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A child presents with recurrent respiratory tract infection, mouth breathing and decreased hearing. Treatment is:
Child is presenting with mouth breathing. Palate is high arched.There is nasal obstruction and recurrent respiratory tract infections along with hearing impairment. All these features are suggestive of adenoid hyperplasia. In case of adenoid hyperplasia, impairment of hearing is due to secretory otitis. Thus the logical step in the management would be myringotomy with grommet inseion (to treat SOM) and adenoidectomy or tonsilectomy (to remove the causative factor).
4
Tonsillectomy
Adenoidectomy
Grommet inseion
All
ENT
null
63a1ddb2-89d9-48c7-8f32-7f854236810e
multi
All are major cytokines in chronic inflammation except
Ans. (a) IL-6(Ref: Fundamental immunology by William E Paubl 1030, Koj -chapter 3; Refer to Ans 69)Il6 IS INVOLVED IN ACUTE FRBRILE RESPONSES Others are involved in chronic inflammation
1
IL-6
IL-12
IFN-y
IL-17
Pathology
Inflammation & Repair
9c7daf15-4f32-4c88-90d7-8b7f9d9dc239
multi
Olopatadine is:
Ref: Clinical Oculor Pharmacology, 1st ed. pg. 257* Olopatadine hydrochloride is an antihistamine (as well as anticholinergic and mast cell stabilizer)* It is used as eye drop to treat itching associated with allergic conjunctivitis.* Side effects include headache, eye burning and/or stinging, blurred vision, dry eyes, foreign body sensation, hyperemia, keratitis and taste perversion.
3
Mast cell stabilizer
Anti-histamine
Both mast cell stabilizer and anti histamine
None of the above
Pharmacology
Endocrinology
13877362-5a67-44b4-ba53-533d503f66e7
multi
Ketone body formation takes place in:
A Harper, 26th ed, p. 183 & 25th ed, p. 243, Fig (24.6)
1
Liver
Kidney
Spleen
Blood
Biochemistry
Lipids
96e52b4c-8fbe-4a68-8437-b9778108cf6b
single
Purposeful movement is staed at
Palmer grasp goes at age of 4 monthTransfer object hand to hand 5.5 monthThe purposeful movement staed when there is an absence of Palmer group, so an above option best answer is 6 month(Refer: Nelson's Textbook of Pediatrics, SAE, 1st edition, pg no. 2798)
1
6 months
8 months
9 months
12 months
Pediatrics
All India exam
592fea53-9a72-43d5-ba1b-9b3dcfdff066
single
Which of the following structures form the superior border of Epiploic foramen ?
In human anatomy, the omental foramen (Epiploic foramen, foramen of Winslow, or uncommonly aditus) is the passage of communication or foramen, between the greater sac (general cavity of the abdomen) and the lesser sac.Borders of Epiploic foramen: It has the following boundaries:Anteriorly : free border of lesser omentum, bile duct, hepatic aery and poal vein.Posteriorly : Inferior vena cava, right suprarenal gland and T12 veebraeSuperiorly : Caudate process of caudate lobe of liverInferiorly : First pa of the duodenum and horizontal pa of hepatic aery
2
Quadrate lobe of liver
Caudate process of caudate lobe of liver
Poa hepatis
First pa of the duodenum
Anatomy
null
d2e66250-f2fd-4151-88f3-c4c5b4909a6b
single
Antidote for organophosphorus poisoning is -
Antidotes for OP compounds : (1) atropine (2) oximes (Pralidoxime : PAM, obidoxime and diacetylmonoxirne : DAM).
1
PAM
Adrenaline
Anti-dopaminergics
Ephedrine
Forensic Medicine
null
e699b00a-fddc-40d6-ba00-cf9960fcc4a4
single
EBV is associated with which type of cancer?
Epstein-barr virus may lead to the following clinical conditions:* Infectious mononucleosis* Epstein-barr virus associated malignancies: - Burkitt's lymphoma - Lymphomas in immunodeficient person such as those with AIDS and transplant recipients - Nasopharyngeal carcinoma in persons of Chinese origin.
1
Nasopharyngeal carcinoma
Epidermodysplasia
Kaposi sarcoma
null
Microbiology
DNB 2018
acac1b45-5029-42a8-ba47-be22e8f3bee0
multi
Hyperaldosteronism is associated with all, EXCEPT:
Primary hyperaldosteronism causes extracellular volume expansion and hypeension by increasing distal sodium reabsorption. Aldosterone increases H+ and K+ excretion, producing metabolic alkalosis and hypokalemia. Therapy for saline-unresponsive metabolic alkalosis includes surgical removal of a mineralocoicoid-producing tumor and blockage of aldosterone effect with an ACE inhibitor or with spironolactone. Metabolic alkalosis in primary aldosteronism can be treated only with potassium repletion. Ref: Cho K.C. (2013). Chapter 21. Electrolyte & Acid-Base Disorders. In M.A. Papadakis, S.J. McPhee, M.W. Rabow (Eds), CURRENT Medical Diagnosis & Treatment 2013.
4
Hypernatremia
Hypokalemia
Hypeension
Metabolic acidosis
Physiology
null
3a22eaa4-bb78-43cb-8aa0-7bca8d751dce
multi
A 28-year-old patient has multiple grouped papulovesicular lesions on both elbows, knees buttocks and upper back associated with severe itching. The most likely diagnosis is –
Look for itching → Severe itching Papulovesicular lesion On extensors (knees, elbows), scapular region (upper back), buttock. Age → 28 years
3
Pemphigus vulgaris
Bullous pemphigoid
Dermatitis herpetiformis
Herpes Zoster
Dental
null
7e8660fb-1d21-4320-a2b8-9760cff656b3
multi
Tongue muscle which is not developed from occipital myotome ?
DEVELOPMENT OF THE TONGUE :? I. Epithelium a) Ant 2/3 -- lingual swellings of 1st arch and tuberculum impar b) Post 1/3 -- large dorsal pa of hypobranchial eminence, Le. 3rd arch c) Posterior most pa -- small dorsal pa of the hypobranchial eminence, i.e. 4th arch II. Muscles From occipital myotomes except palatoglossus which is derived from the 6th arch.
4
Styloglossus
Hyoglossus
Genioglossus
Palatoglossus
Anatomy
null
c32f8547-3512-4256-8030-868502c130e9
single
Sodomy is punishable under:NEET 14
Ans. Sec. 377 IPC
3
Sec. 354 IPC
Sec. 375 IPC
Sec. 377 IPC
Sec. 378 IPC
Psychiatry
null
51351c00-e363-419e-9052-23ca53fc9362
single
The drug of choice for the treatment of Thyrotoxicosis during pregnancy is
(C) Propyl Thiouracil # All antithyroid drugs can cross placenta so risk of fetal hypothyroidism and goitre is always there.> Both carbimazole and propylthiourcil can be used during pregnancy, but propyl-thiouracil is the drug of choice because its greater protein binding allows low doses of propylthioracil to be transferred across the placenta and therefore less chance of hypothyroidism.> Lowest effective dose of propyl thiouracil should be given and it is often possible to stop treatment in the last trimester since TSH Receptor antibodies tend to decline in pregnancy.> Radioactive iodine is C/l during pregnancy> It can destroy the fetal thyroid tissue resulting in cretinism> Carbimazole and methimazole have been associated with rare cases of foetal aplasia cutis.
3
Carbimazole
Iodine therapy
Propyl Thiouracil
Metimazole
Medicine
Miscellaneous
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single
Drugs are used in AKT-4 kit for TB as
null
4
null
Decrease in resistance by conjugation
To cure disease early
Decrease in resistance by mutation
Social & Preventive Medicine
null
fdb3db95-78f0-4579-842d-4c8c9445e57d
multi
A 47-year-old man is found to have edema, ascites, and hepatosplenomegaly. The examination of his neck veins reveals elevated venous pressure with a deep y descent. Heart size on x-ray is normal. Which of the following etiologies is not a possible explanation for this syndrome?
Commonly, no cause is found for constrictive pericarditis. Some patients do give a history of previous acute pericarditis. TB is now an uncommon cause. Cancer can cause constriction but is uncommon. Rheumatic fever does not cause pericarditis.
1
rheumatic fever
TB
unknown cause
previous acute pericarditis
Medicine
C.V.S.
48bf4552-3a7b-4b08-b521-6d2a92697e9a
single
In sickle cell anaemia defect is in which chain ?
Ans. is 'b' i.e., n-chain
2
a-chain
B-chain
Both the chains
None of these
Pathology
null
11a218be-6cac-4265-b84c-5658735c4fff
multi
Waddling gait due to: March 2009
Ans. A: Bilateral congenital dysplasia of hip A waddling gait is the style of walking that is seen in a patient with proximal myopathy. It is characterised by: A broad-based gait with a duck-like waddle to the swing phase The pelvis drops to the side of the leg being raised Forward curvature of the lumbar spine Marked body swing This gait may be seen in patients with bilateral congenital hip dislocation and pregnancy.
1
Bilateral congenital dysplasia of hip
Coxa valga
CTEV
Bilateral coxa valgum
Surgery
null
7bf77e57-99bb-4774-910d-3f16127586d1
single
Treatment of Advanced Proliferative Diabetic Retinopathy with extensive vitreoretinal fibrosis and fractional retinal detachment involves all of the following, EXCEPT:
There is no role of Exophotocoagulation in the management of advanced proliferative diabetic retinopathy with complications such as fractional RD and extensive vitreoretinal fibrosis. Endophotocoagulation may be used in conjunction with vitrectomy. Ref: Oxford Textbook of Medicine 4th /350; Current Geriatric Diagnosis and Treatment (2004)/127
4
Reattachment of detached or torn retina
Removal of epiretinal membrane
Vitrectomy
Exophotocoagulation
Ophthalmology
null
3bdf8cc4-529c-4236-b9ef-771fbc7d45bb
multi
All of the following are H2 blockers except ?
Ans. is `d' i.e., Omeprazole Drugs for peptic ulcer 1. Reduce gastric acid secretion a) H2 antihistaminic - Cimetidine, Ranitidine, Famotidine, Roxatidine. b) Proton pump inhibitors - Omeprazole, Lansoprazole, Pantoprazole, Rabeprazole, Esomeprazole. c) Anticholinergics - Pirenzepine, propantheline, oxyphenonium. d) Prostaglandin analogue - Misoprostol, enprostil, rioprostil. 2. Neutralization of gastric acid (antacids) a) Systemic - Sodium bicarbonate, sodium citrate. b) Non systemic - Magnesium hydroxide, Mag. trisilicate, aluminium hydroxide, Magaldrate, calcium carbonate. 3. Ulcer protectives Sucralfate, colloidal bismuth subcitrate, Prostaglandin analogue. 4. Anti H. pylori durgs Amoxicillin, clarithromycin, metronidazole, Tinidazole, tetracycline. Note - PG analogue have both antisecretory (|- HC1 secretion) as well as cytoprotective action.
4
Cimetidine
Ranitidine
Famotidine
Omeprazole
Pharmacology
null
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multi
X-rays are a type of
null
3
Atomic radiation
Ultrasonic radiation
Electromagnetic radiation
Particulate radiation
Radiology
null
fb980300-ff4b-41b3-b680-9436b1b3ca8c
single
Activation of which receptor causes pulmonary vasoconstriction?
Activation of ETA receptor causes pulmonary vasoconstriction. These are endothelin receptors.Ref: Ganong review of medical physiology, 23rd edition Page no: 609
4
Alpha 2 adrenergic
H2 histamine
M3 cholinergic
ETA epithelial receptor
Physiology
Respiratory system
2889e536-9889-48df-aff7-f1458f6c90e2
single
Shock lung synonym is used for
Ans. C. ARDSShock Lung/ARDS is a clinical syndrome caused by diffuse alveolar capillary and epithelial damage. There is usually rapid onset of life-threatening respiratory insufficiency, cyanosis, and severe arterial hypoxemia that is refractory to oxygen therapy and that may progress to multisystem organ failure. The histologic manifestation of ARDS in the lungs is known as diffuse alveolar damage.
3
COPD
Alveolar proteinosis
ARDS
HMD
Medicine
Respiratory
382dd98d-650d-40ee-82a2-bfa73949ce88
single
The commonest cause of Enuresis in children is -
Ans. is None o Genetic factors are the most common etiology for enuresis. Nelson o Beyond genetic factors, the cause of enuresis likely involves a complex web of physiologic and perhaps psychologic factors.
4
Urinary tract infection
Spina bifida
Psychologic stress
null
Pediatrics
null
c7c5ffa7-c62c-443b-a588-ca092d0debde
multi
Trans-tubular potassium gradient (T.T.K.G) in hypokalemia is?
The expected values of the Trans-tubular potassium gradient (T.T.K.G) are <3-4 in the presence of hypokalemia and >6-7 in the presence of hyperkalemia. TTKG is measured as follows:
1
<3-4
>6-7
>9-10
>10-15
Medicine
Fluids and Electrolyte Imbalance
be02c8e1-11d2-4bd7-88ea-3f0b8c3521a4
single
Which of the following investigation would be diagnostic of cystic fibrosis?
A sweat test measures the amount of chloride, a pa of salt, in Sweat. It is used to diagnose cystic fibrosis (CF). People with CF have a high level of chloride in their sweat. CF is a disease that causes mucus build-up in the lungs and other organs. It damages the lungs and makes it hard to breathe Ref Davidson 23rd edition pg 944
2
Deficiency of the enzyme mucinase
High sweat chloride content
Alpha-1 aldolase deficiency
Increased copper excretion in urine
Medicine
Miscellaneous
7eab82f9-8f1c-4522-8744-570c6cec3c7b
single
Intention tremor is characteristic of :-
Intention tremor is seen in cerebellar lesions and “pill-rolling” tremors at rest is typical of Parkinson’s disease.
4
Parkinson’s disease
Fronto temporal Dementia
Progressive Supra Nuclear Palsy
Cerebellar lesions
Medicine
null
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single
Site of lesion in Bitemporal hemianopia is ?
Ans. is 'c' i.e., Optic chiasma Characteristic defect of central chiasmatic lesion is bitemporal hemianopia. This question has been asked in almost all the examinations. Site oflesion Visual field defect Optic nerveOptic chiasmaOptic tractLateral geniculate bodYOptic radiation (Total)Optic radiation lower fibres (temporal lobe)Optic radiation upper fibres (parietal lobe)Visual coex (anterior occipital coex)Occipital coex tiP BlindnessBitemporal hemianoPiaIncongruent homonymous hemianopiaHomonymous hemianoPiaHomonymous hemianopia, sornetimes with macular sparinqHomonymous upper quadrantanoPiaHomonymous I ower quadrantanoPiaffo*oo"rno"s hemianopia with macular sparingHomonymous macular defect
3
Optic nerve
Optic tract
Optic chiasma
Optic radiation
Anaesthesia
null
79bc1dd0-acfc-4313-8c05-78bce8bd7f03
single
Patient of Rectovaginal fistula should be initially treated with
Recto-Vaginal Fistula Management Preliminary colostomy is done Local repair after 3 weeks Closure of colostomy after 3weeks Ref: D.C.DUTTA&;S TEXTBOOK OF GYNAECOLOGY; 6th edition; Pg no:428
1
Colostomy
Primary repair
Colporrhaphy
Anterior resection
Gynaecology & Obstetrics
Urogynecology
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multi
Turban epiglottis is seen in
Turban epiglottis is due to oedema and infiltration of the epiglottis and is caused by laryngeal tuberculosis. Lupus: a form of tuberculosis, on the other hand, eats away and destroys the epiglottis. Pseudoedema of the epiglottis is known as "turban epiglottis". Ref: PL Dhingra 7th edition of Ear, Nose and Throat; Pg no 331
1
Tuberculosis
Leprosy
Laryngeal papilloma
Epiglottitis
ENT
Larynx
69beeaad-ca09-4c1e-b28e-0a66156d64b7
single
Arthritis mutilans is due to:
Ans: a (Psoriatic arthritis) Ref: Harrison's, 16th ed,p. 1998; 17th ed, p. 2115Arthritis mutilans is due to psoriatic arthritis. Psoriatic arthritis involves PIP, DIP and metacarpopha- langeal joints and may or may not involve the wrist.Psoriatic arthritis can present with a wide spectrum of clinical features namely:1) Asymmetrical inflammatory oligoarthritis - 40%2) Symmetrical polyarthritis - 25%3) Predominant distal interphalangeal joint arthritis -15%4) Psoriatic spondylitis-15% C5) Arthritis mutilans - 5%.It is the most serious condition and the skin of fingers appears telescoped.NoteOsteoarthritis -Involves PIP, DIP and 1st carpometacarpal joint (base of thumb). Spares MCPand wrist.Rheumatoid arthritis -Involves any small joint of hand eg PIP, MCP, wrist. Sparing of DIP.Psoriatic arthritis -Involvement of PIP, DIP, MCP and wrist. Sparing of any joint may or may not be present.RememberIf DIP is involved, Rheumatoid arthritis can be ruled out.Similarly if MCP joint is involved, osteoarthritis can be ruled out.
1
Psoriatic arthritis
Osteoarthritis
Rheumatoid arthritis
Rheumatic arthritis
Medicine
Immunology and Rheumatology
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single
NOT a complication of massive blood transfusion: March 2013 (d)
Ans. C i.e. Hypehermia Hypothermia is seen and hence blood should be warmed before infusion
3
Septicemia
Thrombocytopenia
Hypehermia
ARDS
Anaesthesia
null
af5d8acd-c032-48a6-8c88-86fa51b49381
single
A 50-year-old male presented with signs and symptoms of restrictive hea disease. A right ventricular endomyocardial biopsy revealed deposition of extracellular eosinophilic hyaline material. On transmission electron microscopy, this material is most likely to reveal the presence of
Amyloidosis is the major cause of restrictive cardiomyopathyCardiac amyloid is classically suspected from thickened ventricular walls with an ECG that shows low voltage.By electron microscopy, all types of amyloid consist of continuous, nonbranching fibrils with a diameter of approximately 7.5 to 10 nm. X-ray crystallography and infrared spectroscopy demonstrate a characteristic cross-b-pleated sheet conformationHarrison 19e pg: 1567
1
Non branching filaments of 7.5 to 10 nm
Cross banded fibres with 67 m periodicity
Weber Palade bodies
Concentric whorls of lamellar structures
Pathology
miscellaneous
7ad10ce8-f679-47fd-8fd7-69dd293ccc27
single
Which of the following is a disinfectant, sterilizing agent and an antiseptic?
null
1
Sodium hypochlorite
Glutaraldehyde
Hydrogen peroxide
Methylated spirit
Dental
null
e7d116c0-133f-474a-8aab-23dcfcc16ad7
single
Prevalence of vitamin-A deficiency in a community is assessed as the following:
Prevalence criteria for determining the xerophthalmia problem: Criteria Prevalence in population at risk (6 months to 6 years) Nightblindness More than 1% Bitot's spots More than 0.5% Corneal xerosis/corneal ulceration/ keratomalacia More than 0.01% Corneal ulcer More than 0.05% Serum retinol (less than 10 mcg/dl) More than 5% Ref: Textbook of Preventive and Social Medicine by K Park, 19th edition, Page 486.
3
Night blindness-10%
Corneal ulcer-0.1%
Bitot spots-0.5%
Decreased serum retinol level-0.05%
Social & Preventive Medicine
null
6c70b09c-5d5d-4a9b-9037-64983280ab89
single
In the Post-disaster phase, all of the following vaccines are mandatory for doctors except:-
Vaccines C/I for population:- Cholera Typhoid Tetanus Other vaccines are relatively CI Vaccines mandatory for Doctors/health providers:- Cholera Typhoid Tetanus
3
Cholera
Typhoid
Measles
Tetanus
Social & Preventive Medicine
Vaccines
a4f8e175-5dce-49d7-a934-deb5e1e65d66
multi
Bence Jones proteinuria is found on a urinalysis specimen from a 63 year old woman. She is developing chronic renal failure and has a high serum urea nitrogen and creatinine. A radiograph of the veebral column demonstrates multiple 1 to 2 cm rounded areas of decreased bone density. The pathological examination from a renal biopsy is likely to show which of the following complication?
Multiple myeloma is one of the most common causes for amyloidosis that leads to renal failure. The plasma cells secrete light chains and produce the proteinuria as well as the amyloid.
4
Pneumocystis carinii pneumonia
Sclerodactyly
Chronic myelogenous leukemia
Amyloidosis
Surgery
null
9d0b06e8-5c5f-4de0-a86f-35d49cdc43db
single
True statements regarding vancomycin uses are all of the following except: September 2009
Ans. B: Drug of choice for pseudomembranous enterocolitis Vancomycin is used in Proven methicillin-resistant (MR) Staph. aureus (S.A.) or coagulase-negative Staphylococcal infections Serious infections where coagulase-negative Staphylococci is highly suspected (e.g., central line, prosthesis, sternotomy, etc). Endocarditis caused by methicillin-resistant Staphylococci (plus gentamicin and rifampin for prosthetic valve endocarditis caused by coagulase-negative Staphylococci). Meningitis caused by flavobacteria or Penicillin-resistant pneumococcus (plus cefotaxime) CNS shunt infection caused by methicillin resistant Staphylococci (+ rifampin) Infections caused by organisms susceptible only to vancomycin (e.g., Corynebacterium jeikium) Ampicillin-resistant enterococcal infections. Prophylaxis for major surgical procedures for implantation of prosthetic materials or devices at hospitals with a high rate of infections due to methicillin-resistant Staphylococci. A single dose administered immediately before surgery is sufficient unless the procedure lasts more than 6 hours, in which case the dose should be repeated. Prophylaxis should be discontinued after a maximum of two doses. It is second choice drug to metronidazole for antibiotic associated pseudomembranous enterocolitis caused by C.difficile.
2
Surgical prophylaxis in MRSA prevalent areas
Drug of choice for pseudomembranous enterocolitis
Effective in penicillin-resistant pneumococcal infection
Methicillin-resistant Staphylococcus aureus infection
Pharmacology
null
613a5e42-ac53-4b5c-9b52-51ed9b2938ef
multi
All are true about scleritis except?
null
1
painless condition
glaucoma may occur
necrotising scleritis is more severe and destructive form
Anterior scleritis pain worsens at night
Ophthalmology
Sclera
2453a113-427e-4910-8606-7c7b8e1d05a2
multi
After a single episode of painless gross hematuria in a boy. Doctor performed an excretory urogram showing a filling defect towards the lower renal infundibulum 1.5 cm. in size. What will be the next investigation to be done ?
Ans. is 'c' ie USG There can be various reason for a filling defect on IVP - stones, mass, cyst etc. They can be very well be diagnosed by USG.
3
Cystoscopy
Urine cytology
USG
Retrograde pyelography
Surgery
null
ce1d98be-17da-4361-b90f-897af1e29b48
single
A 60-year-old female presents with epigastric pain, nausea and vomiting, hea rate of 50, and pronounced first-degree AV block on ER cardiac monitor. Blood pressure is 130/80. The coronary aery most likely to be involved in this process is the
(Fuster, 10/e, pp 52, 88.) The right coronary aery supplies most of the inferior myocardium and supplies the AV node in over 70% of patients. Thus occlusion of this aery can cause ischemia of the AV node with AV block or bradycardia, as well as symptoms of an inferior MI as seen in this patient. AV block can occur with anterior MI related to LAD occlusion, but this generally implies a greater area of myocardial involvement and hemodynamic instability.
1
Right coronary
Left main
Left anterior descending
Left anterior descending
Surgery
null
18e5d2f4-6c4d-47d6-850e-caef4182f484
single
All are true except?
Ans. B. DNA viruses: Adenovirus, Human papilloma virus, Parvovirus B-19, BK and LC polyomavirus, Polio virus.1. DNA viruses* Parvo viridae (ss DNA) (NE)* Adeno viridae (NE)* Papovaviridae (NE)* Hepadnaviridae (E)* Herpes viridae (E) (1-8)* Pox viridae (E)2. RNA Viruses* Picornaviridae* Rhabdoviridae* Orthomyxoviridae* Paramyxoviridae* Caliciviridae* Astroviridae* Coronaviridae* Togaviridae* Flaviviridae* Bunya viridae* Filo viridae* Arena viridae* Reoviridae DsRNA (+)
2
Penetration - Uncoating - Macromolecular synthesis Transcription, Protein synthesis, Replication - Assembly - Release by budding and lysis.
DNA viruses: Adenovirus, Human papilloma virus, Parvovirus B-19, BK and LC polyomavirus, Polio virus.
Gancyclovir: CMV: act on viral DNA.
Viruses causing congenital and neonatal disease: HSV-2, Echovirus, CMV, Parvovirus B19, VZV, HIV, Hepatitis virus.
Microbiology
Virology
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multi
WHO Rose Questionnaire is used for -
Ans. is 'b' i.e., Angina AssessmentThe London school of Hygjne chest pain questionnaire-The Rose questionaire (version for self administration)PARTAa)Have you ever had any pain or discomfort in your chest# Yes# Nob) Do you get this pain or discomfort when you walk uphill or hurry?# Yes# Noc) Do you get it when you walk at an ordinary pace on the level?# Yes# Nod) When you get any pain or discomfort in your chest what do you do ?# Stop# Slow down# Continue at the same pacee)Does it go away when you stand still?# Yes# Nof) How soon# 10 minutes or less# More than 19 minutesg) Where do you get this pain or discomfort? Mark the place (s) with an X on the diagram.PARTBHave you ever had a severe pain across the front of your chest lasting for half an hour or more# Yes# NoDEFINITIONS OF POSITIVE CLASSIFICA TIONa) Angina 'Yes' to (a) and (b)'Stop' or 'Slow down' to (d),'Yes'to (e)' 10 minutes or less' to (f)Site must include either strenum (any level) or L. anterior chest and left arm.Grade 1 = 'No' to (c), Grade 2 = 'Yes' to 'c'b) Possible infarction 'Yes' in this section
2
Alcohol Addiction
Angina Assessment
DVT Assessment
Arrhythmia Assessment
Medicine
Alcohol
846495f6-24e8-49eb-8bae-ef1ab1371a94
single
Most common mechanism of transfer resistance in Staphylococcus aureus is:
Ans.is. b i.e.' Transduction
2
Conjugation
Transduction
Transformation
Mutation
Microbiology
null
4c93dd91-7915-46c6-89f8-c39152569eef
single
A 39-year-old man presents to his physician with the complaint of loss of peripheral vision. The subsequent magnetic resonance imaging (MRI) scan below demonstrates
This T1-weighted sagittal MRI scan reveals a dumbbell-shaped homogeneous mass involving the sella turcica and the suprasellar region. This lesion is most consistent with a pituitary adenoma, a benign tumor arising from the adenohypophysis. Pituitary adenomas are the most common sellar lesion and constitute 10-15% of all intracranial neoplasms. Macroadenomas (>10 mm) are generally non secreting tumors. Microadenomas (<10 mm) become clinically apparent from hormonal secretion. They may secrete prolactin (amenorrhea or galactorrhea), growth hormone (gigantism or acromegaly), or ACTH (Cushing syndrome). The tumor pictured is a macroadenoma. Its dumbbell shape results from impingement on the adenoma by the diaphragm of the sella turcica. The suprasellar extension seen here makes a frontal craniotomy rather than a transsphenoidal approach more appropriate.
2
Cerebral atrophy
Pituitary adenoma
Optic glioma
Pontine hemorrhage
Surgery
Nervous System
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single
The following are true of Mendelson's syndrome –
Symptoms of Mendelson's syndrome generally occurs within 30 minutes of aspiration. Critical pH is 2.5 and critical volume is 25 ml. Use of corticosteroid is generally not recommended.
3
Critical volume of aspirate is 50 mls
Critical pH of gastric aspirate is 1.5
Onset of symptoms generally occurs within 30 minutes
Steroids have been shown to improve outcome
Anaesthesia
null
11390e5f-a182-4670-b1cb-1adccd75750c
multi
Commonest haematological malignancy in children is:
Acute lymphoblastic leukemia (ALL) is the most common malignancy of childhood, accounting for about 25% of all cancer diagnoses in patients younger than age 15 years. The peak age at onset is 4 years; 85% of patients are diagnosed between ages 2 and 10 years. Leukemia is defined by the presence of more than 25% malignant hematopoietic cells (blasts) in the bone marrow aspirate. Ref: Graham D.K., Quinones R.R., Keating A.K., Maloney K., Foreman N.K., Giller R.H., Greffe B.S. (2012). Chapter 31. Neoplastic Disease. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e.
4
CLL
AML
CML
ALL
Pediatrics
null
3a6e9052-0da7-49da-ac04-863b91a89562
multi
Common sites of bleeding are: (PGI June 2008)
Ans, B. (Little's area] Little's area or kiesselbach's plexus Q - This is the vascular area in the antero inferior part of nasal septum. It is the commonest1-1 site for epistaxis.Arteries Involved in Kisselbach's Plexus Formation"Four arteri es-anterior ethmoidal, septal branch of superior labialQ, septal branch of sphenopalatine1'1 & the greater palatine1 anastomose to form a vascular plexus called kisselbach's plexus"- P.L Dhingra 4th/166According to LT other arteries involved beside above four are-posterior ethmoidal artery, infra orbital artery, superior dental artery & pharyngeal branch of maxillary artery.According to maqbool-there are four arteries involved as like Dhingra.So, from above discussion it is clear that posterior ethmoidal artery should not mark as correct option because in PG1 it is better to leave it there is confusion. Even Scott & Brown could not help.Little s AreaIt is situated in the antero- inferior part of nasal septum just above the vertibule.This area is exposed to the drying effect of inspiratory current and to fingernail trauma & is the usual site for epistaxis in children & young adults.Also the site for origin of the bleeding polypus (haemangioma) of nasal septum.Woodruffs AreaThis vascular area is situated under the posterior end of inferior turbinate where sphenopalatine artery anastomoses with posterior pharyngeal artery. Posterior epistaxis may occur in this area.Fig. Blood supply of nasal septum.
2
Woodruff plexus
Little's area
Brown's area
Vestibular Area
ENT
Nose and PNS
57acc815-aa87-4417-9db6-26f6a456c054
single
The expression of the following oncogene is associated with a high incidence of Medullary carcinoma of thyroid-
Harshmohan textbook of pathology 7th edition. RET gene is a proto oncogene normally code for receptor for growth factor ( RET receptor). Point mutation to this gene causes multiple endocrine neoplasi type 2A, type2B , medullary carcinoma of thyroid..
3
P 53
Her 2 neu
RET protooncogene
Rb gene
Pathology
General pathology
95e81367-e0bb-4cba-83f1-647af94138f2
single
Most common cardiac anamoly associated with Noonan 's syndrome is
Most common cardiac anamoly associated with Noonan's syndrome is pulmonary stenosis.
3
Aortic stenosis
Ventricular septal defect
Pulmonary stenosis
Atrial septal defect
Pediatrics
null
2467534e-db69-4826-9ebe-3f03adaad3ee
single
1 day old m ale baby delivered by LSCS had swelling over back in midline.
Ans. is 'b' i.e., Folic acid o Folic acid supplementation decreases the incidence and recurrence of neural tube defects (NTD). Because the neural tube closes within the 1st 28 days ofconception, periconceptional supplementation is needed for prevention. It is recommended that women without a prior history of a NTD, ingest 400 ?g/day throughout their reproductive years. Women with a history of a prior pregnancy complicated by a NTD or a Ist-degree relative with a NTD should have preconceptual counseling and they should ingest 4 mgfday of supplemental folic acid at least 1 mo before conception. Use of some antiepileptic drugs (valproatet carbamazepine) during pregnancy is associated with an increased risk of NTD. Women taking these medications should ingest 1-5 mg of folic acid/day in the preconception period.
2
Iron
Folic acid
Thiamine
Vit A
Pediatrics
New Born Infants
87c6d7dd-7ce6-47c3-9daf-4e2ad02a1652
single
Pheochromocytomas arise from:
Answer is D (Neuroendocrine cells of the adrenal medulla): Pheochromocytomas are catecholamine secreting tumors that arise from neuroendocrine chromaffin tissue in the adrenal medulla. The adrenal medulla consists of neuroendocrine cells called chromaffin cells Chromaffin cells are derived from primitive pheochromblasts of the developing sympathetic nervous system. Chromaffin cells are the site of catecholamine biosynthesis Pheochromocytomas arise from chromaffin cells in the adrenal medulla Most pheochromocytomas secrete both norepinephrine and epinephrine The percentage of norepinephrine is usually greater than epinephrine (Often as high as 20:1) Most Extra-adrenal pheochromocytomas (paragangliomas) secrete norepinephrine exclusively
4
Nonendocrine cells of the adrenal coex
Nonendocrine cells of the adrenal medulla
Neuroendocrine cells of the adrenal coex
Neuroendocrine cells of the adrenal medulla
Medicine
null
0aed47ff-32bb-413d-9568-5deb6b84730b
multi
Which of the following is NOT consistent with antemoem burns?
In case of antemoem burns the blisters are filled with serous fluid and the base is red in colour. All the other options given are consistent with ante moem burns. Note that no inflammatory changes are seen in post-moem burns. Ref: Essentials of Forensic Medicine and Toxicology By Dr.K S Narayan Reddy, 21st Edition, Page 277
3
Presence of marked cellular exudates
Presence of line of redness
Blisters containing air and thin clear fluid with yellow base
Presence of increased enzymatic reaction at peripheral zone of burns
Forensic Medicine
null
371c2c9c-5b9b-4c5e-ab2d-423d6be70b81
single
Parrot like repetitive speech is found in:
Autism  spectrum  disorder  (ASD)  includes  three  neurodevelopmental disorders: autism disorder, Asperger syndrome, and pervasive development disorder (PDD). There are three levels of impairment noted.  The first notable impairment is social, which, in some cases is extreme,  with  lack  of  eye  contact  and  not  responding  to one’s name.  The second is an impairment in communication, which can result in the delay or complete lack of spoken  language.  Children  with  Asperger  syndrome  do not have a general delay in language or cognitive development;  however,  they  often  have  communication  difficulties, especially in sustaining conversations. The third area of impairment in ASD is repetitive behaviors. They may include staring, floppy hands, an odd interest in or preoccupation with specific objects. Parrot like repetitive speech is found in Autism. Reference: McDONALD AND AVERY’S DENTISTRY for the CHILD and ADOLESCENT, 10th ed page no 528
1
Autism
Cerebral palsy
Marfan's syndrome
Mental retardation
Dental
null
f81cd95c-d6b4-4d16-9abd-3951de36ef9b
single
Which is not a pathologic feature of H. pylori chronic gastritis -
. Eosinophilic infiltrates
1
Eosinophilic infiltrates
Intraepithelial neutrophil deposits
Affects intestinal gland formation in stomach
Subepithelial plasma cell deposits
Pathology
null
086a0b17-4488-4ee9-a83c-d1b75fbeed66
single
A 36-year-old woman has become increasingly icteric for 1 month. She has had several bouts of colicky, midabdominal pain for 3 years. On physical examination, she has generalized jaundice with scleral icterus. Her BMI is 32. There is tenderness in the right upper quadrant, and the liver span is normal. A liver biopsy is obtained, and microscopic examination shows bile duct proliferation and intracanalicular bile stasis, but no inflammation or hepatocyte necrosis. The level of which of the following is most likely to be increased in the patient's serum?
The findings suggest obstructive jaundice from biliary tract disease (e.g., gallstones). Elevation of the serum alkaline phosphatase level is characteristic of cholestasis from biliary obstruction. The alkaline phosphatase comes from the bile duct epithelium and hepatocyte canalicular membrane. The blood ammonia concentration increases with worsening liver failure. When hepatic failure is sufficient to cause hyperammonemia, mental obtundation is seen. In this case, the patient has only jaundice. Primary biliary cirrhosis with an increased antimitochondrial antibody titer is much less common, and PBD eventually leads to bile duct destruction. Most cases of active HCV infection are accompanied by some degree of inflammation with fibrosis. In obstructive biliary tract disease, the direct bilirubin, not the indirect bilirubin, should be elevated.
1
Alkaline phosphatase
Ammonia
Antimitochondrial antibody
Hepatitis C antibody
Pathology
Liver & Biliary Tract
7ec42bad-f304-4d2a-ac90-e749c49e07f3
single
Which X-ray needs to be taken for 16 year old male is ?
Ans. is 'b' i.e., Elbow
2
Wrist
Elbow
Shoulder
Ilium
Forensic Medicine
null
a7c55dc3-84cc-4ec8-9b48-c9229a1a4c2e
single
Symptoms of narcolepsy are all except
NarcolepsyThe classic tetrad of symptoms is:i. Sleep attacks (most common): ii. Cataplexy: iii. Hypnagogic hallucinations: iv. Sleep paralysis (least common): Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 138
2
Cataplexy
Catalepsy
Daytime sleepiness
hypnagogic hallucinations
Psychiatry
Sleep disorders and eating disorders
f318a0ef-01f6-43e7-beff-de29694040ea
multi
In hemoglobin, the innate affinity of heme for carbon monoxide is diminished by the presence of -
Isolated heme binds carbon monoxide (CO) 25,000 times more strongly than oxygen. However, in myoglobin and hemoglobin, heme binds carbon monoxide to only about 200 times more strongly than oxygen. This is because of distal histidine (His E7 of protein part of hemoglobin and myoglobin create a hindered environment which precludes the high-affinity orientation of CO. The details of this mechanism are not required at this level.
2
His F8
His E7
Gly B6
Thr C4
Biochemistry
null
c452015a-5daa-46ed-b7a6-abd4724f06a0
single
The key cell types involved in the acquired immunity include all EXCEPT:
The main physiological role of red blood cells (RBCs), or erythrocytes is to transport gases (O2, CO2) from the lung to the tissues and to maintain systemic acid/base equilibria.  In addition, RBCs are well equipped with antioxidant systems, which essentially contribute to their function and integrity. They are not involved in acquired immunity.
2
B lymphocytes
Erythrocytes
T lymphocytes
Antigen presenting cells (APC)
Microbiology
null
b30b00ff-501e-41cd-b970-d1b8e88867a3
multi
Screening is not recommended if -
Ans. is 'd' i.e., Disease with no latent period o The disease to be screened should fulfil the following criteria before it is considered suitable for screening:-The condition sougth should be an important health problem (in general, prevalence should be high).There should be a recognizable latent or early asymptomatic stage.The natural history of the conti ti on, including development from latent to declared disease, should be adequately understood (so that we ean know at what stage the process ceases to be reversible).There is a test that can detect the disease prior to the onset of signs and symptoms.Facilities should be available for confirmation of the diagnosis.There is an effective treatment.There should be an agreed-on policy concerning whom to treat as patients (e.g., lower ranges of blood pressure; border-line diabetes).There is good evidence that early detection and treatment reduces morbidity and mortality.The expected benefits (e.g., the number of lives saved) of early detection exceed the risks and costs.
4
Prevalence of disease is high
Life expectancy can be prolonged by early diagnosis
Diagnostic test should be available
Diseases with no latent period
Social & Preventive Medicine
Screening for Disease
517972b9-93be-4904-8025-4291e8fc4f1e
single
Aminoacyl t-RNA is not required for
The enzymes aminoacyl tRNA synthetases activate the amino acids. The enzyme is highly selective in the recognition of both the amino acid and the transfer RNA acceptor. There is at least one tRNA for each of the 20 amino acids. Eg: hydroxylysine is the active form of lysine .hence not recognised by tRNA The D arm of tRNA is very impoant for the recognition by the enzyme. The CCA 3&; terminus of the acceptor&;s arm carries amino acid (Figs 41.14A and B). iii. Amino acid is first activated with the help of ATP. Then the carboxyl group of the amino acid is esterified with 3&; hydroxyl group of tRNA. Aminoacyl tRNA synthetase Amino acid ----------------> Aminoacyl tRNA + tRNA + ATP + AMPRef: DM Vasudevan - Textbook of Biochemistry, 6th edition, page no: 490
3
Proline
Lysine
Hydroxylysine
Methionine
Biochemistry
Metabolism of protein and amino acid
6a407698-2895-4bd7-b962-5b201b48b308
single
Maximum infection of CMV is seen after what duration post transplantation ?
.Therapeutic invasive procedures may be in the form of IV cannula, bladder catheter, tracheostomy and other minor surgical procedures which permit the skin organisms like staphylococcus epidermidis to penetrate the skin and invade the deeper tissues. Organisms Bacteria: Gram-negative: E. coli, Pseudomonas, Klebsiella, Proteus, Serratia. Gram-positive: Staphylococcus epidermidis, Streptococcus pneumoniae. Viruses: Herpes, CMV, Varicella zoster, may cause fatal pneumonia. ref:SRB&;s manual of surgery,ed 3,pg no 59
3
Immediate
< 1 month
1-4 months
> 6 months
Surgery
Urology
bf442290-30a0-4fc2-be12-4fdaf82c1052
single
What is the treatment of a child with supraventricular tachycardia?
Ans. is 'a' i.e., Adenosine Treatment of supraventricular tachycardias in childreno In severe haemodynamic compromise, or if ventricular tachycardia is suspected, tachycardia should immediately be terminated by external cardioversion during deep sedationo Vagal manoeuvres are effective in patients with atrioventricular reentrant tachycardias.o Adenosine is the drug of first choice in any age group for tachycardias involving the atrioventricular node; its advantages include short half-life and minimal or absent negative inotropic effects. Adenosine may also be used in patients with wide QRS complex tachycardia.o Intravenous verapamil is contraindicated in neonates and infants because of the high risk of electromechanical dissociation. In older children (>5 years) and adolescents, verapamil may be administered with the same restrictions as in adult patients
1
Adenosine
Digoxin
Sotalol
Flecainide
Pediatrics
Cardiac Therapeutics
830b248a-d95b-45af-9257-6eae0efccd72
single
Gene for Wilms tumor iis located on
characterized by Wilms tumor, aniridia, genital anomalies, and mental retardation. Their lifetime risk of developing Wilms tumor is approximately 33%. Individuals with WAGR syndrome carry constitutional (germline) deletions of 11p13. Studies on these patients led to the identification of the first Wilms tumor-associated gene, WT1, and a contiguously deleted autosomal dominant gene for aniridia, PAX6, both located on chromosome 11p13. Patients with deletions restricted to PAX6, with normal WT1 function, develop sporadic aniridia, but they are not at increased risk for Wilms tumors Refer Robbins 9/e 481
3
Chromosome 1
Chromosome 10
Chromosome 11
Chromosome 12
Anatomy
Urinary tract
81fd3ae7-1e8a-4e82-b1ac-977b6e781419
single
How much is punishment for sex determination -
Ans. is 'a' i.e., 3 yearso According to pre-conception and pre-natal diagnostic techniques (prohibition of sex selection) act 2002, sex detection can lead to a fine of Rs. 10,000 and up to three years Inprisonment for a first offence, with greater fines and longer terms of imprisonment for repeated offenders.
1
3 years
5 years
7 years
9 years
Forensic Medicine
Misc.
0aec6663-d0df-4115-b513-402586daf3dd
single
Most impoant layer of a slow sand filter is ?
Ans. is 'a' i.e., Vital layer o This is confusing one because of the following statements of Park. "The most impoant pa of the filter is the sand bed" - Park "The vital layer is the hea of the slow sand filter" - Park o Following statement may help in choosing the answer : ? "Vital layer is the layer that provides the effective purification in potable water treatment. the underlying sand layer providing the suppo medium for this biological treament layer" - Water & Healt 3rd/e 733. o Read the mechanism of action of slow sand filter and there will be no confusion. Mechanism of action of slow sand filter o Slow sand tiller work through the formation of a gelatinous layer called vital layer or hypogea I layer or Sch mu tzdecke in the top few cm of sand layer. o This layer is formed in the first 10-20 days of operation. o The formation of vital layer is known as "Ripening of the filter". o This vital layer consists of bacteria. fungi. Protozoa, and a range of aquatic insect larvae. o As waste passes through vital layer, paicles of foreign matter arc trapped in the mucilagenous matrix and dissolved organic material is absorbed and metabolized by bacterial, fungi and protoza --> Vital layer has mechanical (physical) as well as biological action. o So, the vital later acts as the hea of slow sand filter.
1
Vital layer
Sand bed
Filter system
Raw water
Social & Preventive Medicine
null
836ce8d1-4690-48a5-ac85-b84d4c9f8563
single
All are features of tabes dorsalis, except -
null
4
Ataxia
Argyll Robertson's pupil
Bladder disturbances
Hyperreflexia
Medicine
null
e6f11baf-c966-4521-bc87-25e8fb2ab686
multi
Micturition centre is present in -
Ans. is 'd' i.e., Medial frontal cortex o Micturition centers are located in the brain-stem and cerebral cortex.1) In cerebral cortex (cortical center) : A cortical center for voluntary control of initiation and cessation of micturition is located in the superior frontal gyrus on medial surface (medial frontal cortex).2) Pontine centers: Two pontine centers of micturition are located in pons: -i) One pontine micturition center (Barringtons center) sends excitatory impulses to the sacral parasympathetic neurons that elicit contraction of detrusor muscle.ii) Second pontine micturition center sends excitatory impulses to the lower motor neurons of the Onuf nucleus that supply external urethral sphincter.
4
Lateral temporal cortex
Medial temoral cortex
Lateral frontal cortex
Medial frontal cortex
Physiology
Nervous System
4e909f68-d30e-4fd3-8d2f-b628b2c310f5
single
During an operation, if a pair of scissors is left in abdomen, the doctrine applicable is: JIPMER 10
Ans. Res ipsa loquitor
3
Res integra
Res gestae
Res ipsa loquitor
Res judicata
Forensic Medicine
null
d747eea5-2998-4c0d-9ad2-a20d435a94ff
single
Hypophosphatemia is seen in all except-
<P>Improved medical management of chronic kidney disease now allows many patients to survive for decades and hence time enough to develop features of renal osteodystrophy, which must be controlled to avoid additional morbidity. Impaired production of 1,25(OH) 2 D is now thought to be the principal factor that causes calcium deficiency, secondary hyperparathyroidism, and bone disease; hyperphosphatemia typically occurs only in the later stages of CKD. Low levels of 1,25(OH) 2 D due to increased FGF23 production in bone are critical in the development of hypocalcemia. The uremic state also causes impairment of intestinal absorption by mechanisms other than defects in vitamin D metabolism. Nonetheless, treatment with supraphysiologic amounts of vitamin D or calcitriol corrects the impaired calcium absorption. Since increased FGF23 levels are seen even in early stages of renal failure in some patients, and have been repoed to correlate with increased moality, there is current interest in methods (lowering phosphate absorption) to lower FGF23 levels and concern as to whether vitamin D supplementation (known physiologically to increase FGF23) increases FGF23 in CKD(harrison 18 pg 3116)</p>
1
Acute renal failure
Rickets
Respiratory alkalosis\/COPD
Chronic alcoholism
Medicine
Endocrinology
1e760ab5-a127-4a3a-aad7-fa755baafe7c
multi
Bell's palsy not responding to the steroid. What will be the further line of management -
If the patient of Bell's palsy is not responding to conservative treatment, electrodiagnostic study (electrophysiological study) should be done. The electrodiagnostic study includes electromyography (EMG), Electroneurography (ENG), minimal excitability test and maximal excitability test. Surgery is reserved for those who meet electrodiagnostic (electrophysiological) study criteria or are worsening on medical treatment.
4
Increase the dose of steroid
Vasodilators and ACTH
Surgical decompression
Electrophysiological nerve testing
ENT
null
4fb5852f-aeee-4390-bdd3-46f16022a6ed
single
Not attached on medial border of scapula ?
Ans. is 'd' i.e., Teres majorMuscles attached to scapula are :-Coracoid process :- Tip of the coracoid process gives origin to coracobrachialis (medially) and sho head of the biceps laterally.The upper surface receives inseion of pectoralis minor.Spine of scapula and acromion process :- There is origin of Deltoid and inseion of trapezius.Glenoid tubercle :- Supraglenoid tubercle gives origin to the long head of biceps and infra glenoid tubercle gives origin to long head of triceps.Lateral border :- Origins of teres minor and teres major.Medial border :- Inseions of serattus anterior (anteriorly); and rhomboideus major, rhomboideus minor and levator scapulae (posteriorly).Costal (anterior) surface (origin) Subscapularis.Dorsal surface (origins) Supraspinatus, infraspinatus and at inferior angle latissimus dorsi.
4
Serratus anterior
Levator scapulae
Rhamboides major
Teres major
Anatomy
null
a818fc9d-7f8b-4e93-b984-f728f3742795
single
All is true about Giant cell arteritis except -
Giant cell arteritis (Temporal arteritis) It is the most common form of systemic vasculitis in adults, is an acute and chronic, often granulomatous, inflammation of arteries of large to small size. It affects principally the arteries in the head-especially the temporal arteries—but also the vertebral and ophthalmic arteries and the aorta, where it may cause a thoracic aortic aneurysm Giant cell arteritis or temporal arteritis It is the most common form of systemic vasculitis in adults. It is an acute and chronic; often granulomatous inflammation of arteries of large to small size, Giant cell arteritis affects principally the arteries in the head, especially the temporal arteries which is the extracranial branch of the carotid artery, Vertebral and ophthalmic arteries may also be involved. A segment of the affected artery develops nodular thickening with narrowing of the lumen. There is granulomatous inflammation in the vessel wall with a foreign body and Langhans type multinucleated giant cells and fragmentation of internal elastic lamina. Presentation of Giant cell arteritis  o Constitutional symptoms Most common nonspecific symptoms Include malaise, fatigue, anorexia and weight loss. These symptoms are due to the generalized involvement of the body and are not related to any organ involvement, o A headache It is the most common vasculitis related symptom. Most commonly over temporal region. o Jaw claudication It is the most specific symptom of GCA. It is manifested as pain in masseter when eating food that requires vigorous chewing because oxygen demand of the masseter exceeds the supply provided by narrowed and inflamed arteries. o Visual symptoms Diplopia and visual loss. Ophthalmic artery involvement can lead to sudden blindness which is the most feared complication of GCA. o Polymyalgia rheumatica Aching and stiffness of the shoulder, neck and lip girdle area, o Arthritis o Raised ESR o Normocytic-Normochromic anaemia
1
Most commonly involved artery is abdominal aorta
Involves large to small sized arteries
Granulomatous inflammation
Segmental nature of the involvement
Pathology
null
e2e62c46-db9d-4c67-bf48-d0d6626d5def
multi
All tests are used for infanticide except ?
Ans. is 'c' i.e., Gettler's test Tests used in infanticide (for respiration) Ploucquet's test : Weight of lung is measured in relation to body wieght. Before bih weight of lung is 1/70 of body weight and after respiration it becomes 1/35 of body weight due to increased blood flow in lung beds. Static test or Fodere's test : The average weight ofboth lungs before respiration is 30-40 gm and after respiration is 60-70 cm. Hydrostatic test (Raygat's test, I" life test) : The specific gravity of a non-respired lung is 1040-1050 and of a respired lung is 940-950, so, after respiration lung floats on water (specific gravity of water is 1000). False positive hydrostatic test may occur (i.e.non-respired lung may float) in decomposition and in attempted aificial respiration. False negative hydrostatic test (i.e. respired lung may sink down) may occur in atelectasis, pulmonary oedema, bronchopneumonia, and congenital syphylis. Breslau's second life test : It assumes that a live born child would respire and therefore, would also swallow some air into the stomach and bowel. Hence they float on water. This test is falsely positive in putrefaction (due to putrefied gases) or in cases of attempted aificial respiration. Werdin's test : Before bih middle ear contains gelatinous embryonic tissue which is replaced by air after respiration
3
Ploucquet test
Fodere's test
Gettler's test
Raygat's test
Forensic Medicine
null
3e141dc2-8561-4ec8-a2cc-19299a0a005d
multi
A female Mamta, 26 year old presented with gradually increasing respiratory distress since 4 days. She gives history of hospitalisation and mechanical ventilation with orotracheal intubation for 2 weeks . Now she is diaganosed as having severe tracheal stenosis. What would be the next line of management -
null
4
Laser excision and stent insertion
Steroids
Tracheal dilatation
Tracheal resection and end to end anastomosis
ENT
null
409c4cdc-4c81-4c4b-a194-f063caee71a9
multi
MRI scan of a mentally retarded child with recurrent seizures and hemangioma. Diagnosis is?
Ans. (b) Encephalofacial angiomatosis.* The CT scan shows extensive intracranial calcification which will lead to seizures, paralysis and hemiatrophy. The presence of hemangioma shows presence of Sturge-Weber syndrome called as encephalofacial angiomatosis.* Epilolia is alternative term for tuberous sclerosis.* Louis bar syndrome is alternative term for phakomatosis by name of ataxia telangiectasia.* Neuronal ceroid lipofuscinosis includes leukodystrophy like Krabbe's disease and adrenoleukodystrophy. Image source. style="font-size: 1.04761904761905em; color: rgba(0, 0, 0, 1); font-family: Times New Roman, Times, serif; margin: 0 0 8pt">
2
Epiloias
Encephalofacial angiomatosis
Louis Bar syndrome
Neuronal ceroid lipofuscinoses
Unknown
null
39f2fb0f-6818-429f-a93f-9aab29782c3c
multi
At t = 0 there are 6 x 1023 radioactive atoms of a substance, which decay with a disintegration constant (A,) equal to 0.01/sec. What would be the initial decay rate?
Ans. 6 x 1021
3
6 x 1023
6 x 1022
6 x 1021
6 x 1021
Radiology
null
574515d5-6f1a-49ff-bfeb-cb7ef8f87f26
single
Uremic complications typically arise during which of the following phases of Renal Failure:
Answer is B (Maintenance) Uremic complications and Electrolyte imbalance typically arise during the Maintenance Phase of Acute Renal Failure (Also known as Oliguric Phase). Maintenance phase refers to the phase of Renal Failure in which the renal injury becomes established. It is also known as the Oliguric Phase. During this phase the GFR and Urine output progressively decrease until they stabilize at their lowest. Fluid retention gives rise to edema, water intoxication, and pulmonary congestion if the period of oliguria is prolonged. Hypeension frequently develops during this phase. Uremic complications and Electrolyte imbalance typically arise during this phase. Continuous Renal Replacement Therapy (CR) or Dialysis should be initiated in this phase. The oliguric-anuric phase generally lasts 10 to 14 days but can last for several more. The longer the patient remains in this phase, the poorer the prognosis for a return to normal renal function.
2
Initiation
Maintenance
Diuretic Phase
Recovery Phase
Medicine
null
dd4b1f96-4e1a-4136-8ecd-3ede17ebabfd
multi
Normal saline is used as diluent in which vaccine?
Ans. is 'c' i.e., BCG BCG vaccine BCG vaccine is a live attenuated vaccine produced by `Bacille Calmette Guerin' an avirulent strain produced by 230 subcultures over a period of 13 years. Types of vaccine It is a live attenuated vaccine. There are two types of vaccine :- Liquid (fresh) vaccine Freeze dried (lyophilized) -more stable, currently in use. Diluent - Normal saline is recommended as a diluent for reconstituting vaccine, as distilled water may cause irritation. The reconstituted vaccine should be used within 3 hours. Route - Intradermal Site - Just above the inseion of deltoid (usually left)
3
Measles
Rubella
BCG
HAV
Social & Preventive Medicine
null
5f1b79d8-e5e2-4f43-b5a8-e53c562fe222
single
Which is the most common complication of GERD
Esophagitis is the most common complication
1
Esophagitis
Strictures
Dental damage
Vocal cord damage
Surgery
null
950e6485-e5cb-4d18-bf8e-7eebee897f35
single
The rate limiting step in glycolysis is catalyzed by-
Ans. is 'd >a & c' i.e., Phosphofructokinase > Pyruvate kinase & Giucokinase o Phosphofructokinase, giucokinase and pyruvate kinase are rate limiting enzymes of glycolysis. However,phosphofructokinase is the most important one."The irreversible phosphorylation reaction catalyzed by phosphofructokinase - l (PFK-1) is the most important control point and the rate limiting and commited step of glycolysis ". --Lippincott's"Phosphofructokinase - I is the regulatory enzyme of glycolysis -- Pankaj Naik"Most important control point for glycolysis is through regulation of phosphofructokinase". -- Dinesh puriImportant facts about glycolysiso An important biochemical significance is the ability of glycolysis to provide ATP in the absence of oxygen (anerobic glycolysis) and allows tissues to survive anoxic episodes,o It occurs in cytosol0o 3 Carbon atoms end product (pyruvate or lactate) is producedQ.o Irreversible steps are catalyzed by : - Glucokinase'Hexokinase, phosphofructokinase-I, and pyruvate kinase,o Reversible steps are catalyzed byQ : - Phosphohexose isomerase, aldolase, phosphotriose isomerase, glyceraldehyde 3-phosphate dehydrogenaseQ, Phosphoglycerate kinase, Phosphoglycerate mutaseQ, EnolaseQ.o Energy (ATP) using steps are catalyzee by : - Hexokinase/glucokinase, phosphofurctokinase.o Energy (ATP) production at substrate level are catalyzed by : Phosphoglycerate kinase. Pyruvate kinase,o Reducing equivalent (NADH) production is catalyzed by : Glyceraldehyde 3-phosphate dehydrogenase,o Cancer ceils derive nutrition from glycolysisQ as they have lack of O2 supply because of lack of capillary network. Glycolysis (anaerobic glycolysis) is the only metabolic pathway in the body which can provide energy by glucose metabolism in anerobic conditions.
4
Pyruvate kinase
Enolase
Glucokinase
Phosphofructokinase
Biochemistry
Glycolysis
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Facial Nerve stimulation during testing of nerve indicated by contraction of muscle?
Orbicularis oris. Orbicularis oris is a facial muscle All facial muscles are supplied by facial nerve Temporalis & Masseter are supplied by Mandibular nerve Sternocleidomastoid is supplied by spinal accessory nerve
4
Temporalis
Masseter
Sternoleidomastoid
Orbicularis oris
Anatomy
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single
A 9 yr old child came to the dental clinic with spacing in anterior teeth. The line of treatment is
null
4
Fixed appliance
Removable appliance
Inclined plane
No treatment, observation of patient
Dental
null
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Hepatic fibrosis is associated with which of the following
S.NoDiseaseInheritance PathogenesisKidney featuresExtrarenal manifestations 1ADPKDADPKD1mutation in chr16pPKD2 mutation in chr 4qPKD1 produce polycystin-1PKD2 produce polycystin-2Enlarged kidneys, Multiple cysts in both kidneysDisease manifest only in adultsCysts in liver, spleen, pancreas and lung.Berry aneurysmMitral valve prolapse2ARPKDARMutation of PKHD1 in chr6pPKHD1 produce fibrocystinEnlarged kidneys, Cysts in both kidneysLiver cysts, congenital hepaticfibrosis and spleenomegaly3Medullarysponge kidneyNone UnceainCysts restricted to the collecting ducts of medulla None4Familial juvenile nephronophthisis ARMutation of NPH1 to NPH6NPH1 & NPH3-6 produce nephrocystinNPH2 produce inversin Shrunken kidney, Cysts in coicmedullary junction, salt wastingGrowth retardation,Liver fibrosis, ocular motor abnormalities, retinal dystrophy and cerebellar abnormalities5Adult-onset medullary cystic diseaseADMutation of MCKD1 and MCKD2Shrunken kidney, Cysts in coicmedullary junction, salt wastingNone 6Simple cystsNone UnceainMultiple cysts in normal sized kidneys HematuriaNone7Acquired renal cystic diseaseNone Renal dialysisCysts with end stage renal disease, calcium oxalate crystals, renal cell carcinoma None(Ref: Robbins 8/e p956)
3
Medullary cystic kidney
ADPKD
ARPKD
Nephronopthosis
Pathology
Urinary tract
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single
Height of a newborn doubles at: September 2005, March 2010
Ans. D: 4 year In general, length in normal term infants increases about 30% by 5 months and > 50% by 12 months; infants grow 25 cm during the 1st yr; and height at 4 yr is about double bih length.
4
1 year
2 year
3 year
4 year
Pediatrics
null
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single
Histological feature of lichen planus is ?
Ans. is `d>a' i.e., Basal cell degeneration > Acantosis The basic pathology in lichen planus is the damage to the basal cell layer of epidermis leading to hydropic degeneration of basal cells". --Venkataram Pie 59 Histopathologv in Lichen planus The basic pathology in lichen planus is the damage to the basal cell layer of epidermis leading to hydropic degeneration of basal cells. Epidermal thickening especially of granular cell layer ---> Hypergranulosis. Hyperkeratosis (Thickening of stratum cornuem) Acanthosis (Thickening of Stratum) malpighi. Subepidermal - lichenoid band due to deposition of lymphocytes & histiocytes in upper dermis. Dropping of melanin pigment from damaged keratinocytes of epidermis into dermis --> pigment incontinence. This melanin is engulfed by macrophages which results information of cytoid bodies (civatte or colloid bodies). Mox Joseph Histological cleft -3 Separation of epidermis in small clefts.
4
Acantosis
Interphase dermatitis
Non specific
Basal cell degeneration
Skin
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The Anaesthesia technique of choice in severely preeclamptic women for cesarean delivery -
The use of spinal anesthesia is discouraged in severe preeclampsia. Epidural anaesthesia is preferred since it has more hemodynamic stability. Regional anaesthesia spinal /epidural preferred over general anaesthesia for cesarean delivery since in pregnant female there are many risk associated with general anaesthesia.
2
Spinal Anaesthesia
Epidural Anaesthesia
General Anaesthesia
Pudendal shock
Anaesthesia
Central Neuraxial Blockade
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Tinel sign is seen in ?
Ans. is 'b' i.e., Nerve regeneration Pathological changes after nerve injury After nerve injury, nerve first degenerates and then tries to regenerate. Nerve degeneration The pa of the neurone distal to the point of injury undergoes secondary or Wallerian degeneration; the proximal pa undergoes primary or retrograde degeneration upto a single node. Nerve regeneration As regeneration begins, the axonal stump from the proximal segment begins to grow distally. If the endoneural tube with its contained Schwann cells is intact, the axonal sprout may readily pass along its primary course and reinnervate the end-organ. The rate of recovery of axon is 1 mm per day. The muscles nearest to the site of injury recovers first, followed by others as the nerve reinnervates muscles from proximal to distal, the so-called motor march. When the skin over the nerve is percussed gently from distal to proximal, the patient gets a tingling sensation if the nerve is recovering. This is called Tinel's sign and is a sign of recovery.
2
Nerve degeneration
Nerve regeneration
Muscle degeneration
Muscle regeneration
Surgery
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single
A patient is diagnosed to have CIN II. She approaches you for advice. You can definitely tell her the risk of malignancy as
CIN I and CIN II, the lesions have a 5-10% chance to progress to a high grade lesion CIN III progressing to cervical cancer is almost 10-30% Transformation Rates Form low grade CIN to High grade CIN takes around 5-6 years From High Grade CIN to invasive cancer takes around 10 years time. HPV related cervical lesions occur more on the cervical anterior lip than the lower lip (2:1 incidence).
4
15%
60%
30%
5%
Gynaecology & Obstetrics
Cervical Carcinoma
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single
Which of the following is a feature of external haemorrhoids below the dentate line?
Hemorrhoids are cushions of submucosal tissue containing venules, aerioles and smooth-muscle fibres. These anal cushions are found in the left lateral, right anterior and right posterior position. (3,7 and 11 o'clock position). External hemorrhoids located distal to the dentate line are covered by anoderm which is richly innervated. As a result thrombosis of external hemorrhoids is extremely painful. Because of this innervation external hemorrhoids should not be ligated or excised without adequate anaesthesia. An anal skin tag usually persist as the residua of a thrombosed external hemorrhoid. When left untreated it does not turn malignant.
1
Painful
Ligation is done as management
Skin tag is not seen in these cases
May turn malignant
Surgery
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single
Frie test is done in
B i.e. LGV
2
Donovanosis
LGV
Syphillis
Leprosy
Skin
null
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single
Anticoagulant effect of Warfarin is increased by all of the following EXCEPT:
Phytonadione is Vit K. It is used as an antidote in warfarin toxicity. From essential of medical pharmacology K D Tripati 7th edition Page no 613
2
Cimetidine
Phytonadione
Amiodarone
Phenylbutazone
Pharmacology
Hematology
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multi
Surgical neck fracture leads to all EXCEPT
Axillary nerve supplies: Deltoid (abductor of arm) and Teres Minor(lateral rotation) muscles. It winds up through surgical neck of humerus. So fracture of surgical neck damages axillary nerve causes: Teres minor palsy Deltoid palsy Abduction Of shoulder joint is damaged. Teres major is supplied by Lower subscapular nerve
3
Weakness of abduction
Deltoid muscle palsy
Teres major palsy
Teres minor palsy
Anatomy
Upper limb bones and muscles (proximal region) & Scapular movements
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multi
Percentage of GFR to renal plasma flow:
Ans. (a) 20%Ref: Guyton's physiology 11th ed. / 316* GFR Is About 20 Per Cent of the Renal Plasma Flow.* In an average adult GFR is about 125 ml/min, or 180 L/ day.* Renal plasma flow is 650ml/min* The filtration fraction is calculated as follows: Filtration fraction = GFR/Renal plasma flow* Therefore125ml/min------------650ml/min= 0.2* The fraction of the renal plasma flow that is filtered (the filtration fraction) averages about 0.2; this means that about 20 per cent of the plasma flowing through the kidney is filtered through the glomerular capillaries.Also Know* The entire plasma volume is only about 3 liters, whereas the GFR is about 180 L/day, the entire plasma can be filtered and processed about 60 times each day.
1
a.. 20%
b. 38%
c. 50%
d. 60%
Physiology
Glomerular Filtration, Renal Blood Flow, and Their Control
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Ossification at two months: JIPMER 12
Ans. Capitate
2
Lunate
Capitate
Scaphoid
Hamate
Forensic Medicine
null
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single
Primary Hyperoxaluria occurs due to defect in metabolism of
Glycine is the amino acid that has a single hydrogen atom as its side chain. It is the simplest possible amino acid. The chemical formula of glycine is NH2‐CH2‐COOH. Glycine is one of the proteinogenic amino acids. It is encoded by all the codons starting with GG (GGU, GGC, GGA, GGG). Glycine is a colorless, sweet-tasting crystalline solid. It is the only achiral proteinogenic amino acid. It can fit into hydrophilic or hydrophobic environments, due to its minimal side chain of only one hydrogen atom. The acyl radical is glycyl
4
Cystein
Tryptophan
Tyrosine
Glycine
Biochemistry
null
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single
A 45-year-old lady presents with persistent reflux symptoms. The most accurate investigation in establishing diagnosis before surgical treatment includes
investigations for GASTROESOPHAGEAL REFLUX DISEASE, *24 hours oesophageal pH monitoring - the gold standard. PPI should be stopped for 3 weeks prior to pH monitoring. *Barium study in head down position. * Endoscopy to exclude other disease and to assess any mucosal injury - red inflamed mucosa often with ulceration. Sliding hernia can be identified through endoscopy. When patient retches, gastric mucosa will enter the OG junction and ascends upwards to variable distance. Ref: SRB&;s manual of surgery,3 rd ed, pg no 723
4
Endoscopy
An UGI series
Esophageal manometry
Ambulatory pH monitoring
Surgery
G.I.T
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Immuno-proliferative lymphoma presents with?
Immunoproliferative small intestinal disease (IPSID), is a B cell tumor. The presentation includes chronic diarrhoea, steatorrhea associated with vomiting and abdominal cramps. IPSID presents with intestinal secretions of an abnormal IgA that contains a shoened heavy chain and is devoid of light chains. It is suspected that the abnormal chains are produced by plasma cells infiltrating the small bowel. The clinical course is one of exacerbations and remissions, with death due to malnutrition and wasting or the development of a lymphoma.
1
Chronic diarrhea
Obstruction
Peritonitis
Tenesmus
Surgery
Vascular surgery
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Structure preserved in Radical Neck Node dissection:
Ans. (a) Vagus nerve(Ref Sabiston 20th Edition Page 794)* Standard RND (CRILE operation) removes nodal levels I through V and the sternocleidomastoid muscle, internal jugular vein, cranial nerve XI, cervical plexus, and submandibular gland.* Modified RND (Bocca Operation) preserves one or more of the three structures - SCM, IJV and Spinal Accessory nerve.
1
Vagus nerve
Spinal Accessory Nerve
Internal Jugular Vein
Sterno cleido mastoid muscle
Surgery
Oral Cavity
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The only cranial nerve which supplies a contralateral muscle is-
"It is important to remember that cranial nerves never cross (except for one exception, the 4th cranial nerve) and clinical findings are always on the same side as the cranial nerve involved". —Clinical neurology
2
Third
Fourth
Seventh
Tenth
Ophthalmology
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