	multi
Renal collar which surrounds the aoa has its two limbs split by -	Ans. is 'a' i.e., Left renal vein The left renal vein normally passes anterior to the aoa to join the I.V.C. However sometimes the left renal vein may divide and send one limb anterior and one posterior to the aoa to reach the inferior vena cava k/a venal collar representing persistence of embryological state. Also remember The most common anatomic variant of the renal vessels is --> supernumerary renal aeries.	1	Left renal vein	Left renal aery	Isthumus of horseshoe kidney	All of the above	Surgery	null	a10e555a-800e-466d-8bf6-545e33478772	multi
Which of the following drug is an Immunostimulant?	(Ref: Goodman & Gliman 11/e p1422) All other drugs listed in the options posses immunosuppressant propeies.	2	Prednisolone	Levamisol	Cyclosporine	Thalidomide	Pharmacology	Other topics and Adverse effects	5a6e37a7-2877-41c6-b075-b507cfa83f93	single
OCP's are contraindicated in A/E :	Ans. is c i.e. Polycystic ovarian disease	3	Smoking 35 years	Coronary occlusion	Polycystic ovarian ds	Cerebro vascular ds	Gynaecology & Obstetrics	null	5b7f5e6f-870b-4690-a5ec-3a7dd3cd48cc	single
Japanese encephalitis vaccine is:	Ans. (a) Live attenuatedRef : K. Park 23rd ed. / 286-87* JE vaccine is a live attenuated vaccine. It is available in killed vaccine form also.* Strain: SA 14-14-2- liveNakayama strain- killed* One dose of JE vaccine is given at 16-24 months of age.Also Know* MC live vaccine used: BCG* MC killed vaccine used: Pertusis* All live vaccines are contra-indicated in I pregnancy EXCEPT: YF and OPVLive VaccineKilledToxoidsCell FractionCombined* BCG* OPV (sabin)* MMR* Yellow fever* Live J.E.* Live H1N1* Live choleraHep AHep B PertusisIPV (salk)Rabies Meningo- coccalKilled J.E.Killed H1N1DiphtheriaTetanusHep BMeningo- coccalHiBPneumo- coccalDPTMMR	1	Live attenuated	Inactivated toxoid	Cellular fractions	Combined	Social & Preventive Medicine	Principles of Immunization and Vaccination	41495777-2894-4317-b625-a955be5396d1	single
Which of the following is not a sign of reversible cell injury?	Ans. (b) Cell shrinkage(Ref: Robbins 9th/38;8th/pg 17)Features of reversible cell injury seen in light microscopy are cellular swelling and fatty change.Cell shrinkage is a feature of apoptosis (cell death)	2	ATP depletion	Cell shrinkage	Fatty acid deposition	Reduction of phosphorylation	Pathology	Cellular Pathology	fd2816b5-6580-4168-b2ea-189524732d12	single
The tooth bud for the third molar is initiated at about the age of:	null	4	6th month I.U	1st year of life	2nd year of life	8th year of life	Dental	null	34e4535e-4967-4484-ab47-9d75d24e726b	single
Most common site for minor salivary glands tumor is:	null	3	Lip	Floor of oral mucosa	Hard palate	Gingivolabial folds	Surgery	null	f95a3179-0ca0-465e-9de2-32944758f009	single
Wormian bones are not noted in -	Wormian bones Wormian bones are extra bone pieces that occur within a suture in the cranium. These are irregular isolated bones which appear in addition to the usual centres of ossification of the cranium. They occur most frequently in the course of the lambdoid suture. Causes of Wormian bones (Mnemonic - PORKCHOPS) Pyknodysostosis Osteogenesis imperfecta Rickets Kinky hair syndrome Cleidocranial dysostosis Hypothyroidism (cretinism) / Hypophosphatasia Otopalatodigital syndrome Progeria Syndrome of Downs Wormian bone appears radiographically as islands of ossification in the skull in non ossified membranous bone. To be diagnostic value, the wormian bones should be 4 mm by 6 mm in size, 10 in number and arranged in a mosaic pattern. Wormian bones are not present in the normal skull.	1	Fibrous dysplasia	Osteogenesis inperfecta	Cretinism	Rickets	Orthopaedics	null	2f844c59-f5e0-4072-9d19-6bd4baca6a37	single
Hidradenitis suppurativa is a disease of:	Hidradenitis suppurativa is chronic inflammation and secondary infection of apocrine sweat glands Aetiology : Unknown ,common in post-pubeal females, maybe inherited(AD in some families) C/F Rare chronic painful skin condition with inflammation of the skin at sites rich in apocrine glands (axilla, groin, natal cleft) O/E Papules/nodules and abscesses which often progress to cysts/sinus formation. Abscess may rupture--> Purulent discharge. Rx: Weight loss, antibiotics, oral retinoids and co-cyprindiol ('2 mg cyproterone acetate +35 ug ethinylestradiol' in females only) have been tried Severe recalcitrant cases- Sx , skin grafting and IV infliximab therapy Hidrocystoma- Eccrine sweat glandsHidradenitis suppurativa- Apocrine sweat glands	2	Eccrine sweat glands	Apocrine sweat glands	Kaposi sarcoma	Hair follicles	Dental	Disorders of sebaceous and sweat glands	e3bf752b-0339-40d5-950b-412f182cba4c	single
Positive G effect ?	Ans. is 'b' i.e., Black outEffects of positive G:Venous return decreases --> hence, cardiac output decreases.Blood rushes towards lower limbs --> hence increased pressure in lower limb vessels.Blood is drawn away from upper body --> hence decreased cerebral aerial pressure.At very high positive G:Difficulty in blood flow to brain --> results in cerebral ischemia & unconsciousness.Moments before unconsciousness, there is gray-out.Everything appears gray - Due to ischemia of cone & loss of color vision.Eg: Gray-out serves as warning sign for pilots - Indicates need for slowing down aircraft & reduce positive'G'.Gray-out followed by black-outBlack-out means total loss of vision.	2	Red out	Black out	Increased cerebral aerial pressure	Increased cardiac output	Physiology	null	3ee97e14-cca4-4712-8080-8611d71adf61	single
All of the following are preschool age problems EXCEPT: March 2013 (b, c, d)	Ans. B i.e. Temper tantrum Temper tantrum reaches its peak point during second and third year of life and gradually subsides in between 3-6 years as the child learns to control his negativism and complies to the request of others	2	Sleeping disorde	Temper tantrum	Pica	Stuttering	Pediatrics	null	543807e9-a25d-44e2-bd9f-f2ae3c46ee5c	multi
Squamous cell carcinoma spreads commonly via -	null	3	Implantation	Hematogenous spread	Lymphatic spread	Trancoelomic spread	Pathology	null	a32e6674-ea4e-47de-b214-46fc0e632f3e	single
Function of UGA codon -	Ans. is 'c' i.e., Terminates protein synthesis o Termination (stop/nonsense) codons signal to terminate the translation. These are 3 stop codons UAA, UGA and UAGo Initiation codon - AUGo Stop codons (termination codons or nonsense codons) - UAA, UGA, UA G	3	Initiates transcription	Translates	Terminates protein synthesis	null	Biochemistry	Chemistry of Nucleotides	e8e0a6a1-2652-4e75-9be0-5e79dbf0aa55	multi
Most common site of intracranial metastasis is from primary carcinoma of	MC brain tumor is metastasis,arising from - (1) Oat cell Ca lung/small cell Ca lung (2) Ca Breast (3) M. Melanoma MC 1deg Brain tumour- Glioma MC benign brain tumour - Meningioma	2	Breast	Lungs	Stomach	Testes	Medicine	FMGE 2018	d37f7d4a-22fd-4b56-80cd-ef86d68c3b84	single
Regarding S3 heart sound all are true except	S3 is heard in chronic MR (not in acute MR)	3	May be physiological	Due to early diastolic filling of ventricles	S3 is heard in acute MR	Seen in Conditions associated with increased preload	Medicine	null	a1e12ebc-5433-4c38-949f-df711d200c26	multi
A 65-year-old diabetic woman develops weakness on the left side of the face, right arm,and right leg. She also has diplopia on left lateral gaze. What is the site of lesion?	Weakness on the left side of the face Weakness of the right sides of arm and leg \| Crossed hemiplegia / Millard gubler syndrome. Pontine stroke. I/L 6th N. palsy- Diplopia on looking laterally I/L 7th N. palsy- facial paralysis but sensations not affected Coicospinal tract damage in pons will lead to C/L hemiplegia in arms and legs.	2	Right pons	Left pons	Right midbrain	Left midbrain	Medicine	Stroke and TIA	49c23a01-6c83-4c86-9fad-c1a1295940a7	single
Buerger's Disease is	Buerger's Disease is non atherosclerotic inflammatory disorder involving medium sized and distal vessels. It is segmental, progressive , occlusive, inflammatory disease.	2	Non - progressive	Segmental	Non - inflammatory	Atherosclerotic	Surgery	null	bab08deb-206d-41e4-b4a6-00dd1a34e9d6	single
Most common nerve to be damaged in dislocation of shoulder is :	A i.e. Axillary Nerve	1	Axillary nerve	Radial nerve	Median nerve	Musculocutaneous nerve	Surgery	null	56c78e1f-4067-46a8-80dc-3b3c2cac3b08	single
Most common cause of stridor in infant and young children –	Laryngomalacia is the most common congenital laryngeal anomaly. It is the most common cause of stridor in infants and children.	3	Abductor palsy	Croup	Laryngomalacia	Epiglottitis	Pediatrics	null	08b89b55-502f-4d82-95c0-a2212e1270c4	single
Mallory denk bodies are seen in all except	Mallory denk bodies are not seen in Hemochromatosis and 2o biliary cirrhosis.	4	Wilson's disease	Alcoholic fatty liver disease	Non alcoholic fatty liver disease	Hemochromatosis	Pathology	null	30158fed-b58e-4230-83e7-6b7c2a0b3007	multi
Which of the following statement is not true about NSAIDs	Acetylsalicylic acid (asprin) is an Irreversible inhibition of COX enzyme. IT results in inhibition of prostaglandin and TX synthesis at low doses for (40 to 325 milligrams) it exes antiplatelet action. this drug shows saturation kinetics at high doses that is kinetics changes from first order to zero order. therefore at high doses amount of drug exeed will be constant that means clearance il is not constant. Refer kDT 6/e p185	3	Acetylsalicylic acid is an Irreversible inhibitors of Cox enzyme acetylsalicylic acid is an Irreversible inhibitors of Cox enzyme	Acetylsalicylic acid reduces in Vivo synthesis of prostaglandins	Its clearance is independent of Plasma concentration	Antiplatelet effect of low dose aspirin is related to pre systemic Cox inhibition	Pharmacology	Autacoids	3f8bd29d-073d-4c79-9365-58edb62cd041	multi
Rothera&;s test used for detection of	The presence of ketosis can be established by the detection of ketone bodies in urine by Rothera&;s test.Rothera&;s test: Saturate 5 mL of urine with solid ammonium sulfate. Add a few drops of freshly prepared sodium nitroprusside followed by 2 mL of liquor ammonia along the sides of the test tube. Development of a purple ring indicates the presence of ketone bodies in urine. Strip tests based on the same principle are also available.Ref: D M Vasudevan 7th edition Page no: 166	4	Proteins	Glucose	Fatty acid	Ketones	Biochemistry	miscellaneous	e8cd6b5a-5056-4fd4-85ab-444fa290928d	single
A man weighing 70 kg has a hematocrit of 45%. What would he his approximate plasma volume?	Ans. (d) 3080mL(Ref: Ganong Review of medical physiology, 21st ed p.2)8% of body weight is blood volumeSo, here for 70 kg man, Blood volume is 5.6 Litres (708/100)Blood Volume = Plasma volume/1-hematocritSo, Plasma volume = Blood volume(1-hematocrit)Here, Plasma volume =5.6*(1-0.45)=3080mL	4	2310 mL	2695 mL	2890 mL	3080 mL	Physiology	General	c8f2f6ca-4e81-4d34-b7c4-b5e51d8632c1	single
Median nerve supplies all muscles of the thumb except -	Median nerve supply in hand - Flexor pollicis brevis - Opponens pollicis - Abductor pollicis brevis First two lumbricals Adductor pollicis is supplied by Ulnar nerve	4	Abductor-pollicis-brevis	Flexor-pollicis-brevis	Opponens pollicis	Adductor pollicis	Anatomy	null	813abbf9-2842-4fd0-ab21-ef863eb9bdb1	multi
Secondary glaucoma in early stage of herpes zoster ephthalmicus occurs due to:	Ans. Trabeculitis	1	Trabeculitis	Iridocyclitis	Haemorrhagic hypopyon	Hypersecretion of aqueous humour	Ophthalmology	null	ab8aa60d-3032-4590-9eb6-b432d5e25e6e	single
Sodium content in mmol/L in WHO oral rehydration solution is -	Ans. is 'c' i.e., 90	3	20	80	90	111	Pediatrics	null	ee472006-4c8f-4dc1-baf6-78e0b5e72034	single
Division of long thoracic nerve results in	Nerve to serratus anterior is also called long thoracic nerve(C5,C6,C7). A)Serratus anterior muscle along with the pectoralis minor pulls the scapula forwards around the chest wall to protract the upperlimb. B)The fibres inseed into the inferior angle of the scapula pull it forwards and rotate the scapula so that the glenoid cavity is turned upwards.In this action,the serratus anterior is helped by the trapezius which pulls the acromion upwards and backwards. when the muscle is paralyzed,the medial margin of the scapula gets raised specially when 'pushing movements' are attempted.This is called 'winging of scapula'. REF.B D Chaurasia's human anatomy,Vol.1,pg.47	4	Inability to retract the scapula	Wasting of pectoralis major muscle	Weakness of adduction of humerus	Winging of scapula	Anatomy	Thorax	5f4d2928-eff3-400e-a5a9-e17f6a9cb585	single
Epidemic dropsy is caused by	Ans. (a) Sanguinarine	1	Sanguinarine	Ergot	Alkaloid	BOAA	Social & Preventive Medicine	Nutrition and Health	05bcd2ff-0b8e-460c-932c-e349153f7419	single
Patient is having scanty, foul smelling discharge from middle ear, develops fever, headache and neck rigidity. CT of the temporal lobe shows a localized ring enhancing lesion, which of the following is least likely cause of this condition?	Commonest organisms in otogenic brain abscess include gram negative (Proteus, E coli, Pseudomonas) and anaerobic bacteria along with Staphylococcus and Pneumocci. H. Influenza infection is a rare cause of otogenic abscess.	4	S. aureus	Pseudomonas	S.Pneumoniae	H. influenza	ENT	null	47cd7810-d31f-4b29-979b-45635195fe40	single
A 36-year-old woman has a cough and fever for 1 week. On physical examination, her temperature is 38.3deg C. She has diffuse crackles in all lung fields. A chest radiograph shows bilateral extensive infiltrates. CBC shows hemoglobin, 13.9 g/ dL; hematocrit, 42%; MCV, 89 mm3; platelet count, 210,000/mm3; and WBC count, 56,000/mm3 with 63% segmented neutrophils, 16% bands, 7% metamyelocytes, 3% myelocytes, 1% blasts, 8% lymphocytes, and 2% monocytes. A bone marrow biopsy is obtained and shows normal maturation of myeloid cells. Which of the following is the most likely diagnosis?	Marked leukocytosis and immature myeloid cells in the peripheral blood can represent an exaggerated response to infection (leukemoid reaction), or it can be a manifestation of chronic myelogenous leukemia (CML). Normal maturation of myeloid cells in the marrow rules out CML. Although not provided in this case, a leukocyte alkaline phosphatase (LAP) score is high in the more differentiated cell population of reactive leukocytosis, whereas in CML, the LAP score is low. The Philadelphia chromosome (present in most CML cases) is lacking in patients with leukemoid reactions. Hairy cell leukemia is accompanied by peripheral blood leukocytes that mark with tartrate-resistant acid phosphatase. Hodgkin lymphoma is not characterized by an increased WBC count. A myelodysplastic syndrome is a stem cell maturation disorder involving all nonlymphoid cell lineages, not just granulocytes.	4	Chronic myelogenous leukemia	Hairy cell leukemia	Hodgkin lymphoma, lymphocyte depletion type	Leukemoid reaction	Pathology	Blood	232792cb-b1de-4aab-84f7-ef28f7110972	multi
Secondary prevention is applicable to ?	Ans. is 'b' i.e.,Early stage of disease Primordial prevention - Before risk factor present.Primary prevention - Before onset of disease (risk factor present).Secondary prevention - In early stage of disease.Teiary prevention - Late stage of disease.	2	Causal factors	Early stage of disease	Late stage of disease	None of the above	Social & Preventive Medicine	null	35234bb9-1aa3-4cff-88ea-2b7f3625db1e	multi
A leukemia patient who has undergone multiple courses of chemotherapy develops herpes simplex encephalitis. Which of the following would you expect a CT scan of the patient's brain to show?	Herpes simplex can cause a necrotizing, hemorrhagic acute encephalitis that may rapidly produce death. The encephalitis characteristically involves the lower poions of the cerebral coex, notably the temporal lobes and the base of the frontal lobes, possibly because the infection spreads from the oropharynx. Ref: Ropper A.H., Samuels M.A. (2009). Chapter 33. Viral Infections of the Nervous System, Chronic Meningitis, and Prion Diseases. In A.H. Ropper, M.A. Samuels (Eds), Adams and Victor's Principles of Neurology, 9e.	4	Generalized volume loss	Volume loss selectively in the basal ganglia	Volume loss selectively in the brainstem	Volume loss selectively in the temporal and frontal lobes	Medicine	null	ccc6cd04-a065-4601-8550-136e30fffa03	single
Diarrhoea syndrome in an AIDS patient can be d/t – a) Rota virusb) Cryptosporac) Adenovirusd) E. soli	Agents commonly causing diarrhea in HIV patient. Rota virus Isospora Cryptosporidium Cyclospora Microsporidium Giardia Lambi Bacterial pathogens	1	ab	a	ad	bc	Pediatrics	null	db6a4fc9-b443-4043-aaf9-e364faf7a187	single
Position that is least likely possible by means of bilateral saggital split osteotomy is	null	4	Advancement	Set back	Rotation	Transverse	Surgery	null	984a8b25-b8c4-4aae-bfb6-625be5d28ca7	single
Physiological jaundice of newborn may be managed by all except -	Ans. b (Phenytoin sodium). (Ref. Nelson Textbook of Pediatrics 17th ed., 593, 597) # Jaundice during the 1st 24 hrs of life warrants diagnostic evaluation and should be considered to be due to hemolysis until proved otherwise. Septicemia and intrauterine infections such as syphilis, cytomegalovirus, and toxoplasmosis should also be considered, especially in infants with an increase in plasma direct-reacting bilirubin. # Jaundice after the 1st 24 hrs may be "physiologic" or may be due to septicemia, hemolytic anemia, galactosemia, hepatitis, congenital atresia of the bile ducts, inspissated bile syndrome after erythroblastosis fetalis, syphilis, herpes simplex, or other congenital infections. Physiologic jaundice (icterus neonatorum) # Under normal circumstances, the level of indirect-reacting bilirubin in umbilical cord serum is l-3mg/dL and rises at a rate of less than 5mg/dL/24hr; thus, jaundice becomes visible on the 2nd-3rd day, usually peaking between the 2nd and 4th days at 5-6 mg/dL and decreasing to below 2mg/dL between the 5th - 7th days of life. # Jaundice associated with these changes is designated "physiologic" and is believed to be the result of increased bilirubin production after the breakdown of fetal red blood cells combined with transient limitation in the conjugation of bilirubin by the liver. # Risk factors for indirect hyperbilirubinemia include maternal diabetes, race (Chinese, Japanese, Korean, and Native American), prematurity, drugs (vitamin K3, novobiocin), altitude, polycythemia, male sex, trisomy 21, cutaneous bruising, cephalohematoma, oxytocin induction, breastfeeding, weight loss (dehydration or caloric deprivation), delayed bowel movement, and a sibling who had physiologic jaundice. # A family history of neonatal jaundice, exclusive breastfeeding, bruising, cephalohematoma, Asian race, and maternal age older than 25 yr identify approximately 60% of cases of extreme hyperbilirubinemia. # Indirect bilirubin levels in full-term infants decline to adult levels (mg/dL) by 10-14 days of life. # Persistent indirect hyperbilirubinemia beyond 2 wk suggests hemolysis, hereditary glucuronosyl transferase deficiency, breast milk jaundice, hypothyroidism, or intestinal obstruction. Jaundice associated with pyloric stenosis may be due to caloric deprivation, deficiency of hepatic UDP-glucuronyl transferase or ileus-induced increased enterohepatic circulation of bilirubin. Treatment of hyperbilirubinemia Phototherapy # Clinical jaundice and indirect hyperbilirubinemia are reduced on exposure to a high intensity of light in the visible spectrum. # Bilirubin absorbs light maximally in the blue range (420-470 nm). Nonetheless, broad-spectrum white, blue, special narrow-spectrum (super) blue, less often, green lights are effective in reducing bilirubin levels. # Bilirubin in the skin absorbs light energy, which by photo-isomerization converts the toxic native unconjugated 4Z, 15Z-bilirubin into the unconjugated configurational isomer 4Z,15E-bilirubin. # Phototherapy also converts native bilirubin, by an irreversible reaction, to the structural isomer lumirubin, which is excreted by the kidneys in the unconjugated state. # When indications for exchange transfusion are present, phototherapy should not be used as a substitute. # However, phototherapy may reduce the need for repeated exchange transfusions in infants with hemolysis. # Phototherapy is indicated only after the presence of pathologic hyperbilirubinemia has been established. # The basic cause or causes of jaundice should be treated concomitantly. # Prophylactic phototherapy in VLBW infants may prevent hyperbilirubinemia and may reduce the incidence of exchange transfusions. # Dark skin does not reduce the efficacy of phototherapy. # Maximal intensive phototherapy should be used when indirect bilirubin levels approach. Such therapy includes "special blue" fluorescent tubes, placing the lamps within 15-20 cm of the infant, and placing a fiberoptic phototherapy blanket under the infant's back to increase the exposed surface area. # Complications of phototherapy include loose stools, erythematous macular rash, a purpuric rash associated with transient porphyrinemia, overheating and dehydration (increased insensible water loss, diarrhea), chilling from exposure of the infant, and bronze baby syndrome. # Phototherapy is contraindicated in the presence of porphyria. # The term bronze baby syndrome refers to a dark grayish brown discoloration of the skin sometimes noted in infants undergoing phototherapy. Almost all infants observed with this syndrome have had a mixed type of hyperbilirubinemia with significant elevation of direct-reacting bilirubin and often with other evidence of obstructive liver disease. # Those using phototherapy should remain alert to these possibilities and avoid any unnecessary use because untoward effects on DNA have been demonstrated in vitro. Exchange transfusion. # Exchange transfusion is performed if intensive phototherapy has failed to reduce bilirubin levels to a safe range and if the risk of kernicterus exceeds the risk of the procedure or the infant has signs of kernicterus. # Potential complications from exchange transfusion are not trivial and include acidosis, electrolyte abnormalities, hypoglycemia, thrombocytopenia, volume overload, arrhythmias, NEC, infection, graft vs host disease, and death. # The appearance of clinical signs suggesting kernicterus is an indication for exchange transfusion at any level of serum bilirubin. Other therapies # Tin (Sn)-protoporphyrin (or tin-mesoporphyrin) administration has been proposed for reduction of bilirubin. It may inhibit the conversion of biliverdin to bilirubin by heme oxygenase. A single intramuscular dose on the 1st day of life may reduce the need for phototherapy. Such therapy may be beneficial when jaundice is anticipated (G6PD deficiency) or when blood products are discouraged (Jehovah's Witness). Complications include transient erythema if the infant is receiving phototherapy. # IV immunoglobulin (500 mg/kg/dose over a 4hr period), given ql2hr for 3 doses, is effective in reducing bilirubin levels in patients with Coombs-positive hemolytic anemia, presumably by reducing hemolysis.	2	Metalloporphyrin	Phenytoin sodium	Phototherapy	None of the above	Unknown	null	c4bd1268-abae-4f12-bb8e-82a2cf060c4d	multi
1, 25 (OH)2 Cholecalciferol is formed in-	25-hydroxy Cholecalciferol is formed in liver Whereas 1, 25 (OH)2 Cholecalciferol is formed in kidneys. Additional edge on synthesis of Vitamin D: Activation of 7-dehydro cholesterol by UV light in skin produces Cholecalciferol 25-hydroxylation in liver to form 25-hydroxy cholecalciferol 1-alpha- hydroxylation in kidneys to form 1,25 dihydroxy cholecalciferol PTH activates 1-alpha hydroxylase of kidneys	4	Skin	Liver	Spleen	Kidney	Biochemistry	Vitamins and Minerals	992646b8-2d5b-4a85-b058-30ffb6b3511f	single
Most common cause of obstruction in atrophic rhinitis is:	(a) Excessive formation of crust(Ref. Cummings, 6th ed., 695)The excessive crusting leads to nasal obstruction in spite of roomy cavities.On removal of crusts there is bleeding. But there is no synechiae formation. There is no polypoidal change .	1	Excessive formation of crust	Polyp	Synechiae	Hypertrophy of turbinate	ENT	Rhinitis	41a747eb-3827-4dcf-bb4e-6090f9b704b5	single
Which of the following does not cause hemorrhagic conjunctivitis –	Hemorrhagic conjunctivitis is caused by picornaviruses (Enterovirus - 70, coxsackievirus A24) and sometimes Adenovirus type 11.	4	Adenovirus	Coxsackie – 24	Enterovirus – 70	Papilloma virus	Ophthalmology	null	b1d4887d-8229-4af1-89e6-a435e4cc09e2	single
A patient with acute leukaemia is admitted with febrile neutropenia. On day four of being treated with broad-spectrum antibiotics, his fever increases. X-ray chest shows bilateral fluffy infiltrates. Which of the following should be the most appropriate next step in the management	Cotrimoxazole is an antibiotic. As the patient is immunocompromised, most probable oppounistic infection is a fungal infection. And X-Ray shows fluffy infiltrates is suggestive of fungal infection. So antifungals are to be added. Ref: Textbook of Microbiology, Ananthanarayan and Paniker; 9th edition	2	Add antiviral therapy	Add antifungal therapy	Add cotrimoxazole	Continue chemotheraphy	Microbiology	mycology	21e9a60d-8b45-4410-bfbc-1f78b4219f99	multi
A population is divided into relevant subgroups and random sample selection is done from each of the subgroups. This is which type of sampling method?	- in stratified random sample, the sample is deliberately drawn in a systematic way so that each poion of the sample represents a corresponding strata of the universe. - this method is paicularly useful where one is interested in analysing the data by a ceain characteristic of the population. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no:850	2	Systematic random sampling	Stratified random sampling	Simple random sampling	Cluster sampling	Social & Preventive Medicine	Biostatistics	d74d4814-098b-4866-8117-50149c5a9e50	single
In thin basement membrane disease, the defect is in	TBM disease (also known as benign familial hematuria and thin basement membrane nephropathy) is, along with IgA nephropathy, the most common cause of blood in the urine without any other symptoms. The only abnormal finding in this diseaseis a thinning of the basement membrane of the glomeruli (filters) in the kidneys. Refer robbins 9/e	2	a1 and a2 chains of type IV collagen	a3 and a4 chains of type IV collagen	a1 and a2 chains of type VI collagen	a3 and a4 chains of type VI collagen	Pathology	Urinary tract	197c922c-6f02-4ff8-9629-2e82f40864a8	single
A newborn presenting with intestinal obstruction showed on abdominal X-ray, multiple air fluid levels. The diagnosis is not likely to be-	A i.e. Pyloric obstruction	1	Pyloric obstruction	Duodenal atresia	Illeal atresia	Ladd \\ s bands	Radiology	null	36bb2006-8baf-4b25-bb66-d1bb860b8539	single
Anti-neutrophil cytoplasmic antibodies (ANCA) is seen in	PR3-ANCAs are also present in up to 95% of cases; they are a useful marker of disease activity and may participate in Wegener’s granulomatosis.	3	Rheumatoid arthritis	Diabetes mellitus	Wegener’s Granulomatosis	Churg-Strauss syndrome	Pathology	null	ade5ddec-73fa-487b-9958-4e76ff78a830	single
Patient with jaundice and white stools. Which of the following enzymes is not raised	Large increase in gamma glutamyl transferase and ALP ours biliary obstruction (Davidson; page 929) 5&;nucleotidase rise parallels ALP but more specific for diseases of hepatic origin (Harsh mohan page 594)	3	5' nucleotidase	Alkaline phosphatase	Glutamate reductase	Gamma glutamyl transpeptidase	Medicine	G.I.T	83939c0a-197b-440a-a8f8-7e37f4f33371	single
Least clearance is for among these	Glucose is completely reabsorbed in proximal tubules. So its clearance is zero.	1	Glucose	Inulin	Urea	Creatinine	Physiology	null	b8b6cb77-cdd4-4633-a890-ee94c0feb74c	single
Characteristics of glycoprotein:	A i.e. Protein linked with glycosidic bond	1	Protein linked with glycosidic bond	Core protein	Sugar residues are long in carbohydrate poion of glycoprotein	null	Biochemistry	null	a6bee775-12c8-4675-a3f2-15c51cd3990d	multi
At what age baby with congenital hypertrophic pyloric stenosis show symptoms	Baby show the symptoms of projectile vomiting, olive shaped mass and visible peristalsis	3	At the time of birth	First week	3rd to 4th week	Second month	Surgery	null	7e822c2e-b62b-4f0e-9306-9b5ec1ff9ca7	single
All of the following may be used to treat hypercalcemia, except:	Answer is A (Normal saline with forced diuresis with Thiazides): Thiazide diuretics should not be used in cases of hypercalcemia as these may themselves cause hypercalcemia.	1	Normal saline with forced diuresis with chlohiazide	Plicamycin	Gallium nitrate	Mitramycin	Medicine	null	89500db2-ff0d-4895-a9cf-86fb6c58d465	multi
The most commonly practiced operative procedure for a perforated duodenal ulcer is -	Ans. is 'd' i.e., Graham's omentum patch repair	4	Vagotomy and pyloroplasty	Vagotomy and antrectomy	Vagotomy and perforation closure	Graham's omentum patch repair	Surgery	null	f5e78622-1e8a-4e33-a166-676c72d4c3f0	single
Donovan bodies are:	Monocytes that contain the organism, Calymmatobacterium granulomatis	4	Leukocytes that contain the organism, Calymmatobacterium granulomatis	EosinophiLs that contain the organism, Calymmatobacterium granulomatis	Monocytes that contain the organism, Haemophilus influenza	Monocytes that contain the organism, Calymmatobacterium granulomatis	Microbiology	null	d54ab332-7771-48fd-8721-be014089d3fa	single
Which of the following structures seen in the cavernous sinus?	Ans. c. Internal carotid aery	3	Maxillary division of V nerve	Mandibular division of V nerve	Internal carotid aery	Trochlear nerve	Anatomy	null	60dc935f-82bf-49e1-aa25-58a037bb5f42	single
A symptom of medullary sponge kidney disease is -	Medullary sponge kidney is a congenital disorder characterized by cystic dilatation of papillary collecting ducts of one or both kidneys. Urinary stasis in the dilated ducts, hypocitraturia, and, occasionally, incomplete distal renal tubular acidosis (dRTA) contribute to the formation of small calcium-containing calculi. Most cases are asymptomatic or are discovered during investigation of asymptomatic hematuria. Symptomatic patients typically present as young adults with: Kidney stones with renal colic Recurrent hematuria Infection (UTI) Most cases are sporadic, while some show autosomal dominant inheritance Involvement is bilateral in most cases	4	Nocturia	Anemia	Azotemia	UTI	Surgery	null	71873be2-d2fa-4f70-bb70-f2b08942ecf9	single
Tardieu spots are a feature of which of the following forms of death?	Tardieu spots or petechial haemorrhages are pinhead size bleeding spots occurring as a result of rupture of venules and are most commonly seen in sclera, conjunctiva or on serous membranes. It is seen in case of mechanical asphyxia. Ref: Textbook of Forensic Medicine and Toxicology By V.V Pillay, 15th Edition, Page 275	2	Cyanide poisoning	Mechanical asphyxia	Cobra bite	Organophosphate poisoning	Forensic Medicine	null	53b6d52f-ce67-475e-9f14-5731aa6bfb3b	single
Metastasis in neuroblastoma goes to -	Lung metastasis at initial diagnosis of neuroblastoma is associated with MYCN amplification and elevated LDH levels. Although lung metastasis at diagnosis was not independently predictive of outcome in this analysis, it remains a useful prognostic marker of an unorable outcome.	2	Liver	Lung	Bone	Bone marrow	Pathology	Pediatrics, environment and nutrition	286c7f83-dc51-4a9d-b407-b36c60de36e7	single
Deposition of protein 'A beta 2m' is seen in which clinicopathologic category of amyloidosis -	Ans. is 'b' i.e., Hemodialysis associated	2	Familial Mediterranean fever	Hemodialysis associated	Senile cerebral	Systemic senile	Pathology	null	92e72deb-d0bc-485c-81a3-6af699e85c8a	single
Aerial blood gas of a 5 year old child done at sea level gives the following results: pH 7.41, PaO2, 100 mmHg, and PaCO2, 40 mmHg. The child is being ventilated with 80% oxygen. What is the (A-a) DO2.-	Alveolar air equation: Using the alveolar air equation - PAO2 = - Data: Fraction of O2 in the inspired air = 80% Barometric pressure = 760 mm Hg (sea level) Water vapor pressure = 47 mm Hg Respiratory quotient = 0.8 Hence, Alveolar PO2 = - = 570.4 - 50 = 520.4 mm Hg Aerial PO2 is given = 100 mm Hg Hence, (A - a) DO2 = 520.4 - 100 = 420.4 mm Hg	4	570.4 mm Hg	520.4 mm Hg	470.4 mm Hg	420.4 mm Hg	Physiology	Respiratory System Pa 3	94c2904d-2d6d-4d92-9ad9-a88415418efb	single
A child presented with a history of unilateral purulent nasal discharge with occasional bloody discharge from the same side, The diagnosis is -	Unilateral purulent nasal discharge with occasional bloody discharge in a child is highly suggestive of foreign body. Antrochoanal polyp does not cause bloody discharge. Angiofibroma most commonly presents with nasal obstruction and epistaxis (not purulent nasal discharge). Rhinosporidiosis presents most commonly with polypoid mass.	2	Antrochoanal polyp	Foreign body	Angiofibroma	Rhinosporidiosis	ENT	null	85a88804-96b9-42ec-93b8-a13c0b2daaf1	single
DNA fingerprinting was founded by:	C i.e. Jeffrey	3	Watson	Calton	Jeffrey	All of the above	Medicine	null	278a64a6-fe13-486e-83ab-b3541733296c	multi
For a class V cavity for amalgam:	null	3	Mesio-distal walls are parallel and occluso-gingival walls converging	Mesio-distal walls diverging, occlusogingival walls converging	MD walls diverging, OG walls diverging	MD walls and OG walls parallel	Dental	null	948272d8-4118-44e3-becc-6c60a3f8222a	multi
A patient Shweta with raised serum alkaline phosphatase and raised parathormone level along with low calcium and low phosphate level is likely to have	Answer is D (Vitamin D deficiency) Serum Ca Serum phosphorus Alkaline phosphatase PTH * Osteomalacia (Rickets) (\|iNit. D) \| \| \| \| * Primary hyperparathyroidism bone disease \| \| , \| \| * Bone disease in renal failure with secondary hyperparathyroidism N/\| \| \| \| * Lytic bone neoplasms N/\| N/\| N/\| N * Osteoporosis N N N N * Paget's disease N N \| N	4	Primary hyperparathyroidism	Paget's disease	Osteoporosis	Vitamin D deficiency	Medicine	null	a6958436-9471-4225-b5d2-c477192da91d	single
During the Window period of patient with AIDS -	sero negative infective stage is known as the window period REF:ANANTHANARAYANAN TEXT BOOK OF MICROBIOLOGY 9EDITION PGNO.579	3	ELISA is -ve	Western Blot is -ve	Both are -ve	PCR is -ve	Microbiology	Virology	24bfc067-fe79-4696-89ae-f92efce9d84e	multi
In Bismuth/ Strasberg classification system cystic blow out is classified as:	null	1	Type A	Type B	Type C	Type D	Surgery	null	851f0325-df1c-4498-80e3-4a5d276396a4	single
If circumflex aery gives the posterior interventricular branch, this circulation is described as	In about 10% of heas,the right coronary is rather small and is not able to give the posterior interventricular branch. In these cases the circumflex aery,the continuation of left provides the posterior interventricular branch and called left dominant. <img src=" /> B D CHAURASIA'S HUMAN ANATOMY UPPER LIMB THORAX-VOLUME1 SIXTH EDITION Page no:265	2	Right dominance	Left dominance	Codominance	Undetermined	Anatomy	Thorax	9988d555-e41d-4f02-b78f-60f6b6f93b66	single
Parvovirus B19 does not cause	parvovirusB19 causesaplasyic crisi ,persistent anemia,erythema infectiosum&fetal hydrops REF:ANATHANARAYANAN MICROBIOLOGY NINTH EDITION PAGE.554	1	Roseola infantum	Aplastic anemia in sickle cell disease	Fetal hydrops	erythema infectiosum	Microbiology	Virology	9fe50a93-278b-41d1-898d-a31b95709b08	single
Marker of acute kidney injury all except?	Ans. is 'd' i.e., Acid phosphatase o Acid phosphatase is not a market of AKI, instead it is alkaline phosphatase.o List of markers for AKI# Alanine aminopeptidase(AAP)# Alkaline phosphatase (AP)# a-GIutathione-S-transferase (a-GST)# g-Glutamyl transpeptidase (gGT)# N-Acetyl-b-(D) gluco-saminidase (NAG)# b2-Microglubulin# a1-Microglubulin# Retinol-binding protein# Cystatin C# Microalbumin# Kidney injury molecule-1 (KIM-1)# Neutrophil gelatinase associated lipocalin (NGAL)# Interleukin-18 (IL-18)# Cysteine-rich protein (CYR-61)# Osteopontin# Liver fatty acid-binding protein (L-FABP)# Sodium/hydrogen exchanger isoform (NHE3)# Exosomal fetuin-A	4	Clusterin	Osteopontin	Alanine aminopeptidase	Acid phosphatase	Medicine	Acute Renal Failure	6220ae04-06a1-47bf-81cc-b325989a0074	multi
Button hole sign is seen in:	Due to defect in dermis, pressure on a neurofibroma gives a feeling of hole in dermis, which is called as Button hole sign.	3	Lupus vulgaris	Intertigo	Neuro fibromatosis	Psoriasis	Dental	null	1a9dc641-10a9-4571-90d1-9483cb14029e	single
Lipoxins synthesized from arachidonic acid act by-	lopoxins are the metabolites produced lipooxygenase pathway. They act to regulate and counter Balance actions ad Leucotriens i:e, decreases leukocyte adhesion, migration and chemotaxis. .ref Robbins 9/e p46	1	Decrease leucocyte migration, adhesion, chemotaxis	Increase leucocyte migration, adhesion, chemotaxis	Vasoconstriction	Increased vascular permeability	Pathology	General pathology	108ab257-4a62-4cb6-804b-a8fb57aedf1a	single
Active management of 3rd stage of labour is needed for all the following EXCEPT	Ans. d (Delivery of first baby of twins) (Ref. Textbook of Obstetrics D.C. Dutta 6th/pg. 142)Accidental administration of ergometrine or methergin during delivery of first baby in undiagnosed twins produce grave danger to the unborn 2nd baby caused by asphyxia due to tetanic uterine contractions.MANAGEMENT OF THE THIRD STAGE OF LABORThe third stage of labor begins following the delivery of the baby and ends with the delivery of the placenta.Signs of spontaneous placental separation include an apparent lengthening of the umbilical cord, a gush of vaginal bleeding, and a change in shape of the uterus from discoid to globular along with a rise in fundal height.Active management of the third stage of labor, which involves prompt umbilical cord clamping and cutting, administration of an oxytocic agent, and gentle umbilical cord traction, reduces maternal blood loss and the frequency of postpartum hemorrhage, and lessens the risk that the third stage will be prolonged.# Cord clamping is part of management of 2nd stage of labour.# Cord traction should be used only against fundally applied counter-traction to lessen the potential for uterine inversion and catastrophic hemorrhage. If at any time heavy bleeding occurs during the third stage of labor or if the placenta is not delivered within 30 minutes of the birth, the placenta should be manually removed.# General anesthesia may be required for women who have no regional anesthesia, and curettage may be necessary if the placenta does not readily separate from the uterine wall.# Manual removal is accomplished by developing a cleavage plane with the intrauterine hand between the maternal surface of the placenta and the uterine wall, while simultaneously fixing the uterus with the abdominal hand, and progressively peeling the placenta free.# If any portion of the placenta or the membranes is missing, the uterine cavity should be manually explored. Some advocate routine exploration of the uterine cavity to reduce the risk of infection and bleeding from retained placental fragments. In most women, especially those without regional anesthesia, the benefit of manual exploration is outweighed by the discomfort it causes, as well as the increased risk for uterine infection.# The uterus should be frequently palpated following delivery of the placenta to ensure that it remains well contracted. Oxytocin, 10 to 20 U administered intramuscularly or as a dilute intravenous solution, has been demonstrated to decrease the incidence of postpartum hemorrhage secondary to uterine atony. The birth canal, including the cervix,vagina, and perineum should be inspected for lacerations requiring repair.	4	Rh incompatibility	Diabetic mother	Prolonged pregnancy	Delivery of first baby of twins	Gynaecology & Obstetrics	Miscellaneous (Gynae)	611702fc-bc99-44cf-a9bb-69e365205fbb	multi
Which is a DNA virus ?	Ans. is 'b' i.e., Hepatitis B	2	Hepatitis A	Hepatitis B	Hepatitis C	Hepatitis D	Microbiology	null	9f6df3d9-afba-4deb-a685-78f648de5caf	single
Which of the following glycolytic enzyme is used in gluconeogenesis?	Aldolase is the enzyme which catalyzes the reversible reaction of glycolysis. So this enzyme is utilized in gluconeogenesis.Glucokinase, pyruvate kinase and phosphofructokinase are enzymes which catalyze the irreversible reaction of glycolysis and which are bypassed by different sets of enzymes during gluconeogenesis.	3	Glucokinase	Pyruvate kinase	Aldolase	Phosphofructokinase	Microbiology	All India exam	d17e8812-8507-4726-b1f8-d82be8a09a9b	single
In pneumothorax due to blunt injury, treatment of choice is -	null	4	Observation	Pneumonectomy	Thoracotomy	Intercostal drainage	Surgery	null	390ec4b8-dd44-4cdd-8065-609d9fc943d9	single
A 53-year-old female nonsmoker is being evaluated with symptoms of progressive shoness of breath. She has a past history of trauma to the right side of the chest. There is no history of asthma, sputum production, or recent chest pain. CXR is shown in,The likely diagnosis is	There is a large, well-demarcated, calcified pleural-based opacity abutting the lateral chest occupying two-thirds of the left hemithorax. It has a rounded, intensely calcified inferior and medial border and thus suggests a pleural origin. The shadow is most consistent with a large, old organized hemothorax. The calcified and organized pleuralbased opacity is consistent with an old hemothorax secondary to previous trauma. The pulmonary functions in this case would show restrictive limitation due to fibrosis of the pleural space and decreased lung compliance.	2	Calcified cyst	Organized hemothorax	Blastomycosis	Asbestosis	Radiology	Respiratory system	29c07a2a-41e2-4929-a4af-b18191223ff9	single
Predisposing factors for endometrial carcinoma is :	All	4	Hypeension	Late menopause	Nulliparity and Diabetes mellitus both	All	Gynaecology & Obstetrics	null	9ddb4c7b-5115-4349-80c4-a973b09a0771	multi
Which of the following connective tissue disorder is associated with gastroesophageal reflux?	Scleroderma is systemic disease accompanied by esophageal abnormalities in approximately 80% of patients. The esophageal lesion consists of atrophy of the smooth muscles, manifested by weakness in the lower two-third of the esophageal body and incompetence of the LES. Gastroesophageal reflux is due to incompetent LES combined with poor esophageal clearance which inturn leads to severe reflux esophagitis and stricture formation. Ref: Schwaz 9/e, Page 846; Harrison 17/e, Page 1850.	2	SLE	Scleroderma	Behcet's syndrome	Dermatomyositis	Surgery	null	7570ad1b-7a71-4a46-a6d7-0125cbc2a61a	single
Subdural Hematoma (SDH) is caused by	(A) Bridging veins # SUBDURAL BLEEDING arises from rupture of cortical vessels/bridging veins.> Relatively severe trauma> No lucid interval> Diffuse concave lesion on computed tomography> Require immediate transfer to a neurosurgical unit for decision on evacuation 50 per cent mortality.	1	Bridging veins	Caroticocavemous fistula rupture	Middle meningeal artery	null	Surgery	Miscellaneous	2f7b1086-cd8d-411b-a2e4-811532e8fbcb	multi
Thiazide diuretic used when GFR<30 ml/min?	Ans. is 'a' i.e., Metolazone o Metolazone is the only thiazide which is effective in severe renal failure.	1	Metolazone	Benzthiazidc	Chlohiazide	Hydrofulthiazide	Pharmacology	null	5487bd71-7f0e-4d50-91a6-9e486d860c72	single
Which of the following traditional medicines is effective in the treatment of hea failure	Ans. a. Terminalia Arjuna Terminalia Arjuna (An ayurvedic cardioprotective botanical) Although many Ayurvedic plants have shown to help coronary aery disease, Arjuna (Terminalia Arjuna) by far seems to be the best plant for hea health. Terminalia arjuna is a traditional ayurvedic plant containing tannins, triterpenoid saponins (arjungenin, arjunglucosides), flavonoids (arjunon, arjonolone), phytosterols, oligomeric proanthocyanidins (OPC's), calcium, magnesium, zinc, and copper.	1	Terminalia Arjuna	Neem bark extract	St. John's wo	Gingkoba biloba	Pharmacology	null	9c5a488d-97f1-4e77-b4d3-d21cb0f0c9f6	single
Selenocysteine is derivative of which aminoacid -	Ans. is 'a' i.e., Serine o Selenocysteine is considered as 21" standard amino acid. o It is present at the active site of some enzymes that catalyze redox reactions, e.g. thioredoxin reductase, glutathione peroxidase, and the deiodinase (converts thyroxin to triiothyronine). o Biosynthesis of selenocysteine requires cysteine, serine, ATP and a specific t-RNA o Serine provides the carbon skeleton of selenocysteine. o Selenocysteine has a structure similar to cysteine, but containing the trace element selenium in place of sulfur atom of cysteine.	1	Serine	Alanine	Arginine	Glycine	Biochemistry	Amino Acids Basics	95f22481-cf82-4c1f-bac4-be74a2e1997f	single
Which of the following local anaesthetic is NOT used as a surface anaesthetic?	Bupivacaine is a widely used amide local anesthetic. It is a potent agent capable of producing prolonged anesthesia. Its long duration of action plus its tendency to provide more sensory than motor block has made it a popular drug for providing prolonged analgesia during labor or the postoperative period. By taking advantage of indwelling catheters and continuous infusions, bupivacaine can be used to provide several days of effective analgesia. Lignocaine, tetracaine, and cocaine are used as local anaesthetics and anesthesia lasts for 30-45 minutes (30-60 minutes with tetracaine). Anesthesia is entirely superficial; it does not extend to submucosal structures. Ref: Catterall W.A., Mackie K. (2011). Chapter 20. Local Anesthetics. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e.	4	Lignocaine	Tetracaine	Cocaine	Bupivacaine	Anaesthesia	null	b010c4fd-35c5-440f-a8aa-8219c856ae18	single
Undescended testis can lead to all of the following complications except: March 2012	Ans: D i.e. Hyperophy of testes Complications of undescended testes Torsion can be seen in incomplete testicular descent Sterility is seen in bilateral cases (especially intra-abdominal testes) Incomplete testicular descent predisposes to malignant disease; cancer is more common in an incompletely descended testes-orchidopexy may or may not diminish the risk. Atrophy of an inguinal testes before pubey may possibly be caused by recurrent minor trauma.	4	Torsion	Sterility	Carcinoma	Hyperophy of testes	Surgery	null	f717c467-4c26-4e62-9e7a-fdfd8007986f	multi
Keratoderma Blenorrhagica is typically seen in	Ans. is 'c' i.e., Reactive ahritis Keratoderma Blenorrhagica is the characteristic skin lesion seen in patients with Reactive Ahritis. "The Characteristic skin lesions in Reactive Ahritis, Keratoderma Blenorrhagica, consist ofvesicles that become hyperkeratotic, ultimately forming a crust before disappearing. These are seen in palms and soles.	3	Rheumatoid ahritis	Psoriatic Ahritis	Reactive Ahritis	Ankylosing spondylitis	Medicine	null	45d980dc-0b54-4db0-b556-6df36cbc1534	multi
Initial amino acid in prokaryotic protein synthesis -	Ans. is 'c- i.e., Formyl-methionine o in prokaryotes and in mitochondria, the first amino acid methionine is modified by formylation, i.e. the initiator t-RNA carries an N-formylated methionine. The formyl group is added by the enzyme transformylase (formyl- transferase). In Eukaryotes, the initiator t-RNA carries a methionine that is not formylatedDifferenceProkaryotesEukaryotesm-RNAPolycistronic i.e. have several coding regions; each with its initiation & termination codon producing a seperate polypeptideMonocistr onic with one coding regionAmino acid incorporation rate18 aa/sec6aa/sec.Initial amino acidFormylated methionine ( f-met)Methionine r (Met)Initial t-RNAt-RNA/MettRNAMetTranscription & translationTranslation starts before transcription is ended (coupled)UncoupledInitiation factors (IF)3i.e.IF1,IF2,IF3> 10 designated elFDetermination of initiatingcodon# Shine Dalgarno sequencer# Facilitated by IF-2 bound to GTPKozak consensus sequencesr Facilitated by elF-2 bound to GTP (Plus additional elF)Elongation: Del Every of aminoacyl t-RNA to A site# Facilitated by EF-Tu & EF-TsFacilitated by EF1 a and EF 1 b yNucleotide exchange factors# EF - Ts (as it exchanges its GTP for GDP on EFTu)EF 1 b g (as it exchanges its GTP forGDP on EF a)Peptidyi transferase activity catalyzing peptide bond formation23 S rRNA of 50 S ribosomal subunit (ribozyme)28 S rRNA of 60 S ribosornal subunit (ribozyme)TranslocationRequires EF-G & GTPRequires EF-2 & GTPTerminationRelease factor (RF) 1 recognizes UAA & UAG, RF2 recognizes UAA & UGARF-3 (bound to GTP) causes release ofRF-1 or RF-2 as GTP is hydrolysedeRF recognizesail 3 UAA, UAGandUGA and release nascent polypeptide chaineRF-3 (bound to GTP) function like prokaryotic RF-3 & release eRF	3	Arginine	Methionine	Formyl-methionine	Alanine	Biochemistry	Amino Acids Basics	4fccd3d5-4706-4f62-8708-46c2d05b5faf	single
Antiglaucoma drug which acts by increasing uveo- sclerol outflow -	Ans. is 'b' i.e., Latanoprost Drugs used in open-angle glaucoma MechanismMethods of AdministrationCholinomimetics Pilocarpine, carbachol, physostigmine, echothiophate, demecariumCiliary muscle contraction, opening of trabecular meshwork, increased outflowTopical drops of gel; plastic film slow-release insertAlpha agonists UnselectiveEpinephrine, dipivefrinIncreased outflowTopical dropsAlpha2-selectiveDecreased aqueous secretion ApraclonidineBrimonidine Topical, postlaser only TopicalBeta-blockers Timolol, betaxolol, carteolol, levobunolol, metipranololDecreased aqueous secretion from the ciliary epitheliumTopical dropsDiuretics Dorzolamide, brinzolamideDecreased aqueous secretion due to lack of HCO3TopicalAcetazolamide, dichlorphenamide, Methazolamide OralProstaglandins Lantanoprost, bimatoprost, travoprost, unoprostoneIncreased outflowTopical	2	Apraclonidine	Latanoprost	Timolol	Brinzolamide	Pharmacology	Anti Adrenergic System	6bbd139e-6000-4acb-beb0-042dc471df1e	single
Most commonly affected organ in the disorder characterized by the peripheral blood smear is:	Hereditary Spherocytosis—Peripheral blood smear. Splenomegaly is more common and prominent in hereditary spherocytosis than in any other form of hemolytic anemia. The splenic weight usually is between 500 and 1000 g. The enlargement results from marked congestion of the splenic cords and increases in the numbers of macrophages. Phagocytosed red cells are seen within macrophages lining the sinusoids and, in particular, within the cords. Robin’s Textbook of pathology 10th ed Page 442	3	Lungs	Kidney	Spleen	Liver	Pathology	null	f8000fa0-b8f6-47d3-9503-f2cd30e935f9	single
Boiled cabbage or rancid butter smelling urine is seen in	Tyrosinemia REF: Sapira's a & science of bedside diagnosis - Page 138, Textbook of Pediatric Emergency Medicine by Gary R. Fleisher, Stephen Ludwig Page 1566 Tyrosinaemia is an error of metabolism, inherited, in which the body cannot effectively break down the amino acid tyrosine, found in most animal and plant proteins. It is an autosomal recessive, which means two copies of an abnormal gene must be present in order for this to develop. There are three types of tyrosinemia, each with distinctive symptoms and caused by the deficiency of a different enzyme. One of the symptoms of Tyrodinaemia type 1 is an odor like cabbage or rancid butter.	2	Phenylketonuria	Tyrosinemia	Isovaleric Acidaemia	Multiple carboxylase deficiency	Biochemistry	null	6a48c652-ecd2-40d4-b57b-074bf293d393	single
All are side effects of clozapine expect:	Ref: KDT 8th ed Clozapine is an atypical antipsychotic drug. It does not block D2 receptors, therefore chances of extrapyramidal symptoms are least with this drug.	4	Granulocytopenia	Seizures	Sedation	Extrapyramidal side effects	Pharmacology	Central Nervous system	26a9c0a6-cf97-40dc-bac8-b30db91d1860	multi
All of the following are true about staing betablocker therapy in cases of CHF, Except	Answer is A (They should be initiated at the effective doses) Beta blocker should be initiated at lower than effective doses in CHF Beta blockers should be initiated at lower than effective doses in CHF and be 'Beta blockers should be initiated at low doses followed by gradual increments in the dose if lower doses have been well tolerated. The dose of beta blockers should be increased until the doses used are similar to those that have been repoed effective in clinical trials. The titration of beta blockers should proceed no more rapidly than at 2 week intervals because the initiation and / or increased dosing of these agents may lead to worsening fluid retention' -- Harrison's 17th/1450 Special precaution should be taken in NYHA class III & IV 'Although data suggests that patients with NYHA class IHB and IV CHF may tolerate beta blockers and benefit from their use, this group of patients should be approached with considerable caution' --Goodman & Gillman's Manual of Pharmacology (2007)/570 Carvedilol and Metoprolol are the preferred beta blockers in CHF `Non selective third generation beta blockers (Bucindolol, Carvedilol) as well a the Beta-I selective agent (Metoprolol) are generally well tolerated by patients with CHF'. -'Current Diagnosis & Treatment in Cardiology' 3,1/217	1	They should be initiated at the effective doses	They should be gradually increased over weeks	Special precautions should be taken in NYHA class III & IV	Carvedilol and Metoprolol are the preferred drugs	Medicine	null	c1d9a954-ed52-4723-973a-355d3be579ae	multi
A patient with a peptic ulcer was admitted to the hospital and a gastric biopsy was performed. The tissue was cultured on chocolate agar incubated in a microaerophilic environment at 37degC for 5 to 7 days. At 5 days of incubation, colonies appeared on the plate and were curved, Gram negative rods, oxidase positive. The most likely identity of this organism is	This organism is readily isolated from gastric biopsies but not from stomach contents. It is like Campylobacter species and grows on chocolate agar at 37degC in the same microaerophilic environment suitable for C. jejuni (Campy-Pak or anaerobic jar without the catalyst). H. pylori, however, grows more slowly than C. jejuni, requiring 5 to 7 days incubation. C. jejuni grows optimally at 42degC, not 37degC, as does H. pylori.	4	Campylobacter jejuni	Vibrio parahaemolyticus	Haemophilus influenzae	Helicobacter pylori	Microbiology	Systemic Bacteriology (Haemophilus, Yersinia, Spirochaetes, Ricketssia, Chlamydia, Mycoplasma and Miscellaneous Bacteria)	bbdd80b6-d9db-484a-b348-612f8131340e	single
In CML serum vitamin B12 level is:	Wintrobes hematology mentiins granulocytes contain and release B12 binding proteins.Markedly elevated transcobalamin 1 level are seen in chronic myelocytic leukemia and myeloid metaplasia whereas low levels are seen in chronic leucopenia and aplastic anemia. Williams hematology 8th adds that the increase is propoional to the total leucocyte count in untreated patients and falls with treatment.(ref Robbins 7th /697-698)	4	Slightly decreased	Normal	Markedly decreased	Increased	Anatomy	Haematology	0de12fbd-c9de-4106-b321-27db49459f1e	single
A 52-year-old businessman with nephrotic syndrome after a non-stop flight from New York to New Delhi presents with sudden onset of breathlessness, haemoptysis, and chest pain. He is brought into Casualty in shock. His chest X-ray is normal. The ECG shows sinus tachycardia.	1. In this patient no pulmonary edema, MI absent and aoic dissection also absent. 2. Nephrotic syndrome patient will be in hypercoagulable state, long flight- DVT- pulmonary embolism- acute Cor pulmonale 3. Most common causes of Cor pulmonale- pulmonary embolism 4. CXR is normal because it is only a small clot and clot usually not visible on X-ray	3	Pneumothorax	Myocardial infarction	Pulmonary embolism	Aoic dissection	Medicine	Thromboembolism and Fat Embolism Syndrome	b6967054-beb5-4661-a64d-40cb11cd2b4d	single
A farmer has an ulcer on leg with indurated margin and multiple sinuses with discharging granules. The likely diagnosis is -	Ans. is 'a' i.e., Mycetoma Mycetoma (Maduramycosis) . Is a localized chronic granulomatous involvement of the subcutaneous and deeper tissues, commonly affecting the foot and less often the hand and other pas. . Presenting as a subcutaneous swelling with multiple discharging sinuses. . Sinuses discharge seropurulent fluid containing granules. . These granules are microcolonies of the etiological agents. . A similar condition called botryomycosis is caused by staphylococcus aureus.	1	Mycetoma	Scrofuloderma	Lupus vulgaris	Actinomycosis	Microbiology	null	335dafcd-9a46-42c8-a359-e59cb1b94af7	single
Spaghetti and meatball appearance is seen in	In pityriasis versicolor while doing KOH mount shows a mixture of short , branched hyphae and spores described as spaghetti and meatballs appearance.	3	Dermatophytes	Aspergillus	Pityriasis versicolor	Candida	Dental	null	28f2d995-58df-4b65-8b72-5363141151c9	multi
Drug which is useful in neuronal diabetes inspidus in both children and adults given intra nasally -	Ans. is 'b' i.e., Desmopressin Desmopressin (intranasal) is the DOC for central DI.	2	Vasopressin	Desmopressin	Lypressin	Presselin	Pharmacology	null	f09ed125-f426-4aa4-9cd1-0ca304cf0787	multi
Magnan syndrome is seen in which poisoning-	Ans. is 'd' i.e., Cocaine	4	Morphine	Alcohol	Cannabis	Cocaine	Forensic Medicine	null	ea2f8f25-318b-49d3-9cfa-cf8e661a5eeb	single
The denominator in General feility rate	General feility rate (GFR) : Number of live bihs per 1000 women in the reproductive age group 15-49 years in a given year Denominator : Takes 'mid-year population' of 15-49 years age females into account Ref: Park 25th edition Pgno : 539	3	Live bihs	Mid year population	Reproductive women in the age group 15-45 mid year population	Married women in the age group 15-45	Social & Preventive Medicine	Non communicable diseases	81e75f78-2c14-4b8d-bcff-1f3d47cdc9ed	single

Involvement of the joints of hand is relatively uncommon in which of following ahritis?

Joints involved in ankylosing spondylitisAnkylosing spondylitis primarily affects the axial skeletonThe disease usually begins in the sacroiliac joints and usually extends upwards to involve the lumbar, thoracic, and often cervical spineIn the worst cases, the hips or shoulders are also affected. The hip joint is the most commonly affected peripheral jointRarely knee and ankle are also involved(Refer: Mohindra's Fundamentals of Ohopedics, 2nd edition, pg no. 302, 426)

1

Ankylosing spondylitis

Reactive ahritis

Psoriatic ahritis

Rheumatoid ahritis

Orthopaedics

All India exam

b3abeea7-7099-43a6-a7a7-511dbc41f7c5

single

The best investigation for colorectal carcinoma -

null

4

Exfoliative cytology

Air contrast barium enema

Ultrasound

Colonoscopy and biopsy

Surgery

null

d7721e32-bf89-4bb7-9a03-67448742bf3d

single

Which of the following is not true about ACE inhibitors?

null

3

Used in asthma

Increase quality of life

Postural hypotension is seen

Na level decrease

Pharmacology

null

0d6277b2-8c3a-4174-82a1-09b4ded897c0

multi

Asymptomatic gonorrhoea in females is due to infections of :

Endocervix

3

Vagina

Urethra

Endocervix

Fundus

Gynaecology & Obstetrics

null

0bd35e48-62db-4c8f-ae9c-64648f045f98

single

Orphan drugs are:-

* Orphan drugs are defined as the medicines which are unlikely to be developed by pharmaceutical industry due to economic reasons but which respond to public health needs. * Orphan drug is developed specifically to treat a rare medical condition (affecting fewer than 200,000 people), the condition itself being referred to as an orphan disease. Ex- deferiprone to treat iron overload in thalassemia patients, N-acetylcysteine to treat paracetamol poisoning etc. * Since the pharmaceutical companies will not like to develop such a drug due to lack of financial benefits, a separate law known as 'The Orphan Drug Act' was passed in 1983. The intent of the Orphan Drug Act is to stimulate the research, development, and approval of products that treat rare diseases. Few examples of the orphan drugs: Liposomal amphotericin B Digoxin antibody Fomepizole

2

Commercially easy to obtain

Drugs to treat rare diseases

Developed with an intention of monetary gain

All of the above

Pharmacology

Pharmacodynamics

5df9ef5c-32ce-407f-9604-c87a2e83373d

multi

Renal collar which surrounds the aoa has its two limbs split by -

Ans. is 'a' i.e., Left renal vein The left renal vein normally passes anterior to the aoa to join the I.V.C. However sometimes the left renal vein may divide and send one limb anterior and one posterior to the aoa to reach the inferior vena cava k/a venal collar representing persistence of embryological state. Also remember The most common anatomic variant of the renal vessels is --> supernumerary renal aeries.

1

Left renal vein

Left renal aery

Isthumus of horseshoe kidney

All of the above

Surgery

null

a10e555a-800e-466d-8bf6-545e33478772

multi

Which of the following drug is an Immunostimulant?

(Ref: Goodman & Gliman 11/e p1422) All other drugs listed in the options posses immunosuppressant propeies.

2

Prednisolone

Levamisol

Cyclosporine

Thalidomide

Pharmacology

Other topics and Adverse effects

5a6e37a7-2877-41c6-b075-b507cfa83f93

single

OCP's are contraindicated in A/E :

Ans. is c i.e. Polycystic ovarian disease

3

Smoking 35 years

Coronary occlusion

Polycystic ovarian ds

Cerebro vascular ds

Gynaecology & Obstetrics

null

5b7f5e6f-870b-4690-a5ec-3a7dd3cd48cc

single

Japanese encephalitis vaccine is:

Ans. (a) Live attenuatedRef : K. Park 23rd ed. / 286-87* JE vaccine is a live attenuated vaccine. It is available in killed vaccine form also.* Strain: SA 14-14-2- liveNakayama strain- killed* One dose of JE vaccine is given at 16-24 months of age.Also Know* MC live vaccine used: BCG* MC killed vaccine used: Pertusis* All live vaccines are contra-indicated in I pregnancy EXCEPT: YF and OPVLive VaccineKilledToxoidsCell FractionCombined* BCG* OPV (sabin)* MMR* Yellow fever* Live J.E.* Live H1N1* Live choleraHep AHep B PertusisIPV (salk)Rabies Meningo- coccalKilled J.E.Killed H1N1DiphtheriaTetanusHep BMeningo- coccalHiBPneumo- coccalDPTMMR

1

Live attenuated

Inactivated toxoid

Cellular fractions

Combined

Social & Preventive Medicine

Principles of Immunization and Vaccination

41495777-2894-4317-b625-a955be5396d1

single

Which of the following is not a sign of reversible cell injury?

Ans. (b) Cell shrinkage(Ref: Robbins 9th/38;8th/pg 17)Features of reversible cell injury seen in light microscopy are cellular swelling and fatty change.Cell shrinkage is a feature of apoptosis (cell death)

2

ATP depletion

Cell shrinkage

Fatty acid deposition

Reduction of phosphorylation

Pathology

Cellular Pathology

fd2816b5-6580-4168-b2ea-189524732d12

single

The tooth bud for the third molar is initiated at about the age of:

null

4

6th month I.U

1st year of life

2nd year of life

8th year of life

Dental

null

34e4535e-4967-4484-ab47-9d75d24e726b

single

Most common site for minor salivary glands tumor is:

null

3

Lip

Floor of oral mucosa

Hard palate

Gingivolabial folds

Surgery

null

f95a3179-0ca0-465e-9de2-32944758f009

single

Wormian bones are not noted in -

Wormian bones Wormian bones are extra bone pieces that occur within a suture in the cranium. These are irregular isolated bones which appear in addition to the usual centres of ossification of the cranium. They occur most frequently in the course of the lambdoid suture. Causes of Wormian bones (Mnemonic - PORKCHOPS) Pyknodysostosis Osteogenesis imperfecta Rickets Kinky hair syndrome Cleidocranial dysostosis Hypothyroidism (cretinism) / Hypophosphatasia Otopalatodigital syndrome Progeria Syndrome of Downs Wormian bone appears radiographically as islands of ossification in the skull in non ossified membranous bone. To be diagnostic value, the wormian bones should be 4 mm by 6 mm in size, 10 in number and arranged in a mosaic pattern. Wormian bones are not present in the normal skull.

1

Fibrous dysplasia

Osteogenesis inperfecta

Cretinism

Rickets

Orthopaedics

null

2f844c59-f5e0-4072-9d19-6bd4baca6a37

single

Hidradenitis suppurativa is a disease of:

Hidradenitis suppurativa is chronic inflammation and secondary infection of apocrine sweat glands Aetiology : Unknown ,common in post-pubeal females, maybe inherited(AD in some families) C/F Rare chronic painful skin condition with inflammation of the skin at sites rich in apocrine glands (axilla, groin, natal cleft) O/E Papules/nodules and abscesses which often progress to cysts/sinus formation. Abscess may rupture--> Purulent discharge. Rx: Weight loss, antibiotics, oral retinoids and co-cyprindiol ('2 mg cyproterone acetate +35 ug ethinylestradiol' in females only) have been tried Severe recalcitrant cases- Sx , skin grafting and IV infliximab therapy Hidrocystoma- Eccrine sweat glandsHidradenitis suppurativa- Apocrine sweat glands

2

Eccrine sweat glands

Apocrine sweat glands

Kaposi sarcoma

Hair follicles

Dental

Disorders of sebaceous and sweat glands

e3bf752b-0339-40d5-950b-412f182cba4c

single

Positive G effect ?

Ans. is 'b' i.e., Black outEffects of positive G:Venous return decreases --> hence, cardiac output decreases.Blood rushes towards lower limbs --> hence increased pressure in lower limb vessels.Blood is drawn away from upper body --> hence decreased cerebral aerial pressure.At very high positive G:Difficulty in blood flow to brain --> results in cerebral ischemia & unconsciousness.Moments before unconsciousness, there is gray-out.Everything appears gray - Due to ischemia of cone & loss of color vision.Eg: Gray-out serves as warning sign for pilots - Indicates need for slowing down aircraft & reduce positive'G'.Gray-out followed by black-outBlack-out means total loss of vision.

2

Red out

Black out

Increased cerebral aerial pressure

Increased cardiac output

Physiology

null

3ee97e14-cca4-4712-8080-8611d71adf61

single

All of the following are preschool age problems EXCEPT: March 2013 (b, c, d)

Ans. B i.e. Temper tantrum Temper tantrum reaches its peak point during second and third year of life and gradually subsides in between 3-6 years as the child learns to control his negativism and complies to the request of others

2

Sleeping disorde

Temper tantrum

Pica

Stuttering

Pediatrics

null

543807e9-a25d-44e2-bd9f-f2ae3c46ee5c

multi

Squamous cell carcinoma spreads commonly via -

null

3

Implantation

Hematogenous spread

Lymphatic spread

Trancoelomic spread

Pathology

null

a32e6674-ea4e-47de-b214-46fc0e632f3e

single

Function of UGA codon -

Ans. is 'c' i.e., Terminates protein synthesis o Termination (stop/nonsense) codons signal to terminate the translation. These are 3 stop codons UAA, UGA and UAGo Initiation codon - AUGo Stop codons (termination codons or nonsense codons) - UAA, UGA, UA G

3

Initiates transcription

Translates

Terminates protein synthesis

null

Biochemistry

Chemistry of Nucleotides

e8e0a6a1-2652-4e75-9be0-5e79dbf0aa55

multi

Most common site of intracranial metastasis is from primary carcinoma of

MC brain tumor is metastasis,arising from - (1) Oat cell Ca lung/small cell Ca lung (2) Ca Breast (3) M. Melanoma MC 1deg Brain tumour- Glioma MC benign brain tumour - Meningioma

2

Breast

Lungs

Stomach

Testes

Medicine

FMGE 2018

d37f7d4a-22fd-4b56-80cd-ef86d68c3b84

single

Regarding S3 heart sound all are true except

S3 is heard in chronic MR (not in acute MR)

3

May be physiological

Due to early diastolic filling of ventricles

S3 is heard in acute MR

Seen in Conditions associated with increased preload

Medicine

null

a1e12ebc-5433-4c38-949f-df711d200c26

multi

A 65-year-old diabetic woman develops weakness on the left side of the face, right arm,and right leg. She also has diplopia on left lateral gaze. What is the site of lesion?

Weakness on the left side of the face Weakness of the right sides of arm and leg | Crossed hemiplegia / Millard gubler syndrome. Pontine stroke. I/L 6th N. palsy- Diplopia on looking laterally I/L 7th N. palsy- facial paralysis but sensations not affected Coicospinal tract damage in pons will lead to C/L hemiplegia in arms and legs.

2

Right pons

Left pons

Right midbrain

Left midbrain

Medicine

Stroke and TIA

49c23a01-6c83-4c86-9fad-c1a1295940a7

single

Buerger's Disease is

Buerger's Disease is non atherosclerotic inflammatory disorder involving medium sized and distal vessels. It is segmental, progressive , occlusive, inflammatory disease.

2

Non - progressive

Segmental

Non - inflammatory

Atherosclerotic

Surgery

null

bab08deb-206d-41e4-b4a6-00dd1a34e9d6

single

Most common nerve to be damaged in dislocation of shoulder is :

A i.e. Axillary Nerve

1

Axillary nerve

Radial nerve

Median nerve

Musculocutaneous nerve

Surgery

null

56c78e1f-4067-46a8-80dc-3b3c2cac3b08

single

Most common cause of stridor in infant and young children –

Laryngomalacia is the most common congenital laryngeal anomaly. It is the most common cause of stridor in infants and children.

3

Abductor palsy

Croup

Laryngomalacia

Epiglottitis

Pediatrics

null

08b89b55-502f-4d82-95c0-a2212e1270c4

single

Mallory denk bodies are seen in all except

Mallory denk bodies are not seen in Hemochromatosis and 2o biliary cirrhosis.

4

Wilson's disease

Alcoholic fatty liver disease

Non alcoholic fatty liver disease

Hemochromatosis

Pathology

null

30158fed-b58e-4230-83e7-6b7c2a0b3007

multi

Which of the following statement is not true about NSAIDs

Acetylsalicylic acid (asprin) is an Irreversible inhibition of COX enzyme. IT results in inhibition of prostaglandin and TX synthesis at low doses for (40 to 325 milligrams) it exes antiplatelet action. this drug shows saturation kinetics at high doses that is kinetics changes from first order to zero order. therefore at high doses amount of drug exeed will be constant that means clearance il is not constant. Refer kDT 6/e p185

3

Acetylsalicylic acid is an Irreversible inhibitors of Cox enzyme acetylsalicylic acid is an Irreversible inhibitors of Cox enzyme

Acetylsalicylic acid reduces in Vivo synthesis of prostaglandins

Its clearance is independent of Plasma concentration

Antiplatelet effect of low dose aspirin is related to pre systemic Cox inhibition

Pharmacology

Autacoids

3f8bd29d-073d-4c79-9365-58edb62cd041

multi

Rothera&;s test used for detection of

The presence of ketosis can be established by the detection of ketone bodies in urine by Rothera&;s test.Rothera&;s test: Saturate 5 mL of urine with solid ammonium sulfate. Add a few drops of freshly prepared sodium nitroprusside followed by 2 mL of liquor ammonia along the sides of the test tube. Development of a purple ring indicates the presence of ketone bodies in urine. Strip tests based on the same principle are also available.Ref: D M Vasudevan 7th edition Page no: 166

4

Proteins

Glucose

Fatty acid

Ketones

Biochemistry

miscellaneous

e8cd6b5a-5056-4fd4-85ab-444fa290928d

single

A man weighing 70 kg has a hematocrit of 45%. What would he his approximate plasma volume?

Ans. (d) 3080mL(Ref: Ganong Review of medical physiology, 21st ed p.2)8% of body weight is blood volumeSo, here for 70 kg man, Blood volume is 5.6 Litres (70*8/100)Blood Volume = Plasma volume/1-hematocritSo, Plasma volume = Blood volume*(1-hematocrit)Here, Plasma volume =5.6*(1-0.45)=3080mL

4

2310 mL

2695 mL

2890 mL

3080 mL

Physiology

General

c8f2f6ca-4e81-4d34-b7c4-b5e51d8632c1

single

Median nerve supplies all muscles of the thumb except -

Median nerve supply in hand - Flexor pollicis brevis - Opponens pollicis - Abductor pollicis brevis First two lumbricals Adductor pollicis is supplied by Ulnar nerve

4

Abductor-pollicis-brevis

Flexor-pollicis-brevis

Opponens pollicis

Adductor pollicis

Anatomy

null

813abbf9-2842-4fd0-ab21-ef863eb9bdb1

multi

Secondary glaucoma in early stage of herpes zoster ephthalmicus occurs due to:

Ans. Trabeculitis

1

Trabeculitis

Iridocyclitis

Haemorrhagic hypopyon

Hypersecretion of aqueous humour

Ophthalmology

null

ab8aa60d-3032-4590-9eb6-b432d5e25e6e

single

Sodium content in mmol/L in WHO oral rehydration solution is -

Ans. is 'c' i.e., 90

3

20

80

90

111

Pediatrics

null

ee472006-4c8f-4dc1-baf6-78e0b5e72034

single

Division of long thoracic nerve results in

Nerve to serratus anterior is also called long thoracic nerve(C5,C6,C7). A)Serratus anterior muscle along with the pectoralis minor pulls the scapula forwards around the chest wall to protract the upperlimb. B)The fibres inseed into the inferior angle of the scapula pull it forwards and rotate the scapula so that the glenoid cavity is turned upwards.In this action,the serratus anterior is helped by the trapezius which pulls the acromion upwards and backwards. when the muscle is paralyzed,the medial margin of the scapula gets raised specially when 'pushing movements' are attempted.This is called 'winging of scapula'. REF.B D Chaurasia's human anatomy,Vol.1,pg.47

4

Inability to retract the scapula

Wasting of pectoralis major muscle

Weakness of adduction of humerus

Winging of scapula

Anatomy

Thorax

5f4d2928-eff3-400e-a5a9-e17f6a9cb585

single

Epidemic dropsy is caused by

Ans. (a) Sanguinarine

1

Sanguinarine

Ergot

Alkaloid

BOAA

Social & Preventive Medicine

Nutrition and Health

05bcd2ff-0b8e-460c-932c-e349153f7419

single

Patient is having scanty, foul smelling discharge from middle ear, develops fever, headache and neck rigidity. CT of the temporal lobe shows a localized ring enhancing lesion, which of the following is least likely cause of this condition?

Commonest organisms in otogenic brain abscess include gram negative (Proteus, E coli, Pseudomonas) and anaerobic bacteria along with Staphylococcus and Pneumocci. H. Influenza infection is a rare cause of otogenic abscess.

4

S. aureus

Pseudomonas

S.Pneumoniae

H. influenza

ENT

null

47cd7810-d31f-4b29-979b-45635195fe40

single

A 36-year-old woman has a cough and fever for 1 week. On physical examination, her temperature is 38.3deg C. She has diffuse crackles in all lung fields. A chest radiograph shows bilateral extensive infiltrates. CBC shows hemoglobin, 13.9 g/ dL; hematocrit, 42%; MCV, 89 mm3; platelet count, 210,000/mm3; and WBC count, 56,000/mm3 with 63% segmented neutrophils, 16% bands, 7% metamyelocytes, 3% myelocytes, 1% blasts, 8% lymphocytes, and 2% monocytes. A bone marrow biopsy is obtained and shows normal maturation of myeloid cells. Which of the following is the most likely diagnosis?

Marked leukocytosis and immature myeloid cells in the peripheral blood can represent an exaggerated response to infection (leukemoid reaction), or it can be a manifestation of chronic myelogenous leukemia (CML). Normal maturation of myeloid cells in the marrow rules out CML. Although not provided in this case, a leukocyte alkaline phosphatase (LAP) score is high in the more differentiated cell population of reactive leukocytosis, whereas in CML, the LAP score is low. The Philadelphia chromosome (present in most CML cases) is lacking in patients with leukemoid reactions. Hairy cell leukemia is accompanied by peripheral blood leukocytes that mark with tartrate-resistant acid phosphatase. Hodgkin lymphoma is not characterized by an increased WBC count. A myelodysplastic syndrome is a stem cell maturation disorder involving all nonlymphoid cell lineages, not just granulocytes.

4

Chronic myelogenous leukemia

Hairy cell leukemia

Hodgkin lymphoma, lymphocyte depletion type

Leukemoid reaction

Pathology

Blood

232792cb-b1de-4aab-84f7-ef28f7110972

multi

Secondary prevention is applicable to ?

Ans. is 'b' i.e.,Early stage of disease Primordial prevention - Before risk factor present.Primary prevention - Before onset of disease (risk factor present).Secondary prevention - In early stage of disease.Teiary prevention - Late stage of disease.

2

Causal factors

Early stage of disease

Late stage of disease

None of the above

Social & Preventive Medicine

null

35234bb9-1aa3-4cff-88ea-2b7f3625db1e

multi

A leukemia patient who has undergone multiple courses of chemotherapy develops herpes simplex encephalitis. Which of the following would you expect a CT scan of the patient's brain to show?

Herpes simplex can cause a necrotizing, hemorrhagic acute encephalitis that may rapidly produce death. The encephalitis characteristically involves the lower poions of the cerebral coex, notably the temporal lobes and the base of the frontal lobes, possibly because the infection spreads from the oropharynx. Ref: Ropper A.H., Samuels M.A. (2009). Chapter 33. Viral Infections of the Nervous System, Chronic Meningitis, and Prion Diseases. In A.H. Ropper, M.A. Samuels (Eds), Adams and Victor's Principles of Neurology, 9e.

4

Generalized volume loss

Volume loss selectively in the basal ganglia

Volume loss selectively in the brainstem

Volume loss selectively in the temporal and frontal lobes

Medicine

null

ccc6cd04-a065-4601-8550-136e30fffa03

single

Diarrhoea syndrome in an AIDS patient can be d/t – a) Rota virusb) Cryptosporac) Adenovirusd) E. soli

Agents commonly causing diarrhea in HIV patient. Rota virus Isospora Cryptosporidium Cyclospora Microsporidium Giardia Lambi Bacterial pathogens

1

ab

a

ad

bc

Pediatrics

null

db6a4fc9-b443-4043-aaf9-e364faf7a187

single

Position that is least likely possible by means of bilateral saggital split osteotomy is

null

4

Advancement

Set back

Rotation

Transverse

Surgery

null

984a8b25-b8c4-4aae-bfb6-625be5d28ca7

single

Physiological jaundice of newborn may be managed by all except -

Ans. b (Phenytoin sodium). (Ref. Nelson Textbook of Pediatrics 17th ed., 593, 597) # Jaundice during the 1st 24 hrs of life warrants diagnostic evaluation and should be considered to be due to hemolysis until proved otherwise. Septicemia and intrauterine infections such as syphilis, cytomegalovirus, and toxoplasmosis should also be considered, especially in infants with an increase in plasma direct-reacting bilirubin. # Jaundice after the 1st 24 hrs may be "physiologic" or may be due to septicemia, hemolytic anemia, galactosemia, hepatitis, congenital atresia of the bile ducts, inspissated bile syndrome after erythroblastosis fetalis, syphilis, herpes simplex, or other congenital infections. Physiologic jaundice (icterus neonatorum) # Under normal circumstances, the level of indirect-reacting bilirubin in umbilical cord serum is l-3mg/dL and rises at a rate of less than 5mg/dL/24hr; thus, jaundice becomes visible on the 2nd-3rd day, usually peaking between the 2nd and 4th days at 5-6 mg/dL and decreasing to below 2mg/dL between the 5th - 7th days of life. # Jaundice associated with these changes is designated "physiologic" and is believed to be the result of increased bilirubin production after the breakdown of fetal red blood cells combined with transient limitation in the conjugation of bilirubin by the liver. # Risk factors for indirect hyperbilirubinemia include maternal diabetes, race (Chinese, Japanese, Korean, and Native American), prematurity, drugs (vitamin K3, novobiocin), altitude, polycythemia, male sex, trisomy 21, cutaneous bruising, cephalohematoma, oxytocin induction, breastfeeding, weight loss (dehydration or caloric deprivation), delayed bowel movement, and a sibling who had physiologic jaundice. # A family history of neonatal jaundice, exclusive breastfeeding, bruising, cephalohematoma, Asian race, and maternal age older than 25 yr identify approximately 60% of cases of extreme hyperbilirubinemia. # Indirect bilirubin levels in full-term infants decline to adult levels (mg/dL) by 10-14 days of life. # Persistent indirect hyperbilirubinemia beyond 2 wk suggests hemolysis, hereditary glucuronosyl transferase deficiency, breast milk jaundice, hypothyroidism, or intestinal obstruction. Jaundice associated with pyloric stenosis may be due to caloric deprivation, deficiency of hepatic UDP-glucuronyl transferase or ileus-induced increased enterohepatic circulation of bilirubin. Treatment of hyperbilirubinemia Phototherapy # Clinical jaundice and indirect hyperbilirubinemia are reduced on exposure to a high intensity of light in the visible spectrum. # Bilirubin absorbs light maximally in the blue range (420-470 nm). Nonetheless, broad-spectrum white, blue, special narrow-spectrum (super) blue, less often, green lights are effective in reducing bilirubin levels. # Bilirubin in the skin absorbs light energy, which by photo-isomerization converts the toxic native unconjugated 4Z, 15Z-bilirubin into the unconjugated configurational isomer 4Z,15E-bilirubin. # Phototherapy also converts native bilirubin, by an irreversible reaction, to the structural isomer lumirubin, which is excreted by the kidneys in the unconjugated state. # When indications for exchange transfusion are present, phototherapy should not be used as a substitute. # However, phototherapy may reduce the need for repeated exchange transfusions in infants with hemolysis. # Phototherapy is indicated only after the presence of pathologic hyperbilirubinemia has been established. # The basic cause or causes of jaundice should be treated concomitantly. # Prophylactic phototherapy in VLBW infants may prevent hyperbilirubinemia and may reduce the incidence of exchange transfusions. # Dark skin does not reduce the efficacy of phototherapy. # Maximal intensive phototherapy should be used when indirect bilirubin levels approach. Such therapy includes "special blue" fluorescent tubes, placing the lamps within 15-20 cm of the infant, and placing a fiberoptic phototherapy blanket under the infant's back to increase the exposed surface area. # Complications of phototherapy include loose stools, erythematous macular rash, a purpuric rash associated with transient porphyrinemia, overheating and dehydration (increased insensible water loss, diarrhea), chilling from exposure of the infant, and bronze baby syndrome. # Phototherapy is contraindicated in the presence of porphyria. # The term bronze baby syndrome refers to a dark grayish brown discoloration of the skin sometimes noted in infants undergoing phototherapy. Almost all infants observed with this syndrome have had a mixed type of hyperbilirubinemia with significant elevation of direct-reacting bilirubin and often with other evidence of obstructive liver disease. # Those using phototherapy should remain alert to these possibilities and avoid any unnecessary use because untoward effects on DNA have been demonstrated in vitro. Exchange transfusion. # Exchange transfusion is performed if intensive phototherapy has failed to reduce bilirubin levels to a safe range and if the risk of kernicterus exceeds the risk of the procedure or the infant has signs of kernicterus. # Potential complications from exchange transfusion are not trivial and include acidosis, electrolyte abnormalities, hypoglycemia, thrombocytopenia, volume overload, arrhythmias, NEC, infection, graft vs host disease, and death. # The appearance of clinical signs suggesting kernicterus is an indication for exchange transfusion at any level of serum bilirubin. Other therapies # Tin (Sn)-protoporphyrin (or tin-mesoporphyrin) administration has been proposed for reduction of bilirubin. It may inhibit the conversion of biliverdin to bilirubin by heme oxygenase. A single intramuscular dose on the 1st day of life may reduce the need for phototherapy. Such therapy may be beneficial when jaundice is anticipated (G6PD deficiency) or when blood products are discouraged (Jehovah's Witness). Complications include transient erythema if the infant is receiving phototherapy. # IV immunoglobulin (500 mg/kg/dose over a 4hr period), given ql2hr for 3 doses, is effective in reducing bilirubin levels in patients with Coombs-positive hemolytic anemia, presumably by reducing hemolysis.

2

Metalloporphyrin

Phenytoin sodium

Phototherapy

None of the above

Unknown

null

c4bd1268-abae-4f12-bb8e-82a2cf060c4d

multi

1, 25 (OH)2 Cholecalciferol is formed in-

25-hydroxy Cholecalciferol is formed in liver Whereas 1, 25 (OH)2 Cholecalciferol is formed in kidneys. Additional edge on synthesis of Vitamin D: Activation of 7-dehydro cholesterol by UV light in skin produces Cholecalciferol 25-hydroxylation in liver to form 25-hydroxy cholecalciferol 1-alpha- hydroxylation in kidneys to form 1,25 dihydroxy cholecalciferol PTH activates 1-alpha hydroxylase of kidneys

4

Skin

Liver

Spleen

Kidney

Biochemistry

Vitamins and Minerals

992646b8-2d5b-4a85-b058-30ffb6b3511f

single

Most common cause of obstruction in atrophic rhinitis is:

(a) Excessive formation of crust(Ref. Cummings, 6th ed., 695)The excessive crusting leads to nasal obstruction in spite of roomy cavities.On removal of crusts there is bleeding. But there is no synechiae formation. There is no polypoidal change .

1

Excessive formation of crust

Polyp

Synechiae

Hypertrophy of turbinate

ENT

Rhinitis

41a747eb-3827-4dcf-bb4e-6090f9b704b5

single

Which of the following does not cause hemorrhagic conjunctivitis –

Hemorrhagic conjunctivitis is caused by picornaviruses (Enterovirus - 70, coxsackievirus A24) and sometimes Adenovirus type 11.

4

Adenovirus

Coxsackie – 24

Enterovirus – 70

Papilloma virus

Ophthalmology

null

b1d4887d-8229-4af1-89e6-a435e4cc09e2

single

A patient with acute leukaemia is admitted with febrile neutropenia. On day four of being treated with broad-spectrum antibiotics, his fever increases. X-ray chest shows bilateral fluffy infiltrates. Which of the following should be the most appropriate next step in the management

Cotrimoxazole is an antibiotic. As the patient is immunocompromised, most probable oppounistic infection is a fungal infection. And X-Ray shows fluffy infiltrates is suggestive of fungal infection. So antifungals are to be added. Ref: Textbook of Microbiology, Ananthanarayan and Paniker; 9th edition

2

Add antiviral therapy

Add antifungal therapy

Add cotrimoxazole

Continue chemotheraphy

Microbiology

mycology

21e9a60d-8b45-4410-bfbc-1f78b4219f99

multi

A population is divided into relevant subgroups and random sample selection is done from each of the subgroups. This is which type of sampling method?

- in stratified random sample, the sample is deliberately drawn in a systematic way so that each poion of the sample represents a corresponding strata of the universe. - this method is paicularly useful where one is interested in analysing the data by a ceain characteristic of the population. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no:850

2

Systematic random sampling

Stratified random sampling

Simple random sampling

Cluster sampling

Social & Preventive Medicine

Biostatistics

d74d4814-098b-4866-8117-50149c5a9e50

single

In thin basement membrane disease, the defect is in

TBM disease (also known as benign familial hematuria and thin basement membrane nephropathy) is, along with IgA nephropathy, the most common cause of blood in the urine without any other symptoms. The only abnormal finding in this diseaseis a thinning of the basement membrane of the glomeruli (filters) in the kidneys. Refer robbins 9/e

2

a1 and a2 chains of type IV collagen

a3 and a4 chains of type IV collagen

a1 and a2 chains of type VI collagen

a3 and a4 chains of type VI collagen

Pathology

Urinary tract

197c922c-6f02-4ff8-9629-2e82f40864a8

single

A newborn presenting with intestinal obstruction showed on abdominal X-ray, multiple air fluid levels. The diagnosis is not likely to be-

A i.e. Pyloric obstruction

1

Pyloric obstruction

Duodenal atresia

Illeal atresia

Ladd \\ s bands

Radiology

null

36bb2006-8baf-4b25-bb66-d1bb860b8539

single

Anti-neutrophil cytoplasmic antibodies (ANCA) is seen in

PR3-ANCAs are also present in up to 95% of cases; they are a useful marker of disease activity and may participate in Wegener’s granulomatosis.

3

Rheumatoid arthritis

Diabetes mellitus

Wegener’s Granulomatosis

Churg-Strauss syndrome

Pathology

null

ade5ddec-73fa-487b-9958-4e76ff78a830

single

Patient with jaundice and white stools. Which of the following enzymes is not raised

Large increase in gamma glutamyl transferase and ALP ours biliary obstruction (Davidson; page 929) 5&;nucleotidase rise parallels ALP but more specific for diseases of hepatic origin (Harsh mohan page 594)

3

5' nucleotidase

Alkaline phosphatase

Glutamate reductase

Gamma glutamyl transpeptidase

Medicine

G.I.T

83939c0a-197b-440a-a8f8-7e37f4f33371

single

Least clearance is for among these

Glucose is completely reabsorbed in proximal tubules. So its clearance is zero.

1

Glucose

Inulin

Urea

Creatinine

Physiology

null

b8b6cb77-cdd4-4633-a890-ee94c0feb74c

single

Characteristics of glycoprotein:

A i.e. Protein linked with glycosidic bond

1

Protein linked with glycosidic bond

Core protein

Sugar residues are long in carbohydrate poion of glycoprotein

null

Biochemistry

null

a6bee775-12c8-4675-a3f2-15c51cd3990d

multi

At what age baby with congenital hypertrophic pyloric stenosis show symptoms

Baby show the symptoms of projectile vomiting, olive shaped mass and visible peristalsis

3

At the time of birth

First week

3rd to 4th week

Second month

Surgery

null

7e822c2e-b62b-4f0e-9306-9b5ec1ff9ca7

single

All of the following may be used to treat hypercalcemia, except:

Answer is A (Normal saline with forced diuresis with Thiazides): Thiazide diuretics should not be used in cases of hypercalcemia as these may themselves cause hypercalcemia.

1

Normal saline with forced diuresis with chlohiazide

Plicamycin

Gallium nitrate

Mitramycin

Medicine

null

89500db2-ff0d-4895-a9cf-86fb6c58d465

multi

The most commonly practiced operative procedure for a perforated duodenal ulcer is -

Ans. is 'd' i.e., Graham's omentum patch repair

4

Vagotomy and pyloroplasty

Vagotomy and antrectomy

Vagotomy and perforation closure

Graham's omentum patch repair

Surgery

null

f5e78622-1e8a-4e33-a166-676c72d4c3f0

single

Donovan bodies are:

Monocytes that contain the organism, Calymmatobacterium granulomatis

4

Leukocytes that contain the organism, Calymmatobacterium granulomatis

EosinophiLs that contain the organism, Calymmatobacterium granulomatis

Monocytes that contain the organism, Haemophilus influenza

Monocytes that contain the organism, Calymmatobacterium granulomatis

Microbiology

null

d54ab332-7771-48fd-8721-be014089d3fa

single

Which of the following structures seen in the cavernous sinus?

Ans. c. Internal carotid aery

3

Maxillary division of V nerve

Mandibular division of V nerve

Internal carotid aery

Trochlear nerve

Anatomy

null

60dc935f-82bf-49e1-aa25-58a037bb5f42

single

A symptom of medullary sponge kidney disease is -

Medullary sponge kidney is a congenital disorder characterized by cystic dilatation of papillary collecting ducts of one or both kidneys. Urinary stasis in the dilated ducts, hypocitraturia, and, occasionally, incomplete distal renal tubular acidosis (dRTA) contribute to the formation of small calcium-containing calculi. Most cases are asymptomatic or are discovered during investigation of asymptomatic hematuria. Symptomatic patients typically present as young adults with: Kidney stones with renal colic Recurrent hematuria Infection (UTI) Most cases are sporadic, while some show autosomal dominant inheritance Involvement is bilateral in most cases

4

Nocturia

Anemia

Azotemia

UTI

Surgery

null

71873be2-d2fa-4f70-bb70-f2b08942ecf9

single

Tardieu spots are a feature of which of the following forms of death?

Tardieu spots or petechial haemorrhages are pinhead size bleeding spots occurring as a result of rupture of venules and are most commonly seen in sclera, conjunctiva or on serous membranes. It is seen in case of mechanical asphyxia. Ref: Textbook of Forensic Medicine and Toxicology By V.V Pillay, 15th Edition, Page 275

2

Cyanide poisoning

Mechanical asphyxia

Cobra bite

Organophosphate poisoning

Forensic Medicine

null

53b6d52f-ce67-475e-9f14-5731aa6bfb3b

single

Metastasis in neuroblastoma goes to -

Lung metastasis at initial diagnosis of neuroblastoma is associated with MYCN amplification and elevated LDH levels. Although lung metastasis at diagnosis was not independently predictive of outcome in this analysis, it remains a useful prognostic marker of an unorable outcome.

2

Liver

Lung

Bone

Bone marrow

Pathology

Pediatrics, environment and nutrition

286c7f83-dc51-4a9d-b407-b36c60de36e7

single

Deposition of protein 'A beta 2m' is seen in which clinicopathologic category of amyloidosis -

Ans. is 'b' i.e., Hemodialysis associated

2

Familial Mediterranean fever

Hemodialysis associated

Senile cerebral

Systemic senile

Pathology

null

92e72deb-d0bc-485c-81a3-6af699e85c8a

single

Aerial blood gas of a 5 year old child done at sea level gives the following results: pH 7.41, PaO2, 100 mmHg, and PaCO2, 40 mmHg. The child is being ventilated with 80% oxygen. What is the (A-a) DO2.-

Alveolar air equation: Using the alveolar air equation - PAO2 = - Data: Fraction of O2 in the inspired air = 80% Barometric pressure = 760 mm Hg (sea level) Water vapor pressure = 47 mm Hg Respiratory quotient = 0.8 Hence, Alveolar PO2 = - = 570.4 - 50 = 520.4 mm Hg Aerial PO2 is given = 100 mm Hg Hence, (A - a) DO2 = 520.4 - 100 = 420.4 mm Hg

4

570.4 mm Hg

520.4 mm Hg

470.4 mm Hg

420.4 mm Hg

Physiology

Respiratory System Pa 3

94c2904d-2d6d-4d92-9ad9-a88415418efb

single

A child presented with a history of unilateral purulent nasal discharge with occasional bloody discharge from the same side, The diagnosis is -

Unilateral purulent nasal discharge with occasional bloody discharge in a child is highly suggestive of foreign body. Antrochoanal polyp does not cause bloody discharge. Angiofibroma most commonly presents with nasal obstruction and epistaxis (not purulent nasal discharge). Rhinosporidiosis presents most commonly with polypoid mass.

2

Antrochoanal polyp

Foreign body

Angiofibroma

Rhinosporidiosis

ENT

null

85a88804-96b9-42ec-93b8-a13c0b2daaf1

single

DNA fingerprinting was founded by:

C i.e. Jeffrey

3

Watson

Calton

Jeffrey

All of the above

Medicine

null

278a64a6-fe13-486e-83ab-b3541733296c

multi

For a class V cavity for amalgam:

null

3

Mesio-distal walls are parallel and occluso-gingival walls converging

Mesio-distal walls diverging, occlusogingival walls converging

MD walls diverging, OG walls diverging

MD walls and OG walls parallel

Dental

null

948272d8-4118-44e3-becc-6c60a3f8222a

multi

A patient Shweta with raised serum alkaline phosphatase and raised parathormone level along with low calcium and low phosphate level is likely to have

4

Primary hyperparathyroidism

Paget's disease

Osteoporosis

Vitamin D deficiency

Medicine

null

a6958436-9471-4225-b5d2-c477192da91d

single

During the Window period of patient with AIDS -

sero negative infective stage is known as the window period REF:ANANTHANARAYANAN TEXT BOOK OF MICROBIOLOGY 9EDITION PGNO.579

3

ELISA is -ve

Western Blot is -ve

Both are -ve

PCR is -ve

Microbiology

Virology

24bfc067-fe79-4696-89ae-f92efce9d84e

multi

In Bismuth/ Strasberg classification system cystic blow out is classified as:

null

1

Type A

Type B

Type C

Type D

Surgery

null

851f0325-df1c-4498-80e3-4a5d276396a4

single

If circumflex aery gives the posterior interventricular branch, this circulation is described as

In about 10% of heas,the right coronary is rather small and is not able to give the posterior interventricular branch. In these cases the circumflex aery,the continuation of left provides the posterior interventricular branch and called left dominant. <img src=" /> B D CHAURASIA'S HUMAN ANATOMY UPPER LIMB THORAX-VOLUME1 SIXTH EDITION Page no:265

2

Right dominance

Left dominance

Codominance

Undetermined

Anatomy

Thorax

9988d555-e41d-4f02-b78f-60f6b6f93b66

single

Parvovirus B19 does not cause

parvovirusB19 causesaplasyic crisi ,persistent anemia,erythema infectiosum&fetal hydrops REF:ANATHANARAYANAN MICROBIOLOGY NINTH EDITION PAGE.554

1

Roseola infantum

Aplastic anemia in sickle cell disease

Fetal hydrops

erythema infectiosum

Microbiology

Virology

9fe50a93-278b-41d1-898d-a31b95709b08

single

Marker of acute kidney injury all except?

Ans. is 'd' i.e., Acid phosphatase o Acid phosphatase is not a market of AKI, instead it is alkaline phosphatase.o List of markers for AKI# Alanine aminopeptidase(AAP)# Alkaline phosphatase (AP)# a-GIutathione-S-transferase (a-GST)# g-Glutamyl transpeptidase (gGT)# N-Acetyl-b-(D) gluco-saminidase (NAG)# b2-Microglubulin# a1-Microglubulin# Retinol-binding protein# Cystatin C# Microalbumin# Kidney injury molecule-1 (KIM-1)# Neutrophil gelatinase associated lipocalin (NGAL)# Interleukin-18 (IL-18)# Cysteine-rich protein (CYR-61)# Osteopontin# Liver fatty acid-binding protein (L-FABP)# Sodium/hydrogen exchanger isoform (NHE3)# Exosomal fetuin-A

4

Clusterin

Osteopontin

Alanine aminopeptidase

Acid phosphatase

Medicine

Acute Renal Failure

6220ae04-06a1-47bf-81cc-b325989a0074

multi

Button hole sign is seen in:

Due to defect in dermis, pressure on a neurofibroma gives a feeling of hole in dermis, which is called as Button hole sign.

3

Lupus vulgaris

Intertigo

Neuro fibromatosis

Psoriasis

Dental

null

1a9dc641-10a9-4571-90d1-9483cb14029e

single

Lipoxins synthesized from arachidonic acid act by-

lopoxins are the metabolites produced lipooxygenase pathway. They act to regulate and counter Balance actions ad Leucotriens i:e, decreases leukocyte adhesion, migration and chemotaxis. .ref Robbins 9/e p46

1

Decrease leucocyte migration, adhesion, chemotaxis

Increase leucocyte migration, adhesion, chemotaxis

Vasoconstriction

Increased vascular permeability

Pathology

General pathology

108ab257-4a62-4cb6-804b-a8fb57aedf1a

single

Active management of 3rd stage of labour is needed for all the following EXCEPT

Ans. d (Delivery of first baby of twins) (Ref. Textbook of Obstetrics D.C. Dutta 6th/pg. 142)Accidental administration of ergometrine or methergin during delivery of first baby in undiagnosed twins produce grave danger to the unborn 2nd baby caused by asphyxia due to tetanic uterine contractions.MANAGEMENT OF THE THIRD STAGE OF LABORThe third stage of labor begins following the delivery of the baby and ends with the delivery of the placenta.Signs of spontaneous placental separation include an apparent lengthening of the umbilical cord, a gush of vaginal bleeding, and a change in shape of the uterus from discoid to globular along with a rise in fundal height.Active management of the third stage of labor, which involves prompt umbilical cord clamping and cutting, administration of an oxytocic agent, and gentle umbilical cord traction, reduces maternal blood loss and the frequency of postpartum hemorrhage, and lessens the risk that the third stage will be prolonged.# Cord clamping is part of management of 2nd stage of labour.# Cord traction should be used only against fundally applied counter-traction to lessen the potential for uterine inversion and catastrophic hemorrhage. If at any time heavy bleeding occurs during the third stage of labor or if the placenta is not delivered within 30 minutes of the birth, the placenta should be manually removed.# General anesthesia may be required for women who have no regional anesthesia, and curettage may be necessary if the placenta does not readily separate from the uterine wall.# Manual removal is accomplished by developing a cleavage plane with the intrauterine hand between the maternal surface of the placenta and the uterine wall, while simultaneously fixing the uterus with the abdominal hand, and progressively peeling the placenta free.# If any portion of the placenta or the membranes is missing, the uterine cavity should be manually explored. Some advocate routine exploration of the uterine cavity to reduce the risk of infection and bleeding from retained placental fragments. In most women, especially those without regional anesthesia, the benefit of manual exploration is outweighed by the discomfort it causes, as well as the increased risk for uterine infection.# The uterus should be frequently palpated following delivery of the placenta to ensure that it remains well contracted. Oxytocin, 10 to 20 U administered intramuscularly or as a dilute intravenous solution, has been demonstrated to decrease the incidence of postpartum hemorrhage secondary to uterine atony. The birth canal, including the cervix,vagina, and perineum should be inspected for lacerations requiring repair.

4

Rh incompatibility

Diabetic mother

Prolonged pregnancy

Delivery of first baby of twins

Gynaecology & Obstetrics

Miscellaneous (Gynae)

611702fc-bc99-44cf-a9bb-69e365205fbb

multi

Which is a DNA virus ?

Ans. is 'b' i.e., Hepatitis B

2

Hepatitis A

Hepatitis B

Hepatitis C

Hepatitis D

Microbiology

null

9f6df3d9-afba-4deb-a685-78f648de5caf

single

Which of the following glycolytic enzyme is used in gluconeogenesis?

Aldolase is the enzyme which catalyzes the reversible reaction of glycolysis. So this enzyme is utilized in gluconeogenesis.Glucokinase, pyruvate kinase and phosphofructokinase are enzymes which catalyze the irreversible reaction of glycolysis and which are bypassed by different sets of enzymes during gluconeogenesis.

3

Glucokinase

Pyruvate kinase

Aldolase

Phosphofructokinase

Microbiology

All India exam

d17e8812-8507-4726-b1f8-d82be8a09a9b

single

In pneumothorax due to blunt injury, treatment of choice is -

null

4

Observation

Pneumonectomy

Thoracotomy

Intercostal drainage

Surgery

null

390ec4b8-dd44-4cdd-8065-609d9fc943d9

single

A 53-year-old female nonsmoker is being evaluated with symptoms of progressive shoness of breath. She has a past history of trauma to the right side of the chest. There is no history of asthma, sputum production, or recent chest pain. CXR is shown in,The likely diagnosis is

There is a large, well-demarcated, calcified pleural-based opacity abutting the lateral chest occupying two-thirds of the left hemithorax. It has a rounded, intensely calcified inferior and medial border and thus suggests a pleural origin. The shadow is most consistent with a large, old organized hemothorax. The calcified and organized pleuralbased opacity is consistent with an old hemothorax secondary to previous trauma. The pulmonary functions in this case would show restrictive limitation due to fibrosis of the pleural space and decreased lung compliance.

2

Calcified cyst

Organized hemothorax

Blastomycosis

Asbestosis

Radiology

Respiratory system

29c07a2a-41e2-4929-a4af-b18191223ff9

single

Predisposing factors for endometrial carcinoma is :

All

4

Hypeension

Late menopause

Nulliparity and Diabetes mellitus both

All

Gynaecology & Obstetrics

null

9ddb4c7b-5115-4349-80c4-a973b09a0771

multi

Which of the following connective tissue disorder is associated with gastroesophageal reflux?

Scleroderma is systemic disease accompanied by esophageal abnormalities in approximately 80% of patients. The esophageal lesion consists of atrophy of the smooth muscles, manifested by weakness in the lower two-third of the esophageal body and incompetence of the LES. Gastroesophageal reflux is due to incompetent LES combined with poor esophageal clearance which inturn leads to severe reflux esophagitis and stricture formation. Ref: Schwaz 9/e, Page 846; Harrison 17/e, Page 1850.

2

SLE

Scleroderma

Behcet's syndrome

Dermatomyositis

Surgery

null

7570ad1b-7a71-4a46-a6d7-0125cbc2a61a

single

Subdural Hematoma (SDH) is caused by

(A) Bridging veins # SUBDURAL BLEEDING arises from rupture of cortical vessels/bridging veins.> Relatively severe trauma> No lucid interval> Diffuse concave lesion on computed tomography> Require immediate transfer to a neurosurgical unit for decision on evacuation 50 per cent mortality.

1

Bridging veins

Caroticocavemous fistula rupture

Middle meningeal artery

null

Surgery

Miscellaneous

2f7b1086-cd8d-411b-a2e4-811532e8fbcb

multi

Thiazide diuretic used when GFR<30 ml/min?

Ans. is 'a' i.e., Metolazone o Metolazone is the only thiazide which is effective in severe renal failure.

1

Metolazone

Benzthiazidc

Chlohiazide

Hydrofulthiazide

Pharmacology

null

5487bd71-7f0e-4d50-91a6-9e486d860c72

single

Which of the following traditional medicines is effective in the treatment of hea failure

Ans. a. Terminalia Arjuna Terminalia Arjuna (An ayurvedic cardioprotective botanical) Although many Ayurvedic plants have shown to help coronary aery disease, Arjuna (Terminalia Arjuna) by far seems to be the best plant for hea health. Terminalia arjuna is a traditional ayurvedic plant containing tannins, triterpenoid saponins (arjungenin, arjunglucosides), flavonoids (arjunon, arjonolone), phytosterols, oligomeric proanthocyanidins (OPC's), calcium, magnesium, zinc, and copper.

1

Terminalia Arjuna

Neem bark extract

St. John's wo

Gingkoba biloba

Pharmacology

null

9c5a488d-97f1-4e77-b4d3-d21cb0f0c9f6

single

Selenocysteine is derivative of which aminoacid -

Ans. is 'a' i.e., Serine o Selenocysteine is considered as 21" standard amino acid. o It is present at the active site of some enzymes that catalyze redox reactions, e.g. thioredoxin reductase, glutathione peroxidase, and the deiodinase (converts thyroxin to triiothyronine). o Biosynthesis of selenocysteine requires cysteine, serine, ATP and a specific t-RNA o Serine provides the carbon skeleton of selenocysteine. o Selenocysteine has a structure similar to cysteine, but containing the trace element selenium in place of sulfur atom of cysteine.

1

Serine

Alanine

Arginine

Glycine

Biochemistry

Amino Acids Basics

95f22481-cf82-4c1f-bac4-be74a2e1997f

single

Which of the following local anaesthetic is NOT used as a surface anaesthetic?

Bupivacaine is a widely used amide local anesthetic. It is a potent agent capable of producing prolonged anesthesia. Its long duration of action plus its tendency to provide more sensory than motor block has made it a popular drug for providing prolonged analgesia during labor or the postoperative period. By taking advantage of indwelling catheters and continuous infusions, bupivacaine can be used to provide several days of effective analgesia. Lignocaine, tetracaine, and cocaine are used as local anaesthetics and anesthesia lasts for 30-45 minutes (30-60 minutes with tetracaine). Anesthesia is entirely superficial; it does not extend to submucosal structures. Ref: Catterall W.A., Mackie K. (2011). Chapter 20. Local Anesthetics. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e.

4

Lignocaine

Tetracaine

Cocaine

Bupivacaine

Anaesthesia

null

b010c4fd-35c5-440f-a8aa-8219c856ae18

single

Undescended testis can lead to all of the following complications except: March 2012

Ans: D i.e. Hyperophy of testes Complications of undescended testes Torsion can be seen in incomplete testicular descent Sterility is seen in bilateral cases (especially intra-abdominal testes) Incomplete testicular descent predisposes to malignant disease; cancer is more common in an incompletely descended testes-orchidopexy may or may not diminish the risk. Atrophy of an inguinal testes before pubey may possibly be caused by recurrent minor trauma.

4

Torsion

Sterility

Carcinoma

Hyperophy of testes

Surgery

null

f717c467-4c26-4e62-9e7a-fdfd8007986f

multi

Keratoderma Blenorrhagica is typically seen in

Ans. is 'c' i.e., Reactive ahritis Keratoderma Blenorrhagica is the characteristic skin lesion seen in patients with Reactive Ahritis. "The Characteristic skin lesions in Reactive Ahritis, Keratoderma Blenorrhagica, consist ofvesicles that become hyperkeratotic, ultimately forming a crust before disappearing. These are seen in palms and soles.

3

Rheumatoid ahritis

Psoriatic Ahritis

Reactive Ahritis

Ankylosing spondylitis

Medicine

null

45d980dc-0b54-4db0-b556-6df36cbc1534

multi

Initial amino acid in prokaryotic protein synthesis -

Ans. is 'c- i.e., Formyl-methionine o in prokaryotes and in mitochondria, the first amino acid methionine is modified by formylation, i.e. the initiator t-RNA carries an N-formylated methionine. The formyl group is added by the enzyme transformylase (formyl- transferase). In Eukaryotes, the initiator t-RNA carries a methionine that is not formylatedDifferenceProkaryotesEukaryotesm-RNAPolycistronic i.e. have several coding regions; each with its initiation & termination codon producing a seperate polypeptideMonocistr onic with one coding regionAmino acid incorporation rate18 aa/sec6aa/sec.Initial amino acidFormylated methionine ( f-met)Methionine r (Met)Initial t-RNAt-RNA/MettRNAMetTranscription & translationTranslation starts before transcription is ended (coupled)UncoupledInitiation factors (IF)3i.e.IF1,IF2,IF3> 10 designated elFDetermination of initiatingcodon# Shine Dalgarno sequencer# Facilitated by IF-2 bound to GTPKozak consensus sequencesr Facilitated by elF-2 bound to GTP (Plus additional elF)Elongation: Del Every of aminoacyl t-RNA to A site# Facilitated by EF-Tu & EF-TsFacilitated by EF1 a and EF 1 b yNucleotide exchange factors# EF - Ts (as it exchanges its GTP for GDP on EFTu)EF 1 b g (as it exchanges its GTP forGDP on EF a)Peptidyi transferase activity catalyzing peptide bond formation23 S rRNA of 50 S ribosomal subunit (ribozyme)28 S rRNA of 60 S ribosornal subunit (ribozyme)TranslocationRequires EF-G & GTPRequires EF-2 & GTPTerminationRelease factor (RF) 1 recognizes UAA & UAG, RF2 recognizes UAA & UGARF-3 (bound to GTP) causes release ofRF-1 or RF-2 as GTP is hydrolysedeRF recognizesail 3 UAA, UAGandUGA and release nascent polypeptide chaineRF-3 (bound to GTP) function like prokaryotic RF-3 & release eRF

3

Arginine

Methionine

Formyl-methionine

Alanine

Biochemistry

Amino Acids Basics

4fccd3d5-4706-4f62-8708-46c2d05b5faf

single

Antiglaucoma drug which acts by increasing uveo- sclerol outflow -

Ans. is 'b' i.e., Latanoprost Drugs used in open-angle glaucoma MechanismMethods of AdministrationCholinomimetics Pilocarpine, carbachol, physostigmine, echothiophate, demecariumCiliary muscle contraction, opening of trabecular meshwork, increased outflowTopical drops of gel; plastic film slow-release insertAlpha agonists UnselectiveEpinephrine, dipivefrinIncreased outflowTopical dropsAlpha2-selectiveDecreased aqueous secretion ApraclonidineBrimonidine Topical, postlaser only TopicalBeta-blockers Timolol, betaxolol, carteolol, levobunolol, metipranololDecreased aqueous secretion from the ciliary epitheliumTopical dropsDiuretics Dorzolamide, brinzolamideDecreased aqueous secretion due to lack of HCO3TopicalAcetazolamide, dichlorphenamide, Methazolamide OralProstaglandins Lantanoprost, bimatoprost, travoprost, unoprostoneIncreased outflowTopical

2

Apraclonidine

Latanoprost

Timolol

Brinzolamide

Pharmacology

Anti Adrenergic System

6bbd139e-6000-4acb-beb0-042dc471df1e

single

Most commonly affected organ in the disorder characterized by the peripheral blood smear is:

Hereditary Spherocytosis—Peripheral blood smear. Splenomegaly is more common and prominent in hereditary spherocytosis than in any other form of hemolytic anemia. The splenic weight usually is between 500 and 1000 g. The enlargement results from marked congestion of the splenic cords and increases in the numbers of macrophages. Phagocytosed red cells are seen within macrophages lining the sinusoids and, in particular, within the cords. Robin’s Textbook of pathology 10th ed Page 442

3

Lungs

Kidney

Spleen

Liver

Pathology

null

f8000fa0-b8f6-47d3-9503-f2cd30e935f9

single

Boiled cabbage or rancid butter smelling urine is seen in

Tyrosinemia REF: Sapira's a & science of bedside diagnosis - Page 138, Textbook of Pediatric Emergency Medicine by Gary R. Fleisher, Stephen Ludwig Page 1566 Tyrosinaemia is an error of metabolism, inherited, in which the body cannot effectively break down the amino acid tyrosine, found in most animal and plant proteins. It is an autosomal recessive, which means two copies of an abnormal gene must be present in order for this to develop. There are three types of tyrosinemia, each with distinctive symptoms and caused by the deficiency of a different enzyme. One of the symptoms of Tyrodinaemia type 1 is an odor like cabbage or rancid butter.

2

Phenylketonuria

Tyrosinemia

Isovaleric Acidaemia

Multiple carboxylase deficiency

Biochemistry

null

6a48c652-ecd2-40d4-b57b-074bf293d393

single

All are side effects of clozapine expect:

Ref: KDT 8th ed Clozapine is an atypical antipsychotic drug. It does not block D2 receptors, therefore chances of extrapyramidal symptoms are least with this drug.

4

Granulocytopenia

Seizures

Sedation

Extrapyramidal side effects

Pharmacology

Central Nervous system

26a9c0a6-cf97-40dc-bac8-b30db91d1860

multi

All of the following are true about staing betablocker therapy in cases of CHF, Except

Answer is A (They should be initiated at the effective doses) Beta blocker should be initiated at lower than effective doses in CHF Beta blockers should be initiated at lower than effective doses in CHF and be 'Beta blockers should be initiated at low doses followed by gradual increments in the dose if lower doses have been well tolerated. The dose of beta blockers should be increased until the doses used are similar to those that have been repoed effective in clinical trials. The titration of beta blockers should proceed no more rapidly than at 2 week intervals because the initiation and / or increased dosing of these agents may lead to worsening fluid retention' -- Harrison's 17th/1450 Special precaution should be taken in NYHA class III & IV 'Although data suggests that patients with NYHA class IHB and IV CHF may tolerate beta blockers and benefit from their use, this group of patients should be approached with considerable caution' --Goodman & Gillman's Manual of Pharmacology (2007)/570 Carvedilol and Metoprolol are the preferred beta blockers in CHF `Non selective third generation beta blockers (Bucindolol, Carvedilol) as well a the Beta-I selective agent (Metoprolol) are generally well tolerated by patients with CHF'. -'Current Diagnosis & Treatment in Cardiology' 3,1/217

1

They should be initiated at the effective doses

They should be gradually increased over weeks

Special precautions should be taken in NYHA class III & IV

Carvedilol and Metoprolol are the preferred drugs

Medicine

null

c1d9a954-ed52-4723-973a-355d3be579ae

multi

A patient with a peptic ulcer was admitted to the hospital and a gastric biopsy was performed. The tissue was cultured on chocolate agar incubated in a microaerophilic environment at 37degC for 5 to 7 days. At 5 days of incubation, colonies appeared on the plate and were curved, Gram negative rods, oxidase positive. The most likely identity of this organism is

This organism is readily isolated from gastric biopsies but not from stomach contents. It is like Campylobacter species and grows on chocolate agar at 37degC in the same microaerophilic environment suitable for C. jejuni (Campy-Pak or anaerobic jar without the catalyst). H. pylori, however, grows more slowly than C. jejuni, requiring 5 to 7 days incubation. C. jejuni grows optimally at 42degC, not 37degC, as does H. pylori.

4

Campylobacter jejuni

Vibrio parahaemolyticus

Haemophilus influenzae

Helicobacter pylori

Microbiology

Systemic Bacteriology (Haemophilus, Yersinia, Spirochaetes, Ricketssia, Chlamydia, Mycoplasma and Miscellaneous Bacteria)

bbdd80b6-d9db-484a-b348-612f8131340e

single

In CML serum vitamin B12 level is:

Wintrobes hematology mentiins granulocytes contain and release B12 binding proteins.Markedly elevated transcobalamin 1 level are seen in chronic myelocytic leukemia and myeloid metaplasia whereas low levels are seen in chronic leucopenia and aplastic anemia. Williams hematology 8th adds that the increase is propoional to the total leucocyte count in untreated patients and falls with treatment.(ref Robbins 7th /697-698)

4

Slightly decreased

Normal

Markedly decreased

Increased

Anatomy

Haematology

0de12fbd-c9de-4106-b321-27db49459f1e

single

A 52-year-old businessman with nephrotic syndrome after a non-stop flight from New York to New Delhi presents with sudden onset of breathlessness, haemoptysis, and chest pain. He is brought into Casualty in shock. His chest X-ray is normal. The ECG shows sinus tachycardia.

1. In this patient no pulmonary edema, MI absent and aoic dissection also absent. 2. Nephrotic syndrome patient will be in hypercoagulable state, long flight- DVT- pulmonary embolism- acute Cor pulmonale 3. Most common causes of Cor pulmonale- pulmonary embolism 4. CXR is normal because it is only a small clot and clot usually not visible on X-ray

3

Pneumothorax

Myocardial infarction

Pulmonary embolism

Aoic dissection

Medicine

Thromboembolism and Fat Embolism Syndrome

b6967054-beb5-4661-a64d-40cb11cd2b4d

single

A farmer has an ulcer on leg with indurated margin and multiple sinuses with discharging granules. The likely diagnosis is -

Ans. is 'a' i.e., Mycetoma Mycetoma (Maduramycosis) . Is a localized chronic granulomatous involvement of the subcutaneous and deeper tissues, commonly affecting the foot and less often the hand and other pas. . Presenting as a subcutaneous swelling with multiple discharging sinuses. . Sinuses discharge seropurulent fluid containing granules. . These granules are microcolonies of the etiological agents. . A similar condition called botryomycosis is caused by staphylococcus aureus.

1

Mycetoma

Scrofuloderma

Lupus vulgaris

Actinomycosis

Microbiology

null

335dafcd-9a46-42c8-a359-e59cb1b94af7

single

Spaghetti and meatball appearance is seen in

In pityriasis versicolor while doing KOH mount shows a mixture of short , branched hyphae and spores described as spaghetti and meatballs appearance.

3

Dermatophytes

Aspergillus

Pityriasis versicolor

Candida

Dental

null

28f2d995-58df-4b65-8b72-5363141151c9

multi

Drug which is useful in neuronal diabetes inspidus in both children and adults given intra nasally -

Ans. is 'b' i.e., Desmopressin Desmopressin (intranasal) is the DOC for central DI.

2

Vasopressin

Desmopressin

Lypressin

Presselin

Pharmacology

null

f09ed125-f426-4aa4-9cd1-0ca304cf0787

multi

Magnan syndrome is seen in which poisoning-

Ans. is 'd' i.e., Cocaine

4

Morphine

Alcohol

Cannabis

Cocaine

Forensic Medicine

null

ea2f8f25-318b-49d3-9cfa-cf8e661a5eeb

single

The denominator in General feility rate

General feility rate (GFR) : Number of live bihs per 1000 women in the reproductive age group 15-49 years in a given year Denominator : Takes 'mid-year population' of 15-49 years age females into account Ref: Park 25th edition Pgno : 539

3

Live bihs

Mid year population

Reproductive women in the age group 15-45 mid year population

Married women in the age group 15-45

Social & Preventive Medicine

Non communicable diseases

81e75f78-2c14-4b8d-bcff-1f3d47cdc9ed

single