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Which of the following characteristics is not of much impoance in a screening test
High specificity All are impoant attributes of screening test but among them high specificity is less impoant as Park states -'Screening test is not intended to be a diagnostic test. It is only an initial examination. Those who are found to have positive test results are refen-ed to a physician for fuher diagnostic work-up & treatment. High specificity is a necessary attribute for a diagnostic test. Below are given the differences between screening and diagnostic tests. Screening test Diagnostic test * Done on apparently healthy Done on those with indications or sick (asymptomatic) * Applied to groups Applied to single patients, all diseases are considered * Test results are arbitrary and final Diagnosis is not final but modified in light of new evidence, diagnosis is the sum of all evidence 4. Based on one criterion or cut-off Based on evaluation of a number of symptoms, signs and point (e.g., diabetes) laboratory findings Less accurate More accurate 6. Less expensive More expensive 7. Not a basis for treatment Used as a basis for treatment 8 The initiative comes from the investigator or agency providing care The initiative comes from a patient with a complaint Criteria for Screening test Screening test must satisfy the criteria of - acceptability - repeatability - validity - simplicity - safety - rapidity - ease of administration - low cost 1. Acceptability - Considering that screening tests are applied on asymptomatic people in large numbers, a high rate of people cooperation is needed. Thus the tests should be acceptable to the people. In general, tests that are painful, discomfoing or embarrasing (eg. rectal or vaginal examinations) are not likely to be acceptable to the population in mass campaigns. 2. Repeatability (Precision or reproducibility) - means that the test must give consistent results when repeated more than once on the same individual or material under the same conditions. 3.Low cost - A screening should be inexpensive. As a screening test has to be applied on millions of people to identify a small percentage who have early disease or its precursors, an expensive test however good, cannot justify use of restricted financial resources that has to be used for fuher diagnostic workup and t/t of those screened on positives. 4. High safety margin - This is an attribute of any test, whether diagnostic or screening. Moresoever for screening as screening tests are to be applied on millions of asymptomatic people and any adverse effect would bring whole process into disrepute. iims IN/nee answers & explanations -- May 2007 5. Validity - It expresses the ability of a test to separate or distinguish those who have the disease from those who do not - Validity has two components - sensitivity & specificity - An ideal screening test should be both highly sensitive and highly specific. But this is seldom possible and a compromise has always to be made.
4
Low cost
High safety margin
High sensitivity
High specificity
Social & Preventive Medicine
null
6a8cedf9-21c8-4a97-a4a3-2426d5352004
single
Causes of iron deficiency anemia are-a) CRFb) Young malec) Celiac sprued) Hook worme) Carcinoma cecum
null
2
bce
acde
abcd
abde
Medicine
null
96452419-6636-48c7-a6d0-e1d684b1cbf4
single
which of the following is a tri cyclic antidepressant
knowlede about the classes of antidepressents is very impoant as they are frequently asked in examinations amitriptilline is a tri cyclic antidepressent Fluoxetine is a selective serotonin reuptake inibitor trazadone is a serotonin antagonist and reuptake inhibitor (SARI) Bupropion is a Noradrenaline and Dopamine reuptake inhibitor Ref.kalon and sadock, synopsis of psychiatry, 11 th edition, 1040
1
amitryptilline
fluoxetine
trazadone
bupropion
Anatomy
Pharmacotherapy in psychiatry
5b399597-9652-4958-8e90-3d218c133b7f
single
A 30–year old male presents with severe chest pain, breathlessness, hypotension and ECG shows ST elevation in V3, V4, V5 and. V6 leads. He will be best treated with:
null
4
Streptokinase
t–PA
Heparin
PTCA
Pharmacology
null
25f303c5-c69f-4dcd-be9e-4f3083767a78
single
thrombocytopenia is the side effect of which drug
LETHAL SIDE EFFECTS OF VALPROATE - Hyperammonemia - Pancreatitis - Hepatic failure - Neural tube defects - Thrombocytopenia MINOR SIDE EFFECTS OF VALPROATE - Hair loss - PCOD - WEIGHT GAIN - TREMORS Ref.kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 935
1
valproate
clonazepam
aripiprazole
amisulpride
Anatomy
Pharmacotherapy in psychiatry
c01abea7-7ffe-42eb-b6a9-34d15880b196
single
The intiating mechanism in endotoxic shock is
Ref Robbins. 9/e p132-133 Endothelial injury is also a cause..see the above questions In gram-negative sepsis, free LPS attaches to a circulating LPS-binding protein, and the complex then binds to the CD14 receptor on monocytes, macrophages, and neutrophils. Engagement of CD14 (even at doses as minute as 10 pg/mL) results in intracellular signaling an associated "Toll-like receptor" protein 4 (TLR-4). This signaling results in the activation of nuclear factor kappaB (NF-kB), which leads to transcription of a number of genes that trigger a proinflammatory response. It was the result of significant activation of mononuclear cells and synthesis of effector cytokines. It also results in profound activation of mononuclear cells and the production of potent effector cytokines such as IL-1, IL-6, and TNF-a. TLR-mediated activation helps to trigger the innate immune system to efficiently eradicate invading microbes, but the cytokines they produce also act on endothelial cells. There, they have a variety of effects, including reduced synthesis of anticoagulation factors such as tissue factor pathway inhibitor and thrombomodulin. The effects of the cytokines may be amplified by TLR-4 engagement on endothelial cells
4
Peripheral vasodilation
Endothelial injury
Increased vascular permeability
Cytokine release
Anatomy
General anatomy
8fe21cce-6639-4ace-a59f-9c4b1a720bef
single
What % of drug is eliminated by first order kinetics after four half-life cycles?
Ans. a (93.75 %). (Ref. KDT, Pharmacology, 4th ed., 53)Elimination of drugsZero order eliminationRate of elimination is constant regardless of C (i.e., constant amount of drug eliminated per unit time). Cp linearly with time. Examples of drugs--ethanol., phenytoin aspirin (at high or toxic concentrations).First order eliminationRate of elimination is proportional teo the drug concentration (i.e., constant fraction of drug eliminated per unit time). Cp exponentially with time. tl/2Drug eliminated1 t 1/2 50% drug is eliminated.2 t 1/2 75% (50 + 25) drug is eliminated.3 t 1/2 87.50% (50+ 25 + 12.50) drug is eliminated.4 t 1/2 93.75% (50+ 25 + 12.50 + 6.25) drug is eliminated.Thus, complete drug elimination occurs in 4-5 t ViVolume of distribution (apparent)Vd =Dose---C # Vd estimates the volume into which the drug has distributed (one needs to extrapolate plasma concentration at time zero)# The lower the Co, the higher the Vd, and vice versa# Drug stored in non fluid compartments like fat may have a Vd greater than TBW (e.g. lipid soluble drugs, quinacrine),# Drugs that bind strongly to plasma proteins have a Vd that approaches plasma volume.# Approximate Vd values (weight 70 kg)--plasma volume (3 L), blood (5L), extracellular fluid (12-14 L), TBW (40-42 L)Cdeg = Plasma concentration at time zeroClearanceCI =Rate of drug elimination----------------Plasma drug concentrationClearance is the theoretical volume of blood totally cleared of drug/unit time. It represents the ratio of drug elimination to its plasma concentration. For a drug with first-order elimination, clearance is constant. CI=Kc x Vd Kc=Elimination constant EliminationThe rate of elimination of the active drug. It is not drug excretion because it may be metabolized before excretion.
1
93.75%
87.50%
75.00%
50.00%
Pharmacology
General Pharmacology
b8225ec8-8461-4ede-b757-f651354feb30
single
Anti-DNAase B is used for diagnosis of
Antideoxyribonuclease B ( anti-DNA as B)antibody: serological test to determine streptococcal infection. Anti-DNAase B and antihyaluronidase test are very useful for retrospective diagnosis of streptococcal pyogenes infections, where ASO titer may be low. Ref: Textbook of Microbiology; Ananthanarayanan and Panicker; 10th Edition; page:214
2
Staphylococcus
Streptococcus
Corynebacterium
Neiserria
Microbiology
Bacteriology
95ca07c4-e6bc-40cc-9bb7-3ecd6f517910
single
Which statement is not true about Perthes disease?
Ans. C. The bone age is same as that of the chronological ageThe bone age is typically lower than the chronological age by 1-3 years.Since the blood supply of the femoral capital epiphysis is affected, it is characterized by avascular necrosis and disordered enchondral ossification of the primary and secondary centers of ossification.Salient clinical features of Perthes disease:* Typically affects boys aged 4-8 years* Proximal thigh atrophy* Muscle spasm* Short Stature (Altered longitudinal growth of proximal femur)* Limitation of abduction and internal rotation* Antalgic gait* When the hip is flexed it may go into obligatory external rotation called Catterall sign.
3
It is characterized by avascular necrosis
More common in males
The bone age is same as that of the chronological age
All are true
Orthopaedics
Miscellaneous
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multi
Mostly granulosa cell tumors are benign. Marker for granulosa cell tumor is:
Granulosa Cell Tumor: Most are benign; however, between 5 and 25% are malignant. The tumors can produce estrogen, thus leading to endometrial hyperplasia and cancer. Microscopic morphology of granulosa cell tumor shows Call-Exner bodies (appear similar to ovarian follicle), and produce inhibin, which can be identified in serum and by immunohistochemistry. Ref: Wyatt C., Moos P.J., Brown T.G. (2008). Chapter 17. Pathology of the Male and Female Reproductive Tract and Breast. In C. Wyatt, P.J. Moos, T.G. Brown (Eds), Pathology: The Big Picture.
2
CA 19-9
CA 50
Inhibin
Teratoma
Gynaecology & Obstetrics
null
a395398e-aa48-4b4e-81b2-24c909683872
single
Most common Paraneoplastic syndrome of HCC
Para neoplastic syndromes in HCC Hypocholesterolemia(most common) Hypoglycemia Erythrocytosis Hypercalcemia Ref:Sabiston 20th edition Pgno : 1458-1463
1
Hypoglycemia
Hypeension
Hypercalcaemia
Erythrocytosis
Anatomy
G.I.T
0585563f-db79-458c-a2b8-50540502f2ee
single
APGAR score includes following parameters except
Ans. c (Blood pressure) (Ref Text book of PSM by Park 22nd/492)APGARSCALE# In 1953, American anesthesiologist, Virginia Apgar, published her new method for evaluating the newborn infant. This scoring system which became known as the APGAR scale later evolved into the standard for medical practice.# The test is administered at one minute and five minutes after birth. If there are problems with the infant, an additional score may be repeated at a 10-minute interval.# For a Cesarean section the baby is additionally assessed at 15 minutes after delivery. The table below displays the criteria used in the APGAR scale.Test0 Points1 Point2 PointsActivity (Muscle Tone)AbsentArms & legs extendedActive movement with flexed arms & legsPulse (Heart Rate)AbsentBelow 100 bpmAbove 100 bpmGrimace (Response Stimulation or Reflex Irritability)No responseFacial grimaceSneeze, cough, pulls awayAppearance(Skin Color)Blue-gray, pale all overPink body and blue extremitiesNormal over entire body - Completely pinkRespiration(Breathing)AbsentSlow, irregularGood, crying# After the infant is examined, the scores are totaled.# A score of 7-10 is considered normal.# A newborn with a score of 4-7 may require additional resuscitative measures while a score of 3 and below necessitates immediate medical attention.# It is important to remember that the APGAR score is strictly used to determine the newborn's immediate condition at birth and does not necessarily reflect the future health of the baby.
3
Heart rate
Muscle tone
Blood pressure
Body tone
Social & Preventive Medicine
Obstetrics, Paediatrics and Geriatrics
3477d6c0-e927-4e15-9ea1-81921a376762
multi
Which of the following ion is absorption in proximal convoluted tubule?
Maximum sodium reabsorption occours in PCT. Ref: Ganong's review of medical physiology; 24th edition; page no: 681
1
Na+
Urea
K+
Mg+
Physiology
Renal physiology
2aa41409-8860-4856-b79b-f74cfcd45b11
single
The postoperative quality of life (QOL) scores of 200 prostate cancer patients have a mean of 60 and a standard detion of 10. How many patients are expected to have a QOL score between 40 and 80?
The values enclosed in a normal distribution curve are:Mean +- 1 SD 68% of data Mean +- 2 SD 95% of dataMean +- 3 SD 99% of dataIn the above question,Mean = 60SD = 10Hence, the range of values from 40 to 80 i.e. 60 +- 20 (Mean +- 2 SD) would include 95% of the readings.Therefore, the total number of readings in the given range = (95 x 200) / 100 = 190Hence, 190 patients are expected to have a QOL score between 40 and 80.
1
190
136
120
140
Microbiology
All India exam
8000c837-6d44-4898-80c6-49e19de8a2a6
single
A 40 year old male patient came for routine checkup. Intra-oral examination reveal multiple teeth restored with silver amalgam restoration. Linear coefficient of thermal expansion of this restoration is?
Amalgam has a linear coefficient of thermal expansion that is 2.5 times greater than tooth structure, and it does not bond to tooth structure (unless an amalgam bonding agent is used).  Sturdevant’s Art and Science of Operative Dentistry, Mosby, 4th Edition, Page No: 155
4
5 times greater than tooth structure
2 times greater than tooth structure
3 times greater than tooth structure
2.5 times greater than tooth structure
Dental
null
30995109-2ebe-4b4d-b943-1bac84e778dd
single
which cranial nerve is present arround the origin of occipital aery of lower end of sternocleidomastoid muscle ?
hypoglossal nerve hooks arround the origin of occipital aery of lower end of sternocleidomastoid muscle ref : bd chaursia
3
spinal accesory cranial nerve
superior laryngeal nerve
hypoglossal nerve
petrosal nerve
Anatomy
All India exam
2a3a259d-d58a-4eeb-92f7-7b78c1fad52f
single
Husband having a suspicion that his wife is having affair with another man, diagnosis is
A delusion is false, firm (unshakeable) belief that is not accepted by other members of patient’s culture and society. Above is an example of delusion of infidelity (morbid jealousy, Othello syndrome) i.e. False belief that one's lover has been unfaithful. Persecutory delusions (paranoid) : The patient feels that he is being persecuted against. There is a false belief that one is being harmed, threatened, cheated, poisoned, harassed or spied on or is a victim of a conspiracy to damage his reputation. The supposed persecutor of the patient may be people in the environment (e.g., members of the family, neighbours, former friend) or may be political or religious groups. These delusions occur in schizophrenia (especially paranoid), severe affective disorders (severe mania or severe depression) and organic brain syndrome. This is the most common type of delusion. The delusion of persecution may occur in the context of primary delusional experiences, auditory hallucinations, bodily hallucinations or experiences of passivity Grandiose delusion (expansive delusions) : False belief that one is exceptionally powerful, talented or important. These delusions are seen most commonly in mania, However, can also occur in schizophrenia and organic states. Delusions of reference : False belief that certain objects, people or events have intense personal significance and refer specifically to oneself, e.g., Believing that a television newsreader is talking directly about oneself, or people walking on the road are talking about him. These delusions are seen in schizophrenia, mania and organic states. Religious delusions : False belief pertaining to a religious theme, often grandiose in nature, e.g. : believing that one is a special messenger from God. These delusions are seen in schizophrenia. Delusions of love (erotomania) : False belief that another person is in love with one (commoner in a woman). In one form, termed de clerambault syndrome, a woman (usually) believes that a man, frequently older and of higher status, is in love with her. The delusion of infidelity (morbid jealousy, Othello syndrome) : False belief that one’s lover has been unfaithful. These are seen in schizophrenia, alcohol-related psychosis, organic states. The delusion of misidentification : Capgras syndrome (Delusion of double) : Belief that a familiar person has been replaced by an exact double i.e. an impostor. Fregoli syndrome : Belief that a complete stranger is actually a familiar person already known to one. The delusion of self - accusation or guilt : False feeling of remorse of guilt. It occurs in Depression. Nihilistic delusions : False belief that oneself, others or the world is non - existent or about to end. There are pessimistic ideas that the patient’s career is finished, he is about to die, the world is doomed. These occur in severe depression : If nihilistic delusions are accompanied by ideas concerning bodily function failure, e.g., putrefaction of intestines, etc. the syndrome is called COTARD’s SYNDROME. Hypochondriacal delusions :  False belief about one’s health, patient wrongly believes that he has a severe medical illness, contrary to the all medical evidence. It is seen in depression. The delusion of infestations : False belief that one is infested with small but visible organisms. As a monosymptomatic delusional disorder, this is called EKBOM SYNDROME. It is seen in the acute confusional state (due to drugs or alcohol withdrawal), in schizophrenia, in dementing illness, and as a delusional elaboration of tactile hallucinatory experiences (secondary to fornication). Delusion of control : Belief that his actions, impulses or thoughts are controlled by an outside agency and accordingly called as made action, made impulse or made an effect. Also called somatic passivity experiences (passivity phenomenon). Commonly seen in schizophrenia. Delusions concerning possession of thoughts : Patients with delusions about possession of thoughts may lose the conviction that their thoughts are their own. Most commonly seen in schizophrenia.
1
Delusion
Illusion
Hallucination
Delirium
Psychiatry
null
89015da4-646e-473b-8dbd-4484e98deab0
multi
Good pasture's syndrome is characterised by -
Ans. is 'a' i.e., Necrotizing hemorrhagic interstitial pneumonitis Goodpasture syndromeo Goodpasture syndrome is a rare condition characterized by rapid destruction of the kidney and diffuse pulmonary hemorrhage.o It is an autoimmune disease characterized by presence of circulating autoantibodies targeted against basement membrane of lung and kidney.o These antibodies are directed against the noncollagenous domain of the a-3 chain of type IV collegen (collegen of basement membrane).o The antibodies initiate an inflammatory destruction of the basement membrane in kidney glomeruli and lung alveoli.o In Goodpasture syndrome, immune reaction is type II hypersensitivity.Morphological changes1. Lungo The lungs are heavy, with areas of red brown consolidation.o There is focal necrosis of alveolar walls associated with intraalveolar hemorrhages.o Alveoli contain hemosiderin-laden macrophages.o Linear deposits of immunoglobulins along the basement membranes of the septal walls.2. Kidneyo Diffuse proliferative rapidly progressive glomerulonephritis,o Focal necrotizing lesion and crescents in >50% of glomeruli.o Linear deposits of immunoglobulins and complement along glomerular basement membrane.Clinical manifestationso Occur typically in young males.o Most cases begin clinically with respiratory symptoms, principally hemoptysis.o Soon, manifestations of glomerulonephritis appear and typically present as nephritic syndrome - hematuria, nephritic urinary sediment, subnephrotic proteinuria, rapidly progressive renal failure,o The common cause of death is renal failure.
1
Necrotisting hemorrhagic interstitial pneumonitis
Alveolitis
Patchy consolidation
Pulmonary edema
Pathology
Glomerular Diseases
8b308da1-b9b5-41ed-98cb-4453ee1d11cc
single
Which of the following is the major site of erythropoietin production during the fetal stage?
Erythropoietin is produced in the fetal liver in the first and second trimester.After bih, the major site of production is in the kidney.(Refer: Nelson's Textbook of Pediatrics, SAE, 1st edition, pg no. 2305 - 2306)
1
Liver
Yolk sac
Bone
Spleen
Pediatrics
All India exam
f99295fa-7fb4-4cef-aad2-84f36fa583ff
single
Bristow elevator is used in:
null
1
Gillies approach.
Keen's technique.
Both of the above.
None.
Surgery
null
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multi
Parents of a 7 year old girl are concerned about the spacing between her front teeth. She has a habit of thumb sucking till date. Intra Oral Findings are skeletal Class I relation, overjet present & spacing in the anterior teeth. This child is expected to show which type of swallowing pattern
The mature or adult swallow pattern appears in some normal children as early as age 3 but is not present in the majority until about age 6 and is never achieved in 10% to 15% of a typical population.  Tongue thrust swallowing in older patients superficially resembles the infantile swallow and sometimes children or adults who place the tongue between the anterior teeth are spoken of as having a retained infantile swallow. This is clearly incorrect. Only brain damaged children retain a truly infantile swallow in which the posterior part of the tongue has little or no role .Because coordinated movements of the posterior tongue and elevation of the mandible tend to develop before protrusion of the tongue tip between the incisor teeth disappears, what is called “tongue thrusting” in young children is often a normal transitional stage in swallowing. During the transition from an infantile to a mature swallow, a child can be expected to pass through a stage in which the swallow is characterized by muscular activity to bring the lips together, separation of the posterior teeth, and forward protrusion of the tongue between the teeth. This is also a description of the classic tongue thrust swallow. A delay in the normal swallow transition can be expected when a child has a sucking habit.
3
Retained infantile swallow
Mature or adult swallow
Classic tongue thrust swallow
Complex tongue thrust swallow
Dental
null
33166311-4058-4c88-a1ba-7d03f84ced96
multi
Which is the commonest abdominal mass in neonate :
The commonest intra - abdominal tumor in first two years of life → Neuroblastoma. The commonest intra - abdominal tumor between 2nd to 5th  year of life → Wilm’s tumor. The commonest intro - abdominal tumor in children (no age specification) → Neuroblastoma. (Wilm's tumor is the second most common abdominal tumor in children). Remember: The commonest cause of abdominal mass in Newborn is Multiple dysplastic kidneys (if neoplasm or tumor has not been mentioned when asking for the commonest intra-abdominal mass, the answer will be multiple dysplastic kidneys).
3
Wilm's tumor
Polycystic kidney
Neuroblastoma
Rhabdomyosarcoma
Pediatrics
null
1bc4d1f2-7093-4a15-bb44-1be1f63b5774
single
A married woman died in unnatural conditions within 5 years of her marriage. Her parents complained of frequent demand of dowry. Her autopsy will be conducted under which section: AI 10; Punjab 10
Ans. Sec. 176 CrPC
2
Sec. 174 CrPC
Sec. 176 CrPC
Sec. 302 IPC
Sec. 304B IPC
Forensic Medicine
null
0fa8fbe2-b593-45d7-80be-84cbbe8d12c2
single
child rolls over by ?
O.P. Ghai 7th ed, page7 Achild rolls over by 5 months
2
3 months
5 months
7 months
8 months
Anatomy
General anatomy
2c1722ef-950e-486c-aca8-450a1263b312
single
Platelet-activating factor is biochemically a
Platelet-activating factor (PAF) (I-alkyl-2-acetyl-sn-glycerol-3- phosphocholine) is synthesized from the corresponding 3-phosphocholine derivatives. It is formed by many blood cells and other tissues and aggregates platelets at concentrations as low as 10 mol/L.
3
Prostaglandin
Glycolipid
Glycerol ether phospholipid
Leukotrienes
Biochemistry
null
72e3ab3e-e6fb-4caf-931a-6c6209a1b385
multi
True about renal secretion----
Ans. is 'c' i.e., Glucose is reabsorbed in proximal tubule
3
Maximum reabsorption in distal tubule
Urea is absorbed 100%
Glucose is reabsorbed in proximal tubule
null
Physiology
null
4ff90cee-b556-4743-bff0-875845f6ed14
multi
World diabetes day is celebrated on ?
Ans. is 'c' i.e., 14th November8 May - World Red Cross Day8th March - International Women's Day14th November -/ World Diabetes Dayl' December - World AIDS Day
3
8th may
8th march
14th November
1" december
Social & Preventive Medicine
null
4811f36f-4846-4e80-ae5c-45fa6dafd801
single
Enzymatic markers of plasma membrane include all except
Markers of Plasma membrane - 5-Nucleotidase, Adenylyl cyclase, Na+K+ ATPase Marker of Endoplasmic reticulum - Glucose-6-phosphatase Markers of Golgi apparatus - GlcNAc transferase I, Golgi mannosidase II, Galactosyl transferase, Sialyltransferase Marker of Mitochondria - ATP synthase, Glutamate dehydrogenase Marker of Peroxisome - Catalase. Marker of Cytosol - LDH.
4
5'-nucleotidase
Adenylyl cyclase
Na+-K+-ATPase
Galactosyl transferase
Physiology
null
b8053c76-55ed-4f1a-aeae-8966957e86a9
multi
According to disabilities ACT 1995. Seventh disability is usually referred to as?
The definition of the term disability as per the provisions of the persons with disability act 1995 disability means :­ Blindness. Low vision. Leprosy cured. Hearing impairment. Locomotor disability. Mental retardation. Mental illness.
2
Neurological abnormality
Mental illness
Substance abuse
Diability due to road traffic accident
Psychiatry
null
e6106c75-74bf-4de0-9937-d5f748a3a282
multi
All are true about peripheral-neuropathy except :
Answer is B (Proximal Muscle Weakness): Symptoms and findings in Peripheral neuropathy whether motor or sensory are generally symmetric and 'graded distally' & not proximally. Involvement of the peripheral nerve explains both, defects in conduction as well as decreased reflexes.
2
Glove and stocking anaesthesia
Proximal muscle weakness
Nerve-conduction deficit
Decreased reflexes
Medicine
null
0441bfa2-bcf5-4cbd-85cc-1cdaa4733fcf
multi
Commonest complication of pancreatic pseudocyst ?
Answer is 'b' i.e. Infection "Other than pain, infection is the most common complication" - Maingot's 10/e, p 1929 Other complications are: Obstruction of GIT Hemorrhage Rupture Pseudoanetoysm - splenic aery is most frequently involved.
2
Rupture
Infection
Obstruction of GIT
Hemorrhage
Surgery
null
bf54dfd8-9b7b-484a-bd37-f4cbe1b77903
single
Which of the following anaesthetic agent causes adrenal suppression –
null
1
Etomidate
Thiopentone
Ketamine
Propofol
Anaesthesia
null
d456a161-f581-418e-8a4a-44f533a4ee81
single
Omeprazole effects are due to: March 2013
Ans. C i.e. Proton pump inhibitor Omeprazole It is a proton pump inhibitor used in the treatment of: - Dyspepsia, - Peptic ulcer disease (PUD), - Gastroesophageal reflux disease (GORD/GERD), - Laryngopharyngeal reflux (LPR) and - Zollinger-Ellison syndrome.
3
Prostaglandin analogue
H, antihistamines
Proton pump inhibitor
Ulcer protective mechanism
Pharmacology
null
3c4ede0e-5148-40ed-bb7f-5f5e6370e316
single
Blood supply of great toe are:
A . i.e. Dorsalis pedis aery
1
Dorsalis pedis aery
Dorsalis pedis aery
Matacarpal aery
Posterior tibial aery
Anatomy
null
389caf1e-08bc-4c0b-9f94-1b62b6276f5d
single
All of the following muscles are supplied by recurrent laryngeal nerve except
Cricothyroid is supplied by external laryngeal branch of superior laryngeal nerve
1
Cricothyroid
Arytenoid
Cricoarytenoid
null
Anatomy
null
7236c633-eb43-4305-8d5b-44076cb61b0f
multi
Uronic acid pathway does not have role in formation of which glycosaminoglycan proteoglycan?
Glycosaminoglycans are heteropolysaccharide (heteropolysaccharides are polysaccharides which contain two or more different monosaccharide unit or their derivates).Glycosaminoglycans are linear (unbranched) polysaccharides, with repeating diasaccharide units. Each disaccharide unit consists of an amino sugar and an acid sugar (sugar acid).
1
Keratan sulfate
Chondroitin sulphate
Hyaluronic acid
Heparan sulphate
Biochemistry
null
7e080e57-4eec-4fca-bb60-9211849b93de
single
15 months old child feeding on cow milk with water wih severe wasting and bipedal edema with poor appetite ?
Ans. is 'a' i.e., Kwashiorkar
1
Kwashiorkar
Marasmus
Both
null
Pediatrics
null
1d7ed2fb-68e3-450c-8474-54664af210de
multi
Which of the following has cytoplasmic receptor:
null
4
Epinephrine
Insulin
FSH
Cortisol
Pharmacology
null
66403b10-e00f-4673-870d-dd2bd4868698
single
The following pathological features are associated with Plasmodium falciparum except-
Pathology Red cells infected with malaria are prone to haemolysis. This is most severe with P. falciparum, which invades red cells of all ages but especially young cells; P. vivax and P. ovale invade reticulocytes, and P. malariae normoblasts, so that infections remain lighter. Anaemia may be profound and is worsened by dyserythropoiesis, splenomegaly and depletion of folate stores. In P. falciparum malaria, red cells containing trophozoites adhere to vascular endothelium in post-capillary venules in brain, kidney, liver, lungs and gut by the formation of 'knob' proteins. They also form 'rosettes' and rouleaux with uninfected red cells. Vessel congestion results in organ damage, which is exacerbated by rupture of schizonts, liberating toxic and antigenic substances . P. falciparum has influenced human evolution, with the appearance of protective mutations such as sickle-cell , thalassaemia , glucose-6-phosphatedehydrogenase (G6PD) deficiency and HLA-B53. P. falciparum does not grow well in red cells that contain haemoglobin F, C or especially S. Haemoglobin S heterozygotes (AS) are protected against the lethal complications of malaria. P. vivax cannot enter red cells that lack the Duffy blood group; therefore many West Africans and African Americans are protected. Ref Harrison20th edition pg 1056
4
Cytoadherence
Sequestration
Rosetting
Tissue phase
Medicine
Infection
09e82fa4-121e-45e9-abb4-a31ec9441348
multi
The most common presentation of a blue rubber bleb nevus syndrome is:
Blue rubber bleb nevus syndrome is a rare disorder characterized by the development of cavernous hemangiomas, most commonly involve the skin and the GI tract. The most common presentations of blue rubber bleb nevus syndrome are either the appearance of the skin lesions alone or iron deficiency anemia. Ref: American Gastroenterological Association (AGA) Institute Technical Review on Obscure Gastrointestinal Bleeding 2007.
1
Asymptomatic iron deficiency anemia
Cardiac conduction defects
Renal aminoaciduria
Painful peripheral neuropathy
Medicine
null
5a7144e1-c1c7-4459-8a65-953340a9eed6
single
Flumazenil is used for reversing the respiratory depression caused by which one of the following drugs?
null
2
Fentanyl
Midazolam
Propofol
Ketamine
Pharmacology
null
4c916921-6959-473f-9588-dc5d79e8b21c
single
Which test can detect facial nerve palsy occurring due to the lesion at the outlet of stylomastoid foramen -
Injury at stylomastoid foramen causes LMN palsy, so the face sags and drawn across to the opposite side. Chorda tympani is spared at this level, taste sensation over anterior 2/3 of tongue is preserved.
1
Deviation of angle of mouth towards opposite side
Loss of taste sensation in anterior 2/3 of tongue
Loss of sensation over right cheek
Deviation of tongue towards opposite side
ENT
null
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single
Conn's syndrome is associated with all the following, except:
Conn's syndrome is associated with metabolic alkalosis, not with metabolic acidosis. Conn's syndrome refers to primary hyperaldosteronism due to an adrenal adenoma. Increased aldosterone secretion results in hypokalemia from increased excretion of potassium and metabolic alkalosis due to increased hydrogen ion secretion. Ref: Harrisons Internal Medicine, 18th Edition, Pages 2949-2951 ; Hypeension By Joseph Cheriyan, Page 148 ; Mosby's Handbook Of Diseases By Rae Langford, 3rd Edition, Page 28
4
Hypeension
Hypokalemia
Muscle weakness
Metabolic acidosis
Medicine
null
aa95c115-57a9-4049-8635-c4bbe40c3e76
multi
From 1st Jan 2007 to 30th June 2007, 22 new cases of tuberculosis were reported per 1,65,000 population. But during this period 120 suspected cases of TB were registered. What will be the incidence rate?
null
1
133 Per 10,00,000 population
90 Per 10,00,000 population
75 Per 10,00,000 population
270 Per 10,00,000 population
Social & Preventive Medicine
null
a8da7d91-75f5-450d-966f-d3a5ba9c6369
single
DNA is selected for genetic information compared to RNA because
The presence of the oxygen atom in the 2nd carbon of RNA make it more prone to spontaneous hydrolysis DNA is much more stable, the half-life of spontaneous hydrolysis is about 200 million years The possibility of mutations occurring and remaining unidentified is more with uracil since cytosine can be easily deaminated to uracilRef: DM Vasudevan, 7th edition, page no: 576, boxes 44.1
1
It is stable
Double stranted compared to RNA
Two strands are complementary
I has genes
Biochemistry
Metabolism of nucleic acids
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single
Least A-V O2 difference is seen in ?
Ans. is 'd' i.e., Cyanide poisoning
4
Hypoxic hypoxia
Anemic hypoxia
Stagnant hypoxia
Cyanide poisoning
Physiology
null
ca90cc5d-eab9-4028-ab3e-c105b0fffe85
single
The complication least likely to occur in a pseudocyst of the pancreas
Pseudocyst complications Infection (MC) :14% Pain due to expansion Hemorrhage upto 10% Duodenal obstruction Rupture Abscess Ref: Shackelford 7th edition Pgno :1159
4
Hemorrhage
Rupture
Infection
Carcinomatous change
Anatomy
G.I.T
da9670b6-4737-40c6-bc39-ba1393755c18
single
Maximum dose of lignocaine with adrenaline is (in mg/ kg)
Ans. c (7). (Ref. Harrisons Medicine, 18th/735)LIGNOCAINE# Maximum safest dose 3 mg/kg or 200 mg and with adrenaline 7 mg/kg or 500 mg.# Duration of effect 45 to 60 min and with adrenaline it is 2-3 hours.# Should not be given in patients with history of malignant hyperthermia.# Concentration usedo Surface topical analgesia- 4%o As jelly, for urethra- 2%o Nerve blocks/epidural/infiltration block-- 1-2%o Spinal- 5%# Lignocaine is an amide# It is 4 times less potent than bupivacaine# Drug of choice for lignocaine-induced arrhythmia is bretylium tosylate (SGPGI 2002)# Repeated doses of 4-5 mL of 0.5% bupivacaine or 1% lignocaine are used to maintain epidural analgesia.# 'Transient neurological symptoms' is an disntinct side-effect of LignocaineEducational point:The baricity of the local anesthetic solution. Baricity is defined by the ratio of the density of the local anesthetic solution to the density of CSF. A solution with a ratio > 1 is hyperbaric and tends to sink with gravity within the CSF. An isobaric solution has a baricity of 1 and tends to remain in the immediate area of injection. A ratio < 1 is a hypobaric solution, which rises in the CSF.
3
4
2
7
10
Anaesthesia
Local and Regional Anesthesia
d86b98eb-c7ef-4052-ab4e-2b0c78dcdd58
single
Which of the following includes inflammatory bowel disease in children -
Ans. is 'c' i.e., Regional ileitis Inflammatory bowel disease o Inflammatory bowel disease (IBD) is used to represent two distinct disorders of idiopathic intestinal inflammation : i) Crohn disease or regional ileitis ii) Ulcerative colitis
3
Coeliac disease
Tropical sprue
Regional ileitis
Cystic fibrosis
Pediatrics
null
510bb2c9-e6cc-46c4-b836-263b513f8c36
single
Which of the following serves as the MOST DIAGNOSTIC sign of Pregnancy?
Ans. C. Foetal heart soundsPresence of fetal heart sounds is considered to be one of the most diagnostic signs of pregnancy.Other absolute signs of pregnancy are mentioned as follows:* Perception of active fetal movements and Palpation of fetal parts.* Ultrasonographic evidence of gestational sac and embryo in early pregnancy and even later.Probable signs:* Osiander's sign (increased pulsation felt through lateral fornix by 8 weeks), Chadwick's sign (Blue hue of vagina), and Goodell sign (softening of cervix)* Enlargement of the abdomen.* Change in shape, size as well as consistency of uterus* Softening of cervix* Internal as well as external ballottement* Contraction of Braxton Hicks
3
Amenorrhoea
Quickening
Foetal heart sounds
Distention of abdomen
Gynaecology & Obstetrics
Diagnosis of Pregnancy
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single
Which one of the following patterns of visual disturbance would be predicted to be demonstrable on examination of this patient?
Answer A. Inferior hemifield lossDilated ophthalmoscopy of this left eye illustrates a nonrefractile plaque in the proximal superior retinal artery with retinal whitening in the superior macula signifying retinal ischemia. Superior retinal ischemia will result in a defect in the inferior visual field, as in this patient. A diagnosis of hemiretinal arterial occlusion was made.
1
Inferior hemifield loss
Temporal quadrantanopsia
Uniocular blindness
Macular sparing hemianopia
Medicine
C.N.S.
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single
Denominator while calculating the secondary attack rate includes -
Ans. is 'c' i.e., All susceptible amongst close contact Secondary attack rate (SAR) SAR is defined as "the number of exposed persons developing the disease within the range of incubation period, following exposure to primary case".
3
All the people living in next fifty houses
All the close contacts
All susceptible amongst close contact
All susceptible in the whole village
Social & Preventive Medicine
null
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multi
All of the following are therapeutic uses of penicillin G, except -
Ans. is 'b' i.e., Rickettsial infection Antibacterial spectrum of Penicillin G (Benzyl Penicillin) o PnG is a narrow spectrum antibiotic o Activity is limited primary to gram positive bacteria (and few others). o Amongst gram negative organisms, penicillin has activity against gonococci, meningococci, few Ecoli & proteus. o Majority of gram negative bacilli are insensitive. o M. Tuberculosis, Ricketsiae, chlamydia, protozoa, fungi and viruses are totally insensitive to penicillin G. Penicillin G is the DOC for (Laurence 9th/e 218. Katzun_g 7301 1. Meningococcal meningitis 7. Leptospira 2. Bacillus anthracis (anthrax) 8. Actinomyces israelii (Actinomycosis) 3. Clostridium perfringens (gas gangrene) 9. Borrelia burgdorferi (Lyme disease) 4. Clostridium tetani (tetanus) 10. Enterococci 5. Corynebacterium diphtheriae 11. Streptococci 6. Treponema pallidum (syphilis) 12. Susceptible pneumococci
2
Bacterial meningitis
Rickettsial infection
Syphilis
Anthrax
Pharmacology
null
4db6f28c-a8a1-4469-8d2d-6e9f0a910264
multi
Sheehan syndrome is due to:
Ans: b (Pituitary haemorrhage) Ref:Harrison, 16th ed, p. 2078Sheehan syndrome refers to panhypopituitarism after postpartum pituitary apoplexy.Apoplexy is an endocrine emergency that may result in severe hvpoglycaemia. hypotension. CNS haemorrhage and death.The hyperplastic enlargement of the pituitary during pregnancy increases the risk for haemorrhage and infarction. Acute symptoms - severe headache, signs of meningeal irritation, bilateral visual changes, ophthalmoplegia, cardiovascular collapse and loss of consciousness.Investigation:Pituitary CT or MRI - intratumoral or sellar haemorrhage. Pituitary stalk deviation and compressionTreatmenta) Patient with visual loss and impaired consciousness - surgical decompressionb) No visual loss, no loss of consciousness - high dose glucocorticoids.
2
Adrenal haemorrhage
Pituitary haemorrhage
Hypothalaamic hemorrhage
Pancreatic haemorrhage
Gynaecology & Obstetrics
Miscellaneous (Gynae)
467199b8-81d2-477c-aea5-7b59224bcf45
single
Lymes disease all are true except ?
Ans. is 'c' i.e., Polymorphonuclear leucocytosis in C.S.F. suggests meningeal involvement Spread of infection and immune response in lyme disease Borrelia burgdorferi is transmitted to humans the bite of ixodes tick vector Borrelia burgdorferi is inoculated in the skin, where local replication takes place locally and outward migration in the dermis occurs. Days to week after the tick bite, hematogenous dissemination to secondary sites (like joints, hea eye, nervous system) takes place. If untreated, the bacteria may persist in the body for months or even years, despite the production of antiBorrelia burgodorferi antibodies by the immune system. The following mechanisms have been described - i) Tick saliva, which accompanies the spirochete into the skin during the feeding process, contains substances that disrupt the immune response at the site of the bite. - This provides a protective environment where the spirochete can establish the.infection. ii) Once inside the body, Borrelia burgdorferi become; a stealth invader i.e., it changes shape. - In the tick and mice which host the bacterium through most of its life cycle, the bacterium has a thick cell wall and spiral shape. If it maintains its thick cell wall and its spiral shape, immune system can control infection. However, in the human body, it can shed its cell wall and can take a different shape. When under attack from immune system, it simply changes shape so it is not recognized. iii) Borrelia burgdorferi produces antigenic variation in a "cell surface lipoprotein VIsE", during the course of infection - The VIsE system presents a challenge to immune system because after an immune response is generated to one version of VISE protein, a different version is quickly produced. By using this type of antigenic variation, B. burgdorferi can escape the adaptive immune system. Lyme meningitis Meningitis (meningeal involvement) is the most common neurological event that occurs in the setting of early lyme dissemination. - In this clinical setting CSF is always abnormal and shows: 1) Pleocytosis with predominantly lymphocytosis (not polymorphonuclear leukocytosis). 2) Increased protein 3) Glucose content is usually normal, but it falls below the serum concentration in 20% of patients. Immunoglobulin abnormalities are common in the CSF of patients with lyme meningitis. - Specific 1gM, IgG or IgA antibody against B. burgdorferi appears in CSF and indicates intrathecal antibody synthesis.
3
Borellia bourgdorferi replicates locally and invades locally
Infection progresses inspite of good humoral immunity
Polymorphonuclear lymphocytosis in CSF suggest meningial involvement
IgA intrathecally confirms meningitis
Microbiology
null
b11dfc3e-a1d5-4256-a29f-ddb08de8e380
multi
The ratio of concentration of drug in co-trimoxazole trimethoprim and sulfamethoxazole is:
Trimethoprim is usually given orally, alone or in combination with sulfamethoxazole, which has a similar half-life. Trimethoprim-sulfamethoxazole can also be given intravenously. Trimethoprim is well absorbed from the gut and distributed widely in body fluids and tissues, including cerebrospinal fluid. Because trimethoprim is more lipid-soluble than sulfamethoxazole, it has a larger volume of distribution than the latter drug. Therefore, when 1 pa of trimethoprim is given with 5 pas of sulfamethoxazole (the ratio in the formulation), the peak plasma concentrations are in the ratio of 1:20, which is optimal for the combined effects of these drugs in vitro. Ref: Deck D.H., Winston L.G. (2012). Chapter 46. Sulfonamides, Trimethoprim, & Quinolones. In B.G. Katzung, S.B. Masters, A.J. Trevor (Eds), Basic & Clinical Pharmacology, 12e.
3
1:02
1:03
1:05
3:01
Pharmacology
null
e9841753-72a1-4f8c-8375-a967e4a0bf87
single
Which is the last organ to be dissected during autopsy in asphyxial death?
The autopsy in a case of a suspected asphyxial death has to be thorough including conventional neck dissection protocol. Dissection of the neck is performed after removal of the brain and thoracic organs in order to provide a clean bloodless field for the study of neck organs and prevents any aifactual seepage of blood in soft tissues of the neck. Ref: Concise Text and Manual of Forensic Medicine, Medical Law, and Ethics, 2005, Page 224.
1
Neck
Head
Abdomen
Thorax
Forensic Medicine
null
b1cf0dd3-bf12-41fe-8d87-ee8ada94a093
single
A young man back from leisure trip has swollen knee joints & foreign body sensation in eyes. Likely cause is -
Ans. is 'a' i.e., Reiter's syndrome Arthropathy following a recent leisure trip suggests reactive arthritis.Eye involvement points towards Reiter's syndrome.Reactive arthritis refers to acute nonpurulent arthritis, complicating an infection elsewhere in the body.Reiter's syndrome is one of the classic forms of reactive arthritis i.e. an aseptic inflammatory arthritis associated with nonspecific urogenital or bowel infection (with manifestations in the eye).Reactive arthritis is frequently associated with the human leucocyte antigen B27 (HLA - B27) Q haplotype.The etiology of reactive arthritis remains uncertain. The most accepted theory about the pathophysiology of reactive arthritis involves initial activation by a microbial antigen followed by an autoimmune reaction that involves skin, eyes and joints.Two forms of reactive arthritis have been recognized a sexually transmitted form and a dysenteric form.Gastrointestinal infections with, Shigella Q, salmonella Q and Campylobacter species and genitourinary infections with chlamydia trachomatis Q have been found to trigger reactive arthritis.The characteristic triad of Reiter's syndromeArthritis Q {polyarthritis, non erosive)Urethritis QConjunctivitis Q
1
Reiter's syndrome
Sarcoidosis
Behcet's disease
SLE
Medicine
Miscellaneous (Infection)
e43692cb-196e-4ee2-8082-324750ba68f2
single
Widest spectrum aminoglycoside is –
null
2
Streptomycin
Amikacin
Framycetin
Netilmicin
Pharmacology
null
b8dc0f9e-c922-42b5-bda5-09cdc5c66150
single
Cataract is seen in following except:
Ans. is 'b' i.e. Rheumatoid arthritis Aetiological classification of cataract:Senile CataractDevelopmental or congenitalComplicated cataractTraumaticMetabolicDiabetes*Tetany (hypoparathyroidism)Hypoglycemia*Galactosemia*Galactokinase deficiency*Lowe's syndrome*Wilson's disease*Maternal infectionRubella*Toxoplasma*CMV*ToxicGlucocorticoids *Busulphan*Chlorambucil*Long acting miotics*SyndromesWerner's*Alport's*Rothmund*Downs*Radiation alDermatogenicAtopic dermatitis*Rothmund' s syndrome*Werner's syndrome*
2
Glucocorticoid administration
Rheumatoid arthritis
Hypoparathyroidism
Galactosemia
Ophthalmology
Acquired Cataract
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multi
All of the following are seen in digitals toxicity except
Ref-critical care toxicology 4/e p395 Digital characteristics cause atrial tachycardia with AV block, it does not cause at atrial tachycardia with fast Venturicular rate
2
Ventricular bigeminy
Paroxysmal arial tachycardia with fast ventricular rate
Regularization of atrial fibrillation
Bidirectional ventricular tachycardia
Pharmacology
Cardiovascular system
18cfcfe7-c8c7-4a7e-a108-383ee96a1e75
multi
Iron absorption occurs from
Almost all iron absorption occur in duodenum & upper jejunum (proximal small intestine). Absorption of the majority of nutrients takes place in the jejunum, with the following notable exceptions: Vitamin B12 and bile salts are absorbed in the terminal ileum. Water and lipids are absorbed by passive diffusion throughout the small intestine. Sodium bicarbonate is absorbed by active transport and glucose and amino acid co-transport. Fructose is absorbed by facilitated diffusion.
2
Ileum
Small intestine and jejunum
Stomach
Oesophagus
Physiology
null
511d43a1-27e9-4d74-9564-91eb23024678
multi
Which of the following is an example of hyaline cailage?
Thyroid cailage is a type of hyaline cailage. Hyaline cailage is the most common type of cailage, in adults this is replaced by bone by a process called enchondral ossification. In the aicular surface of bone, costal cailage, nose, larynx, trachea and bronchi hyaline cailage persist throughout life and does not calcify.Elastic cailage: is highly flexible and is found in the external ear, walls of auditory tube, epiglottis and larynx.Fibrocailage is present in the interveebral disc, pubis symphysis and ceain joints.
2
Epiglottis
Thyroid cailage
Apex of Arytenoid Cailage
Pinna
Anatomy
null
3b2c538e-be58-4f09-9208-196ffb8bd3c4
single
DEC (Di–ethyl–carbamazine) is used for the treatment of :
null
1
Filariasis
Dracunculiasis
Schistosomiasis
Taeniasis
Pharmacology
null
2e26d0f6-5088-411a-9f5a-f951227c5f56
single
Orthopnea is heart failure develops due to
When a normal individual lies down, the pulmonary blood volume increases by up to 400 mL When the person stands up this blood is discharged into the general circulation. This shift is the cause of the decrease in vital capacity in the supine position and is responsible for the occurrence of orthopnea in heart failure.
3
Reservoir function of pulmonary veins
Reservoir function of leg veins
Reservoir function of pulmonary arteries
Reservoir function of leg arteries
Physiology
null
535c95ae-2fce-4a02-aba3-5905414bf29c
single
If APGAR score is 6, at 5 minutes of life, then what is the interpretation?
b. Moderate asphyxia(Ref: NNF & WHO guidelines)Apgar scoreInterpretation0-3Severe birth asphyxia4-7Moderate birth asphyxia>7Normal
2
Child is normal
Moderate asphyxia
Severe birth asphyxia
It requires immediate resuscitation
Pediatrics
New Born Infants
57ef66d4-145d-49e6-9997-57439a71aead
single
All are true regarding Hodgkin's lymphoma, except :
Answer is A (CNS is the commonest site of involvement) CNS involvement is an uncommon feature of Hodgkins. disease CNS involvement is an uncommon feature with Hodgkins disease: This may occur as : Sudden spinal cord compression in advanced progressive disease. Headache and visual disturbance in very rare patients with intra-cranial Hodgkins disease. Reed stern berg cell is the characteristic cell in Hodgkins, and the diagnosis of Hodgkins Lymphoma is still based entirely upon histological examination & the finding of classic Reed-Sternberg cell or one of its variants is considered essential for diagnosis. Plasms cells, Eosinophils and Neutrophils are seen in the reactive background Histology in Hodgkins shows distinctive Reed Sternberg cells (few) that are admixed with variable number of Lymphocytes, plasma cells, histocytes, eosinophills neutrophils and fibroblasts. Mediastinal involvement is paicularly common with nodular sclerosis variant Ceain Distincitive Features Seen In Nodular Sclerosis Variant it is the most common variant. Q it is the only variant more common in females. Q mediastinal involvement is paicularly common. Q large Reed Sternberg cell variants - 'Lacunar cells' Q -are present on histology. it has a good prognosis Q {2nd best, following Lymphocyte predominance (best)}
1
CNS is the commonest site of involvement
Characteristic cell is a Reed Sternberg cell
Mediastinal involvement is common in nodular--sclerosis type.
Eosinophils, plasma cells and neutrophils increase
Medicine
null
b49e6429-4cc8-43c4-bb0d-e9a9b878aa0b
multi
The index age group for deciduous teeth in year is:
null
2
12
5
35 - 44
65 - 74
Dental
null
597c072a-fe70-49d3-a775-42803e04cbcb
single
In organophosphorus compound poisoning, atropine can reverse all the following signs except -
Atropine given in organophosphorus poisoning has effects on muscarinic manifestations; it has no effect on nicotinic manifestations like muscle weakness, fasciculations, cramps, and areflexia.
4
Lacrimation
Diaphoresis
Diarrhea
Muscle weakness
Forensic Medicine
null
0bf251e9-f900-490d-93e6-748806c396df
multi
Which of the following is not involved in synthesis of pyrimidines?
The pyrimidine synthesis is a similar process than that of Purines(Purines Synthesis). In the de novo synthesis of Pyrimidines, the ring issynthesized first and then it is attached to a ribose-phosphate to for a pyrimidinenucleotide. Pyrimidine rings are assembled from bicarbonate, aspaate, and Ammoni
4
Glutamine
CO2
Aspaic acid
Glycine
Biochemistry
Metabolism of nucleic acids
36e089e2-16a3-4153-9779-887021d1e6ff
single
The closest pre-pubeal increase in height each year is
Length at bih - 50cms At the end of 1st year-75 cms Increase in length is 25cm/yr -1st year of bih At the end of 4yrs - 100cm. From there on till 12 yrs ( i.e, pre pubeal age) increase in height is 6cm per year. There is marked acceleration in height during pubey. Ref- Ghai , Chapter 2
3
1-2cm
3-4cm
5-7cm
8-10cm
Pediatrics
Growth and development
b8f7f067-4910-4e2d-aaec-1c90bc8f670f
single
Maximum liver toxicity is seen with which anti -TB drug?
Ans. is 'c' i.e., Pyrazinamide Three first line antitubercular drugs are associated with hepatotoxicity :? i) Rifampicin ii) INH iii) Pyrazinamide Of the three, rifampicin is least likely to cause hepatocellular damage, although it is associated with cholestatic jaundice. Pyrazinamide is the most hepatotoxic of the first line drugs. Among the second-line drugs, ethionamide, PAS and protionamide can also be hepatotoxic, although less so than any of the first line drugs.
3
Isoniazid
Rifampicin
Pyrazinamide
Streptomycin
Pharmacology
null
fe3d0afd-eeb0-4c45-84b1-a11ae4386833
single
A 20 year old college student working pa-time in a pediatric AIDS clinic develops a viral exanthem with a rash. Her blood is drawn and tested for specific antibodies to varicella-zoster (chickenpox). Anti-varicella immunoglobulin belonging to which of the following antibody classes would indicate that she is immune to chickenpox?
The immunoglobulin that represents past exposure to an antigen is IgG. It is the predominant antibody in the secondary response and is an impoant defense against bacteria and viruses. In the secondary response, a much larger amount of IgG antibody is produced than IgM, and the levels of IgG tend to persist for a much longer time than in the primary response. IgA , the main immunoglobulin found in secretions, prevents the attachment of bacteria and viruses to mucosal surfaces. It does not bind complement. IgD probably functions as an antigen receptor. It is found on the surface of many B lymphocytes and is found in small amounts in serum. IgE is the primary antibody in type I hypersensitivity. It mediates the anaphylactic response and also paicipates in host defenses against parasites (antibody-dependent cell-mediated cytotoxicity-ADCC). Ref: Brooks G.F., Carroll K.C., Butel J.S., Morse S.A., Mietzner T.A. (2013). Chapter 8. Immunology. In G.F. Brooks, K.C. Carroll, J.S. Butel, S.A. Morse, T.A. Mietzner (Eds), Jawetz, Melnick, & Adelberg's Medical Microbiology, 26e.
4
IgA
IgD
IgE
IgG
Medicine
null
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single
Actinomyces viscous that initially colonises the PDL environment most likely attaches to the pellicle or saliva coated surface through?
null
3
Membrane protein
Heat sensitive protein
Fimbriae
Outer membrane protein
Microbiology
null
d465b923-acc9-4cab-a5fa-9f5c09c6d0f0
multi
Unilateral breast involvement with scaly skin around the nipple and intermittent bleeding is suggestive of: September 2005
Ans. B: Pagets disease Paget's disease of the breast is an eczema-like change in the skin of the nipple, and is a superficial manifestation of an underlying breast cancer. The underlying breast cancer may be an invasive breast cancer or ductal carcinoma in situ (DCIS). In DCIS, the cancer cells are completely contained within the milk ducts. Paget's disease affects about 1-2 out of every 100 women with breast cancer. It is most common in women in their 50s, but can occur at a younger or older age. It can affect men, but this is extremely rare
2
Galactocoele
Pagets disease
Eczema
Sebaceous cysts
Surgery
null
b0e4fd42-0451-4e7b-aa03-f1eb166fbb80
single
Pouches are lined by which germ layer?
Pouches inside are lined by Endoderm Clefts outside are lined by Ectoderm
1
Endoderm
Ectoderm
Mesoderm
Both Mesoderm and Ectoderm
Anatomy
Pharyngeal Arches
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multi
A 20 year old woman presents with bilateral conductive deafness, palpable purpura on the legs and hemoptysis. Radiograph of the chest shows a thin-walled cavity in left lower zone. Investigations reveal total leukocyte count 12000/mm3, red cell casts in the urine and serum creatinine 3mg/dL. What is the most probable diagnosis?
Answer is C (Wegener's granulomatosis) The patient in question has been depicted to have one manifestation each of the classical triad as mentioned below along with skin lesion in the _Pm of palpable purpura and hence the answer is clearly Wegener's granulomatosis. Wegener's granulomatosis in its classical form presents as characteristic triad of ? - Upper respiratory infection (ENT manifestations): includes otitis media (conductive deafness) - Lower respiratory tract infection (Lung): includes haemoptysis and radiological cavity. - Renal involvement: includes red cell casts and raised serum creatinine. Skin lesions are seen in 46% of patients and may take the form of palpable purpura. Wegener's granulomatosis: Review Wegener's granulomatosis is a distinct clinicopathological entity characterized ? Clinically * Triad of Upper respiratory tract manifestation (ENT) Lower respiratory tractdeg manifestations (Lung) Renal manifestations' - Otitis media (conductive deafness) - Paranasal sinus pain & drainage - Septal perforationQ Other manifestations - Cough, haemoptysis, dyspneaQ - Multiple bilateral cavitatory nodular infiltrates - Rapidly progressive rena failureQ - Crescentric glomerulonephritisQ * FeverQ, skin manifestationQ in the form of papules, vesicles, palpable purpura etc eye manifestationsQ, joint manifestationsQ cardiac manifestationsdeg and nervous system manifestationsQ. Pathologically by * Necrotizing vasculitis' of smalls' aeries and veins * Intravascular and extravascular granuloma formation Q Granulomas contain multiple well defined multinucleated giant cells Bronchoalveolar lavage fluid contains high percentage of neutrophils compared to other granulomatous diseases which contain increased number of Lymphocytes Q c-ANCA is the predominant ANCA in the disease Characteristic laboratory findings include: I . Positive c-ANCA0 2. Elevated ESR (mild elevation) 3. RFdeg (often elevated) 4. Hypergammaglobunemia (paicularly IgA class)Q * Hypocomplementemia is not seen despite presence of circulating immune complexes" Treatment of choice is: cyclophosphamide Q
3
Henoch-Schonlein purpura
Polyaeritis nodosa
Wegener's granulomatosis
Disseminated tuberculosis
Medicine
null
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multi
Progesterone of choice in emergency contraception is the following:
Postcoital contraceptive methods prevent implantation or cause regression of the corpus luteum and are highly efficacious if used appropriately. Levonorgestrel is more effective and is associated with fewer side effects than the combination estrogen-progestin regimens. Other hormone-based emergency contraception: Estrogen-progestin Combinations Antiprogestins and selective progestin-receptor modulators Copper-containing intrauterine devices within 5 days after unprotected intercourse Ref: Hall J.E. (2012). Chapter 347. The Female Reproductive System, Infeility, and Contraception. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.
2
DMPA
Levonorgestrel
Norgestrel
Micronised progesterone
Gynaecology & Obstetrics
null
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single
The best way to diagnose the degree of placenta pre is
Trans vaginal sonography
1
Trans vaginal sonography
Double set-up examination
Observation during C.S.
Examination of placenta after delivery
Gynaecology & Obstetrics
null
023c7862-ae74-4462-a686-d6f414132e1d
single
HLA HI gene codes for -
Ans. is 'b' i.e., Complement
2
Immunological reaction in graft rejection
Complement
Graft versus host reaction
Immunoglobulins
Microbiology
null
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single
Which among the following is known as 'Eaton agent' which causes respiratory infection?
M. pneumoniae pneumonia is also referred to as Eaton agent pneumonia (the organism having first been isolated in the early 1940s by Monroe Eaton), primary atypical pneumonia, and "walking" pneumonia. A mild tracheobronchitis with fever, cough, headache, and malaise is the most common syndrome associated with acute M pneumoniae infection. The pneumonia is typically less severe than other bacterial pneumonias. It has been described as "walking" pneumonia because most cases do not require hospitalization. Ref: Hardy R.D. (2012). Chapter 175. Infections Due to Mycoplasmas. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.
3
Corynebacterium
Pseudomonas
Mycoplasma
Streptococcus
Microbiology
null
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single
In type 4 thyroplasty, vocal cord is
Thyroplasty Isshiki divided thyroplasty procedures into 4 categories to produce a functional alteration of vocal cords. Type I: It is medial displacement of vocal cord as in achieved in Teflon paste injection. Type II: It is lateral displacement of the vocal cord and is used to improve the airway. Type III: It is used to shoen the vocal cord. Relaxation of vocal cord lowers the pitch. This procedure is done in mutational falsetto or in those who have undergone gender transformation from female to male. Type IV: This procedure is used to lengthen the vocal cord and elevate the pitch. It conves the male character of the voice to female and has been used in gender transformation. It is also used when the vocal cord is lax and bowing due to the ageing process or trauma. Ref: Textbook of diseases of ENT, PL Dhingra, 7th edition, pg no. 340,341
3
Medially displaced
Laterally displaced
Lengthened
Shoened
ENT
Larynx
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multi
Reduvid bug transmitts-
Ans. is 'd' i.e., Chaga's disease Arthopods Arthropod borne diseases1) Mosquito:1) AnophelesMalariaFilaria (Not in India) 2) CulexJapanese encephalitisWest nile feverBancroftian filariasisViral arthritis 3)AedesYellow feverDengueDengue hemorrhagic feverChikangu nya feverRift valley feverFilaria (Not in India)Zika virus 4) MansonoidesBrugian filariasis2) SandflyKalazarOriental soreOraya feverSandfly fever 3) Tse - tse flySleeping sickness4) LouseEpidemic typhus, relapsing fever, trench fever; pediculosis, vogabond disease.5) Rat fleaBubonic plague, endemic typhus, chiggerosis, hymenolepis diminua6) Black flyOncocerciasis7) ReduvidbugChagas disease8) Hard tickTick typhus, viral encephalitis, viral hemorrhagic fever, KFD, Tularemia, tick paralysis, human babesiosis, Lyme's disease9) Soft tickQ fever, relapsing fever, KFD10) Trombiculid miteScrub typhus, Ricketssial pox11) Itch miteScabies12) CyclopsGuinea worm disease, Fish tape worm ( D. latum )13) CockroachesEnteric pathogens14) HouseflyTyphoid and paratyphoid fever, diarrhoea, dysentery cholera, gastro-enteritis, amoebiasis, helminthic infestations, poliomyelitis, conjunctivitis, trachoma, anthrax, yaws, etc.
4
Kalaazar
Relapsing fever
Trench fever
Chagas disease
Social & Preventive Medicine
Communicable Diseases
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single
The most frequent direction in which the articular disc gets displaced is
null
3
Anterior and lateral direction
Posterior and lateral direction
Anterior and medial direction
Posterior and medial direction
Surgery
null
ce3ced3e-8b09-4d84-a037-3ca75d27c417
single
Initially renal aeries are branches of
Initially the renal aeries are branches of the common iliac aeries, then the distal end of aoa and when kidneys are located at a higher level, they receive new branches from the aoa. Normally the caudal renal vessels undergo involution and disappear. Ref - pubmed.com
2
Aoa
Common iliac aery
External iliac aery
Internal pudendal aery
Anatomy
Abdomen and pelvis
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multi
The following is/are true of a descending aoic dissection:
Descending Aoa dissections Almost always seen in hypeensive patients. Diagnosis is made by locating the tear in the aoa distal to the left subclan aery. Type III dissections may involve only the descending thoracic aoa but can extend the entire length of the aoa.
4
It originates distal to the subclan aery.
It is usually found in hypeensive patients.
It may extend the entire length of the aoa.
All of the above
Surgery
Aerial disorders
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multi
Eligible couple register is maintained at
null
1
Sub center
PHC
District hospital
Community Hospital
Social & Preventive Medicine
null
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single
Which of the following develop first during dependence of a substance -
Ans. is 'c' i.e., Psychological dependence Drug dependenceo Drug dependence, as the name suggests, is a state where a person becomes dependent on a drug despite knowing the harmful effect of the drug.o This state arises from repeated, periodic or continuous administration of a drug, that results in harm to the individual.o The subject feels a desire, need or compulsion to continue using the drug and feels ill if abruptly deprived of it (withdrawl syndrome)o Drug dependency is characterized by the triad of:i) Psychological dependenceo First to appearo There is emotional distress if the drug is withdrawnii) Physical dependenceo Follows psychological dependenceo There is physical illness if the drug is withdrawn (withdrawl symptoms)iii) Toleranceo Tolerance may beSelf tolerance -To the drug on which the subject is dependentCross tolerance - To the other similar (usually) or dissimilar (sometimes) drugs.o The frequency of use of drug is usually daily and duration is inevitably greater than 2-3 weeks.
3
Tolerance
Physical dependence
Psychological dependence
Withdrawal symptoms
Pharmacology
Pharmacodynamics
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single
Which of the following is utmost important factor considered in balanced occlusion with little change in esthetics and change in inclination or amplitude leads to the loss of facial appearance?
null
3
Inclination of condyle guidance
Compensating curve of spec.
Inclination of incisal guidance
Cuspal height and angulation
Dental
null
8c3f5293-93e7-458d-996c-6fbda96c5c71
single
A 55 year old patient with disseminated tuberculosis is prescribed drugs. Which of the following might be seen in patient of TB, who has regularly been injecting intramuscular injection of streptomycin:
Deafness
4
Blindness
Increased AST levels
Impotence
Deafness
Pharmacology
null
b04d29ea-23e7-4046-8162-e8d110dffdc0
single
A 10 year old male child presents with pallor and h/o blood transfusion 2 months back. On investigation, Hb-4.5 gms, Total count-60,000,Platelet count-2 lakhs and CD 10+ve, CD 19+ve, CD 117 +ve, MPO +ve and CD 33 -ve. What is the most probable diagnosis?
. Mixed phenotypic a/c leukemia
4
ALL
AML
Undifferentiated leukemia
Mixed phenotypic a/c leukemia
Pathology
null
b9321602-1020-4daa-9653-4b91bee1122c
multi
The severity of pelvic pain in endometriosis correlates best with :
Depth of invasion
2
Number of implants
Depth of invasion
Stage of disease
Ca 125 levels
Gynaecology & Obstetrics
null
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single
Drugs that can enhance action of sulfonylurea include the following, except:
Drugs that enhance SU action (may precipitate hypoglycaemia) are- (a) Displace from protein binding: Phenylbutazone, sulfinpyrazone, salicylates, sulfonamides. (b) Inhibit metabolism/excretion: Cimetidine, ketoconazole, sulfonamides, warfarin, chloramphenicol, acute alcohol intake (also synergises by causing hypoglycaemia). (c) Synergise with or prolong pharmacodynamic action: Salicylates, propranolol (cardioselective antihypertensives, lithium, theophylline, alcohol (by inhibiting gluconeogenesis). Minoxidil and diazoxide are K+ channel openers, which were used earlier in severe hypertension and hypertensive  emergencies.   Reference: Essentials of Medical Pharmacology Eighth Edition KD  TRIPATHI  page no 296
2
Salicylates
Diazoxide
Propranolol
Cimetidine
Pharmacology
null
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multi
All are true about Migratory motor complex except
Migratory motor complex resumes 90 - 120 mins after the meal and occurs at interval of 90 mins till next meal.
2
Also knows as Broom sticks of GIT
It starts immediately after meals
It is controlled by motilin hormone
It clears contents of stomach and small intestine in between the meals
Physiology
null
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multi
Diastatic fracture is
(Seperation of the cranial sutures) (222-Reddy's 29th)DIASTAT1C OR SUTURAL FRACTURES - separation of the sutures occurs only in young persons due to a blow on head with blunt weapon* It may occur alone but often is associated with fracture* It is usually seen in saggital sutures* These are particularly common in traffic accidents* Most successful estimate to union of skull is done from sagittal sutures, next lambdoid and then coronal (72- Reddy 29th)* Fissured fracture - These are linear fractures involving the whole thickness of the bone or inner or outer table only about 70% skull fractures are linear* Comminuted fracture - There are two or more intersecting lines of fracture which divide the bone into three or more fragments, and blows from weapon with a large striking surface eg heavy iron bar* Depressed fracture - "fractures a la signature" (signature fracture) as their pattern often resembles the weapon or agent which caused itLocalized depressed fractures are caused by blows from heavy weapon with a small striking surface** stone, stick, axe, chapper, hammer etc.Gutter fractures - They are formed when part of the thickness of the bone is removed so as to form a gutter eg oblique bullet wounds. They are usually accompanied by irregular, depressedfracture of the inner table of the skull* Hinge fracture of base of skull is also termed as a 'Motor cycylist's fracture' *** (247-Reddy 28th)Crescent fracture is - fracture of the iliac bone with sacroiliac joint disruption**Jefferson is - is a burst fracture where both the anterior and posterior arches of atlas (C1) are fractured by a vertical force acting through the skullClay shroveller's fracture - fracture of spinous process of T1 vertebra caused by violent muscular actionHangman fracture - fracture of C2 vertebra seen injudicial hanging due to extensionBox or Bursting fracture - is an extensive fracture running parallel to the two points of contect separating the two hemisphere. It is frequently caused by being run over by heavy vehicleRing fracture - any fracture round the foramen magnum it result fromI. fall from a height on feet or buttockII. sudden violent turn of the head on the spineIII. severe blow on vertex which drives the skull down wards on the vertebral columnIV. heavy blow directed underneath the occiput or chin
1
Seperation of the cranial sutures
Also known case "Fracture a-la-signature"
There are two or more intersecting lines of fracture
A linear fracture involving the whole thickness of the bone
Forensic Medicine
Injuries
74bf3532-83e7-42a6-ae27-ac89b576e0cf
single
Which one of the following is the drug of choice for treating systemic fungal infection ?
Amphotericin B is an antifungal medication used for serious fungal infections and leishmaniasis. The fungal infections it is used to treat include aspergillosis, blastomycosis, candidiasis, coccidioidomycosis, and cryptococcosis. For ceain infections it is given with flucytosine Ref Harrison20th edition pg 1078
2
Griseofolvin
Amphotericins
Ketoconazole
trimoxazole
Medicine
Infection
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single
Normal anion gap is seen in all except
Ans: b) Methanol poisoning (Ref: Harrison 17th edition/ Page 291-292)Anion gap is the measure of unmeasured anions.AG = Na+-Normally anions = cationsAny increase in anions other than Cl- or HCO3- will cause decrease in Cl- or HCO2 so that total anions is same in quantity. Eg increase in acetate, lactate, methanol, phosphate, albumin will increase AGDecrease in unmeasured cation (Ca++, Mg++ K+) will also have same result - increase AGExample of high anion gap acidosis:Lactic acidosis, Ketoacidosis, Ethylene glycol, Methanol, Salicylates, and Renal failure.Normal anion gap: 10-12 mmol/LNormal anion gap acidosis:Loss of HCO3- from GIT or kidney will result in reciprocal change in - No change in anion gap ( and vice versa)Eg : 1) RTA/ Ureterosigmoidoscpy/CaCl,2) Renal failure with drug induced hyperkalemia3) Cation exchange resins
2
Ureterosigmoidoscopy
Methanol poisoning
Renal tubular acidosis
Diarrhoea
Medicine
Fluid & Electrolyte
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multi
Which of the following amino acids is involved in one carbon pool?
Ans. is 'a' i.e., Glycine* Goups, containing a single carbon atom are called one carbon groups. One carbon groups are formed from following amino acids during their metabolism:- Serine, glycine, histidine and tryptophan. One carbon groups formed during metabolism are: methyl (CH3), methylene (CH2), methenyl (C H), formyl (CHO) and formimino (CH=NH)* These one carbon groups are transferred by way of tetrahydrofolate (THF), which is derivative of folic acid. One carbon groups carried by THF are attached either to nitrogen N5 or N10 or to both N5 and N10. Different one corbon derivatives of THF are- N5- methyl THF, N5, N10-methylene THF, N5, N10-methenyl THF, N5- formyl THF and N5-formimino THF. These derivatives are interconvertable.
1
Glycine
Proline
Threonine
Hydroxyproline
Biochemistry
Proteins and Amino Acids
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single
The ratio of anaerobe to aerobes in stool is
The mean number of bacteria in colon exceeds 10^11 bacteria/ gram of faecal matter. Approximately 99.9% of these bacteria are anaerobic in the colon. 300 to 400 different species or types of bacteria can be found. So the ratio of anaerobes to aerobes in the stool is 1000:01. Ref: Baveja textbook of microbiology; 4th edition.
3
10:01
100:01:00
1000:01:00
10000 : 1
Microbiology
general microbiology
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single
Antidiabetic drug with insulin independent action is ?
Ans. is'a'i.e., SGLT 2 inhibitor(Ref: KDT p.270)Sodium-glucose cotranspo-2 (SGLT-2) inhibitor: Dapagliflozin - antidiabetic drugs - action independent of insulin
1
SGLT2 inhibitor
DPP4 inhibitor
Meglitinide analogues
GLP1 agonist
Pharmacology
null
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single