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Primary cause of hyaline membrane disease is
Ans. d (Surfactant deficiency). (Ref. Nelson, Textbook of Paediatrics, 18th/731)HYALINE MEMBRANE DISEASE# Common in premature, IDM and infants delivered by caesarean section.# Clinically manifests shortly after birth (dyspnoea and cyanotic attacks).# X-ray chest shows "ground glass" mottling.# As HMD progresses, influx of plasma renders the lungs more radio-opaque, reticulogranular shadowing becomes more confluent & ground glass haziness is seen with loss of clarity of diaphragm & heart.# Mortality 33%# Hyaline membrane is a homogenous eosinophilic membrane plastering the alveolar ducts and terminal bronchiole in HMD.# Rx .-Timely steroids, exogenous surfactant therapy and oxygen (not 100 %) are useful in treatment.
4
Prematurity
Oxygen toxicity
Alveolar inflammation
Surfactant deficiency
Pediatrics
New Born Infants
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single
Meckel's derived from;
Ans. (a) Proximal part of VIDRef: Sabiston 20th edition, Page 1284* Meckel's diverticulum results from incomplete closure of proximal VID* Raspberry tumor (Umbilical adenoma) is persistence of distal VID
1
Proximal part of VID
Distal part of VID
Entire VID
Urachus
Surgery
Small & Large Intestine
a2914d7d-f520-476f-a51e-1e5ac51f12c7
single
Effo during normal respiration is done due to ?
A i.e. Lung elasticity
1
Lung elasticity
Respiratory air passages
Alveolar air spaces
Creating negative pleural pressure
Physiology
null
d511635b-7723-42f3-bc8e-74b8d2da653d
single
The Most common fungus to cause meningitis is
(C) Cryptococcus neoformans
3
Blastomyces dermatitides
Candida albicans
Cryptococcus neoformans
Coccidioides immitis
Microbiology
Misc.
51fe5c68-dc49-43a9-9d84-b0f7d0f81366
single
Stellwag'sign is:
null
1
Absence of normal winking.
Failure of convergence of eye balls.
Exophthalmos.
None.
Surgery
null
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multi
Condition which does not cause metabolic acidosis
Pyloric stenosis causes Metabolic alkalosis. Rest all causes metabolic acidosis.
2
Renal failure
Pyloric stenosis
Biliary fistula
Ureterosigmoidostomy
Surgery
null
52f0d816-ae13-4537-88cb-6789a498f8d2
single
Classical cesarean section in indicated in a patient with :
Carcinoma cervix
3
Previous cesarean section
Placenta pre
Carcinoma cervix
Shoulder presentation
Gynaecology & Obstetrics
null
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single
True about subcutaneous nodule in Rheumatic fevera) Non tenderb) Most common manifestationc) Present in extensor surfacesd) Associated with arthritis
null
1
ac
bc
ad
b
Medicine
null
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multi
Hyperbilirubinemia in a child can be due to –a) Breast milk jaundiceb) Cystic fibrosisc) Fanconi's syndromed) α–1 antitrypsin deficiency
al-antitrypsin deficiency can cause cholestatic Jaundice.
1
ad
c
ac
ab
Pediatrics
null
7368afb5-786e-410d-8674-f12ce9bdec3f
single
An obsessive compulsive neurosis patient is likely to develop:
Most of the patients with OCD, develop secondary depression. It is the M/C Comorbidity associated with OCD. The lifetime prevalence for major depressive disorder in persons with OCD is 67%.
2
Hallucination
Depression
Delusion
Schizophrenia
Psychiatry
Neurotic, Stress Related and Somatoform Disorders
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Patient with genotype X0 will have following phenotype, except: PGI 09; WB 09; MAHE 12
Ans. Tall stature
1
Tall stature
Broad chest
Webbed neck
Lymphedema
Forensic Medicine
null
2201f40d-2ac0-465d-92c5-a01d18522f18
multi
Cell-matrix adhesions are mediated by
.
2
Cadherins
Integrins
Selectins
Calmodulin
Pathology
General pathology
af26b5f0-be33-4627-ac26-fc356b39b814
single
Which type of chocking in SHOT gun produce maximum dispersion of pellets?
Firearm are of 2 types - rifled and shotgun weapons. The rifled weapon contains grooves called riffling. In shotgun no grooves are present so it is also known as smooth bore gun in which small lead shots or pellets are used which spreads to other distances when the lead pellets come out. This is called dispersion. To avoid dispersion, choking is done in which terminal end of barrel is narrowed. There are different grades of choking - full choked, half choked, quaer choked So in quaer choking maximum depression is produced.
3
Fully chocked
Half
Quaer
Three fouh
Forensic Medicine
Ballistics
36724429-06b0-4f79-beee-cec6fde30782
single
True statement about Antistreptolysin &;O&; titre is
In Rheumatic fever and glomerulonephritis, a retrospective diagnosis of streptococcal infection may be established by demonstrating high levels of antibody to streptococcal toxins. The standard test in antistreptolysin O titration. High levels are usually found in acute rheumatic fever but in glomerulonephritis, titers are often low. Reference: Textbook of Microbiology; Anathanarayan and paniker's; 10th edition; Page no: 218
2
In normal people the titre is <200
In acute glomerunephritis the titre is low
ASO titre >200 indicate rheumatic fever
Streptozyme test is an active haemagglutination test
Microbiology
Bacteriology
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multi
Toxic epidermal necrolysis {TEN} involves body surface area
Based on body surface area ( BSA) of skin involved, epidermal necrolysis is classified into SJS: less than 10% BSASJS_TEN overlap: 10-30% BSA TEN : more than 30% BSA. From illustrated synopsis of dermatology and sexually transmitted diseases neena khanna 5th edition page no 92
4
<10%
10-20%
20-30%
>30
Dental
Vestibulobullous disorders
2adacb9b-8446-43d6-891f-e7f5836b614f
single
Incidence of suicide is-
C i.e. 8-10 / 1 lac population
3
8-10 / 100 population
8-10 / 10000 population
8-10 / 1 lac population
8-10 / 10 lac population
Forensic Medicine
null
577f587f-6bb7-497b-ab71-3dc9465300ba
single
All are indications for surgery in bronchiectasis except:
Ans: C (Bilateral disease) Ref: Schwartz s Principles of Surgery: 9th EditionExplanation:"Patients with diffuse bilateral disease, of which cystic fibrosis is the best example, rarely benefit from resection and should be considered for lung transplantation as they approach end-stage disease. " (Ref: Schwartz)Treatment of BronchiectasisThe majority of patients with bronchiectasis do not require operative treatment.Postural drainage and chest physical therapy minimize retention of purulent sputum, and antibiotic treatment of all episodes of pneumonitis should be pursued indefinitely.When debilitating effects of chronic infection become prominent and surgery is contemplated, the anatomy should be defined carefully with CT scan before resection is planned.When extensive saccular disease is confined to one lobe or segment in a sufficiently symptomatic patient, resection is a clear choice.In children, interference with growth is often the sign of debility.Frequent hemoptysis associated with localized disease deserves operation.Patients with diffuse bilateral disease, of which cystic fibrosis is the best example, rarely benefit from resection and should be considered for lung transplantation as they approach end-stage disease.The operative strategy is to remove as little normal lung as possible without entering the central focus of infection.This usually requires segmentectomy or lobectomy and depends on an accurate preoperative assessment of the diseased segments.Pneumonectomy is rarely indicated in this disease.
3
Refractory foul smelling copious sputum
Hemoptysis
Bilateral disease
Bleeding
Surgery
Stomach & Duodenum
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Most common type of psoriasis –
Plaque psoriasis, also known as psoriasis vulgaris is the most common type and usual form of psoriasis.
3
Plaque psoriasis
Psoriasis vulgaris
Both 1 and 2
Penile psoriasis
Dental
null
3135aaaa-eaf4-49d4-93ff-d1e5765b332a
multi
Which of the following is not an indication of radiotherapy in Pleomorphic adenoma of parotid?
Ans. is none or (b) is the best option The above mentioned books mention the following indications of postop radiotherapy in Pleomorphic adenoma of parotid. Indications for postop radiotherapy in Pleomorphic adenoma Involvement of the deep lobe of the parotid Recurrent lesions Large (> 5 cm) lesions, which may not allow complete surgical excision with adequate margins. Microscopically positive margins after surgical resection. Malignant transformation within a predominantly benign tumor. So all the given options are indications for post op radiotherapy, but if we have to choose one option we would go for option (b) i.e. 2nd histologically benign recurrance, as its the most controversial one.
2
Involvement of deep lobe
2nd histologically benign recurrence
Microscopically positive margins
Malignant transformation
Surgery
null
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multi
The dietary fats are transmitted from GIT to adipocytes in the form of
TG derived from intestinal absorption of fats are transpoed in the blood as a lipoprotein complex called chylomicrons. Chylomicrons are small microscopic paicles of fats, about 1m in diameter and are responsible for transpo of exogenous (TG) in the blood. * Similarly, TG that are synthesised in Liver cells is conveed to lipoprotein paicles, called very low-density lipoproteins (VLDL) and thrown into the circulation. VLDL is mainly concerned with transpo of endogenous TG. In addition to above: * Fatty acids released from adipose tissue by hydrolysis of TG are thrown in the circulation as free fatty acid (FFA). They are carried in non-esterified state in plasma, hence also called NEFA. In circulation, FFA/ NEFA combines with albumin and are carried as albumin-FFA complex. Some 25 to 30 mols of FFA are present in combination with one mol. of albumin.Ref: Textbook of Medical Biochemistry 8th Edition Dr (Brig) MN Chatterjea, Rana Shinde page no: 445
4
Diacyl glycerol
Triacylglycerol
Fat misseles
Chylomicrons
Biochemistry
Metabolism of lipid
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single
Splicing activity is a function of
A small nuclear RNA (snRNA) is one of many small RNA species confined to the nucleus; several of the snRNAs are involved in splicing or other RNA processing reactions.Small cytoplasmic RNAs (scRNA) are present in the cytoplasm and (sometimes are also found in the nucleus).snRNPs (snurp) are small nuclear ribonucleoproteins (snRNAs associated with proteins).scRNPs (scyrp) are small cytoplasmic ribonucleoproteins (scRNAs associated with proteins).The spliceosome is a complex formed by the snRNPs that are required for splicing together with additional protein factors.Anti-Sm is an autoimmune antiserum that defines the Sm epitope that is common to a group of proteins found in snRNPs that are involved in RNA splicing. The five snRNPs involved in splicing are U1, U2, U5, U4, and U6.Together with some additional proteins, the snRNPs from the spliceosome.All the snRNPs except U6 contain a conserved sequence that binds the Sm proteins that are recognized by antibodies generated in autoimmune disease.
2
mRNA
snRNA
rRNA
tRNA
Biochemistry
Metabolism of nucleic acids
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single
Patient presenting with cutaneous vasculitis, glomerulonephritis, peripheral neuropathy, which of the following will help in diagnosis?
Ref. API Textbook of Medicine. Pg. 1313   Cutaneous vasculitis features – Diagnosis Anti-neutrophil cytoplasmic antibodies (ANCAs): Group of autoantibodies IgG type mainly, Produced against antigens in cytoplasm of neutrophil granulocytes & monocytes. Particularly associated with systemic vasculitis, so called “ANCA-associated vasculitis”. c-ANCA – Abs against MPO, p-ANCA -  Abs Against PR3
1
ANCA
RA factor
Hbsag
MIF
Unknown
null
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single
Meningococci differ from gonococci as they:
Characteristics Neisseria gonorrhoeae Neisseria meningitidis 1 Referred Gonococcus Meningococcus. 2 Vaccine Development No Serogroup A, B, C, Y and W-135 meningococcal infections can be prevented by vaccines. 3 Colony Morphology Smooth, round, moist, uniform grey/brown colonies with a greenish colour Smooth, round, moist, uniform large grey/brown colonies with a glistening surface and entire edges. 4 Morphology Kidney shaped with apposing ends concave. Semicircular ,diplococcus with flat apposing ends. 5 Autolyse May autolyse Autolyse 6 Maltose Fermentation No Yes 7 Nitrite Reduction Doesn't reduce nitrites. Reduce nitrites 8 Capsule No Yes (anti-phagocytic) 9 Site of Infection Infection of the anogenital tract. Colonizes the upper respiratory tract as a commensal 10 Pathogens Always a pathogen Not always considered as pathogens 11 Enzyme Production Doesn't produce gamma-glutamylaminotransferase. Produces gamma-glutamylaminotransferase. 12 Specimen Collection Transpo swab of endocervix, urethra, rectum, pharynx, conjunctiva, blood, joint fluid, aspirates from skin lesions. Collect cerebrospinal fluid (CSF) and blood, swab skin lesions and nasopharynx. 13 B-Lactamase Production Common Rare 14 Prevalence and Moality High prevalence and low moality Low prevalence and high moality. 15 Superbug Considered as "superbug" Not considered as "superbug" 16 Pathogenesis Cause conjunctivitis, pharyngitis, proctitis or urethritis, prostatitis, and orchitis. Cause meningitis and other forms of meningococcal disease such as meningococcemia, a life-threatening sepsis.
2
Are intracellular
Possess a capsule
Causes fermentation of glucose
Are oxidase positive
Microbiology
Systemic Bacteriology Pa 1 (Gram Positive Cocci, Gram Negative Cocci)
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single
Enzyme used in Leukemia-
Asparaginase. Asparaginase is an enzyme that is used as a medication and in food manufacturing. As a medication, L-asparaginase is used to treat acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), and non-Hodgkin's lymphoma. It is given by injection into a vein, muscle, or under the skin Ref Davidson 23rd edition pg 920
1
Asparginase
Lipase
Amylase
Transminase
Medicine
Haematology
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single
Tillaux's sign is seen in
Tillaux's sign: In mesenteric cyst, the swelling moves freely in a plane at right angles to the attachment of the mesenteryRef: Bailey and love 27e pg: 1063
3
Abdominal tuberculosis
Peritonitis
Mesenteric cyst
Misty mesentery
Surgery
General surgery
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Oncogenic virus is:
Ans. is 'd' i.e., EBV (Ref: Ananthanarayan, 9th/e, p. 565 and 8th/e, p. 563)* EBV has been implicated in causation of Nasopharyngeal carcinoma and Burkitt's lymphoma.
4
CMV
VZV
Polio virus
EBV
Microbiology
Human Immunodeficiency Virus
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Integration of health services was first proposed by?
ANSWER: (B) Jungallwalla commiteREF: Park 20th ed p. 778See APPENDIX-45 below for "Health planning committee" APPENDIX - 45Health Planning CommitteeBHORECOMMITTEE1946Before 1st five year planIntegration of preventive and curative servicesPrimary health Centre (short term plan-1 PHC/40,000 population & long term plan aka- 3 million plan)Social physicianMUDALIARCOMMITTEE1962By the end of 2nd five year plan (1956-1961)Also known as "Health survey and planning committee"All India health services like Indian administrative services 1 PHC/40,000 populationCHADAHCOMMITTEE1963To study maintenance phase of malaria eradication programmeBasic health workers to wrork as Multipurpose health workers (1/10 f000 population, combine for malaria & family planning)MUKERJICOMMITTEE(lst & 2nd)1st-1965To review strategies of family planningSeparate staff for family planning Delink family planning & malaria2nd _ 1966To examine national health programmesBasic health servicesJUNGALWALLACOMMITTEE1967Committee on integration of health servicesUnified cadre, common seniority,Integrated health services No private practiceEqual pay for equal work, Special pay for special work Recognition of extra qualificationKARTAR SINGH COMMITTEE1973Accepted for 5th five year plan, Committee on multipurpose workers under health & family planning.Single cadre of multipurpose workers i.e. MPW (Female)- Female health workers (in place of nurse/midwifes) & MPW (Male) Male health workers (in place of family planning assistant) 1 PHC/50,000 population divided into 16 subcentres (one for 3000 to 3500 population)SRIVASTAVACOMMITTEE19756th five year plan"Group on Medical Educationand Support Manpower"' Referral Services Complex"Medical & health education commission ROME scheme (reorientation of medical education) Acceptance of the recommendations of the Shrivastava Committee led to "Rural Health Service"KRISHNANCOMMITTEE1982To address the problems of urban healthHealth post run by a doctor, a Public Health Nurse, 4 Auxiliary Nurse Midwives, 4 multipurpose workers and 25 Community Health workers for a population of 50,000.BAJAJCOMMITTEE1986 National medical & health education policy Educational commission for health sciences (ECHS) like UGC Health science universities, Vocationalization of education Health manpower cells at Centre and states
2
Bhore committee
Jungallwalla commite
Mudaliar commite
Srivastava commite
Social & Preventive Medicine
Health Planning and Management
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RNA polymerase has which activity -
Ans. is 'a' i.e., Primaseo DNA synthesis cannot commence with deoxyribonucleotides because DNA polymerase cannot add a mononucleotide to another mononucleotide.o Thus, DNA polymerase cannot initiate synthesis of complementary DNA synthesis strand of DNA on a totally single stranded template.o For this, they require RNA primer, which is a short piece of RNA formed by enzyme primase(RNA polymerase) using DNA as a template.o RNA primer is then extended by addition of deoxyribonucleotides.o Later on, the ribonucleotides of the primer are replaced by deoxyribonucleotides.# Note : Primase is actually a DNA primase which has RNA polymerase activity. This DNA primase is also called DNA polymerase a.
1
Primase
Helicase
Ligase
Topoisomerase
Biochemistry
Transcription
ec13c2b3-9b79-42c2-ab28-e38a7132429f
single
Which of the following will give Medusa head colony on x-ray -
Ans is 'b' ie. Round worm infestation I have looked in Chapman, Sutton, Sabiston, and Schwaz without any success. Residents do not know about it (Only God Knows)
2
Hook worm infestation
Round worm infestation
Tenia solium infestation
a + b
Surgery
null
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single
Pupillary dilatation is seen in which of the following drug abuse ?
ATROPA BELLADONNA AND HYOSCYAMUS NIGER: Atropa belladonna/ deadly nightshade is a plant of Europe and Asia. All pas are toxic The active principle is - hyoscyamine. This group of compounds acts by inhibiting the muscarine effects of acetylcholine. Mydriatic Test: A drop of the solution to be tested is put into the eyes of a cat. The pupils dilate within half hour if datura is present, due to the presence of atropine. Drugs causing dilatation of pupils: Datura, Atropine, Belladonna, Cannabis, Cocaine, Alcohol
2
Organophosphorus compounds
Belladona
Heroin
Morphine
Forensic Medicine
Drug Abuse
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Allanto-enteric diverticulum is formed by the outgrowth of-
(A) (Yolk sac):Allantoic diverticulum* Before the formation of the tail fold, a small endodermal diverticulum called the allantoic diverticulum arise from the Yolk Sac near the caudal end of the embryonic disc. This diverticulum grows into the mesoderm of the connecting stalk (figure A). After the formation of the tail fold part of this diverticulum is absorbed into the hindgut. It now passes from the ventral side of the hindgut into the connecting stalk (figure B), we will refer to it again while considering the development of urinary bladder**Allantoic diverticulum, and its relationship to the connecting stalk
1
Yolk sac
Amnion
Intra-embryonic coelom
Extra-embryonic coelom
Anatomy
Embryology
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Which of the following drug is not used for MDR-TB?
null
1
Amikacin
Kanamycin
Levofloxacin
Ethionamide
Medicine
null
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single
DOC for Cisplatin induced nausea & vomiting occuring within 24 hours is
DOC for Cisplatin induced nausea & vomiting within 24 hours is Ondansetron. DOC for Cisplatin induced nausea & vomiting after 2days is Aprepitant.
3
Aprepitant
Fosaprepitant
Ondansetron
Promethazine
Pharmacology
null
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Posterior cord supplies ?
Ans. is 'a' i.e., Teres minor Branches of posterior cord are :?Upper subscapular :- Supplies subscapularis.Lower subcapular :- Supplies subscapularis and teres major.Axillary nerve :- Supplies teres minor and deltoid.Thoracodorsal nerve :- Supplies latissimus dorsi.Radial nerve :- Supplies triceps and extensors of elbow, wrist and fingers.
1
Teres minor
Teres minor
Coracobrachialis
Long head of biceps
Anatomy
null
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single
Macroglosia is seen in -
Ans. is 'a' i.e., Amyloidosis
1
Amyloidosis
Folic acid deficiency
Motor neurone disease
null
Pathology
null
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multi
30 years old primipara in labour with transverse lie. Treatment of choice is :
Ans. is b i.e. Emergency cesarean section Patients in labour with transverse lie can be managed by external cephalic version followed by surgical rupture of the membrane. But it is impoant to note that the patient is a primigravida with age 30 years i.e. elderly primi, so, ECV is contraindicated.
2
Internal cephalic version
Emergency cesarean section
Wait and watch
External cephalic version
Gynaecology & Obstetrics
null
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Collection of urine sample of a patient of TB kidney is done:
Ans. is 'c' i.e., In early morningSampling - Collect the whole of patient early morning urine on three consecutive days (Previously it was 24 hours urine collection but now it is not recommended).Culture of three morning urine samples yields a definitive diagnosis in 90% cases.
3
24 hours urine
12 hours urine
In early morning
Any time
Microbiology
Bacteria
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Approach to Caldwell Luc operation is ?
Ans. is'b'i.e., Sublabial sulcus[Rel Dhingra Sh/ep. 422)Caldwell-Luc operation is a process of opening the maxillary antrum through canine fossa by sublabial approach and dealing with the pathology inside the antrum.
2
Hard palate
Sublabial sulcus
Inferior metus
Superior meatus
ENT
null
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The following is not a method of isolation of chlamydia from clinical specimens -
Ans. is 'b' i.e., Enzyme immunoassay Although chlamydia are bacteria, they are obligate intracellular parasites, therefore cultures and other diagnostics tests for chlamydia require procedures much like those used in diagnostic virology laboratories rather than those used in bacteriology laboratories.Diagnosis of chlamydia.Four approaches are available for the laboratory diagnosis of chlamydial infectionsMicroscopic demonstration of elementary or inclusion bodiesIsolation of chlamydia (culture)Antigen detection & Nucleic acid hybridizationSerologyMicroscopic demonstration of elementary or inclusion bodies,Chlamydial elementary bodies and inclusions are large enough to be seen under the light microscopeCytological examination is important and useful only in the examination of conjunctivitis and trachoma caused by chlamydia trachomatis.Another method available for microscopic examination is Immunoflorescence using monoclonal antibody.Isolation of chlamydia.Isolation of chlamydia can be done by inoculation into:embryonated eggsexperimental animals (Hi) tissue culturesEmbryonated eggs -Chlamydia can be grown in yolk sac of 6-8 days old chick embryosIsolation by egg inoculation is tedious and relatively insensitive and has been replaced by tissue cultures. Tissue cultureCell culture is the preferred method for isolation of chlamydiaCell cultures for Chlamydia Trachomatis } - McCoy cells Chlamydia Psittaci } Chlamydia pneumonia -HL or HEp+2 cellsCell cultures used for isolation of chlamydia are pretreated by irradiation or chemicals.Pretreatment with DEAD-dextran reduces the electrostatic barrier to infection before centrifugation of chlamydial or clinical specimen on to the cells. Thus it promotes contact between chlamydial particles and cell monolayer increasing chance of isolation.The cells are then usually incubated in an antimetabolite such as cycloheximide to favour chlamydial competition for host amino acid pool.Antigen detection & Nucleic acid hybridization Antigen detection can be done by two methodDirect florescent antibody (DFA) demonstration -The DFA uses monoclonal antibodies directed against a species specific antigen on the chlamydial major outer membrane protein (MOMP)Enzyme linked immunoassays (EIA'S) -This test detects the presence of genus specific lipopoly saccharide antigens extracted from the elementary bodies in the specimen.Nucleic acid detection * Molecular methods used for the detection of chlamydiae arePolymerase chain reactionLigase chain reactionSerologyAntibodies against chlamydia can be used for diagnosis.A fourfold rise in titres is diagnostic.Serological test are not useful in the diagnostic of genital chlamydia infections because of high prevalence of chlamydial genital tract infection is some societies.Also knowHypersensitivity test -Demonstration of hypersensitivity by skin testing (Frei's test) was widely used formerly for diagnosis of L.G.V. but has been given up because of false positive results.Note:-Enzyme immunoassay is not a method of isolation.I am not sure whether irradiated BHK cell are used in isolation of chlamydia.
2
Yolk sae inoculation
Enzyme immunoassay
Tissue culture using irradiated McCoy cells.
Tissue culture using irradiated BHK cells
Microbiology
Bacteria
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Bamboo-spine is seen in:
Ans. a (Ankylosing-spondylitis). (Ref: Sutton Radiology, 6th/pg. l220, Harrison, Medicine, 18th/84,1949)ANKYLOSING-SPONDYLITIS (Marie-Strumple disease or Beschtrew disease)# Bamboo-spine (knobly spine, poker back or universal syndesmophytosis) is a characteristic feature of ankylosing spondylitis.# Syndesmophytes are gracile ossifications of the outer fibres of annulus fibrosus.- They are marginal, delicate; vertically oriented extending from edge or margin of one vertebral body to that of other.# Syndesmophytes should be differentiated from the parasyndesmophytes or the paravertebral ossifications seen in psoriatic arthritis or Reiter's disease by which although vertically oriented are thicker, denser, non-marginal extending from mid-body to mid-body, larger, coarse and may effect any part of spine to start with without proper order.# Shiny corner sign, Romano's lesionf Anderson's lesions, trotty-track sign & drager sign are also described in spine.# Other diagnostic radiological features of ankylosing spondylitis are:- Bilateral symmetrical sacroilitis (most specific).- Enthesitis (earliest pathological change).- Uncommon involvement of small joints of hand and feet.OPLL (Ossified posterior longitudinal ligament)# Japanese disease# Best evaluated with CT (for ossification) and MRI (for evaluation of cord)# Likely to progress to myelopathy with canal compromise of 60% and sagittal canal diameter of 8mm# Cervical spine involvement is most common# Advanced cases of OPLL are easily recognized on routine radiographyDISH (Diffuse idiopathic skeletal hypertrophy)# Diffuse idiopathic skeletal hyperostosis (DISH) (hyperostotic spondylosis, Forestier's disease) is a multifocal entity of older people characterized by 'flowing' ossifications of the spine involving four or more contiguous vertebrae and hyperostosis of some ligamentous attachments.
1
Ankylosing-spondylitis
Rheumatoid arthritis
Paget's disease
All
Radiology
Skeletal System
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multi
A sewage worker presents to the emergency depament with fever and jaundice. Laboratory findings reveal an elevated BUN and serum creatinine suggestive of renal failure. Which of the following antibiotics is recommended?
Ans. is 'd' i.e., Penicillin G . Information in this question are :- i) Patient is sweage worker (high risk group for developing leptospirosis). ii) Jaundice and elevated BUN & creatinine - > Hepatorenal syndrome (Weil's disease). . So, presence of fever, jaundice and elevated BUN & creatinine in a sewage worker ( contact with rat urine) suggests a diagnosis of Weil's disease. . Penicillin G (intravenous) is the recommended agent.
4
Cotrimaxozole
Erythromycin
Ciprofloxacin
Penicillin G
Microbiology
null
e6923a9b-c3be-4d6e-a7e4-21d12ec06a65
single
Which of the following are situated away from the coding region
Structural genes are present in coding region. Rest all genes, like promoter gene, operator gene, regulatory gene (enhancer/repressor), are present away from coding region.
4
Promoter
Enhancer
Operator
All of these
Biochemistry
null
36f1fbf0-0a80-4b36-8375-3e4133073bf5
multi
Apoptosis is characterized by all of the following except -
. Inflammation
4
DNA fragmentation
Chromatin condensation
Cell shrinkage
Inflammation
Pathology
null
511387a1-c024-4747-8e40-b0cdb35b59d7
multi
A patient presents with evidence of lytic lesion in the bone. Histology from the bone lesion reveals monoclonal plasma cells. Bone marrow biopsy from the from the sternum shows <10 percent Plasma cells. Skeletal Survey is otherwise unremarkable. A small positive M spike is repoed on electrophoresis. The diagnosis is:
Answer is B (Plasmacytoma) Presence of a solitary lytic lesion of the bone with monoclonal plasma cells suggests a diagnosis of Solitary Plasmacytoma of Bone. A small M spike may be identified in some patients but Bone Marrow biopsy taken some distance away from the primary site is typically not involved typically showing < 10 percent plasma cells Solitary Bone Plasmacytoma The diagnosis of SBP requires histologic evidence of a monoclonal plasma cell infiltrate in a single bone lesion, absence of other bone lesion on skeletal survey, and lack of marrow plasmacytosis elsewhere. Fuhermore, there should be no evidence of anemia, hypercalcemia, or renal dysfunction that could be attributed to the plasma cell proliferative disorder spike may be identified in some patients hut Bone Marrow biopsy taken some distance away from the primary site is not involved typically showing < 10 percent plasma cells. Diagnostic criteria for Solitary Plasmacytoma of bone and Extramedullary Plasmacytoma Solitary Osseous lesion or Extramedullary lesion due to clonal plasma cell proliferation Normal marrow with no evidence of clonal plasma cells or aneuploidy by flow-cytometry. Normal skeletal survey with proximal humeri and femora and a Normal magnetic resonance image of the axial skeleton (for Solitary Plasmacytoma of Bone); or a Normal regional computed tomographic scan (for Extramedullary Plasmacytoma). Absent or low serum or urinary concentration of monoclonal protein. No anemia, hypercalcemia, or renal insufficiency attributable A myeloma.
2
Multiple Myeloma
Plasmacytoma
Smoldering Myeloma
Lymphoma
Medicine
null
9ba35421-ea94-4fa6-9abc-352edc2787e7
multi
Most common cause of hypehyroidism-
Most common cause of hypehyroidism is Graves' disease - 76% followed by Toxic Multinodular goitre - 14% and Toxic Solitary thyroid adenoma - 5%. Reference : page 740 Davidson's Principles and practice of Medicine 22nd edition
4
Thyroid hyperplasia
Thyroid adenoma
Thyroid carcinoma
Grave disease
Medicine
Endocrinology
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single
A contact carrier in cholera has the following characteristic -
<p> The duration of contact carrier state is usually less than 10 days. The gall bladder is not infected. It plays an impoant role in the spread of cholera. The stool culture is frequently positive for V. cholera O1. Park&;s textbook of preventive and social medicine,K.Park,23rd edition,page no:230. <\p>
4
Gall bladder is infected
Stools are not positive for cholera vibrio
Does not play any role in spread of infection
Duration of carrier state is less than 10 days
Social & Preventive Medicine
Communicable diseases
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multi
Mc Keon, in nineteenth century studied the decline in the incidence of the infectious diseases like tuberculosis and he explained the co-relation between the decline in the incidence of infectious disease and told that the relation is better understood in terms of -
null
2
Increased awareness and knowledge
Social and economic factors
Behavioral interventions
Medical interventions
Social & Preventive Medicine
null
46b6c985-70e6-46c1-885c-13ac8e3a1597
single
Discrete muscle of Panninculus carnosus is:-
Panninculus carnosus is a striated muscle lying in the subcutaneous fascia. Daos muscle is subcutaneous involuntary muscle which continues in front with the fascia of Camper and fascia of Scarpa of anterior abdominal wall. NOTE: In humans the platysma muscle of the neck, palmaris brevis in the hand, and the daos muscle in the scrotum are described as a discrete muscle of the panniculus carnosus.
4
Temporo parietalis
Occipitalis.
Cremastric.
Daos.
Anatomy
Abdominal wall ,Inguinal and Femoral region
86b1a14e-237a-4ff7-b67a-240a1143f1e0
single
Estimation of free chlorine of water is done by: March 2012, March 2013 (c, g)
Ans: A i.e. Ohotolidine test Test/instruments and their use Ohotolidine test enables both free and combined chlorine in water to be determined with speed and accuracy Horrock's water testing apparatus is designed to find out the dose of bleaching powder required for disinfection of water Paterson's chloronome is one such device for measuring, regulating and administering gaseous chlorine to water supplies Kata thermometer was originally devised for measuring the "cooling power" of the air. The Kata thermometer is now largely used as an anemometer for recording low air velocities rather than the cooling power of the air
1
Ohotolidine test
Horrock's apparatus
Paterson's chloronome
Kata thermometer
Social & Preventive Medicine
null
dbb88dc3-9cf4-4c17-9845-4ed11c1f4e68
single
Which of the following drugs acts on trabecular meshwork and affects the aquatic outflow
Miotics-like pilocarpine act by increasing the trabecular outflow. Drugs for Glaucoma- Mechanism of Action Brimonidine- Reducing aqueous production and Latanoprost- Increasing uveoscleral flow . Pilocarpine-Increase the trabecular outflow Betaxolol-Reduces aqueous secretion by cilary body Ref-KDT 6/e p145
2
Timolol
Pilocarpine
Brimonidine
Brinzolamide
Pharmacology
Autonomic nervous system
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single
Investigation of choice for detection and characterization of interstitial lung disease is
High Resoluon CT (HRCT) is investigation of choice for interstitial lung disease as it can delineate the lung parenchyma upto the level of secondary pulmonary lobule.
4
MRI
Chest x-ray
Venlaon perfusion scan
High resoluon CT
Medicine
null
b6a63ccb-de8b-4d1b-8c95-87cfe02bf801
single
Craig's cyst is:
Paradental cyst is associated with vital tooth and mandibular 3rd molar, recurrent pericoronitis.
4
Paradental cyst.
Buccal bifurcation cyst.
Collateral cyst.
All of the above.
Pathology
null
8cef1d05-bee4-4fdc-a5c4-e5fcacda3d1b
multi
If a 4 nucleotide sequence code for an amino acid instead of 3 then theoretically how many unique amino acids could be coded by such a system?
There are four types of nucleotides (A, T, G, C). Normally the codons are made up of 3 nucleotides. Thus there are 43 = 64 possible codon combinations. If the codons are made up of 4 nucleotides, then there would be 44 = 256 possible codon combinations. If the codons are made up of 2 nucleotides, there would be 42 = 16 possible codon combinations.
4
16
64
128
256
Biochemistry
null
6a1bd621-cf4b-4f75-a8cc-2c5e9f0f320c
multi
First step in control of cholera epidemic-
Ans. is 'c' i.e., Verification of diagnosis o First stem in control of any epidemic is verification of diagnosis.Control of cholera (WHO guidelines)o Measures taken to control cholera epidemic are1) Verification of diagnosis : Identification of V. cholera 01 in stools of few patients is sufficient. It is not necessary to culture stools of all cases or contacts.2) Notification : Cholera is notifiable disease locally, nationally and internationally. Under the International health Regulations, cholera is notifiable to WHO within 24 hours of its occurrence by national government. An area is declared free of cholera when twice the incubation period (i.e., 10 days) has elapsed since the death, recovery or isolation of the last case.3) Early case finding4) Establishment of treatment centers.5) Rehydration therapy : Oral (ORS) or intravenous.6) Adjunct to therapy : Antibiotic should be given as soon as vomiting has stoped. Doxycyclone (tetracycline) in single dose is the treatment of choice in adults. In children, cotrimoxazole is the drug of choice. Furazolidine is preferred in pregnant females.7) Epidemiological investigation : Epidemiological studies.8) Sanitation measures: As water is the most important vehicle, provision of safe water (chlorination or boiling) is most important. Other important measures are proper excreta disposal, food sanitation and disinfection of stools/vomits/clothes etc by cresol.9) Chemoprophylaxis : Chemoprophylaxis to close contact is indicated. Mass chemoprophylaxis is not advised. Drug of choice is tetracycline.10) Vaccination : They are of no value in controlling epidemic.11) Health education : The most effective prophylactic measure.
3
ORS therapy
Provision of safe water
Verification of diagnosis
Chemoprophylaxis
Social & Preventive Medicine
Cholera
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multi
Essential amino acids include all EXCEPT:
ANSWER: (D) AlanineREF: Essentials of Biochemistry - Herbert J. Fromm, Mark Hargrove Page 9Essential amino acids are "essential" not because they are more important to life than the others, but because the body does not synthesize them, making it essential to include them in ones diet in order to obtain them.Nutritionally Essential Amino Acids include: (Mnemonic: "MATT VIL PhLy")MethionineArginineTyrosineTryptophanValineIsoleucineLeucinePhenylalanineLysine
4
Methionine
Tryptophan
Leucine
Alanine
Biochemistry
Miscellaneous (Structure & Function of Proteins)
55f173e9-5881-4ac5-a698-98dc07c00762
multi
Synaptic potentials can be recorded by
Potential" refers to electrical potential, or voltage, and paicularly to voltage recorded with a microelectrode embedded within neuronal tissue, typically in the brain of an anesthetized animal or within a thin slice of brain tissue maintained in vitro. The electrical activities in the neurons are rapid being measured in milliseconds, and the voltage changes are too small measured in millivolts.........the microelectrode has a tip diameter of less thanone mirometer .....hence it is used to measure the synaptic potential. Ref guyton and hall textbook of medical physiology 12/e p58
3
Patch clamp technique
Voltage clamp technique
Microelectrode
EEG
Physiology
General physiology
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single
which of the following is best for ante-moem diagnosis of rabies?
Option 1-Anti Rabies antibodies in blood appear late and can also be present after vaccination. So detection of antibodies in CSF is more significant. Option 2: Direct fluorescent antibody test is the ideal method of antemoem diagnosis of rabies. Samples can be: Corneal impression smear is only 30% sensitive, mainly it is positive in late stage. Biopsy of hair follicle of base of neck is more sensitive and considered as the best sample for direct fluorescent antibody (DFA) test . (But it is not given in the options above.) Hence, the answer is Immunofluorescence of corneal impression. Option 3: The brain biopsy of the dead animal is the specimen of choice for postmoem diagnosis of rabies. A B fig:-Histopathological examination of central nervous system tissue from autopsy of a decedent with suspected rabies infection,. (A)showing neuronal cytoplasmic inclusions (Negri bodies) after hematoxylin and eosin staining. (B).rabies virus antigen (red) after immunohistochemical staining Negri body detection is postmoem method of diagnosis, however it may not be detected in 20% of the cases.
2
Anti Rabies antibodies in blood
Immunofluorescence of corneal impression
Negri body detection
Isolation of virus from saliva.
Microbiology
Virology Pa-2 (RNA Virus Pa-1,2 & Miscellaneous Viruses)
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single
"Bamboo spine" is seen in
Ans. a (Ankylosing spondylitis). (Ref. Sutton Textbook of Radiology, 6th ed., 1220)RADIOGRAPHIC FINDINGS OF ANKYLOSING SPONDYLITIS# Radiographically demonstrable sacroiliitis is usually present in AS.# The earliest changes by standard radiography are blurring of the cortical margins of the subchondral bone, followed by erosions and sclerosis.# Progression of the erosions leads to "pseudowidening" of the joint space; as fibrous and then bony ankyloses supervene, the joints may become obliterated.# The changes and progression of the lesions are usually symmetric.# In the lumbar spine, progression of the disease leads to straightening, caused by loss of lordosis, and reactive sclerosis, caused by osteitis of the anterior corners of the vertebral bodies with subsequent erosion, leading to "squaring" of the vertebral bodies. (The Anderson & Romano's lesions)# Progressive ossification leads to eventual formation of marginal syndesmophytes, visible on plain films as bony bridges connecting successive vertebral bodies anteriorly and laterally - 'the bamboo-spine' appearance.# In mild cases, years may elapse before unequivocal sacroiliac abnormalities are evident on plain radiographs. Dynamic MRI is the procedure of choice for establishing a diagnosis of sacroiliitis.MRI is highly sensitive and specific for identifying early intra-articular inflammation, cartilage changes, and underlying bone marrow edema in sacroiliitis.
1
Ankylosing spondylitis
Diffuse idiopathic skeletal hypertrophy
Osteitis fibrosa cystica
All
Radiology
Skeletal System
6c2b8a1f-c5d4-43a9-8bce-662ae1bd1b1d
multi
Which of the following potentially represents the most dangerous situation?
* Rh-ve mother with 2nd Rh+ve child can result in the development of hemolytic disease of newborn or erythroblastosis fetalis. So, it is a dangerous condition. * This condition is a type II hypersensitivity reaction. * This is Not to be confused with Hemorrhagic disease of the newborn which is a coagulation disturbance in the newborns due to vitamin K deficiency. As a consequence of vitamin K deficiency there is an impaired production of coagulation factors II, VII, IX, X, C and S by the liver.
2
Rh+ve mother with 2nd Rh-ve child
Rh-ve mother with 2nd Rh+ve child
Rh+ve mother with 1st Rh-ve child
Rh-ve mother with 1st Rh+ve child
Pathology
Hypersensitivity
f46abde9-5952-4dac-a908-5a5a2c991226
multi
All of the following activities of Junior Red cross except -
It gives an oppounity to lakhs of boys and girls all over India to be associated with activities like the village uplift,first aid,anti epidemic work and building up of an international fraternity of youth thus promoting international friendliness understanding and cooperation (refer pgno:925 park 23rd edition)
1
Military hospital worker
Village uplift
Prevent epidemic work
Any of the above
Social & Preventive Medicine
Health care of community & international health
76742b10-f7be-4d5b-a526-04bab862670b
multi
Which of the following is not true about otosclerosis?
Ans: B (Eustachian tube is always abnormal) Ref: Diseases of the Ear, Nose, and Throat by PL Dhingra 5th edn.2010. P. 98 Explanation: Eustachian tube function is normal in otosclerosis. Otosclerosis Irregular spongy bone replaces the dense endochondral layer of the bony labyrinth. Hereditary. Associated with Van der hoove's syndrome- osteogenesis imperfecta, otosclerosis and blue sclera. More common in females. Hearing loss worsens during pregnancy. Cochlear type presents with SNHL. The stapedial type has CHL and may have anterior (most common) posterior, circumferential, biscuit or obliterative focus. C/F Hearing loss. Paracusis willisi and tinnitus (indicates an active focus). O/E Schwartze sign-- reddish hue over the promontory because of the increased vasculature in active lesions. PTA will show the type of hearing loss and Carhart's notch which is a dip in the bone conduction at 2kHz. Impedance audiometry will show an As type curve. Medical treatment with sodium fluoride can be tried. Surgery is the treatment of choice and includes stapedotomy or stapedectomy followed by replacement with a piston made of Teflon or stainless steel or titanium.
2
Hearing better in louder conditions
The eustachian tube is always abnormal
The tympanic membrane is normal
Bilateral progressive conductive deafness
Unknown
null
1b1f2830-40ef-4f91-9e0d-2b8b207b3d28
multi
Vitamin K is involved in the action of the following proteins except
Vitamin K dependent factors are Factors II, VII, IX, X, Protein C and S Ref: Ganong 25th ed/page 566
3
Factor II
Factor X
Factor I
Protein C
Physiology
Cardiovascular system
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multi
Berkesonian bias is a selection bias which occurs in-
.bias is any systematic error in the determination of the association between the exposure and disease.the relative risk may increase or decreaseas a result of the bias,it reflects some type of non comparability between the study and control groups.berkensonian bias,named after Joseph Berkenson.this bias arises because of the different rates of admission to hospitals for people with different diseases,that is HOSPITAL CASES AND CONTROLS. ref:park&;s textbook,ed 22,pg no 71
2
Community - based studies
Hospital - based sudies
Laboratory - based studies
Natural exposure studies
Social & Preventive Medicine
Epidemiology
f162a241-94e0-475b-85af-0eff52b26936
single
Primary ketone body
Acetoacetate is the primary ketone body while beta-hydroxybutyrate and acetone are secondary ketone bodies. They are synthesised exclusively by the liver mitochondriaRef: DM Vasudevan - Textbook of Biochemistry, 6th edition, page no: 143
2
b-hydroxybutyrate
Acetoacetate
Acetone
null
Biochemistry
Metabolism of lipid
4a303673-5d11-4aee-ac59-c2f6c6ff2035
multi
The nasopharynx is visualised in OPD by:
(c) Both PNS (postnasal space) mirror and tongue depressor(Ref. Scott Brown, Vol 3; 98)To examine nasopharynx or post nasal space in OPD, posterior rhinoscopy is done.Here the tongue is depressed using a tongue depressor and then the PNS mirror is passed behind the uvula. The glass surface of the PNS mirror is pre warmed so as to avoid mist formation, due to patient's breath, during examination.
3
PNS mirror
Tongue depressor
Both PNS mirror and tongue depressor
null
ENT
Pharynx
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multi
Injury that comes under sec 320 IPC -
Sec 320 IPC defines grievous hurt and among the given options, only b (fracture) is grievous injury.
2
Abrasion over face
Nasal bone fracture
Epistaxis
Lacerated wound over scalp
Forensic Medicine
null
3d5cba40-ca33-4156-a30b-ce706f97c0e3
single
Which one of the following is not a feature of clear cell carcinoma of the kidney?
* Clear cell carcinoma arises from Proximal Convoluted Tubule * Most common ,associated with VHL gene mutation, invade the renal vein& bony secondaries. * Clinical features : -Hematuria -Palpable mass -Costoveebral pain -Fever/ weight loss/malaise * It is not a childhood tumor.
2
Bony secondaries
Childhood tumour
Haematuria
Renal vein invasion
Pathology
Renal carcinoma
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single
In a dental clinic, auxiliary perform duties after personal diagnosis and direction of dentist and patient is sent after his clearance comes under
null
1
Direct guidance/ supervision
Indirect guidance/ supervision
Personal guidance/ supervision
General guidance/ supervision
Dental
null
1574a5c2-1d3a-4d9c-8ac4-06dfeea5f7c5
single
Not true about propagated epidemics
null
2
Herd immunity present
Sharp rise and decrease sharply
Person to person transmission
Multiple waves of epidemic
Dental
null
50b57763-0c1e-4ca8-95e8-f7ae72eaeb6c
multi
Patient diagnosed to have malaria, smear shows all stage of schizonts 14-20 merozoites, yellowish -brown pigment. The type of malaria is -
null
3
Pl. Falciparum
Pi. Malariae
Pl. Vivax
Pl. Ovale
Microbiology
parasitology
f3dd0132-3ff5-4820-a4aa-b328dfa05993
multi
A neonate had suffered from a teratogenic insult during embryonic growth that has affected the mesencephalic pa of his developing neural tube. In the presented cast of his ventricular system (left lateral view), which of the following areas might have suffered
The cerebral aqueduct (D) is the cavity of the midbrain that develops from the mesencephalon. The lateral ventricle (A) is the cavity of telencephalon and the third ventricle (C) is the cavity of diencephalon. The interventricular foramen of Monro (B) serves as the communication between the two. The fouh ventricle (E) is the cavity of the rhombencephalon.
3
Area B
Area C
Area D
Area E
Anatomy
Neuroanatomy, Head and Neck
fb4e4761-2b46-43b5-ae8d-496a1e23bf4c
single
A patient needs antibiotic treatment for Aificial valve, culture positive infective entercoccal endocarditis. His medical history include several anaphylactic reaction to penicillin G during the past year. The best approach would be treatment with
Ref-KDT 6/e 732 * Severe allergy to penicillins rule out the use of amoxicillin and cefazolin. * Vancomycin is highly effective against MRSA and enterococcal intections. * Drugs for VRSA and VRE (Vancomvcin Resistant enterococcus faecalis) include linezolid and daptomycin.
4
Amoxicillin clavulanic acid
Aztreonam
Cefazolin plus gentamicin
Vancomycin
Anatomy
Other topics and Adverse effects
e1891651-bf7a-4679-bc07-d661283e32e7
single
Hypersensitivity angiitis is seen in?
Cutaneous small-vessel vasculitis (also known as “Cutaneous leukocytoclastic angiitis and “Hypersensitivity angiitis”) is an inflammation of small blood vessels characterized clinically by palpable purpura. Subtypes of Small-Vessel Vasculitis Include: • Henoch-Schonlein purpura • Acute hemorrhagic edema of infancy • Urticarial vasculitis • Cryoglobulinemic vasculitis
4
SLE
Polyarteritis Nodosa
Buerger's disease
Henoch Schonlein purpura
Pathology
null
ca089948-e471-4aa8-8770-b54c4a7f63c1
single
Treatment of Hodgkin's disease -
null
4
CHOP
MOPP
ABVD
All of the above
Medicine
null
a1c9f8bf-e6d6-4f2b-946e-ba932e283f56
multi
Marfan's syndrome has which of the following prominent eye defects?
Marfan's syndrome is characterized by ectopia lentis (superior-temporal) 80% and megalocornea 15% in the eye. Ref: A.K KHURANA (2005), Chapter 8, "Disease of The Lens", In the book, "Opthalmology", 3rd Edition, Newdelhi, Page 210
4
Megalocornea
Microcornea
Microspherophakia
Ectopia lentis
Ophthalmology
null
7067e1bc-2445-4585-8a6a-c2ef63dfc666
single
Which of the following is cardio protective?
Cardioprotective: HDL It is synthesized and secreted by liver cells. It has maximum phospholipids. It takes cholesterol from periphery to liver, also known as reverse cholesterol transpo. HDL conves this cholesterol into cholesterol ester with the help of enzyme LCAT-Lecithin Cholesterol Acyl Transferase. Removes cholesterol from extrahepatic tissue
1
HDL
LDL
VLDL
CHYLOMICRON
Biochemistry
FMGE 2019
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single
Introns are exised by
Introns are excised by RNA splicing by Sn-RNAs/Snurp.
1
RNA splicing
RNA editing
Restriction endonuclease
DNAase
Biochemistry
null
002bc54b-1848-4d1a-8faa-2771da6c0938
single
All are true regarding Normal distribution curve except
NORMAL DISTRIBUTION The normal distribution or 'normal curve' is an impoant concept in statistical theory. Let us suppose, we collect the haemoglobin values of a very large number of people and make a frequency distribution with narrow class intervals, we are likely to get a smooth, symmetrical curve. Such a curve is called a normal distribution or normal curve. The shape of the curve will depend upon the mean and standard detion which in turn will depend upon the number and nature of observations. It follows, therefore, there will be an infinite number of normal curves. Standard normal curve Although there is an infinite number of normal curves depending upon the mean and standard detion, there is only one standardized normal curve, which has been devised by statisticians to estimate easily the area under the normal curve, between any two ordinates. The standard normal curve is a smooth, bell-shaped, perfectly symmetrical curve, based on an infinitely large number of observations. The total area of the curve is 1; its mean is zero; and its standard detion is 1. The mean, median and mode all coincide. The distance of a value (x) from the mean (X) of the curve in units of standard detion is called "relative dete or standard normal variate" and is usually denoted by Z. Ref : Park 23rd edition Pgno : 849
1
One standard detion includes 95% of values
Mean, Median, Mode coincides
Median is mid value
Area under the curve is one
Social & Preventive Medicine
Biostatistics
97b618d2-e538-4e63-babf-8a5002e22cb2
multi
Which one of the following disinfectant is effective in killing spores -
Halogens are potent bactericidal, fungicidal, sporicidal, tuberculocidal, and virucidal. Others are given are only slowly effective against spores. Park's textbook of preventive and social medicine.K Park. Edition 23.Pg no: 128
3
Alcohol
Aldehyde
Halogens
Phenol
Social & Preventive Medicine
Environment and health
2db364ab-1afa-49bf-a766-0bf4be574965
single
Incidental finding in CT scan, a 3 cm adrenal mass, which of the following is not done?
Nonoperative therapy, with close periodic follow-up, is advised for lesions <4 cm in diameter with benign imaging characteristics, whereas adrenalectomy is recommended for lesions >=4 cm in size due to the increased risk of cancer.
1
Adrenalectomy
Dexamethasone suppression test
Measurement of catecholamines
Midnight plasma coisol
Surgery
Parathyroid and adrenal glands
f6e7113b-9509-4a56-8725-f975923ec2f8
single
Trabecular (conventional) outflow of aqueous humour accounts for:
Ans. 90 percent
1
90 percent
80 percent
70 percent
60 percent
Ophthalmology
null
9c649770-c6dc-4106-bda9-245c2fc076c5
single
False about Echinococcus granulosus is
Hydatid fluid is Secreted by Endocyst also called as Germinal epithelium.
4
Man is the dead end
Causes hydatid disease
Casoni's test is Sensitive
Hydatid fluid is secreted by Ectocyst
Microbiology
null
74b00971-a56b-4eef-8bff-b4c32464376c
multi
In humans, nails grow at an average rate of ______ a month:
In humans, nails grow at an average rate of 3 mm (0.12 in) a month. Fingernails require three to six months to regrow completely, and toenails require twelve to eighteen months. Actual growth rate is dependent upon age, sex, season, exercise level, diet, and hereditary factors. Nails grow faster in the summer than they do in the winter.
2
1 mm
3 mm
5 mm
7 mm
Dental
Disorders of nail
d3be89a4-9bd5-46a8-8d62-af21c0a5b899
single
About Myocardial Oxygen Consumption true is:
D i.e. Directly propoional to mean aerial pressure- Myocardial O2 demand/ consumption is primarly determined by hea rate, contractility of myocardium (or ventricles) (i.e. inotropy), intramyocardial wall tension (which is directly propoional to after load or intra cavitatory pressure and preload or ventricular radius and inversely propoional to myocardial muscle mass or wall thickness) and ventricular work per beat (i.e. stroke volume X mean aerial pressure). For left ventricle mean aerial pressure of aoa and for right ventricle MAP in pulmonary aery is used.Myocardial O2 demand is not negligible at restQ. It has a constant relation (not directly propoional) to external cardiac work (during ejection phase of cardiac cycle). Myocardial O2 demand is directly propoional to hea rate but has no relation to duration of systoleQ.Myocardial oxygen consumptionBasal O2 consumption (determined by stopping the hea and aificially maintaining coronary circulation) is 2 mL/100 gm /min, which is considerably higher than that of skeletal muscleQ. O2 consumption by beating hea is 9 mL/100 gm /min at rest, which is the highest per unit mass consumption of O2Q.Due to very high O2 extraction, the aerio - venous O2 difference (ML/L) is also maximum in hea. So increase in O2 demand requires increase in coronary blood flow otherwise ischemia develops.Factors that enhance magnitude & /or rate of tension development will increase myocardial O2 demand. So increasing hea rate increases O2 demand by increasing rate (number of tension cycles developed/minute); whereas increasing inotropy (contractility) by increasing both magnitude & rate of tension developedQ.So myocardial O2 consumption is primarily determined by intramyocardialtension, contractile state & hea rateQ.Left ventricular stroke work is 7 times greater than that of right ventricle since the aoic pressure is 7 times greater than the pulmonary aery pressure. Theoratically, a 20% increase in stroke volume without a change in aerial pressure and a 20% increase in aerial pressure without a change in stroke volume should produce the same increase in 02 consumption But because of La plat relationship, pressure work (i.e, increase in after load or mean aerial pressure) produces a greater increase in 02 consumption than volume work (i.e., increase in preloadQ or stroke volume). This is why angina is more common in AS than AR (aoic regurgitation).
4
Inverse relation with hea rate
Inverse relation to mean systolic aerial pressure
Constant relation to external work done
Directly propoional to mean aerial pressure
Physiology
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Renal angle lies between -
The angle between the lower border of 12th rib and the outer border of erector spinae (sacrospinalis) is known as a renal angle.
1
12th rib & lateral border of sacrospinalis
11th rib & lateral border of sacrospinalis
12th rib & lateral border of quadratus lumborum
11th rib & lateral border of quadratus lumborum
Anatomy
null
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MC congenital abnormality of uterus is :
Septate Sorry for this one friends, 2 very reliable textbooks quote different incidences of different malformations. Anomaly r Per cent Anomaly Per cent' * Bicornuate uterus 37% * Septate uterus 35% * Arcuate uterus 15%. * Bicornuate uterus 26% I * Incomplete septum 13%' * Arcuate uterus 18% * Uterus didelphys 11% * Unicornuate uterus 10% * Complete septum 9% - * Uterus didelphys 8% * Unicornuate uterus 4% Now decide for yourself which book would you like to follow.
4
Uterus didelphys
Arcuate
Unicornuate
Septate
Gynaecology & Obstetrics
null
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single
White-coat hypeension is an example of :
The patient's elevated blood pressure in the doctor's office is the conditioned (learned) response. This response results from an association that has been made by classical conditioning between the doctor and/or his white coat (conditioned stimulus) and something negative in the patient's past (unconditioned stimulus), a reaction commonly called "white-coat hypeension." The patient's blood pressure is relatively normal when taken at home.
4
the unconditioned stimulus
the unconditioned response
the conditioned stimulus
the conditioned response
Psychiatry
Miscellaneous
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The heme prosthetic group is found in
Myoglobin is a monomeric protein that acts as a secondary oxygen transporter and binder in the muscle tissues. Furthermore, the tertiary feature of myoglobin resembles water-soluble globule protein characteristics. The diffusion and use of oxygen in the muscles are necessary for the bodily system processes such as respiration. Myoglobin has 8 right-handed a-helices separately forming a polypeptide chain and each contains a single heme prosthetic group with a central bound iron atom.
1
Myoglobin
Cytochrome oxidase
Xanthine oxidase
Tyrosine
Biochemistry
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single
An antiepileptic drug used in petitmal epilepsy is:
null
4
Phenobarbitonse
Dilantoin sodium
Dilantoin sodium
Ethosuximide
Pharmacology
null
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single
The earliest diagnostic test of pregnancy :
Beta HCG
2
Ultrasound
Beta HCG
Fetal movements
Fetal hea sounds
Gynaecology & Obstetrics
null
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single
Which sensitizes the myocardium to catecholamines
Halothane-catecholamine sensitization also promotes abnormal automaticity of dominant and latent atrial pacemakers. These effects may produce premature ventricular contractions and arrhythmias originating from the His bundle. Intact sinoatrial node function reduces the incidence of epinephrine induced ventricular escape during halothane anesthesia and is protective against His bundle arrhythmias. Halothane and, to a lesser extent, other volatile anesthetics sensitize the myocardium to the arrhythmogenic effects of epinephrine. Sensitization is the interaction between volatile anesthetics and catecholamines that leads to reductions in the threshold for both atrial and ventricular arrhythmias. Halothane and, to a lesser extent, isoflurane may be arrhythmogenic in Purkinje fibers in experimental myocardial infarction by facilitating reentrant activity or increasing temporal dispersion of the refractory period recovery. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e
3
Isflurane
Ether
Halothane
Propofol
Anaesthesia
General anaesthesia
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Dystocia dystrophia syndrome is seen in
Dystocia dystrophia syndrome Charecteristic appearence Short  Stalky Subfertile  Masculine hair distribution History of delayed menarche Has android pelvis
3
Anthropoid
Platypelloid pelvis
Android pelvis
Gynaecoid pelvis
Gynaecology & Obstetrics
null
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single
Carpel tunnel syndrome is caused by all except
Ref - Researchgate.net
3
Rheumatoid ahritis
Hypothyroidism
Addisson's disease
Diabetes mellitus
Anatomy
Upper limb
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multi
All of the following are risk factors for carcinoma gall bladder, EXCEPT -
null
4
Typhoid carriers
Adenomatous gall bladder polyps
Choledochal cysts
Oral contraceptives
Surgery
null
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multi
A 25 year old female comes to OPD with history of spots, red bumps that are located principally on the proximal cheeks, central chin, nose and central forehead. It gets aggravated on sun exposure. On examination, telangiectasia is seen on cheeks. What is the most probable cause ?
The given clinical scenario is of Rosacea as it gets aggravated on exposure to sunlight, redness seen on face convexities and telangiectasia Rosacea has 4 subtypes : Subtype 1: Erythematotelangiectatic rosacea (ETTR). Subtype 2: Papulopustular rosacea (PPR). Subtype 3: Phymatous rosacea (PR). Subtype 4: Ocular rosacea (OR). In SLE, rash spares Nasolabial fold
4
Polymorphic light eruption
SLE
Acne vulgaris
Rosacea
Dental
Disorders of sebaceous and sweat glands
6e90315e-2341-44dd-892e-26443d3dc27f
multi
Hypogonadism in cirrhosis is due to ?
Ans. is 'a' i.e., Direct effect of alcohol on testes ; 'b' i.e., Increased estrogen due to decreased catabolism; 'c' i.e., Increased peripheral conversion of androgens into estrogeno The testicular atrophy is due to disorder of hormonal metabolism or direct toxic effect on testis.o In cirrhosis of liver a combined testicular and pituitary abnormality leads to decreased testosterone production. The decreased testosterone (i.e. androgen insufficiency) production most likely result from inhibition of L H secretion by estrogens in patients with chronic liver disease.o The increased estrogen production result from impaired hepatic extraction of adrenal androstenedione and subsequent increased extraglandular conversion to estrone and estradiol.o The hyperestrogenemia cause hypogonadism and gynecomastia.
4
Direct effect of alcohol on testes
Increased estrogen due to decreased catabolism
Increased peripheral conversion of androgens into estrogen
All
Pathology
null
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multi
Pseudo Cushing's syndrome is seen in?
Ans. D. All of the abovePseudo Cushing's syndrome:a. Some patient resemble like Cushing's syndrome (Pseudo Cushing syndrome).b. These are patient with obesity, chronic alcoholism, depression and acute illness of any type.
4
Obesity
Alcoholism
Depression
All of the above
Medicine
Miscellaneous
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multi
Which of the following mucolytic contains free sulphydryl group
null
4
Guanfacine
Ambroxal
Carbocistene
N-Acetyl cysteine
Pharmacology
null
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single
Pupil in acute attack of Anterior Uveitis is –a) Semi Dilatedb) Large and fixedc) Irregular & constrictedd) Constricted & sluggish reacting
There is a narrowing of the pupil (miosis) due to irritation of sphincter pupillae by toxins. Iris edema and engorged radial vessels of iris also contribute to making the pupil narrow. The shape of pupil becomes irregular due to segmental posterior synechiae. The papillary reaction becomes sluggish or may even be absent due to edema and hyperemia of iris which hamper its movement. There may be ectropion of pupil (eversion of papillary margin), owing to the contraction of organising exudates upon the iris. This causes the pigmented epithelium on the posterior surface of iris to be pulled around the papillary margin so that the patches of pigment may be seen on the anterior surface of the iris, i.e. ectropion of the uveal pigment.
1
cd
bc
bd
ac
Ophthalmology
null
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single
Shrinking lung syndrome is seen most commonly in -
Ans. is 'a' SLE Shrinking Lung syndrome* First described by Hoffbrand and beck in 1965.* It manifests as dysnea and is best characterized as diaphragmatic dysfunction leading to diminished lung volumes.* Radiographic evaluation shows diaphragmatic elevation with bibasilar atelectasis - in the absence of parenchymal lung abnormalities.* PFT reveals a restrictive ventilator defect and a decrease in DLCO, that normailses when corrected for alveolar volume.* The hallmark of shrinking lung is the presence of these PFT features in the absence of parenchymal lung abnormalities but with disproportionately severe dysnea.* This is a typical feature of the pulmonary involvement of systemic lupus erythematosus.
1
SLE
Scleroderma
Rheumatoid arthritis
Ankylosingspondilytis
Medicine
Respiratory
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