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An adolescent boy presents with endocrinopathy, fibrous dysplasia of bone and hyperpigmentation. The probable diagnosis is :
Ans-BRef: Robbins Pathologic Basis of Disease, 8th editionExplanation:McCune Albright syndromeIt is characterized by the triad ofPolyostotic fibrous dysplasiaCafe-au-lait skin pigmentationMultiple EndocrinopathiesThe endocrinopathies include:Sexual precocityHyperthyroidismPituitary adenomas secreting GH Primary adrenal hyperplasiaThe severity depends on the presence of GjVAS gene mutationThe most common clinical presentation is precocious sexual development, esp in girls.The bone lesions are often unilateral as sc with same-sided skin pigmentationThe cutaneous macules are classically large; are dark to cafe-au-lait: have irregular serpiginous borders (coastline of Maine)The cafe au lait patches are found primarily on the:NeckChestBackShoulderPelvic regionAlagille Syndrome (aka Syndromatic Paucity of Bile Ducts; Arteriohepatic Dysplasia)Autosomal dominant multi-organ disorderLiver pathology is characterized by the absence of bile ducts in portal tracts.Mutations or deletion of the gene encoding Jagged1. on chromosome 20p.Jagged 1 is a cell surface protein that functions as a ligand for Notch receptorsJagged mutations in 94% & remaining patients have mutations in the Notch 2 receptor geneAffected patients have five major clinical features:Chronic cholestasisPeripheral stenosis of the pulmonary arteryButterfly-like vertebral arch defectsPosterior embryotoxon in the eyePeculiar hype tie lie facies* Patients can survive into adulthood hut are at risk for hepatic failure and hepatocellular carcinoma.MULTIPLE ENDOCRINE NEOPLASIAMEN I Wermers syndromeMEN II* Parathyroid tumors* Pituitary adenomas* Islet cell hyperplasia* ZE syndrome* Insulinoma* Glucagonoma* Pancreatic cholera* Medullary Ca of thyroid* PheochromocytomaMEN-II A (Sipple syndrome)* Hyper para thyroidism* Parathyroid adenoma* Cutaneous lichen amyloidosis* Hirschsprung disease* FMTC (familial medullary thyroid Case)Other manifestations:* Foregut carcinoid* Pheochromocytoma* Lipomas* AngiofibromasMEN - II B syndrome* Marfanoid habitus* Mucosal neuromas* GIT neuromas
2
Alagille syndrome
McCune Albright syndrome
MEN Type 1
MEN Type 2
Unknown
null
3c4a2d43-d678-49c4-b7b3-19b26dac9387
single
Massage and application of liniments to painful areas in the body relieves pain due to
Many people have learned from practical experience that rubbing or shaking an injured area decreases the pain due to the injury. The relief may be due to the simultaneous activation of innocuous cutaneous mechanoreceptors whose afferents emit collaterals that terminate in the dorsal horn. The activity of these cutaneous mechanosensitive afferents may reduce the responsiveness of dorsal horn neurons to their input from nociceptive afferent terminals. This is called the gate-control mechanism of pain modulation and it serves as the rationale behind the use of transcutaneous electrical nerve stimulation (TENS) for pain relief. This method uses electrodes to activate Aa and Ab fibers in the vicinity of the injury.
4
Stimulation of endogenous analgesic system
Release of endorphins by first order neurons in brainstem
Release of glutamate and substance P in the spinal cord
Inhibition by large myelinated fibres
Physiology
Nervous system
f3e07129-506e-4da7-8ec8-4ee76e4f6f11
single
In which of the following, parallel and uniform spaced collagen present?
Corneal stroma: a thick, transparent middle layer, consisting of regularly arranged collagen fibers along with sparsely distributed interconnected keratocytes Inderbir Singh&;s human Histology Seventh edition Pg 391
2
Diapharagm
Cornea
Basement membrane
Tympanic membrane
Anatomy
General anatomy
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multi
Mycobacterium leprae can be cultured in: September 2006
Ans. C: Footpad of mice In 1960 the American Charles Shepard discovered that it is possible to culture the bacterium in the footpads of mice (average 20 degree C). In 1971 Waldeman Kirchheimer and Eleanor Storrs discovered that the nine-banded armadillo, Dasypus novemcinctus, could also become infected. This species was selected because it has a low body temperature (approximately 34 degree C) and a primitive immune system. The animal develops a generalised infection with involvement of the internal organs, especially the liver and spleen.
3
Testes of guinea pig
LJ medium
Footpad of mice
Testes of albino rats
Microbiology
null
9b350802-974f-4836-9663-e51ae2b75027
single
Hepatitis A virus is best diagnosed by -
HAV best diagnosed by demonstration of IgM antibody in serum REF:<\p> ANATHANARAYANAN MICROBIOLOGY NINTH EDITION PAGE.542
1
IgM antibodies in serum
Isolation from stool
Culture from blood
Isolation from bile
Microbiology
Virology
927a5d1a-6e45-4bcc-949e-f9f7eda4d109
single
Optic tract lesions presents with
(C) Homonymous hemianopia SITES OF LESIONS CLINICAL FEATURES* Optic NerveComplete loss of vision* Optic tractHomonymous hemianopia* Optic radiationComplete homonymous hemianopia* Proximal part of optic NerveIpsilateral blindness with contralateral hemianopia* Occipital lobeHomonymous hemianopia (usually sparing the macula)* Sagittal lesion of chiasmaBitemporal hemianopia* Lateral optic chiasmaBinasal hemianopia* Temporal lobeQuadrantic homonymous defect> Binasal hemianopia produced due to lesion in Lateral optic chiasma.> LGB lesion produce Homonymous hemianopia with sparing of pupillary reflex.
3
Bitemporal hemianopia
Binasal hemianopia
Homonymous hemianopia
Superior quadrantic
Ophthalmology
Miscellaneous
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single
Presence of which of the following correlates best with renal pathology
Answer is C (Broad Cast): Broad casts are characteristic of Chronic Renal .failure. Broad Casts : arise in the dilated tubules of enlarged nephrons, that have- undergone compensatory hyperophy in response to reduced renal mass i.e. chronic renal failure. Waxy casts : are degenerated cellular casts seen in urine of patients with chronic renal failure.
3
Hyaline cast
Coarse granular cast
Broad cast
Epithelial cast
Medicine
null
0fcf311b-e3e1-4a90-bf13-7b42c242f095
single
In the bisecting technique, the film is placed
null
2
Parallel to the tooth
As close as possible
Parallel to the bisector
Perpendicular to the bisector
Radiology
null
254dcbf9-83a9-461c-ba96-4aa58fae910c
multi
FESS means:
Indications ofFESSi) Chronic bacterial sinusitis unresponsive to adequate medical treatment.ii) Recurrentacutebacteridsinusitis.iii) Polypoid rhinosinusitis (diftrse nasal polyposis)'w) Fungal sinusitis with fungal ball or nasal polypi'v) Antrochoanal polyp and Ethmoid polypvi) Mucocele of frontoethmoid or sphenoid sinus.vii) Control of epistaxis by endoscopic cautery.viii) Removal of foreign body from the nose or sinus'ix) EndoscoPicsePtoPlastY.x) Removal of benign tumours, e.g. inveedpapillomas or an$ofibromas.xi) Orbital abscess ot cellulltls nonageme,tt.xii) DacryocYstorhinostomY.:lolii) RepaltofCSFleak,xiv) Pituitarysurgeryxv) Optic nerve decomPression.xvi) Orbitd decompression for Graves disease-xvii) Control ofposterior epistaxis(endoscopicclipping ofsphenopalatine aery).xviii) Choanal atresia.
4
Factual endoscopic sinus surgey
Functionl endonasal sinus surgery
Factual endonasal sinus surgery
Functionl endoscopic sinus surgery
ENT
null
ce9fcdda-cf8f-4ab0-a0a8-89cf85c804e6
single
What is least useful as diagnostic procedure in case of acute haemetemesis
C i.e. Gastric content aspiration - Patient is already having frank haematemesis (upper GI bleed coming through mouth). So there is no diagnostic role of gastric aspiration. It may be of some value, when there is doubt of upper GI bleed. Endoscopy is the investigation of choice for upper GI bleedQ. Endoscopy is helpful in dx of Oesophagitis, gastritis, ulcer, reflux, carcinoma, varicose veins. Barium meal is helpful in diagnosing ulcer & gastritis. Angiography tells about bleeding vessel.
3
Barium meal
Endoscopy
Gastric content aspiration
Angiography
Radiology
null
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single
A 40-year-old obese man presents with intense pain in his left first metatarsophalangeal (MTP) joint for the past few hours. He has no history of trauma, fever, chills, and no previous similar episode. He has no history of renal disease or diabetes though he has been told he is "prediabetic." He does not recall any recent skin infections and no family members have had any reported staphylococcal infection. On examination he has a swollen, red, warm, tender first MTP joint on the left. Uric acid level is 9 mg/dL; serum creatinine is normal. What is the best treatment approach for this patient?
This patient is experiencing his first episode of acute gout. The first MTP joint is the most commonly affected, and 80% of acute gout attacks will be monoarticular. Predisposing conditions include trauma, surgery, starvation, high intake of beer and hard liquor (not wine), or diets high in meat and seafood. Certain medications also increase the chances of acute gout including thiazide and loop diuretics and even the initiation of uric acid lowering drugs such as allopurinol and uricosuric agents. Appropriate initial treatment must be tailored to the patient and their comorbidities. The patient in this question has no contraindication, so a potent NSAID (indomethacin) can be used and is likely to be highly effective. Other acceptable alternatives would have been to start colchicine immediately or oral prednisone in relatively high doses. Since this patient is "prediabetic," steroids may result in overt hyperglycemia and hence would not be the first choice. Allopurinol should not be started until the acute attack has been controlled by anti-inflammatory regimens. All agents that lower uric acid levels (either allopurinol or uricosuric agents) can cause worsening of joint pain, probably by mobilizing uric acid microcrystals previously deposited in the synovial membrane. While narcotics may lessen the pain, they are less effective than anti-inflammatories. Referring the patient to a rheumatologist is unnecessary and would leave the patient in pain and suffering in the meantime.
3
Start allopurinol immediately and titrate for a uric acid level below 6. Add colchicine if this is not effective within the first 24 hours.
Begin prednisone until symptoms subside.
Begin indomethacin. As the patient improves, reduce the dose to minimize gastrointestinal side effects.
Prescribe a narcotic until pain is under control.
Medicine
Miscellaneous
cdc0feed-b89a-4fe7-b0f2-a6f41a583245
multi
Which of the following movements would suffer in case of paralysis of the quadriceps femoris muscle?
Quadriceps femoris extends the leg (rectus femoris and the vastus muscles) and helps flex the hip (rectus femoris). It is innervated by the femoral nerve, which is made from the contributions of L2, 3, and 4 in the lumbar plexus. If a patient could not adduct at the hip, the adductor muscles might be damaged. These are supplied by the obturator nerve,which also comes from L2, 3, and 4 in the lumbar plexus. If a patient could not extend at the hip or flex the leg, the hamstring muscles might be damaged. These muscles are supplied by the tibial nerve, a branch of the sciatic nerve. If a patient could not rotate the knee medially, popliteus might be injured. This muscle, which is innervated by the tibial nerve, allows the knee to twist and unlock from a fully extended position, as in erect stance.
3
Adduction at the hip
Extension at the hip
Extension at the knee
Flexion at the knee
Anatomy
null
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single
Eutectic lignocaine–prilocaine has the following unique property :
null
2
It causes motor blockade without sensory block
By surface application, it can anesthetize unbroken skin
It is not absorbed after surface application
It has strong vasoconstrictor action
Pharmacology
null
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single
Sudden painful loss of vision seen in –a) Angle closure glaucomab) Central retinal artery occlusionc) Acute uveitisd) Endophthalmitise) Retinal detachment
Causes of sudden painful loss of vision are :- Acute angle closure glaucoma, acute iridocyclitis (acute uveitis), chemical or mechanical injury to eye, endophthalmitis and optic neuritis.
2
abc
acd
bc
bde
Ophthalmology
null
be7c975f-d8fd-4c98-943f-0038bde070a6
single
All of the follwoing are of the size of adult at bih expect?
Development of the mastoid air cell system does not occur until afterbih, with about 90% of air cell formation being completed by the age of six with the remaining 10% taking place up to age of 18
4
Tympanic membrane
Ossicle
Tympanic cavity
Mastoid
ENT
null
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multi
Assessment and aiding for development of funds for the National Blindness Control Programme is done by
Funding for the NPCB- The allocation of funds for the NPCB increased with the sta of the World Bank-financed Project in 1995.
4
WHO
UNICEF
DANIDA
World Bank
Pathology
All India exam
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single
A young man with T.B presents with massive reccurere haemoptysis. For angiography treatment which vascular structure should be evaluated first
More significant hemoptysis can result from the proximity of the bronchial aery and vein to the air-way, with these vessels and the bronchus running together in what is often referred to as the bronchovascular bundle. Ref Harrison 19th edition pg 245-246
2
Pulmonary aery
Bronchial aery
Pulmonary vein
Superior vena cava
Anatomy
Respiratory system
237a7e05-914e-4a2a-9217-d568c792678e
single
Birth weight of all 10 babies born in a nursing home on a day was 2.7 kg. Standard deviation is -
Ans. is 'a' i.e., 0.00 o This question is very simple.o Standard deviation is a measure of dispersion from central value.o In the question, there is only one central value (2.7 Kg) as all 10 babies have same weight. Thus, there is no dispersion.o Also, you can get the answerMean= 2.7+2.7+2.7+2.7+2.7+2.7+2.7+2.7+2.7+2.7=2.710(x-x)=2.7-2.7 = 0o Thus SD is Zero.
1
0
1
0.27
2.7
Social & Preventive Medicine
Measures of Central Tendency and Distribution
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multi
Differential diagnosis of Hyperemesis gravidarum:
Ans. is a, b and c Nausea and vomiting of pregnancy commonly termed morning sickness' is a normal phenomenon in pregnancy, occurring in about 70% of all pregnancies. in most women, it is limited to the first trimester. but a few may continue to have symptoms throughout pregnancy. Hyperernesis gravidarum is the other end of the spectrum characterised by severe nausea and intractable vomiting sufficient to interfere with nutrition. Risk Factors : - Maternal age > 35 years High body weight. Nulliparity H. mole - Cigarette smoking Twin pregnancy - Fetal loss Positive family history - Unplanned pregnancy Clinical features are due to : -- Dehydration Stareation Ketoacidosis Vomiting associated with Pregnancy (unr-lated to pregnancy) Medical W * intestinal infestation * Urinary tract infection * Hepatitis/Pancreatitis * Keto-acidosis of diabetes * Uraemia * CNS disorder Surgical * Appendicitis *Peptic ulcer reflux *Intestinal obstruction * Cholecystitis/Cholelithiasis Gynaecological * Twisted ovarian tumour * Red degeneration of fibroid Management : Mild to moderate Nausea and Vomiting of Pregnancy - usually needs no treatment except reassurance and frequent small meals. Vitamin B5 alone or with doxylamine is safe and can be considered. Vomiting associated with Pregnancy (unr-lated to pregnancy) Medical W * intestinal infestation * Urinary tract infection * Hepatitis/Pancreatitis * Keto-acidosis of diabetes * Uraemia * CNS disorder Surgical * Appendicitis * Peptic ulcer reflux * Intestinal obstruction * Cholecystitis/Cholelithiasis Gynaecological * Twisted ovarian tumour * Red degeneration of fibroid
4
Gastritis
U.T.I
Reflux oesophagitis
All
Gynaecology & Obstetrics
null
6d53b647-13d0-4bd6-8d95-6f11c4225532
multi
A patient with carcinoma endometrium has >50% myometrial invasion and vaginal metastasis. Pelvic and retroperitoneal lymph nodesa are not involved. Peritoneal seedings are positive. The stage is:
Ans. b. Mb Stage of the patient with carcinoma endometrium having >50% myometrial invasion and vaginal metastasis with involvement of pelvic and retroperitoneal lymph nodes is Mb. Stage Feature I Cancer confined to corpus uteri IA No or less than half myometrial invasion. IB Invasion equal to or more than half of the myometrium II Tumor invades cervical stroma but does not extend beyond the uterus. III Local and/or regional spread of the tumor IIIA Tumor invades the serosa of the corpus uteri and/or adnexa 111B Vaginal and/or parametrial involvement II1C1 Positive pelvic lymph nodes II1C2 Positive para-aoic lymph nodes with or without positive pelvic lymph nodes IV Spread beyond the pelvis IVA Tumor invasion of bladder and/or bowel mucosa.
2
Ma
Tub
HIC1
II1C2
Gynaecology & Obstetrics
null
50ca064d-6a7a-42e1-b5e4-632504a8a77f
single
According to Child - pugh staging Child's B is
CTP scoring system ClassA: 5-6 points ClassB: 7-9 points ClassC: 10-15 points Ref: Sabiston 20th edition Pgno :1436
2
6-May
9-Jul
11-Oct
12-Sep
Anatomy
G.I.T
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single
Xylocaine heavy in subarachnoid space has concentration of
D i.e. 5%
4
1%
2%
3%
5%
Anaesthesia
null
0fb20e43-3a03-417c-8ece-49349e9b63d3
single
In a patient with a history of burning pain localized to the plantar aspect of the foot, the differential diagnosis must include -
Three most common caused of pain in the plantar aspect of the foot are plantar fasciitis, tarsal tunnel syndrome, and posterior tibial tendinopathy. Plantar fasciitis is the most common cause; however, burning pain is characteristic of neural pain. "If the patient describes the sensation as `burning "tingling ' or `numbness', the cause is peripheral nerve entrapment" __Neuromedicine
3
Peripheral vascular disease
Tarsal coalation.
Tarsal tunnel syndrome
Planter fibromatosis
Orthopaedics
null
7f35c6c6-aeb5-423d-b287-b9ed367870e9
single
Which of the following statements concerning skin melanocytes is true?
Melanocytes are present in the stratum basale of the epidermis. They synthesize melanin pigment and transfer it to keratinocytes to protect against damage caused by UV radiation. Melanocytes can give rise to a form of skin cancer called malignant melanoma. They derive from neural crest and migrate into the epidermis early during embryonic development.
1
They synthesize a pigment that protects against damage caused by UV radiation.
They are located only in the dermis.
They produce keratohyalin granules.
They may give rise to basal cell carcinoma
Anatomy
Lymphoid tissue & Integumentary system
7aacc093-1fb1-4c8b-8d05-34490c62e7f0
multi
The most common cause of hirsutism:
Hirsutism M/C cause : PCOS Due to Hyperandrogenism Increase Androgen- increase Serum Testosterone & Andronstendione - decrease Sex hormone binding globulin- increase Free Androgen - Hirsutism Drugs for management of hirsutism OCP containing anti androgenic progesterones Spironolactone Cyproterone Acetate Other drugs- Flutamide Finasteride Ketoconazole Topical Eplornitihine Metformin GnRH Agonists
2
Drug induced
PCOS
Endometriosis
Adenomyosis
Gynaecology & Obstetrics
Polycystic Ovarian Syndrome
988e0696-e988-473f-9c26-39de493c8ba9
single
Following is true about bayard's spots:-
Tardieu's or Bayard's ecchymoses/spots: Round, dark-red, well-defined, pin-head sized spots, found in those pas where capillaries are least Suppoed, e.g. conjunctiva, face, epiglottis, subpleural urface of lungs, hea, meninges and thymus. They tend to be better made out in fair skinned persons, readily visible in fresh bodies. Disappear with putrefaction. They are not pathognomic of asphyxia, and their absence does not exclude asphyxia. It can be seen in other forms of death--electrocution, poisoning, coronary thrombosis, in persons on anticoagulants, with bleeding disorders such as scurvy, leukemia and thrombocytopenia, but distribution is more generalized.
3
Due to the rupture of aerioles
Pathognomic of asphyxia
Present in putrefaction
Well defined, dark red spots seen over conjunctiva, subpleural surface of lungs, hea etc.
Forensic Medicine
Asphyxial deaths
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multi
Rabies virus is inactivated by
The best method of diagnosis for Rabies is a demonstration of Rabies virus by immunofluorescence Materials from which it is collected Antemortem → Corneal smears Facial skin biopsy Postmortem → Brain Rabies does not cause lifelong immunity, infact rabies infection causes the death of all patients. Rabies virus has a Single serotype. Rabies vaccine is a killed inactivated vaccine. It is inactivated by phenol or β propiolactone. More Questions on Rabies virus. It is a bullet-shaped virus. The genome is. Single-stranded RNA Uncemented Linear Negative Sense Rabies virus has haemagglutinating activity.
4
Phenol
UV radiation
BPL
All
Microbiology
null
ac362130-627e-46fe-bce4-51f858467834
multi
In sympathetic ophthalmitis first sign is :
A i.e. Presence of KP's
1
Presence of KPs.
Retrolental flare
Presence of aquous flare
Constriction of pupil
Ophthalmology
null
f9741224-f9e3-41e1-b1bd-07f938dda7a9
single
After I.V. drug administration, elimination of a drug depends on
if a drug is highly lipid soluble it is unionized-easily eliminated if vd is more, elimination is difficult if clearance is good, elimination is easy Pg.no 30 KD TRIPATHI SEVENTH EDITION
4
Lipid solubility
Volume of distribution
Clearance
All of the above
Pharmacology
General pharmacology
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multi
Diagnostic Criteria of JRA
It is defined as ahritis of one or more joints with onset below 16 yr age and persisting for atleast 6 weeks Ref Ghai pediatrics eighth edition pg no 625
1
Disease persisting 6 weeks or longer
Onset before age 16 years
Ahritis involving >5 joints
Polyaicular JRA ANA is +ve
Pediatrics
Musculoskeletal disorders
dd43d72c-1a78-4d51-b8c5-d376182cc99a
single
Lymphangitis carcinomatosa is a typical feature of:
Ans.b and e
2
Carcinoma of the thyroid
Carcinoma of the bronchus
Hepatoma
b and e
Radiology
null
ef947105-cc7d-40a4-9844-26eab7f201b3
single
Which structure DOESN'T pass through the gap between superior and middle constrictor muscle of pharynx
- Structures passing b/w superior & middle constrictor Glossopharyngeal Nerve (Nerve of 3rd arch) Stylopharyngeus Muscle ( muscle of 3rd arch )
3
Glossopharyngeal nerve
Stylopharyngeus muscle
Internal laryngeal nerve
Both stylopharyngeus and Glossopharyngeal nerve
Anatomy
Pharynx, larynx and trachea and cranial nerves 3,4,6
ffdd7983-523c-4c85-b05e-3491eb22c338
multi
Laminar necrosis and watershed infarcts are most suggestive of
Decreased brain perfusion may be generalized (global) or localized. Global ischemia results from generalized decreased blood flow, such as with shock, cardiac arrest, or hypoxic episodes (e.g., near drowning or carbon monoxide poisoning). Global hypoxia results in watershed (border zone) infarcts, which typically occur at the border of areas supplied by the anterior and middle cerebral aeries, and laminar necrosis, which is related to the sho, penetrating vessels originating from pial aeries. The Purkinje cells of the cerebellum and the pyramidal neurons of Sommer's sector in the hippocampus are paicularly sensitive to hypoxic episodes. Atherosclerosis, which predisposes to vascular thrombi and emboli, is related to regional ischemia. Hypeension damages parenchymal aeries and aerioles, producing small ischemic lesions (lacunar infarcts). Fat emboli, related to trauma of long bones, lodge in small capillaries to form petechiae. Venous sinus thrombosis is related to systemic dehydration, phlebitis, and sickle cell disease. Ref - Harrison's internal medicine 20e pg 1117, 2039-2040
1
Shock
Hypeension
Fat emboli
Vascular thrombosis
Medicine
C.N.S
83d7a565-3257-4e37-9049-eadfaf8df0d7
single
Target cells are seen in?
Ans. D. All of the aboveTarget cells (Central area of hemoglobinization)a. Liver diseaseb. Post - splenectomyc. thalassemiad. Hemoglobin C disease
4
Liver disease
Post splenectomy
Thalassemia
All of the above
Medicine
G.I.T.
1a0cbe09-6191-4ee1-9375-a28a9778bfb1
multi
Common complement component for both the pathways is the following:
Classic and alternate pathways lead to the production of C3b, the central molecule of the complement cascade. The presence of C3b on the surface of a microbe marks it as foreign and targets it for destruction. C3b has two impoant functions: (1) It combines with other complement components to generate C5 convease, the enzyme that leads to the production of the membrane attack complex; and (2) It opsonizes bacteria because phagocytes have receptors for C3b on their surface. Ref: Levinson W. (2012). Chapter 63. Complement. In W. Levinson (Ed), Review of Medical Microbiology & Immunology, 12e.
1
C3
C5
Clq
C8
Pathology
null
e8b909c5-d96b-4c8e-86ee-e910e1c05e6a
multi
Paget's disease of breast following are true except ?
Answer is None "A skin specimen containing Paget cells secures the diagnosis and can be obtained by nipple scrape cytology or biopsy."
4
Treated by simple mastectomy
Represents underlying malignancy
Presents as eczema
null
Surgery
null
3a4ddb59-2b69-4d26-a499-29e3b0ff6d27
multi
If tyrosine level in blood is normal without external supplementation, deficiency of which of the following is ruled out ?
Ans. is 'b' i.e., PhenylalanineTyrosine is synthesized from phenylalanine.In phenylalanine deficiency or in disorders in which phenylalanine cannot be conveed into tyrosine (phenylketonuria), tyrosine becomes an essential amino acid and should be supplemented from outside.
2
Tryptophan
Phenylalanine
Histidine
Isoleucine
Biochemistry
null
826d575c-08a9-4525-b667-473b5d7cd2f6
single
Chikungunya virus belongs to which family:
Chikungunya is caused by the chikungunya virus, which is classified in the family Togaviridae, genus Alphavirus. Ref:
3
Enterovirus
Herpes virus
Toga virus
None of the above
Social & Preventive Medicine
null
2c4d133f-4a54-4d86-bccd-7295189ae911
multi
In neonatal cholestasis, if the serum gamma glutamyl- transpeptidase (GGT) is more than 600 IU/L the most likely diagnosis is:
D. Biliary atresia(Ref: Nelson's 20/e p 1933)3 Enzymes reflect cholestasis: Alkaline phosphatase, 5'nucleotidase & Gamma glutamyl transpeptidase.About GGT in Cholestasis: (Normal value of GGT is 5-40IU/L)"GGT levels are commonly elevated to values more than 10 times normal in biliary atresia while in hepatic causes it is raised to about three times normal"Thus a value of 600IU/L in the patient in question reflects an elevation of more than ten times the normal value. The patient is thus likely suffering from 'biliary atresia'.
4
Neonatal hepatitis
Choledochal cyst
Sclerosing cholangitis
Biliary atresia
Pediatrics
Gastro Intestinal System
627a133d-ec6b-4fb0-9310-bd5d55285efb
single
Stauffer syndrome is associated with the following malignancy:
The presenting signs and symptoms of renal cell carcinoma include hematuria, abdominal pain, and a flank or abdominal mass. A spectrum of paraneoplastic syndromes has been associated with this malignancy, including erythrocytosis, hypercalcemia, nonmetastatic hepatic dysfunction (Stauffer syndrome), and acquired dysfibrinogenemia. Anemia, a sign of advanced disease, is more common. Reference: Cooper C.S., Joudi F.N., Williams R.D. (2010). Chapter 38. Urology. In G.M. Dohey (Ed), CURRENT Diagnosis & Treatment: Surgery, 13e.
1
Renal cell carcinoma
Neuroblastoma
Prostate cancer
Small cell carcinoma of lung
Surgery
null
a8db15a4-2e24-43a9-9037-85feb3fb2f45
multi
Central muscle relaxants act by -
Ans. is 'b' i.e., Inhibits spinal polysynaptic reflexes Centrally acting muscle relaxants selectively depress spinal and supraspinal polysynaptic reflexes involved in the regulation of muscle tone without significantly affecting monosynaptic mediated stretch reflex.
2
Decreased nerve conduction
Inhibits spinal polysynaptic reflexes
Block conduction across NM junction
CNS depression
Pharmacology
null
3e48b698-7c19-467e-a3be-bceb3ccc4158
single
Which of the following is not an enzyme of Urea biosynthesis?
Carbamoyl Phosphate Synthase I Is the Pacemaker Enzyme of the Urea Cycle. Other enzymes are; Argininosuccinate Synthase. Argininosuccinate Lyase. Arginase.Ref: Harpers Illustrated Biochemistry, 30th edition, page no: 295
1
Carbomoyl phosphate synthetase II
Ornithine transcarbamylase
Argininosuccinase
Arginase
Biochemistry
Metabolism of nucleic acids
d1f6dd73-80e4-43c1-9b1f-3dbd52e582d4
single
Normal respiratory compliance is ?
The lungs and thoracic cage are both elastic structures. Hence they display a constant relationship between distending pressure and change in volume. The change in volume per unit change in pressure is called "compliance". The total compliance of both lungs together in the normal adult human being is about 0.2 L/cm water. That is, every time the transpulmonary pressure increases by 1 centimeter of water, the lung volume will expand 0.2 L (200 ml). Compliance is a measure of distensibility. Ref: Guyton 12th Ed.
1
200 ml/cm water
50 ml/cm water
100 ml/cm water
150 ml/cm water
Physiology
All India exam
c76b06f3-d265-4d4a-a299-f25721d1c03a
single
In one carbon metabolism when Serine converted to Glycine, which carbon atom is added to THFA?
Ans. B. Beta carbon
2
Alpha carbon
Beta carbon
Delta carbon
Gamma carbon
Biochemistry
Nutrition & Digestion
15b37c99-5935-4b50-b557-9e22ed4878b6
single
Pressure-Volume loop of cardiac cycle is shown below. What does point C represent?
At point C, Ventricular pressure becomes more than aortic pressure. Hence, aortic valve opens.
3
Mitral valve opens
Mitral valve closes
Aortic valve opens
Aortic valve closes
Physiology
null
8caf790f-1098-4597-ba5d-4b3b97d92c14
single
Which of the following will not cause a low lung diffusing capacity(DL)?
A decrease in the diffusion distance will lead to an increase in DL. A decrease in capillary blood volume, surface area, cardiac output, and blood hemoglobin concentration will decrease DL.
1
Decreased diffusion distance
Decreased capillary blood volume
Decreased surface area
Decreased cardiac output
Physiology
General physiology
1738c9f4-63c9-4f1a-b3be-12f52f1541e0
single
The alveoli are filled with exudate the air is displaced conveing the lung into a solid organ. This description suggests-
Ans. is 'd' i.e., Lobar pneumonia
4
Chronic bronchitis
Bronchial asthma
Bronchiectasis
Lobar pneumonia
Pathology
null
ad369ffa-ee11-4c8d-9a54-09aacbceb02b
single
Most common indication for pediatric liver transplant?
Ans: b (Biliary atresia) Ref: Nelson, 18th ed, p. 1712, Table 365-1; 17th ed, p. 1349, Table 349-1Most frequent indication of pediatric liver transplantation is extrahepatic biliary atresia after a failed portoenterostomy (Kasai) procedure.Causes of neonatal cholestasisIntrahepatic* Idiopathic-- Commonest cause* Infections-- TORCH, hepatitis, HIV, parvo B19, Reovirus, Bacterial infections esp E. coli.* Metabolic amino acid-- TyrosinemiaCHO-- Galactosemia, fructosemia, GSDIVLipid-- Neimann Pick, Gaucher, Wolman* Inherited-- a 1 antitrypsin deficiency, cystic fibrosis, neonatal iron storage disease.* Endocrine-- Hypopituitarism, hypothyroidism* Chromosomal-- Down / Edwards syndrome* Others-- Zellweger / Watson Alagille / Byler / neonatal lupus / histiocytosisExtra hepatic* EHB A (extra hepatic biliary atresia)* Choledochal cyst* Inspissated bile* Sclerosing cholangitis* Bile duct stenosis
2
Wilson disease
Biliary atresia
Neonatal hepatitis
Cystic fibrosis
Pediatrics
Gastro Intestinal System
6d97b397-a3a4-411a-b3e0-1f7b807e27ee
single
Deficiencies in the enzyme glucose-6-phosphatase are likely to lead to which of the following?
Glucose-6-phosphate is required in the liver in order for this organ to supply the rest of the body with glucose that has been produced by hepatic gluconeogenesis or released from stored hepatic glycogen. A deficiency in glucose-6- phosphatase leads to the most common of the glycogen storage diseases, von Gierke's disease. This glycogen storage disease results from excess hepatic glucose-6-phosphate allosterically activating the beta form of glycogen synthase leading to increased incorporation of glucose into glycogen. Ref: Bender D.A., Mayes P.A. (2011). Chapter 20. Gluconeogenesis & the Control of Blood Glucose. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e.
2
Decreased glucagon production
Decreased Skeletal Muscle Glycogen Accumulation
Hyperglycemia
Increased hepatic glycogen accumulation
Biochemistry
null
c54456eb-6e08-4bcf-a621-66b28979175c
single
Cadmium can cause all cancer except-
Cadmium can cause lung cancer and possibly has also been related to prostate cancer. Cadmium has also been linked to cancer of breast, kidney, pancreas and urinary bladder. Lung cancer is caused by inhaled cadmium while other are due to ingestion.
4
Lung
Pancreas
Prostate
Skin
Social & Preventive Medicine
null
48d5843d-58ed-4984-b040-c2b750b69ce2
multi
An 18 year old female patient reports for her routine orthodontic appointment. 1st premolars from all quadrants had been extracted at the beginning of treatment. Her current status reveals 3 mm of space between the canines and 2nd premolars in all quadrants. Class II elastics were initiated to close these spaces. The type of anchorage provided by the elastics is known as :
In 1893, Henry A. Baker introduced intermaxillary rubber bands to correct protrusions. His method came to be known as “Baker anchorage.” Class II elastic acts to correct a Class II relationship by providing a retraction force to the upper anterior teeth and a simultaneous protraction force to the lower molars.
2
Intramaxillary anchorage
Baker’s anchorage
Moyer’s anchorage
Absolute anchorage
Dental
null
62c27755-d0fe-4eaa-8f42-9ad317b37965
multi
Human immunodeficiency virus (HIV) has been isolated from many body fluids. Which of the following is a major source of transmission?
HIV has been isolated from blood, semen, vaginal secretions, saliva, tears, breast milk, CSF, amniotic fluid, and urine. It is an extremely fastidious virus that ordinarily is transmitted only after repeated admixture of body fluids. Blood and semen are by far the major transmission fluids.
3
Tears
Sweat
Semen
Urine
Surgery
Transplantation
b5ef92f8-77d0-46b6-9d7d-a3f9747d22d9
single
Which of the following reflects wavelength (nanometers) of Laser used for shaping cornea in refractive surgery:
A i.e. 193 - Corneal reshaping refractive procedures such as photorefractive keratectomy (PRK), laser assisted epithelial keratomileusis (LASEK), & laser assisted insitu keratomileusis (LASIK), used to correct refractive errors (myopia and hypermetropia), are ultraviolet-photoablation procedures using Excimer (also k/a argon fluoride/Ar-F- excimer) laser of ultraviolet (193 nm) wave lengthQ. Myopia is treated by ablating the central anterior corneal surface so that it becomes flatter; 10um ablation corrects 1D myopia. Hypermetropia is corrected by ablation of periphery so that the centre becomes steeper. Excimer laser (193 nm) corneal reshaping refractory surgery is of 2 types. In PRK the anterior surface of cornea is ablated by laser, which can correct myopia upto 6D, astigmatism upto 3D and low hypermetropia. The more popular other method is LASIK, in which superficial circular flap of epithelium & stroma is cut with microkeratome (an automated sharp blade), lifting up 120-150 pm thick hinged flap attached on one side. The stromal bed is laser ablated to desired extent ensuring minimal stromal bed thickness of 250 pm (to maintain stability & prevent iatrogenic ectasia). Following this the flap is repositioned without sutures; this can corret hypermetropia upto 4D, astigmatism upto 5D and myopia upto 12D. Modifications to minimize microkeratome related complications include use of 20% alcohol (30-40 seconds) to lift / clear thin epithelial flap (LASEK), use of special microkeratome to cut & separate a thin flap of epithelium & Bowman's layer (Epi - LASIK) and use of femto second laser to pre fashion the anterior flap to a desired size and depth without using a surgical blade Refractive Keratoplasty to modify refractive power of cornea may be done by: (i) radial keratotomy (radial incisions are made in cornea); (ii) arcuate keratotomy (arcuate shaped incisions in steeper or more myopic meridian to reduce astigmatism); (iii) Keratomileusis (tissue resected & modified in shape before replacement) and (iv) epikeratophakia, where donor corneal tissue is attached to the host cornea after removal of epithelium capsulectomy in an eye with a silicone intraocular lens implant is challenging because optical breakdown occurs in silicone at relatively low power, therefore damaging IOL even when the laser is focused posterior to implant. Procedure is even more difficult if capsule is in intimate contact with the implant. Use of corneal contact lens during laser capsulectomy result in steeper convergence & more sharply focused Nd YAG laser beam. - IOL made of PMMA and acrylic are less susceptible to optical breakdown than silicone lenses. Photodisruption (PD) - PD is a mechanical effect produced by highly focused laser (with high electromagnetic field strength), which can actually strip electrons from their nuclei, destroying chemical nature of material producing an entirely different physical state of matter called plasma. - In plasma, the orderly array of molecules is fractured into a random mixture of electron & protons in a process called optical break down, which is basically a miniature lightening bolt or thunderclap. Vapors formed by lightning bolt expands, quickly collapse and produce a miniature thunder clap. Acoustic shock waves produced from thunderclap cause most of the tissue damage. - PD optical breakdown requires electro magnetic fields so powerful they can be produced only by concentrating lasr energy into very brief periods, thereby giving each pulse an extremely high power. Infrared Nd: YAG laser (1064nm) with Q switching or mode locking pulsing is used for PD. Q switching is most commonly used, inexpansive and reliable but cant produce pulses as sho or powerful as mode locking. Whereas, mode locking are expansive and difficult to maintain but more powerful. - Nd: YAG laser is infrared, invisible, so aiming system (a red helium-neon / He-Ne laser) is necessary. However, the patient's eye cause the red aiming beam to bend more than Nd:YAG's infrared laser. Therefore, the focus of both rarely coincide precisely (chromatic aberration). Photodisruption with infrared Nd: YAG laser (1064nm) is used in performing posterior lens capsulectomyQ. Photocoagulation (PC) - In PC, laser light (mostly visible or sometimes infrared) is absorbed by the target tissue or by neighbouring tissue, generating heat that coagulates (denatures) proteins. - It is the most commonly used laser procedure performed during panretinal photocoagulation, argon laser trabeculoplasty, peripheral iridecotomy, and thermal destruction of choroidal neovascular membranes. It is used in treatment of various conditions. Anterior segment PC Posterior segment PC - lridoplasty - Proliferative DR - Iridotomy - Diabetic macular edema - Trabeculoplasty - Choroidal neovascularization - Cyclophoto secondary to age related macular coagulation degeneration - Retinal breaks - Retinal detachments - Types of laser that produce PC include Laser Wave length (nm) Argon Blue- Green 488 Argon-Green 514 Frequency doubled (2x) Nd-YAG (green) 532 Rhodamine 6G Organic tunable Dye laser (Yellow-Red) 570 to 630 Krypton-Red 647 Ruby - Red 694 Diode (near infrared) 810 - Increase in exposure time modestly increases the lesion's diameter and also extends damage deeper into target tissue (eg 10 fold ET doubles diameter). Whereas very brief exposure times (0.01-0.05 seconds), allow little time for heat to dissipate from the burn. Therefore a small area of intense burn is produced, resulting in perforation of delicate ocular structures like neural retina & Bruch's membrane. - An increase in power has strong influence on lesion diameter (doubling power doubles size) but creates more damage and can be painful. In most PC lasers, the energy is concentrated in the centre of beam, with less energy at edges. Therefore, use of excessive power during laser treatment of retina may result in inadveent retinal hole. Also the lower energy at periphery may produce permanent tissue damage even though it does not produce a visible reaction. This means the area of laser damage may extend beyond the area of immediately visible reaction. In sensitive areas such as macula, a small spot size (100pm) is preferred so as to minimize unnecessary adjacent damage. In contrast, larger spot size (200-500pm) is preferred for panretinal photocoagulation. - Laser contact lenses also increase spot size Laser contact lens Multiplication factor of increased spot size Goldman three mirror lens 1.08 Panfundoscopic lens 1.41 Mainster wide angle lens 1.47 Quadr Aspheric lens 1.92 If the spot size is increased, the power needs to be increased. However, because energy is concentrated in centre of beam, it is best to raise power only modestly (no more than two folds at a time) and to test burns to refine the power settings. Photoablation (PA) - PA breaks chemical bonds that hold tissue together, essentially vaporizing the tissue. Chemical bonds are broken by absorption of Photons without any external mechanical pressure. Therefore, the laser is able to remove tissue with more precision and with much less damage to surrounding tissue. - It is most recent light tissue interaction using argon-fluoride (Ar-F) excimer laser producing electro magnetic energy with a wave length of 193 nm (in the extreme ultraviolet). - Photoablation used for shaping cornea in refractive surgery and to treat corneal pathology such as corneal ulcers and scars. - Excimer laser removes --0.1 mm of corneal tissue with each pulse. Beam shaping optics are used to create even beam profile; however, these are ablated slowly & must be replaced periodically. - Irregularities in corneal stroma, presence of keratinocytes, & variable corneal collagen density (depending on altitude, atmospheric pressure, humidity, age and duration of procedure) may cause uneven ablation even when beam profile is uniform.
1
193
451
532
1064
Ophthalmology
null
47258b4c-232e-4ff0-ae1b-313e0ea015c8
single
Biotin may be used for treatment of which of the following conditions?
Biotin is a cofactor for carboxylase, so it can be used in the treatment of multiple carboxylase deficiency. Maple syrup urine disease- Thiamine Methylmalonic acidemia- Vitamin B12, L- carnitine, Metronidazole Phenylketonuria- Tetrahydrobiopterin
4
Maple syrup urine disease
Methylmalonic acidemia
Phenylketonuria
Multiple carboxylase deficiency
Pediatrics
Disorders of Amino acid Metabolism
5cddb146-df5b-4d78-a16c-0086f662b230
single
The significance of difference between propoions can also be tested by-
* Chi-Square test offers a method of testing the significance of difference between the propoions. * Its advantage lies in the fact that it can also be used when more than two groups are to be compared. * By using this test, we can find out if the difference between two propoions or ratios has occurred by chance. The steps involved are- 1) Testing the null hypothesis. 2) Applying chi-square test. 3) Calculating the degree of freedom. 4) Comparing with probability tables.
2
.'t' test
Chi square test
ANOVA
Correlation and regression
Surgery
null
c4fb3d4c-62d8-437b-ac29-15b4dd5093df
single
Most of the viral infections present as
(Refer: AK Khurana Comprehensive Ophthalmology, 6th edition, pg no. 74 - 75)*Most of the viral infections tend to affect the epithelium, both of the conjunctiva and cornea. So, the typical viral lesion is a Keratoconjunctivitis*Causes of viral conjunctivitis are:- HSV adenovirus, Picornavirus (enterovirus-70, Coxsackievirus A24), Measles (myxovirus), VZV, Paramyxovirus (mumps, Newcastle conjunctivitis), Molluscum conjunctivitis
3
Conjunctivitis
Keratitis
Keratoconjunctivitis
None of the above
Ophthalmology
Miscellaneous
9b20be2b-ae13-4bd5-965f-e25613060d89
multi
Most common tumor of eyelid is
Ans. a (Basal cell carcinoma). (Ref. Baily & Love, 25th/pg. 609)BASAL CELL CARCINOMA (BCC, rodent ulcer)# Basal cell carcinoma is the commonest form of skin cancer and typically affects individuals between the ages of 40 and 79 years; 50 percent are male.85 percent occur in the head and neck region.# Are thought to originate from pluripoten epithelial cells of the epidermis and hair follicles.# BCCs grow slowly, but locally invasive and penetrate deeper tissues -- hence the term rodent ulcer,# Metastasis is rare.# Typically these tumours have a nodular appearance with a pearly rolled edge (which is apparent on stretching the skin) and telangiectatic vessels.# Clinically types in order of frequency:- Nodular: 50-54%; (90% nodular/nodular cystic). Superficial : 9-11%;- Cystic: 4-8%; Pigmented: 6%; Morpheic : 2%.# Treatment:- Surgical excision -- the treatment of choice with cure rates between 85 and 95%.- Electrodessication and curettage -- commonly used for small superficial lesions (2--5 mm in diameter) gives cure rates between 85 and 100%.- Radiotherapy -- BCC is very radiosensitive and has an overall response of 92 % in selected patients. This is reserved for elderly patients who are not suitable for surgery or for specialised anatomical sites.- Moh's micrographic surgery (chemosurgery) --involving serial horizontal excision and mapping of the tumour. Usually reserved for recurrent lesions, tumours in difficult areas or those with indistinct borders (morphea-form).- Following complete excision it is unnecessary routinely to follow-up these patients unless they have a familial disposition for BCC formation (Gorlin's syndrome).
1
Basal cell carcinoma
Keratoacanthoma
Melanoma
Squamous cell carcinoma
Surgery
Neoplasia
5d96ace8-2f21-466d-9368-8ee16b9716cf
single
The following is a feature of Korsakoff’s psychosis
Ref. Oxford textbook of Psychiatry. Page. 28   Anterograde amnesia is also observed in patients with Korsakoff syndrome. Korsakoff syndrome is seen mainly in alcoholics who have a thiamine deficiency and often follows an acute presentation of Wernicke encephalopathy. Wernicke encephalopathy presents with ocular palsies, confusion, and gait ataxia and is also related to a thiamine deficiency. In Wernicke-Korsakoff syndrome, lesions are always found in the mammillary bodies and the dorsomedial nuclei of the thalamus. In addition to exhibiting an anterograde amnesia, Korsakoff patients also present with retrograde amnesia. These patients confabulate, making up stories to replace past memories they can no longer retrieve.
1
Confabulation
Encephalopathy
Opthalmoplegia
Hallucination
Unknown
null
327b2c73-a4a2-42af-931e-c7104466e386
multi
Area of the brain is usually not involved in WernickeKorsakoff syndrome: Karnataka 11
Ans. Hippocampus
3
Periventricular gray matter
Mammillary bodies
Hippocampus
Thalamus
Forensic Medicine
null
7630c4ae-c36a-4b7c-9dab-5c006245440c
multi
Rett's syndrome is characterized by -
Ans. is 'a' i.e., Regression of language and motor milestones Rett's syndromeo Age of onset is around 5 months.o Development may proceed normally until 1 yr of age, when regression of language and motor milestones become apparent.o This is the characteristic features, that they begin to loose their acquired skills, e.g., cognitive and head growth is normal during early period after which there is an arrest of growth,o Acquired microcephaly (Decleration of head growth due to significantly reduced brain weight).o Most children develop peculiar sighing respirations with intermittent periods of apnea that may be associated with cyanosis - Breath holding spells.o Autistic behavior is a typical finding in all patients - Impaired social interaction, language and communication.o Generalized tonic-clonic convulsions occur in the majorityo Feeding disorder and poor weight gain are commono Death occurs in adolescence or in the 3rd decadeo Cardiac arrhythmias may result in sudden, unexpected death.
1
Regression of language and motor milestones
Hyperactive child
Normal weight
Macrocephaly
Psychiatry
Mood Disorders
7c9f6920-5687-4255-98b9-1aa652db9fd1
single
Which of the following is treatment of Type I hypersensitivity
Sodium cromoglicate stabilises the mast cell membrane, inhibiting release of vasoactive mediators. It is effective as a prophylactic agent in asthma and allergic rhinitis, but has no role in acute attacks. It is poorly absorbed and therefore ineffective in the management of food allergies DAVIDSON&;S 22 ND EDITION
3
Histamine
IgA immunoglobulin
Sodium cromoglycate
Interleukin 5
Medicine
Immune system
883cedd9-849c-4418-b2fa-3046b86e3ba1
single
Most common presentation of nasopharyngeal carcinoma is: (JIPMER 2011 Repeat)
Ans: B (Cervical lymphadenopathy) Ref: Diseases of the Ear, Nose and Throat by PL Dhingra. 5th edn .2010 page 265Explanation:Nasopharyngeal CarcinomaMost commonly seen in the Chinese populationBimodal age distributionRisk factors are burning of incense sticks, preserved salted fish and decreased intake of vitamin CTypes of Nasopharyngeal carcinoma Type I - squamous cell carcinoma Type II - non keratinizing carcinoma Type III - undifferentiated carcinomaPresents most commonly as cervical lymph node 160%)Most common region is posterior cervicalAlso presents as hearing loss, nasal block, epistaxis and cranial nerve palsy (most common VIN)Other cranial nerves which can be involved are II, III, IV, VI, V, IX, X XI, Homer's syndromeDiagnosis is with CT scan and MRI scansTreatment is with radiotherapy and chemotherapy (cisplatin +/- 5FU)
2
Epistaxis
Cervical lymphadenopathy
Nasal obstruction
Hearing loss
ENT
Pharynx
8ce7c547-9d58-4bfb-9a62-47de48218dec
single
Which is true of ivermectin
Ref-KDT 6/e p813,814 Ivermectin is the drug of choice for onchocerciasis (river blindness) and strongyloidosis. It is also effective against other filarial worms It can also be used orally for the treatment of scabies and pediculosis. DEC is contraindicated in onchocerciasis
4
It is the most effective drug for strongyloidiasis
It is drug of choice for onchocerciasis
It can be used to treat scabies
All the above a
Anatomy
Other topics and Adverse effects
221bfeb0-3c49-4d58-ae7c-61e935db2a4f
multi
Which of the following is stored in freezer?
Ans: d (Measles) Ref: Park, 19th ed, p. 95The two vaccines which must be stored in the freezer compartment are:* Polio* Measles.Vaccines which must be stored in the cold part but never allowed to freeze are:* DPT* TT* DT* BCG* Diluents.Nothing is kept in the door!All vaccines with the letter T are kept in the cold part and not in the freezer. Remember that BCG is Bacille CalmetteGuerin.Cold chain:The "cold chain" is a system of storage and transport of vaccines at low temperature from the manufacturer to the actual vaccination site, at 4-8degC.Among the vaccines polio is most heat sensitive, requiring storage at minus 20degC.The cold chain equipment consists of the following.a) Walk in cold room (WIC) - located at regional level, meant to store vaccines up to 3 months and serve 4-5 districts.b) Deep freezers and ice lined refrigerators (ILR) - supplied to all districts and the WIC locations to store vaccines. Deep freezers are used for making ice packs and to store polio and measles vaccines.c) Small deep freezers and Ice lined refrigerators (ILR) - one set is provided to PHCs, urban family planning centres, and post partum centres.d) Cold boxes - supplied to all peripheral centres, mainly for the transportation of vaccines.e) Vaccine carriers - used to carry small quantities of vaccine (16-20) vials to out of reach sessions.f) Day carrier - used to carry small quantities of vaccine (6-8) vials to nearby sessions.
4
DT
IT
DPT
Measles
Social & Preventive Medicine
Miscellaneous
76c4ccfc-f326-4098-9286-dfaa885137b0
single
Most common joint to undergo recurrent dislocation is ?
Shoulder joint is the commonest joint to undergo dislocation.it occurs commonly in adults and rare in children. Anterior dislocation is common than posterior dislocation. Shoulder instability is term used when head of humerus is not stable within the glenoid. The instability may be uni or bidirectional. The instability can be in many directions-multi directional. A fall on out stretched hand with shoulder abducted and externally rotated is common mechanism of injury. Ref: Essential Ohopaedics, Maheswari & Mhaskar, 9th ed Page no: 89
1
Shoulder joint
Patella
Knee joint
Hip joint
Orthopaedics
Shoulder and arm injuries
e78ccbfa-b7a6-40a3-954d-9b3cd46fae3e
single
Rigor mois can be simulated by
A i.e. Cadaveric spasm
1
Cadaveric spasm
Algor mois
Adipocere
Livor mois
Forensic Medicine
null
ec6536ef-5ea4-468d-805d-f2a0dd64597c
single
Exomphalos is a disease involving
null
3
Umbilicus
Cervix
Abdominal wall
Urinary bladder
Surgery
null
85b6c4f5-63b4-45f2-831b-babe5bbd5b87
multi
Among the following, which of the following is/are the greatest contributors to global warming as a consequence of human activities and life style ?
Carbon dioxide is not commonly regarded as an air pollutant it is a natural constituent of air. It does not take pa in any significant chemical reactions with other substances in the air However, it could increase global temperature enough to affect climate markedly
1
Carbon dioxide
Chlorofluorocarbons
Methane
Ozone
Social & Preventive Medicine
Environment and health
62cc354b-1489-42f3-9929-59afd7283a38
single
Dose of centchroman is -
Ans. is 'a' i.e., 30 mg Cetchroman (Saheli)o Ormeloxifene, research product of Central Drug Research Institute, Lucknow, India.o It is a potent non - steroidal compound with potent anti - estrogenic and weak estrogenic properties. It is taken orally (30 mg) twice a wreek for first three months then once a wreek.o It works primarily by preventing implantation of fertilized ovum. It does not inhibit ovulation,o It is avoided in PCOD, writh liver and kidney diseases and in tuberculosis. There may be a tendency of oligomenorrhoea.o The failure rate is 1 - 4/100 woman years of use. Failure rate is less with increased doses. It is devoid of any significant adverse metabolic effect.o This may also be used as a emergency contraceptive.
1
30 mg
60 mg
120 mg
240 mg
Pharmacology
Vitamin
b20ecc89-dbd2-4273-821c-499669049679
single
The major clinical use of nimodipine is in ?
Ans. is 'c' i.e., Subarachnoid haemorrhage Nimodipine selectively relaxes cerebral vasculature, approved for prevention and treatment of neurological deficit due to cerebral vasospasm following subarachnoid haemorrhage or ruptured congenital intracranial aneurism.
3
Hypeension
Angina pectoris
Subarachnoid haemorrhage
Raynaud's phenomenon
Pharmacology
null
5afea53d-0275-4df0-a1cd-1b34194bd51b
single
A child presented with Intermittent episodes of left sided flank pain. Ultrasonography reveals large hydronephrosis with dilated renal pelvis and coical thinning with a normal ureter. Kidney differential function was observed to be 19% which of the following is the best management
Pyeloplasty is performed to treat an uretero-pelvic junction obstruction if residual renal function is adequate There are different types of pyeloplasty depending on the surgical technique and patterns of incision used. These include the Y-V, Inveed &;U&;, and Dismembered types of pyeloplasty. The dismembered type of pyeloplasty (called an Anderson-Hynes pyeloplasty) is the most common type of pyeloplasty. This was described in relation to retrocaval ureter (now renamed as preureteric vena cava). Another technique of pyeloplasty is Culp&;s pyeloplasty, in this method a flap is rotated from dilated pelvis to decrease narrowing of ureter. A pyeloplasty can either be done by the robotic, open, or laparoscopic route. Reference: GHAI Essential pediatrics, 8th edition
2
Nephrectomy
Pyeloplasty
External drainage
Endopylostomy
Pediatrics
Urinary tract
8f70c1be-1adf-4ce3-b7c4-fd47d22db38c
single
Wavelength of carbon dioxide laser is?
Ans- A 10600 nm Ref- CO2 Lasers Definition: infrared lasers based on a gas mixture in which light is amplified by carbon dioxide molecules The CO2 laser (carbon dioxide laser) is a molecular gas laser based on a gas mixture as the gain medium, which contains carbon dioxide (CO2), helium (He), nitrogen (N2), and possibly some hydrogen (H2), water vapor and/or xenon (Xe). Such a laser is electrically pumped via a gas discharge, which can be operated with DC current, with AC current (e.g. 20-50 kHz) or in the radio frequency (RF) domain. Nitrogen molecules are excited by the discharge into a metastable vibrational level and transfer their excitation energy to the CO2 molecules when colliding with them. Helium serves to depopulate the lower laser level and to remove the heat. Other constituents such as hydrogen or water vapor can help (particularly in sealed-tube lasers) to reoxidize carbon monoxide (formed in the discharge) to carbon dioxide. Figure 1: Schematic setup of a sealed-tube carbon dioxide laser. The gas tube has Brewster windows and is water-cooled. CO2 lasers typically emit at a wavelength of 10.6 mm, but there are other lines in the region of 9-11 mm (particularly at 9.6 mm). In most cases, average powers are between some tens of watts and many kilowatts. The power conversion efficiency can be well above 10%, i.e., it is higher than for most gas lasers (due to a particularly favorable excitation pathway), also higher than for lamp-pumped solid-state lasers, but lower than for many diode-pumped lasers. - Laser Types The family of CO2 lasers is very diverse: For laser powers between a few watts and a several hundred watts, it is common to use sealed-tube or no-flow lasers, where the laser bore and gas supply are contained in a sealed tube. Such lasers are compact and rugged, and reach operation lifetimes of several thousands of hours. High-power diffusion-cooled slab lasers (not to be confused with solid-state slab lasers) have the gas in a gap between a pair of planar water-cooled RF electrodes. The excess heat is efficiently transferred to the electrodes by diffusion, if the electrode spacing is made small compared with the electrode width. Several kilowatts of output are possible. Fast axial flow lasers and fast transverse flow lasers are also suitable for multi-kilowatt continuous-wave output powers. The excess heat is removed by the fast-flowing gas mixture, which passes an external cooler before being used again in the discharge. Transverse excited atmosphere (TEA) lasers have a very high (about atmospheric) gas pressure. As the voltage required for a longitudinal discharge would be too high, transverse excitation is done with a series of electrodes along the tube. TEA lasers are operated in pulsed mode only, as the gas discharge would not be stable at high pressures. They often produce average output powers below 100 W, but can also be made for powers of tens of kilowatts (combined with high pulse repetition rates). There are gas dynamic CO2 lasers for multi-megawatt powers (e.g. for anti-missile weapons), where the energy is not provided by a gas discharge but by a chemical reaction in a kind of rocket engine. The concepts differ mainly in the technique of heat extraction, but also in the gas pressure and electrode geometry used. In low-power sealed-tube lasers (used e.g. for laser marking), waste heat is transported to the tube walls by diffusion or a slow gas flow. The beam quality can be very high. High-power CO2 lasers utilize a fast forced gas convection, which may be in the axial direction (i.e., along the beam direction) or in the transverse direction (for the highest powers). - Applications CO2 lasers are widely used for material processing, in particular for cutting plastic materials, wood, die boards, etc., exhibiting high absorption at 10.6 mm, and requiring moderate power levels of 20-200 W cutting and welding metals such as stainless steel, aluminum or copper, applying multi-kilowatt powers laser marking of various materials. Other applications include laser surgery (including ophthalmology) and range finding. CO2 lasers used for material processing (e.g. welding and cutting of metals, or laser marking) are in competition with solid-state lasers (particularly YAG lasers and fiber lasers) operating in the 1-mm wavelength regime. These shorter wavelengths have the advantages of more efficient absorption in a metallic workpiece, and the potential for beam delivery via fiber cables. (There are no optical fibers for high-power 10-mm laser beams.) The potentially smaller beam parameter product of 1-mm lasers can also be advantageous. However, the latter potential normally cannot be realized with high-power lamp-pumped lasers, and diode-pumped lasers tend to be more expensive. For these reasons, CO2 lasers are still widely used in the cutting and welding business, particularly for parts with a thickness greater than a few millimeters, and their sales make more than 10% of all global laser sales (as of 2013). This may to some extent change in the future due to the development of high-power thin-disk lasers and advanced fiber cables in combination with techniques which exploit the high beam quality of such lasers. Due to their high powers and high drive voltages, CO2 lasers raise serious issues of laser safety. However, their long operation wavelength makes them relatively eye-safe at low intensities. - Bibliography C. K. N. Patel, "Continuous-wave laser action on vibrational-rotational transitions of CO2", Phys. Rev. 136 (5A), A1187 (1964) C. K. N. Patel, "Interpretation of CO2 optical maser experiments", Phys. Rev. Lett. 12 (21), 588 (1964) A. Robinson and D. Johnson, "A carbon dioxide laser bibliography, 1964-1969", IEEE J. Quantum Electron. 6 (10), 590 (1970) P. T. Woods et al., "Stable single-frequency carbon dioxide lasers", J. Phys. E: Sci. Instrum. 9, 395 (1976) A. L. S. Smith and J. Mellis, "Operating efficiencies in pulsed carbon dioxide lasers", Appl. Phys. Lett. 41, 1037 (1982) K. M. Abramski et al., "Power scaling of large-area transverse radiofrequency discharge CO2 lasers", Appl. Phys. Lett. 54, 1833 (1989) O. Svelto, Principles of Lasers, Plenum Press, New York (1998)
1
10600 nm
1082nm
2940 nm
1064 nm
Unknown
null
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What is the disease in which these hand abnormalities are seen?
d. Marfan syndromeA - ArachnodactylyB - Steinberg sign (thumb tip extends from palm of hand, in a closed fist)C - Walker-Murdoch sign (thumb & 5th finger overlap each other, when opposite wrist is gripped)
4
Down syndrome
Osteogenesis imperfecta
Turner syndrome
Marfan syndrome
Pediatrics
Genetics And Genetic Disorders
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Regarding the sling procedure for Urodynamic Stress Incontinence (USI):
Ans. is c, i.e. Intrinsic sphincter deficiency is an indicationLets see each option:TVT acts by increasing urethral coaptation, kinking the urethra with the rise in abdominal pressure and not by elevating bladder neck hence option a is incorrect.TVT is made from polypropylene (marlex) or polytetrafluoroethylene (Goretex) and not autologous sling material. Autologus sling material refers to natural sling materials made from rectus fascia or porcine dermis. These are less Antigenic; hence option b is incorrect.TVT is done in case of intrinsic sphincter deficiency, i.e. option c is correct.Success rate of sling procedure are over 80%, i.e option d is incorrect
3
Tension-free vaginal tape (TVT) elevates the bladder neck to a retropubic position
TVT is an autologous sling material
Intrinsic sphincter deficiency is an indication
Success rate of TVT is low than other retropubic procedures
Gynaecology & Obstetrics
Urinary Fistulas
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A gravida 3 female with H/o 2 previous 2nd trimester aboion presents at 22 weeks of gestation with funneling of cervix. Most appropriate management would be:
<p> Cervical incompetency is the one of the cause for recurrent 2nd trimester miscarriage(20%) Management of cervical incompetence is by two types of operations named after Shirodkar and McDonald Reference:DC Dutta&;s textbook of obstetrics,8th edition,page no:199 <\p>
4
Administer dinoprostone and bed rest
Administer misoprostol and bed rest
Apply fothergill stretch
Apply McDonald stitch
Gynaecology & Obstetrics
General obstetrics
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Most common site for the osteoporotic veebral Fracture is :
*Most common symptom of osteoporosis is back pain secondary to veebral compression fracture. *Dorso - lumbar spine is the most frequent site. <img alt="" src=" /> * Other common sites of fracture are lower end radius and fracture neck femur. *Osteoporotic fracture are : (1)Fracture veebrae (2)Colle's Fracture (3) Fracture neck (4) femur Ref: Maheshwari 6th/e p.308
1
Dorsolumbar spine
Cervical spine
Lumbosacral spine
Dorsal spine
Anatomy
null
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single
Which of the following component of the eye has highest refractive index?
The refractive index of the lens coex is 1.386 while that of the lens core is 1.406. Refractive index of each component of the eye as an optical system Refracting medium Refractive index Air 1.000 Cornea 1.373 Aqueous humour 1.336 Lens(coex-core) 1.386 - 1.406 Vitreous humour 1.336 Ref: Parsons' Diseases of the Eye By Ramanjit Sihota & Radhika Tandon page 52. Theory And Practice Of Optics And Refraction By Khurana page 32.
3
Anterior surface of the lens
Posterior surface of the lens
Centre of the lens
Cornea
Ophthalmology
null
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The immediate treatment of unstable tibial plateau fracture is:
(Internal fixation with plate & screw) (720-ApIey's 8th)* Unstable fracture of Tibial plateau - In younger patient, and more so those with a central depression of more than 5 mm, open reduction with elevation of the plateau and internal fixation with a buttress plate is preferred.* Stable fracture - depression is slight (less than 5 mm), if the patient is old and frail or osteoporotic the fracture is treated with closed reduction (Skeletal traction for 3-4 weeks and then hinged cast brace for another 6 weeks.
1
Internal fixation with plate & screw
Internal fixation with nail
External fixator
Complete bed rest
Orthopaedics
Injuries Around the Thigh & Knee
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Content of superficial perineal pouch ?
Bulbospongiosus
3
Sphincter urethrae
Deep transverse perinei
Bulbospongiosus
Aery of penis
Anatomy
null
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The Basal Electrical Rhythm occurs in all pas of GIT, EXCEPT:
Except in the esophagus and the proximal poion of the stomach, the smooth muscle of GIT has spontaneous rhythmic fluctuations in membrane potential between about -65 and -45 mV. Basic electrical rhythm (BER) is initiated by the interstitial cells of Cajal, stellate mesenchymal pacemaker cells with smooth muscle-like features that send long multiply branched processes into the intestinal smooth muscle. In the stomach and the small intestine, these cells are located in the outer circular muscle layer near the myenteric plexus; in the colon, they are at the submucosal border of the circular muscle layer. In the stomach and small intestine, there is a descending gradient in pacemaker frequency, and as in the hea, the pacemaker with the highest frequency usually dominates.
1
Esophagus
Stomach
Duodenum
Colon
Physiology
GIT
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All are present in mild dehydration, except ?
Ans. is 'c' i.e., Dry tongue
3
Thirst
Restlessness
Dry tongue
Normal BP
Social & Preventive Medicine
null
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Ketamine is contraindicated in all except-
In contrast to other anesthetics, ketamine increases aerial blood pressure, hea rate and cardiac output. This is because it is sympathomimetic. Accompanying there changes true is increase in pulmonary aery pressure and myocardial work. Thus should be avoided in - Coronary aery disease Uncontrolled hypeension Congestive hea failure Aerial aneurysm On the other hand good in patients with acute shock.
4
Congestive hea failure
Uncontrolled hypeension
Aerial aneurysm
Shock.
Anaesthesia
Intravenous Anesthetic Agents
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In rabies, human diploid cell culture vaccine for post-exposure vaccination is given on the following days -
Post exposure prophylaxis(HDCV) requires 5 or 6 doses on 0,3,7,10,14,30&Optionally90. REF:<\p> ANATHANARAYANAN MICROBIOLOGY NINTH EDITION PAGE.531
3
0, 7, 28 then booster dose in 90 days
0, 7, 28 then booster dose in 2 days
0, 3, 7, 14, 30 then booster dose in 90 days
0, 3, 7 and booster dose in 90 days
Microbiology
Virology
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Malignant gastric ulcers are characterized by A/E ?
Ans. is 'a' i.e., Ulcer extends beyond the gastric wallo In malignant ulcers mucosal rugae stop far of the ulcers whereas in benign ulcers mucosal rugae projects outwards from the margins of the ulcer
1
Malignant gastric ulcers are characterized by A/E ?
Mucosal rugae stop far of ulcers
Eccentric crater
Margins are raised
Pathology
null
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Wilson disease all are true except -
Ans. is 'd' i.e., Raised ceruloplasmin level Wilson diseaseo Autosomal recessive.o Degenerative changes in brain, liver and KF ring in cornea (Descement membrane),o Defect in Copper metabolism (copper toxicosis).o Best screeing test is to measure serum ceruloplasmin,o Decrease ceruloplasmin in WDo Failure of copper to be incorporated into ceruloplasmin leads to plasma protein with shorter TlA which leads to decrease ceruloplasmin level.
4
AR
KF ring
Raised copper level
Raised ceruloplasmin level
Pediatrics
Inborn Errors of Metabolism
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‘Dipstick Test’ for rapid diagnosis of Plasmodium falciparum is based on
‘Dipstick Test’ is used for the rapid diagnosis of Plasmodium falciparum (Pf) – Is a ‘rapid whole blood immuno-chromatographic test’ – Uses 2 antibodies specific for ‘Pf Histidine Rich Protein II Antigen’ – Is a ‘antigen capture assay’ – Colloidal gold is used in the test card – Gives results in 3 – 5 minutes – Specificity and negative predictive value is 99% – Not as effective when parasite levels < 100 parasites/ml of blood • Rapid tests for diagnosis of Pf: – Dipstick test (Pf Histidine rich protein II – HRP II) – Leishman stain – Field’s stain – Acridine orange.
4
Arginine-rich protein
Serine-rich protein
Tyrosine-rich protein
Histidine-rich protein
Social & Preventive Medicine
null
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20 years old female with complaints of nausea, vomiting, dizziness and pain in the legs. Her physical examination and all lab investigations and radiological investigations are normal. What would be the most probable diagnosis?
Here the patient presents with multiple, medically unexplained symptoms (MUS). This is an example of Somatisation Disorder. In somatoform pain disorder the major symptom will be unexplained chronic pain, which is usually isolated. Patients have a long history of complaints of severe pain out of propoion to any biomedical findings that are present. Exacerbations and remission of complaints correlate with psychogenic factorsThe term somatization refers to the experience and repoing of physical symptoms that cause distress but lack a corresponding level of tissue damage or pathology and are linked to psychosocial stress. In contrast to this broad and inclusive view of the process, psychiatrists have developed strict diagnostic criteria that define several distinct disorders, which are collectively referred to as the somatoform disorders. As such, clinicians should be careful to distinguish between somatization, as defined above, and somatization disorder, which is one type of somatoform disorder. In general, these conditions are chronic and reflect an enduring way for the affected individuals to cope with psychosocial stressors. Ref: Shim J., Eisendrath S.J. (2008). Chapter 25. Somatization. In M.D. Feldman, J.F. Christensen (Eds), Behavioral Medicine: A Guide for Clinical Practice, 3e.
4
Generalized anxiety disorder
Conversion disorder
Somatoform pain disorder
Somatisation disorder
Psychiatry
null
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In a child with hyperophied adenoids, the voice abnormality that is seen is
HYPONASALITY (RHINOLALIA CLAUSA) It is lack of nasal resonance for words which are resonated in the nasal cavity, e.g. m, n, ng. It is due to blockage of the nose or nasopharynx. Ref:- Dhingra; pg num:-315
4
Hot potato voice
Staccato voice
Rhinolalia apea
Rhinolalia clausa
ENT
Larynx
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In acute anterior uveitis, the pupil is
Pupillary signs in acute iritis: 1. Narrow pupil: It occurs in an acute attack of iridocyclitis due to irritation of sphincter pupillae by toxins. Iris edema and engorged radial vessels of iris also contribute to making the pupils narrow. 2. Irregular pupil shape: It results from segmental posterior synechiae formation. Dilatation of pupils with atropine at this stage results in a festooned pupil. 3. Ectropion pupillae (eveion of pupillary margin).It may develop due to contraction of fibrinous exudateon the anterior surface of the iris. 4. Pupillary reaction becomes sluggish or may evenbe absent due to edema and hyperemia of iris which hamper its movements. 5. Occlusio pupillae results when the pupil iscompletely occluded due to an organization of the exudates across the entire pupillary area. Ref: Khurana; 4th edition; Pg.No.145
3
Oval
Circular
Small, Irregular
Large, Irregular
Ophthalmology
Uveal tract
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These instruments are used for the surgery of
CHALAZION CLAMP is used to fix the chalazion and achieve haemostasis during the incision and curettage operation CHALAZION SCOOP it is used to scoop out contents of the chalazion during incision and curettage.
2
Ptosis
Chalazion
Ectropion
Entropion
Ophthalmology
Lacrimal Apparatus and Eyelid Disorders
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A mother brought her child which has got a vascular plaque like lesion over the lateral aspect of forehead mainly involving ophthalmic and maxillary division of trigeminal nerve. Mother says that the lesion remains unchanged since bih. Also mother gives a history that the child is on valproate for seizure disorder. The probable diagnosis is
C i.e. Sturge -Weber Syndrome Vascular plaque (capillary malformation) over lateral aspect of forehead mainly involving ophthalmic (VI) and maxillary (V2) division of trigeminal nerve and sezuresQ suggest diagnosis of Sturge-Weber syndrome (encephalo-trigeminal angiomatosis).
3
Tuberous sclerosis
Infantile hemangioma
Sturage weber syndrome
Incontinentia pigment
Skin
null
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Ductopenia seen in
Ans. (b) Alagille syndromeRef: Internet Sources* Alagille syndrome is an autosomal dominant genetic disorder affecting liver and heart commonly.* Bile duct paucity is the common manifestation which results in Cirrhosis and Liver failure
2
Primary biliary cholangitis
Alagille syndrome
Caroli's disease
EHPVO
Surgery
Gall Bladder & Bile Ducts
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single
X–ray detect congenital anorectal malformation at –
An X-ray film of the abdomen is obtained 12-24 hours after birth, with baby being kept in an inverted position.
2
Immediately after birth
24–48 hours
48–72 hours
After 72 hours
Pediatrics
null
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single
Which of the following anti hypertensives act by decreasing heart rate only?
Ans: a (Propranolol) Ref: Katzung, 10th ed, p. 160Beta blockers decrease heart rate, force of contraction and cardiac output, this leads to decrease in blood pressure.Drugs used in hypertension are:1) Diuretics - Low-dose thiazide diuretics are often used as first-line agents, alone or in combination with other antihypertensive drugs e.g., hydrochlorthiazide, chlorthalidone.2) ACE-inhibitors and angiotensin receptor blockers - ACE inhibitors decrease the production of angiotensin n, increase bradykinin levels, and reduce sympathetic nervous system activity. Angiotensin II receptor blockers provide selective blockade of AT1 receptors.3) Beta Blockers - a adrenergic receptor blockers lower blood pressure by decreasing cardiac output, due to a reduction of heart rate and contractility. Other actions include renin inhibition.4) Calcium Channel Blockers - Calcium channel antagonists reduce vascular resistance through L- channel blockade, which reduces intracellular calcium and blunts vasoconstriction.5) Aldosterone Antagonists - It may be a particularly effective agent in patients with low-renin essential hypertension, resistant hypertension, and primary aldosteronism.The newer agent, eplerenone, which is a selective aldosterone antagonist have lesser side effects than spironolactone.6) a adrenergic blockers - They lower blood pressure by decreasing peripheral vascular resistance.7) Sympatholytic Agents - Centrally acting a2 agonists lower blood pressure by inhibiting sympathetic outflow and thereby decreasing peripheral resistance e.g., clonidine.8) Direct vasodilators - These agents decrease peripheral resistance.Hydralazine is a potent direct vasodilator.S/e: lupus-like syndrome.Minoxidil is another vasodilator and is most frequently used in patients with renal insufficiency that is refractory to all other drugs.S/e: hypertrichosis and pericardial effusion.9) Adrenergic neuron-blocking agents-These drugs lower blood pressure by preventing normal physiological release of norepinephrine from postganglionic sympathetic neurons.E.g. Guanethidine, reserpine
1
Propranolol
Methyl dopa
Prazosin
Nitrate
Pharmacology
C.V.S
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True about hepatitis A virus -
Hepatitis A leads to cirrhosis of the liver REF:ANANTHANARAYANAN TEXTBOOK OF MICROBIOLOGY 9EDITION PGNO.541
1
Causes cirrhosis
Helps HDV replication
Common cause of hepatitis in children
Causes chronic hepatitis
Microbiology
Virology
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multi
Which statement regarding glaucoma is true?
Glaucoma is the leading cause of irreversible blindness in the world. When sufficient axinal loss occurs, peripheral vision declines. Loss of central vision occurs much later in the disease process. Retinopathy due to glaucoma is irreversible. Treatment is focused on lowering intraocular pressure. Reduction in intracecular pressure has been demonstrated to protect against fuher damage to the optic nerve. Primary open-angle is by far the most common type of glaucoma in the United States. Closed-angle glaucoma is more common among Asians. The Schijltz tonometer, due to the fact that it is inexpensive, is the most frequently used device to measure intraoccular pressure in the United States. It is used in both hospitals and outpatient clinics. b-Adrenergic antagonists are one of the more commonly used drugs and are initially staed as a topical agent. Unfounately, excess drug drains through the nasolacrimal duct into the nose and is absorbed into the systemic circulation. Therefore systemic side effects can occur and may be severe. It is not unusual for patients to be treated with a bronchodilater drug for new-onset bronchospasms without the physician considering the use of topical b-adrenergic antagonist, used for glaucoma treatment, which may have contributed to the condition.
4
If recognized early, the optic neuropathy of glaucoma is reversible
Topical B-adrenergic antagonists have few if any side effect due to their systemic absorption
The initial symptom oh optic neuropathy due to glaucoma is loss of central vision
None of the above
Surgery
null
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All of the following are features of mumps, except:
d. Incubation period is less than 2 weeks(Ref: Nelsons' 20/e p 1552-1553, Ghai 8/e p 217-218)Mumps virus is a single stranded RNA virus in the family Paramyxoviridae and the genus Rubulavirus.
4
Caused by paramyxovirus
Aseptic meningitis is a complication in children
Orchitis is a complication in adults
Incubation period is less than 2 weeks
Pediatrics
General Considerations - Infectious Diseases
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Biological clock of brain is located in
Ans. is 'c' i.e., Suprachiasmatic nucleus
3
Preoptic nucleus
Lateral nucleus
Suprachiasmatic nucleus
Supraoptic nucleus
Physiology
null
37033126-c04e-452c-a27b-db940e5284c1
single
All of the following form the boundary of MacEwen's triangle except -
Mastoid antrum is marked externally on the surface by suprameatal (Mac Ewen’s) triangle.
3
Temporal line
Posterosuperior segment of bony external auditory canal
Promontory
Tangent drawn to the external auditory meatus
ENT
null
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multi
In Coronary aery disease the cholesterol level (mg/dl) recommended is:
In Coronary Aery Disease (CAD) the cholesterol level (mg/dl) recommended is below 200. Desirable High risk of Hea disease Total cholesterol <200 > 240 HDL > 60 <40 LDL <100 >200 TG <150
1
Below 200
< 220
< 250
< 280
Biochemistry
Lipoproteins
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single