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Scissors gait is seen in
Scissor gait is a form of gait abnormality primarily associated with spastic cerebral palsy rigidity and excessive adduction of the leg in swing plantar flexion of the ankle flexion at the knee adduction and internal rotation at the hip progressive contractures of all spastic muscles complicated assisting movements of the upper limbs when walking
2
Poliomyelitis
Cerebral palsy
Hyperbilirubinemia
Hyponatremia
Surgery
Trauma
1825fbdb-260f-4277-894c-884957f106d3
single
Kaposi's sarcoma (KS) usually occurs when CD4+ lymphocyte counts are:
When CD4 count falls less than 200/L, the patient develops full-blown AIDS. This stage is characterized by the development of HIV wasting syndrome with weight loss and diarrhea for 1 month. The patients with AIDS show a marked susceptibility to the development of malignancies.  Human herpes virus-8–associated Kaposi’s sarcoma is the most noted malignancy associated with AIDS. ​Parija SC. Textbook of Microbiology & Immunology. Elsevier Health Sciences; 2014. Page:571
3
Above 600
Between 1000-2000
Below 200
Above 2000
Microbiology
null
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multi
Caudal regression syndrome is seen in
Gestational diabetes is associated with caudal regression syndrome.
2
Preeclampsia
Gestational diabetes
Sickle-Cell anemia
Systemic lupus erythematosus
Gynaecology & Obstetrics
null
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single
MCH located on -
(A) (Chromosome number 6) (136 Baveja 4lh) (106 D. Greenwood 18th)MAJOR HISTOCOMPATIBILITY COMPLEX (MHO* The MHC in human is known as human leucocyte antigen (HLA) complex.* The HLA complex of genes is located on short arm of chromosome 6.* They are arranged over a region of between 2000 and 4000 kilobases is size, containing sufficient DNA for more than 200 genes.HLA Complex (MHC complex)||||Class IClass 11Class III* Comprising A, B and C loci* 'D' region - DR, DQ, DPComplement region encodes* Responsible for* Responsible for* C2&C4# Graft rejection# Graft versus host response* Properdin factor B# Cell mediated cytolysis# Mixed leucocyte reaction* Heat shock protein* Found on the surface of all nucleated cells and platelets* Found only on cells of the immune system* TNF a and b* Enzyme 21 hydroxylaseIndications of HLA typing:* Tissue typing prior to transplantation.* Paternity determination.* Disease and HLA - associationHLA - B27 - Ankylosing spondylitis.HLA - DR4 - Rheumatoid arthritis
1
Chromosome number 6
Chromosome number 7
Chromosome number 8
Chromosome number 9
Microbiology
Immunology
78f93c5b-dc84-45c8-a709-80989ce38230
single
A lady comes with melanotic pigmentation of lip, presence of multiple polyps in the intestine, and a positive family history. What is the most probable diagnosis?
Peutz-Jeghers syndrome (PJS) is an autosomal dominant inherited disorder characterized by intestinal hamaomatous polyps in association with a distinct pattern of skin and mucosal macular melanin deposition. Gardner syndrome, a variant of familial adenomatous polyposis (FAP), is an autosomal dominant disease characterized by GI polyps, multiple osteomas, and skin and soft tissue tumors. Cutaneous findingsof Gardner syndrome include epidermoid cysts, desmoid tumors, and other benign tumors. Turcot syndrome is a rare autosomal recessive disorder that can present with brain tumors (glioblastoma multiforme, medulloblastoma) and colonic adenomas that frequently become malignant in those younger than 30 years. Hereditary nonpolyposis colorectal cancer (HNPCC) is an autosomal-dominant syndrome. It is divided into Lynch syndrome I (familial colon cancer) and Lynch syndrome II (HNPCC associated with other cancers of the gastrointestinal or reproductive system).
1
Peutz-Jegher's Syndrome
Gardner's syndrome
Turcot's syndrome
Lynch syndrome
Medicine
null
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In complicated cataract opacity develops in
Answer-C. Posterior subcapsularComplicated cataract refers to the lens opacification secondary to some other intraocular disease, Anterior uveitis is the most common cause.Posterior coical complicated cataract : - This type of cataract is due to affections of posterior segment. This cataract is located in a posterior subcapsular cataract and typically opacification stas in the posterior pa of the coex in the axial region.
3
Anterior capsule
Nucleus
Posterior subcapsular
Coical
Ophthalmology
null
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single
Which is a product of purine metabolism?
Uric acid is the common end product of purine catabolism. However, in non-primate mammals, Allantoin is the end product of purine catabolism as an extra enzyme, Uricase is present. OTHER OPTIONS: OPTION B: The end products of pyrimidine catabolism are NH3, CO2 & beta alanine (for Cytosine, Uracil) Option C - Xanthine is an intermediate of catabolism of purines. Xanthine gets conveed to uric acid by Xanthine Oxidase.
1
Uric acid
Urea
Xanthine
Beta alanine
Biochemistry
FMGE 2019
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Secondary Oocyte is :
Primary Oocyte – 2n. Secondary Oocyte – n and 2N. Spermatid – n and N.
2
n and N
n and 2N
2n and N
2n and 2N
Anatomy
null
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single
Biomedical waste(s) to be discarded in Yellow :
Ans. is 'a' i.e., Human anatomical waste; b i.e., Animal waste; 'c' i.e., Microbiological waste o Wastes discarded in yellow bag arc : (i) Category I (Human anatomical waste), (ii) Category 2 (Animal waste), (iii) Catagory 3 (Microbiology and Biotechnology waste), and (iv) Catagory 6 (Solid waste).
4
Human anatomical waste
Animal waste
Microbiological waste
All
Social & Preventive Medicine
null
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multi
Cervical cytology smear revealed CIN2- next step -
Ans- A Colposcopy guided biopsy
1
Colposcopy
Cryocautery
Hysterectomy
Laser ablation
Unknown
null
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multi
pH 7.24, PaO2 55 mm Hg, PaCO250 mm Hg, HCO3-30 mEq/L consistent with:
pH < 7.35 is acidosis ; pH >7.45 is alkalosisPrimary change in HCO3- is termed as metabolic (normal range: 22-30 meq/l)If there is acidosis and HCO3- decreased, the problem is a metabolic oneIf in acidosis HCO3- is increased or normal, the problem is compensatory metabolicPrimary change in CO2 is termed as respiratory (normal range: 35-45 mmHg)If in acidosis CO2 is raised, the problem is respiratoryIf in acidosis CO2 is decreased or normal, the problem is compensatory respiratorypH is low, HCO3- is high, Pa CO2 is high.Ref: Harrison's 18/e p363, 17/e p384, 2061
1
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
Medicine
All India exam
35d75098-0242-48cc-8a93-5f7f14ab4241
single
Tardy ulnar nerve palsy is due to _____:
Ans. A. Cubitus valgusTardy ulnar nerve palsy is due to cubitus valgus.Fracture of the lateral condyle of humerus in the long run can lead to complications such as cubitus valgus.Friction neuritis of the ulnar nerve as it moves over the medial epicondyle every time the elbow is flexed and extended may result in a late ulnar nerve palsy called as 'tardy ulnar nerve palsy'.
1
Cubitus valgus
Fixation of the nerve in the groove by osteoarthritis
Excision of elbow joint
Fracture of internal condyle
Orthopaedics
Injuries Around Arm & Elbow
2dbd8ee9-c3c1-48d7-b579-ab971f653b6a
single
All are chemokines except -
Histamines are most impoant vasoactive amines , formed by decarboxylation of histidine found in granules of mast cells, basophils & in platelets. Reff: Ananthanarayan & Panikers textbook of microbiology 9th edition pg: 164
3
IL-8
IL-1
Histamine
Eotaxin
Microbiology
Immunology
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Phacoemulsification is done with
Ans. b (Ultrasound) Ref: AK Khurana, 4th ed, p. 193In phacoemulsification nucleus is emulsified & aspirated by phacoemulsification. Phacoemulsifier acts through a titanium needle ( hollow 1 mm needle)It vibrates in its longitudinal axis at an ultrasonic speed of40000 times a second and thus emulsifies nucleusAdvantage: Very small corneoscleral incision (3.2-3.5 mm), hence sutureless surgeryNOTE:Various surgical techniques with length of corneoscleral incisionECCE- 7-8 mm (120deg)ICCE- 10-12 mm (180deg)Small incision cataract surgery (SICS) - 4-6 mmPhacoemulsification- 3.2-3.5 mm (30deg)
2
Laser
Ultrasound
Cryo
UV light
Ophthalmology
Lens
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On the 4th postoperative day of laparotomy a patient presents with bleeding & oozing from the wound. Management is :
Ans. is 'b' i.e. IV fluids
2
Dressing of wound & observe for dehiscence
IV fluids
Send for USG abdomen
Sta treatments for peritonitis
Surgery
null
224f073a-8ed8-472b-8d1e-f4e81f1f5ee2
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Mondor's disease is?
ANSWER: (D) Superficial thrombophlebitis of breastREF: Schwartz 9th ed chapter 17MQNDOR'S DISEASEMondor's disease is a variant of thrombophlebitis that involves the superficial veins of the anterior chest wall and breast. In 1939, Mondor described the condition as "string phlebitis ," a thrombosed vein presenting as a tender, cord-like structure. Frequently involved veins include the lateral thoracic vein, the thoracoepigastric vein, and, less commonly, the superficial epigastric vein. Typically, a woman presents with acute pain in the lateral aspect of the breast or the anterior chest wall. A tender, firm cord is found to follow the distribution of one of the major superficial veins. Rarely, the presentation is bilateral, and most women have no evidence of thrombophlebitis in other anatomic sites. This benign, self-limited disorder is not indicative of a cancer. When the diagnosis is uncertain, or when a mass is present near the tender cord, biopsy is indicated. Therapy for Mondor's disease includes the liberal use of anti-inflammatory medications and application of warm compresses along the symptomatic vein. Restriction of motion of the ipsilateral extremity and shoulder as well as brassiere support of the breast are important. The process usually resolves within 4 to 6 weeks. When symptoms persist or are refractory to therapy, excision of the involved vein segment is appropriate.
4
Congenital breast disease
Carcinoma breast
Radiation induced carcinoma breast
Superficial thrombophlebitis of breast
Surgery
Miscellaneous (Breast)
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single
Most commonly used material post pulpectomy is:
null
1
ZOE.
Gutta-percha.
META PEX.
All of the above.
Dental
null
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multi
All of the following measure the plaque index except:
null
2
Ramjford index
Moller's index
OHI-S index
Loe and Silness
Dental
null
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multi
In chronic alcoholism which of the following is seen-a) Delirium tremensb) Wernicke's syndromec) Korsakoff psychosisd) All of the above
Some guides have given, option `d' as the answer. But delirium tremens is not a chronic complication; it is a symptom of alcohol withdrawal. Wernicke's-Korsakoff's syndrome (Wernicke's encephalopathy and Korsakoff's psychosis) is a chronic complication of alcoholism.
2
a
bc
ac
ad
Forensic Medicine
null
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multi
Most radiosensitive tumor of the following is-
null
3
Supraglottic Ca
Ca glottis
Ca nasopharynx
Subglottic ca
ENT
null
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The parasympathetic supply to otic ganglion comes from: (Repeat)
Ans: C (9th cranial nerve) Ref: Gray Is Anatomy. 40th edition, pg. 495Explanation:Pharyngeal Arches and Their DerivativesArchnumberArch nameEmbryoniccartilageCartilage derivativeMuscleNerveArterylMandibularQuadrateMeckel's* Incus* Malleus* Anterior ligament of malleus* Spine of sphenoid* Sphenomnndibular ligament* Genial tubercle of mandible* Tensor tympani* Muscles of mastication* Mylohyoid* Anterior belly of digastric* Tensor veli palatiniTrigeminal (V) Mandibular division* First aortic arch artery 2HyoidReichert's* Stapes* Styloid process of temporal bone* Stylohyoid ligament* Lesser horn and upper part of body of hyoid bone* Stapedius* Stylohyoid* Facial muscles, including* Buccinator* Platysma* Posterior belly of digastricFacial (VII)* Stapedial artery 3Third * Greater hom and lower part of body of hyoid* StylopharyngeusGlossopharyngeal(IX)* Common carotid artery, first part of internal carotid artery4Fourth * Thyroid cartilage* Comiculate cartilage* Cunieform cartilage* Pharyngeal and extrinsic laryngeal muscles, levator veil palatiniVagus (X)Phary ngeal branch* Proximal part of subclavian artery on the right side* Arch of aorta between origins of left common carotid and left subclavian arteries6Sixth * Arytenoid cartilages* Intrinsic laryngeal musclesVagus (X) recurrent laryngeal branch* Part between the pulmonary trunk and dorsal aorta* Becomes ductus arteriosus on left, disappears on rightThis is a small, oval, flat reddish-grev ganglion situated just below the foramen ovale.It is a peripheral parasympathetic ganglion related topographically to the mandibular nerve, but connected functionally with the glossopharyngeal nerve. (See the following figure)
3
7th cranial nerve
8th cranial nerve
9th cranial nerve
3rd cranial nerve
Anatomy
Head & Neck
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single
All of the following drugs can precipitate acute attack of asthma except -
Ans. is 'c' i.e., Glucocoicoids Drugs precipitating asthma o NSAIDs Heparin Heparin Nitrofurantoin beta-blockers Opioids Disulfiram Organophosphates Phenylbutazone, Naproxen and Aspirin are NSAIDS.
3
Pheylbutazone
Naproxen
Glucocoicoids
Aspirin
Pharmacology
null
31433d81-0cc7-4225-b858-8aba31c1534b
multi
Best preventive measure againts tetanus neonatorum-
Active immunisation with tetanus toxoid to mother will protect both mother and child.2 doses should be given. Reference; Park&;s Textbook of preventive and social medicine, 24th edition.Pg no. 331
1
Active immunization of mother
Passive immunization of child
Active immunization of child
Passive immunization of mother
Social & Preventive Medicine
Communicable diseases
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A 5-year-old child is brought to the emergency room with massive, painless bleeding from the rectum. Colonoscopy fails to demonstrate a lesion in the colon or anus. Upper endoscopy fails to demonstrate esophagitis, gastric ulcer or duodenal ulcer. A 99mTc (technetium) scan demonstrates an abnormality in the lower half of the abdomen. Failure of a normal developmental process involving which of the following structures is the most likely cause of this child's bleeding?
A Meckel's diveiculum is caused by failure of obliteration of the vitello-intestinal duct. It is classically located in the distal ileum within 30 cm of the ileocecal valve, and the structure is a true diveiculum with mucosa, submucosa, and muscularis propria. Many Meckel's diveicula contain ectopic pancreatic tissue or gastric mucosa, and the acid production from the gastric mucosa may be sufficient to produce a small peptic ulcer in adjacent intestinal mucosa. Such small peptic ulcers are occasional sources of mysterious appendicitis-like pain or intestinal bleeding. Peptic ulceration adjacent to a Meckel's diveiculum should be suspected in any child who presents with massive, painless rectal bleeding. Technetium concentrates in gastric mucosa, and the scan in this patient demonstrated a small amount of ectopic gastric mucosa located in the diveiculum.Acute appendicitis is usually very painful and does not typically cause rectal bleeding. A lesion of the cecum would have been revealed by thorough colonoscopy. Failure of upper endoscopy to demonstrate a peptic ulcer of the duodenum makes duodenal disease unlikely.
4
Appendix
Cecum
Duodenum
Ileum
Anatomy
null
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single
The skeletal classification of malocclusion is given by
null
3
Calvin case
Martin Dewey
Paul Simon
E.H. Angle
Dental
null
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single
Single disease control strategy done by program known as
Health systems are made up of: * "Horizontal system" of general services, providing prevention and care for prevailing health problems. "Veical programmes" for specific health conditions .
2
Horizontal program
Veical program
Interventional program
Volunteer program
Social & Preventive Medicine
PH Care, Elements & Principles
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single
Epidermoid carcinoma of renal pelvis is usually associated with -
null
2
Multiple papilomas
Pelvic calculus
Tuberculosis of kidney
Filariasis
Surgery
null
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True about silent mutation in gene : (PGI Nov 2009)
Ans:B (No change in Amino acid sequence in protein) &D(No change in expression of protein) Silent MutationsThere may be no detectable effectQ because of the degeneracyQ of the code.This would be more likely if the changed base in the mRNA molecule were to be at the third nucleotide of a codon. Because of wobbleQ, the translation of a codon is least sensitive to a change at the third positionMissense MutationQ# A missense effect will occur when a different amino acid is incorporated' at the corresponding site in the protein molecule. This mistaken amino acid or missense, depending upon its location in the specific protein- might be acceptable, partially acceptable, or unacceptable degto the function of the protein molecule.Nonsense MutationQ In this a nonsense codon result in the prema ture termination of aminoacid incorporation into a peptide chain Si the production of only a fragment of intended protein molecule. The probability' is high that a prematurely terminated protein molecule or peptide fragment will not functionQ in its assigned role
2
No change in mRNA
No change in Amino acid sequence in protein
No expression of protein
No change in expression of protein
Microbiology
Immunology
c77892dc-e6ff-4032-b645-858c8ff9ba2c
multi
For a patient undergoing anticoagulant therapy, who requires unavoidable dental surgical treatment, the dental surgeon should:
null
4
Not take up the patient till the therapy is over
Bring down the dosage and proceed further
Adjust the dosage before and after dental visit
Consult the physician of the patient for joint decision
Surgery
null
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single
A patient with conjunctival infection, which led to corneal perforation, was positive for Gram-negative coccoid appearance on Gram stain. Fuher investigation showed small translucent colonies, which is oxidase positive. What could be the most probable causative organism?
Ans. b. Neisseria gonorrhea Gram negative coccoi with small translucent colonies, which is oxidase positive is Neisseria gonorrhea. Hyperacute Conjunctivitis of Adults or Gonococcal Conjunctivitis Disease affects adults, predominantly males Infection directly spreads from genitals to eye Markedly decreased incidence of gonococcal conjunctivitis Characteristic Features of Gonococci: Oxidase positive Small transluscent colonies Clinical Features: Moderate to severe pain with copious purulent discharge and marked swelling of eyelids Conjunctiva shows marked chemosis, congestion and papillae giving bright red velvety appearance Frequently, a pseudomembrane is seen on the conjunctival surface Preauricular lymph nodes are usually enlarged and tender Hyperacute Conjunctivitis of Adults or Gonococcal Conjunctivitis Associations: Gonococcal conjunctivitis is usually associated with urethritis and ahritis Complications: Corneal involvement is frequent as the gonococcus can invade the normal cornea through an intact epithelium. It may occur in the form of diffuse haze and edema, central necrosis, corneal ulceration or even perforation. Iridocyclitis Systemic complications (rare): Ahritis, endocarditis and septicemia
2
Moraxella catarrhalis
Neisseria gonorrhoea
Pseudomonas aeruginosa
Acinetobacter actinatus
Ophthalmology
null
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multi
Conditions predisposing to leukemia include all except -
null
3
Ionising radiation
Myelofibrosis
Infectious mononucleosis
Polycythemia vera
Pathology
null
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multi
Gene duplication plays an impoant role in the evolution of
Analysis of the human genome suggests novel genes created by retroposition may play an impoant role in primate evolution. However, data from non-human primates is still scarce. A comprehensive comparison was thus performed among four primate genomes (human, chimpanzee, orangutan, and macaque), which detects elevated rates of retroposition in both the common ancestor of hominoids and macaques. Fuher analysis shows approximately 10% of intact retrocopies may be under positive selection and at least 4% of retrocopies become functional copies eventually. Moreover, human intact retrocopies were found enriched in transcription-related functions. Collectively, these findings emphasize the impoant contribution of retroposition to primate genome evolution
1
mRNA
rRNA
tRNA
hnRNA
Biochemistry
Metabolism of nucleic acids
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single
Which does not cause malignant hypehermia
Malignant hypehermia (MH) is a rare (1:15,000 in pediatric patients and 1:40,000 in adult patients) genetic hypermetabolic muscle disease, the characteristic phenotypical signs and symptoms of which most commonly appear with exposure to inhaled general anesthetics or succinylcholine (triggering agents). MH may occasionally present more than an hour after emergence from an anesthetic, and rarely may occur without exposure to known triggering agents. Most cases have been repoed in young males; almost none have been repoed in infants, and few have been repoed in the elderly. Neveheless, all ages and both sexes may be affected. The incidence of MH varies significantly from country to country and even among different geographic localities within the same country, reflecting varying gene pools. The upper Midwest appears to have the greatest incidence of MH in the United States. Anesthetic drugs that trigger MH include ether, halothane, enflurane, isoflurane, desflurane, sevoflurane, and depolarizing muscle relaxants, succinylcholine being the only anesthetic drug currently used. Desflurane and sevoflurane appear to be less potent triggers than halothane and produce a more gradual onset of MH. The onset may be explosive if succinylcholine is used. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e
3
Isoflurane
Desflurane
N2O
Enflurane
Anaesthesia
Complications of anaesthesia
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single
The stomach wash for phenol poisoning is done with?
Ans. a (10% glycerin). (Ref. Parikh, FMT, 5th/pg.l68)PHENOL OR CARBOLIC ACID POISONING# Corrosive poison# Hardening of the tissues occurs with it.# Thorough gastric lavage with 10% glycerine in water + MgS04 till phenolic odour emited.# Then, about 2 ounces of liquid may be left in stomach.
1
10% glycerin
KMnO4
Alkaline water solution
Saline water
Forensic Medicine
Toxicology
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single
Treatment of orthostatic hypotension is
null
3
Dopamine
Diuretics
Fludrocortisone
Calcium channel blockers
Medicine
null
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single
A 3-year-old male child is brought by his father with complaint of recurrent infections despite proper treatment and hygiene. While reviewing his history, pediatrician notices that the child has been infected multiple times with S. aureus, Pseudomonas & E. coli. Which of the following test will be useful to diagnose condition of the child?
Given scenario suggests diagnosis of Chronic granulomatous disease. Chronic granulomatous disease. Due to NADPH oxidase defect Subtypes: X linked recessive Autosomal recessive Gp 91 PHOX defect Gp 47 PHOX defect Gp 67 PHOX defect C/F: Recurrent infections: by catalase positive organism.Eg- S. aureus, Pseudomonas, Nocardia Granuloma formation Diagnosis: Nitroblue-tetrazolium test- No O2 radicals - No formazan - No colour Flow cytometry: Done using Dihydro Rhodamine (DHR)
1
Negative nitroblue-tetrazolium test
Positive nitroblue-tetrazolium test
Increased IgM, Decreased IgG, IgA, and IgE
Increased IgE and IgA, Decreased IgM
Microbiology
Immunology Pa 1 (Immune Response, Antigen-Antibody Reactions, Hypersensitivity, Structure of Immune System, Immunodeficiency Disorders)
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single
False about informed consent: AIIMS 07; AFMC 12
Ans. Alternate procedures/treatment to be concealed from the patients
1
Alternate procedures/treatment to be concealed from the patients
Patient must be told about the risks
Patient must be explained about the whole procedure
Patient must be explained in the language he understands
Forensic Medicine
null
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multi
Which number blade is useful for Crevicular incision :
Crevicular incision is also known as Second incision for which 12 number blade is used.
3
10
11
12
15
Dental
null
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single
Solitary erythematous oval lesion with central clearing giving target appearance is seen with?
Erythema migrans secondary to Lyme disease is an erythematous oval lesion with central clearing. The classic "bull's-eye" occurs in this. Erythema migrans is the term applied to skin lesions of Lyme borreliosis. Caused by Borrelia burgdorferi Transmitted by bites from Ixodes ticks. The primary lesion of erythema migrans at the site of a tick bite is usually solitary and usually macular . The lesion expands slowly with central clearing. Erythema Multiforme: Target lesion seen on distal extremeties. typically involves the extremities, palms, and soles .. multiple lesions
1
Erythema migrans
Erythema annulare
Erythema multiformie
All of the above
Dental
Bacterial infections
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multi
Histiocytosis X is seen in except -
Ans. is 'd' i.e., Torres syndrome Langerhans cell histiocytosis (Histiocvtosis X) C.) Histocytosis X is characterized by proliferation of Langerhans histiocytes (tissue macrophages). o It is subdivided into three categories : - i) Letterer - Siwe syndrome ii) Hand -Schuller-Christian disease iii)Eosinophilic granuloma. o Tumor cells in each are derived from dendritic cells and express S-100, CD1 a and HLA-DR. o The presence of Birbeck granules in the cytoplasm is characteristic. o Under the electron microscope, Birbeck granules have a pentalaminar, rodlike, tubular apperance and sometimes a dilated terminal end (tennis - racket appearance).
4
Hand schuller Christian disease
Eosinophilic granuloma
Letter-siwe syndrome
Torres syndrome
Pediatrics
null
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multi
Not true about Eltor vibrio 01-
null
1
Animals are the only reservoir
Epidemiologically indistinguisible from V. cholera O-139
Human acts as vehicle for spread
The efficacy of vaccine against Eltor vibrio is great
Microbiology
null
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multi
A 40-year-old woman admitted with fever, chills, and changing mental status is transferred to the ICU with a clinical suspicion of sepsis. Examination shows sinus tachycardia, no murmur, and clear lung fields. The patient is given IV fluids aggressively for hydration. Blood cultures are drawn and the patient is placed on antibiotics. Subcutaneous heparin is given for thromboembolic prophylaxis. As the patient does not improve satisfactorily, a procedure is performed. One hour after this procedure, the patient suddenly develops moderate hemoptysis. A CXR is done.The next step should be
This chest x-ray shows a pulmonary aery catheter inseed through the internal jugular vein. The PA catheter extends peripherally beyond the right ventricular shadow and past the main pulmonary aery branches into the subsegmental vessels. The patient presents with sepsis and septic shock. It is impoant to determine the fluid status of the patient, especially if no improvement is noted with initial fluid challenge. The procedure performed was a placement of a pulmonary aery catheter to determine the capillary wedge pressure. The PA catheter in this case extended peripherally into the small vessels and thereby caused pulmonary infarction. The hemoptysis represents that complication, and withdrawal of the catheter is of utmost priority. Other options outlined are inappropriate or inapplicable.
4
Perform an urgent echocardiogram
Administer protamine sulfate
Sta inotropic agents
Withdraw the catheter
Radiology
Fundamentals in Radiology
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"Colon Carcinogenesis" is associated with all except:
Mismatch repair
4
APC
k RAS
B-catenin
Mismatch repair
Pathology
null
67ff8877-4273-443f-ad82-44dff0061dc0
multi
Which defect in RBC is shown below ?
Ans. (c) Heinz bodiesImage source - style="font-family: Times New Roman, Times, serif">
3
Cabot ring
Basophilic stippling
Heinz bodies
Toxic granules
Unknown
null
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single
Malrotation presents with which of the following features: 1. Mass abdomen 2. Bleeding PR 3. Bilious vomiting 4. Hematemesis
"Bilious vomiting is the first sign of the volvulus, and all infants with bilious vomiting must be evaluated rapidly to ensure that they do not have intestinal malrotation with volvulus. If left untreated, vascular compromise of the midgut initially causes bloody stools, but eventually results in circulatory collapse" Ref: Schwaz 9/e, Page 1428.
2
1 & 2
2 & 3
1 & 3
3 & 4
Surgery
null
37f89b56-ed0e-419b-858e-b215841497a0
single
Closure of Neural tube begins at which of the following level?
Fusion of neural folds begins in middle and gradually extend in cranial and caudal directions REFERENCE: TEXTBOOK OF CLINICAL EMBRYOLOGY... VISHRAM SINGH SECOND EDITION..PAGE NO:52
2
Cervical region
Thoracic region
Cephalic end
Caudal end
Anatomy
General anatomy
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single
A 45-year-old male has multiple grouped vesicular lesions present on the T10 segment dermatome associated with pain The most likely diagnosis is -
Ans. is 'a' i.e., herpes zoster * Here is a D/d of commonly asked vesico bullous disorders* So the crux is -Painful lesions are seen in Herpes infection.Painless lesions are seen in-Dermatitis herpetiformis Pemphigoid Pemphigus Erythema multiformeDermatomal involvement-Herpes zosterItchy lesions-Dermatitis herpetiformisIntraepidermal-Herpes and pemphigusSubepidermal-Dermatitis herpetiformis Pemphigoid Erythema multiforme
1
Herpes zoster
Dermatitis herpetiformis
Herpes simplex
Scabies
Unknown
null
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single
Concentration of sodium in RL is
Sodium concentrations in various crystalloids and colloid Hamann's (RL) 130mmol/L Normal saline (0.9% NaCl) 154mmol/L Dextrose saline (4% dextrose in 0.18 saline) 30mmol/L Gelofusine 150mmol/L Hemacel 145 mmol/L Hetastarch - Lactated potassium saline injection (Darrow's solution) 121mmol/L Ref: Bailey and love 27th edition Pgno :281
3
154
120
130
144
Surgery
General surgery
22f45302-4183-4557-ad02-7d3086c0f56b
single
MC cause of aboion in first trimester is, defect in:
Ans. is c i.e. Embryo As explained earlier most common cause of aboion in first trimester are chromosomal abnormalities involving the zygote or embryo
3
Placenta
Uterus
Embryo
Ovarian
Gynaecology & Obstetrics
null
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single
All are true regarding pes planus except:
PES PLANUS (FLAT FOOT) Flat foot refers to obliterated medial longitudinal arch Heel is often in valgus called as planovalgus Pes Planus is of 2 types: (Differentiated by Jack's test) Flexible: Disappears on non-weight bearing. Management is conservative Rigid: Due to congenital veical talus or RA or infection or tarsal coalition or tibialis posterior dysfunction. They often require surgical intervention Tarsal Coalition is autosomal dominant fusion of tarsal bones (talocalcaneal, calcaneonavicular and talonavicular)
4
There is collapse of medial longitudinal arch
The heel becomes valgus and foot pronates at the subtalar-mid complex joint
Jack's test differentiates between flexible and rigid deformity
One of the common type of tarsal coalition is calcaneonavicular & it is autosomal recessive
Orthopaedics
Neuromuscular disorders
b97145e8-ab1b-4a7e-bb4f-121e99e8e8cd
multi
The following statements are true about Tumour Suppressor Gene p53 except -
Ans. is 'c' i.e., Its activity in the cells decreases following UV irradiation and stimulates cell cycle
3
It regulates cetain genes involved in cell cycle regulation
Its increased levels can induce apoptosis
Its activity in the cells decreases following UV irradiation and stimulates cell cycle
Mutations of the p53 gene are the most common genetic alteration seen in human cancer
Pathology
null
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multi
These nail changes are seen in
Fingernail involvement in psoriasis appears as punctate pitting, onycholysis, nail thickening, or subungual hyperkeratosis The nail matrix will have pitting, which appears as punctate depressions that are small, shallow, and various shapes and sizes. Characteristically, they are isolated and deep, though they may occur as regular lines or grid-like pattern. The nail is dull, rough, and fragile The nail bed may have "oil" spots, which are oval, salmon-coloured nail beds, and there may be onycholysis secondary to "oil" spots affecting hyponychium medially or laterally. Secondary infections may occur. The nail plate may become raised off the hyponychium (subungual hyperkeratosis). The most frequent signs of nail matrix disease are pitting, leukonychia, crumbling, and red spots in the lunula, whereas salmon patches or oil spots, subungual hyperkeratosis, onycholysis, and splinter hemorrhages represent changes of nail bed psoriasis Ref: Harrison 19e pg: 347; Fitzpatrick dermatology
2
Lichen planus
Psoriasis
Darier disease
Onychomycosis
Dental
Papulosquamous disorders
12c866c8-22e0-40d7-af76-4ceec267c3f2
single
Neuropraxia is a condition characterized by
Ans. (d) Physiological blockRef Apley's 8th/ 231Patterns of nerve injuryNeuropraxiaAxonotmesisNeurotmesis* Reversible physiological nerve conduction block* It is seen in crutch palsy tourniquet palsy, and Saturday night palsy.* There is loss of conduction because of axonal interruption but the nerve is in continuity and the neural tubes are intact* Seen in closed fractures and dislocations* There is complete division of nerve with complete loss of conduction (i.e. epineurium, perineurium, endoneurium, & axon all have lost their continuity)* Seen in open wounds
4
Division of nerve sheath
Division of axons
Division of nerve fibres
Physiological block
Orthopaedics
Nervous System
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single
Sinusoids are seen in all of the following except
Sinusoids are found in the liver, lymphoid tissue, endocrine organs, and hematoploietic organs such as the bone marrow and the spleen. Sinusoids found within terminal villi of the placenta are not comparable to these because they possess a continuous endothelium and complete basal lamina.
2
Liver
Kidney
Lymph nodes
Spleen
Anatomy
Abdomen and pelvis
3d164993-aeee-4bb8-9202-daf820ef2ea2
multi
Acid base based polyacrylic cements have most important property of
null
1
Bio adhesion
Reparative dentin formation
Bond strength
Severe irritant to pulp
Dental
null
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single
A 55-year-old male presents with features of obstructive jaundice. He also reports a weight loss of seven kilograms in last two months. On CT scan, the CBD is dilated till the lower end and the main pancreatic duct is also dilated. Pancreas is normal. The most likely diagnosis is:
Ans. (d) Periampullary carcinoma* Periampullary cancer presents with dilatation of both Pancreatic and Bile ducts.* Of the sites of cancer in Pancreas - Periampullary cancer has better prognosis than Head of pancreas cancer because of early presentation.
4
Choledocholithiasis
Carcinoma gallbladder
Hilar cholangiocarcinoma
Periampullary carcinoma
Surgery
Pancreas
9351841b-34f7-4b57-bc91-41dbc30158ab
multi
Which type of cells are not found in stomach:
Goblet cells
4
Chief cells
Parietal cells
Argentaffin cells
Goblet cells
Anatomy
null
ee18b44d-017e-4a94-a69d-be65d46b87ea
single
Sorghum is pellagrogenic due to excess content of
Jowar (sorghum) Jowar is also known as kaffir corn or Milo. It is a major crop grown in India next only to wheat and rice. For several population groups, it is a staple diet. The protein content of jowar varies from 9 to 14 per cent, and the proteins are limiting in lysine and threonine. Ceain varieties of jowar have a high leucine content and consumption of these varieties is associated with pellagra. This disorder is often seen in the Telengana and Marathwada regions where jowar is predominantly consumed. Ref:Park's Textbook of Preventive and Social Medicine 23th Ed Pgno: 628
3
Lysine
Threonine
Leucine
Tryptophan
Social & Preventive Medicine
Nutrition and health
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single
In infants, the cause of blindness arising out of oxygen toxicity is -
Ans. is 'b' i.e., Growth of blood vessels into vitreous followed by fibrosis
2
Degeneration of crystalline lens
Growth of blood vessels into vitreous followed by fibrosis
Damage to cornea
Enzymic defect in lens
Pediatrics
null
939bac28-0796-4854-b4e4-e6288fd461d7
multi
Papilloedema is characterised by all of the following, EXCEPT:
C i.e. Sudden painless loss of vision In papilloedema there is painless gradually progressive loss of vision which is usually bilateralQ which occurs after a long time only when optic atrophy sets in. "Visual acuity is not affected by Papilloedema unless it is severe, long standing, or accompanied by macular edema & haemorrhage"-Harrison's P 169 In contrast, in papillitis there is U/L sudden & marked painful loss of vision with ocular tenderness at inseion of MR & SRQ (medial & superior rectus), which is accompanied by pain on ocular movements, pulfrich phenomenon & RAPD Q. Papilloedema It is hydrostatic noninflammatory oedema of optic disc or nerve head d/t raised intracranial pressure. Aetiology Pathogenesis Clinical Features * Raised ICT, which may be due * Old concept? * General features of raised ICT ? to compression of central headache, nausea, projectile 1. Congenital condition - retinal veinQ as it vomiting, diplopia & focal aqueductal stenosis, crosses the subdural & neurological deficit craniosynostosis subarachnoid spaces, * Ocular features 2. Intracranial Space Occupying while thicker wall Lit Painless progressive loss of lesions (ICSOLS) - eg brain aery continue to visionQ with the following tumor, gumma, hematoma, transmit blood sequence of symptoms: aneurysm, infection * New Hayreh's theory - Ther are no visual symptoms & - Papilloedema is most frequent - Papilloedema develops acuity is normal in Early with tumors arising in posterior as a result of stasis of papilloedema fossa (cerebellum, mid brain, axoplasm in - Reccurent attacks of transient parieto occipital region)Q which prelaminar regioinQ of black out of vision (amaurosis obstruct aqueduct of sylvius and optic disc due to an fugax)Q precipitated by change in least with pituitary tumors alteration in the posture - Papilloedema due to tumors of pressure gradient - Enlargement of blind spot & anterior fossa is relatively rare and across lamina cribrosa progressive contraction of visual occurs late in the course of - Raised ICT & orbital fieldQ disease lesion produce - Relative scotoma first to green & - ICSOLS in any position (even disturbance in red spinal cord) excepting medulla pressure gradient by - Visual acuity & pupillary oblongataQ may induce increasing tissue reaction remain normal until papilloedema pressure with in the optic atrophy sets inQ which may 3. Intracranial infections retrolaminar region lead to severe lossof central (meningitis, encephaliltis), while ocular hypotony vision intracranial haemorrhages, alters it by lowering - As optic atrophy sets in complete obstruction of CSF absorption the tissue pressure blindness ensues & pupils arachnoid villi with in prelaminar become large & immobile. 4. Systemic conditions eg. malignant hyper tensionQ, toxaemia of pregnancyQ, area Mnemonic- "Blurring Has Reduced * Fundoscopic features Physiological Pulse So 26 Elevated cardiopulmonary insufficiency, blood dyscarasis & nephritis Fans Must Flame the Cotton" 5. Pseudotumor cerebriQ usually due to drugs like Tetracycline, Blurring Blurring of margins of optic discQ vitamin A, Nalidixic acid, Has Hyperaemia of disc Contraceptive (oral) & Reduced - Reduced Physiological cupQ CoicoSteroid Physiological - Pulsation (venous) may be absent() (Memonic - " TANCS") Pulse So Striated appearance d/t prominent small aerioles * Ocular hypotony & 2-6 - 2-6 DQ difference for focusing vessels on disc on Foster Kennedy SyndromeQ retina d/t elevation of disc F.K. Syndrome is associated Elevated Elevated discQ (mushroom or dome shaped)Q with olfactory or sphenoidal Fans Must Macular FanQ - an incomplete star with temporal meningiomata & frontal lobe pa missing tumor. These compress optic Flame - Flame shaped & Punctate haemorrhage() nerve on same side 1/t The pressure optic atrophy C/L papilloedemaQ (d/t raised ICT) Cotton - Cotton wool spotsQ
3
Loss of retinal venous pulsations
Transient obscurations of vision
Sudden painless loss of vision
Disc oedema
Ophthalmology
null
20fbf251-0343-4a4f-ac7e-e7d8b00bd382
multi
In the diagram below A-D represent depolarization of ventricles. Which one represents "R" wave?
Ans. C. (C).a. P waveThe P wave is a small deflection wave that represents atrial depolarization.b. PR intervalThe PR interval is the time between the first deflection of the P wave and the first deflection of the QRS complex.c. QRS wave complexThe three waves of the QRS complex represent ventricular depolarization. For the inexperienced, one of the most confusing aspects of ECG reading is the labeling of these waves. The rule is: if the wave immediately after the P wave is an upward deflection, it is an R wave; if it is a downward deflection, it is a Q wave:i. small Q waves correspond to depolarization of the interventricular septum. Q waves can also relate to breathing and are generally small and thin. They can also signal an old myocardial infarction (in which case they are big and wide)ii. the R wave reflects depolarization of the main mass of the ventricles -hence it is the largest waveiii. the S wave signifies the final depolarization of the ventricles, at the base of the heartd. ST segmentThe ST segment, which is also known as the ST interval, is the time between the end of the QRS complex and the start of the T wave. It reflects the period of zero potential between ventricular depolarization and repolarization.e. T waveT waves represent ventricular repolarization (atrial repolarization is obscured by the large QRS complex).
3
A
B
C
D
Physiology
Heart, Circulation, and Blood
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single
Fully embryonated egg of trichuris trichiura contains
null
3
Eight blastomeres
Unsegmented ova
Rhabditiform larva
Ciliated embryo
Microbiology
null
89299fcd-bf42-4bb8-b20b-0cdc577bc801
single
During post transcriptional modification of RNA the following process does not take place:
Ans. D. GlycosylationRNA produced after transcription is hn RNA. To form m RNA it undergoes modifications to remove intervening sequence called introns by splicing. For this 5'capping and 3'tailing is done to stabilize RNA.
4
Splicing
5'capping
3'polyadenylation
Glycosylation
Biochemistry
Molecular Genetics
8ef60370-a6c1-4264-b837-ade67b118a64
single
A 65-year-old smoker presents with hoarseness, hemoptysis and a hard painless lump in the left supraclavicular fossa. Which of the following is the most appropriate diagnostic step -
Ans. is 'a' i.e., Undeake an open biopsy of the neck lump
1
Undeake an open biopsy of the neck lump
Undeake a radical neck dissection
Do fine needle aspiration cytology
Give a trial of Anti tuberculous therapy
Surgery
null
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multi
Chlorhexidine on tooth causes
null
2
No stain
Brownish yellow stains
Greenish yellow stain
Blue back stain
Dental
null
2dcfdf00-22ae-4888-a360-c446cae20eb4
single
Pseudohyponatremia is found in all of the following EXCEPT:
Hyponatremia is defined as a plasma level less than 135 meq/L. Most often it reflects excess water, rather than less of Na+, in the plasma. Hence, plasma becomes hypo-osmolar in most instances. Hyponatremia with a normal plasma osmolality is the so-called "pseudohyponatremia". It occurs when plasma lipids or proteins are greatly elevated (options A & B). The proteins or lipids do not increase plasma osmolality significantly. However, they occupy a significant volume of the plasma; and hence the measured in the entire plasma is low. Hyponatremia with normal body Na+ content is seen in hypothyroidism (option D), coisol deficiency, and SIADH. Hyponatremia with increased total body Na+ is seen in edematous states, such as congestive hea failure, cirrhosis of liver, and nephrotic syndrome. Hyponatremia with increased plasma osmolality is seen in hyperglycemia associated with uncontrolled DM. In such a condition, the high plasma glucose causes water to move by osmosis, from cells into plasma. The excess water in ECF leads to hyponatremia.
3
Severe hyperlipemia
Extreme hyperproteinemia
Aldosterone excess
Hypothyroidism
Physiology
Endocrine System
340b0221-5590-495d-9d96-49e1f9f38659
multi
Polio virus infection can result in all, except -
null
4
Anterior horn cell damage
Autonomic involvement
Respiratory involvement
Paralysis in > 70% of cases
Medicine
null
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multi
Urea cycle is linked to TCA cycle by -
Ans. is 'd' i.e., Fumarate |Ref: Harper 29th/e p. 276-277]o Fumarate is released during urea cycle, which is an intermediate of Kreb's cycle, thus linking the two.Both urea cycle and TCA cycle have been explained in previous years.
4
Arginine
Ornithine
Oxaloacetate
Fumarate
Biochemistry
Urea Cycle and Disorders
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single
Both antibody-dependent and independent complement pathway converge on which complement component?
Complement is a collective term that describes a system of about 20 proteins, many of which are enzyme precursors. All these are present normally among the plasma proteins in the blood as well as among the proteins that leak out of the capillaries into the tissues. They are usually inactive i.e. enzyme precursors They are activated by two pathways i. Classic pathway ii. Alternate pathway Classic pathway - The classical pathway is initiated by an antigen-antibody reaction. Alternative pathway Alternative pathway complement activation does not require the interaction of complement with an antigen /antibody complex. Rather a bacterial lipopolysaccharide (LPS, endotoxin) and other general bacterial substances (also immunoglobulin A aggregates) can activate complement. In both the classical and alternative pathways a key outcome is the conversion of the C3 component of complement into C3a and C3b proteins. Both the pathways follow different course only up to the activation of C3. Activation or splicing of the C3 is the convergence point of both the pathways, after which both the pathways follow the same course.
2
C5
C3
Clq
C8
Pathology
null
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multi
Weight gain in pregnancy depends on all except?
FACTORS INFLUENCING WEIGHT GAIN IN PREGNANCY Maternal age - Increased weight gain in younger women Physical activity - Several studies have demonstrated an inverse relation between weight gain and level of physical activity Prepregnancy weight - Weight gain in pregnancy is generally inversely propoional to BMI (Body Mass Index) in the pre pregnancy period Race / ethnicity - The mean weight gain differs in various ethnic / racial groups Parity - Lower weight gain was noted in multipara Hormonal milieu - Levels of hormones like insulin and leptin can influence weight gain in pregnancy Multiple pregnancy - Tend to gain more weight in multiple pregnancy Hyperemesis gravidarum - Lower weight gain in women with hyperemesis gravidarum Anorexia nervosa - Lower weight gain and lower bih weight in anorexic women Substance abuse - Studies have found no significant difference in mean weight gain between smoking and non smoking women. But the bih weight was lower in babies born to women who were smokers. Family violence - Greater risk of inadequate weight gain Marital status - Many studies have found that married women were more likely to gain weight than single / divorced women Ref : Dutta book of obstetrics 8th Ed
1
Smoking
Pre pregnancy weight
Ethnicity
Maternal age
Gynaecology & Obstetrics
All India exam
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multi
True about combination therapy with anakinra and infliximab in rheumatoid arthritis patients is:
Ans. A. Combination should be avoidedRef: Harrison's Principles of Internal Medicine 19th/ed, p2147Explanation# Option a: Anakinra (IL 1 antagonist) and infliximab (anti-TNF) should not be combined.# Both agents restrict inflammatory process markedly and lead to high rate of serious infections.# This finding is observed in trials that used this regimen.# New strategy in treatment of RA focuses on several goals:1. Early, aggressive therapy to prevent joint damage and disability.2. Frequent modification of therapy and use of combination therapy where appropriate.3. Individualization of therapy, to maximize response and minimize side effects;4. Achieving, remission of clinical disease activity.# Preferred first line drug as monotherapy in moderate to severe RA: Methotrexate# Effective combinations include:# Methotrexate, sulfasalazine, and hydroxychloroquine (oral triple therapy);# Methotrexate and leflunomide;# Methotrexate plus a biological (e.g. methotrexate and infliximab an anti-TNF agent; methotrexate + Etanercept is equivalent to oral triple therapy options b and d)# Early RA (<6 months of disease duration)# Started with methotrexate - switch or add DMARD therapy after 3 months of worsening or persistent moderate/high disease activity - If disease still persists after 3 months of intense DMARD therapy, add a biologic agent.# Oral triple therapy (hydroxychloroquine, methotrexate, and sulfasalazine) is a reasonable first step for the treatment of early RA, including its use as a step-up strategy where treatment is initiated with methotrexate alone and then combined at 6 months with hydroxychloroquine and sulfasalazine if the disease is not adequately controlled.# Patients with established RA.# Treatment with a biologic agent or aggressive combination DMARD therapy was also recommended as initial therapy in certain patients with high disease activity and poor prognosis.
1
Combination should be avoided
Combination is superior to methotrexate plus etanercept
Combination is superior to methotrexate alone
Combination is equally effective as oral triple therapy
Pharmacology
Immunomodulator
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multi
T helper cells recognises -
CD4+ T cells have TCRs with an affinity for Class II MHC Ref: Ananthanarayanan & Panikers textbook of microbiology 9th edition pg: 135
2
MHC class I
MHC class II
Processed peptides
Surface Ig
Microbiology
Immunology
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single
Which of the following is not a contraindication for use of digitalis:
null
4
Acute rheumatic carditis
Thyrotoxicosis
WPW syndrome
Hyperkalemia
Pharmacology
null
35680715-3d6a-4682-8087-92b19324e409
single
Aldose reductase inhibitor drugs are useful in
Ans. is 'b' i.e., Diabetes mellitus Aldose reductase catalyzes the NADPH-dependent conversion of glucose to sorbitol, the first step in polyol pathway of glucose metabolism. Aldose reductase inhibitors are a class of drugs being studied as a way to prevent eye and nerve damage in people with diabetes mellitus. Examples of aldose reductase inhibitors include: Tolrestat (withdrawn from market) Apalrestat Ranirestat Fidarestat
2
Cataract
Diabetes mellitus
Hereditary fructose intolerance
Essential fructosuria
Medicine
null
e4958250-5d35-4cae-8d1e-af35dec6617d
single
Abortion stick used in criminal abortion causes abortion by the mechanism of
Ans. is 'a' i.e. Uterine contraction Abortion stick is a thin wooden or bamboo stick about 15 to 20 cm long, or a twig of similar length from some irritant plant as mentioned below.When the stick is used it is equipped at one end with cotton wool or a piece of cloth soaked in an irritant substance as mentioned below.The abortion stick or the twig is introduced in the os of the uterus and retained there till uterine contractions begin.Irritant substances used to soak the abortion stickmarking nut juicecalotropis (madar)jequirityasafoetidapaste made from white arsenic, red lead etc.Irritant plants twig used for abortionmadar (Calotropis)chitra (Plumbago zeylandica)lal chitra (Plumbago rosea)kaner (Nerium odorum)
1
Uterine contraction
Stimulation of uterine nerves
Uterine infection & necrosis
Placental separation
Forensic Medicine
Misc.
d7870fb8-928a-40e1-943a-cbdc834832d5
single
Which of the following post is most difficult to bond in the root canal:
It is because zirconia cannot be etched.
1
Zirconia ceramic post.
Carbon fiber reinforced post.
Polyethylene fiber reinforced post.
Glass fiber reinforced post.
Dental
null
218b8351-aaf9-437d-8eec-e0843c3c0436
single
An 80 year old asymptomatic woman on a routine examination was detected to have a monoclonal spike on serum electrophoresis (IgG levels 1.5 g/dl). Bone marrow revealed plasma cells of 8%. Which of the following represents the most likely diagnosis?
Patient is showing features of monoclonal gammopathy of unknown significance. It refers to a clinical condition, defined by the presence of monoclonal immunoglobulin production without evidence of myeloma, waldenstorms macroglobulinemia or other lymphoproliferative disorder. It is an incidental finding detected by elevated total protein concentration. Serum protein electrophoresis shows a monoclonal spike. In MGUS, IgG is seen in 75% cases, IgM in 15% and IgA in 10%. Plasma cells in the bone marrow and smear appear mature ( Ref: Harrisons Principles of Internal Medicine, 18th Edition, Chapter 111 ; Hematopathology: Morphology, Immunophenotype, Cytogenetics and Molecular By Faramarz Naeim, Page 386 ; Cancer and The Kidney: The Frontier of Nephrology and Oncology By Eric P. Cohen, 2nd Edition, Page 102
3
Multiple myeloma
Indolent myeloma
Monoclonal gammopathy of unknown significance
Waldenstorm's macroglobulinemia
Medicine
null
44326465-758f-48ec-aca1-5d98db6514ef
single
Patient with cirrhosis is positive HBs Ag+ and has increased levels of alpha feto protein. What is the most probable diagnosis ?
Ans. is `b' i.e., Hepatocellular carcinoma Cirrhosis, hepatitis B positive and alpha fetoprotein strongly suggests hepatocellular carcinoma.
2
Submassive hepatic necrosis
Hepatocellular carcinoma
Massive hepatic necrosis
None of the above
Pathology
null
9c69bdc9-6721-4a42-9a9a-c642144cb021
multi
Opioid induced constipation is treated by
Alvimopan, Naloxegal & Methyl naltrexone are peripherally acting opioid antagonists used to treat opioid induced constipation & paralytic ileus.
3
Loperamide
Biperiden
Alvimopan
Naltrexone
Pharmacology
null
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single
The schedule of HDCV in rabies is-
Ans- A 0,3, 7,14, 28 Ref- Vaccine Post-exposure prophylaxis depends on the type of contact with the confirmed or suspect rabid animal, as follows: 1. Wound treatment Thorough washing of the wound with soap/detergent and water, followed by the application of ethanol or an aqueous solution of iodine or povidone. 2. Passive immunization Human rabies immunoglobulin (HRIG) or equine rabies immunoglobulin (ERIG) or F(ab')2 products should be used for category III exposures as well as for some category II exposures (see table above). Passive immunization should be administered just before or shortly after administration of the first dose of vaccine given in the post-exposure prophylaxis regimen. If it is not immediately available, passive immunization can be administered up until the seventh day after initiation of the primary series of postexposure prophylaxis (with cell-culture or embryonated-egg rabies vaccine). Dosage and administration: The dose for HRIG is 20 IU/kg body weight and for ERIG and F(ab')2 products 40 IU/kg body weight. The full dose of rabies immunoglobulin, or as much as is anatomically feasible, should be administered into and around the wound site. Any remainder should be injected i.m. at a site distant from the site of active vaccine administration. Multiple needle injections into the wound should be avoided. If the correct dose of rabies immunoglobulin is too small to infiltrate all wounds, as might be true of a severely bitten individual, it can be diluted in physiological buffered saline to ensure greater wound coverage. 3. Active immunization Cell-culture- or embryonated-egg-based rabies vaccines should always be used for post-exposure prophylaxis. They can be administered either i.m. or i.d. Intramuscular regimens: Both a five-dose and a four-dose i.m. regimen are recommended for post-exposure vaccination; the fivedose regimen is the more commonly used: The five-dose regimen is administered on days 0, 3, 7, 14 and 28 into the deltoid muscle. The four-dose regimen is administered as two doses on day 0 (one dose in the right and one in the left arm (deltoid muscles), and then one dose on each of days 7 and 21 into the deltoid muscle. An alternative post-exposure regimen for healthy, fully immunocompetent exposed people who receive wound care plus high-quality rabies immunoglobulin plus WHO-prequalified rabies vaccines consists of four doses administered i.m. on days 0, 3, 7 and 14. Intradermal regimens: Intradermal administration of cell-culture- and embryonated-egg-based rabies vaccines has been successfully used in many developing countries that cannot afford the five- or four-dose i.m. schedules. The two-site i.d. method: one i.d. injection at two sites on days 0, 3, 7 and 28. The volume per intradermal injection should be 0.1 ml with both purified Vero cell rabies vaccine, and purified chick embryo rabies vaccine.
1
0,3, 7,14, 28
0, 3, 14, 28, 90
3, 7, 14, 16,18
0, 7, 14, 16, 18
Unknown
null
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Anticoagulant used for chelating calcium -
Answer-D. All of the aboveMost of the anticoagulants used in the laboratory act by binding calcium as an insoluble salt or soluble but un-ionized salt.Thesecalciumchelatinganticoagulantsare :-EDTADouble oxalateSodium citrateSodiumJluoride
4
E DTA
Oxalate
Sodium citrate
All of the above
Pathology
null
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Warm antibody hemolytic anemia is seen in all expect
Warm antibody type hemolytic anaemia can be induced by drugs. A small portion of patients receiving methyl dopa develop AIHA .They are tolerance breaking drugs Penicillin antibiotics develop antibodies agaist RBC , drug complex which induces hemolysis.  Quinidine forms a complex with plasma protein to which an antibody forms This complex may induce lysis of bystanding RBC or platelets. Stibophen is an antihelminthic drug which cannot induce AIHA.
1
Stibophen
Methyl dopa
Penicillin
Quinidine
Pathology
null
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Abnormality to check if lithium is given to a pregnant female -
Ans. is 'a' i.e., Cardiac anomaly Lithium is a weak teratogen in human.The main effects attributable to lithium are increased cardiac malformation in the fetus especially "Ebsteins anomaly".Lithium may increase the incidence of Ebstein9s anomaly in fetus but it is not contraindicated during pregnancy.Lithium is not considered a major human teratogen and the risk for Ebstein's anomaly is only .5% for babies whose mother takes lithium during pregnancy.Therefore lithium is not contraindicated during pregnancy. It is however advisable to perform a "fetal echocardiography" to exclude the possibilities of cardiac anomaly.Evaluation of studies on lithium in pregnancy shows that lithium therapy throughout pregnancy does not seem to increase the general rate of major anomalies and apparently add only a small risk for cardiovascular defects notably Ebstein's anomaly.It can be concluded that whenever lithium is the drug of choice in women with bipolar disorder, it may be continued even in pregnancy.Moreover it is advised not to discontinue lithium as it may subsequently lead to relapse of the disorder.In addition, pregnancy of lithium treated women should be considered high risk and therefore monitoring during pregnancy has to include "fetal echocardiography".Pregnancy interruption in lithium treated mothers can probably be considered only if severe cardiac anomaly is diagnosed.According to K.D.T.Lithium is contraindicated during pregnancy.But all other books states that lithium can be administered is during pregnancy.
1
Cardiac anomaly
Neural tube defect
Facial defect
Urogenital defect
Pharmacology
C.N.S
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single
The most common cause of Volkmann's ischaemic contracture (V.I.C) in a child is:
D i.e. Supracondylar fracture humerus
4
Intercondylar fracture of humerus
Fracture both bone of forearm
Fracture lateral condyle of humerus
Supracondylar fracture of humerus
Surgery
null
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DIC is seen with all except -
Disseminated intravascular coagulation (DIC) is an acute or chronic disorder causing thrombosis or hemorrhage, which occurs as a secondary complication of an underlying disease. It is characterized by consumption of coagulation factors caused by intravascular activation of the coagulation sequence, which leads to the formation of thrombi throughout the microcirculation of the body, and secondarily, activation of fibrinolysis
1
Accidental hemorrhage
Black water fever
Amniotic fluid embolism
Overdosage with Vitamin K
Pathology
null
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Circular DNA is found in:
Circular DNA is found in viruses (eg polyoma virus has double stranded & porcine virus has single stranded circular genome), prokaryotes (most bacterial DNA is circular), blue green algae as well as in eukaryotic cells like mitochondrial DNA or plasmid DNA and in chloroplast.A distinguishing characteristic of prokaryotes is their capacity to exchange small packets of genetic information carried on plasmids. Plasmid are small, specialized genetic element that are capable of replication within at least one cell line or exhibit broad hoast range and may carry sets of specialized genetic information (eg drug resistance) through a population. Plasmids were identified as small genetic elements carrying genes and capable of independent replication in prokaryotes (bacteria & yeast). Unlike viruses, plasmids are naked DNA and donot carry genes necessary to encase genetic material for transfer to new host. Sometimes plasmids may be found in eukaryotes like saccharomyces cerevisiae). In genetic engineering, plasmid is a small genetic (DNA) element that is separate from and can replicate independently of the chromosoml DNA. So introduction of DNA restriction fragment into a plasmid allows the fragment to be amplified many times.
4
Virus
Chloroplast
Bacteria and Mitochondria both
All
Biochemistry
null
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multi
Clayton is used in a close breathing system for the purpose of
D i.e. As an indicator
4
As a hardner
As an absorbent
As a softner
As an indicator
Anaesthesia
null
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single
The rate-limiting step in the synthesis of bile acids is catalyzed by:
The rate-limiting step in the formation of bile acids is the 7a-hydroxylation of cholesterol, catalyzed by a microsomal NADPH-dependent enzyme 7a-hydroxylase. 12a-Hydroxylase is also involved in the bile acid synthesis, but is not regulated. HMG CoA reductase and pyro diphosphomevalonate decarboxylase are both cholesterol-synthesizing enzymes; 25-hydroxycholecalciferol 1-hydroxylase is a kidney enzyme, which catalyzes the formation of an active vitamin D3 metabolite, 1,25-di-OH D3. Ref: Lippincott's Biochemistry, 5th Ed, page 241
2
12a-Hydroxylase
7a-Hydroxylase
HMG coA reductase inhibitors and bile acid sequestrant
25-hydroxycholecalciferol 1-hydroxylase
Biochemistry
null
0920976b-00c7-4a2b-9c9a-ec5149f5bb2d
multi
The buffering capacity of a buffer is maximum when the pH is equal to:
Buffering capacity of a buffer is most effective when the concentrations of salt and acid are equal or when pH = pKa. The effective range of a buffer is 1 pH unit higher or lower than pKa. pKa refers to the pH at which the concentration of the acid equals that of the base. Phosphate buffer is effective at a wide range because it has three pKa values. Ref: Vasudevan, Biochemistry, 3rd Edition, Page 320
2
0.5 pKa
pKa
pKa+1
2 pKa
Biochemistry
null
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single
All are X-ray findings of RA except:
Radiological features of RA are Evidence of soft tissue swelling and joint effusion Symmetrical involvement Juxta-aicular osteopenia (within weeks) Loss of aicular cailage and bone erosions (after months) Narrowing of joint space Aicular destruction and joint deformity, e.g. subluxation of atlantoaxial and cervical joints Lack of hyperophic bone changes (sclerosis or osteophyte)
3
Reduced joint space
Soft tissue shadow
Periaicular new bone formation
Subchondral cyst
Orthopaedics
Joint disorders
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multi
Cellular suppo is provided by:
Cytoskeleton froms framework of the cell It has microtubules, microfilaments,intermediate filaments
2
Mitochondria
Cytoskeleton
Golgi apparatus
All
Anatomy
General anatomy
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multi
After a meal of pizza, dietary lipid is absorbed by the small intestine and transported in the lymph mainly as
Ans. C. ChylomicronsThe small intestine transports dietary triglyceride as chylomicrons in lymph. VLDLs are secreted by the small intestine during fasting. Although some dietary fatty acids are transported in the portal blood bound to albumin, it is not the predominant pathway for the transport of dietary lipids to the circulation by the small intestine. The intestine does not secrete LDLs, and although it does secrete HDLs, they are not used as a vehicle for transporting dietary lipids to the blood by the small intestine.
3
VLDLs
Free fatty acids bound to albumin
Chylomicrons
LDLs
Physiology
G.I.T.
d776592c-8996-422d-8cf8-efb02898075f
multi
Mesothelioma is caused by –
Asbestosis There are two distinct geometric forms of asbestos - Serpentine chrysolite Amphibole (crocidolite) Serpentine chrysolite accounts for most of the asbestos used in industry. Both serpentine and amphibole can cause all asbestosis related disease except for mesotheloma, which is usually associated with amphibole (crocidolite). Asbestos related diseases Localized fibrous plaques which may be calcified. Diffuse pleural fibrosis Pleural effusion Parenchymal interstitial fibrosis (asbestosis). Lung carcinoma → Most common neoplasm associated with asbestos exposure. Mesothelioma of pleura and peritoneum → most specific neoplasm associated with asbestos exposure. Laryngeal and colon carcinomas. Stomach carcinoma Note - Concomitant cigarette smoking greatly increase the risk of lung carcinoma but not that of mesotheloma.
1
Asbestosis
Silicosis
Baggasois
Anthracosis
Social & Preventive Medicine
null
6890b2de-674b-452f-b016-0cbca62ca572
single
Meconium is excreted by a new born till _______ day:
The baby may pass meconium in utero or soon after birth, but all healthy newborn babies must evacuate within 24 hours of birth. During the first 2..3 days the baby passes black, tarry (like tar) 'meconium' stools which are followed by greenish (transitional) stools for the next 1 or 2 days. The normal breastfed baby usually passes 4-8 semisolid sticky golden yellow stools everyday. Some babies may pass stools after each feed due to the 'exaggerated' gastrocolic reflex. The stools are often very small (at times like drippings of the birds) with normal consistency. The babies continue to gain weight. Tar means a thick, sticky, brown to black liquid with a pungent odor, obtained by the destructive distillation of wood, coal, peat, shale, etc.
2
2
3
6
4
Gynaecology & Obstetrics
null
cfcac655-98cf-43df-ae68-859cc8eac2a1
single
Lanatoprost used topically in glaucoma primarily acts by:
B i.e. Increased uveoscleral outflow Prostaglandin analogues (e.g. latanoprost Q, unprostone, bimatoprost, travoprost) lower intraocular pressure by stimulating a prostanoid receptor in ciliary muscle. This causes the release of matrix metalloproteinases and increase the uveoscleral outflow. Q Latanoprost lower IOP by 25-30% (equivalent to effect produced by timolol). Common side effects are conjunctival hyperaemia, superficial punctate keratopathy & pigmentation. Prostaglandin analogues and pilocarpineQ are contraindicated in inflammatory glaucoma (e.g. glaucoma with uveitis, hypeensive uveitis syndrome) Q. Prostaglandin analogues are 2nd drug of choice after )6 blocker in treatment of open angle glaucoma Q
2
Decreasing aqueous humour formation
Increasing uveoscleral outflow
Releasing pupillary block
All
Ophthalmology
null
2da18416-e7fd-4079-9099-05618a8da885
multi
Main cell of shedding are:
Odontoclasts are the main shedding cells.
2
Osteoclasts.
Odontoclasts.
Fibroblasts.
All of the above.
Dental
null
5ab2d5be-8081-4571-8f97-6104439e2737
multi
Home to bilirubin conversion is carried out by
Within the macrophage, heme derived from haemoglobin is broken down by heme oxygenase, conveing it to biliverdin Carbon monoxide and iron arereleased as by-productsReference: Harper biochemistry 30th edition page no 672
1
Heme oxygenase
Heme reductase
Heme isomerase
Heme hydrolase
Biochemistry
miscellaneous
84733d91-02fd-4eda-a7b5-9de87d086c77
single
A 60-year-old farmer presents with multiple patches of discoloration on his face. Biopsy of lesional skin reveals actinic keratosis. Which of the following terms best describes this response of the skin to chronic sunlight exposure?
Dysplasia. Actinic keratosis is a form of dysplasia in sun-exposed skin. Histologically, such lesions are composed of atypical squamous cells, which vary in size and shape. They show no signs of regular maturation as the cells move from the basal layer of the epidermis to the surface. Dysplasia is a preneoplastic lesion, in the sense that it is a necessary stage in the multistep evolution to cancer. However, unlike cancer cells, dysplastic cells are not entirely autonomous, and the histologic appearance of the tissue may still revert to normal. None of the other choices represent preneoplastic changes in sun-exposed skin.Diagnosis: Actinic keratosis, dysplasia
2
Atrophy
Dysplasia
Hyperplasia
Hypertrophy
Pathology
Cellular Pathology
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single
Krogman's formula is related to: Odisha 11
Ans. Sex
3
Race
Age
Sex
Stature
Forensic Medicine
null
5388484b-194a-4c2e-a9fa-4cfee3df7341
single
Drug of choice in drug induced parkinsonism is:
Ans. (B) Benzhexol(Ref: KDT 8/e p460)Central anticholinergics like trihexy phenydyl (Benzhexol) are the only drugs effective in drug induced Parkinsonism.
2
Levodopa
Benzhexol
Amantidine
Carbidopa
Pharmacology
C.N.S
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single