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Treatment of Helicobacter pylori are EXCEPT
(Cisapride) (1124-CMDT- 08) (949-H17th)Helicobacter pylori* Drug of choice - Amoxicillin + Clarithromycin + Proton pump inhibitor (PPI)* Alternative drugs - Bismuth subsalicylate + Tetracycline + metronidazole + PPI
2
Clarithromycin
Cisapride
Bismuth subsalicylate
Metronidazole
Medicine
G.I.T.
e01a29aa-d803-4615-b4ba-11bb60fe795e
multi
Thrombosis of the Superior branch of middle cerebral aery leads to:
* In the Syln fissure, the MCA in most patients divides into superior and inferior divisions (M2 branches). * Branches of the inferior division supply the inferior parietal and temporal coex, Branches from the superior division supply the frontal and superior parietal coex. * Hence due to damage of the blood supply of the Broca's area the main feature shall be motor aphasia. ENTIRE MCA is occluded at its origin (blocking both its penetrating and coical branches) - clinical findings are 1) contralateral hemiplegia, 2) hemianesthesia, 3)Homonymous hemianopia, 4) A day or two of gaze preference to the ipsilateral side. 5)Dysahria is common because of facial weakness. Dominant hemisphere is involved- global aphasia is present Nondominant hemisphere is affected- anosognosia, constructional apraxia, and neglect are found. PAIAL SYNDROME A)Brachial syndrome- embolic occlusion of a single branch include hand, or arm and hand, weakness alone . B)Frontal opercular syndrome-. facial weakness with nonfluent (Broca) aphasia, with or without arm weakness C)Proximal superior division of MCA. A combination of 1)sensory disturbance, 2) motor weakness, and 3) nonfluent aphasia suggests that an embolus has occluded the proximal superior division and infarcted large poions of the frontal and parietal coices D)inferior devision OF MCA IN DOMINANT HEMISPHERE- -If a fluent (Wernicke's) aphasia occurs without weakness, the inferior division of the MCA supplying the posterior pa (temporal coex) of the dominant hemisphere is probably involved. other menifestations -Jargon speech and an inability to comprehend written and spoken language are prominent -Contralateral, homonymous superior quadrantanopia. IN NON DOMINANAT HEMISHERE-Hemineglect or spatial agnosia without weakness indicates that the inferior division of the MCA in the nondominant hemisphere is involved. E)Occlusion of a lenticulostriate vessel produces small-vessel (lacunar) stroke within the internal capsule . This produces pure motor stroke or sensory-motor stroke contralateral to the lesion. F)Ischemia within the genu of the internal capsule- 1) primarily facial weakness followed by arm and then leg weakness as the ischemiamoves posterior within the capsule., 2) Clumsy hand, dysahria lacunar syndrome). The contralateral hand may become ataxic, and dysahria will be prominent G) Lacunar infarction affecting theglobus pallidus and putamen -parkinsonism and hemiballismus.
1
Motor aphasia
Urinary retention
Bitemporal hemianopia
Grasp reflex
Medicine
Stroke and TIA
af8c73d6-1cb8-4ff4-b7bb-005c3ce54d28
single
The most sensitive index for renal tubular function is :
Ans. is 'a' specific gravity of urineThe main function of renal tubules is concentration of urine and this can be measured by the specific gravity of urine.
1
Specific gravity of urine
Blood urea
GFR
Creatinine clearance
Physiology
Glomerular Filtration, Renal Blood Flow, and Their Control
8b4fbfa6-301d-4237-b641-24ca4795381f
single
Which of the following are situated away from the coding region:
A i.e. Promoter; B i.e. Enhancer; C i.e. Operator
4
Promoter
Enhancer
Operator
All
Biochemistry
null
9501a69a-97d0-49fc-9c4b-1679800c2265
multi
The ideal method of representation of frequency distribution with continuous variable:
Histogram
2
Line diagram
Histogram
Simple bar diagram
Component bar diagram
Social & Preventive Medicine
null
aca3ff44-15fd-439c-a3ee-862a0a6116fe
single
Characteristic feature of Rheumatic carditis is ?
Ans. is 'd' i.e., Pancarditis During Acute Rheumatic fever, diffuse inflammation and Aschoff bodies may be found in any of the three layers of hea - pericardium, myocardium or endocardium - PANCARDITIS.
4
Pericarditis
Endocarditis
Myocarditis
Pancarditis
Pathology
null
83fb5a08-cdb0-48b2-b8cf-f9e769e86ada
single
Which of the following is true about hypothermia during anesthesia?
Ans. b. Prevented by giving warm fluids Hypothermia during anesthesia can be prevented by giving warm fluids. Hypothermia During Anesthesia Mild hypothermia is extremely common during anesthesia and surgery. The physiological effects of hypothermia may have significant potential for detrimental effects on patient well-being. Major consequences of inadveent hypothermia include morbid myocardial events, reduced resistance to surgical wound infection, impaired coagulation, delayed recovery, and postoperative shivering. Heat loss occurs primarily from the skin of a patient to the environment through several processes, including radiation, conduction and convection, and evaporation. Of these, radiation is most significant and accounts for --60% of total heat loss. Drug metabolism can be markedly decreased by hypothermia. Although hypothermia is generally regarded as deleterious, it can be beneficial in some situations. Hypothermia decreases the overall metabolic rate by 8% per degC to about half the normal rate at 28degC. Oxygen demand drops and those tissues that have high oxygen consumption normally, such as brain and hea, have a propoionally greater reduction of oxygen use. This allows aerobic metabolism to continue through greater periods of compromised oxygen supply, thereby reducing the production of anaerobic byproducts such as superoxide radicals and lactate. Hypothermia During Anesthesia Hypothermia lowers intracranial pressures and cerebral perfusion pressure. Warming of fluids can only help to minimize heat loss. Warm fluids are probably of benefit only when large amounts are administered for fluid replacement.
2
Beneficial to patients
Prevented by giving warm fluids
Body looses heat mainly by conduction
Always occur irrespective of the type of anesthesia
Anaesthesia
null
5e75ce5d-ee9e-4f15-8887-981329a4cf4e
multi
All are true about innate immunity except -
Innate immunity is the first line of defense against infection. it is non specific. It is the resistance to infections that an individual possess by viue of his or her genetic and constitutional make up. Reference : Anathanarayan & paniker's 9th edition, pg no:78 <\p>
3
Non-specific
First line of defence
Not affected by genetic affected
Includes complement
Microbiology
Immunology
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multi
Sputum positive TB is?
One positive specimen out of the two sputum specimens is enough to declare a patient as smear positive TB Reference; Park&;s Textbook of preventive and social medicine, 24th edition.Pg no. 193
1
1 out of 2 sputum sample +ve
2 out of 3 sputum sample +ve
BACTEC +ve
null
Social & Preventive Medicine
Communicable diseases
caa044a5-1c87-439b-96ab-805acec92271
multi
Which of the following is RNA with catalytic activity?
RNA with catalytic activity is known as Ribozyme. All the 3 enzymes given as Options are Ribozymes.
4
Ribonuclease P
Peptidyl transferase
Sn RNA
All of the above
Biochemistry
null
21e2dbbb-2eca-475d-8cd6-a4d08972052e
multi
Wernicke's encephalopathy occurs due to deficiency of
(A) Vitamin B1 # Dry Beriberi involves both the peripheral and the central nervous systems.> Peripheral nerve involvement is typically asymmetric motor & sensory neuropathy with pain, paresthesias& loss of reflexes.> The legs are affected more than the arms. Central nervous system involvement results in Wernicke-Korsakoff syndrome.> Wernicke's encephalopathy consists of nystagmus progressing to ophthalmoplegia, truncal ataxia & confusion> Koraskoff's syndrome includes amnesia, confabulation, and impaired learning.
1
Vitamin B1
Vitamin B2
Vitamin B6
Vitamin B12
Biochemistry
Miscellaneous (Bio-Chemistry)
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single
Deltoid ligament is attached to all except
DELTOID LIGAMENT:- Very strong Triangular shape Present on medial side of ankle. Ligament is crossed by the tendons of Tibialis posterior and flexor digitorum longus. Prone to injuries in inversion.Superficial and deep pa. Both pas have common attachments above to the apex and margins of medial malleolus. Superficial pa:-1. Anterior/Tibionavicular- attached to tuberosity of the navicular bone and medial margin of spring ligament.2. Middle/Tibiocalcanean-attached to whole length of sustentaculum tali.3. Posterior/posterior tibiotalar-attached to medial tubercle and medial surface of talus. Deep fibres:-Anterior tibiotalarAttached to the anterior pa of medial surface of talus. {Reference: BDC 6E pg no.149}
4
Medial malleolus
Talus
Calcaneum
Lateral malleolus
Anatomy
Lower limb
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multi
Acute osteomyelitis can best be distinguished from soft tissue infection by –
MRI is the best radiographic imaging technique for the identification of abscess and for differentiation between bone and soft tissue infection.
4
Clinical examination
X–Ray
CT scan
MRI
Pediatrics
null
086d021b-af51-42e1-b696-cf266ff3783d
single
Kangaroo mother care .True is -
Ans. is 'd' i.e., All of the above o Repeat from All India Dec-15
4
Can be done by father also
Indicated for LBW babies
Effective thermal control
All of the above
Pediatrics
Newborn Infant - Parent-Infant Bonding
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multi
Acute Osteomylitis in children most commonly affects-
Ans. is 'a' i.e., Metaphysis Metaphysis is most commonly involved in acute osteomyelitis as-o Long loop vessels are present leading to easy bacterial seeding o Excessive bone turnover in this regiono It has thin cortexo It has relatively fewer phagocytic cells
1
Metaphysis
Diaphysis
Epiphysis
Physis
Orthopaedics
Osteomyelitis
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single
Commonest cause of non - engagement at term, in primi is:
Engagement is said to occur when the greatest transverse diameter of the presenting part, has passed through the pelvic inlet. In all cephalic presentations, the greatest transverse diameter is always the biparietal. Engagement occurs in multipara with commencement of labour in the late Ist stage after rupture of membranes and in Nullipara during the last few weeks of pregnancy, i.e. ≈ 38 weeks In primi’s the most common cause of non engagement at term is deflexed head or occipitoposterior position followed by cephalopelvic disproportion (CPD). Since deflexed head or occipitoposterior is not given in option, we will go for CPD as the answer.
1
CPD
Hydramnios
Brow presentation
Breech
Gynaecology & Obstetrics
null
dc0e3465-17c6-4f28-b982-2da431e37880
single
Which part of DNA is most susceptible to radiation?
(D) Double helix > Relatively flexible areas of the DNA double helix are most susceptible to damage.> Radiation can damage the DNA "double helix" - a two-stranded, twisting molecule - in a variety of ways: 1) by knocking off one or more of the DNA "bases" known by the letters A, T, G, and C, which form the bonds between the two strands of the double helix; 2) by oxidizing these bases; or 3) by breaking through one or both strands. All can result ir a failure of the molecule to perform its main task - telling cells which proteins to make. That can lead to out-of-control cell growth (cancer) or death.
4
Nucleotides
Nucleosides
Histones
Double helix
Radiology
Radiotherapy
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Drug used for Buerger's disease
A drug used in Buerger's disease is Xanthinol nicotinate. xanthine nicotinate tablet was used daily once earlier. Now, graded injection of xanthine nicotinate 3000 mg from day 1 to 9000 mg on day 5 is used to promote ulcer healing. It also helps to increase claudication distance as a temporary basis. Beta blockers such as propranolol & GTN have no ulcer healing propey in case of Thromboangitis obliterans (Buerger's disease).
2
Propranolol
Xanthinol nicotinate
GTN
All the above
Surgery
Vascular surgery
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multi
Cutaneous infection due to exogenous exposure to TB bacilli in a person who is already sensitized by previous exposure to TB leads to:
TB verrucosa cutis also called as anatomist's / pathologist's wart ,presents as wart / cauliflower like hypertrophic lesions typically over fingers and feet.
4
Lupus vulgaris
TB chancre
Erythema induratum
TB veruccosa cutis
Dental
null
e7930f3d-05fe-4cd2-96e0-d2883862f318
single
Spermatogenesis is mostly controlled by
Spermatogenesis is the process in which spermatozoa are produced from spermatogonial stem cells by way of mitosis and meiosis. The initial cells in this pathway are called spermatogonia, which yield primary spermatocytes by mitosis. The primary spermatocyte divides meiotically (Meiosis I) into two secondary spermatocytes; each secondary spermatocyte divides into two spermatids by Meiosis II. These develop into mature spermatozoa, also known as sperm cells.LH appears to have little role in spermatogenesis outside of inducing gonadal testosterone productionRef: Ganong&;s review of medical physiology; 24th edition; page no:-420
3
Inhibin
FSH
LH
GnRH
Physiology
Endocrinology
1d693ade-8d09-4a3d-9c0a-d75747bae255
single
Which lesion displays an ill-defined border?
Ill-Defined Borders Blending Border: A blending border is a gradual, often wide zone of transition between the adjacent normal bone trabeculae and the abnormal appearing trabeculae of the lesion. The focus of this observation is on the trabeculae and not on the radiolucent marrow spaces. Examples of conditions with this type of margin are sclerosing osteitis and fibrous dysplasia. Oral radiology White and Pharaoh; 7th ed. Page no 276,277
2
Periapical cyst
Sclerosing osteitis
Soft tissue capsule
Multiple myeloma
Radiology
null
b64c2848-0e12-41f7-b291-2421e250ecf1
single
In a 2 months old infant undergoing surgery for biliary atresia, you would avoid one of the following anaesthetic
B i.e. Halothane Among all these options only halothane is hepatotoxic so it should be avoided Lets revise some impoant facts. All coagulation factors with exception of factor VIII (8) & von wille brand factor are produced by liverQ Vit K is necessary for synthesis of prothrombin (factor II) and factor VII, IX and XQ. PT is normally 11-14 seconds, mesures the activity of fibrinogen, prothrombin and factors, V, VII, and XQ All opioids cause spasm of sphincter of oddi & increase biliary pressure Halothane hepatitis is more common in middle age, obese, female sex, and a repeated exposure (esp with in 28 days)
2
Thiopentone
Halothane
Propofol.
Sevoflurane
Anaesthesia
null
89f1fc8f-a728-4ccf-aa39-31bee8fa38aa
single
Skin grafting done on wound following major skin taken from twin brother:
Ans. (a) IsograftRef: Bailey 26th Edition Page 1408* Isograft: A graft between identical donor such as identical twin* Autograft: A graft from one site to another on the same patient* Allograft: Graft from individual of same species.* Xenograft: Graft from another species
1
Isograft
Allograft
Autograft
Xenograft
Surgery
Transplantation
98b996a4-70f3-4d71-a394-3bebf7b7650f
multi
Tuberculides are seen in
(Lichen scrofulosorum) (202-Behl lCfh, 1756-Dorland 28th, 219- Neena khanna)TUBERCULIDES - Group of disease where the evidence for a tuberculous etiology is not definite {May be hypersensitivity reaction) but which show a tuberculous granuloma on histology and respond to ATT)Conditions included in TuberculidsCutaneous Tuberculosis (Non Tuberculides)* Lichen scrofulosorum* Lupus vulgaris* Erythema- induratum* Sacrofuloderma* Papulonecrotc tuberculides (Acne-scrafulosorum)* Tubercularis cutis verrucosus* Lupus miliaris disseminatus faciei* Miliary tuberculosis and metastatic tuberculosis* Rosaceous tuberculide* Miliary tuberculosis and metastatic tuberculosis abscess may also present as cutaneous tuberculosis(According to 'Behl' Erythema - nodosum is also a tuberculide while some texts do not include it as a tuberculide)Features of TB in AIDS patients* |Sputum positivity *** Little or no cavitation*** |ed extra pulmonary tuberculosis *** Negative PPD skin test*** Lack of classic granuloma* Atypical CXR- Diffuse interstitial or military infiltrate* Response to short course chemotherapy is similar*** but adverse effects may be more pronounced including severe or even fatal skin disease* High rate of reactivation Indications of pulmonary resection in tuberculosis / haemoptysis areAbsoluteRelative* Massive haemoptysis (600cc/24 hours)* Destroyed lung, positive sputum* Bronchopleural fistula* Suspicion of carcinoma* Haemoptysis* Bronchial stenosis* Persistent positive sputum* Open negative cavity* T.B. Empyema* Atypical tuberculus infections* Aspergilloma (Fungus balls)Lupus - vulgaris - is a form of cutaneous tuberculosis that is seen in previously infected and sensitized individualsLupus- pernio - is a particular type of sarcoidosis that involves the tip of nose & earlobes with lesions that are violaceous in colourSpino- ventosa - Tuberculosis of bone in which bone is expanded & the cortex thins eg digitsScrofuloderma - Tuberculosis first develops in a lymph node or a bone producing a swelling and subsequently ruptures through the overlying skinFalse negative tuberculin skin test - reactions may result from improper testing technique - concurrent infections, malnutrition advanced age, immunologic disorders, lymphoreticular malignancies, corticosteroid therapy, CRF, HIV infections and fulminant tuberculosis
3
Lupus vulgaris
Scrofuloderma
Lichen scrofulosorum
Erythema nodosum
Medicine
Skin
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N. gonorrhea causes -
Ans. is All-`a' i.e., Urethritis; 'b' i.e., Salpingitis; 'c' i.e., Cervicitis
4
Urethritis
Salpingitis
Conjunctivitis
All
Microbiology
null
ec9fb91b-78f9-4d68-987a-226a2e715fff
multi
A child has a vocabulary of4-6 words however the main mode of communication and social interaction continues to be non-verbal what is the most likely developmental age of the child -
Ans. is 'b' i.e., 15 months o Vocabulary of 4-6 words in addition to jargon is achieved by 15 months of age. However
2
12 months
15 months
18 months
24 months
Pediatrics
null
298d8c60-b34a-476f-b9e0-9ce94c49625c
single
Not true about rt. kidney is -
It is left kidney, not Rt. that is preferred for transplantation because it has a longer renal vein which simplifies the transplantation operation.
1
Rt. kidney is preferred over the left for transplantation
It is lower than the left kidney
Rt. renal vein is shorter than the left
Rt. kidney is related to the duodenum
Surgery
null
fafccadc-a2ad-4a98-91f1-9fdcc0bf1284
multi
Selective plating medium for V. cholerae is:
AQns. is. 'b' i. e., TCBS agar
2
Carry-Blair medium
TCBS agar
VR medium
MacConkey medium
Microbiology
null
101bcce3-bed1-4a7b-809b-aa8e1dcd8cd9
single
Acetazolamide can be used in all except
Acetazolamide is a carbonic anhydrase inhibitor USES: 1. Glaucoma: as an adjuvant to other ocular hypotensives 2. Epilepsy: increases co2 levels- inhibits seizures to some extent- used only for catamenial epilepsy- epilepsy during menses 3. Acute mountain sickness - by increasing co2 and stimulating the breathing center 4. edema 5. alkalinization of urine ( Essentials of Medical Pharmacology, K.D Tripathi,6th edition, page 569 )
3
Epilepsy
Cute mountain sickness
Cirrhosis
Glaucoma
Pharmacology
Kidney
80d7667f-bebe-452c-b674-9e799dfe6ec7
multi
Renal function failure is best evaluated by?
Ans. All options are correct i.e., 'a, b, c
4
DTPA
DMSA
Iodohippurate
All
Surgery
null
a04055b0-51a8-4fdc-86fb-2da44acc516c
multi
Antidote for oxalic acid poisoning:
C i.e. Calcium gluconate
3
BAL
Animal charcoal
Calcium gluconate
Magnesium
Forensic Medicine
null
d2e3332b-879b-4e74-85cc-e95297af87ea
single
A patient met with Road traffic Accident with subsequent injury to the left knee. Dial test was positive. What could be the cause:
D i.e. Posterolateral Corner Injury
4
Medial Collateral Ligament Injury
Medial Meniscal Injury
Lateral Meniscus Tear
Posterolateral Corner Injury
Surgery
null
d0e89bb0-e4b4-47f1-8e28-286831a0bd73
single
In erythema migrans, which papilla of tongue are absent:
null
3
Fungiform
Foliate
Filliform
Circumvallate
Pathology
null
852e7046-1cd1-4af0-8a52-618b6dfa2603
multi
Lymphatic drainage of ovary?
Ans. is 'd' i.e., Para-aoicLymphatics of the ovary drain to para-aoic nodes alongside the origin of the ovarian aery (L2).
4
Deep inguinal
Superficial inguinal
Obturator
Paraaoic
Anatomy
null
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single
Hernia occurring in a potential space posterior to gastrojejunostomy is called
Answer- B. Peterson's HerniaPetersen hernias are a type ofinternal hernia which occurs in the potential space posterior to a gastrojejunostomy.This hernia is caused by the herniation of intestinal loops through the defect between the small bowel limbs, the transverse mesocolon and the retroperitoneum, after any type of gastrojejunostomy.
2
Bochdalek's Hernia
Peterson's Hernia
Littre's Hernia
Richter's Hernia
Surgery
null
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multi
Ahritis involving DIP, PIP, 1st carpometacarpal with sparing of MCP and wrist joints is typical of:
Osteoahritis characteristically involves distal interphalangeal joint (Heberden's node), proximal interphalangeal joint (Bouchard's node), 1st carpometacarpal joint (base of thumb) of hand with sparing of metacarpophalangeal joint and wrist joint. Fig. Joints involved in osteoahritis
1
Osteoahritis
Rheumatoid ahritis
Ankylosing spondylitis
Psoriatic ahritis
Orthopaedics
Joint disorders
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single
False about malignancy in ulcerative colitis:
Colitis associated colon cancer Arise from flat dysplasia or dysplasia associated lesion or mass Multiple synchronous colon cancer in 12% Mean age: 30 years Distributed uniformly throughout the colon Mucinous or anaplastic cancers are more common Poor prognosis in sporadic cancer is seen .
3
Mean age is 30 years
Anaplastic cancers are common
Poor prognosis as compared to sporadic
Evenly distributed
Surgery
Inflammatory bowel disease
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multi
In oogenesis, which of the following events occurs immediately following the completions of meiosis II?
The secondary oocyte is arrested in metaphase of meiosis II, and it will remain in this meiotic stage until feilization occurs. Following feilization, the secondary oocyte completes meiosis II, forming a mature ovum and a polar body. The nucleus of the mature ovum is called the female pronucleus, which fuses with the male pronucleus to form a zygote.
3
Degeneration of the zona pellucida
Sperm penetration of the corona radiata
Formation of a female pronucleus
Appearance of the blastocyst
Anatomy
Introduction and gametogenesis.
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single
Venous return to hea during quiet standing is facilitated by all of the following factors, except
During quiet standing gravity act against venous return to the heaGravity induces peripheral pooling of blood in leg instead.Calf muscle contraction pushes the blood towards heavalves prevents backflowRef: Medical Physiology Indu Khurana 2015 edition pAge No:220
4
Calfmuscle contraction during standing
Valves in perforators
Sleeve of deep fascia
Gravitational ihcrease in aerial pressure
Physiology
Cardiovascular system
fd04f177-dd1d-4061-a178-608484a3e472
multi
CYP-450 inducers are:
eg for enzyme inducers of cyp3a4 - phenobarbitone, rifampin, glucocoicoids, Phenobarbitone also induces CYP2Bl and rifampin also induces CYP2D6.Isoniazid and chronic alcohol consumption induce CYP2El.Other impoant enzyme inducers are- chloral hydrate, phenylbutazone, griseofulvin, DDT. Erythromycin, cimetidine, ketoconazole are enzyme inhibitors ref ;KD Tripathi Pharmacology 7th edition (page no;26)
4
Cimetidine
Ketoconazole
erythromycin
DDT
Pharmacology
General pharmacology
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single
Flagella not true
Flagella They are long unbranched sinuous filaments which are organs of locomotion . Each flagellum consist of 3 distinct part the filament the hook and the basal body.the filament is external to the cell and connected to the hook at the cell surface  Structure: The Hook-Basal bodyportion is embedded in the cell envelope . They are antigenically different. Flagella are made up of protein(flagellin). Though flagella of different bacteria have similar composition they antigenically different.flagellar antibodies are not protective but are usful in sero diagnosis  The presence or absence of flagella and their number and arrangement are characteristic of different genere of bacteria. Flagella may be arranged all round the cell (peritrichous) as a typhoid bacilli, or situated at one or both ends of the cell (polar). Polar flagella may be single (monotrichous) as in cholere vibrio, in tufts (lophotrichous)as in spirilla or with flagella at both poles(amphitrichous)
2
Locomotion
Attachment
Protein in nature
Antigenic
Microbiology
null
50ee058e-a81c-4548-9f65-9c87c1a8dec1
multi
How is endotoxin shock initiated?
. Endothelial injury
1
Endothelial injury
Peripheral vasodilation
Increased vascular permeability
Cytokines action
Pathology
null
6867c7a9-c7d8-44fe-b266-2c6ca6443b7c
single
Which among the following is true about Super antigens?
A group of antigens have been termed superantigens because they stimulate a much larger number of T cells than would be predicted based on the specificity of combining site diversity. This causes a massive cytokine release. The action of superantigens is based on their ability to bind directly to MHC proteins and to paicular V regions of the TCR without involving the antigen combining site. Individual superantigens recognize exposed poions defined by framework residues that are common to the structure of one or more V regions. Any T cells bearing those V sites may be directly stimulated. Ref: Ray C.G., Ryan K.J. (2010). Chapter 2. Immune Response to Infection. In C.G. Ray, K.J. Ryan (Eds), Sherris Medical Microbiology, 5e.
4
They bind to the cleft of the MHC
Needs to processed before presentation
They are presented by APC' S to T cells
Directly attached to lateral aspect of TCR B chain
Microbiology
null
a8507886-bf89-4018-8e46-ef0c37539a34
multi
A 12 year old boy presents with hemetemesis, malena and mild splenomegaly. There is no obvious jaundice or ascitis. The most likely diagnosis is:
Answer is A (EHPVO): Presence of hemetemesis, malena and splenomegaly suggests a diagnosis of poal hypeension. The most common cause of poal hypeension in a male child (12 year old boy) is Extra Hepatic Poal Vein Obstruction (EHPVO). EHPVO is therefore the single best answer by exclusion Non Cirrhotic Poal Fibrosis presents in a similar fashion clinically, however it is more common in females and in an adult population (third or fouh decade). NCPF is usually associated with a moderate/large (massive) splenomegaly Cirrhosis is an uncommon cause of poal hypeension in children and the absence of jaundice and ascitis makes this diagnosis more unlikely. 'An infant or child presenting with hemetemesis and mild/moderate splenomegaly in the absence of features of chronic - liver disease is likely to be suffering from EHPVO. In adults, one needs to exclude diseases such as NCPF and compensated cirrhosis - 'Poal Hypeension': by Robeo De Franchis (Wiley - Blackwell) 2006 /314 Ate of presentation ors a diagnosis of EHPVO over NCPF Age at presentation is an impoant factor in distinguishing EHPVO from NCPF - Indian Journal of Gastroenterology; 1984: Vol 3; No 4; 201-202 'More than three quaers of Indian Children with poal Inpeension were found to have extra hepatic poal vein obstruction (EHPVO) and Indian studies have shown extra hepatic poal vein obstruction (EHPVO) to be the commonest non cirrhotic cause for poal hypeension' - 'Diseases of the Liver and Biliary System in Children' by Kelly 3rd /559 'In a prospective study 'Yaccha etal provided suppo for the hypothesis that the etiology of zipper gastro intestinal bleeding in children may differ between developed and developing countries. They showed that 95% of children had upper gastrointestinal variceal bleeding, 92% of whom had bleeding due to EHPVO, a .figure significantly higher than that seen in the west' - Disease of the Liver & Bihar/ system in Children by Kelly 3rd /560 *Occasional impairment may be observed NCPF, non-cirrhotic poal fibrosis: EHPVO, extrahepatic poal vein obstruction: US, ultrasound
1
EHPVO
NCPF
Cirrhosis
Malaria with DIC
Medicine
null
4053e2a3-3f27-46e5-9966-a284e869e4fd
single
In decoicate animal which reflex is lost?
Removal of the cerebral coex (Decoication) produces decoicate rigidity which is characterized by flexion of the upper extremities at the elbow and extensor hyperactivity in the lower extremities. The flexion can be explained by Rubio spinal excitation of flexor muscles in the upper extremities; the hyperextension of lower extremities is due to the same changes that occur after mid-collicular decerebration. Decoicate rigidity is seen on the hemiplegic side in humans after hemorrhages or thromboses in the internal capsule. Probably because of their anatomy, the small aeries in the internal capsule are especially prone to rupture or thrombotic obstruction, so this type of decoicate rigidity is fairly common. Sixty percent of intracerebral hemorrhages occur in the internal capsule, as opposed to 10% in the cerebral coex, 10% in the pons, 10% in the thalamus, and 10% in the cerebellum.Reference: Ganong review of medical physiology 23rd edition Page no: 247
1
Hopping and placing reflex
Tonic neck reflex
Tonic labyrinthine reflex
Stretch reflex
Physiology
Nervous system
0db06833-8bc5-4fb2-bcd7-76a96d467489
single
Which of the following is universal donor blood group -
Individuals with type O Rh D negative blood are often called universal donors, as they do not contain antigen A and B on the surface of their RBC and those with type AB Rh D positive blood are called universal recipients ref:harsh mohan text book pathology
4
A
B
AB
O
Pathology
Haematology
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single
Three policemen, with difficulty, drag an agitated and very combative young man into an emergency room. Once there, he is restrained because he reacts with rage and tries to hit anyone who approaches him. When it is finally safe to approach him, the resident on call notices that the patient has very prominent veical nystagmus. Sholy thereafter, the patient has a generalized seizure. Which of the following substances of abuse is the most likely to produce this presentation?
Hallucinogens (Psychotomimetics, psychedelics, psychotogens) are drugs which alter mood, behaviour, thought and perception in a manner similar to that seen in psychosis. These are as:1. Lysergic acid diethylamide (LSD) 2. Psilocybin3. Harmine 4. Bufotenin5. Mescaline (Phenyl alkyl amines) 6. Phencyclidine7. Lysergic acid amide.
3
Amphetamine
PCP
Cocaine
Meperidine
Psychiatry
null
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multi
A 25-year soldier is trapped in an avalanche in Siachen glacier. He is airlifted to the base hospital. On admission the pulse is thready and BP is unrecordable. ECG strip is shown below. All of the findings are seen except:
V5 lead recording shows: HR of 50 bpm with absence of P wave Presence of Osborn wave at the J point. Concomitant ST Elevation is noted. The patient is suffering from hypothermia which explains the ECG change. Atrial bigeminy should have discernible P wave.
4
Bradycardia
Osborn wave
ST segment elevation
Atrial bigeminy
Medicine
ECG and Arrhythmia 2
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multi
Incidence rate is measured by -
Ans. is 'b' i.e., Coho study Coho study analyses the following data :?1) Incidence rate among exposed and nonexposed2) Estimation of riska) Relative risk (risk ratio)b) Attributable risk (risk difference)c) Population attributable riskIncidence rateo In coho study, incidence rate can be determined directly in those exposed and nonexposed.
2
Case control study
Coho study
Cross sectional study
Cross over study
Social & Preventive Medicine
null
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single
A 45 yr old female complains of progressive lower limb weakness, spasticity, urinary hesitancy. MRI shows intradural enhancing mass lesion. MOST likely diagnosis is:
Meningioma are now the most common primary brain tumor. On an MRI it appears as a paially calcified densely enhancing extra axial tumor arising from the dura. Occasionally it has a dural tail, consisting of thickened, enhanced dura extending like a tail from the mass. Meningiomas are typically located over the cerebral convexities, especially adjacent to the sagittal sinus. It can also occur in the skull base and along the dorsum of the spinal cord. They are more common in women and in patients with neurofibromatosis type 2. They also occur more commonly in patients with a past history of cranial irradiation. Most of them are found incidentally, but it can also present with headache, seizures or focal neurologic deficits. Ref: Harrison's Principles of Internal Medicine, 18e chapter 379.
4
Dermoid cyst
Intradural lipoma
Neuroepithelial cyst
Meningioma
Surgery
null
33aec826-9735-4fe6-af9e-cad5cbeddd7b
single
A man has just received his fourth DUI citation. The judge orders an alcohol dependency program complete with a medication that makes him have nausea and vomiting if he drinks alcohol while taking the medication. The drug-induced illness is caused by the buildup of which one of the following?
The court-ordered medication is disulfiram. Disulfiram inhibits ALDH, which greatly reduces the amount of acetaldehyde that is converted to acetate. This causes an accumulation of acetaldehyde, which is the substance responsible for the symptoms of a "hangover," including nausea and vomiting. Alcohol dehydrogenase reduces ethanol to acetaldehyde. Acetyl-CoA synthetase converts acetate to acetyl-CoA.
2
Ethanol
Acetaldehyde
Acetate
Acetyl-CoA
Biochemistry
Lipids
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single
Factors which decrease the cement space for a complete crown would be
null
4
Thermal and polymerization shrinkage of the impression material
Use of a solid cast with individual stone dies
Use of an internal layer of soft wax
Use of resin or electroplated dies
Dental
null
65040f25-fa91-4d71-b152-0517bd966710
single
Middle part of jugular foramen transmits all of the following cranial nerves except:
null
3
Glossopharyngeal nerve
Vagus nerve
Hypoglossal nerve
Accessory nerve.
Anatomy
null
173cfacb-d6d6-49ce-ab63-0377edecdf14
multi
Early childhood caries or baby bottle tooth decay is usually seen in the age group of _____ month old child?
Early childhood caries or baby bottle tooth decay is usually seen in the 18 to 36 month old child, although it can be seen even in younger patients.
1
18-36
24-36
18-Jun
18-Dec
Dental
null
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multi
Body temperature in Fahrenheit is an example of which of the following scales?
Metric scale is fuher divided into interval and ratio scales. In an interval scale, there is no absolute zero, such as in body temperature. A temperature of 105? F cannot be interpreted as 5% higher than 100? F. Ref: Medical biostatistics, 1st edition pg: 99
3
Nominal
Ordinal
Interval
Ratio
Social & Preventive Medicine
null
804ee5d3-5128-4fe2-a485-37b78f0c217e
single
Which one of the following is not included in the treatment of malignant melanoma?
Ans. is 'a' i.e., Radiation Radiation is the best answer. Schwaz 9/e writes- "although initially thought to be ineffective in the treatment of melanoma, the use of radiation therapy, regional and systemic chemotherapy, and immunotherapy are all under investigation."
1
Radiation
Surgical excision
Chemotherapy
Immunotherapy
Surgery
null
05984fe2-80e8-4fd0-bc43-387369e511f3
single
Regarding Xenon anesthesia all are true accept
Xenon Advantages of Xenon Anesthesia 1. Ine (probably nontoxic to liver and kidney with no metabolism) 2. Minimal effect on CVS function 3. Lowest blood solubility (Lowest blood gas paition coefficient) therefore rapid induction and recovery. 4. Does not trigger malignant hypehermia 5. Environmental friendly 6. Non-explosive Disadvantages of Xenon Anesthesia 1. High cost 2. Low potency (MAC = 70%) 3. No commercially available anaesthesia equipment.
1
Slow induction and recovery
Non explosive
Minimal cardiovascular side-effects
Low blood solubility
Pharmacology
Miscellaneous
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multi
The only neuron in retina showing action potentials are
Ganglion cells are a type of neuron located near the inner surface of the retina and are the final output neurons of the veebrate retina. Ganglion cells collect visual information in their dendrites from bipolar cells and amacrine cells and transmit it to the brain throughout their axon to the brain. Ref: guyton and hall textbook of medical physiology 12 edition page number:742,743,744
4
Rods and cones
Bipolar cells
Amacrine cells
Ganglion cells
Physiology
Nervous system
c2c80117-21f3-43c9-b78b-c75a58426d9f
single
Cavernous hemangioma is characterized by:
A i.e. Reticulated popcorn like configuration T2 gradient echo MRI is the investigation of choice for identification of cavernous angioma (cavernous hemangioma or cavernoma), which typically demonstrates a mass characterized as popcorn in appearance (mulberry shaped lesion)Q.
1
Reticulated popcorn like configuration
Well defined nidus
Well defined aerial feeder
Phlebectasis
Radiology
null
024dd67f-5af2-4f51-8633-e8b06ea3bf54
single
Munsell scale and lab system measure:
A popular system for the visual determination of color is the Munsell color system, the parameters of which are represented in three dimensions, hue, value, and chroma. These three parameters constitute the three dimensions of “color space”.
1
Quantity of color
Quality of color
Both
null
Dental
null
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multi
Which flexor muscle is attached to hook of hamate?
Ans. is 'c' i.e., Flexor digiti minimi
3
Flexor pollicis brevis
Flexor pollicis longus
Flexor digiti minimi
Flexor carpi ulnaris
Anatomy
null
2620835a-2319-4907-87cd-93de5b17dcdd
single
Nikolsky sign is positive in all except –
null
2
Pemphigus
Bullous pemphigoid
Toxic epidermal Necrolysis
Staphylococcal skin scaled syndrome
Dental
null
a0e5a51c-40c3-425c-abee-4dfcd1399511
multi
The enzyme not involved in substrate level phosphorylation is:
(Refer: Harper’s Illustrated Biochemistry, 27th edition, pg no: 172 – 185) Oxidative phosphorylation The energy released as a result of biological oxidation is trapped in the form of higher energy phosphate bonds in ATP by phosphorylation of ADP.
2
Succinyl thiokinase
Phosphofructokinase
Pyruvate kinase
Phosphoglycerate kinase
Unknown
null
2ff94bbd-cb1b-4f7a-b2e3-5f557b788f60
single
DNA fingerprinting can be done with all, except: UP 07; Delhi 08; NEET 13
Ans. RBC
1
RBC
WBC
Saliva
Spermatozoon
Forensic Medicine
null
a2daf894-78cf-45b2-9c88-67b0db80b8dd
multi
Spleen is derived from -
Ans. is 'b' i.e., Dorsal mesogastrium o Spleen develops as a collection of mesenchymal cells in the dorsal mesogastrium.o Initially the splenic tissue is arranges as a number of lobules which later join together to form a single spleen. The notches in the superior border of adult spleen are representatives of growth that separated the lobules during fetal period.
2
Ventral mesogastrium
Dorsal mesogastrium
Septum transversorium
Allantois
Anatomy
Spleen
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multi
The following vaccine, if contaminated can cause Toxic Shock Syndrome (TSS) -
Toxic shock syndrome (TSS) occurs while measles vaccine is contaminated or the same vial is used for more than one session on the same day or next day. Now the question arises, why only measles vaccine causes TSS more commonly and not the other commonly used vaccines? : - It is due to the absence of preservatives. Preservatives are substances used in vaccines to prevent bacterial & fungal contamination. Measles vaccine contains limited or no amount of preservative, therefore rapid multiplication of pathogen takes place. Most of the other commonly used vaccines contain preservatives. Note : TSS can be caused by all vaccines (Park 20th/e 107), but it is mostly associated with measles vaccine.
1
Measles vaccine
DPT
Hepatitis B
Typhoral
Social & Preventive Medicine
null
c29b2b3f-c2db-4444-b891-44c5fd14d90f
single
Name the technique which usually involves teaching the patient how to induce a state of deep muscle relaxation and describing imaginary scenes relevant to his fear:
Desensitization: The technique usually involves teaching the patient how to induce a state of deep muscle relaxation and describing imaginary scenes relevant to his fear. Indications of desensitization are: Child's initial visit. At subsequent appointments when introducing dental procedures which are new to the patient. When treating referral patients.
1
Desensitization
Contingency management
Hypnosis
null
Dental
null
ca229cd0-dd50-452e-84fd-e55fe5d73fd6
multi
Best way to confirm that no stones are left back in the CBD?
Ans. is 'c' i.e., Cholangiogram o "An operative cholangiogram at time of cholecystectomy will also demonstrate presence or absance of bile duct stones".o "If a CBD exploration was performed and a T-tube left in place, a T-tube cholangiogram is done before its removal".
3
Choledochoscope
Palpation
Cholangiogram
ERCP
Surgery
Gallstone Disease
6c74dfb0-dd94-4905-905d-6d2b5e5c76cf
single
Fallopian tube dysmotility is seen in ?
Kaagener syndrome Repeat from Nov 09 Q no. l58
3
Noonan syndrome
Turner syndrome
Kaagener syndrome
Marfan syndrome
Surgery
null
a340624c-9ff1-41f3-a1ef-779661cd68d5
multi
Definite diagnosis of pregnancy include all, except: Kerala 09; 11
Ans. hCG in blood
4
Fetal hea sound
Palpation of fetal pas
Fetal skeleton on X-ray
hCG in blood
Forensic Medicine
null
8947272a-306b-4737-8811-13ae1d67e8df
multi
Which of the following is a precancerous condition of cancer stomach?
Premalignant Conditions of gastric carcinoma Atrophic gastritis: Both type A (autoimmune pernicious anemia) and type B (associated with H. Pylori) atrophic gastritis are associated with increase risk for gastric cancer. Gastric Polyp: Gastric polyp are of 5 type - inflammatory, hamaomatous, heterotopic, hyperplastic and adenomatous. Of these two namely hyperplastic and adenomatous are associated with increased risk for gastric carcinoma. Adenomatous polyp is having a risk of approximately 38% of malignant transformation and hyperplastic polyp have only Intestinal metaplasia and dysplasia: Both are precursor lesion of gastric cancer. Familial adenomatous polyposis coli: patients with familial adenomatous polyposis have a high prevalence of gastric adenomatous polyp (50%) and 10 times more likely to develop adenocarcinoma stomach. Ref: Schwaz 9/e, Page 927; Maingot's 10/e, Page 1006.
2
Peptic ulcer
Chronic gastric atrophy
Achalasia cardia
Curling's Ulcer
Surgery
null
2122dd25-fcb9-43cd-b51f-e8a881e4912f
single
Following are the normal features in temporomandibular joint except
null
2
Joint sound
Pain while opening the mouth
Deviation of the mouth in opposite while opening the mouth in eccentric movements
None of the above
Surgery
null
5070a51d-4bab-46ed-ba4b-f4039a963075
multi
Confirmatory test for syphilis -
null
2
VDRL
FTA-ABS
RPQ
null
Microbiology
null
96a5ee5c-1e10-4c58-a3a4-bdcea20abcc4
multi
Feature of slow filter (w.r.t. fast filter) is/are:
Ans. is 'd' i.e. Takes more time for purification o Slow sand filter occupies large area (more space). o Slow and filter requires less skilled operation. o Slow sand filter removes more bacteria and has better bacterial control (99.9-99.99%) o Slow sand filter requires longer duration for purification. o Size of sand is smaller (0.2-0.3 mm).
4
Occupies less space
Highly skilled operation
Poor bacterial quality
Takes more time for purification
Social & Preventive Medicine
null
e12f3e1c-5f3c-41ba-bd76-b894607f9128
single
Whitnall's Tubercle is present in
Whitnall&;s or zygomatic tubercle is a palpable elevation on the zygomatic bone just within the orbital margin. It provides attachment to the lateral check ligament of the eyeball.Reference: Chaurasia Head and Neck; 6th edition; Page no: 27
1
Lateral wall of Orbit
Medial wall of Orbit
Roof of Orbit
Floor of Orbit
Anatomy
Head and neck
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multi
Extended spatulation of ZnPO4
null
1
Prolongs the setting time
Decreases the setting time
Does not alter the setting time
All of the above
Dental
null
f9a43bc3-3a43-4b54-ab11-21d9b90c04fa
multi
Privation of any member of joint is a .... hu:
B i.e. Grevious
2
Simple
Grevious
Serious
Dangerous
Forensic Medicine
null
ece6207f-fd4d-404d-a11d-60edcbb83413
single
All of the following are associated with supracondylar fracture of humerus, except-
Median nerve, especially anterior interosseous branch, is injured most commonly.
4
It is uncommon after 15 yrs of age
Extension type fracture is more common than the flexion type
Cubitus varus deformity commonly results following malunion
Ulnar nerve is most commonly involved
Orthopaedics
null
4ea65394-f23f-4418-ba9b-7215bd9b2e83
multi
Golgi tendon apparatus conveys message to cns, depends upon
The Golgi tendon organ (GTO) (also called Golgi organ, tendon organ, neurotendinous organ or neurotendinous spindle) is a proprioceptive sensory receptor organ that senses changes in muscle tension. It lies at the origins and inseion of skeletal muscle fibers into the tendons of skeletal muscle. It provides the sensory component of the Golgi tendon reflex.(Ref: Ganong&;s review of medical physiology 23rd edition Page no: 162 )
1
Tension in muscle
Length of muscle
Rapaidity of contraction
Blood supply
Physiology
General physiology
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single
FRC is volume of air in lung after ?
Ans. is d i.e., Normal expiration
4
Maximal inspiration
Maximal expiration
Normal inspiration
Normal expiration
Physiology
null
4e6981a4-1144-4e58-a5d9-ca14a5b595d6
single
An infant presented with erythematous lesions on cheek and extensor aspect of upper and lower limbs. There is a family history of Asthma. The probable diagnosis is:
History of atophy (asthma) in family, with erythematous lesions on face (cheek) and extensor surface of limbs is suggestive of atopic dermatitis. Ref: Pediatric Allergy, Asthma And Immunology By Arnaldo Cantani, 2008, Page 511; Harrison's Principles of Internal Medicine 16th Edition, Page 268; Roxburgh's Common Skin Diseases 17th Edition, Page 105-112; Illustrated textbook of dermatology: Pasricha 3rd Edition, Page 152; Fitzpatrick's Dermatology in General Medicine 6thEdition, Page 1181-1203; Rooks Textbook of Dermatology 7th Edition, Page 18.1-18.30
2
Air borne contact dermatitis
Atopic dermatitis
Seborraehic dermatitis
Infectious eczematoid dermatitis
Skin
null
76f1428f-1754-41ba-8a15-135665844338
single
Microbiological waste should be segregated in which color bag:
Ans. A. YellowColor coded bagItemYellow bagInfectious non-plastic (Anatomical & microbiological)Red bagInfectious plastic wasteWhite/Translucent sharp container (Puncture proof box)Metal sharpBlue container (Puncture proof box)Broken glass items and metal implants
1
Yellow
Red
Blue
Black
Microbiology
General
fae6b4a7-8bcc-4a7b-a00f-48808631bc7d
single
Which of the following is a dynamic cause of intestinal obstruction: March 2011
Ans. A: Gall stoneGall stone causes dynamic ileus (intraluminal cause)Adynamic cause of intestinal obstruction includes 1) paralytic ileus, 2) mesenteric vascular occlusion and 3) pseudo-obstructOgilvie's syndrome is acute colonic pseudo-obstruction
1
Gall stone
Paralytic ileus
Mesenteric vascular obstruction
Ogilvie syndrome
Surgery
null
0aed05a7-9800-4a25-b58c-17cfe6bac91b
multi
Which of the following is not a rapidly growing atypical mycobacteria causing lung infections -
null
4
M. chelonae
M.fortuitum
M.abscessus
M.kansasii
Microbiology
null
f2ac43ce-1b23-47d7-9595-ca5515515b0f
single
All of the following anticancer drugs are cell cycle non-specific except?
CELL CYCLE NON-SPECIFIC DRUGS 1. Alkylating agents Melphalan Cyclophosphamide Nitrosourea 2. Platinum compounds Cisplatin Carboplatin Oxaliplatin 3. Anthracyclines Doxorubicin Daunorubicin Epirubicin Mitoxantrone 4. Antitumor antibiotics Dactinomycin Mitomycin-C
2
Cisplatin
Vincristine
Mitomycin-C
Cyclophosphamide
Pharmacology
Cytotoxic Anticancer Drugs
fe374efe-4600-4d12-9ed1-1d9f8aafca4a
multi
Pulmonary plethora is seen in ?
PLETHORA= INCREASED PULMONARY MARKINGS SEEN IN TAPVC, ASD,VSD, TGA REF : BRAUWALD CARDIOLOGY
1
TAPVC
TOF
EBSTIEN ANAMOLY
TRICUSPID ATRESIA
Medicine
All India exam
90f33636-ab0a-4db3-a03d-4270bd9045f8
single
A 40-year-old patient presents with an inability to keep the arm in contact with the chest. When the arm is forcibly brought into contact with the chest there is winging of the scapula. There is a history of repeated intramuscular injections into the deltoid muscle. What is the diagnosis?
Ans. C. Deltoid contractureThe above history and examination suggest a diagnosis of deltoid contracture.* Deltoid contracture can be congenital or acquired. Anatomical aberrations, repeated intramuscular injections into the deltoid, chronic infection due to the injected drugs and pressure ischemia are all causes of acquired contracture.* A patient with a deltoid contracture presents with inability to keep his arm in contact with the chest in the anatomical plane of the scapula. When the arm is forcibly brought into contact with the chest there is winging of the scapula. On palpation, a thick intermediate fibrotic deltoid is felt.
3
Serratus anterior muscle palsy
Poliomyelitis
Deltoid contracture
Neglected anterior dislocation of shoulder
Orthopaedics
Injuries Around Shoulder
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single
Most common site of metastasis for Breast Carcinoma is
1) Bone(most common) (70%) - in order -lumbar veebrae, femur, ends of long bone, thoracic veebrae, ribs, skull 2)Liver 3)Lung- causes malignant pleural effusion and cannon ball secondaries. 4)Brain- causes increased ICP 5)Adrenals and ovaries Reference: SRB's Manual of Surgery, 6th Edition, page no = 530.
4
Thoracic veebra
Pelvis
Femur
Lumbar veebra
Surgery
Endocrinology and breast
1f878ad7-2362-466d-9d06-a8e0e6e6bc15
single
Life-threatening intravascular hemolysis, due to a toxin with lecithinase activity, occurs with sepsis due to:
Life-threatening intravascular hemolysis, due to a toxin with lecithinase activity, occurs with Clostridium perfringens sepsis. Reference: Harrisons Principles of Internal Medicine, 18th Edition, Page 881
4
Pseudomonas
Babesia
Parvovirus B 19
Clostridium perfringens
Medicine
null
c7dc4138-78a0-47d3-a887-5be40e19f29f
single
Causes of atonic PPH are following except :
Preeclamptic
4
Fibroid
Multiple pregnancy
Multiparity
Preeclamptic
Gynaecology & Obstetrics
null
ff3b3ccd-3f29-417b-9202-780dfd3a49a2
multi
Inspiratory stridor is found in what kind of lesions
Airway obstruction above the glottis - an inspiratory stridor Obstruction in the lower trachea & bronchi - indicative of expiratory stridor Lesion in glottic or subglottic lesion. - A biphasic stridor So answer is option a - supraglottis Ref : PL Dhingra 7th edition ; pg num:- 333,334
1
Supraglottic
Subglottic
Tracheal
Bronchus
ENT
Ear
eae6bf1b-9984-45d5-a3f8-4193ace9a603
single
Which class of antifungals inhibits the synthesis of the fungal cell wall
ECHINOCANDINS Caspofungin It is the first and the prototype member of the class, active mainly against Candida and Aspergillus mechanism of action:- It inhibits the synthesis of b-1, 3-glucan, which is a unique component of the fungal cell wall. Cross linking between chitin (a fibrillar polysaccharide) and b-1, 3-glucan gives toughness to the fungal cell wall. Weakening of the cell wall by caspofungin leads to osmotic susceptibility of fungal cell, which then succumbs. Pharmacokinetics:- Caspofungin is not absorbed orally; has to be infused i.v. It is distributed into tissues, but does not enter CSF. Metabolism is extensive and metabolites are excreted in urine as well as faeces with a plasma t 1/2 of 10 hours. uses:- Caspofungin is approved for use in deep and invasive candidiasis, esophageal candidiasis and salvage therapy of nonresponsive invasive aspergillosis. Because of good tolerability, it is now increasingly used in neutropenic immunocompromised patients whose fever is not responding to antibacterial antibiotics. Ref:- kd tripathi; pg num:-790
2
Polyene macrolides
Echinocandins
Azoles
Allylamines
Pharmacology
Antibiotics
64056ecd-4d50-4e9b-8d75-3db2f9b2b40a
multi
All are tubal patency tests EXCEPT
Ans. c (Fern test). (Ref. Shaws, Textbook of Gynaecology, 12th/pg.l62)Tests for tubal patencyTests for ovulation1CO2 insufflation/Rubin's test (obsolete)BBT2HSGEndometrial biopsy3Laproscopic chromopertubationFern test4Sonosalpingography and standard USGFolliculometry (USG) -noninvasive, accurate, safe5HysteroscopyHormonal study (progesterone, LH and prolactin)6Transcervical falloscopy 7Ampullary and fimbria! salphingoscopy
3
Tubal CO2 insufflation test
Laproscopy
Fern test
HSG
Gynaecology & Obstetrics
Gynaecological Diagnosis
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Lacerated wound looks like incised wound over:
A i.e. Scalp
1
Scalp
Abdomen
Thigh
Forearm
Forensic Medicine
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single
All of the following are features of hallucinations, except:
B i.e. Sensory organs are not involved
2
It is independent of the will of the observer
Sensory organs are not involved
It is as vivid as that in a true sense perception
It occurs in the absence of a perceptual stimulus
Psychiatry
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Which of the following drugs should NOT be used in the setting of severe hypeension in elderly on empirical basis?
For the elderly, alpha blockers like prazosin can cause severe hypotension and 1st dose hypotension DOC for elderly with severe HTN - CCBs DOC for HTN with diabetes- ARBs or ACE inhibitors Ref:Tripati 8th edition
4
Enalapril
Amlodipine
Chlohiazide
Prazosin
Pharmacology
Cardiovascular system
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The following structures are felt on per rectal examination except
During this procedure, areas which can be palpated are: the bulb of the penis, the urogeital diaphram-, the annorectal ring, and other nearby anatomical landmarks. However, structures like the ureter(the two tubes that run from each kidney to the urinary bladder), and the urethra (which, in a male, is divided into three pas, and is inside the penis) cannot be palpated. Ref - researchgate.net
2
Bulb of penis
Ureter
Anorectal ring
Urogenital diaphragm
Anatomy
Abdomen and pelvis
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multi
The commonest valvular lesion in SLE-related cardiac disease is-
Valvular involvement is the most encountered form of hea disease in systemic lupus erythematosus (SLE). Immunoglobulin and complement deposition in the valvular structure will subsequently lead to Libman-Sacks vegetations, valve thickening, and valve regurgitation. Valvular stenosis is rarely seen.resulting in mitral regurgitation Ref Davidson 23rd edition pg 455
2
Tricuspid regurgitation
Mitral regurgitation
Mitral stenosis
Aoic regurgitation
Medicine
C.V.S
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Most common epithelial tumor of lacrimal gland:-
Pleomorphic adenoma are most common epithelial tumors of lacrimal gland Lacrimal tumors High Yield Facts Pleomorphic adenoma are most common epithelial tumors of lacrimal gland Adenoid cystic adenocarcinoma are most common malignant tumors of lacrimal gland. They are usually painful Present with superotemporal mass and inferonasal dystopia Inflammatory lesion and lymphomas are most common tumors of lacrimal gland
2
Adenoid cystic carcinoma
Pleomorphic adenoma
Squamous cell carcinoma
Non hodgkins lymphoma
Ophthalmology
Nasolacrimal Disorders
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Digoxin acts by inhibiting:
Ans: a (Na K ATPase) Ref: Tripathi, 6th ed, p. 499All cardiac glycosides are potent and highly selective inhibitors of the active transport of Na+ and K+ across cell membranes by their reversible binding to the alpha subunit of the. Na+, K+- ATPase the elimination 11 /2 for digoxin is 36 hours in patients with nonnal renal function. Digoxin is excreted by the kidney with a clearance rate that is proportional to the glomerular filtration rate. It is now recommended that digoxin be reserved for patients with heart failure who are in atrial fibrillation, or for patients in sinus rhythm who remain symptomatic despite maximal therapy with ACE inhibitors and beta adrenergic receptor antagonists. Although the drug has no net effect on mortality, it reduces hospitalization and death, from progressive heart failure at the expense of an increase in sudden death.Other than heart failure digitalis is useful in the management of atrial arrhythmias because of its cardioselective parasympathomimetic effects. In atrial flutter and fibrillation, the depressant effect of the drug on atrioventricular conduction will help control an excessively high ventricular rate. Digitalis has also been used in the control of paroxysmal atrial and atrioventricular nodal tachycardia.ToxicityExtracardiacAnorexia, nausea, vomiting are usually first symptoms of toxicity. Other complaints include fatigue, malaise, headache, mental confusion, restlessness, disorientation, psychosis and visual disturbances.CardiacAlmost every type of arrhythmia can be produced by digitalis: pulsus bigeminis, nodal and ventricular extrasystoles, ventricular tachycardia and fibrillation. Partial to complete A-V block, severe bradycardia.Atrial extra systoles, AF or atrial flutter have also been noted.Treatmenta) For tachyarrythmias:KC1 infusion 20 m mol /hr IV or give orally in mild cases.b) For ventricular arrythmias: Lidocaine IV repeated as required is the drug of choice.c) For supraventricular arrythmias: Propranolol may be given IV or oral depending on urgencyd) For A-V block and bradycardia: Atropine 0.6-1.2 mg IM may help: otherwise cardiac pacing is recommended.Therapy of toxicity manifested as visual changes or gastrointestinal disturbances generally requires no more than reducing the dose of the drug.Immunotherapy with purified Fab fragments from bovine antidigoxin antisera (DIGIBIND) provides an effective antidote for lifethreatening digoxin toxicity.Precautions and contraindicationsHypokalaemia:enhances digitalis toxicityby increasing its binding to Na+ K+ATPase elderly, renal or severe hepatic disease Myocardial infarction: sever arrythmias are more likely thyrotoxicosis-reduces responsiveness to digitalis.Myxedema: these patienst eliminate digoxin more slowly, toxicity can appearVentricular tachycardia:digitalis is contraindicated, may precipitate ventricular fibrillationIt is explicitly contraindicated in patients with Wolff-Parkinson-White syndrome and atrial fibrillation
1
Na K ATPase
Ca channel
K channel
Adenyl cyclase
Pharmacology
C.V.S
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