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Oximes are contraindicated in which poisoning: NEET 13
|
Ans. Carbamate
| 4
|
Malathion
|
Diazinon
|
Phorate
|
Carbamate
|
Forensic Medicine
| null |
0c101f82-8e4b-47f0-ba4b-706846433823
|
single
|
High environmental temperature, best step for malaria control-
|
Ans. is 'a' i.e., Remove breeding place "The most important step in reducing number of mosquitoes is to eliminate their breeding places "..............ParkAntilarval MeasuresEnvironmental control(source reduction)Chemical control(Larvicidal agents)Biological controlThe most important step in reducing number of mosquitoes is to eliminate their breeding places.Methods include :a) Minor engineering methodsy Levellingy Fillingy Drainage of breeding placesb) Water management:y Intermittent irrigationy Changing salinity of water (making water unsuitable for mosquito breeding)Employs usage of chemical insecticides that act as larvicides]i.) Mineral oilsii) Paris green (copper aceto- arsenite)iii)Synthetic insecticidesy Fenthiony Chlorpvrfosy AbateEmploys usage of small fish that feed on mosquito larvae# Gambusia affinis# Lebister reticulatus
| 1
|
Remove breeding place
|
Full sleeve cloth
|
Indoor insecticide
|
Early treatment
|
Social & Preventive Medicine
|
Malaria
|
ec813bf5-a147-4783-87f1-7ff48b3373d7
|
multi
|
A 42 yr old male from srilanka presented with multiple polyps in nose .the causative agent might be
|
Rhinosporidiosis -common in India, Srilanka .pt presents with multiple friable polyps in nose, mouth or eye. It is a chronic granulomatous disease Ref: Baveja 5th ed pg: 552
| 2
|
Histoplasma
|
Rhinospiridium
|
Coccidiodes
|
Mucor
|
Microbiology
|
mycology
|
6b832f26-ba8d-422a-8f34-f6e36704ad4f
|
single
|
In a patient with chronic atrial fibrillation with a regular beat of 60/min , the most probable cause is -
| null | 2
|
Sleep
|
Digitalis toxicity
|
Sino nodal block
|
Hypothyroidism
|
Medicine
| null |
f2bf673e-954d-413a-a79b-358d951599f2
|
single
|
A 50 year old male patient complains of heaviness of face, headache and blocked nose. Patient gives history of chronic sinusitis. Waters view x-ray was taken. If the patient’s mouth is open during x-ray, the sphenoid sinus is seen superimposed over-
|
Waters view-
The image receptor is placed in front of the patient and perpendicular to the midsagittal plane. The patient’s head is tilted upward so that the canthomeatal line forms a 37-degree angle with the image receptor. If the patient’s mouth is open, the sphenoid sinus is seen superimposed over the palate.
White and Pharoah, Oral radiology, ed 7th, pg-161
| 4
|
Nasal bone
|
Coronoid process
|
Maxillary sinus
|
Palate
|
Radiology
| null |
795f366d-19f2-4725-b0d3-a4262ff688a2
|
single
|
Streptococcal toxic shock syndrome is due to liberation of-
|
Ans. is 'c' i.e., Pyrogenic exotoxin . Streptococcal toxic shock syndrome ---> Pyrogenic exotoxin 'A' . Staphylococcal toxic shock syndrome -Toxic shock Syndrome Toxin Type - 1 (TSST-1) also known as enterotoxin-F or Pyrogenic exotoxin C. Rarely enterotoxin B or C may also cause TSS.
| 3
|
TSS - 1
|
Enterotoxin
|
Pyrogenic exotoxin
|
Endotoxin
|
Microbiology
| null |
16b739ad-e657-499d-9b15-0c83c65f9e2a
|
single
|
Symptoms of opioid withdrawal are all, EXCEPT:
|
Opioid withdrawal syndrome may resemble a severe flu-like illness. The syndrome is characterized by rhinorrhea, sneezing, yawning, lacrimation, abdominal cramping, leg cramping, piloerection (gooseflesh), nausea, vomiting, diarrhea, dilated pupils, fever, and insomnia. Heroin and methadone withdrawal symptoms peak in 36-72 hours and 72-96 hours, respectively, and may last for 7-10 days and at least 14 days, respectively.
| 1
|
Polyuria
|
Yawning
|
Fever
|
Insomnia
|
Forensic Medicine
| null |
32d2a9f6-d4f3-4d9b-bfe5-f271477839f4
|
multi
|
NSAIDs attenuate action of which of the following diuretics:
|
Loop diuretics increase prostaglandin production by stimulating Cycloxygenase enzyme (COX) and NSAIDs attenuate the diuretic action of these drugs.
| 2
|
Carbonic anhydrase inhibitors
|
Loop diuretics
|
Thiazide diuretics
|
Spironolactone
|
Pharmacology
| null |
3e9dcb9e-8c8d-4082-aab0-015d188ce291
|
single
|
Which one of the following needs cholesterol and other lipids for growth -
|
Ans. is 'd' i.e., Mycoplasma . Unique among prokaryotes is the requirement of most mycoplasma for cholesterol and related sterols, which are incorporated in their surface membrane.
| 4
|
Mycobacterium TB
|
Chlamydia
|
Hemophilus
|
Mycoplasma
|
Microbiology
| null |
98cd9dca-cfea-4856-915f-dd34ff981322
|
single
|
Which among the following is the best method to assess intake of fluid in poly trauma patient:
| null | 1
|
Urine output
|
CVP
|
Pulse rate
|
BP
|
Surgery
| null |
a16a6f05-57aa-458b-bd6b-6ff47f4690d8
|
single
|
The threshold limit value of mercury exposures is:
| null | 2
|
0.01 mg / m3
|
0.05 mg/ m3
|
0.1 mg /m3
|
0.001 mg /m3
|
Dental
| null |
709aedd3-5383-4b37-b0cf-9c44e701cd0e
|
single
|
A CKD patient had to undergo dialysis. His Hb was 5.5. So two blood transfusions were to be given. First bag was completed in 2 hours. Second was staed and midway between he developed shoness of breath, hypeension. Vitals: BP 180/120 mm Hg and pulse rate 110/min. What is the cause?
|
Usually 1 bag takes 4 hr. Option A- Allergic it is very nonspecific symptom Here word mismatch blood transfusion would be a better answer. Option B- TACO As he has been administered with 2 units of blood at a very fast rate causing volume overload Contributing to pulmonary edema Volume expansion-HTN- Compensatory tachycardia Option C- TRALI Ruled out d/t fact that in this case as 1st unit of blood was given much faster even though it wasn't an emergency from the perspective that he is not bleeding, Fast transfusion given to patients with bleeding, moreover it was wrong to give patient with CKD blood transfusion ideally SHOULD Be given erythropoietin injection or packed RBC to patient. If we do volume expansion of patients, chances of pulmonary edema are high. TRALI ruled out because in a question above there are symptoms of volume overload mentioned. TRALI could be answer if Normal BP & no volume overload (it is a non-cardiogenic pulmonary edema.) Option D- Febrile non hemolytic transfusion Rxn causes fever, chills and rigors but does not result in development of HTN, |HR in patients.
| 2
|
Allergic
|
Transfusion related circulatory overload (TACO)
|
TRALI
|
FNHTR
|
Medicine
|
Blood Bank & Transfusion Therapy
|
654216b5-a0c7-461d-a6ae-e8a3f316783d
|
multi
|
A 30-year-old male, Rajinder presents to your office with fatigue, muscle weakness and headache. His blood pressure is 170/120 mm Hg and his hea rate is 100/min. Laboratory evaluation reveals hypokalemia, metabolic alkalosis and decreased plasma renin activity. On CT scan, a mass was noted on left suprarenal gland. Patient was prescribed a drug for few weeks and the symptoms subsided. Laboratory values and blood pressure returned to normal values. The likely drug given to this patient is?
|
Mosty likely diagnosis in this patient is aldosterone secreting tumor (adenoma) leading to primary hyperaldosteronism (Conn's Syndrome). Aldosterone excess will cause hypeension, hypokalemia, metabolic alkalosis and depressed renin. Aldosterone antagonists such as spironolactone or eplerenone can be used as medical therapy for Conn's syndrome.
| 4
|
Clonidine
|
Propanolol
|
Hydrochlorothiazide
|
Spironolactone
|
Pharmacology
|
Kidney
|
18269b74-4837-43b7-96ed-d191f63e35d2
|
single
|
Reduction of diametervat the muzzle end of a barrel of shotgun is called
|
Choking Reduction of diameter at the muzzle end of the barrel of a shotgun is called choking Choking reduces the dispersion of pellets and holds the pellets together for a longer distance Choke- bore means diameter of the barrel is reduced at the muzzle end. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 137
| 2
|
Rifling
|
Choking
|
Yawing
|
Tembling
|
Anatomy
|
Miscellaneous
|
2c1dd4b8-4494-4232-a364-7c77acc134e0
|
multi
|
CSF pressure depends primarily on:
|
Rate of CSF absorption
| 1
|
Rate of CSF absorption
|
Rate of formation from the choroid plexus
|
Cerebral blood flow
|
Blood pressure
|
Anatomy
| null |
f5c44f09-8c38-4c18-90fd-116af6f38841
|
single
|
Meig's syndrome is commonly associated with:
|
Meig's syndrome is present with ovarian fibroma, ascites and right sided pleural effusion Any other ovarian tumor or a pedunculated fibroid causing ascites with pleural effusion is known as Pseudo Meig's syndrome Most common cause of Pseudo meig's syndrome is Brenner tumor.
| 3
|
Teratoma
|
Brenner tumour
|
Fibroma
|
Theca cell tumour
|
Gynaecology & Obstetrics
|
Ovarian Tumors
|
b1bd2eff-fb59-40ec-9f35-c5dcef85b29e
|
single
|
The phase I reactions of drug metabolism include the following except:
|
Biotransformation reactions can be classified into:
Nonsynthetic/Phase 1/Functionalization reactions:
A functional group (- OH, -COOH, -CHO, H2, - SH) is generated or exposed- metabolite may be active or inactive.
Synthetic / Conjugation / Phase lI reactions:
An endogenous radical is conjugated to the drug- metabolite is mostly inactive; except few drugs, e.g. glucuronide conjugate of morphine and sulfate conjugate of minoxidil are active.
Certain drugs already have functional groups and are directly conjugated, while others undergo a phase I reaction first followed by a phase II reaction.
| 4
|
Hydrolysis
|
Reduction
|
Oxidation
|
Conjugation
|
Pharmacology
| null |
73667260-99c8-4624-916a-68380ee9dc2b
|
multi
|
Oblique popliteal ligament is pierced by ?
|
Ans. is 'd' i.e., Middle genicular branch of popliteal aery Oblique popliteal ligament It is an expansion from the tendon of semimembranosus attachment to intercondylar line of femur.It is closely related to popliteal aery and is pierced by middle genicular vessels and nerve and the terminal pa of the posterior division of the obturator nerve.
| 4
|
Anterior branch of popliteal aery
|
Medial inferior genicular branch of popliteal aery
|
Medial superior genicular branch of popliteal aery
|
Middle genicular branch of popliteal aery
|
Anatomy
| null |
f68e192e-0a3a-452e-8221-96e3fa7b0d19
|
single
|
A nurse is giving instructions to a client who is receiving Mycophenolate mofetil (CellCept) and Mycophenolic acid (Myfortic) after undergoing a heart transplant. The nurse tells the client to anticipate the following side effects, except?
|
These medications can cause diarrhea, vomiting, sepsis, back pain, neutropenia and hypertension.
| 1
|
Insomnia.
|
Vomiting.
|
Hypertension.
|
Diarrhea.
|
Medicine
| null |
3f488ccd-7c3a-4ee8-8d2f-1ea04a2a01ae
|
multi
|
Mechanism of action of theophylline in bronchial asthma is:
|
Ans. (A) Phosphodiesterase 4 inhibition(Ref: Katzung 11th/e p345; KDT 8th/e p245)Theophylline is used in bronchial asthma. Its mechanism of action is:Inhibition of phosphodiesterases particularly PDE-4.Antagonism of adenosine receptors.Enhancement of histone deacetylation. Acetylation of histone is required for activation of inflammatory gene transcription. By inhibiting this process, low-dose theophylline may restore responsiveness to corticosteroids.
| 1
|
Phosphodiesterase 4 inhibition
|
Beta2 agonism
|
Anticholinergic action
|
Inhibition of mucociliary clearance
|
Pharmacology
|
Asthma
|
bb5dda5b-b7a0-48ab-8509-d74fcd374c53
|
single
|
Structure forming medial boundary of femoral ring is:
|
Ans. C i.e. Lacunar ligament
| 3
|
Inguinal ligament
|
Pecten pubis
|
Lacunar ligament
|
Conjoint tendon
|
Anatomy
| null |
f9cd9a87-0dbb-42c2-8b37-590a613ac2f7
|
single
|
Following admission to the hospital for intestinal obstruction, a 48-year-old woman states that she previously had undergone cholecystectomy and choledochoduodenostomy. The most likely indication for the performance of the choledochoduodenostomy was:
|
Multiple stones were present in the CBD at the previous operation. During exploration of the CBD, most stones can be removed by using Desjardin's forceps or under direct vision using a choledochoscope and Dormia basket. However, if there are multiple stones impacted in the lower part of the CBD, a drainage procedure may be indicated. The CBD must be dilated before considering performing a choledochoduodenostomy at the time of gallbladder surgery (Figure below). If a stone is present in a dilated CBD after previous cholecystectomy, a choledochoduodenostomy is performed, because the rate of recurrent jaundice is high (>20%). Alternatively ERCP and sphincterotomy could be considered.Treatment for invasive gallbladder cancer is cholecystectomy and a wedge resection of the liver along with a regional lymphadenectomy. The wedge resection of the liver is illustrated. Segments 4 and 5 together with the lymph node regions should be removed.
| 3
|
Hepatic metastasis were present.
|
Multiple stones were present in the gallbladder at the previous operation.
|
Multiple stones were present in the CBD at the previous operation.
|
The common hepatic duct had a stricture.
|
Surgery
|
Pancreas
|
05c29e05-aa6c-4bf4-bc3d-79bac0903ecd
|
multi
|
Normal role of Micro RNA is
|
MicroRNA (abbreted miRNA) is a small non-coding RNA molecule (containing about 22 nucleotides) found in plants, animals, and some viruses, that functions in RNA silencing and post-transcriptional regulation of gene expression.miRNAs (microRNAs) are sho non-coding RNAs that regulate gene expression post-transcriptionally. They generally bind to the 3&;-UTR (untranslated region) of their target mRNAs and repress protein production by destabilizing the mRNA and translational silencing.
| 1
|
Gene Regulation
|
RNA splicing
|
Initiation of translation
|
DNA conformational change
|
Biochemistry
|
Metabolism of nucleic acids
|
bbe3d2fd-68f9-49fa-bca5-7b36c8ce091d
|
single
|
Malignant tumor associated with Waldenstrom macroglobulinemia includes -
|
Waldenstrom macroglobulinemia is a syndrome in which high levels of IgM lead to symptoms related to hyperviscosity of the blood. It occurs in older adults , most commonly associated with lymphoplasmacytic lymphoma. Smoldering myelomas an uncommon variant of multiple myeloma defined by a lack of symptoms and a high plasma M component. Primary effusion lymphoma presents as a malignant pleural or ascitic effusion in patients with advanced HIV and older adults. Mycosis fungoides is a slowly evolving cutaneous T cell lymphoma occuring in middle aged adult males. Reference; Robbins and Cotran Pathologic basis of disease.South Asia Edition volume 1.page no. 596,598 Harsh Mohan textbook of pathology, 7th edition.Pg no.359
| 4
|
Smoldering myeloma
|
Primary effusion lymphoma
|
Mycosis fungoides
|
Lymphoplasmacytic lymphoma
|
Pathology
|
Haematology
|
552901c4-38e6-4bb4-925b-0580c5cfb35e
|
single
|
Death occurs faster in: MP 08
|
Ans. Fresh water drowning
| 1
|
Fresh water drowning
|
Salt water drowning
|
Near drowning
|
Warm water drowning
|
Forensic Medicine
| null |
36ebc5da-c86b-49f2-9b78-3e8abd0da792
|
single
|
All are to access platelet functions EXCEPT:
|
Prothrombin time REF: Wintrobe's hematology lied page 1242 Tests for platelet function: Bleeding time: Hemostasis in a small superficial wound, such as that produced when measuring the bleeding time, depends on the rate at which a stable platelet plug is formed and, thus, provides a measure of the efficiency of the vascular and platelet phases. However, it does not discriminate between vascular defects, thrombocytopenia, and platelet dysfunction. Platelet enumeration Platelet volume measurements Platelet aggregation Clot Retraction: Clot retraction usually is deficient when the platelet count is below 50,000411 and in a rare disorder of platelet function (Glanzmann thrombasthenia). It is normal in most other disorders of platelet function. This test is primarily of historical interest; Glanzmann thrombasthenia is typically diagnosed using platelet aggregation methods or flow cytometer. Tests of Coagulation Phase: Paial thromboplastin time: The PTT is a simple test of the intrinsic and common pathways of coagulation. When a mixture of plasma and a phospholipid platelet substitute is re-calcified, fibrin forms at a normal rate only if the factors involved in the intrinsic pathway (prekallikrein, high-molecular-weight kininogen, and factors XII, XI, IX, and VIII) and in the common pathway (factors X and V, prothrombin, and fibrinogen) are present in normal amounts. The PTT is somewhat more sensitive to deficiencies of factors VIII and IX than to deficiencies of factors XI and XII or factors involved in the common pathway Prothrombin time The production of fibrin by means of the extrinsic and common pathways requires tissue factor and factor VII, in addition to factors X and V, Prothrombin, and fibrinogen Thromboplastin generation test: The thromboplastin generation test is impoant for historical reasons. This two-stage test measures the amount and rate of prothrombinase formation by way of the intrinsic pathway Assay of plasma fibrinogen Interpretation of Common Tests of Hemostasis and Blood Coagulation Test Normal Range a (+-2 Common Causes of Abnormalities SD) and Reference Platelet count Thrombocytopenia, thrombocytosis Phase microscopy 140,000-440,000/u1 Automated 177,000-406,000/111 Paial thromboplastin 26-37 sec Deficiencies or inhibitors of prekallikrein; high? time(activated)* molecular-weight kininogen; factors XII, XI, IX, VIII, X, and V; Prothrombin or fibrinogen; lupus inhibitors; heparin Prothrombin time* 12.0-15.5 sec Deficiencies or inhibitors of factors VII, X, and V; prothrombin or fibrinogen; dysfibrinogenemia; lupus inhibitors; heparin Thrombin time* 18-22 sec A/dys/hypo/hyper-fibrinogenemia; inhibitors of thrombin (heparin) or fibrin polymerization (fibrin degradation products, Para proteins) Fibrinogen assay* 150-430 mg/dl Afibrinogenemia, dysfibrinogenemia, and hypofibrinogenemia; inhibitors of thrombin or fibrinpolymerization Factor VIII assay* 50-150 U/dl Hemophilia A and von Willebrand disease; acquired antibodies to factor VIII Fibrin degradation 0-5 pg/m1 Disseminated intravascular coagulation; fibrinogenolysis; product assay thrombolytic drugs, liver disease; Dysfibrinogenemia NOTE: (1 mark signifies tests affected by heparin
| 1
|
Prothrombin time
|
Bleeding time
|
Clot retraction time
|
Prothrombin deactivation
|
Pathology
| null |
d2d275b4-21c0-4e87-9ad0-6da8844a268d
|
multi
|
Bohn's nodules are
| null | 1
|
Cystic swellings in neonates
|
Cysts associated with soft palate
|
Cysts of gingiva in growing children
|
Warts on the tongue
|
Pathology
| null |
ffc8ab89-0698-4078-b977-9a3f689faf88
|
single
|
Gluconeogenesis can occur from all except
|
Substrates for gluconeogenesis are lactate (lactic acid), pyruvate, glycerol, glucogenic amino acids (all amino acids except leucine and lycine), propionate and intermediates of the citric acid cycle.
| 2
|
Lactic acid
|
Aceto acetate
|
Glycerol
|
Alanine
|
Biochemistry
| null |
573dbda0-3e06-4846-b8aa-f973d2abdf8a
|
multi
|
Which of the following vasculitis is ANCA negative
|
ANCAs are not seen in Polyarteritis nodosa.
| 4
|
Microscopic polyangitis
|
Churg straus syndrome
|
Granulomatosis with polyangitis
|
Polyarteritis nodosa
|
Pathology
| null |
64f2dcf2-c583-4649-8760-d3d9c94d5799
|
single
|
Anitskov's cells are modified:
|
Ans: b (Macrophages) Ref: Robbins, p. 593In acute rheumatic fever, focal inflammatory lesions found in the heart are called Ashoff bodies. They consist of foci of swollen eosinophils, collagen surrounded by lymphocytes, but occasionally they contain plasma cells and plump macrophages. These plump macrophages are called Anitschkow cells.They are pathognonomic of rheumatic fever.Some other important cells:-LEcell- Neutrophil in SLETart cell- lymphocyte in SLELangerhan'scell- Ag presenting cells in epidermis (modified macrophages)Langhan's cell- Giant cells in granulomaGlitter cells- leucocytes in pyelonephritisGitter cells- microglia in CNSFlame cells- plasma cells in multiple myelomaFoam cells- lipid containing macrophages in leprosyHofbauer cells- placentaArmani Ebstein cells- Epithelial cells of PCT in DM
| 2
|
Neutrophils
|
Macrophages
|
Lymphocytes
|
Eosinophils
|
Pathology
|
C.V.S
|
a8028fed-30e4-40ac-89d8-4b5c1d00cc7d
|
single
|
Increased blood volume in tissue is known as -
|
Hyperemia is an active process due to aeriolar dilatation and increased blood inflow, resulting in high blood volume at tissues. Basic Pathology, Robbins. Page no.: 75
| 1
|
Hypermia
|
Edema
|
Congestion
|
Purpura
|
Pathology
|
General pathology
|
0b8e9ab7-513f-4fe2-a0e7-4d03a040980b
|
single
|
Deformity is most commonly seen in primary osteoarthritis of the knee joint -
|
In knee joint osteoarthritis, medial joint space is affected earliest and causes asymmetrical joint space narrowing. This results in varus deformity (genu varus).
| 3
|
Genu valgum
|
Germ recurratum
|
Genu varus
|
Procurvaturn.
|
Orthopaedics
| null |
06292198-370a-455b-a7b3-add6d10997c3
|
single
|
First increase of reticulocyte count occurs after how many hours of iron therapy
|
Ans: a (48 - 72 hrs) Ref: OP Ghai, 6th ed, p. 302Rise in reticulocyte count occurs by 48 - 72 hrs after start of Iron therapy.Course of events after starting iron therapy :1. Child becomes less irritable and appetite improves within 24 hrs2. Bone marrow response is observed within 48 hrs3. Rise in reticulocyte count by 2nd to 3rd day4. Elevation of hemoglobin occurs next which may take upto 2 months depending on the severity of anaemiaNote:Dosage for parentral iron (iron dextran)Iron (mg) = Wt (kg) x Hb deficit (gm/dl) x 4
| 1
|
48 - 72 hrs
|
24 hrs
|
96 hrs
|
6 hrs
|
Medicine
|
Blood
|
bb80f176-b1c1-4af1-86ef-63f70ba96f77
|
single
|
Tongue anomaly is called as:
|
A completely cleft or bifid tongue is a rare condition that is apparently due to lack of merging of the lateral lingual swellings of this organ. A partially cleft tongue is considerably more common and is manifested simply as a deep groove in the midline of the dorsal surface. The partial cleft results because of incomplete merging and failure of groove obliteration by underlying mesenchymal proliferation. Interestingly, it is often found as one feature of the oral-facial-digital syndrome in association with thick, fibrous bands in the lower anterior mucobuccal fold eliminating the sulcus and with clefting of the hypoplastic mandibular alveolar process.
Ref:Shafer’s Ed 7th Pg 26
| 2
|
Fissured tongue
|
Bifid tongue
|
Macroglossia
|
All of the above
|
Pathology
| null |
fadb82ab-59ad-4964-85b7-66c6dac9d0b6
|
multi
|
Lymphocytic colitis
|
The characteristic feature of LC is an infiltration by lymphocytes into the colonic epithelium. Collagenous colitis (CC) shares this feature but additionally shows a distinctive thickening of the subepithelial collagen table. LC and CC have been suggested to represent different phases of a single pathophysiologic process, with LC possibly being a precursor or earlier phase of CC; however, this has not been proven. REFERANCE. MEDSCAP.COM IMAGE REF:
| 2
|
Bloody diarrhea
|
Intra epithelial lymphocytes
|
Lymphocytes is stools
|
Through Ileoscopy look for payer's patches
|
Pathology
|
G.I.T
|
88aef4f8-4bb8-449a-be92-ad4b98a5d58d
|
single
|
The most aggressive and destructive cyst is
| null | 2
|
Periapical cyst
|
Dentigerous cyst
|
Globulornaxillary cyst
|
Nasopalatine cyst
|
Pathology
| null |
1360e978-897e-4caa-8d8b-f86f8752d7a0
|
single
|
A Bone marrow transplant receipient patient, developed chest infection. ON chest Xray Tree in Bud appearance is present. The cause of this is:
|
D i.e. (RSV) - Most common cause of tree in bud (bronchiectasis) appearance is Mycobacterium tuberculosis (endobronchial). Most common specific cause of tree in bud appearance in HSL (bone marrow) transplant patients is CMV (30-70%) > RSV (18%) > M. tuberculosis (5-6%) > Pneumocystis > Invasive aspergillosis. Tree in Bud appearance 6 Months) - Pneumocystis - S.pneumoniae - CMV, Seasonal respiratory virus (RSV & para influenza viruses) - Pneumocystis - Toxoplasma " v:shapes="_x0000_s1031">Tree in bud appearance (or gloved finger appearance) is depiction of normally invisible branching course of intralobular bronchiole on HRCT. It indicates the endobronchial spread of disease lit bronchiolar luminal impaction with mucus, pus or fluid, bronchiolar wall thickening, peribronchiolar inflammation and dilatation of distal bronchioles. On HRCT, it appears as peripheral (within 5mm of pleural surface) small (2-4mm) centrilobular well defined nodules connected to linear branching opacities with more than one contiguous branching sites.
| 4
|
Klebsiella
|
Pneumocystis
|
TB
|
RSV
|
Radiology
| null |
f4691d8f-f6f6-4308-bea7-04e9f037f0e0
|
single
|
A newborn baby presents with shock, hyperkalemia and hypoglycemia. What is the most likely diagnosis-
|
Ans. is 'd' i.e., Congenital adrenal hyperplasia
| 4
|
Septicemia
|
Inborn error of metabolism
|
Diabetes mellitus
|
Congenital adrenal hyperplasia
|
Pediatrics
| null |
d40e57cb-723f-4c3e-939e-a3319f46ca1d
|
single
|
Dissociated sensory loss is seen in
|
Harrison's principles of internal medicine 17th edition. * The classical presentation in syringomyelia is a central cord syndrome consisting of a dissociated sensory loss and areflexic weakness in upper limbs
| 1
|
Syringomyelia
|
Vitamin B12 deficiency
|
Transverse myelitis
|
Pellagra
|
Medicine
|
C.N.S
|
bc9cdf4f-348a-4e10-9fc5-24b1670ac702
|
single
|
Subacute combined degeneration of cord is due to deficiency of:-
|
Vitamin B12 deficiency leads to:- Megaloblastic anemia Pernicious anemia Sub-acute combined degeneration of spinal cord Peripheral neuropathy Infeility Atrophic glossitis.
| 4
|
Vitamin B1
|
Vitamin B6
|
Folic acid
|
Vitamin B12
|
Social & Preventive Medicine
|
Vitamins and Nutritional Deficiencies
|
c25f62b0-06a9-4448-a574-474265af35d0
|
single
|
H.P. inclusion bodies in trachoma are seen to be:
|
Ans. Intracytoplasmic
| 2
|
Extracellular
|
Intracytoplasmic
|
Intranuclear
| null |
Ophthalmology
| null |
66910143-9780-4cfe-b0b6-edbc63af66dd
|
multi
|
Maximum effect of bronchodilatation in asthma is caused by -
|
Ans. is 'd' i.e., b2-Agonist b-agonists in Asthmao Bronchi have b2-adrenergic receptors which cause bronchodilatation - So, the adrenergic drugs used in asthma are selective b2 agonists.o b2-agonists are the most effective bronchodilatorso b2-agonists have some other effects also on airways (other than bonrchodilatation), that are responsible for beneficial effects in asthma:Inhibition of release of mast cells mediators -mast cells stabilizing action.Inhibition of exudation and airway edema.Increased mucociliary clearanceDecreased cougho b2-agonists have no effect on inflammation - no antiinflammatory action.
| 4
|
Corticosteroids
|
Theophylline
|
Anticholinergic
|
Beta 2-Agonist
|
Pharmacology
|
Asthma
|
c7136fd7-c28f-4a4c-9f2c-58b27a00cfb7
|
single
|
The diluent used for BCG is -
|
<p>BCG Aim- To induce a benign,aificial primary infection which will stimulate an acquired resistance to possible subsequent infection with virulent tubercle bacilli, and thus reduce the morbidity and moality from primary tuberculosis among those most at risk. WHO recommends the &;Danish 1331&; strain for vaccine production. Stable for several weeks at ambient temperature in a tropical climate and for upto 1 year if kept away from direct light and stored in a cool environment below 10 deg celcius. Vaccine must be protected from light ( wrapped up in a double layer of red/ black cloth). Normal saline is recommended as diluent for reconstituting the vaccine as distilled water may cause irritation. Reconstituted vaccine may be used within 3 hours. Dosage-0.1 mg in 0.1 ml volume. The dose of newborn below 4 weeks is 0.05 ml. Administered intradermally using tuberculin syringe. Injected slightly above the inseion of left deltoid. If injected too high / too low adjacent lymph nodes may become involved and tender. The vaccine must not be contaminated with an antiseptic/detergent. If alcohol is used to swab the skin , it must be allowed to evaporate before the vaccine is given. Phenomenon after vaccination:/ 2-3 weeks after a correct intradermal injection of a potent vaccine, a papule develops at the site of vaccination. It increases slowly in size and reaches a a diameter of about 4-8 mm in 5 weeks. It then subsides or breaks into a shallow ulcer but usually seen covered by a crust. Healing occurs within 6-12weeks leaving a permanent,tiny, round scar (4-8 mm in diameter).This is a normal reaction. Normally the individual become mantoux postive after 8 weeks has elapsed. Adverse reactions: prolonged severe ulceration at the site of vaccination, suppurative lymphadenitis, osteomyelitis and disseminated BCG infection. Contraindications: BCG should not be given to patients with generalised eczema, infective dermatosis, hypogammaglobulinemia , those with history of deficient immunity, patients under immunosuppressive treatment and in pregnancy. {Reference: park&;s textbook of preventive and social medicine, 23rd edition, pg no.196}</p>
| 2
|
Distilled water
|
Normal saline
|
Dextrose solution
|
Ringer - lactate
|
Social & Preventive Medicine
|
Communicable diseases
|
1c4164ab-1264-4957-9479-b39a808a5e77
|
single
|
Adverse reaction following whole cells pertussis immunization is -
|
Ans. is 'd' i.e.. All of above Advese effect with pertusis (used in DPT)o Local pain, swelling, rednesso Fevero Convulsiono Anaphylaxiso Hypotensive, hyporesponsive episod.
| 4
|
Fever
|
Ecessive cry
|
Local swelling
|
All of above
|
Pediatrics
|
Immunization
|
4ef35673-dbfc-4262-8984-131c33073a44
|
multi
|
Which of the following arises from infraglenoid tubercle -
|
Ans. is'b' i.e., Long head of tricepsSupraglenoid tubercle of scapula : origin oflong head ofbiceps.Infraglenoid tubercle of scapula : origin of long head of triceps
| 2
|
Longheadofbiceps
|
Longheadoftriceps
|
Shoheadofbiceps
|
Coracobrachialis
|
Anatomy
| null |
f11f21b3-b3f1-4469-aa84-f01dd35630b5
|
single
|
In metabolism of xenobiotics, all of the following reactions occur in phase one EXCEPT ?
| null | 3
|
Oxidation
|
Reduction
|
Conjugation
|
Hydrolysis
|
Pharmacology
| null |
b39233e8-b117-4c55-8bb5-3f1163c5ceac
|
multi
|
Thickness of lead apron to prevent radiation -
|
lead aprons of thickness 0.5mm will reduce the intensity of scattered X rays over 90% and should be worn by all workers regularly exposed to X ray procedures. Radiation protection is the youngest bramch of hygiene and is called radiation hygiene. Parks textbook of preventive and social medicine.K Park. Edition 23.page no: 745
| 3
|
1 mm
|
3 mm
|
0.5mm
|
7mm
|
Social & Preventive Medicine
|
Environment and health
|
9cd61149-cdc7-4b66-bdd0-153893c9e0c3
|
single
|
The names Brechner and Bethune are associated with which of the following devices?
|
Ans. d. End tidal capnography (Ref: Bethune, R. W. M., and Brechner, V. L. (1968). Detection of venous air embolism by carbon dioxide monitoring. Anesthesiology, 29, 178)Brechner and Bethune are associated with end-tidal capnography.
| 4
|
Precordial Doppler
|
Transesophageal echocardiography
|
Plethysmography
|
End tidal capnography
|
Anaesthesia
|
Breathing Systems
|
c50ee3f1-1621-4c3e-9219-49a611992c4a
|
single
|
Sexually active male comes with complaints of recurrent ulcers over the glans which heals with hyperpigmentation . Lesions characteristically recur after intake of sulfonamidees, probable diagnosis is -
|
Fixed drug eruption It characteristically recur at the same site following administration of offending drugs or occasionally a member of the same group of drugs. They occur 30min to 8hrs after drug administration Most common drugs: Sulfonamides NSAIDS Dapsone Batbiturates Ciprofloxacin Phenytoin Griseofulvin Metronidazole Antituberculous drugs Pathomechanism Drug induced CD8 positive Tcells induce INFs and TNFalpha dependent damage to keratinocytes Clinical features Single / multiple, round / oval lesions Well demarcated erythematous edematous plaques that resolve with violaceous /hyperpigmented macules Associated burning/ stinging and pruritus Most common sites: oral mucosa; glans penis; hands and feet Bulbous fed: generalised well defines erythematous and bulbous lesions bilateral and symmetrical. Pseudoephedrine causes nonpigmented FDE lesion heal without pigmentation Investigations: oral or topical provocation test. Test drug is taken orally or applied topically Treatment Discontinue the offending drug Coicosteroids: topical and systemic Antihistamines IADVL textbook of dermatology page 1668
| 2
|
Aphathous ulcer
|
fixed drug eruption
|
Herpes genitalis
|
Chlamydial infection
|
Dental
|
Autoimmune skin disorders
|
e24ddfd5-4822-4be7-aea2-ece8a2215836
|
multi
|
Why pyridostigmine is preferred in myasthenia gravis?
|
DOC FOR myasthenia gravis is pyridostigmine as it long acting than neostigmine.both are quaternanry coumpounds and so cant cross BBB Ref: KDT 6th ed pg 101-102
| 2
|
It doesn't cross BBB
|
Longer acting than neostigmine
|
It crosses BBB
|
Sho-acting than neostigmine
|
Pharmacology
|
Autonomic nervous system
|
53cca08c-6266-40a5-a83c-b40c1edb0fee
|
single
|
A black necrotic mass was seen in the nose of an elderly diabetic patient. The most probable diagnosis is?
|
The most probable diagnosis is mucormycosis which is a fungal infection of the nose and paranasal sinuses. It is seen in those on immunosuppressive therapy or those with uncontrolled diabetics. It is associated with rapid destruction due to the affinity of the fungus to aeries causing endothelial damage and thrombosis. A typical finding is the presence of a black necrotic mass filling the nasal cavity and eroding the septum and hard palate. Ref: Textbook of diseases of ENT; PL Dhingra; 7th edition, pg no. 178
| 3
|
Lupus vulgaris
|
Aspergillosis
|
Mucormycosis
|
Pseudomonas infection
|
ENT
|
Nose and paranasal sinuses
|
136a13b9-9600-474e-bb8c-ee6eaa25eeb4
|
single
|
The efferent limb of the cremasteric reflex is provided the-
|
Ans. B. Genital branch of the genitofemoral nerveCremasteric Reflexa. Contraction of the cremaster muscle is elicited by lightly stroking the skin on the medial aspect of the superior part of the thigh with an applicator stick or tongue depressor. The afferent limb is ilio-inguinal nerve supplies this area of skin. Cremaster muscle is innervated by the genital branch of the genitofemoral nerve, derived from the first and second lumbar spinal nerves. The rapid elevation of the testis on the same side is the cremasteric reflex.b. This reflex is extremely active in children; consequently, hyperactive cremasteric reflexes may simulate undescended testes. A hyperactive reflex can be abolished by having the child sit in a cross-legged, squatting position; if the testes are descended, they can then be palpated in the scrotum.c. It may represent a protective reflex, and the cremaster may also have a role in testicular thermoregulation.
| 2
|
Femoral branch of the genitofemoral
|
Genital branch of the genitofemoral nerve
|
Ilioinguinal nerve
|
Pudendal nerve
|
Anatomy
|
Male Genital System
|
99de7e6c-61b0-44de-91f2-49b83d78dee8
|
single
|
Most abundant immunoglobulin present in breast milk?
|
Most abundant type of Ig = IgA > IgD > IgG, IgM & IgE Anti-infective factors present in breast milk are: IgA (ratio of IgA: IgG is 100:1) Lymphocytes Anti- streptococcal factor Lysosome Lactoferrin Living cells.
| 1
|
IgA
|
IgM
|
IgG
|
IgE
|
Social & Preventive Medicine
|
Paediatric Care in RCH: BW, BL, PEM, Breast Feeding
|
580a574a-9082-4031-9950-e99f733fb301
|
single
|
Moality rates are taken into account while calculating: March 2011
|
Ans. B: NRR Net reproduction rate measures the number of daughters a woman would have in her lifetime if she experiences prevailing age-specific feility and moality rates Net reproduction rate/NRR It is the average number of daughters that would be born to a female (or a group of females) if she passed through her lifetime conforming to the age-specific feility and moality rates of a given year. This rate is similar to the gross reproduction rate but takes into account that some females will die before completing their childbearing years. An NRR of one means that each generation of mothers is having exactly enough daughters to replace themselves in the population. The NRR is paicularly relevant where sex ratios at bih are significantly affected by the use of reproductive technologies, or where life expectancy is low Total feility rate/ TFR/ Feility rate/ Period total feility rate (PTFR)/ Total period feility rate (TPFR) It is the average number of children that would be born to a woman over her lifetime if (1) she were to experience the exact current age-specific feility rates (ASFRs) through her lifetime, and (2) she were to survive from bih through the end of her reproductive life. It is obtained by summing the single-year age-specific rates at a given time.
| 2
|
General feility rate
|
NRR
|
Total feility rate
|
Gross reproduction rate
|
Social & Preventive Medicine
| null |
f0a8a5cd-841a-40d5-a463-617f1d516d3b
|
single
|
During radiotherapy the Buccal Mucosa exhibits radiation reaction before skin due to -
|
Rapidly dividing cells are generally more radio sensitive then slowly dividing cells, reflecting radiation induced inhibition of D.N.A. synthesis.
| 4
|
Rapid cellular turn-over in bone
|
Slow cellular turn-over in blood vessel
|
Rapid cellular turn-over in skin
|
Rapid cellular turn-over in mucosa
|
Pathology
| null |
ff1c5737-a640-43de-8d57-1dc75e3d27b4
|
single
|
Tributaries of Lt renal vein are all except:
|
Ans is 'a' ie left lumbar vein (Ref. BDC (vol II), 3/e, p 272)Tributaries of left renal veinLeft gonadal veinLeft suprarenal veinLeft inferior phrenic veinOn right side they open directly into the inferior vena cava.
| 1
|
Left lumbar vein
|
Left gonadal vein
|
Left suprarenal vein
|
Left diaphragmatic vein
|
Surgery
|
Anatomy (Stomach and Duodenum)
|
ce99dac9-19c0-4e39-86c5-da8964319574
|
multi
|
Which of the following antibiotic acts by inhibiting cell wall synthesis ?
| null | 4
|
Chloramphenicol
|
Gentamicin
|
Erythromycin
|
Penicillin
|
Pharmacology
| null |
4fbf0e48-f428-4f52-bc5c-b9982408af9f
|
multi
|
All the following represent risk factors associated with pelvic inflammatory disease except
|
Ans is 'd' i.e., Age 30 - 39 yearRisk factors associated with pelvic inflammatory disease are :DouchingSingle statusSubstance abuseMultiple sexual panersLower socio - economic statusRecent new sexual panerYoung age 10 - 19 yearsOther sexually transmitted infectionsSexual paner with urethritis or gonorrheaPrevious diagnosis of pelvic inflammatory diseaseNot using mechanical or chemical contraceptive barriersEndocervical testing positive for N. gonorrhea or C. trachomatis
| 4
|
Recent new sexual paner
|
Doughing
|
Low socioeconomic status
|
Age 30 - 39 years
|
Gynaecology & Obstetrics
| null |
77a588e5-01f1-4f34-adc2-06ff796742c0
|
multi
|
A 45 year old victim of head Injury from an accident Who is unconscious requires an emergency surgical Intervention. In the absence of any consenting pay, the doctor should
|
No duty to inform arises in an emergency in which the patient is unconscious or otherwise incapable of giving valid consent and harm from failure to treat is imminent. However, an emergency does not give the doctor a license to do whatever he deems advisable for the patient; it suppos only limited measures to save patient's life and/or preserve function. Ref - Krishan Vij 5th edition pg: 373
| 3
|
Not operate at all
|
Obtain consent from the police
|
Operate without consent
|
Obtain consent from the magistrate
|
Forensic Medicine
|
Medico legal procedures
|
5c22d56f-801c-46c1-bd92-933bc50710aa
|
multi
|
A 55 year old male presented with painless terminal hematuria. Cystoscopic examination revealed a solitary papillary tumor. Histopathological examination of completely resected tumor is suggestive of grade transitional cell carcinoma with no muscle invasion. fuher management of this patient is best done by
|
Ans. is 'c' i.e., Intravesical BCG Management of bladder cancer Cystoscopy and transurethral resection or biopsy - initially, any pt. with hematuria is examined by cystoscopy and any tumor seen is removed by transurethral resection (if possible) or biopsied. Fuher treatment decisions are made after tumor staging on histology. Such decisions are based on tumor stage (TNM), grade, size, multiplicity, and recurrence pattern. First see the staging (TNM) The primary bladder cancer is staged according to the depth of invasion into the bladder wall or beyond The urothelial basement membrane separates superficial bladder cancers into Ta (noninvasive) and T1 (invasive) tumors. The muscularis propria separates superficial disease from deeply (muscularis propria) invasive disease. Stage T2 and higher T stage tumors invade the muscularis propria, the true muscle of the bladder wall. If the tumor extends through the muscle to involve the full thickness of the bladder and into the serosa, it is classified as T3. If the tumor involves contiguous structures such as the prostate, the vagina, the uterus, or the pelvic sidewall, the tumor is classified as stage T4.
| 3
|
Just follow up
|
Intravesical chemotherapy
|
Intravesical BCG
|
Cystectomy
|
Surgery
| null |
843fc85d-f360-47df-8ecb-2dd0168d1d7b
|
single
|
Preservative added in DPT vaccine is :
|
Ans. is 'b' i.e. Aluminium Phosphate Aluminium phosphate is used as an adsorbent in DPT vaccine. Adsorption increases the immunological effectiveness of the vaccine
| 2
|
Zinc phosphate
|
Aluminum phosphate
|
MgS04
|
ZnS04
|
Social & Preventive Medicine
|
Communicable Diseases
|
485b0fa3-952c-49ed-bb71-d414fdf4e4ad
|
single
|
Serratus arterior is supplied by -
|
Ans. is 'd' i.e., Nerve of bell o Serratus anterior causes protraction of scapula,o It is supplied by long thoracic nerve (Nerve of Bell),o It forms medial boundary of axilla.Serratus anterioro Origin : Outer surface of upper 8 ribs by 8 digitations (multipennate muscles),o Insertion : Medial border of scapula and inferior angle.o Nerve supply : Long thoracic nerve (nerve of bell),o Actions : Action of serratus anterior are -Rotates the scapula so that glenoid cavity is raised upward & forward - Helps in Vertical over head abductionQ (in this action assisted by trapezius).Draws the scapula forward around the throeic wall so paraiysis leads to winging of scapula.QAlso used when arm is pushed forward in horizontal position as in forward punchQ (helped by Pectoralis minor in this action)Q.Steadies the scapula during wreight carrying.Helps in forced inspiration^ (Accessory muscle of inspiration).Because of greater pull exerted on the inferior angle, inferior angle passes laterally and forward and the glenoid cavity is raised upward & forward; in this action the muscle is assisted by trapezius.
| 4
|
Thoracodorsal nerve
|
Axillary nerve
|
Musculocutaneous nerve
|
Nerve of bell
|
Anatomy
|
Nerves of Upper Extremity
|
37e8161a-efc3-46af-bbc7-c38ff9f44f8c
|
single
|
Froment's sign is positive in cases of weakness of ?
|
Ans. is 'a' i.e., Thumb adduction Normally when a person is asked to grasp a book between the thumb and index finger, he will grasp the book firmly with thumb extended, taking full advantage of the adductor pollicis and the first dorsal interosseous muscles. If the ulnar nerve is injured the adductor pollicis will be paralysed and the patient will hold the book by using the flexor pollicislongus (supplied by median nerve) producing flexion at the interphalangeal joint. This becomes more pronounced if the examiner tries to pull the book out while the patient tries to hold it. This sign is known as `Froment's sign' or the 'book test'.
| 1
|
Thumb adduction
|
Thumb abduction
|
Thumb flexion
|
Thumb extension
|
Surgery
| null |
7bdf06c1-3e9f-4c58-97cb-4d26998ddf01
|
single
|
The laboratory test of choice to confirm myxoedema coma is -
|
Laboratory studies are impoant to confirm the diagnosis of myxedema coma. However, if the condition is suspected, treatment should be staed immediately without waiting for the results. Thyroid function tests TSH is elevated in most patients indicating a primary thyroid disorder Free T4 and free T3 levels are low A low or normal TSH level with low levels of free T4 and free T3 may indicate that the disorder is due to pituitary or hypothalamic dysfunction Ref - medscape.com
| 1
|
Thyroid stimulating hormone (TSH)
|
Thyrotropine releasing hormone (TRH)
|
Tri-iodothyronine (T3)
|
Tetra iodothyronine (T4)
|
Medicine
|
Endocrinology
|
4bad66a3-5215-459b-9d8a-5ef1b69ca357
|
single
|
Infection with Sporothrix schenckii (formerly Sporotrichum schenckii) is an occupational hazard for gardeners. The portal of entry for this organism is the
|
Cutaneous sporotrichosis, caused by S. schenckii, begins at the site of inoculation, usually on an extremity or the face. The organism often is found on thorns of rose bushes. Ulceration is common and new lesions appear along paths of lymphatic channels. Extracutaneous sporotrichosis is seen primarily in bones and joints. There is no evidence to suggest that any portal of entry besides skin is important.
| 3
|
Lymphatic system
|
Respiratory tract
|
Skin
|
Mouth
|
Microbiology
|
Mycology
|
164990c5-7eb8-4a54-8f38-c025dd4e9e27
|
single
|
Secretion of estrogen is maximum at
|
Estrogen is a generic term for any of the estrus-producing compounds (female sex hormones), including estradiol, estriol, and estrone. Called also estrogenic hormone. In humans, the estrogens are formed in the ovary, adrenal coex, testis, and fetoplacental unit, and are responsible for female secondary sex characteristic development, and during the menstrual cycle, act on the female genitalia to produce an environment suitable for feilization, implantation, and nutrition of the early embryo.Ref: Ganong&;s review of medical physiology; 24th edition; page no: 405
| 4
|
Just before menopause
|
At pubey
|
At menstruation
|
Before ovulation
|
Physiology
|
Endocrinology
|
5ef2e1e1-d023-4f4b-b9e5-db960a1c364f
|
single
|
Which of the following is aberrant epiphysis
|
Aberrant epiphysis: is not always present example: epiphysis at the head of first metacarpal and base of other metacarpalRef BD CHAURASIA S Handbook of General Anatomy Fouh edition Pg no 42
| 4
|
Coracoid process
|
Greater tubercle of humerus
|
Base of 1" metacarpal
|
Base of 2nd metacarpal
|
Anatomy
|
General anatomy
|
475a9dff-859f-4831-8cb9-2a92cbfccd1e
|
single
|
disorder where amenorrhea was once needed for diagnosis was
|
Anorexia nervosa Anorexia nervosa is a eating disorder where the patient has decreased weight and altered body image and persistent desire to maintain thinness * Gender==== more common in females * Age=======adolescence * Comorbidity=== depression and social phobia * Duration====3 months * Criteria= * Intense fear of becoming fat * Restriction of food intake * Restricting type * Binge eating and purging type * Amenorrhea is not needed for diagnosis, previously amenorrhea is considered as a diagnostic criteria for diagnosis, in recent DSM 5 amenorrhea is considered for a diagnosis * Association= * OCD and depression * Decreased interest in sex * Complication * 7-14% moality * ECG changes * Hypokalemic alkalosis because of induced vomiting * Gastric dilation * Drugs * Cypro hepatidine * SSRI * Management * Admit in severe cases * Prevent vomiting by making restroom inaccessible for 2 hours after food intake * Avoid laxatives * Small frequent meals * Avoid refeeding syndrome Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 509
| 1
|
anorexia nervosa
|
metabolic syndrome
|
bulimia nervosa
|
binge eating
|
Anatomy
|
Sleep disorders and eating disorders
|
a29bf584-4dd6-4707-84d0-05ab91aee05a
|
single
|
In Vitamin A deficiency, respiratory tract infection due to:
|
Vitamin A: - Role 1) Vision 2) Reproduction & growth 3) Maintenance of epithelial cell 4) Stabilization of cellular and intra Cellular membrane 5) Synthesis of glycoprotein 6) Antioxidant 7) Skin & Bone Metabolism
| 3
|
Keratinization of upper epithelial cells
|
Lack of antibody production
|
Dysfunction of epithelial layer
|
Defective chemotaxis
|
Medicine
|
JIPMER 2017
|
14bc7576-bd7b-4e8e-906c-d3d8695a9516
|
single
|
All of the following are decrease in Nephrotic syndrome except -
| null | 3
|
Transferrin
|
Ceniloplasmin
|
Fibrinogen
|
Albumin
|
Medicine
| null |
7a014ee1-de7e-4619-bf3a-f7c3ecf4f5c2
|
multi
|
What is the working time of amalgam?
| null | 2
|
One to two minutes
|
Three to four minutes
|
Five to six minutes
|
Seven to eight minutes
|
Dental
| null |
bc010c61-7d3d-4fad-9710-df4eecff1b15
|
single
|
An old man who is edentulous developed squamous cell carcinoma in buccal mucosa that has infiltrated to the alveolus. Following is not indicated in treatment
|
Marginal mandibulectomy with removal of outer table is not recommended. Marginal mandibulectomy -- It include incontinuity excision of tumour with margin of the mandible and overlying gingival at least 1 cm thick mandible inferiorly. It is indicated in carcinoma close proximity to the lower gingival or extending onto the mandible without clinical or radiological mandibular involvement. It is also recommended in patients with minimal coical mandibular invasion
| 3
|
Radiotherapy
|
Segmental mandibulectomy
|
Marginal mandibulectomy involving removal of the outer table only
|
Marginal mandibulectomy involving removal of upper half of mandible
|
Surgery
| null |
62645a33-cff9-42d3-9aef-29ddfad1cfd0
|
single
|
A child with complaints of cough. Characteristic inspiratory whoop. Sample for investigation is ?
|
Ans. is 'a' i.e., Nasopharyngeal swab "Culture of nasopharyngeal secretion remains the gold stadard for diagnosis of whooping cough"
| 1
|
Nasopharyngeal swab
|
Tracheal aspiration
|
Cough plate culture
|
Sputum culture
|
Pediatrics
| null |
8eec27a6-cae8-4aa6-9a56-721850dbe6f6
|
single
|
In PHC how to dispose placenta -
|
- placenta is a human anatomical waste that comes under category no 1. - category no 1 wastes are discarded in yellow colour plastic bag and should be treated by incineration. Reference: Park's textbook of preventive and social medicine, 23rd edition, pg no: 793,794 <\p>
| 1
|
Incineration
|
Microwaving
|
Autoclaving
|
Chemical treatment
|
Social & Preventive Medicine
|
Hospital waste and disaster management, Occupational health
|
e1d3cc6f-61b3-4cb3-9978-21231387c9ac
|
single
|
Chi square test is applied to test the independence of cross distribution of two variables and each of them should have
| null | 2
|
Equal number of cases
|
Mutually exclusive cases
|
Normal distribution
|
Non-mutually exclusive cases
|
Dental
| null |
2e58a281-3b48-4a60-be6d-e6693a434839
|
multi
|
Mc benign epithelial ovarian tumor is
|
Serous cystadenoma and cystadenocarcinoma
Serous cystadenoma and cystadenocarcinoma are amongst the most common of cystic ovarian neoplasms, accounting about 50% of all ovarian tumours; of these, 60-70% are benign, 15% borderline and 20-25% are malignant.
| 1
|
Serous cystadenoma
|
Mucinous cystadenoma
|
Brenner tumor
|
Ovarian fibroma
|
Unknown
| null |
f968aea4-be9b-4740-b6a2-f04da6de5d38
|
single
|
What is the MOST likely diagnosis for this 25-year-old man with sickle cell trait?
|
A large infiltrative mass is present in the right kidney with extension of mass into the renal pelvic fat, the right renal vein and IVC. There is also retroperitoneal lymphadenopathy and splenomegaly. A. Non-Hodgkin's lymphoma can involve the kidney but is seen on presentation in only 5.8% of cases. Although it can involve the kidney as a single mass, renal lymphoma most commonly presents as multiple lymphomatous masses. Additionally, renal vein and IVC invasion would be distinctly unusual for lymphoma. B. Angiomyolipoma is a benign tumor of the kidney that is characterized by regions of macroscopic fat (seen in 95% of cases). No areas of fat density are seen in the images provided with this case. Additionally, renal vein and IVC invasion and lymphadenopathy would not be a characteristic of this benign tumor. C. Renal medullary carcinoma is an unusual tumor that almost always occurs in young patients with sickle cell trait. No cases have been repoed in patients with sickle cell disease. The tumor arises from the calyceal epithelium and grows in an infiltrative pattern. It is a very aggressive tumor with early metastases to lymph nodes and vascular invasion. D. Transitional cell carcinoma can fill the renal pelvis and diffusely infiltrate the kidney as in this case. However, transitional cell carcinomas typically affect older individuals and would be rare to affect someone of this age. Also, transitional cell carcinomas would not demonstrate vascular invasion as in this case.
| 3
|
Non-Hodgkin lymphoma
|
Angiomyolipoma
|
Renal medullary carcinoma
|
Transitional cell carcinoma
|
Radiology
|
GIT and hepatobiliary system
|
58d0bbf4-2153-475c-bf96-56dd0f0d95bc
|
single
|
The term 'id' was coined by:
|
A. i.e. Freud
| 1
|
Freud
|
Skinner
|
Weyker
|
Weyker
|
Psychiatry
| null |
f51614f4-e6b6-4511-821a-b7a8afef4376
|
single
|
Kit B given at subcentre –
|
Sub-center kit A contains :- (i) Iron (Ferrous sulphate) & folic acid; (ii) Zinc sulphate; (iii) Cotrimoxazole; (iv) Vitamin A; (v) ORS; and (vi) Gentian violet crystals.
Sub-center kit contains :- (i) Paracetamol; (ii) Dicyclomine hydrochloride; (iii) Albendazole; (iv) Methylergometrine; (v) Povidone iodine ointment; (vi) Chloramphenicol eye ointment; (vii) Rolled bandage; and (viii) Absorbent cotton wool.
| 3
|
Vit A
|
ORS
|
Paracetamol
|
Iron
|
Social & Preventive Medicine
| null |
76a401f9-61da-426a-85a8-b03e7ebd7552
|
single
|
Triple helix is found in
|
Robbins basic pathology 9th edition page no 63 The collagens are composed of three seperate polypeptide chains braided into a ropelike triple helix.
| 2
|
Cystine
|
Collagen
|
Pectin
|
DNA
|
Pathology
|
General pathology
|
80351dcb-3f71-4433-b1b1-2a505f97e74b
|
single
|
Hypersensitivity vasculitis involve
|
Hypersensitivity vasculitis, which is usually represented histopathologically as leukocytoclastic vasculitis (LCV), is a term commonly used to denote a small-vessel vasculitis. There are many potential causes of hypersensitivity vasculitis; however, up to 50% of cases are idiopathic. Hypersensitivity vasculitis may present clinically as cutaneous disease only or it may be a cutaneous manifestation of systemic disease. The internal organs most commonly affected in hypersensitivity vasculitis are the joints, gastrointestinal tract, and kidneys. Hypersensitivity vasculitis may be acute and self-limited, recurrent, or chronic. Overall, hypersensitivity vasculitis has a orable prognosis, paicularly when no internal involvement is present . Hypersensitivity vasculitis tends to affect the skin and occasionally the kidney. The loss of integrity of the capillaries and post capillary venules results in extravasation of red blood cells, usually causing purpura and a burning or minimally pruritic sensation. Hypersensitivity vasculitis is thought to be mediated by immune complex deposition.In this form of vasculitis, circulating antigens in the body (produced by factors such as medications, infections, and neoplasms) induce antibody formation. These antibodies bind to the circulating antigen and create immune complexes, which then deposit within vessels, activating complement and inducing inflammatory mediators. Inflammatory mediators, adhesion molecules, and local factors may affect the endothelial cells and play a role in the manifestations of this disease. Additionally, autoantibodies, such as antineutrophil cytoplasmic antibody (ANCA), may be associated with disease manifestations. In ANCA-mediated vasculitis, intracellular proteins from neutrophils become expressed on the cell surface, leading to formation of antibodies (ANCA). These autoantibodies then bind neutrophils, subsequently leading to neutrophil adhesion to vessel walls and cellular activation. Ref - medscape.com
| 3
|
Capillary
|
Aerioles
|
Postcapillary venules
|
Medium sized aeries
|
Medicine
|
Immune system
|
98c462da-4f5b-464c-b71c-d62415965b81
|
single
|
A 32-year-old woman is admitted to the emergency department after an automobile collision. Radiographic examination reveals multiple fractures of the humerus. Flexion and supination of the forearm are severely weakened. She also has loss of sensation on the lateral surface of the forearm. Which of the following nerves has most likely been injured?
|
The musculocutaneous nerve supplies the biceps brachii and brachialis, which are the flexors of the forearm at the elbow. The musculocutaneous nerve continues as the lateral antebrachial cutaneous nerve, which supplies sensation to the lateral side of the forearm (with the forearm in the anatomic position). The biceps brachii is the most powerful supinator muscle. Injury to this nerve would result in weakness of supination and forearm flexion and lateral forearm sensory loss. Injury to the radial nerve would result in weakened extension and a characteristic wrist drop. Injury to the median nerve causes paralysis of flexor digitorum superficialis and other flexors in the forearm and results in a characteristic flattening of the thenar eminence. The lateral cord of the brachial plexus gives origin both to the musculocutaneous and lateral pectoral nerves. There is no indication of pectoral paralysis or weakness. Injury to the lateral cord can result in weakened flexion and supination in the forearm, and weakened adduction and medial rotation of the arm. The lateral cutaneous nerve of the forearm is a branch of the musculocutaneous nerve and does not supply any motor innervation. Injury to the musculocutaneous nerve alone is unusual but can follow penetrating injuries.
| 2
|
Radial
|
Musculocutaneous
|
Median
|
Lateral cord of brachial plexus
|
Anatomy
|
Upper Extremity
|
c4cef47f-ecca-44e5-ab65-c1e0ce2d4887
|
single
|
After 28 weeks of gestation true is/are:a) Viableb) > 1000 gm c) Lecithin/Sphingomyelin ratio >2d) Type II pneumocytes presente) Phosphatidyl glycerol present
| null | 1
|
abd
|
bcd
|
abc
|
ab
|
Gynaecology & Obstetrics
| null |
480b3528-611a-4b2e-84cf-264b9f6ff457
|
multi
|
In a study following interpretation are obtained: Satisfied, Very satisfied, Dissatisfied. Which type of scale is this?
|
Ans is 'b' i.e. Ordinal Repeat from All India 07, AIIMS May 2005, Nov. 2003Statistical data can be of two types -Qualitative data -Quantitative dataQualitative DataIn such data there is no notion of magnitude or size of the variables as they cannot be measuredVariables can be categorized according to some characteristics or quality.eg: Sex, occupation marital status, education level, vaccinated or not vaccinated, acquired the disease or not, died or cured, grades in the class.The qualitative data can be placed on 2 scales -NominalOrdinal.Nominal scaleNominal scale data are divided into qualitative categories or groups, such as male / female, black / white, died / cured, attacked/not attacked, vaccinated/not vaccinate, urban/sub urban/ruralThere is no implication of order or ratio, means that the data cannot be placed in a meaningful order.Ordinal ScaleHere the data can be placed into categories that can be rank ordered (eg. students may be ranked 1st / 2nd / 3rd / 4th in their class or into grades A/B/C, the activity of an animal can be rated on a scale of 1 to 6, hardness scale for water etc.)However, there is no information about the size of the interval ie no conclusion can be drawn about whether the difference between the first and second students is the same as the difference between the second and third.Variables in the form of mild, moderate and severe (or very satisfied, satisfied and dissatisfied) are analyzed by ordinal scale as they can be arranged in a meaningful order but there is no information about the size of the interval between them.Quantitative dataThe quantitative data have a magnitude ie they can be measured.Eg. - height, weight, blood pressure, serum cholesterol level, temperature, number of children in a family etc.Quantitative data can be measured on 2 scalesIntervalRatio scalesInterval scaleInterval scale data are like ordinal data in that they can be placed in a meaningful order; in addition, they have meaningful intervals between items, which can be measured.eg: Temperature on the Celsius scale (the difference between 80 degand 70deg is the same as between 40 degand 30 degCHowever, interval scale data do not have an absolute zero, ratios of the scores are not meaningful ie 80deg C of Celsius temperature is not twice as hot as 40degC because 0degC does not indicate a complete absence of heat.Ratio ScaleA ratio scale has the same properties as an interval scale, however, because it has an absolute zero, meaningful ratio do exist.eg. weights, time, blood pressure, temperature on the Kelvin scale (not Celsius scale) On the Kelvin scale, zero degrees indicate an absolute absence of heat, just as a zero pulse indicates an absolute absence of heartbeat. Thus we can say that 400 K is twice as hot as 200 K.Dichotomous Scale is a type of nominal scale in which nominal data fall into only two groups eg black / white, died / cured, failed / passed.
| 2
|
Nominal
|
Ordinal
|
Interval
|
Ratio
|
Social & Preventive Medicine
|
Statistical Tests
|
e4514ffc-7062-41d2-8e92-fb11da5a7b31
|
single
|
Beillon system is for -
|
Ans. is 'a' i.e., AnthropometryBeillion system is anthropometry.
| 1
|
Anthropometry
|
Dactylography
|
Dentition
|
Nuclear sexing
|
Forensic Medicine
| null |
f76e1d5b-1bf4-4ede-8e20-defeb65a3858
|
single
|
Translocation (8;14) is characteristic of -
|
Ans. is 'a' i.e., Burkitt's lymphoma Chromosomal translocations Associated Neoplasmo 8-14-Burkitt's lymphoma.Acute lymphocytic leukemia (FAB type L3) Immunoblastic B cell lymphomao 15-17-Promyelocytic leukemiao 4-11-Acute lymphocytic leukemiao 11-14-Chronic lymphocytic leukemiao 14-18-Follicular lymphomao 6-14-Cystadenocarcinoma of the ovaryo 3-8-Renal adenocarcinoma, mixed parotid tumor.
| 1
|
Burkitt's lymphoma
|
Ataxia telengieactasia
|
ALL
|
CML
|
Unknown
| null |
e2795850-78f1-46e0-ad99-d6418f26fe9f
|
multi
|
In a population having mid-year population of 1000, there are 150 children less than 15 years and 50 elderly more than 65 years of age. Calculate dependency ratio ?
|
Dependency ratio = (Propoion of ppl in < 15yrs of age + >65yrs of age) / Propoion of ppl in 15-64 yrs of age = 150+50/800 = 0.25
| 3
|
0.2
|
200
|
0.25
|
250
|
Social & Preventive Medicine
|
Definition & Concepts
|
0971d63c-0725-42b6-b279-39ba7a35a121
|
single
|
What are the Rushton bodies ?
|
Rushton Bodies Rushton Bodies or hyaline bodies of odontogenic cysts feature as eosinophilic, straight or curved, irregular or rounded structure within the epithelial lining of odontogenic cyst Rushton bodies occur almost exclusively within odontogenic cyst Ref: Shafers 6th edition Pgno : 268
| 1
|
Hyaline bodies of odontogenic cyst
|
Refractile bodies of radicular cyst
|
Bodies seen in ameloblastomes
|
Hyaline bodies seen in dentigerous cysts
|
Surgery
|
Head and neck
|
a0fb931b-1727-4087-9387-27e55141c30e
|
single
|
A 69-year-old man has had mild arthritis involving many joints for several years. Over 1 or 2 days, he develops severe pain and swelling of his knee. His x-ray reveals calcifications in his articular cartilage. Which of the following is the most likely diagnosis?
|
The articular calcification chondrocalcinosis is typical for pseudogout or calcium pyrophosphate disease (CPPD). The most common joint involved is the knee, but the wrist, shoulder, ankle, elbow, and hand are also frequently involved. Definitive diagnosis depends on finding typical rhomboid-shaped crystals with weak-positive birefringence in the synovial fluid, but chondrocalcinosis in the correct setting allows a presumptive diagnosis. Numerous diseases are associated with CPPD, but the most common predisposing factor is advancing age.
| 3
|
acute gout
|
RA
|
pseudogout
|
infectious arthritis
|
Medicine
|
Immunology and Rheumatology
|
0a22bdab-b65a-48b8-bde8-e73a0ecf5d0b
|
single
|
NOT a ductus dependent congenital heart disease
among the following is
|
Other than Truncus arteriosus, rest all lesions among the choices include maintaining Ductus arteriosus as a part of treatment.
| 4
|
Tetralogy of fallot
|
linterrupted Aortic Arch
|
Tricuspid atresia
|
Truncus arteriosus
|
Pediatrics
| null |
ee10305f-c594-4dcf-9ae9-420489f8f466
|
multi
|
True about acute post infective glomerulonephritis ?
|
Ans. is 'd' i.e., Deposition of IgAPost streptococcal (Acute proliferative) glornerulonephritis Post streptococcal glornerulonephritis (PSGN) is an acute proliferative glomerulonephritis which is characterized by diffuse proliferation of glomerular cells, associated with influx of leukocytes. o PSGN is characterized by -i) Enlarged, hypercellular glomeruli that is caused byInfiltration of leukocytes, both neutrophils and monocytes.Proliferation of endothelial cells and mesangial cells.Proliferation and leukocyte infiltration is diffuse, i.e. involving all lobules of all glomeruli.ii) In severe form --> Crescent formation.iii) By immunofluorescence microscopy, there are granular deposits of IgG, IgM and C3 in the mesangium and along the basement membrane.iv) The characteristic electron microscopic findings are discrete, amorphous, electron dens deposits on the epithelial side of the membrane, often having the appearance of humps - Subepithelial humps.v) Subendothelial, intramembranous (within GBM) and mesangial deposits may be present.Also knowIn its severe form acute diffuse proliferative GN may show rapid deterioration of renal function with formation of crescent in the glomeruli - it is referred as rapidly progressive glomerulonephritis.
| 4
|
Crescent formation
|
Subepithelial deposits
|
Granular deposits of IgG
|
Deposition of IgA
|
Pathology
| null |
54c18a59-9a9d-4482-b040-e6fac2c02e18
|
multi
|
Despite their sho half lives(2hrs) proton pump inhibitors cause a prolonged suppresion of acid secretiin(upto 48hr) because:
|
They irreversibly inhibit the proton pump molecule and hence,acid secretion requires synthesis of new proton pumps(ref Rang and Dale 5/e p370-371, goidman gilman 12/e p1311-1312) The activated form of PPI binds covalently with sulfahydryl groups of cysteine in the H+ K+ atpase ,irreversbly inacativating the pump molecule.acid secretion resumes only after new pump molecules are synthesized and inseed into the luminal membranes ptoviding a prolonged suppresion of acid secretion despite the much shoer pladma half lives of the parent compounds.
| 3
|
They are prodrugs and undergo activation gradually
|
They exit from the palsma and enter acid secretory canaliculi and stay there blocking the secretion of acid for a long time
|
They irreversibly inhibit the proton pump molecule and hence,acid secretion requires synthesis of new proton pumps
|
They are available as enteric coated capsules,from which drug is gradually released
|
Pharmacology
|
Gastrointestinal tract
|
8c6db2f9-fb6a-4f14-86a7-dca31eacd799
|
multi
|
Sectoral sign is positive in -
|
Ans. is 'a' i.e.. Avascular necrosis of femur headClinical features of AVNo In the earlier stages of AVN, the patient is asymptomatic, and by the time patient presents, the lesion is well advanced.o Common histories patient gives (Any of the following) : -i ) Dislocation of HipAlcoholismSteroid intake for any disorderNephrotic syndromeo Pain is a common complaint. Pain is felt in the grain and may radiate to knee,o Decreased range of motion especially internal rotation followed by abduction.o Sectoral sign or Differential rotation : - Internal rotation is possible in extended position of hip, but as seen as the hip is flexed to 90deg no internal rotation is possible. This is the characteristic sign of AVN.o Limp with antalgic gaito Trendelenberg's test positive.
| 1
|
Avascular necrosis of femur head
|
Osteoarthritis of btp
|
Protrusio acetabuli
|
Slipped capita! femoral epiphyses
|
Orthopaedics
|
Avascular Necrosis
|
0c5e460a-0679-4f88-b03e-aaf72a8807fe
|
single
|
39 years female, 40 weeks gestation, 4mm dilated cervix. Which is the safest option for analgesia-
|
Ans. is 'b' i.e., Epidural block o When complete relief ofpain is needed throughout labour, epidural analgesia is the safest and simplest method.o For Vaginal delivery - a complete block from T10 to S5For Caesarian section - a complete block from T4 to SI is needed.o Paracervical nerve blockUsed for pain relief during first stage of labour.o Pudendal nerve block:Does not relieve pain of labour but produces perineal analgesia and relaxation and is mostly used for forceps and vaginal breech delivery).
| 2
|
Intramuscular pentazocin
|
Epidural block
|
Pudendal block
|
Premixed nitrous oxide and oxygen
|
Gynaecology & Obstetrics
|
Operative Gynaecology
|
9c92301d-5ebe-47b7-8fbb-9338f0ac988a
|
multi
|
S.A. node acts as a pacemaker of the hea because of the fact that it:
|
D i.e. Generates impulses at the highest rate
| 4
|
Is capable of generating impulses spontaneously
|
Has rich sympathetic innervations.
|
Has poor cholinergic innervations
|
Generates impulses at the highest rate.
|
Physiology
| null |
9609cf12-50f3-47be-802e-01a5bb8b6045
|
single
|
The stereocilia of hair cells are embedded in which membrane?
|
The scala media is bordered by the basilar membrane and Reissner's membrane and contains a tectorial membrane. The apical border of hair cells has stereocilia that are embedded in the tectorial membrane.
| 3
|
Basilar
|
Reissner's
|
Tectorial
|
Tympanic
|
Physiology
|
Special Senses
|
7fc651c1-b816-4962-b2ee-db8f5afdea4f
|
single
|
Food with maximum Cholesterol content -
|
In egg cholesterol content is 250 mg. REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION. PAGE NO - 611)
| 1
|
Eggs
|
Coconut oil
|
Hydrogenated Fats
|
Ghee (Hydrogenated)
|
Social & Preventive Medicine
|
Nutrition and health
|
46126fa1-4678-4fee-8bf4-2d8b691409c8
|
single
|
Vesicoureteric reflux is diagnosed by:
|
Ans. A. Micturating cystographyVesicoureteric reflux refers to the retrograde flow of urine from bladder to ureters and pelvis at rest or during micturition.Pathogenic organisms that might be present in the bladder can gain access to the renal parenchyma initiating inflammation and renal scarring. Two techniques are commonly used to detect VUR. The radiocontrast MCU is commonly used since in addition to showing VUR it provides excellent anatomical details. Isotope radionuclide cystography is more sensitive for detecting VUR and causes less radiation exposure but provides less anatomical details.
| 1
|
Micturating cystography
|
X ray abdomen
|
CECT Abdomen
|
Intravenous pyelography
|
Pediatrics
|
Gastro Intestinal System
|
bdf86283-3eca-4eca-ae7d-8142a93ee247
|
single
|
In a seriously ill patient, addition of amino acids in diet results in a positive nitrogen balance. The mechanism for this is
|
Nutrition experiments with various levels of calorie and protein intake were carried out on five healthy young men. Three series of experiments with two persons each were undeaken for periods up to 14 days. The first pa of each experiment, with 1100 to 1500 kcal/day, was immediately followed by the second pa, with 3500 to 2300 kcal/day. The concentrations of insulin, free fatty acids, glucose and amino acids were determined in the morning, fasted blood. The nitrogen balance was also determined. When insufficient carbohydrate intake is coupled with normal and high protein content of the food, there is interindividually an initial drop in the insulin concentration. Regardless of the absolute insulin concentration, this drop causes an increase in the free fatty acids and the branched-chain amino acids, together with a decrease in the concentrations of alanine and glycine (threonine) in the blood and a negative nitrogen balance. The high concentrations of branched-chain amino acids and the low threonine concentrations might be involved as feedback regulators in the fuher regulation of the gluconeogenic metabolism. When carbohydrate calories are added to the diet, a simultaneous decrease in the free fatty acids and branched-chain amino acids and increase in the blood concentrations of insulin, alanine, glycine and threonine within 24 to 48 h are only observed with 3500 kcal/day and 0.8 to 1.4 g protein per kg body weight. A positive nitrogen balance, however, is only observed with 1.4 g protein per kg body weight, regardless of the relative changes in the insulin level, while the increase in alanine and decrease in branched-chain amino acids (valine) are greatest at 0.8 g protein per kg body weight and day. In spite of the high glucose level, the falling insulin level provokes counter-regulatory processes in which the low concentrations of branched-chain amino acids and the high threonine (alanine) concentrations may play a role. Ref: guyton and hall textbook of medical physiology 12 edition page number:610,611,612
| 4
|
Increased Growth hormones secretion
|
Enhanced rate of gluconegenesis
|
Increased absorption of amino acids from diet
|
Increased secretion of Insulin
|
Physiology
|
Endocrinology
|
53d1857f-06d2-4da0-9d7f-88b4a976ac5d
|
single
|
Patient on verapamil should not be given beta blocker as ?
|
Ans. is 'a' i.e., Conduction block Adverse effects of CCBs Nausea, constipation and bradycardia are more common with verapamil. Verapamil can accentuate conduction defect-should be avoided in 2nd & 3rd degree block, in sick sinus syndrome and along with 13-blocker. Most common side effects of DHPs are palpitation, flushing, hypotension, headache, ankle edema, drowsiness and nausea. Nifedipine can paradoxically increase the frequency of angina in some patients. Nifedine can cause voiding difficulty in elderly (relaxant effect on bladder) and glucose intolerance (decreases insulin release).
| 1
|
Conduction block
|
Bronchospasm
|
Neurogenic shock
|
Anaphylaxis
|
Pharmacology
| null |
0746e4e2-9087-4f07-ac87-b93772287bdd
|
single
|
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