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E-cadherin mutation is seen in metastasis of which type of breast carcinoma
Answer- B. Lobular CaMutation in gene encoding for E-cadherin (CDH-I) is associated with gastric carcinoma and lobular breast carcinoma.Detachment of tumor cells is thefrst step tn metastasis. Normally cells are glued to each other by adhesion moleculesE-cadherin. Normal function of E-cadherin is dependent on catenins that helps in linkage of cytoskeleton to E-cadherin.Down regulation of expression of either E cadherins or catenins results looseining of cells that helps ln metastasis.
2
Infiltrative ductal Ca
Lobular Ca
Metaplastic Ca
Medullary Ca
Pathology
null
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single
A 27-year-old man has a history of low back pain and stiffness. After several months of mild symptoms, he notes more severe stiffness at night and hip pain. On physical examination, there is paravertebral muscle tenderness and limited flexion of the lumbar spine. X-ray of the lumbar spine shows sacroiliitis. In addition to recommending physiotherapy and exercise, which of the following is the most appropriate next step in management?
All NSAIDs are probably equally effective in the treatment of this man's ankylosing spondylitis. Options include indomethacin or naproxen, but not phenylbutazone since it can cause aplastic anemia. Exercise and maintaining proper posture are very important.
1
NSAID therapy
phenylbutazone
azathioprine
acetaminophen
Medicine
Miscellaneous
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multi
In mycetoma, pink to red granules are produced by
Actinomadura pelletri - Pink to red granules. Madurella species - Black. Nocardia - White to yellow. Actinomadura madurae - White to yellow.
4
Madurella
Aspergillus
Actinumadura madurae
Actinomadura pelletri
Microbiology
null
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single
Enzymes found in CSF
The diagnostic value of cerebrospinal fluid (CSF) enzyme activities in neurological disorders has been evaluated most extensively with the enzymes aspaate aminotransferase (ASAT), lactate dehydrogenase (LDH), creatine kinase (CK) and lysozyme Refer Robbins page no chatteejee shinde 8th/730
3
GGT+ALP
ALP+CK-MB
CK +LDH
Deaminase and peroxidase
Anatomy
Nervous system
2ba75207-9440-4fbd-a656-1ba83e100a42
single
In coarctation of aorta, site of rib notching is?
Ans. (b) Inferior to ribCauses of inferior rib notchingCauses of superior rib notching* Arterial: aortic coarctation, aortic thrombosis, pulmonary- oligemia/AV malformation, Blalock Taussig shunt, Tetralogy of fallot, absent pulmonary artery and pulmonary stenosis.* Venous: AV Malfomations of chest wall, superior vena cava or other central venous obstruction.* Neurogenic: Intercostal neuroma, Neurofibromatosis type 1, poliomyelitis.* Osseous: Hyperparathyroidism, Thalassemia* Poliomyelitis* Osteogenesis Imperfecta* Neurofibromatosis* Marfan's Syndrome* Collagen vascular disease* Hyperparathyroidism.
2
Superior to rib
Inferior to rib
At sternum
At Vertebra
Medicine
Diseases of the Aorta
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single
The most commonly used, most biocompatible and adhesive cement is:
The use of polyacrylic acid makes GIC capable of bonding to tooth structure. GIC is considered superior to many types of cements because it is adherent and translucent. Various formulas are available depending on the intended clinical application.   Water-soluble polymers and polymerizable monomers have been replacing part of the liquid content. Particles of metal, metal-ceramic, and ceramic have been added to some products to enhance mechanical properties. Other new formulations are capable of being chemically cured, light-cured, or both. GICs have been used for the esthetic restoration of anterior teeth, e.g., Class III and  V sites, as luting cements, as adhesives for orthodontic appliance and intermediate restorations, as pit and fissure sealants, liners and bases, and as core buildup materials. The GICs are classified below: Type I: Luting crowns, bridges, and orthodontic brackets Type IIa: Esthetic restorative cements Type IIb: Reinforced restorative cements Type III: Lining cements, base GICs elicit a greater pulpal reaction than ZOE cement but less than zinc phosphate cement. Glass ionomer luting agents pose a greater pulpal hazard than glass ionomer restorations when the GIC is mixed with a low P/L ratio because the pH remains acidic longer. With any GIC, a protective liner such as Ca(OH) 2 should be used if the preparation is closer than 0.5 mm to the pulp chamber. KEY Concept: The most commonly used, biocompatible and adhesive cement is Glass ionomer cement. Reference: PHILLIPS’ SCIENCE OF DENTAL MATERIALS, 12th ed page no 320, 323, 324
4
Zinc phosphate
Zinc oxide eugenol
Calcium hydroxide
Glass ionomer
Dental
null
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single
In syndrome X, patients have all of the following except -
null
3
Angina like chest pain
Ischemic ST segment depression
Abnormal coronary arteriogram
Excellent prognosis
Medicine
null
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multi
Laryngofissure is
Laryngofissure Opening the larynx in midline. Ref:- Stedman Dictionary; pg num:- 937
1
Opening the larynx in midline
Removal of arytenoids
Making window in thyroid cailage
Removal of epiglottis
ENT
Larynx
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A 3 year male presented with progressive anemia, hepatosplenomegaly and osteomyelitis of jaw with pathological fracture, x-ray shows chalky white deposits on bone, probable diagnosis is
Ans. is 'a' i.e osteopetrosis Osteopetrosis (also known as Marble bone disease, Albers- Schonberg disease)Defect is in bone resorption due to abnormal function of osteoclasts.Defective bone resorption results in uniformly thickened dense bones, often without distinction between cortical and cancellous regions. The bones are dense but brittle therefore known as marble bone disease.Inheritance is both AD & AR*.The AR form dies early in the life.The AD form is of milder variety.Clinical features in osteopetrosis are caused byan increased tendency to fractures and osteomyelitis.Encroachment of the marrow space leading to anaemia and extramedullary hematopiesis- hepato splenomegaly & cranial nerve compression.
1
osteopetrosis
osteopoikilocytosis
alkaptonuria
myositis- ossificans progressiva
Orthopaedics
Metabolic Disorders Leading to Osteosclerosis
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The daily production of hydrogen ions from CO2 is primarily buffered by which of the following?
Aerobic metabolism produces 13,000 to 24,000 mmol CO2 per day. This yields close to that amount of H+ ions produced per day the reaction: CO2 + H2O - H2CO3 - H+ + HCO3-At the tissues, CO2 diffuses into the red blood cells, where the enzyme carbonic anhydrase accelerates the above reaction.The H+ produced is buffered mainly by a large amount of hemoglobin in the red blood cells.Bicarbonate is not an effective buffer of volatile acid (from CO2).
3
Extracellular bicarbonate
Red blood cell bicarbonate
Red blood cell hemoglobin
Plasma proteins
Microbiology
All India exam
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Which of the following enzyme (s) paicipate in protein synthesis:
Ans: d. Peptidyl transferase[Ref Harper 30th/422-24, 28th/359-66, 323; Lippincott 4th/438-42; Chatterjea & Shinde 7th/248-501Enzyme Required for TranslationAmino-acyl-t-RNA synthetase: Enzyme required for activation of amino acids, Peptide synthetase (peptidyl transferase)The NH2 of new aminoacyl t - RNA (AI) in 'A' site combine with the - COOH group of Met - t -RNA occupying the 'P' site. The reaction is catalyzed by peptidyl transferase". "Peptidases degrades proteins to amino acidsThe NH2 of new aminoacyl t - RNA (AI) in 'A' site combine with the - COOH group of Met - t -RNA occupying the 'P' site. The reaction is catalyzed by peptidyl transferase . `` peptidases degrades proteins to amino acids.ProteinfunctionDNA polymerasesDeoxynucleotide polymerizationHelicasesProcessive unwinding of DNATopoisomerases Relieve torsional strain that results from helicase-induced unwindingDNA primaseInitiates synthesis of RNA primersSingle-strand binding proteinsPrevent premature reannealing of dsDNADNA ligaseSeals the single strand nick between the nascent Okazaki chain and fragments on tagging strand
4
DNA ligase
DNA Helicase
Peptidase
Peptidyl transferase
Biochemistry
null
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Reversible monoamine oxidase inbitors (MAOIs) are:
Ans: c (Moclobemide) Ref: Ahuja, 6th ed,p. Katzung Pharmacology, 10th ed,p. 475Moclobemide is a reversible and selective MAO-A inhibitor.MAO is a mitochondrial enzyme involved in oxidative deamination of biogenic amines(Adr,NA,DA,5-HT)ADVERSE EFFECTSHeadache, drowsiness, dry mouth, weight gain, postural hypotension, sexual disturbances, interactions with tyramine containing foods.Serotonin syndrome- It is a condition precipitated when MAO inhibitors are given with serotonin agonists, especially antidepressants of the selective serotonin reuptake inhibitor class (SSRIs). It occurs when overdose with a single drug, or concurrent use of several drugs, results in excess serotonergic activity in the central nervous system .Clinical features are hypertension, hyperreflexia, tremor, clonus, hyperthermia, hyperactive bowel sounds, diarrhoea, mydriasis, agitation, coma.Classification of anti-depressants1.TRICYCLIC ANTIDEPRESSANTS (TCAS)Imipramine, Amitriptyline, Clomipramine, Nortriptyline, Mianserin, Amoxapine2. SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIS)Fluoxetine, Paroxetine, Fluvoxamine, Sertraline, Citalopram, Escitalopram3.SEROTONIN NOREPINEPHRINE REUPTAKE INHIBITORS (SNRIs)Venlafaxine,Duloxetine4.NOREPINEPHRINE SEROTONIN REUPTAKE ENHANCERS (NSREs)Tianeptine5.NOR ADRENERGIC AND SPECIFIC SEROTONERGIC ANTIDEPRESSANTS (NaSSA)Mirtazapine6.NOREPINEPHRINE DOPAMINE REUPTAKE INHIBITORS(NDRIs)Bupropion7.SEROTONIN ANTAGONISTS AND REUPTAKE INHIBITORS (SARIs)T razodone,Nefazodone8. NORADRENERGIC REUPTAKE INHIBITORS ( NARIs)Reboxetine9.MONOAMINE OXIDASE INHIBITORS(MAOIs)REVERSIBLE SELECTIVE MAOIsMAOI-B-Selegiline; MAOI-A- Moclobemide
3
Nicorandil
Selegiline
Moclobemide
Fluphenazine
Psychiatry
Pharmacotherapy In Psychiatry
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Maternal near miss refers to:
Ans. is c, i.e. A woman presenting with life-threatening conditions but has survived.Ref. Master Pass in Obs/Gynae Konar, p 341A woman presenting with any life-threatening condition and survived, is considered as a Maternal Near Miss case. Maternal Near Miss is a retrospective event. From the definition point of view, woman can only be recognized as a maternal near miss, when she survives the server complications in pregnancy, labour or postpartum six weeks.
3
Teenager becoming pregnant
Contraceptive failure in a teenager
A woman presenting with life threatening condition but has survived
A woman presenting with life threatening condition who has died
Gynaecology & Obstetrics
Miscellaneous (Obs)
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Byssinosis is due to exposure of ?
Ans. is 'b' i.e., Cotton dust Byssinosis is due to exposure to cotton dust in textile industries.
2
Coal dust
Cotton dust
Sugarcane dust
Silica
Social & Preventive Medicine
null
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single
A 68-year-old woman had been suffering long term effects of diverticulosis and inflammation of the transverse colon. To permit operating on a patient with severe diverticulosis of the transverse colon, it would be necessary to first ligate (tie off) or clamp the source of arterial supply. Which of the following arteries will most likely be ligated?
The middle colic artery is the principal source of arterial supply to the transverse colon. The right colic artery, an infrequent branch of the superior mesenteric artery, supplies the ascending colon. The ileocolic branch of the superior mesenteric artery supplies distal ileum, cecum, and ascending colon. The left colic artery provides blood supply to the descending colon.
1
Middle colic
Right colic
Superior mesenteric
Ileocolic
Anatomy
Abdomen & Pelvis
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single
Antibiotic of choice for Stenotrophomonas maltophilia infection is:
Ans: b. Trimethoprim-sulfamethoxazole (TMP-SMX)
2
Ampicillin
Trimethoprim-sulfamethoxazole (TMP-SMX)
Penicillin
Ciprofloxacin
Pharmacology
null
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Paroxysmal nocturnal hemoglobinuria (PNH) is a disease that results from defects in:
Paroxysmal nocturnal hemoglobinuria (PNH) is a disease that results from acquired mutations in the phosphatidylinositol glycan complementation group A gene (PIGA), an enzyme that is essential for the synthesis of ceain cell surface proteins. Proteins are anchored into the lipid bilayer in two ways. Most have a hydrophobic region that spans the cell membrane; these are called transmembrane proteins. The others are attached to the cell membrane through a covalent linkage to a specialized phospholipid called glycosylphosphatidylinositol (GPI). In PNH, these GPI-linked proteins are deficient because of somatic mutations that inactivate PIGA. Ref: Robbins 8th edition Chapter 14.
4
Ankyrin
Band 3
Spectrin
GPI
Pathology
null
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Brown atrophy occurs due to deposition of?
Ans. is 'd' i.e., Lipofuscin o Deposition of lipofuscin in the heart is referred as brown atrophy.
4
Melanin
Hemosiderin
Hematin
Lipofuscin
Pathology
Intracellular Accumulations
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single
Animal reservoir for swine influenza virus is:
Ans. is 'c' i.e., PigPigs can be infected with both human and avian influenza viruses in addition to swine influenza viruses. Infected pigs exhibit signs of illness similar to humans, such as cough, fever and runny nose. Because pigs are susceptible to avian, human and swine influenza viruses, they potentially may be infected with influenza viruses from different species (e.g., ducks and humans) at the same time. If this happens, it is possible for the genes of these viruses to mix and create a new virus.
3
Field mice
Urban rats
Pigs
Calomys callosus
Microbiology
Virology
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multi
Which of the following is not a feature of scurvy
Here are the 15 most common signs and symptoms of vitamin C deficiency. Rough, Bumpy Skin. Corkscrew-Shaped Body Hair. Bright Red Hair Follicles. Spoon-Shaped Fingernails With Red Spots or Lines. Dry, Damaged Skin. Easy Bruising. Slowly Healing Wounds. Painful, Swollen Joints Reference: GHAI Essential pediatrics, 8th edition
2
Bony thickening
Metaphyseal widening
Epiphyseal separation
Dense margin at metaphysis
Pediatrics
Nutrition
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A 63-year-old man who has been previously healthy is admitted to the hospital with a 2-day history of cough, rigors, fever, and right-sided pleuritic chest pain. Chest x-ray shows consolidation of the right lower lobe (RLL) and a free-flowing right pleural effusion. Thoracentesis is performed, and the pleural fluid has the following characteristics:Cell count=1110/mm3Glucose=75 mg/dL (serum glucose=85 mg/dL)Protein=4.0 g/dL (serum protein=7.0 g/dL)LDH=400 U/Lserum LDH=200 U/L, normal=100-200 U/LpH=7.35What is the pathogenesis of the pleural effusion?
Clinical conditions associated with either an increase in hydrostatic pressure (such as congestive heart failure) or a decrease in oncotic pressure (such as nephrotic syndrome) are associated with transudative pleural effusions. This patient's pleural fluid is exudative by all three of the Light criteria: pleural fluid/serum protein ratio is greater than 0.5, pleural fluid LDH/serum LDH ratio is greater than 0.6, and pleural fluid LDH is greater than two-thirds the upper limits of the normal serum LDH. The most likely explanation for an exudative pleural effusion in the setting of an acute pneumonia is a parapneumonic effusion. Parapneumonic effusions occur in about 40% of patients with bacterial pneumonia. Parapneumonic effusions are exudative due to the fact that there is increased permeability of the visceral pleural membrane capillaries, and interstitial fluid moves across the visceral pleura into the pleural space. Parapneumonic effusions may be simple or complicated. Simple parapneumonic effusions are sterile and free flowing. If bacteria invade the pleural space, neutrophils move into the pleural space and anaerobic metabolism of glucose results in a low pleural fluid pH (<7.20) and glucose (<60). The characteristics of this patient's pleural fluid suggest that bacterial invasion of the pleural space has not occurred, and that this is a simple parapneumonic effusion. Hemorrhage into the pleural space occurs with trauma, cancer, and pulmonary embolism, but rarely with pneumonia.
3
Increase in hydrostatic pressure
Decrease in oncotic pressure
Increased permeability of visceral pleural membrane capillaries
Bacterial infection in the pleural space
Medicine
Respiratory
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Methacolamine has maximum agonists action at which of the following cholinergic receptors
Katzung 12e p100 KDT 7/e p101 Methacolamine is a non selective muscarine agonists. It has maximum agonist action on M2 receptors. relative selective agonist of cholinergic receptors are: M1 selective -Oxatremorine M2 selective -Methacolamine M3 selective- bethanocol
2
M1
M2
M3
M4
Pharmacology
Autonomic nervous system
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single
Tietze syndrome involves swelling of
Painful swelling of second or third Costo chondral joint.
2
1st Costochondral joint
2nd or 3rd Costochondral joint
4th & 5th Costochondral joint
6th or 7th Costochondral joint
Medicine
null
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single
A 5 yr old male child presented with H/O recurrent infection. O/E the child has rashes as shown below. Routine blood investigation reveal patient has low platelets. Which of the following diagnosis is possible?
Possible Diagnosis isWiskott Aldrich syndrome X linked recessive WASP gene mutation More in boys Characterized byrecurrent infections, eczema like rash and thrombocytopenia
2
Job syndrome
Wiskott Aldrich syndrome
Meales
Henoch Schoenlein purpura
Dental
NEET Jan 2020
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Traveller's diarrhoea is most commonly caused by
Ans. a (ETEC). (Ref. Harrison, 18th/Table 149-2; Chapter 149. Diseases by Gram-Negative Enteric Bacilli)Five types of E.coli include:1. ETEC (enterotoxogenic E.coli)2. EIEC (enteroinvasive E.coli)3. EPEC (enteropathogenic E.coli)4. EHEC (enterohemorrhagic E.coli)5. EAEC (enteroaggregative E.coli)Traveller's diarrhoea is most commonly caused by enterotoxogenic E.coli and then the other common organism responsible is S. dysenteriae.Intestinal Pathogenic E. ColiPathotypeEpidemiologyClinical SyndromeDefining Molecular TraitResponsible Genetic ElementSTEC/EHECFood, water, person-to- person; all ages, industrialized countriesHemorrhagic colitis, HUSShiga toxinLambda-like Stxl- or Stx2- encoding bacteriophageETECFood, water; young children and in travellers to developing countriesTraveller's diarrheaHeat-stable and - labile enterotoxins, colonization factorsVirulence plasmid(s)EPECPerson-to-person; young children and neonates in developing countriesWatery diarrhea, persistent diarrheaLocalized adherence, attaching and effacing lesion on intestinal epitheliumEPEC adherence factor plasmid pathogenicity island (locus for enterocyte effacement)EIECFood, water; children and in travellers to developing countries.DysenteryColonic epithelial cell invasion intra- cellular multipli cation, cell-to-cell spread.Multiple genes contained primarily in a large virulence plasmidEAEC?Food, water; children and in travellers to developing countries; all ages, industrialized countriesTraveller's, acute, Persistent diarrheaAggregative/diffuse adherence, virulence factors regulated by AggRChromosomal or plasmid associated adherence and toxin genesE.coli toxin (GSa), cholera toxin (Gsa), & Pertusis toxin (Gla) cause ADP-ribosylation
1
ETEC
S. dysenteriae
EPEC
Salmonella
Microbiology
Enterobecteriaceae
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What is treatment for class I hypovolemic shock
null
2
Admission and IV fluids
Oral Liquids
IV fluids alone
Blood transfusion
Surgery
null
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Which is true about arboviral disease?
Ans. (c) KFD is transmitted by ticks Yellow fever is an exotic disease for India, i.e. disease which may be impoed in India or India is yellow fever 'receptive' area that is "an area in which yellow fever does not exist but where condition would permit its development if introduced". Dengue virus has at least 4 serotypes (not one). Japanese encephalitis is transmitted by culex (not Aedes).
3
Yellow fever is endemic in India
Dengue viruses have only one serotype
KFD is transmitted by ticks
Japanese encephalitis is transmitted by Aedes
Microbiology
null
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Characteristics of an ideal candidate for copper-T inseion include all of the following except :
Candidate ideal for IUCD insseion: Who has borne atleast one child has no history of pelvic disease has normal menstrual periods is willing to check the IUD tail has access to follow up and treatment of potential problems is in a monogamous relationship. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE 23rd EDITION PAGE NO 497
3
Has at least one child
Is willing to check lUD tail
Has a history of ectopic pregnancy
Has normal menstrual periods
Gynaecology & Obstetrics
Contraception
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A 66-year-old driver suffers a stroke while driving on highway. He has a history of hypeension, is a heavy smoker, and drinks beer every weekend A right upper motor neuron paralysis of the facial nerve is noted; the other cranial nerves are normal. He has a hemiplegia on the right side, with equal paralysis of the arm and leg. His lesion most likely involves the:
Left Internal Capsule
1
Left internal capsule
Left Mid brain
Left Pons
Left Medulla
Anatomy
null
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Most emetogenic anti CA drug:
Ref: Katzung 14th ed. pg. 956; KDT, 6th ed. pg. 828* Cisplatin is a platinum coordination complex that is hydrolyzed intracellularly to produce a highly reactive moiety which causes cross linking of DNA by platinum compound.* It is a highly emetic drug. Antiemetics are routinely administered before infusing cisplatin.* DOC for cisplatin induced vomiting: Ondansetron* Major s/e of cispltin: Ototoxicity and nephrotoxicity.
3
5 FU
Methotrexate
Cisplatin
All
Pharmacology
Anti-Cancer
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Masticatory forces generated by a complete denture prosthesis is about
null
2
44 — 50 pounds
13 — 16 pounds
13 — 15 kgs
70 — 80 pounds
Dental
null
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Lauge - Hansen classification belongs to:-
Classification Fracture Lauge-Hansen Neer's Winquist Galand Gustilo Anderson Garden's/Pauwel's Ankle fracture Shoulder fracture Femur fracture Supracondylar humerus fracture Open fracture Neck of femur fracture
3
Femur fracture
Elbow fracture
Ankle fracture
Shoulder fracture
Orthopaedics
FMGE 2017
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Best Biological indicator of air pollution is
null
3
Gambusia fish
Poecilia
Lichens
Algae
Social & Preventive Medicine
null
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In case of secondary amenorrhea who fails to get withdrawal bleeding after taking Estrogen and Progesterone, the fault lies at the level of
Secondary Amenorrhea Definition: In women who have menstruated previously, no menses for an interval of time equivalent to a total of at least three previous cycles or 6 months Uterus must contain a functional endometrium that can respond to the actions of ovarian sex steroid hormones, estrogen and progesterone When estrogen and progesterone both were given and no menstruation at the end, the pathology lies in the endometrium Causes: Tuberculosis, Schistosomiasis Postabortal or puerperal curettage Asherman's syndrome
2
Pituitary
Endometrium
Ovary
Hypothalamus
Gynaecology & Obstetrics
null
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single
Inspiratory stridor is obstructive lesions of:
STRIDOR 1. Inspiratory stridor - obstructive lesion of supraglottis of pharynx. 2. Expiratory stridor - lesion of thoracic trachea, primary and secondary bronchi 3. Biphasic stridor - lesion of glottis sub glottis and cervical trachea
4
Trachea
Bronchus
Subglottis
Supraglottis
ENT
DNB 2018
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Abesent bile duct is seen in -
Ans. is 'a' i.e., Alagille syndrome Alagille Syndromeo Autosomal dominant diseaseo JAG 1 and NOTCH 2 mutationo Affects the liver and Hearta. Livero Biliary atresiao Autoimmune hepatitiso Jaundiceo Liver cirrhosisb Hearto Pulmonary stenosiso Tetralogy of Falloto VSDo Overriding aortac. Othero Other presentations of Alagille's syndrome include an unusual butterfly shape of one or more of the bones of the spinal column (visible on an x-ray), certain eye defects (such as posterior embryotoxon), and narrowed pulmonary arteries that can contribute to increased pressure on the right heart valves. Many people with Alagille syndrome have similar facial features, including a broad, prominent forehead, deep-set eyes, and a small pointed chin.
1
Alagille syndrome
Crigler Najjar Syndrome
Gilbert's Syndrome
Primary Sclerosing Cholangitis
Surgery
Anatomy (Gall Bladder & Bile Ducts)
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What is the type of inhibition of acetylcholinesterase caused by organophosphates?
Ans. d. Competitive and irreversible (Ref: Goodman Gillman 12/e p242. Katzung 12/e p106: KDT 7/e p99)The type of inhibition of acetyl cholinesterase caused by organophosphates is competitive & irreversible."Organophosphates cause irreversible inhibition of Acetyl-cholinesterase while that caused by carbamates is reversible. Both bind at the esteratic site of the enzyme causing competitive inhibition."" Thus, the terms reversible and irreversible as applied to the carbamoyl ester and organophosphate anti-ChE agents, respectively: reflect only quantitative differences in rates of decarbamoylation or dephosphorylation of the conjugated enzyme. Both chemical classes react covalently with the active center serine in essentially the same manner as does ACh. "--Goodman Gillman 12/e p242AnticholinesterasesReversibleIrreversibleCarbamatesAcridineOrganophosphateCarbamates* Physostigmine* Neostigmine* Pyridostigmine* Edrophonium* Rivastigmine* Donepezil* Galantamine* Tacrine* Dyflos (DFP)* Echothiophate* Parathion* Malathion* Diazinon (TIK -20)* Tabun* Sarin* Soman* Carbaryl* Propoxur
4
Competitive and reversible
Noncompetitive and irreversible
Uncompetitive and reversible
Competitive and irreversible
Pharmacology
Cholinergic System
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Concentration of methemoglobin to appears cyanosis
C i.e. 1.5 01
3
5 gm/ dl
2 gm/di
1.5 gm/ dl
12 gm/dl
Physiology
null
d045aeeb-33a1-4f79-b067-19711e14f2d1
single
Young woman LMP was 2 weeks back complains of pain in lower abdomen with no H/O fever and absence of leukocytosis. Diagnosis is -
Ans. is 'b' i.e., Mittelschmerz o Young female having mid cycle lower abdominal pain without fever and leukocytosis directs to the diagnosis of mittleschmerz.# Mittelschmerz is a mid-cycle pain, not lasting more than 12-24 hours, around ovulation. Pain is located in one of the iliac fossa and may be accompanied with vaginal bleeding.
2
Ectopic pregnancy
Mittleschmerz
Acute intermittent obstruction
Dysuria
Gynaecology & Obstetrics
Urinary System
2db2e744-be8f-4edf-9ea4-5f8c7b06142f
single
Rx of latent syphilis-
Stage of Syphilis Patients without Penicillin Allergy Patients with Confirmed Penicillin Allergy Primary, secondary, or early latent CSF normal or not examined: Penicillin G benzathine(single dose of 2.4 mU IM)CSF abnormal: Treat as neurosyphilis CSF normal or not examined: Tetracycline HCl(500 mg PO qid) or doxycycline (100 mg PO bid)for 2 weeksCSF abnormal: Treat as neurosyphilis Late latent (or latent of unceainduration), cardiovascular, or benignteiary CSF normal or not examined: Penicillin G benzathine(2.4 mU IM weekly for 3 weeks)CSF abnormal: Treat as neurosyphilis CSF normal and patient not infected with HIV:Tetracycline HCl (500 mg PO qid) or doxycycline(100 mg PO bid) for 4 weeksCSF normal and patient infected with HIV:Desensitization and treatment with penicillin if compliancecannot be ensuredCSF abnormal: Treat as neurosyphilis (Harrison's Principles of internal medicine, 20 th edition, page 1387)
1
Penicillin
Erythromycin
Tetracycline
Ciprofloxacin
Medicine
Infection
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single
Treatment of pneumoperitoneum, as a result of colonoscopic perforation in a young patient is:
Risk Associated With Colonoscopy Risks of Colonoscopy: Perforation and hemorrhage MC site of bleeding after colonoscopy: Stalk after polypectomy MC site of perforation during colonoscopy: Sigmoid colon Perforation can be used by excessive air pressure, tearing of the antimesenteric border of the colon from excessive pressure on colonic loops, and at the sites of electrosurgical applications Management: Patients with perforation but no peritoneal signs can be safely managed with careful monitoring (Bowel rest + Broad spectrum antibiotics + Close observation) A large perforation recognized during the procedure requires surgical exploration. Because the bowel has almost always been prepared prior to the colonoscopy, there is usually little contamination associated with these injuries and most can be reapired primarily Ref: Shackelford 7th edition pgno: 1747
2
Temporary colostomy
Closure+Lavage
Permanent colostomy
Symptomatic
Surgery
G.I.T
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single
Ring of Sommerring is seen in
D i.e. After cataract
4
Galactosemia
Dislocation of lens
Acute congestive glaucoma
After cataract
Ophthalmology
null
73072474-d74f-47ed-b4b6-bac96eb21285
single
About cranial trauma false is
.neuroblastoma is the commonest abdominal tumor . it is the tumor of adrenal medulla.. clinical features-chilg presents with huge abdominal mass,in the groin which is non mobile.not moving with respiration. nodular surface,crosses the midline.dancing eye syndrome and opsomyoclonus racoon&;s eye sign is infra orbital ecchymosis due to secondaries in retroorbital region (Ref: SRB&;s Manual of Surgery, 5th edition, pg no.509)
1
Raccoon eyes seen in subgaleal hemorrhage
Depressed skull is associated with brain injury at the immediate area of impact
Caicocavernous fistula occur in base skull
Post traumatic epilepsy seen in 15%
Surgery
Trauma
fce5a1ad-aabd-44bf-bd74-e30d6f0d3a1a
multi
Which of the following statements characterizes idiotypic determinants?
The idiotype is defined as the specific region of the Fab poion of the Ig molecule to which antigen binds. Antibodies against the idiotype poion of an antibody molecule are called anti-idiotype antibodies. The formation of such antibodies in vivo during a normal B cell antibody response may generate a negative signal to B cells to terminate antibody production. Variable regions (VL and VH) constitute the antibody-binding (Fab) region of the molecule. Within the VL and VH regions are hypervariable regions (extreme sequence variability) that constitute the antigen-binding site unique to each Ig molecule.
3
They are found in the crystallizable fragment(Fc) of immunoglobulins
They are found on protein antigens
They can be antigenic
They are found in the constant regions of immunoglobulins
Microbiology
null
2cbbbd98-e55d-4c25-8fd0-e1994199dc10
multi
Barrier method
Barrier methods includes Physical, Chemical and Combined methods Physical methods include Condom, Diaphragm and Vaginal sponge Chemical methods include Foams, Creams, Suppositories and Soluble films Reference : Park&;s textbook of preventive and social medicine, 23rd edition, Page no: 494, 495
3
Hormonal contraceptive
IUD
Condom
Sterilization
Social & Preventive Medicine
Demography and family planning
7ecd167d-c140-461e-9111-69834d395861
single
Stage IIB cervical carcinoma. Best line of management:
Management of Cervical cancer Stage I-IIA -Radical Hysterectomy Stage >= IIB - Chemoradiation
4
Type 3 hysterectomy
Chemotherapy
Radiation therapy
Chemoradiation
Gynaecology & Obstetrics
JIPMER 2017
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single
Oxygen - Hemoglobin dissociation curve is shifted to left by -
Ans. is 'b' i.e., Alkalosis Oxygen dissociation curve Shifted to right Shifted to left o Decreased oxygen affinity to hemoglobin o Increased P50 o Increased oxygen delivery to tissues o Causes : # Decreased pH (Acidosis) # Increased temperature # Increased PCO2 # Increased 2, 3 DPG (BPG) i) Growth hormone, Androgen, thyroid hormone ii) Exercise iii) Tissue hypoxia iv) High altitude v) Anemia vi) Alkalosis vii) Cyanotic CHD viii) Pregnancy ix) Chemicals: Inosine, Pyruvate, PEP, phosphate # Sickle hemoglobin (HbS) o Increased oxygen affinity to hemoglobin o Decreased P50 o Decrease oxygen delivery to tissues o Causes : # Increased pH (alkalosis) # Decreased temperature # Decreased PCO2 # Decreased 2,3 DPG (BPG):-Stored blood # Fetal hemoglobin (HbF)
2
Acidosis
Alkalosis
Hyperthermia
Anaemia
Unknown
null
02a5cb4d-f763-44df-b1f1-a120947c5519
single
Which of the following statements about Pneumococcus is false:
Meningitis is the most severe infection caused by pneumococci. Ref: Textbook of Clinical Pediatrics By A. Y. Elzouki, F. B. Stapleton, R. J. Whitley, William Oh, 2nd Edition, 2012, Page 1021; Textbook of Microbiology By Ananthnarayan, 8th Edition, Page 222
3
Capsule aids in virulence
Commonest cause of Otitis media
Causes mild forms of Meningitis
Respiratory tract of carriers is most impoant source of infection
Microbiology
null
1cfceee3-70d4-4c70-b6f5-af9a1f9fa996
multi
Lens contain which antigen?
Ans. Sequestered antigens
1
Sequestered antigens
Cross antigens
Heterophile antigens
Isoantigens
Ophthalmology
null
298ddae3-060e-4e68-803b-ce8158faa328
single
A 45 years old male presents with complain of black spots on his tooth surface. He gives a history of multiple gold restorations and insists on getting the same for this tooth.The intraoral examination reveals pit and fissure caries in relation to 16. Which of the following features will be preferred for retention of the restoration in this case?
Skirts are preparation features used in cast gold restorations that extend the preparation around some, if not all, of the line angles of the tooth. When properly prepared, skirts provide additional, opposing vertical walls that increase retention of the restoration. The placement of skirts also enables increased resistance to fracture by allowing the envelopment of the remaining compromised tooth structure with the restorative material. Sturdevant operative dentistry 7th Edition, Page No:131
4
Vertically oriented grooves
Horizontally oriented grooves
Coves
Skirts
Dental
null
562b41f3-53dc-41c6-bbd8-776e4d721089
multi
Which organism can penetrate intact cornea: September 2009
Ans. B: Gonococci Organisms that penetrate intact epithelium: Corynebacterium (Diptheria)-a nonencapsulated, nonmotile, gram-positive bacillus Acanthamoeba Neisseria gonorrhoea Aegyptius Listeria Shigella
2
Pneumococcus
Gonococci
Pseudomonas
Staphylococci
Microbiology
null
1cba38ed-facd-40ef-8dc2-f533ae138e47
single
Which of the following is a smallest posterior tooth:
null
2
Maxillary first premolar
Mandibular first premolar
Maxillary second premolar
Mandibular second premolar
Dental
null
78f17ee7-fb10-433d-9e38-ced7d5d6f1de
multi
Which virus is the leading cause of the croup syndrome in young children and, when infecting mammalian cells in culture, will hem absorb red blood cells?
Parainfluenza viruses are important causes of respiratory diseases in infants and young children. The spectrum of disease caused by these viruses ranges from a mild febrile cold to croup, bronchiolitis, and pneumonia. Parainfluenza viruses contain RNA in a nucleocapsid encased within an envelope derived from the host cell membrane. Infected mammalian cell culture will hem absorb red blood cells owing to viral hemagglutinin on the surface of the cell.
3
Group B coxsackievirus
Rotavirus
Parainfluenza virus
Adenovirus
Microbiology
Virology
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single
Ba's hydrops fetalis is lethal because -
Ans. is 'c' i.e., Hb Ba's cannot release oxygen to fetal tissues `In the foetus excess gamma globin chains form tetramers (Hb Bas) with such high affinity for oxygen that they deliver almost no oxygen to tissues' - Robbins o Clinically this condition manifests as hydrops fetalis and fetus shows features similar to those of erythroblastosis fetalis ----> Severe pallor, Generalized edema, Massive hepatosplenomegaly
3
Hb Ba's cannot bind oxygen
The excess a - globin form insoluble precipitates
Hb Ba's cannot release oxygen to fetal tissues
Microcytic red cells become trapped in the placental
Pediatrics
null
a763e042-c693-475f-ab51-a6a718d6099b
single
All are false except one in case of hyperophic pyloric stenosis -
Ans is 'd' ie USG is diagnostic test Hyperophic Pyloric Stenosis (HPS) The musculature of the pylorus and adjacent antrum is grossly hyperophied, the hyperophy being maximum in the pylorus itself. It occurs in approximately 3 in 1000 live bih and is the most common surgical cause of vomitting in infancy. M > F (4 : 1)* Characterstically the first born male child is affected. The conditon is most commonly seen at 4 wks after bih ranging from the 3rd wk to on rare occasion, the 7th. However, 20% of infants are symptomatic from bih, and most are symptomatic within the first 2 months after bih. Non-bilious vomiting, becoming increasingly projectile, occurs over several days to weeks. Eventually the infant will develop a nearly complete obstruction by the second to fouh week of life and will not be able to hold down even clear liquids. This invariably proceeds to severe dehydration if not t/t. These infants develop a metabolic alkalosis with severe depletion of potassium and chloride ions. " The diagnosis of pyloric stenosis usually can be made on physical examination by palpation of the typical 'olive' in the right upper quadrant and the presence of visible gastric waves on the abdomen. When the olive cannot be palpated, ultrasound in experienced hands will diagnose the condition accurately in 95 percent of pts." - Schwaz. Treatment - Pyloric stenosis is never a surgical emergency although dehydration and electrolyte abnormalities may present a medical emergency Fluid resuscitation and correction of electrolyte abnormalities and metabolic alkalosis is essential before surgery. - Surgery : Fredet-Ramstedt pyloromyotomy. (In it the pyloric mass is split without cutting the mucosa) Also know Administration of erythromycin in early infancy has been linked to the subsequent development of HPS. Jaundice may be seen in HPS, although cause is not clear.
4
Symptomatic within one week
Lump is always clinically palpable
T/t of choice is Finney's pyloroplasty
Ultrasonography is diagnostic test
Surgery
null
46cd6fd8-85e7-4753-84c5-3ecec249f4ac
multi
Hutchinson's rule is related to
(Refer: AK Khurana Comprehensive Ophthalmology, 6th edition, pg no. 110, 166) *Hutchinson's rule:- In herpes zoster ophthalmicus, the involvement of the tip of the nose, supplied by external nasal nerve (a terminal branch of nasociliary nerve), signifies increase the risk of ocular involvement (uveitis).
3
Herpes simplex keratitis
Mycotic keratitis
Herpes zoster Ophthalmicus
Vernal keratitis
Ophthalmology
Conjunctiva
afa44b41-1852-4bb5-948e-9a15fec33704
single
Regarding syphilis, all are true, except -a) VDRL titre decreases or even absent after treatmentb) VDRL becomes positive after 10-14 days of infectionc) Earliest serological test to become positive in untreated primary syphilis is TPHAd) Yaws and Pinta cannot be differentiated
null
1
bc
c
ac
ad
Microbiology
null
60ecc230-9135-46e1-ba82-22eaad598780
multi
Pain in tonsillar fossa and upper neck is characteristic of?
Eagle's syndrome is characterised by pain in tonsillar fossa and upper neck. Pain radiates of ipsilateral ear. There is aggravation of pain on swallowing. It is caused by calcification of stylohyoid ligament / elongation of styloid process. Ref: Diseases of Ear, Nose and Throat by P.L. Dhingra, 9th edition, p287.
1
Eagle's syndrome
Ape's syndrome
Sickler's syndrome
Usher's syndrome
ENT
All India exam
fc2ffa72-fa0a-420d-abad-698a6a015a0e
single
Muscle relaxant of choice in hepatic and renal failure
A i.e. Cisatracurium
1
Cisatracurium
Rocuronium
Vecuronium
Rapacuronium
Anaesthesia
null
da16443e-c6ea-421d-b13c-dc046df52e18
single
Mechanism of action of tetanospasmin
Ans. is 'a' i.e., Inhibition of GABA release . Tetanospasmin blocks the release of inhibitory neurotransmitters (GABA and glycine) in brain-stem and spinal cord.
1
Inhibition of GABA release
Inhibition cAMP
Inactivation of Ach receptors
Inhibition of cGMP
Microbiology
null
48d21353-ce61-476c-9477-7673b822ada1
single
Anterior communicating aeries in the circle of Willis is derived from ?
The circulus aeriosus (circle of Willis) is a large aerial anastomosis which unites the internal carotid and veebrobasilar systems. Anteriorly, the anterior cerebral aeries, which are derived from the internal carotid aeries, are joined by the small anterior communicating aery. Posteriorly, the two posterior cerebral aeries, which are formed by the division of the basilar aery, are joined to the ipsilateral internal carotid aery by a posterior communicating aery.
4
Basilar aery
Veebral aery
Internal carotid aery
Anterior cerebral aery
Anatomy
null
cb433bdf-4b22-4c56-b9a8-aea1e86703ab
single
A 48 year old woman was admitted with a history of weakness for two months. On examination, cervical lymph nodes were found enlarged and spleen was palpable 2 cm below the costal margin. Her hemoglobin was 10.5 g/dl, platelet count 2.7 X 1091 L and total leukocyte count 40 X 109/ L, which included 80% mature lymphoid cells with coarse clumped chromatin. Bone marrow revealed a nodular lymphoid infiltrate. The peripheral blood lymphoid cells were positive for CD 19, CD5, CD20 and CD23 and were negative for CD 79 B and FMC-7. The histopathological examination of the lymph node in this patient will most likely exhibit effacement of lymph node arachitecture by -
Ans is 'd' i.e., A diffuse proliferation of medium to large lymphoid cells with high mitotic rate o Lymphocytes postive for CD 19, CD20, CD23, CD5 suggest the diagnosis of chronic lymphocytic leukemia/small lymphcytic lymphoma. o In CLL/SLL larger lymphocytes show high mitotic activity and form proliferation centre. Chronic lymphocytic leukemia (CLL). small lymphocytic lymphoma (SLL). o CLL and SLL are identical neoplasms/arise due to an abnormal neoplastic proliferation of B cells. o CLL involves primarily bone marrow and blood, while SLL involves lymph nodes Morphology of CLL/SLL o The tumor cells of CLL are small B lymphocytes. o Leukemic cells have the morphological appearance of normal small to medium sized lymphocytes with clumped chromatin, inconspicuous nuclei and a small ring of cytoplasm. o The lymph node architecture is diffusely effaced by these tumor cells. o These cells are mixed with variable numbers of larger cells called prolymphocytes. o In many cases, prolymphyocytes gather together focally to form as proliferation centers, so called because they contain relatively large number of mitotic activity. o When present proliferation centers are pathognomonic for CLL/SLL. o In CLL, the peripheral blood contains increased numbers of small, round lymphocytes with scant frequently disrupted in the process of making smears, producing So called smudge cells.. Markers of CLL tumor cells o CLL is a tumor of mature B-cells, therefore it expresses the B-cell markers such as CD19, CD20 and surface IgM and IgD. o In addition CD23 and CD5 are also present (In contrast to mantle cell lymphoma which is positive for CD5 but negative for CD23).
4
A pseudofollicular pattern with proliferation centers
A monomorphic lymphoid proliferation with a nodular pattern
A predominantly follicular pattern
A diffuse proliferation of medium to large lymphoid cells with high mitotic rate
Pathology
null
a1734ce5-c736-4dc9-b9da-b42e37f4597b
single
Rashtriya Swasthya Bima Yojna is:
Ans. c. Government health insurance scheme meant for the poor (Ref: http://www.rsby.gov.in/about_rsby aspx)Rashtriya Swasthya Bima Yojana is Government health insurance scheme meant for the poor."Rashtriya Swasthya Bima Yojana provide health insurance coverage for Below Poverty Line (BPL) families. Objective is to provide protection to BPL households from financial liabilities arising out of health shocks that involve hospitalization."Rashtriya Swasthya Bima Yojana (RSBY) is a government- run health insurance scheme for the Indian poor. It provides for cashless insurance for hospitalization in public as well as private hospitals."Rashtriya Swasthya Bima Yojana provide health insurance coverage for Below Poverty Line (BPL) families. Objective is to provide protection to BPL households from financial liabilities arising out of health shocks that involve hospitalization. "Rashtriya Swasthya Bima YojanaAlso known as National Health Insurance Scheme (NHIS)Rashtriya Swasthya Bima Yojana or RSBY started rolling from 1st April 2008.Government sponsored scheme for the BPL population of IndiaQRs. 600 (75%) by Central governmentQRs. 200 (25%) by State governmentQGovernment of India contribution is 90% in case of North-eastern states & Jammu and KashmirLaunched by Ministry of Labour and Employment, Government of India.Provide health insurance coverage for Below Poverty Line (BPL) familiesQ.Objective:To provide protection to BPL households from financial liabilities arising out of health shocks that involves hospitalizationQ.Beneficiaries:Beneficiaries under RSBY are entitled to hospitalization coverage up to Rs. 30,000 per family per year for hospitalization in public and private hospitalsCover in case of death of a family member: Rs. 25,000/-QPre-existing conditions are covered from day one and there is no age limit.Coverage extends to five members of the family, which includes the head of household, spouse and up to three dependentsQ.Beneficiaries need to pay only Rs. 30/- as registration fee while Central and State Government pays the premium to the insurer selected by the State Government on the basis of a competitive bidding.
3
Low cost insurance scheme by general insurance companies
Industry associated insurance scheme meant for workers
Government health insurance scheme meant for the poor
Central government insurance scheme for employees
Social & Preventive Medicine
Health Programmes in India
75db9702-7f3c-455e-9e92-d89a3191fd04
single
A young patient of schizophrenia is intolerant to anti-psychotic medications. Which drug is most preferred for such a patient: March 2012
Ans: A i.e. ClozapineAbout 30% of patients do not respond to antipsychotics, or are intolerant to them, usually because of extrapyramidal side effects. The only proven drug intervention for this group is clozapine, which is effective in between a third and a half of such patients.
1
Clozapine
Olanzapine
Riseperidone
Haloperidol
Psychiatry
null
4a94ecd6-8e38-4e43-ae92-a260bdc4e54a
single
Neuromuscular transmission is affected by ?
Ans. is 'd' i.e., Streptomycin All aminoglycosides reduce Ach release from the motor nerve endings. They interfere with mobilization of centrally located synaptic vesicles to fuse with the terminal membrane (probably by antagonizing Ca2+) as well as decrease the sensitivity of the muscle end plates to Ach. Neomycin and streptomycin have higher propensity than kanamycin, gentamycin or amikacin, while tobramycin is least likely to produce this effect.
4
Sulfonamide
Nitrofurantoin
INH
Streptomycin
Pharmacology
null
e1f45c5b-4218-44a8-aec5-9c104a5807b7
single
All are long acting reversible contraceptives except :
IUCD is an effective, reversible and long term method of contraception Implanon and Jadella are subdermal implants which are effective for about 1-5 years Ref: Shaw Gynecology 17 e pg 267.
4
Implanon
IUCD
jadelle
OCP
Gynaecology & Obstetrics
Contraception
f93911d0-9cb9-4a4c-8974-a1e217c7bd75
multi
CMV retinitis in HIV occurs when the CD4 counts fall below which of the following levels?
CMV Retinitis is the most common cause of loss of vision in AIDS patients. Majority of cases of CMV retinitis occur in patients with a CD4+ T cell count <50/micro L. Therefore, patients at high risk of CMV retinitis (CD4+ T cell count <100/micro L) should undergo an ophthalmologic examination every 3-6 months. CMV retinitis usually presents as a painless, progressive loss of vision. Patients may also complain of blurred vision, floaters and scintillations. It is usually bilateral. The characteristic retinal appearance is presence of perivascular hemorrhage and exudate. Treatment consists of oral valacyclovir, ganciclovir, IV ganciclovir, or IV foscarnet, with cidofovir as an alternative. Ref: Textbook of Microbiology By Ananthanarayan and Panicker, 8th Edition, Page 573 ; Harrison's Principles of Internal Medicine, 18th Edition, Chapter 189
1
50
100
200
150
Microbiology
null
f99d7b4e-c01b-4ba3-8a45-8fd57623efe0
multi
All of the following are true regarding splenectomy in patients with hereditary spherocytosis, except ?
Ans. is 'd' i.e., Prolonged Anti-pneumococcal Antibiotic Prophylaxis must be given after splenectomy Splencectomv in patients with Hereditary spherocytosis Avoid splenectomy in mild cases. Delay splenectomy until at least 4 years of age after the risk of severe sepsis has peaked. Anti-pneumococcal vaccination befoe splenectomy is imperative while anti-pneumococcal prophylaxis post-splenectomy is controversial.
4
Avoid in mild cases
Delay splenectomy until at least 4 years old age
Anti-pneumococcal vaccination must be given before splenectomy
Prolonged anti-pneumococcal antibiotic prophylaxis must be given after splenectomy
Medicine
null
f6909e77-8e18-4110-9951-3acd11b2c55f
multi
True about subendocardial hemorrhages are all, except
SUBENDOCARDIAL HAEMORRHAGES: The haemorrhages are seen in the left ventricle, on the upper pa of the left side of the interventricular septum and on the opposing papillary muscles and adjacent columnae carnae. The haemorrhages are flame-shaped, confluent and tend to occur in one continuous sheet rather than patches. When the bleeding is severe, it may raise the endocardium into a flat blister. The mechanism of production is obscure. They are nonspecific finding and are seen: (1) after sudden severe hypotension due to severe loss of blood or from shock, (2) after intracranial damage, such as head injury, cerebral oedema, surgical craniotomy or tumours, (3) death from ectopic pregnancy, ruptured uterus, antepaum or postpaum haemorrhage, aboion, (4) various types of poisoning, especially arsenic. Ref:- k s narayan reddy; pg num:-112
1
Involves the right ventricular wall
Flame shaped hemorrhages
Continuous pattern
May be seen after head injury
Forensic Medicine
Death and postmortem changes
a6228ae9-fe28-438e-a803-988515ab5862
multi
Casoni test is positive in:
Echinococcus
3
Diphtheria
Scarlet fever
Echinococcus
Kala Azar
Microbiology
null
d6169c06-74e4-4b7c-b4f0-2a69764dd001
single
A 50-year-old male presented with left upper quadrant pain. On examination, the spleen was palpable 10 cm below left costal margin. Peripheral smear is shown below. Which of the following IHC is used for diagnosis of the condition?
Hairy cell leukemia*An uncommon chronic lymphoproliferative disorder of B lymphocytes *Clinical presentation: Massive splenomegaly, hepatomegaly, and lymphadenopathy*Peripheral blood: Bicytopenia/Pancytopenia, absolute monocytopenia, absolute neutropenia, anemia, and thrombocytopenia. *Cytopenia could be due to hypersplenism, hairy cell infiltration of marrow and TNF-a secreted by hairy cells.*Hairy cells are mononuclear cells with eccentric or central round, ovoid, reniform, or convoluted nuclei. Nuclear forms tend to have a reticular chromatin pattern. Hairy cells have variable amounts of cytoplasm that is blue-gray in appearance, exhibiting thin cytoplasmic projections*Bone marrow aspirate shows "dry tap" due to marrow fibrosis*Bone marrow biopsy shows hairy cells with "fried egg appearance"*Cytochemical stain: Positive for tarate-resistant acid phosphatase *Immunohistochemical stain: Positive for Annexin A1(specific for HCL), CD20, TRAP, DBA44, T-bet*And CD103 (Frozen section)*Flowcytometry : CD11c, CD22, CD25 and CD 103. Also positive for pan-B markers like CD19, CD20, and CD22. Newly identified CD200 marker shows expression only in hairy cell leukemia and chronic lymphocytic leukemia. Treatment of choice: CladribineParametersHCLHCL-VariantSplenic Lymphoma with Villous LymphocytesBloodMorphologyNuclear shapeOvoid, reniformRoundRoundChromatinReticular +- nucleolusCoarse with central nucleolusCoarse +- nucleolusCytoplasmBlue-gray, abundantBlue-gray, abundantBasophilic, scant to moderateMonocytopenia+--TRAP stain++++-+-Aspirated marrow*-++Splenic involvementRed pulpRed pulpWhite pulpFlow cytometry CD22+++++++ CD11c++++++ CD25++-+- CD103+++--Ref: Williams Hematology 8/e chapter 95
3
CD23
CD21
Annexin A1
Cyclin D1
Pathology
Haematology
b5975dd8-57de-4542-ae16-8772a1f432a5
single
Infection with colitis is caused by
Ans. is 'c' i.e., Strongyloides Strongvloidiosis . It is most frequently asymptomatic . In symptomatic cases the following lesions may be observed.
3
Enterobius vermicularis
Trichuris trichura
Strongyloides
Clonorchis
Microbiology
null
64bc11bc-cffc-4a29-ba68-14b5ce7a5689
single
Drug of choice for petit mal seizures is: September 2007
Ans. D: Valproate Choice of antiseizure agents Primary generalised tonic clonic (grand mal)-carbamazepine, phenytoin Paial, including secondary generalized-valproate, carbamazepine,phenytoin Absence (petit mal)-valproate Atypical absence, myoclonic, atonic-valproate Febrile seizures-diazepam Status epilepticus-I/V diazepam
4
Ethosuximide
Carbamazepine
Phenytoin
Valproate
Pharmacology
null
89bfa4ea-c158-4cd7-b0eb-e3ba285325e7
single
Fordyce granules mostly occurs in all of the following areas EXCEPT
null
3
Vermillion of the lip
Posterior tonsillar pillar
Alveolar ridge
Palate
Pathology
null
0da27ea7-a2ab-47b1-9632-2cbcf241f91d
multi
Circumvallate papillae are associated with:
null
3
Sweet taste.
Sour taste.
Bitter taste.
All of the following.
Dental
null
467cd601-4225-4d9a-a7cb-86fccc518c59
multi
Which of the following drug is contraindicated in variant angina?
Variant angina is caused by coronary vasospasm DOC:Sublingual Nitroglycerine Prophylaxis : Calcium channel blockers (like verapamil and Diltiazem) and nitrates Beta blockers are avoided as they may precipitate coronary vasospasm by counteracting beta 2 mediated coronary vasodilation. Therefore they are avoided in variant angina.
3
Diltiazem
Nitrates
Propranolol
Verapamil
Pharmacology
CHF, Angina Pectoris and Myocardial Infarction
46ac4c8c-3125-4230-94c9-bf0951ff0891
single
In comparing laparoscopic salpingostomy vs. laparotomy with salpingectomy for the treatment of ectopic pregnancy, laparoscopic therapy results in
Conservative laparoscopictreatment of ectopic pregnancy is now commonplace, although not yet universal. With increasing sophistication of techniques and fiberoptics, many microsurgical procedures can be done through the laparoscope. Recent studies suggestthat the fertility rates for laparoscopy and laparotomy are comparable, as are the implications of repeat ectopic pregnancies. Certainly laparoscopy, because of its small incision, results in fewer breakdowns and shorter hospital stays, but the incidence of complications due to retained ectopic tissue is higher.
1
Higher fertility rate
Lower repeat ectopic pregnancy rate
Comparable persistent ectopic tissue rate
Greater scar formation
Unknown
null
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single
The prophylaxis of pin prick injury in HIV EXCEPT
(D) Acyclovir for 12 months # Prevention of HIV transmission in health care settings:> In health care settings, universal body fluid precautions should be used, including use of gloves when handling body fluids and the addition of gown, mask, and goggles for procedures that may result in splash or droplet spread, and use of specially designed needles with sheath devices to decrease the risk of needle sticks.> Because transmission of tuberculosis may occur in health care settings, all patients with cough should be encouraged to wear masks.> Hospitalized HIV- infected patients with cough should be placed in respiratory isolation until tuberculosis can be excluded by chest radiograph and sputum smear examination.> Epidemiologic studies show that needle sticks occur commonly among health care professionals, especially among surgeons performing invasive procedures, inexperienced hospital house staff, and medical students.> Efforts to reduce needle sticks should focus on avoiding recapping needles and use of safety needles whenever doing invasive procedures under controlled circumstances.# Risk of HIV transmission from a needle stick with blood from an HIV-infected patient is about 1:300. The risk is higher with deep punctures, large inoculum, and source patients with high viral loads.> Risk from mucous membrane contact is too low to quantitate.> Health care professionals who sustain needle sticks should be counseled and offered HIV testing as soon as possible.> HIV testing is done to establish a negative baseline for worker's compensation claims in case there is a subsequent conversion.> Follow-up testing is usually performed at 6 weeks, 3 months, and 6 months.> Preferred regimen is Tenofovlr 300 mg with Emtricitabine 200 mg daily with Raltegravir 400 mg twice a day.> Providers who have exposures to persons who are likely to have Antiretro-viral medication resistance (eg, persons receiving therapy who have detectable viral loads) should have their therapy individualized, using at least two medications to which the source is unlikely to be resistant.> Because reports have noted hepatotoxicity due to Nevirapine in this setting, this agent should be avoided.> There have been documented cases of seroconversion following potential parenteral exposure to HIV despite prompt use of Zidovudine prophylaxis.> Counseling of the provider should include "safer sex" guidelines.
4
Zidovudine for 4 weeks
If there is scalpel cut wound along with Zidovudine with Stauvudine and Lamivudine
Regular blood testing
Acyclovir for 12 months
Medicine
Miscellaneous
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A patient prescribed crutches for residual paralysis in poliomyelitis is a type of -
Ans. is 'd' i.e., Rehabilitation Provision of aids for crippled is rehabilitation, e.g. prescription of crutches for PRPP. It is a type of teiary prevention.
4
Primary prevention
Primordial prevention
Disability limitation
Rehabilitation
Social & Preventive Medicine
null
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Which of the following is used as prophylaxis in case of diphtheria:
• In most countries, the diphtheria toxoid vaccine is given in combination with tetanus toxoid and pertussis vaccines (DTP vaccine). • DPT vaccine is most effectively used for prophylaxis and prevention of diphtheria. • Diphtheria is caused by the bacterium Corynebacterium diphtheriae. This germ produces a toxin that can harm or destroy human body tissues and organs. • One type of diphtheria affects the throat and sometimes the tonsils. Another type, more common in the tropics, causes ulcers on the skin. • Diphtheria affects people of all ages, but most often it strikes unimmunized children. • It is transmitted from person to person through close physical and respiratory contact. • DOC for Diphtheria infection: Erythromycin
1
DPT vaccine
Erythromycin
Ampicillin
DAT
Microbiology
null
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In low ovarian reserve, Anti Mullerian hormone level will be:-
Ovarian Reserve < 1 is low , more than 2 is normal Markers of a REDUCED ovarian reserve are: Increasing age, especially beyond 35 Decreased ovarian volume Decrease estrogen Decrease Antral Follicular count High serum FSH, especially more than 15 Reduced Inhibin, especially lesser than 45 pg/ml Low AMH - (SINGLE BEST TEST )
1
<1
4-Jan
>7
>10
Gynaecology & Obstetrics
NEET 2019
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In a mutation, if valine is replaced by which of the following, would not result in any change in the function of the protein
Normally functional hemoglobin may have different AA at position 67 of β-chain in place of valine.
4
Proline
Leucine
Glycine
Aspartic acid
Biochemistry
null
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Which of the following drug can lead to increased level of Theophylline
Cimetidine is an enzyme inhibitor which can increase theophylline levels and lead to toxicity.
3
Rifampicin
Phenobarbitone
Cimetidine
Phenytoin
Pharmacology
null
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The following tumours commonly metastasise to the ovary, except :
Ans. is c i.e. Oesophagus
3
Malignant melanoma
Stomach
Oesophagus
Lymphoma
Gynaecology & Obstetrics
null
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Not seen in Narcolepsy:
Narcolepsy is characterized by Cataplexy (loss of muscle tone) not Catalepsy. Catalepsy or catatonia is akinetic mutism & stupor seen in severe depression, schizophrenia. Remember: Two lepsy's can not be together, Catalepsy is not seen in Narcolepsy.
3
Sleep paralysis
Sleep attack
Catalepsy
Cataplexy
Psychiatry
null
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An adult male presented 4 weeks after intercourse with fever, rubbery ulcer, inguinal lymphadenopathy. Causative organism:
Ans. (a) LGVRef: Neena Khanna Synopsis of Dermatology 4th ed./322*LGV is an STD, caused by chlamydia presents classically with painless lymphadenopathy.*Mnemonic to remember LGV:# ABCDEFG: Asymptomatic, Bubo, Chlamydia, Doxy, Esthiomine, Fries test, Groove signDiseaseUlcerLymph nodeSyphilisPainlessPainlessChancroidPainfulPainfulLGVPainlessPainful (Bubo)
1
LGV
Syphillis
Chancroid
HIV
Unknown
null
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The most common cause of short stature is –
Constitutional delay in growth This is significant cause of short stature in mid childhood period but the ultimate height is normal. Their birth weight and height are normal. Strong family history of parents having short stature in childhood with delay in onset of puberty is usually present. The average growth velocity is normal and ultimate growth potential is adequate. The bone age is less than chronological age. Upper segment and lower segement ratio is normal. Growth hormone and gonadotropin level after puberty are within normal range. No treatment is required. The parents need to be reasured.
1
Constitutional
Systemic diseases
Hypothyroidism
Growth hormone deficiency
Pediatrics
null
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Which is the most common cause of delayed urinary tract obstruction after Trans Urethral Resection of Prostrate (TURP):
Bladder neck stenosis is the most common cause of obstructive symptoms following Trans Urethral Resection of Prostrate (TURP). Its due to the presence of a tight membrane at the neck of the bladder. Ref: Transurethral resection By John Peter Blandy, Richard G. Notley, John Reynard, Page 190-91; Contemporary Issues in Prostate Cancer: A Nursing Perspective By Jeanne Held-Warmkessel, Page 167.
4
Stricture of the Navicular fossa
Stricture of the membranous urethra
Stricture of the bulb of urethra
Bladder neck stenosis
Surgery
null
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A 50 years old male patient travels alone in a remote village of Rajasthan was not on any food or water for the past 24 hours. Urine osmolality is 1150 mOsm/Kg. The major site of water reabsorption is
Answer: a) Proximal tubuleWater Transport along the NephronSegmentPercentage of Filtrate ReabsorbedMechanism of Water ReabsorptionHormones That Regulate Water PermeabilityProximal tubule67%PassiveNoneLoop of Henle15%Descending thin limbonly; passiveNoneDistal tubule0%No water reabsorptionNoneLate distal tubule and collecting duct~8%-17%PassiveADH, ANP, BNP*Atrial and brain natriuretic peptides inhibit antidiuretic hormone-stimulated water permeability
1
Proximal tubule
Henle's loop
Distal tubule
Medullary collecting duct
Physiology
Kidneys and Body Fluids
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Substance common in skin, hair and nail is?
Ans. (b) KeratinRef.: Bolognia dermatology ch: 55
2
Vimentin
Keratin
Laminin
Nectin
Skin
Anatomy of Skin
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single
Coronary sinus opens into
null
1
Right atrium
Left atrium
Right ventricle
Left ventricle
Medicine
null
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Cataract is seen in all of the following EXCEPT:
In case of diabetics sugar alcohols (sorbitol) is present, which is hygroscopic in nature i.e. they absorb water. So, if this sugar alcohol is present in excess in cells, it will cause cell swelling. Especially it gets accumulated in lens of the eye causing cataract. 1. Glucose forms Sorbitol which gives rise to Snow Flake Cataract 2. Galactose forms Galactitol/Dulcitol which gives rise to Oil Drop Cataract Wilson's disease: (Condition of Cu excess in body): Leads to Sun Flower Cataract. No cataract is seen in case of Hereditary Fructose Intolerance. Diabetic Cataract - Snowflake on breadcrumb cataract Kayser Fleisher ring: Seen in Wilson's disease
3
Wilson's disease
Diabetes mellitus
Hereditary fructose intolerance
Galactosemias
Ophthalmology
Cataract
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Pathogenesis of diphtheria is attributed to
null
3
Invasion
Endotoxin
Exotoxin
Capsule
Microbiology
null
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single
About Helicobacter pylori, all are true except:
Ans is 'b' i.e., Uncommon in undeveloping Asian countries (Ref: Harrison, 17th/e, p.946,19th/e, p. 1038; Ananthanarayan, 9th/e, p. 400)Approximately 85% of developing countries are affected by H. pylori.
2
Is a Gram -ve spiral bacteria
Uncommon in undeveloping Asian countries
Urea breath test +ve
Associated with duodenal ulcer
Microbiology
Bacteria
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Which flexor muscle is attached to hook of hamate-
Ans. is 'c' i.e., Flexor digiti minimi o The hamate :The tip of the hook gives attachment to the flexor retinaculum.The medial side of the hook gives attachment to the flexor digiti minimi and the opponens digiti minimi.
3
Flexor pollicis brevis
Flexor pollicis longus
Flexor digiti minimi
Flexor carpi ulnaris
Anatomy
Hand
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single
All are true about Hashimoto encephalopathy except -
Answer- D. EEG is normalElectroencephalographyNonspecific electroencephalographic (EEG) abnormalities are seen in 90 to 98 percent of patients, usually demonstrating nonspecific slowing of background activity.Hashimoto's encephalopathy is treated with steroids
4
Myoclonus
Seizures
Steroid responsive encephalopathy
EEG is normal
Medicine
null
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multi
In Medullary Carcinoma thyroid Tumour marker is?
Ans is B ie calcitonin Schwaz Surgery writes ? The presence of amyloid is a diagnostic finding, but immunohistochemistry for calcitonin is more commonly used as a diagnostic tumor marker. These tumors also stain positive for CEA (Carcinoembryonic antigen) and CGRP (Calcitonin gene-related peptide)"
2
TSH
Calcitonin
T3, T4 and TSH
Alpha Feto protein
Surgery
null
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single
A 56-year-old male smoker is referred with symptoms of weakness, dizziness, and right chest pain after playing with his grandson. He admits to having pain in the right shoulder and axilla off and on for the prior 6 mo. He denies any exposure to TB and has a negative PPD skin test. Routine laboratory tests are normal. CXR is shown.Associated findings will include
This x-ray shows a right upper lobe homogeneous opacity merging with the right paratracheal area in the apical segment. This is consistent with a Pancoast tumor. The right clavicle is obscured in its medial aspect but does not show any fracture or erosion. Underlying hyperinflation is seen in all lung fields. The intercostal spaces in the right upper lobe region are diminished. The soft tissue shadows are similar bilaterally above the clavicles. The homogeneous opacity in the apical region is consistent with superior sulcus tumor (Pancoast tumor). This tumor invades the brachial plexus locally and is often associated with pain in the ulnar nerve distribution. It is also associated with Horner syndrome, i.e., anhydrosis, myosis, and ptosis. Lofgren syndrome is associated with sarcoidosis and is a triad of polyaicular ahritis, erythema nodosum, and bilateral hilar adenopathy. Sjogren syndrome may be primary or secondary to another connective tissue disorder and is also known as the sicca syndrome (due to its attendant triad of xerostomia, dry eyes, and ahritis). Heford syndrome is a uveoparotid fever associated with sarcoidosis. The chest x-ray finding is inconsistent with any of the latter conditions mentioned.
1
Horner syndrome
Lofgren syndrome
Sjogren syndrome
Heford syndrome
Radiology
Respiratory system
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single
The amount of potassium delivered to this patient after giving one bottle?
Ans. (b) 4 mmol.Composition of one liter of Ringer's Lactate solution:* 130 mEq of sodium ion = 130 mmol/L* 109 mEq of chloride ion = 109 mmol/L* 28 mEq of lactate = 28 mmol/L* 4 mEq of potassium ion = 4 mmol/L* 3 mEq of calcium ion = 1.5 mmol/LRingers lactate has an osmolarity of 273 mOsm/L
2
2 mmol
4 mmol
8 mmol
10 mmol
Pathology
Hemodynamics
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single
Nightmare is seen in
REM sleep events -        Narcolepsy -        Night mares   -        Nocturnal penile tumescence
1
REM sleep
Stage II NREM sleep
Stage IV NREM sleep
Stage I NREM sleep
Physiology
null
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single