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Which of the following is the side effect of steroids due to its mineralocorticoid component ?
null
2
Skin striae
Hypertension
Osteoporosis
Moon face
Pharmacology
null
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single
The basal body temperature shift after ovulation is due to
Your body temperature dips a bit just before your ovary releases an egg. Then, 24 hours after the egg's release, your temperature rises and stays up for several days. Before ovulation, a woman's BBT averages between36.1degC (97degF) and36.4degC (97.5degF). After ovulation, it rises to36.4degC (97.6degF) to37degC (98.6degF). Ref: guyton and hall textbook of medical physiology 12 edition page number:636,637,638
4
FSH peak
LH peak
Estrodiol
Progesterone
Physiology
Endocrinology
9262dbff-96df-4f6f-94c4-569a580682b3
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Which of the following is NOT to be given in cyclic mastalgia is :
Ans. is d i.e. Estrogen
4
Evening primrosa oil
Danazol
Tamoxifen
Estrogen
Gynaecology & Obstetrics
null
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Ideal investigation for fistula-in-ano is
CLINICAL ASSESSMENT A full medical history and Proctosigmoidoscopy are necessary to gain information about sphincter strength and to exclude associated conditions. Full examination under anesthesia should be repeated before surgical intervention. Diluted hydrogen peroxide, instilled the external opening, is a very useful way of demonstrating the site of the internal opening MRI is the 'gold standard' for fistula imaging Usually reserved for difficult recurrent cases Advantage of MRI: Its ability to demonstrate secondary extensions Fistulography and CT : Useful techniques if an extrasphincteric fistula is suspected. TREATMENT Treatment options: Fistulotomy, Fistulectomy, Setons, Advancement flaps and Glues Laying open is the surest method of eradication, but sphincter division may result in incontinence
2
Endoanal ultrasound
MRI
Fistulography
CT scan
Surgery
GIT
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single
According to Kaban’s protocol rate of distraction osteogenesis to regenerate a new ramus/ condyle unit is?
null
1
1 mm/day
1.5 mm/day
2.0 mm/day
2.5 mm/day
Surgery
null
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single
Stainless steel crowns are contraindicated in:
null
1
Medically compromised patient
After endodontic therapy
Rampant caries
Amelogenesis imperfecta
Dental
null
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multi
Patient come with a midline swelling in the neck measuring 2cms in size On H P E it shows orphan annie eye nuclei Most likely diagnosis
Orphan Annie eyed nuclei are characteristic histopathological feature of PTC ref : bailey and love 27th ed
1
Papillary thyroid ca
medullary thyroid ca
Toxic nodular goitre
Follicular thyroid Ca
Surgery
All India exam
1c9ed576-9c1c-4bdf-9381-9a145b8b0591
single
Which is not a feature of Netherton Syndrome?
Ans. A. Autosomal dominanta. Netherton Syndrome: This autosomal recessive disorder is characterized by ichthyosis (usually ichthyosis linearis circumflexa but occasionally the lamellar or congenital ichthyosiform erythroderma types), trichorrhexis invaginata and other hair shaft anomalies, and atopic diathesis.b. Mutations in the gene SPINK 5, which encodes a serine protease inhibitor, have been identified in patients with Netherton syndrome.c. The ichthyosis is present in the 1st 10 days of life and may be especially marked around the eyes, mouth, and perineal area. The erythroderma is often intensified after infection.d. Infants may suffer from failure to thrive, recurrent bacterial and candidal infections, elevated serum IgE levels, and marked hypernatremic dehydration.e. The most frequent allergic manifestations are urticaria, angioedema, atopic dermatitis, and asthma. Scalp hair is sparse and short and fractures easily eyebrows, eyelashes, and body hair are also abnormal.f. The characteristic hair abnormality can be identified with light microscopy. In the new born, it may best be identified in eye brow hair.
1
Autosomal dominant
Ichthyosis
Very short hair
Erythroderma
Skin
Autoimmune Skin Disorders
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single
Terminal stage of pneumonia is ?
Ans. is 'd' i.e., Resolution
4
Congestion
Red hepatization
Gray hepatization
Resolution
Pathology
null
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T.T.K.G >8 is seen in all except:
Transtubular potassium gradient > 8 is associated with hyperkalemia. Choices 1, 2, 3 lead to hyperkalemia. Choices 1 and 2 lead to kidney damage. Choice 3 due to aldosterone deficiency leads to potassium excess due to inability to loose potassium the collecting duct. Cushing syndrome has excess of coisol, which stimulates the mineralocoicoid receptors to cause hypokalemic metabolic alkalosis.
4
Diabetes mellitus
Acute glomerulonephritis
Adrenocoical insufficiency
Cushing syndrome
Medicine
Fluids and Electrolyte Imbalance
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The type of study used in the 10 year Fluoride tablets study can be also be described as a (an)
null
4
Case control study
Cross section study
Count study
Experimental study
Dental
null
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single
Endophenotypic markers of schizophrenia include all except?
Endophenotypic markers of schizophrenia include: Oculomotor abnormalities Smooth pursuit eye movement alterations Saccadic eye movement disinhibition Prepulse inhibition(PPI) of stale response paradigms Deficits in sensorimotor gating, measured with electroencephalography-based event-related potential (ERP): standardauditory"paired stimuli" paradigm, so called "P50" response amplitude.
4
Smooth pursuit eye movement alterations
Saccadic eye movement disinhibition
Prepulse inhibition of stale response paradigm
P50 visual evoked potential
Psychiatry
Basics of Psychiatry
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Retraction of scapula is by:
Ans. B. Middle fibres of trapeziusThe trapezius is a large paired surface muscle that extends longitudinally from the occipital bone to the lower thoracic vertebrae of the spine and laterally to the spine of the scapula.The trapezius has three functional parts: The upper fibers elevate the scapulae, the middle fibers retract the scapulae, and the lower fibers depress the scapulae.
2
Upper fibres of trapezius
Middle fibres of trapezius
Lower fibres of trapezius
Upper & lower fibres of trapezius
Anatomy
Upper Extremity
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All of the following are the clinical feature of thromboangitis obliterence, EXCEPT:
Clinical features of Thromboangiitis obliterans includes a triad of claudication of the affected extremity, Raynaud's phenomenon, and migratory superficial vein thrombophlebitis. The physical examination shows normal brachial and popliteal pulses, but reduced or absent radial, ulnar, and/or tibial pulses. Claudication usually is confined to the calves and feet or the forearms and hands as it primarily affects distal vessels. In the presence of severe digital ischemia, trophic nail changes, painful ulcerations, and gangrene develop at the tips of the fingers or toes. Ref: Schwaz's Principles of Surgery, 9th Edition, Chapter 23; Harrison's Internal Medicine, 18th Edition, Chapter 249
3
Raynaud's phenomenon
Claudication of extremeties
Absence of popliteal pulse
Migratory superficial thrombophlabitis
Surgery
null
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This serum immunoglobulin constitutes 80% of immunoglobulins in our body is
80% of immunoglobulins in our body is IgG -major ig Half-life is 23 days Transpoed through placenta Ref: Text book of Microbiology Baveja 5th ed Pg 99
3
IgM
IgA
IgG
IgD
Microbiology
Immunology
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Which is the largest pathogenic bacillus ?
Ans: D (Bacillius anthracis) Ref: Ananthnarayan R. Paniker CKJ. Textbook of Microbiology. 8th Edition. Hyderabad: Universities Press; 2009. Pg. 242Explanation:Bacillus anthracisConsiderable historical interest is attached to the anthrax bacillus.First pathogenic bacterium to be observed under the microscopeFirst communicable disease shown to be transmitted by inoculation of infected bloodFirst bacillus to be isolated in pure culture and shown to possess sporesFirst bacterium used for the preparation of an attenuated vaccineThe anthrax bacillus is the largest of pathogenic bacteria, measuring 3-10 mm x 1-1.6 mm.Characteristics of Bacillus anthracisBamboo stick appearancePolypeptide capsule - M'Fadyeans reaction {stain with Polychrome Methylene blue)Edge of colony under dissecting Microscope shows Medusa Head appearance"Nutrient agar -Frosted glass appearanceBlood Agar - No or Minimal HemolysisSelective Medium - PLETmedium (Polymyxin, Lysozyme, EDTA, thallous acetate)Gelatin Stab Culture - Inverted Fir Tree appearance"String of Pearls" - media with .05 - .5 U PenG/ ml
4
Bacillus cereus
Bacillus subtilis
Bacillus megaterium
Bacillius anthracis
Microbiology
Bacillus
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Adenoidectomy with Grommet insertion is treatment of choice for:
Ans. (b) Serous otitis media in childrenRef: Dhingra 5th edp. 71-72* Serous otitis media is also known as Glue ear.* It is an insidious condition characterized by accumulation of non-purulent effusion in the middle ear cleft.* One of common causes of serous otitis media (Glue ear) in children is blockage of Eustachian tube secondary to adenoid hyperplasia.* Therefore, the treatment aims at removal of adenoid (adenoidectomy) and drainage of middle ear by grommet.# Grommet is a small tube inserted in tympanic membrane to drain the middle ear.* Serous otitis media in adults should arouse suspicion of nasopharyngeal carcinoma and hence the treatment aims at removal of carcinoma* Adenoiditis is an acute condition and requires treatment conservatively.
2
Serous otitis media in adults
Serous otitis media in children
Adenoiditis in children
Otitis interna in children
ENT
Disorders of Middle Ear (Otitis Media)
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Sodium fluoride inhibits which enzyme in Glycolysis
Inhibitors Enzyme Inhibited Iodoacetate Glyceraldehyde 3 phosphate dehydrogenase Arsenate 1,3 BPG Kinase Sodium fluoride Enolase.
4
Hexokinase
Pyruvate Kinase
Aconitase
Enolase
Biochemistry
null
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A Toddler has few drops of blood coming out of rectum. Probable diagnosis is
Ans is 'a' i.e. Juvenile Rectal Polyp "The aetiology and management of rectal bleeding depends on the age of the child, the type and quantity of bleeding and the associated symptoms. Unlike adults, malignancy is exceptionally rare. In infants, an anal fissure, necrotizing enterocolitis, intussusception and allergic enterocolitis are possible causes. In older children, more common causes include an anal fissure, a juvenile polyp and certain gastroenteritides (e.g. Campylobacter infection); Meckel's diverticulum, duplication cyst and inflammatory bowel disease are less common. Bailey and LoveJuvenile polyps are the most common type of childhood polyp, occurring in up to 1% of preschool children. They are usually solitary polyps found in the rectum which most commonly present with rectal bleeding.These are hamartomatous polyps, which are usually pedunculated but can be sessile. "The typical child with a juvenile polyp is 4 to 6 years of age, presents with intermittent painless rectal bleeding with bowel movements. Rudolph's PediatricsJuvenile polyps are usually are not premalignant.Because the gross appearance of these polyps is identical to adenomatous polyps, these lesions should also be treated by polypectomy.Juvenile polyposis is a term used when more than 5 to 10 juvenile polyps develop.Juvenile polyposis coli applies if the polyps are limited to the colon, whereas generalized juvenile polyposis describes the presence of polyps throughout the GI tract. Both have a significant malignant potential.Other mentioned options are rare in children.Familial Adenomatous Polyposis (FAP) patients present in Td to 3rd decade.Rectal ulcer (solitary rectal ulcer) is commonly seen in 20 to 40 yrs age group.Piles are rare in children. (Ref: Rudolph's Pediatrics, 21/e Chapter 17.22)
1
Juvenile Rectal Polyp
Adenoid Polyposis Coli
Rectal Ulcer
Piles
Surgery
Colon and Rectum - Polyps and Carcinoma
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Inferior thyroid aery arises from :
B i.e. Thyrocervical Trunk of 1't pa of subclan aery
2
1st pa of subclan aery
Thyrocervical trunk of 1st pa of subclan aery
3rd pa of subclan aery
Int. carotid aery
Anatomy
null
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single
Most common site a spontaneous rupture of esophagus is
MC site: left posterolateral side of the distal esophagus
2
Cricopharyngeal junction
Cardioesophageal junction
Mid esophagus
After the crossing of arch of aoa
Physiology
All India exam
8901a6b2-204d-441e-87cb-2ff0d2a1e7bc
single
A child is born with a single functional copy of a TSG. At the age of 5, the remaining normal allele is lost through mutation. As a result, the ability to control transition from G1 to S phase of cell cycle is lost. Which neoplasm is mot likely to arise in this child?
.
1
Retinoblastoma
Breast carcinoma
Adenocarcinoma colon
Cerebral astrocytoma
Pathology
General pathology
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The end product of one stage fermentation is ?
D i.e. EthanolAerobic glycolysis in cells with mitochondria & adequate oxygen supply PyruvateQ is the end product and NADH enters oxidative phosphorylation for ATP productionAnaerobic glycolysis in cells that lack mitochondria (eg RBCs) or deprived of sufficient 0, LactateQ is the end product as NADH formed in glycolysis is reoxidized by reducing pyruvate to lactate.Fermentation in yeast & some other microorganismsEthanolQ is the end product as pyruvate is decarboxylated & reduced into it
4
Formic acid
Pyruvate
Lactate
Ethanol
Biochemistry
null
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Name the incision
This is Chevron incision or roof-top incision or bilateral subcostal incision. Used in PancreaticoduodenectomyKochers is right subcostal incision, for open cholecystectomyLanz incision used in appendicitisMaylard for pelvic surgeries, rectus muscle is cut in this
2
Kochers incision
Chevron incision
Lanz incision
Maylard incision
Surgery
All India exam
1899062c-4a5e-4ee8-beab-4f79d4d80065
single
All of the following take pa in the pathogenesis of CME in diabetic retinopathy except:
A i.e., Retinal pigment epithelial (RPE) dysfunction
1
Retinal Pigment Epithelial (RPE) dysfunction
Oxidative stress
VEGF
Increased protein kinase c
Ophthalmology
null
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Which of the following organism can cause acalculous cholecystitis?
Precipitating factors for acalculous cholecystitis are vasculitis, obstructing adenocarcinoma of the gallbladder, diabetes mellitus, torsion of the gallbladder, "unusual" bacterial infections of the gallbladder (e.g., Leptospira, Streptococcus, Salmonella, or Vibrio cholerae). Reference: Harrisons Principles of Internal Medicine, 18th Edition, Page 2621
1
Leptospirosis
Malaria
Staphylococcus
Nocardiosis
Medicine
null
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Increased density in skull vault is seen in -a) Hyperparathyroidismb) Multiple myelomac) Fluorosisd) Renal osteodystrophy
All the causes of generalized increased in bone density can cause increased density of skull vault — Practical imaging 2nd /e 73 Fluorosis and secondary hyperparathyroidism (renal osteodystrophy) cause increased density of skull vault.
1
acd
ad
bc
bde
Orthopaedics
null
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American society of anesthesiologists' physical status classification system, P2 is a is a patient who
null
2
Is healthy
With mild systemic disease
With severe systemic disease
None of the above
Pharmacology
null
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multi
Which one of the following is a rare complication of the use of hormonal contraceptives -
Adverse affects of combined Oral contraceptive pills (OCP'S) 1. Cardiovascular effects (Due to oestrogenic component) Myocardial infarction Cerebral thrombosis Venous thrombosis (with or without pulmonary embolism) Hypeension 2. Carcinogenesis Cervical cancer (increased risk). Breast cancer. 3. Metabolic effects (Due to progesterone component) Elevated blood pressure (hypeension) Altered lipid profile (reduced HDL) Blood clotting Hyperglycemia and increased plasma insulin. 3. Hepatocellular adenoma. 4. Gallbladder disease 5. Cholestatic jaundice 6. Monolial vaginitis (candidiasis) 7.Decline milk volume during lactation 8. Slight delay in return of feility (upon discontinuity) 9. Depression 10. Fetal bih defects. 11. General effects Breast tenderness Weight gain (due to water retention) Headache and migraine Bleeding disturbances Ref: Park 25th edition Pgno : 535-536
1
Contraceptive failure
Cardiovascular effects
Carcinogenesis
Metabolic effects
Social & Preventive Medicine
Non communicable diseases
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Number of Golgi tendon organs per 100 extrafusal muscle fibres
About 1 golgi tendon organ is responsible for 10 to 20 extrafusal fibers Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:689
1
20-Oct
200-400
50-60
80-100
Physiology
General physiology
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single
Remote after Loading is done is?
Remote afterloading is done in Brachytherapy in which the system automatically administer a radioisotope directly to cancerous tissue, thereby minimizing the radiation dose to surrounding tissue and eliminating the radiation exposure to hospital staff. In brachytherapy, a radioisotope is placed onto or inside the patient. The source of radiation is put inside a sealed capsule ,which prevents it from moving or dissolving in body fluids but allows the emission of ionising radiation to the surrounding tissues.
4
Stereotactic Radiotherapy
Proton Beam Radiotherapy
External Beam Radiotherapy
Brachytherapy
Radiology
NEET Jan 2020
1da9fb1b-78e7-4da5-b282-5ec9b05e2cd9
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Which of the following anticoagulant is safest in pregnancy?
Oral anticoagulants like warfarin, phenindione and dicumarol can cross placenta and produce teratogenicity if used during pregnancy. Heparin does not cross placenta and is safe in pregnancy.
2
Warfarin
Heparin
Phenindione
Dicumarol
Pharmacology
Hematology
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Specific stain for myeloblasts is ?
Ans. is 'c' i.e., MyeloperoxidaseMyeloperoxidase stainDistinguishes between the immature cells in acute myeloblastic leukemia (cells stain positive) and those in acute lymphoblastic leukemia (cells stain negative).Sudan black B stainThis stain distinguishes between acute lymphoblastic leukemia (cells stain positive) and acute myeloblastic leukemia (cells stain negative).Periodic acid-Schiff stain (PAS) Is primarily used to identify erythroleukemia, a leukemia of immature red blood cells.Terminal deoxynucleotidyl transferase stain (TdT) Differentiates between acute lymphoblastic leukemia (cells stain positive) and acute myelogenous leukemia (cells stain negative).Leukocyte alkaline phosphatase (LAP)Is used to determine if an increase of cells is due to chronic myelogenous leukemia or a noncancerous reaction to an infection or similar conditions. Cells from a noncancerous reaction stain positive with many intense blue granules; cells from chronic myelogenous leukemia have few blue granules.Tarate-resistant acid phosphatase stain (TRAP)Is primarily used to identify hairy cell leukemia cells.Leukocyte specific esteraseThis stain identifies granulocytes, which show red granules.
3
Sudan black
PAS
Myeloperoxidase
LAP
Pathology
null
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Interventional study is used for:-
CLASSIFICATION OF EPIDEMIOLOGICAL STUDIES: 1. OBSERVATIONAL STUDIES: - Descriptive studies - Hypothesis formation is done - Analytical studies - Hypothesis testing is done by coho study/ case-control / cross-sectional/ Ecological studies. 2. EXPERIMENTAL/ INTERVENTIONAL STUDIES: - Hypothesis confirmation is done - Done by clinical trials/ RCT's / Field trials/ Community trials.
3
Hypothesis Formulation
Hypothesis Testing
Hypothesis Confirmation
Hypothesis Manipulation
Social & Preventive Medicine
Classification, Coho Study
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Tuohy's needle is used for:
This is tuohy needle used for epidural anaesthesia
2
Spinal block
Epidural block
Saddle block
Brachial plexus block
Anaesthesia
Regional Anesthesia
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Treatment for childhood hypothyroidism is with –
null
3
T4
T3
Levothyroxine
TSH
Pediatrics
null
54f20189-6a10-40ca-8ab9-cdbc6bd29979
single
A person presented with a tumour at the base of the tongue. What will be the treatment of choice
TONGUE CANCER Management of the neck in early stage oral cavity cancer, including the oral tongue, has been discussed above; however, consideration for elective management of the node-negative neck should be made in all instances. When performing surgical excision of the primary tumour, a 1 cm margin in all planes should be attempted in seeking a complete excision with pathologically clear (>5mm) margins. Resection resulting in paial or hemiglossectomy can be performed with either a cutting diathermy or laser if available. Advanced tumours (T3 and T4) often encroach upon the floor of the mouth and, occasionally, the mandible. In these circumstances a resection of the tongue and floor of the mouth and mandible is required. T4 tumours of the oral tongue may cross the midline, for which (sub)total glossectomy is the only option to achieve adequate tumour clearance. Decisions regarding elective neck dissections on the contralateral side will be dictated by radiological and clinical findings, in paicular proximity of the tumour to the midline. Ref: Bailey and love 27th edition Pgno : 769
3
Wide local excision
Wide local excision + Radiotherapy
Wide local excision + Cervical lymph node dissection
Hemiglossectomy
Surgery
Head and neck
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True about hepatitis A include -a) Virus is destroyed by boiling for 5 minutesb) Spreads by faco-oral routec) Predisposes to cirrhosisd) IgG anti-HIV antibodies used for diagnosis
null
1
ab
a
ad
bc
Medicine
null
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multi
A Warthin's tumour is:
Ans. is 'a' i.e. An adenolymphoma of parotid gland Warthin's tumourIt is also called papillary cystadenoma lymphomatosum because, histologically it consists of papillary cystic pattern with marked lymphoid component.Other important characteristics of Warthin's tumour.2nd most common* benign tumour of parotid gland (Ist is pleomorphic adenoma)*They are usually cysticTypically occur in 6th and 7th decades*More common in males*B/L in about 10%*Histological feature : -Consists of papillary cystic pattern with marked lymphoid component.Unlike all other neoplasms which form a 'cold' spot the adenolymphoma produces a 'hot spot' in a 99mTc - pertechnetate scan*, so that a firm preoperative diagnosis is possible without biopsy.
1
An adenolymphoma of parotid gland
A pleomorphic adenoma of the parotid
A carcinoma of the parotid.
A carcinoma of submandibular salivary gland
Surgery
Salivary Gland Neoplasms
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Causative organism for botryomycosis?
S.aureus is the most common agent for botryomycosis. It is a mycetoma-like condition.
1
S.aureus
S.pyogenes
Clostridium
Bacillus Cereus
Microbiology
null
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Scaphoid fracture is most common in -
Ans. is 'b' i.e., Waist * Most common site of scaphoid fracture is the waist of the scaphoid (70%).* Other sites of fracture are proximal pole (20%), distal body (10%), tuberosity, osteochondral fracture.
2
Proximal pole
Waist
Distal pole
Tuberosity
Orthopaedics
Hand Injuries
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Thiopentone in contraindicated in all except -
Thiopentone is an barbiturate and being barbiturate it is enzyme inducers thus can precipitate porphyria But depending on enzyme affected it has been found to be safe in Porphyria cuneata tarda and absolutely contraindicated in Acute intermittent Porphyria. fuher being cardiovascular unstable it is contraindicated in shock. it is bronchoconstrictor so contraindicated in asthmatic patients .
1
Porphyria cuneata tarda
Staticus asthamaticus
Shock
Acute intermittent porphyria
Anaesthesia
Intravenous Anesthetic Agents
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BP tracking means?
Park's textbook of preventive and social medicine 23rd edition. IF blood pressure levels of individuals were followed up over a period of years from early childhood into adult life, then those individuals whose pressure were initially high in the distribution would probably will continue in the same tract as adults. Low blood pressure levels tend to remain low and high level tend to become higher as individuals grow older.this phenomenon of persistence of rank order of blood pressure has been described as tracking..
3
High BP of a child tends to rack along the life
Adults who have high BP today definitely had high BP as child
Daily measurement of BP and recording it to keep a track
BP should be monitored by a BP tracker
Social & Preventive Medicine
Non communicable diseases
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single
In which of the following conditions oxygen delivery is least to muscles?
In person suffering from carbon monoxide poisoning , perfusion to the muscle is least Ref: guyton and hall textbook of medical physiology 12 edition page number:353,354,355
3
Person inhaling 100 percent oxygen at the top of mout everest
Marathon runner at sea level
Person with carbon monoxide poisoning
None of the above (this option none of the above was also there)
Physiology
Respiratory system
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multi
Sphingomyelinase deficiency is characteristic of?
Ans. D. Niemann Pick diseaseSphingomyelinase deficiency is seen in Niemann Pick disease. The enzymes deficient in the other disease are:a. Fabry disease - alpha galactosidaseb. Krabbe's disease - beta galactosidasec. Tay Sachs disease - Hexosaminidase A
4
Fabry's disease
Krabbe's disease
Tay Sachs disease
Niemann Pick disease
Biochemistry
Lipids
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CSF pressure (lumbar) -
A i.e. 70-180 mm CSF
1
70 -180 mm CSF
70 -180 mm CSF
> 200 mm CSF
150 - 200 mm CSF100. The most impoant
Physiology
null
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single
True regarding haemangioma of the spleen: March 2005
Ans. B: May transforms into a haemangiosarcoma Haemangioma of the spleen is the most common benign tumour of the spleen and may develop into a haemangiosarcoma
2
Least common benign tumour of the spleen
May transforms into a haemangiosarcoma
Malignant transformation may be managed conservatively
None of the above
Surgery
null
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multi
Morphine can be used in all the following conditions except:
Ref: KDT 6/e p457 Head injury is an absolute contra- indication to morphine use. Hypothyroidism and asthma are relative contra indication.
1
Head injury
Asthma
Hypothyroidism
Diabetes
Pharmacology
Central Nervous system
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multi
Under the RNTCP, for diagnosis of MDR TB, currently drug sensitivity testing is done for:
Presently conventional solid egg-based Lowenstein-Jensen (LJ) media will be used for primary culture at the RNTCP accredited laboratory. DST will be performed for streptomycin (S), isoniazid (H), rifampicin (R) and ethambutol (E) only. Pyrazinamide (Z) sensitivity testing may be included at a later period of DOTS-Plus implementation. Ref:
3
Rifampicin
Rifampicin, Isoniazide
Rifampicin, Isoniazide and Ethambutol
Rifampicin, Isoniazide and Pyrazinamide
Social & Preventive Medicine
null
425d33bf-ca74-4bd8-9e9e-f1c6267549cb
single
Cataract is cases of diabetes mellitus is due to accumulation of -
In diabetic cataract the mechanisms are belived to be glycation, carbamylation of crystallins and increased oxidative damage. IMG REF
1
Glycated crytallins
Calcified crystallins
Glycated fibrillins
Calcified fibrillins
Ophthalmology
Lens
7d2ac68d-105a-45e7-a464-4478fb13a674
multi
A pragnant woman is diagnosed to suffering form Grave's disease. The most appropriate therapy for her would be-
The antithyroid drugs like carbimazole, methimazole crosses the placenta (transplacental passage) and produce fetal hypothyroidism and goiter if the maternal dose is excessive. However, oral propylthiouracil would be the most appropriate therapy in early gestation at low doses as its greater protein binding allows less transfer to the foetus. Carbimazole and methimazole are also associated with rare cases of fetal aplasia cutis and other defects, such as choanal atresia. Thyroidectomy and Radioactive Iodine I131 are contraindicated during pregnancy. Reference : page 254 Essentials of Medical Pharmacology K D Tripathi 7th edition and page 2297 Harrison's Principles of Internal Medicine 19th edition
4
Radio lodine therapy
Total thyroidectomy
Carbimazole parenteral
Propylthiouracil oral
Medicine
Endocrinology
79bf3342-8882-492a-bc66-ae39a939a433
single
Yergason's supination sign is seen in lesion of which muscle?
Bicipital tendinitis, or tenosynovitis, is produced by friction on the tendon of the long head of the biceps as it passes through the bicipital groove. When the inflammation is acute, patients experience anterior shoulder pain that radiates down the biceps into the forearm. Abduction and external rotation of the arm are painful and limited. The bicipital groove is very tender to palpation. Pain may be elicited along the course of the tendon by resisting supination of the forearm with the elbow at 90deg (Yergason's supination sign).
2
Triceps
Biceps
Brachioradialis
Supinator
Physiology
All India exam
47f3fb15-2f59-430a-bd71-7bed257e6704
single
Loading of dose of a drug primarily depends on:
Ans. A. Volume of distributionLoading dose is dependent on volume of distribution; whereas maintenance dose depends on the clearance.Loading doseMaintenance dose* It is the initial high dose which is given to achieve the desired plasma concentration after saturating (loading) the tissue binding sites.* Just enough drug is given in each dose to replace the drug eliminated* When time to reach steady state is long, as it is for drugs with long half-lives, it is desirable to give a loading dose that promptly raises the concentration of drug in plasma * LD=Vdx Desired plasma concentration (mg/L)* MD = Clearance x Desired plasma concentration (mg/L)
1
Volume of distribution
Clearance
Rate of administration
Half life
Pharmacology
General Pharmacology
31c5a882-a958-4038-b78c-1f94b6df77b0
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Which of the following is also known as the labourer's nerve?
Median nerve- Labourer’s nerve- involved in coarse movements of hands. Ulnar nerve- Musician nerve- involved in fine movements of hands.
2
Ulnar nerve
Median nerve
Anterior interosseous nerve
Radial nerve
Anatomy
null
63e85531-f91f-4ed0-b739-5e878321d253
single
Which of the ATT drugs is not hepatotoxic?
Ans. is 'd' i.e., Streptomycin Important educational points* First line antitubercular drugs causing hyperuricemia - Ethambutol, pyrazinamide.* Drugs causing peripheral neuropathy - streptomycin, INH, Ethambutol, ethionamide.* Drugs causing hepatitis - INH, rifampicin, pyrazinamide, ethionamide.* Optic neuritis - INH, ethambutol, ethionamide.* First line antitubercular drugs which are not hepatotoxic (does not require dose adjustment in liver diseases) - streptomycin, ethambutol.* Drugs not requries dose adjustment in renal failure - rifampicin, rifabutin rifapentine.* Hypothyroidism can be caused by - PAS, ethionamide.* Ethambutol and streptomycin do not cross BBB.* Active against extracellular mycobacteria: Rifampicin (Tuberculocidal), INH (tuberculocidal), streptomycin (tuberculocidal)* Active against intercellular mycobacteria: Rifampicin (Tuberculocidal), INH (tuberculocidal), Pyrazinamide (tuberculocidal)
4
Pyrazinamide
INH
Rifampicin
Streptomycin
Pharmacology
Anti Microbial
259c605a-663c-4c41-8dde-018000ee378a
single
Free fatty acids in blood are carried by?
Free fatty acids (FFAs)/ Nonesterified (NEFA) fatty acid : Not esterified with fatty acids. Long-chain free fatty acids Transpoed by albumin. Hydrophobic clefts in the albumin binds to albumin. Sho chain fatty acids (butyrate ) More water-soluble Exist as the unionized acid/ fatty acid anion.
3
VLDL
LDL
Albumin
Chylomicron
Biochemistry
Lipoproteins
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single
What is the function of single strand binding proteins (SSBs) during DNA replication
Option a: Topoisomerases Option b: DNA polymerases Option d: DNA ligase.
3
Relieves torsional strain
Deoxynucleotide polymerisation
Prevents premature reannealing of strands
Seals the nick between okazaki fragments
Biochemistry
null
fa88ca49-a519-47af-8515-5b2f8a38b2ce
single
In normal X-ray of shoulder which is superior most structure -
Ans. is 'c' i.e., Coracoid processo From superior to inferior (important structure on X-ray sholder) Clavicle : Acromian : Coracoid : Superior margin of humeral head : greater tuberc le : anatomical neck : surgical neck.
3
Greater tubercle
Surgical neck of humerus
Coracoid process
Head of humerus
Radiology
Skeletal System
2c159cd3-5ea1-4b01-b59f-15ac68ab4283
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What is the recommended dose of steroids for attaining fetal lung maturity?
b. Inj Betamethasone 12mg for 2 doses 24 hours apart(Ref: Nelson's 20/e p 852)Inj Betamethasone 12mg IM 2 doses, 24 hrs apart or Inj Dexamethasone 6mg IM every 12 hrs for 4 doses can be used
2
Inj Betamethasone 12 mg for 2 doses 12 hours apart
Inj Betamethasone 12 mg for 2 doses 24 hours apart
Inj Dexamethasone 6 mg for 4 doses 24 hours apart
Inj Dexamethasone 12 mg for 2 doses 12 hours apart
Pediatrics
Miscellaneous
afd6fdc7-8af7-4451-86cf-01ce18591c5c
single
A patient with history of hypertension, with current blood pressure of 170/120 came to your clinic fur or prophylaxis procedures what will be your next step
null
2
Wait, monitor and start treatment
Refer to physician
Oral prophylaxis can be done with IV drugs
Oral prophylaxis procedure can be done directly
Dental
null
c24612dd-9fc9-4346-8912-a67a3dc1c9a8
multi
A male patient suffering from headache, profuse sweating, palpitations and BP.160/110. The drug which will be useful is?
Ans- D Phenoxybenzamine Ref - Practice Essentials A pheochromocytoma (see the image below) is a rare, catecholamine-secreting tumor that may precipitate life-threatening hypertension. The tumor is malignant in 10% of cases but may be cured completely by surgical removal. Although pheochromocytoma has classically been associated with 3 syndromes--von Hippel-Lindau (VHL) syndrome, multiple endocrine neoplasia type 2 (MEN 2), and neurofibromatosis type 1 (NF1)--there are now 10 genes that have been identified as sites of mutations leading to pheochromocytoma. Axial, T2-weighted magnetic resonance imaging (MRI) scan showing large left suprarenal mass of high signal intensity on a T2-weighted image. The mass is a pheochromocytoma. View Media Gallery Signs and symptoms Classically, pheochromocytoma manifests as spells with the following 4 characteristics: Headaches Palpitations Diaphoresis Severe hypertension Typical patterns of the spells are as follows: Frequency may vary from monthly to several times per day Duration may vary from seconds to hours Over time, spells tend to occur more frequently and become more severe as the tumor grows The following may also occur during spells: Tremor Nausea Weakness Anxiety, sense of doom Epigastric pain Flank pain Constipation Clinical signs associated with pheochromocytomas include the following: Hypertension: Paroxysmal in 50% of cases Postural hypotension: From volume contraction Hypertensive retinopathy Weight loss Pallor Fever Tremor Neurofibromas Tachyarrhythmias Pulmonary edema Cardiomyopathy Ileus Cafe au lait spots See Clinical Presentation for more detail. Diagnosis Diagnostic tests for pheochromocytoma include the following: Plasma metanephrine testing: 96% sensitivity, 85% specificity 24-hour urinary collection for catecholamines and metanephrines: 87.5% sensitivity, 99.7% specificity Test selection criteria include the following: Use plasma metanephrine testing in patients at high risk (ie, those with predisposing genetic syndromes or a family or personal history of pheochromocytoma) Use 24-hour urinary collection for catecholamines and metanephrines in patients at lower risk Imaging studies should be performed only after biochemical studies have confirmed the diagnosis of pheochromocytoma. Studies are as follows: Abdominal CT scanning: Has accuracy of 85-95% for detecting adrenal masses with a spatial resolution of 1 cm or greater MRI: Preferred over CT scanning in children and pregnant or lactating women; has reported sensitivity of up to 100% in detecting adrenal pheochromocytomas Scintigraphy: Reserved for biochemically confirmed cases in which CT scanning or MRI does not show a tumor PET scanning: A promising technique for detection and localization of pheochromocytomas Additional studies to rule out a familial syndrome in patients with confirmed pheochromocytoma include the following: Serum intact parathyroid hormone level and a simultaneous serum calcium level to rule out primary hyperparathyroidism (which occurs in MEN 2A) Screening for mutations in the ret proto-oncogene (which give rise to MEN 2A and 2B) Genetic testing for mutations causing the MEN 2A and 2B syndromes Consultation with an ophthalmologist to rule out retinal angiomas (VHL disease) See Workup for more detail. Management Surgical resection of the tumor is the treatment of choice and usually cures the hypertension. Careful preoperative treatment with alpha and beta blockers is required to control blood pressure and prevent intraoperative hypertensive crises. Preoperative medical stabilization is provided as follows: Start alpha blockade with phenoxybenzamine 7-10 days preoperatively Provide volume expansion with isotonic sodium chloride solution Encourage liberal salt intake Initiate a beta blocker only after adequate alpha blockade, to avoid precipitating a hypertensive crisis from unopposed alpha stimulation Administer the last doses of oral alpha and beta blockers on the morning of surgery See Treatment and Medication for more detail.
4
Nifedipine
Labetalol
Prazosin
Phenoxybenzamine
Unknown
null
5979ed88-277b-4d94-bc02-29ed39557c60
single
Which of the following antibodies is positive in Primary Biliary cholangitis (PBC)
Anti mitochondrial antibodies are a signature autoantibody of PBC and are detected in sera of  95% patients.
2
Anti - nuclear antibody
Anti - mitochondrial antibody
Anti - smooth muscle antibodies
CANCA and PANCA
Pathology
null
0715c60c-eafc-44e1-8fac-5f4ce8b0b109
single
Which type of sample can be used to isolate polio virus earliest
null
1
Stool
Blood
Throat
CSF
Social & Preventive Medicine
null
569fbe97-f087-4800-b056-ec17b69b4875
single
Tretment of pernicious anemia patient with folic acid will improve all except
B 12 resevers will be used up for rbc maturation leaving less of neuronal fuction leading to nerve lesions
1
Nervous lesions
Blood picture
Changes in gut
General symptoms
Anatomy
General anatomy
64fda30d-3390-4020-8267-17eb20bffb41
multi
Standing increases murmur intensity in
The classic ECG finding in hyperophic obstructive cardiomyopathy is large dagger-like "septal Q waves" in the lateral -- and sometimes inferior -- leads due to the abnormally hyperophied interventricular septum.. Wolff-Parkinson-White, or WPW, syndrome can be associated with HOCM The murmur that is pathognomonic for HCM is a crescendo-decrescendo holosystolic murmur best heard at the left sternal boarder. The murmur classically increases with standing and valsalva, while it decreases with squatting, hand-grip, and passive leg lift . Ref Davidson edition23rd pg 463
3
Aoic stenosis
Aoic regurgitation
Hyperophic obstructive cardiomyopathy
Mitral stenosis
Medicine
C.V.S
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single
All are diagnostic criteria for irritable bowel syndrome except:
The diagnostic criteria for irritable bowel syndrome is - Recurrent abdominal pain or discomfo for at least 3 days per month associated with > 2 or more of the following features - Pain improvement with defecation Onset with change in form / appearance of stool Onset with change in frequency of stool Nocturnal diarrhea or pain is not a feature of irritable bowel syndrome and is seen with Diabetic neuropathy. Bleeding is also not a feature. ROME CRITERIA FOR DIAGNOSIS OF IBS
2
Pain improves with defection
Nocturnal episodes of colicky pain
Onset associated with change in frequency of stool
Onset associated with change in appearance / form of stool
Medicine
Malabsorbtion Syndrome
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multi
True about Splenunculi:
Ans. (a) It is encapsulatedRef: Bailey and love, 27th ed; pg. 1178* Splenunculi or Accessory spleen is the most common of all splenic anomalies accounting for 10-30% of population* Formed due to incomplete fusion of embryologic splenic tissue during 5th week leading to the formation of accessory spleen, which is more common or always on the left side of abdomen.* It is encapsulated just like the normal spleen and contains normal splenic tissue and are more commonly identified during radiological investigations and intraoperatively for other conditions* They are mostly multiple, located in the hilum of spleen (50%), tail of pancreas (30%)* They are more prone for torsion and needs emergency resection in such cases.
1
It is encapsulated
MC site is tail of pancreas
Often single
Have more red pulp than spleen
Surgery
Spleen
a35c9baf-e914-4c7e-8096-d0ed4fa3e4c6
multi
who gave the concept of saftey needs in the heirachy of motivation
ABRAHAM MASLOW Gave the hierarchy of needs It is also called as hierarchy of motivation According to Maslow the basic needs should be met to move on to the next stage Once the basic step is attained, we work on to the higher stage The final stage is self-actualization, that is acceptance of your positives, negatives, sho comings, doing things that you are good at and working with satisfaction. Ref, kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 485
4
lorenz
seligman
freud
maslow
Anatomy
Treatment in psychiatry
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single
"Snowflakes" cataract is seen
A. (Diabetes) (181 - Khurana 4th)True Diabetic Cataract - It is also called "snow- flake cataract" or "snow storm cataract". It is rare condition usually occurring in young adults due to osmotic overhydration of the lens. Initially a large number of fluid vaccoules appears underneath the anterior and posterior capsules. Which is soon following by appearance of bilateral "snow - flake white opacities in the cortex* Clasical diabetic cataract consists of snow flake cortical opacities occurring in young diabetics (166 - K)* Galectosaemic cataract - bilateral cataracts oil droplet central lens opacities*** Wilson's disease - "Sunflower cataracts"*** Dystrophia - myotonica - "Christmas tree" patternTreatment of advanced diabetic retinopathy include - Seal the tear and reattach the retina, vitrectomy, exophotocoagulation***
1
Diabetes
Galectosemia
Trauma
Wilson's disease
Ophthalmology
Lens
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single
A 60-year-old female presented to the OPD with complaints of left jaw pain along with fever. On examination, Poor dentition Area of purulent drainage in the mouth Right sided facial swelling Diffuse mandibular tenderness Medication history includes alendronate and lisinopril. Microscopic examination of the purulent secretions is done. What is the most appropriate drug for the above condition: -
This is a case of osteonecrosis of jaw which is a risk factor for Actinomyces infection. 1st image shows lesions from bisphosphonate-related osteonecrosis of the jaw at extraction sites of upper central incisors. Microscopy shows chronic inflammatory changes with Sulphur granules. Actinomyces It has propensity to infect the jaw. Risk factors are: - Abnormal bone due to radiation Osteonecrosis of jaw Gram staining shows intense positive staining at the centre with branching rods at the periphery. It is very sensitive to penicillin therapy.
1
Penicillin
Azithromycin
Griseofulvin
Metronidazole
Unknown
Integrated QBank
e826a9e2-3b76-4ab8-a6d1-54c2999ae9fc
multi
The plasticizers used in polyether impression material is:
null
3
Polyether polymer
Colloidal silica
Glycol ether
Di-vinyl poly (dimethyl siloxane)
Dental
null
ca80ddf8-0057-4107-b39a-bfe7f83259a8
single
In a worker engaged in stone breaking with a chisel and hammer, the most common foreign body which can be lodged in his eye is:
Ans. Paicle from the chisel
2
Stone paicle
Paicle from the chisel
Piece from the hammer
All of the above
Ophthalmology
null
cd52b4f4-e798-4afe-8cb1-04a3639950d6
multi
Drug of choice for primary open angle glaucoma:
Prostaglandin analogues are now the drug of choice for open angle glaucoma and normal tension glaucoma.
2
Beta blockers
Prostaglandin analogues
Alpha agonists
Cholinergics
Ophthalmology
Glaucoma
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single
Vegetations on undersurface of A.V. valves are found in:
Answer is B (Libman Sacks Endocarditis) Vegetation on under-surface of AV valves are typically seen in Libman Sacks Endocarditis (SLE).
2
Acute Rheumatic corditis
Limban Sack's endocarditis
Non thrombotic bacterial endocarditis
Chronic rheumatic carditis
Medicine
null
98759ea8-cfd9-41e8-8ad2-fc6ed0437880
single
Colopotomy is done to treat -
Ans. is 'b' i.e., Pelvic abscess
2
Ischeorectal abscess
Pelvic abscess
Appendicular abscess
Perianal abscess
Surgery
null
36d9dd18-5e78-4c02-a8e8-c868fd7859a0
single
Bilateral lymphadenopathy , along with non caseating granulomas is a characteristic feature of
Patients are usually evaluated for possible sarcoidosis based on two scenarios .In the first scenario, a patient may undergo biopsy revealing a noncaseating granuloma in either a pulmonary or an extrapulmonary organ. In the second scenario, signs or symptoms suggesting sarcoidosis such as the presence of bilateral adenopathy may be present in an otherwise asymptomatic patient or a patient with uveitis or a rash consistent with sarcoidosis. Ref Harrison 19th edition pg 2205-2206
1
Sarcoidosis
Scleroderma
SLE
Stein-leventhal syndrome
Anatomy
Respiratory system
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single
Treatment of Papillary Ca of Thyroid with bony metastasis
Ans. is 'd' i.e. Near total thyroidectomy with radioiodine & radiotherapy As already mentioned in previous question, Total or Near total thyroidectomy is t/t of choice in PTC and also FTC (except minimally invasive cancer). Radioactive iodine '3'1is used post-operatively to detect and destroy any metastatic disease. It is also advised by some expes to do a routine 1311scan and therapy for all patients of differentiated thyroid cancer, postoperatively (except those with occult or minimally invasive disease). Screening with RAI is more sensitive than chest x-ray or CT scanning for detecting metastases; however, it is less sensitive than Tg measurements for detecting metastatic disease in most differentiated thyroid cancers except Huhle cell tumors. External beam radiotherapy is used to treat bone metastasis (to prevent fracture or to control pain). It is also occasionally used to control unresectable, locally invasive or recurrent thyroid carcinoma. There is no role for routine chemotherapy in differentiated thyroid cancers. Other Postop management in differentiated thyroid cancers Thyroid Hormone T4 is given as replacement therapy in patients after total or near-total thyroidectomy, and has the additional effect of suppressing TSH and reducing the growth stimulus for any possible residual thyroid cancer cells. TSH suppression reduces tumor recurrence rates. Thyroglobulin measurement Thyroglobulin (Tg) is produced only by thyroid follicular cells. Following total thyroidectomy, it should be undetectable in serum and any detectable level then indicates the persistence or recurrence of neoplastic disease. This is the basis for the use of Tg as a post-operative tumor marker in the follow-up of thyroid cancer patients Tg levels in patients who have undergone total thyroidectomy should be <2 ng/mL when the patient is taking T4 , and <5 ng/mL when the patient is hypothyroid.
4
Radiotherapy
Radioiodine
Near total thyroidectomy with radiotherapy
Near total thyroidectomy with radioiodine & radiotherapy
Surgery
null
887ff857-d31e-43e9-bf3f-d0ab0ef5542a
single
In recent memory loss, probable lesion is in
The Neuropsychology of Autobiographical Memory The medial temporal lobe memory system includes the hippocampus formation and the adjacent parahippocampal and perirhinal coices. The hippocampus is not the place where the content of memories is stored, but rather appears to contain a set of neural links to the content, which is distributed widely throughout the coex. Memories of an episode in one's life typically contain information from more than one modality: vision, hearing, and even taste, touch, and smell. Each of these components is stored in a unimodal sensory area, for example, the visual components of an episodic memory are stored in the visual coex in the occipital lobe, while the auditory components are stored in the auditory coex in the temporal lobe. These distributed representations are linked to a central index in the hippocampus. When recent episodes are retrieved, the index is reactivated, causing activation to spread to each of the associated unimodal areas. This is more correct of recent episodes, however. Once a representation of an episode has been fully consolidated, activation can spread between the separate features themselves, so that hippocampal activation is no longer needed. We are also beginning to gain an understanding of the brain areas that comprise the frontal components of the medial temporal lobe memory system. Medial temporal and hippocampal regions tend to be more involved in spatial context memory, while the frontocoical region, the diencephalon, and the temporal lobes are involved in temporal context memory. Much has also been learned about the neural bases of sho-term memory systems located in the frontal lobes. Psychologists have had trouble determining whether there is one type of sho-term memory, or several. The time span involved - exactly what 'sho' means - is also not widely agreed upon. In the 1980s, however, neuroscientists began exploring a large area in the dorsolateral poion of the prefrontal lobes. This area seems to be responsible for a so of memory that has been called 'working memory' - a concept that at least overlaps with the psychologist's concept of sho-term memory. Ref Harrison20th edition pg 2235
2
Thalamus
Temporal lobe
Frontal lobe
All of the above
Medicine
C.N.S
95d3875a-c543-4316-a11e-41ed6ce3eb4e
multi
Cranial nerve related to apex of the petrous temporal bone
In the intraneural course,the fibres of VI nerve runs veically and downwardsthrough the trapezoid body,medial lemniscus and basilar pa of the pons to reach the lower border of the pons. The nerve is attached to the lower border of the pons,opposite the upper end of the pyramid of the medulla. The nerve then runs upwards,forwards and laterally through the cristerna pontis and usually dorsal to the anterior inferior cerebellar aery to reach the cavernous sinus. The ebducent nerve enters the cavernous sinus by piercing its posterior wall at a point lateral to the dorsum sellae and superior to the apex of the petrous temporal bone. As the nerve crosses the superior border of the petrous temporal bone,it passes beneath the petrosphenoidal ligament,and bends sharply forwards. In the cavernous sinus,at first it lies lateral to the internal carotid aery and then inferolateral to it. The abducent nerve enters the orbit through the middle pa of the superior orbital fissure. Here it lies inferolateral to the occulomotor and nasociliary nerves. In the orbit,the nerve ends by supplying only the lateral rectus muscle. It enters the ocular surface of the muscle. Ref BDC volume 3.6th edition pg 365
3
VIII
VII
VI
V
Anatomy
Head and neck
e18be598-6d3d-4e54-a101-76ba589cc87c
single
Hepatotoxic inhalational agent
All inhalational agent cause maild hepatotoxicity by decreasing hepatic blood flowIsoflurane is the agent of choice in liver disease as it has least effect on Hepatic blood flowDirect hepatotoxicity (Hepatitis, hepatic necrosis) is caused by- halothane, chloroform, trilene, methoxyflurane(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no. 167-169)
1
Halothane
Enflurane
Desflurane
Sevoflurane
Anaesthesia
All India exam
2aba8f3a-d451-4fb0-91eb-9e740836110a
single
Which of the following drug can be given intravenously,epidurallyor by transdermal route
null
4
Thiopentone
Succinylcholine
Vecuronium
Fentanyl
Anaesthesia
null
d02994f7-52b3-4680-bad6-0cf0042494dd
multi
True about subcutaneous nodule in Rheumatic fever ________
Subcutaneous nodule in RHD is seen in 3 to 20% cases,non tender,on bony prominence like elbow,shine,occiput ,mostly associated with carditis. Ref : Ghai essential of pediatrics, eighth edition ,p.no:436
1
Non tender
Most common manifestation
Present on extensor surfaces
Associated with athritis
Pediatrics
C.V.S
a685c384-ca50-463f-8020-5683afb209fb
multi
Which vaccine gives herd immunity-
Ans. is 'a' i.e., OPV o The vaccine progeny of OPV is excreted in the faeces and secondary spread occurs to household contacts and susceptible contacts in the community. o Non-immunized persons may therefore, be immunized. o Thus widspread "herd immunity"results, even if only approximately 66% of the community is immunized.
1
OPV
Typhoid
Cholera
null
Social & Preventive Medicine
null
87cbea98-e8fc-455b-b20c-28313725e5ca
multi
A 50-year-old lady sprained her ankle 2 months back from which she made a steady recovery. 2 months after the injury she gradually developed severe pain in her right ankle with the significant limitation of ankle movement. Clinical examination reveals oedema and shiny skin. What is the likely diagnosis?
COMPLEX REGIONAL PAIN SYNDROME (ALGODYSTROPHY) Sudeck, in 1900, described a condition characterized by painful osteoporosis of the hand. The same condition sometimes occurs after fractures of the extremities and for many years it was called Sudeck’s atrophy. It is now recognized that this advanced atrophic disorder is the late stage of a post-traumatic reflex sympathetic dystrophy (also known as algodystrophy), which is much more common than originally believed (Atkins, 2003) and that it may follow a relatively trivial injury. Because of continuing uncertainty about its nature, the term complex regional pain syndrome (CRPS) has been introduced. Two types of CRPS are recognized: TYPE 1 a reflex sympathetic dystrophy that develops after an injurious or noxious event. TYPE 2 causalgia that develops after a nerve injury. The patient complains of continuous pain, often described as ‘burning’ in character. At first, there is local swelling, redness and warmth, as well as tenderness and moderate stiffness of the nearby joints. As the weeks go by the skin becomes pale and atrophic, movements are increasingly restricted and the patient may develop fixed deformities. X-rays characteristically show patchy rarefaction of the bone.
2
Fibromyalgia
Complex Regional pain syndrome Type I {CRPS I}
Complex Regional pain syndrome Type II {CRPS II}
Peripheral Neuropathy
Orthopaedics
null
31cd39e5-3fdd-408b-9c1e-39ed4a2cb5e3
multi
True about subendocardial hemorrhage is all except
Subendocardial hemorrhages (SEH) occur after cardiac injuries and resuscitation as well as secondary to noncardiac injuries comprising head injuries, infectious diseases, intoxications, hemorrhagic diathesis, abdominal trauma, asthma, and hypovolemic shock. In paicular, the common incidence of SEH in intracranial lesions led to the suggestion that the phenomenon is mediated by the autonomic nervous system hypersecretion of catecholamines Ramdas Nayak page no. 303
2
May be seen after head injury
Involves RV wall
Continous pattern of sheet like
Flame shaped hemorrhages
Pathology
Cardiovascular system
b99a121a-9056-465d-b002-3dd672b4c194
multi
Antihormone used in Infeility is:
Clomifene citrate : Anti-estrogenic -effects on the Hypothalamic axis which promotes release of FSH and LH which induces folliculogenesis and ovulation. Finasteride: Competitive inhibitor of enzyme 5 alpha reductase. with anti androgenic propeies Mifepristone: antiprogesterone used for inducing aboions Danazol: antiestrogen, weak androgen, weak progesterone action. Used in endometriosis and abnormal uterine bleeding
2
Mifepristone
Clomifene
Danazol
Finasteride
Gynaecology & Obstetrics
Infeility (Eggs'plantation!)
4dc2ecc6-140a-4b61-a0e4-0748f7349462
single
Anaesthesia contraindicated in volvulus of gut is –
null
2
Halothane
Nitrous oxide
Ketamine
Pancuronium
Anaesthesia
null
4f5e9a9e-e0f2-451c-b8e2-5c1967480f9e
single
Which of the following is related to floor of middle ear?
The floor or Jugular Wall of the middle ear is formed by a thin plate of bone which separates the middle ear from the superior bulb of the internal jugular vein. This plate is a pa of the temporal bone, Near the medial wall, the floor presents the tympanic canaliculus which transmits the tympanic branch of the glossopharyngeal nerve to the medial wall of the middle ear. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition.
3
Round window
Internal carotid aery
Internal jugular vein
Tegmen tympani
Anatomy
Head and neck
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single
Therapy of choice for sleep-apnea syndrome is
Harrison's principles of internal medicine 17th edition. * Majority of patients need to use continuous positive airway pressure(CPAP) delivered by a nasal mask every night to splint the upper airway open.
2
Invasive ventilation
Non - Invasive ventilation
Oxygen inhalation
Use of respiratory stimulants
Medicine
C.N.S
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single
Serious infections can occur when absolute neutrophil count decreases below
.
1
<500/microliter
<800/microliter
<1000/microlitre
<2000/microliter
Anatomy
All India exam
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single
Siffert katz sign seen in
null
2
Chondromalacia patella
Blount's disease
CTEV
Rocker Bottom foot
Orthopaedics
null
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single
Osteochondritis in Kohler&;s disease affects which bone ?
types of osteochondritis Bones affected Kohler Navicular Keinbock Lunate Pehes Femur head Johanson- Larsens lower pole of patella REF : MAHESWARI 9TH ED
3
Lunate
Patella
Navicular
Femur head
Anatomy
Avascular necrosis and osteochondroses
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single
Esthesioneuroblastoma arises from:
Ans. (a) Olfactory epitheliumRef: Dhingra's ENT 6th edJ 204* Esthesioneuroblastoma usually arise from the olfactory epthelium . It's a rare tumor of any age group .* Presentation of tumor: cherry red, polypoidal spots mass in upper third of nasal cavity. It is a vascular tumor that bleeds profusely on biopsy.
1
Olfactory epithelium
Ethmoid sinus
Maxillary sinus
Sphenoid sinus
ENT
Tumors of Nose and PNS
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single
A patient 45 years of age, non diabetic, presents with chronic pelvic pain of 1 year duration. She also complains of frequency, urgency and a sense of incomplete evacuation since 1 year without any significant finding on her past ultrasounds, urine examination and urine and high vaginal swab cultures. On pelvic examination there is no significant vaginal discharge. Cystoscopy is normal. Most probable diagnosis is
Urethral syndrome Urethral syndrome is defined as a symptom complex including dysuria, frequency, urgency, suprapubic discomfo , post void fullness and dyspareunia in the absence of any abnormality of urethra or bladder. Cause is unceain and is attributed to subclinical infection, urethral obstruction, psychogenic and allergic factors. It is a diagnosis of exclusion, after ruling out UTI, malignancy, vulvovaginitis. Cystoscopy to rule out urethral diveiculum, stones and malignancy. Management: multidisciplinary approach, antibiotics for sterile pyuria. Post menopausal women may benefit from local estrogen. Physical therapy, cognitive-behavioral therapy and psycological suppo. Asymptomatic bacteriuria is ruled out with normal urine culture, Cystitis with normal urine r/m, c/s, and USG. Vulvovaginitis is ruled out by the given symptoms and normal local examination
1
Urethral syndrome
Asymptomatic bacteriuria
Vulvovaginitis
Cystitis
Gynaecology & Obstetrics
Genitourinary Fistula
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single
Shoest acting anticholinesterase is ?
Ans. is 'a' i.e., Edrophonium Edrophonium is the shoest acting anti-ChE. When carbamates (other than edrophonium) and organophophates react with cholinesterase, they form covalent bond at esteratic site, which is considerably resistant to hydrolysis. In contrast, edrophonium binds electrostatically and by hydrogen bonds at anionic site (not at esteratic site) of cholinesterase. The enzyme inhibitor complex does not involve a covalent bond and is correspondingly sho lived (2-10 minutes). So edrophonium is also called as noncovalent inhibitor.
1
Edrophonium
Pyridostigmine
Glycopyrrolate
Neostigmine
Pharmacology
null
3c522f24-c40e-48d2-bcda-87fe2875a115
single
True about myasthenia gravis
*The weakness increase during repeated use and may improve following sleep or rest.only 10% of cases are associated with thymomas 65% with hyperplasia of thymus. Edrophonium test is positive. In electrodiagnostic testing MG patients show a rapid reduction of >10-15% in the amplitude of evoked response. Ref Harrison20th edition pg 2445
3
Associated with thymomoa in 3/4 of cases
Incremental response seen with repetitive electric stimuli
Skeletal muscle function improve after rest
Edrophonium test negative
Medicine
C.N.S
f0e9729f-ca44-46b1-b38a-ad852f9121ff
multi
Which of the following is true about Facial recess?
O Facial recess or posterior sinus is a depression in posterior wall lateral to pyramid. O It is bounded medially by the veical pa of Facial nerve, inferiorly by the chorda- facial angle and superiorly by fossa incudis. O Surgically, facial recess is impoant, as direct access can be made through this into the middle ear without disturbing posterior canal wall (Posterior Tympanotomy)
4
Medial to veical pa of facial nerve
Lateral to horizontal pa of facial nerve
Medial to horizontal pa of facial nerve
Lateral to veical pa of facial nerve
ENT
Anatomy of Middle Ear
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multi
Treatment recommended for secondary syphilis is
null
2
Benzathine penicillin G 2.4 mIU i.m weekly, 3 doses
Benzathine penicillin G 2.4 mIU i.m single dose
Benzathine penicillin G 2.4 mIU i.m twice weekly, 4 doses
Benzathine penicillin G 2.4 mIU i.m twice daily for 2 weeks.
Gynaecology & Obstetrics
null
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single
The risk of neonatal chicken pox is the maximum, if maternal infection occurs :
Risk of neonatal chicken pox is maximum if maternal infection occurs near delivery (5 days before delivery or 48 hours after).
3
During the first trimester
During the second trimester
Within five days of delivery
Within six weeks of delivery
Pediatrics
null
cfc9f5f2-8252-4224-96b8-81ec993a58b6
single
Which of the following condition is using laparoscopy as the diagnostic tool of investigation?
Laparoscopy is the primary method used for diagnosing endometriosis. Laparoscopic findings are variable and may include discrete endometriotic lesions, endometrioma, and adhesion formation. The pelvic organs and pelvic peritoneum are typical locations for endometriosis. Lesions are variable colors, which may include red, white, and black. Laparoscopic visualization of ovarian endometriomas has a sensitivity and specificity of 97 percent and 95 percent, respectively. Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 10. Endometriosis. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e.
1
Endometriosis
Ca uterus
Ca cervix
Ca rectum
Gynaecology & Obstetrics
null
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single