falan42/meta_data · Datasets at Hugging Face

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A patient having glaucoma develops blepharoconjunctivitis after instilling some anti-glaucoma drug. Which of the following drug can be responsible for it:	Allergic blepharoconjunctivitis is a side effect of beta blockers. Ref: Essentials of Medical Pharmacology By K D Tripathi, 4th Edition, Page 95	1	Timolol	Latanosprost	Dipiverine	Pilocarpine	Ophthalmology	null	7b3b3ac0-042c-4392-bcaf-7f6fe1774d40	single
Standard in perimetry ?	Ans. is 'c' i.e., Goldman type III Projected stimuli in perimetry are usually white and of variable size and intensity. There are five different sizes on Goldmann scale designated by Roman numeral Ito V. The standard used in both manual and automated perimetry is Goldman III (0.05" and area of 4mm2). o Failure to recognize target size III necessitates testing with stimulus V Goldman scale Stimulus size (mm2) I '/4 II 1 III 4 IV 16 v 64	3	Goldman type I	Goldman type II	Goldman type III	Goldman type IV	Ophthalmology	null	529c5ba7-062e-4c95-b8de-a46daa6a87eb	single
Visual acuity in infants is tested with the help of	.	1	Landolt's rings	'4' dot test	Perimeter	Slit lamp	Ophthalmology	All India exam	d30e7409-acbd-4324-9296-7aed34dc33f0	single
NOT a feature of hypothyroidism is ?	Ans. is 'a' i.e., Sho metacarpal in hands Hypothyroidism o Hypothyroidism results from deficient production of thyroid hormone or a defect in thyroid hormone receptor activity. o Hypothyroidism may be : - i) Congenital --> Present since bih ii) Acquired --> Symptoms appear after a period of apparently normal thyroid function. Hypothyroidism causes - i) Delayed bone growth (Bone age markedly delayed) ii) Delayed pubey & Alteration in upper and lower segment ratio (upper segment > lower segment) Hypothyroidism o Hypothyroidism results from deficient production of thyroid hormone or a defect in thyroid hormone receptor activity. o Hypothyroidism may be : - i) Congenital --> Present since bih ii) Acquired --> Symptoms appear after a period of apparently normal thyroid function. Hypothyroidism causes - i) Delayed bone growth (Bone age markedly delayed) ii) Delayed pubey & Alteration in upper and lower segment ratio (upper segment > lower segment)	1	Sho metacarpals in hands	Delayed pubey	Delayed bone age	Altered upper and lower segment ratio	Pediatrics	null	c1d57827-57f5-4711-bffc-256348da1eae	single
Dowry death is defined under section	Dowry death is defined under section 304 B According to this if husband or his relative subjects the woman to cruelty or harassment in demand of dowry within 7 years of marriage,they shall be deemed to have caused her death The punishment for such cases is improvement for not less than 7 years,but may be extended to life imprisonment OptionA :Section 304 A IPC:Causing death by negligence Option C:Section 174 Cr. P. C:Police inquest Option D:Section 176 Cr. P. C. Magistrate inquest Textbook of Forensic Medicine and toxicology 2nd edition pg333	2	304A IPC	304B	174Cr. P. C	176Cr. P. C	Forensic Medicine	Medical Jurisprudence	cb474535-6aaf-41fb-8cc9-e9c0c21e86a6	single
Renal transplantation is most commonly done in -	Renal transplantation is the preferred treatment for many patients with end stage renal disease (ESRD), because it provides a better quality of life for them than dialysis. The most common causes of ESRD (in decreasing order) are: Diabetes mellitus Hypertension Glomerulonephritis	1	Chr. glomerulonephritis	Bilateral staghorn calculus	Horse shoe kidney	Oxalosis	Surgery	null	d6ece7a6-6a6b-4086-9c6a-f8e09391bbe3	single
All of the following are derived from glycerol 3 phosphate, EXCEPT:	Impoant substances such as triacylglycerols, phosphatidylcholine, phosphatidylethanolamine, phosphatidylinositol, and cardiolipin, a constituent of mitochondrial membranes, are formed from glycerol-3-phosphate. Ref: Harper 28th edition, Chapter 24.	4	Phosphatidylcholine	Phosphatidylethanolamine	phosphatidylinosito	None of the above	Biochemistry	null	b52bb5b4-d475-4d42-8d63-992aa0ebe265	multi
Which inhalational agent is used in patients with raised intra cranial tension?	Isoflurane causes least vasodialation and hence helps to moderate the cerebral blood flow. It reduces the ICT and hence is useful in neurosurgery. It is more potent than halothane and has rapid onset of action and induction. Reference 1. Quick Review of Pharmacology, By Dr J G Buch, Page 204	2	Enflurane	Isoflurane	Desflurane	Sevoflurane	Anaesthesia	null	bafe9336-a7e4-4340-bf5d-5abf85243667	single
Which of the following statements about vigabatrin is TRUE?	(Ref: KDT 6/e p410) Vigabatrin act by inhibiting the enzyme GABA transaminase (involved in breakdown of CABA). It is used for the treatment of paial and generalized seizures. It is also used to treat infantile spasms. Visual disturbances are very impoant adverse effect of this agent.	4	Blocks neuronal reuptake of GABA	Drug of choice in absence seizures	Life threatening skin disorders may occur	Visual disturbances can occur	Anatomy	Other topics and Adverse effects	cd707b46-9a77-4796-9364-67cc81e1de1f	multi
Which of the following is used to study current flow across a single channel:	Patch clamp: measures ionic currents through a single ion channel. It has four configurations: Voltage clamp: whole cell voltage clamp measures currents across cell membranes. In using this apparatus, two electrodes are inseed into the nerve fiber. One of these electrodes is used to measure the voltage of the membrane potential, and the other is used to conduct electrical current into or out of the nerve fiber. Iontophoresis: a technique of introducing ionic medicinal compounds into the body through the skin by applying a local electric current.	1	Patch clamp	Voltage Clamp	Iontophoresis	Galvanometry	Physiology	Concepts in physiology	41c8d9b1-237b-4575-9403-fa2b807d0dda	single
In children with type IDM when is ophthalmologic evaluation indicated	Ophthalmologic examination should be conducted once the child is >10 yr of age and has had diabetes for 3 -5 year. Annual follow up should suggest. Reference: OP Ghai,essential paediatrics,8 th edition, page no 546	4	At the time of diagnosis	After 1 year	After 2 years	After 5 years	Pediatrics	Endocrinology	f61d4dca-1b53-40f8-84be-1cb742d717b7	single
Which among the following is considered as a hallmark of the fibrogenic repair:	Granulation tissue is the hallmark of the fibrogenic repair.	1	Granulation tissue	Neovascularization	Neutrophilic infiltration	All of the above	Pathology	null	8510d9f3-ec5f-45b3-85db-cf5ee9784068	multi
Incubation period of influenza -	null	1	18 - 72 hrs	1 - 6 hrs	5 - 10 days	< 1 hrs	Social & Preventive Medicine	null	53a574d0-e460-43ab-8b61-e68b6b99c567	single
A two–year–old boy is brought to emergency with severe anemia (Hb = 2 gm%) and features of congestive heart failure. The most appropriate immediate therapy for this boy would be –	null	1	Packed cell transfusion	Partial exchange transfusion	Whole blood transfusion	Parenteral iron injection	Pediatrics	null	e1b0fffe-edde-4b8e-960e-99ddcc840615	single
Parasympathetic supply to lacrimal glands are passed through -	Ans. is 'c' i.e., Greater petrosal nerve o Secretomotor (parasympathetic) fibers to lacrimal gland travel through greater petrosal nerve.GangliaSensory rootSympathetic rootSecretomotor rootMotor rootDistributionCiliaryFrom nasociliary nervePlexus along ophthalmic artery-Edinger-Westphal nucleus - oculomotor nerve - nerve to inferior obliqueCiliaris musclesSphincter pupillaeOticBranch from auriculotemporal nervePlexus along middle meningeal arteryInferior salivatory nucleus- pharyngeal nerve- tympanic branch- tympanic plexus- lesser petrosal nerveBranch from nerve to medial pterygoidto parotid gland via auriculotemporal nerveTensor veii palatini and tensor tympani via nerve to medial pterygoid (unrelated)Pterygopalatine2 branches from maxillary' nerveDeep petrosal from plexus around internal carotid arteryLacrimatory nucleus nervus intermedins - facial nerve - geniculate ganglion- greater petrosal nerve+ deep petrosal nerve= nerve of the pterygoid canal-Mucous glands of the nose, paranasal sinuses, palate nasopharynxSome fibers pass through zygomatic nerve -zygomaticotemporal branch to the lacrimal nerve-Lacrimal glandSubmandibular2 branches from lingual nervefromplexus around facial arterySuperior salivatory nucleus-facial nerve - chorda tympani joins the lingual nerve-Submandibular, Sublingual and Anterior lingual glands	3	Lesser petorsal nerve	Chorda tympani	Greater petorsal nerve	Lingual nerve	Unknown	null	21d74dc7-2925-48de-b68d-0cdeea41f325	single
Gold standard for reflux esophagitis is -	null	3	Manometry	Barium swallow	24 hours pH study	X-ray abdomen	Surgery	null	fb3aeb94-3b8b-45e5-8712-379e025657ed	multi
Quantity of current can be increased by	null	4	Increased milliamperage	Increased time	Increased tube current	All of the above	Radiology	null	71ec894e-cfbd-4e2d-932d-e8f1f157dfa1	multi
Samter's triad is related to -	Ans, is 'a' i.e., Ethmoid polypSamter-s triado Samtef s triad is a medical condition consisting of asthma, aspirin sensitivity-, and nasal/ethmoidal polyposis. It occurs in middle age (twenties and thirties are the most common onset times) and may not include any allergies,o Most commonly the first symptom is rhinitis.o The disorder typically progeses to asthma, then polyposis, with aspirin sensitivity coming last,o The aspirin reaction can be severe, including an asthma attack, anaphylaxis, and urticaria in some cases. Patients typically react to other NSAIDS such as ibuprofen, although paracetamol is generally considered safe,o Anosmia (lack of smell) is also typical, as the inflammation reaches the olfactory- receptors in the nose.	1	Ethmoid polyp	Nasopharyngial	Angiofibroma	Nasal glioma	ENT	Nose and PNS	db97f656-85a4-4097-b35d-044e1cac663e	single
The most common cause of seizures in a patient of AIDS is	Ans. is 'a' i.e., Toxoplasmosis Neurological manifestations of H.I.V. AIDS dementia complex (HIV encephalopathy) is a result of direct effects of HIV on CNS (not an oppounistic disease). It is subcoical dementia. Most common cause of seizures --> Toxoplasma Most common cause of meningitis --> Cryptococcus M.C. cause of focal neurological deficit --> Toxoplasma Toxoplasmosis is the most common CNS infection in AIDS. CNS lymphoma and prograssive multifocal leukoencephalopathy may occur.	1	Toxoplasmosis	Cryptococcal meningitis	Progressive multifocal leucoencephalopathy	CNS lymphoma	Medicine	null	c8d14b52-e2db-4eb4-bc6d-931743702710	single
Increased levels of alanine in serum after fasting is primarily due to:	Ans. a. Met loss of muscle protein due to increased breakdown (Ref: Ganong 24/e p21)Increased levels of alanine in serum after fasting are primarily due to net loss of muscle protein due to increased breakdown."The quantity of carbohydrate normally stored in the entire body can supply the energy required for body functions for 10-12 hours. Therefore, except for the first few hours of starvation, the major effects are progressive depletion of tissue fat and protein. Fat depletion is steady and continues unabated until most of the fat stores in the body are gone. Proteins undergo three phases of depletion-rapid depletion of mobilizable proteins at first, then greatly slowed depletion (during this time increased fat breakdown leads to a state of ketosis), and finally, rapid depletion again shortly before death. The major aim of protein catabolism during a state of starvation is to provide the glucogenic amino acids (especially alanine and glutamine) that serve as substrates for gluconeogenesis in the liver."	1	Net loss of muscle protein due to increased breakdown	Leakage from cells due to membrane damage	Renal dysfunction	Decreased rate of gluconeogenesis	Biochemistry	Amino Acid Metabolism	56e06587-92c2-448e-870b-c28fc78d5a6f	single
The thickness of the cornea is measured by using –	Pachymetry is used to measure thickness of cornea.	3	Schiotz tonometer	Keratometer	Pachymeter	Aesthesiometer	Ophthalmology	null	d03d9fd0-5c5f-4398-8cd6-aecbac14b09b	single
Which is not a substrate for gluconeogenesis?	Substrate for gluconeogenesis are: -glucogenic amino acids, lactate, glycerol, propionyl CoA Glucose cannot be produced from fatty acidRef: DM Vasudevan, 7th edition, page no: 120	2	Alanine	Fatty acid	Pyruvate	Lactate	Biochemistry	Metabolism of carbohydrate	3b7ddc8c-e912-4b50-ac48-237602b17ec5	single
What does indicate in the following partograph indicators?	Ans. B. Moderate uterine contractionsThe partograph is a graphical presentation of the progress of labor, and of fetal and maternal condition during labor.It is the best tool to help you detect whether labor is progressing normally or abnormally, and to warn you as soon as possible if there are signs of fetal distress or if the mother's vital signs deviate from the normal range. Research studies have shown that maternal and fetal complications due to prolonged labor were less common when the progress of labor was monitored by the birth attendant using a partograph.Different shadings on the squares drawn on partograph indicate the strength & duration of uterine contractions:	2	Mild uterine contractions	Moderate uterine contractions	Strong uterine contractions	Arrest of labor	Gynaecology & Obstetrics	Normal Labour	a0e0bc57-9c23-4d0a-9169-89049e62afda	single
Fenton reaction leads to free radical generation when -	Ans. is 'c' i.e., Ferrous ions converted to ferric ions o Free radicals are generated through Fenton's reaction.o In this reaction iron is converted from its ferrous to ferric form and a free radical is generated,o The effect of these reactive species relevant to cells injury include;Lipid peroxidation of membranesOxidative modification of proteins and lesions in DMA.	3	Radiant energy is absorbed by water	H202 is formed by myeloperoxidase	Ferrous ion converted to ferric ion	Nitric oxide is converted to peroxynitrite	Pathology	Mechanisms of Cell Injury	557547fc-eda8-4a30-9e03-c96b49f7fc5b	single
A 70 kg patient needs to be staed on nitroglycerine (NTG) infusion. A 5 ml ampoule contains 5 mg/ml NTG. One ampoule is added to normal saline and to make a total of 500 ml solution. Calculate the rate of infusion if NTG is required at a rate of 10 mcg/min. (1 micro drip = 60 drops/ml )	Dose to be given = 10 mcg/min As, one ampoule (5 ml) is mixed with normal saline to make 500 ml volume, Means 500 ml of solution contains = 55 = 25 mg NTG = 25000 mcg NTG 25mg -----500ml 1mg----500/25 10mcg -1010 -3-----0.2ml So, we need to infuse 0.2 ml/min of the solution As, 1 ml = 60 drops So, 0.2 ml = 60/1 * 0.2 = 12 drops So, we need to infuse 12 drops/min	1	12 drops/min	14 drops/min	15 drops/min	16 drops/min	Pharmacology	Pharmacokinetics	ff76a738-7668-48ed-b8ef-2a4e83095d14	single
Methyl alcohol causes blindness by affecting which of the following structures?	Methyl alcohol is oxidized by alcohol dehydrogenase into formic acid and formaldehyde. Formic acid by inhibiting cytochrome oxidase is toxic to neurons especially retinal ganglion cells. In methanol poisoning vision loss begins 12 hours or more after ingestion and progress to complete blindness with unreactive pupils and optic disc hyperemia.	1	Retinal ganglion cells	Nerve fibers	Rods & Cones	Rods only	Ophthalmology	null	a93a10d2-fbfa-4c67-965e-b8ecbb52a277	single
Pemberton’s sign is elicited	It is used for or large retrosternal goitres.	2	Swallowing	Raising of arms	Extrusion of tongue	Extension of neck	Medicine	null	91a7f2fb-a4f2-4927-a3bb-05d0d8f1d2b1	multi
Most common part of larynx involved in TB -	Ans. is 4b' i.e., Posterior o Disease affects the posterior third of larynx more commonly than anterior part.o The parts affected in descending order of frequency are i) Interarytenoid fold, ii) Ventricular band, iii) Vocal cords,iv) Epiglottis.o Also see above explanation.	2	Anterior	Posterior	Middle	Anywhere	ENT	Larynx	d544a17b-a0a2-4e98-b42e-72f7878afc55	single
In Barter's Syndrome, what is seen-	Ans. is 'b' i.e., Hypokalemia o In Bartter's syndrome the B.P. is low to normal despite increased level of aldosterone.Pathogenesis of Bartter Syndrome\|Defect in sodium chloride and potasium transportin the ascending loop of henle\|Loss of sodium and chloride\|Volume contraction\|Stimulation of Renin angiotensin\|Increased secretion of Aldosterone\|Promotes sodium uptake and potassiumexcretion\|Hypokalemia -(Polyuria & Nocturia)Increased prostaglandin E\|Further activates the reninangiotensin axiso Classic Bartter *s syndrome presents during childhoodo Weakness and cramps occur secondary to hypokalemiaQo Polyuria and nocturia are common due to hypokalemiaQo Nephrocalcinosis (due to hvpercalciuria)Diagnosis of Bartter's Svndrome :o Hypo kalemiaQo Metabolic alkalosisQo Blood pressure is usually normalQo Urinary-potassium, calcium and sodium elevatedQ.o Serum renin, aldosterone and postaglandin E elevatedQ.o Renal function is typically normalQ.There are two types ofBartter syndromeAntenatalClassicBartter syndromeBartter syndromeo More severe o Presents in infancy o Polyhydramnios (associated) o Salt wasting o Severe dehydration Also know,Gitteman's Syndromeo Autosomal recessive traito Caused due to mutation in thiazide sensitive Na-Cl transporterQ.o Loss of activity of the thazide sensitive transporter increases tubular calcium reabsorption leading toclassic finding of hypoclaciuria in Gitleman's syndrome.o There is also decrease in Na+ reabsorptionQ leading to volume depletion and hypokalemia.Gitleman's syndrome is a close differential diagnosis of Barter's syndrome -SimilaritiesDifferenceso Hypokalemiao Hypomagnesemiao Metabolic acidosiso Hypocalciuriao Salt wasting o Elevated renin and aldosterone o Normal blood pressure It is usually diagnosed during adolescence or adulthood with fatigue, weakness, muscle cramps, nocturia.	2	Metabolic acidosis	Hypokalemia	Hyperkalemia	Decrease in urinary calcium	Medicine	Fluid & Electrolyte	d0405727-f3e3-482c-811c-ba26a9a94042	single
A 6 months old child woke up in night, crying with ahdominal pain, which got relieved on passing red stool. What is the most likely diagnosis?	Ans. b. Intussusception (Ref; Ghai 8/e p287; Sabiston 19/e p1851; Schwartz 9/e p1433-I434; Bailey 26/e 1184. 1187, 1193. 25/e p1191, 1196. 1198; Shackelford 7/e p1059-106)Most likely diagnosis in a 6 months old child, who woke up in night, crying with abdominal pain, which got relieved on passing red stool, is intussusception.'Intussusception refers to the telescoping of a proximal segment of intestine (intussusceptum) into a distal segment (intussuscipiens). This is a common cause of intestinal obstruction in children between 3 months and 6 years. Most cases occur in infants during the weaning period following introduction of a new food, vaccination or upper respiratory tract infection. The classic triad of abdominal pain, red current jelly stools (blood and mucus) and palpable mass is seen only in a small percentage of children. Ultrasound is the investigation of choice that confirms the diagnosis ('dough nut' sign) and provides information about presence of a mass as lead point. Early reduction either with saline (under ultrasound guidance), barium contrast (both diagnostic and therapeutic) or with air insufflation is advisable. Reduction with air is safer with lower recurrence rates. Failure of radiological reduction or suspected intestinal gangrene may necessitate surgery and resection.'- Ghai 8/e p287IntussusceptionTelescoping of one portion of the intestine into the other.Middle layer is isolated between two sharp bends and first to become gangrenousQ.Highest incidence between 4 and 10 monthsQ of ageApprox. 80-90% of cases occurs between 3 and 36 monthsQ.Mostly idiopathic in infants and toddlersQ (no clear etiology).MC type: IleocolicQEtiology and Predisposing Factors:Upper respiratory tract infections or gastroenteritisQ (adenovirus and rotavirus have been implicated) have been thought to be contributory to the development of 'idiopathic' intussusception. Hypertrophy of Peyer's patchesQ can be seen at surgery, but no single etiologic factor predominates.Approximately 5-10% of cases have a true pathologic lead point. The older the toddler, the more likely there will be a lead pointQ.MC lead point is Meckel's diverticulumQ.Other lead points include polyps, the appendix, intestinal duplication, foreign bodies, and tumors such as hamartomas associated with Peutz-Jeghers syndrome.Henoch-Schonlein purpura: Submucosal hemorrhage acts as a lead pointQ.Cystic fibrosis: Risk for recurrent intussusceptionQClinical Features:Typical history: Sudden, short-duration, cyclic crampy abdominal painQ.During these episodes the infant cries inconsolably with the knees drawn upQ.Between episodes the infant is asymptomaticQ.Vomiting is almost universalQ.Initially the passage of stools may be normal while later on blood mixed with mucus is evacuated- red currant jelly stool.An abdominal mass may be palpated- a sausage shaped abdominal massQ (increase in size and firmness during the paroxysm of pain)There may be an associated feeling of emptiness in the right iliac fossa (Sign of Dance)QOccult or gross blood in 60-90% of cases on rectal examinationQApex may be palpable or even protrude from anus in extensive ileocolic or colocoiic intussusceptionQDiagnosis:USG: Kidney-shaped mass in the longitudinal view or a target sign in the transverse viewHydrostatic reduction by contrast agent or air enema (preferred) is the diagnostic and therapeutic procedure of choiceQ.Successful reduction is confirmed by reflux of airQ (or barium) into the small bowel.Treatment:Hydrostatic reduction by contrast agent or air enema is the diagnostic and therapeutic procedure of choiceQ.The success rate with air or barium reduction should exceed 70%Q.Failure of reduction or the presence of peritonitis mandates operative interventionQ, which can be performed laparoscopically or by a standard approach.Definitive surgical procedure: Ileocolectomy with primary anastomosisQRecurrence:Recurrence after successful hydrostatic reduction is 5-10%, recurrence rate after operative reduction is 1-4%.Recurrence is usually managed by hydrostatic reductionQ.Third recurrenceQ is an indication for operative intervention to look for a lead point.	2	Meckel's diverticulum	Intussusception	Malrotation	Intestinal obstruction	Surgery	Intestinal Obstruction	b1a6bae4-34de-4940-ab0a-77b23ded91b7	single
Moure's sign can be detected in	Moure`s sign- Absence of Laryngeal click or crepitusClassical sign in post-cricoid malignancy.Bocca`s sign - is also an absence of post-cricoid click or crackle in cricoid malignancy.Ref: Hazarika; 3rd ed; Pg 534	3	Nasopharyngeal carcinoma	Oropharyngeal carcinoma	Postcricoid carcinoma	Supraglottic carcinoma	ENT	Larynx	86a83376-6be9-4ac9-9d63-8f7c206bb5a6	single
Which of the following is x-linked recessive	Ans. is 'a' i.e., G-6-PD deficiency	1	G-6-PD deficiency	Neurofibromatosis	Thalassemia	Alkaptonuria	Pathology	null	ba104887-69be-4795-aa00-af90304bcfb6	single
Heamorrhagic external otitis media is caused by:	Hemorrhagic external otitis media: (Otitis externa hemorrhagia) is caused by influenza virus. Characterised by formation of haemorrhagic bullae on tympanic membrane. Clinical features: severe pain and blood stained discharge. Treatment: Analgesics + antibiotics.	1	Influenza	Proteus	Staphylococcus	Streptococcus	ENT	null	2cedb88b-1300-40e0-8e93-e0e551abc71b	single
Passive cutaneous anaphylaxis detect:	Ans. (a)Passive cutaneous anaphylaxis-in vivo method for detection of antibodies.Antigen injection intradermally then same antigen with a dye injected IV - after 4 to 24 hours - wheal flare reaction occurs in intradermal site.Helps to detect IgG ab which is heterocytotropic, not for IgM which is homocytotropic.	1	Heterocytotropic ab	Wheal and flare reaction	Atopy	Cutaneous anaphylaxis	Microbiology	Immunology	692da2d0-f12d-4565-b17f-8bc6bd55a0ab	single
Gout can be precipitated by all of the following	Ans. is 'd' i.e., High dose salicylates High dose Salicylates are uricosuric and do not cause Hyperuricemia. Diuretics including Thiazides and Furosemide are known to cause Hyperuricemia. Cyclosporine and Tacrolimus are also associated with Hyperuricemia. High Doses of Salicylates > 3.0 g/day are uricosuric, while Low doses (0.3 to 3.0 g/day) are associated with uric acid retention and Hyperuricemia. Also know Causes of drug or diet induced hvperuricemia. Diuretics (thiazides and loop diuretics) Cyclosporine and tacrolimus. Low dose salicylates. Ethambutol. Pyrazinamide. Ethanol. Levodopa. Methoxyflurane. Laxative abuse (alkalosis). Salt restriction.	4	Thiazides	Furosemide	Cyclosporine	High dose salicylates	Medicine	null	1fe41867-7d8e-4d50-be6e-632c86c69e54	multi
All of the following feature may be seen in throm-botic thrombocytopenic purpura,except-	null	3	Fever	Haemolysis	Hypertension	Low platelets count	Medicine	null	db050c1e-6611-4672-afa9-b4454516a2e6	multi
The lacrimal gland is located in a groove which is overlap by	null	1	Levator palpebrae superioris muscle	Lateral rectus	Inferior oblique	Superior oblique	Anatomy	null	e7c0db27-c239-4e4b-be24-ee15bee6ea10	single
Most common pox virus infection in human is -	Ans. is 'd' i.e., Mulluscum contagiosum o Among the given options, smallpox (variola) virus and molluscum contagiosum affect human as their primary host.o Small pox has been eradicated,o Molluscum contagiosum is a common skin infection.Poxviruses causing disease in humansGenusVirusPrimary HostDisease VariolaHumanSmallpox (new eliminated)VacciniaHumansLocalized lesion; used for smallpox vaccinationBuffalopoxWater buffaloHuman infections rare; localized lesionOrthopoxvirusMonkeypoxRodents, monkeysHuman infections rare; generalized diseaseCowpoxCowsHuman infections rare; localized ulcerating lesion OrfSheepHuman infections rare; localized lesionParapoxvirusPseudocowpoxCows Bovine papular stomatitisCows Mol fuse ipoxvirusMotluscum contagiosumHumansMany benign skin nodulesYaiapoxvirusTanapoxMonkeysHuman infections rare; localized lesionYabpoxMonkeysHuman infections very rare and accidental; localized skin tumors	4	Smallpox	Monkeypox	Cowpox	Mulluscum contagiosum	Microbiology	Poxviruses	7ff5ad04-0ab4-4dea-9148-416203b9d2ef	multi
Wickham's striae are seen in	null	1	Lichen planus	Leukoplakia	Leukoedema	Erythema multiformae	Pathology	null	a5e904d7-25e2-4303-b74d-4065ee923f76	single
True about immunoglobulins -	Of IgE is typically the least abundant isotype--blood serum IgE levels in a normal individual are only 0.05% of the Ig concentration Ref: Ananthanarayan & Panikers textbook of microbiology 9th edition pf:98	1	IgE has minimum concentration	IgG has minimum concentration	IgA has minimum concentration	IgM has minimum concentration	Microbiology	Immunology	edd4ea8b-0e91-4a9c-bb16-dd49e9f402da	multi
Which of the following statements regarding ACE inhibitors is true?	Ans. (B) Omission of prior diuretic dose decreases the risk of postural hypotension(Ref: KDT 8th/e p531)Angiotensin Converting Enzyme Inhibitors (ACEI)This group of drugs inhibits the enzyme kininase II or ACE. So, these drugs decrease the activity of RAAS and also potentiate the vasodilatory action of bradykinin. Because these are preventing the conversion of angiotensin I to angiotensin II, so these can decrease the action of the former but not the latter.ACEI are used for the treatment of hypertension, CHF, evolving MI, diabetic nephropathy, diabetic retinopathy, non-diabetic renal disease and also in scleroderma crisis. These drugs reduce proteinuria in diabetic as well as non-diabetic renal disease and also prevent the manifestations of scleroderma crisis which are mediated by angiotensin II.This group of drugs is more effective in sodium depleted states (like diuretic use) because activity of RAAS is more in such cases (to compensate for salt loss). These drugs may cause postural hypotension in diuretic treated patients, which otherwise is a relatively rare adverse effect.Lisinopril is longer acting than enalapril. Former can be given once daily whereas latter is required twice a day.	2	These inhibit the conversion of angiotensinogen to angiotensin-1	Omission of prior diuretic dose decreases the risk of postural hypotension	Lisinopril is shorter acting than enalapril	These are contra-indicated in diabetic patients.	Pharmacology	C.V.S	f0a66bdc-a03c-431f-834e-882ef1c94e3c	multi
N-MYC amplification is associated with	null	4	Burkitt lymphoma	Squamous cell ca lung	Astrocytoma	Neuroblastoma	Pathology	General pathology	394937f1-ab23-4c7c-a871-43a701f1aa23	single
Serous Demilunes are present in large number in which gland	Serous demilunes are cellular formations in the shape of a half-moon on some salivary glands. It is a feature of mixed (seromucinous)glands like submandibular salivary glands. Theseare the serous cells at the distal end of mucous tubuloalveolar secretory unit of ceain glands. Type of glands: Parotid - serous gland Sublingual (major)- mucinous gland Submandibular and Sublingual- mixed	2	Parotid	Submandibular	Sublingual	Pituitary	Anatomy	Glands & Connective tissue	8b48f911-385f-4c6b-ae2e-cf03474d1231	single
Treatment of tetanus A/E-	null	4	Clindamycin	Doxycycline	Metronidazole	Penicillin	Medicine	null	104b4d46-9fad-4817-8b3a-e38625eb27d2	single
A 25-year-old student with 20/20 vision looks up from his book to view his girlfriend sitting on the other side of the room. Which of the following is most likely to occur when the student changes his view from his book to his girlfriend?	Light rays from distant objects do not require as much refraction (bending) as do light rays from objects close at hand. Therefore, a thinner lens with less curvature is required for viewing distant objects. The process of accommodation adjusts the thickness of the lens for near and far vision by contracting or relaxing the ciliary muscle that surrounds the lens of the eye; contraction of the ciliary muscle thickens the lens, and relaxation causes the lens to become thinner.	4	Thicker lens, contraction of ciliary muscle	Thicker lens, relaxation of ciliary muscle	Thinner lens, contraction of ciliary muscle	Thinner lens, relaxation of ciliary muscle	Physiology	Special Senses	7e89d38f-7a19-48b8-a170-ea432fed9886	single
Dilutional hyponatremia is seen in ?	Answer- B. VincristineAcute kidney injury (AKI) (ARF)CirrhosisNephrotic syndromeCardiac failureAnti cancer drugs	2	Addison's disease	Vincristine	Diuretic therapy	Craniphyrangioma	Medicine	null	0f6734fa-fb78-4dd3-84bb-9edff2f2f25c	single
Indication for relining of complete denture include alt, expect	null	3	Immediate denture at 3-6 months after their original construction	Patient cannot afford new denture	Abuse soft tissues are present	When the construction of new dentures with the multiple appointment cause physical and mental stress	Dental	null	aa4f0026-8f5b-4c4d-a37a-1943f3ca4bc1	single
A 7 year old boy presented with generalized edema. Urine examination revealed marked albuminuria. Serum biochemical examinations showed hypoalbuminaemia with hyperlipidemia. Kidney biopsy was undeaken. On light microscopic examination, the kidney appeared normal. Electron microscopic examination is most likely to reveal-	This is a case of minimal change disease(MCD) On biopsy-no lesion is seen by light microscopy, negative for deposits by immunofluorescent microscopy -so it is also called nil lesion. On electron microscopy -effacement of foot processes suppoing Glomerular cells(podocytes) with weakening of slit pore membranes is seen. Ref:Harrison 20 th edition pg no. 2142	1	Fusion of foot processes of yhe glomerular epithelial cells	Rarefaction of glomerular basement membrane	Deposition of electron dense material in the basement membrane	Thin basement membrane	Medicine	Kidney	efc0932a-558e-462a-bc93-75501d4d27b9	single
Yellow fever vaccination starts protection after how many days of injection -	null	2	5 days	10 days	15 days	20 days	Social & Preventive Medicine	null	50929cbe-d4e1-45c6-9752-eb9ae2fe6753	single
Virchows method of organ removal is	METHOD OF REMOVAL OF ORGANS. Virchow's technique- Organs are removed one by one, Cranial cavity is exposed first, followed by thoracic,cervical and abdominal organs. Spinal cord is removed from the back. Rokitansky's technique- It involves in situ dissection in pa, combined with en block removal. Letulle's technique- Cervical, thoracic, abdominal and pelvic organs are removed en masses and dissected as organ block. Ghon's technique- Cervical,thoracic,abdominal and urogenital system are removed as organ blocks, Neurobal system is removed as another block. Ref: K.S.Narayan Reddy's Synopsis of Forensic Medicine and Toxicology, 29th edition, Chapter 5, Page - 63.	2	Organs removed en masse	Organs removed one by one	In situ removal	Minimal invasive autopsy	Forensic Medicine	Death and postmortem changes	f6115abc-4025-4631-a2c1-e6d51f9b975f	single
A 36-year-old woman is admitted to the hospital with severe head injuries after a car crash. During neurologic examination it is noted that her uvula is deviated to the right. Which of the following muscles is paralyzed?	The uvula would move toward the intact right side. This is because the intact levator veli palatini would be unopposed by the opposite, paralyzed left levator veli palatini.	1	Left levator veli palatini	Left tensor veli palatini	Right levator veli palatini	Right tensor veli palatini	Anatomy	Head & Neck	7060a37b-45b7-4939-a93c-933e3052f9a2	single
All of the following occurs in adrenal deficiency except	null	2	Hypoglycemia	Hypocalcemia	Hypotension	Hyponatremia	Medicine	null	fbb489b9-4cca-42dc-bffb-3287ecd097f2	multi
Savita is 35 years female with Gravida-2 and parity 1+0 is suffering from hepatic encephalopathy. Likely cause will be -	Ans. is 'b' i.e. Hepatitis E (Ref. Dutta, 6/e, p 292 (5/e, p. 308), Robbins illustrated, 6/e, p. 862).Hepatitis E infection has a benign course in normal individuals just like hepatitis A but once it infects a pregnant female it shows its ugly face. It then causes fulminant hepatitis in a large % of pregnant females leading to hepatic coma and death.	2	Hepatitis B	Hepatitis E	Hepatitis D	Hepatitis A	Gynaecology & Obstetrics	Hepatic, Biliary, and Pancreatic Disorders	4354102e-3a13-4cb4-933c-b3bd6f535f6c	single
Which RNA has splicing activity	sn RNA (small nuclear RNA) acts as Ribozyme. (RNA with enzymatic activity) It has splicing activity and is involved in mRNA processing.	4	m RNA	mi RNA	r RNA	sn RNA	Biochemistry	null	1a64f235-feb2-434f-9bed-4bff844c6aaa	single
Which specimen shouldn't be refrigerated before primary innoculation?	Ref: Ananthnarayan R. Paniker CKJ. Textbook of Microbiology. 8th Edition. Hyderabad: Universities Press; 2009. Pg. 332Explanation:Haemophilus influenzae is an important cause of meningitis.The disease is more common in children between two months and three years of age. Infections are caused by the capsulated strains, type b accounting for most cases.CSF specimen from suspected children should be plated promptly on a suitable medium such as blood agar or chocolate agar and incubated in an environment of 5-10 per cent C()2 and high humidity.As this bacillus is very sensitive to low temperatures. CSF specimens should never be refrigerated before inoculation.	1	CSF	Urine	Sputum	Pus	Microbiology	Culture media and method	e33f9d6e-08d0-4781-baf9-a7a60aee4360	single
The Tongue:	null	1	Separated from the epiglottis by glossoepiglottic folds	Contains foramen caecum which is present on the dorsum of frenulum	Contains 6 — 10 circumvallate papilla located posterior to sulcus terminals	Embryologically derives from 1st branchial arch only	Anatomy	null	86a1484f-47b4-4e5a-8717-0ddb94151605	multi
Glomular filtration rate increases if: September 2005	Ans. C: Increased renal blood flow GFR = Kf x Net filtration pressure Net filtration pressure represents the sum of the hydrostatic and colloid osmotic forces that either our/oppose filtration across glomerular capillaries Hydrostatic pressure inside the glomerular capillaries (PGC) - Promotes filtration Hydrostatic pressure in the bowman's capsule outside the capillaries (PB)-opposes filtration Colloid osmotic pressure of glomerular capillary plasma proteins-Opposes filtration Colloid osmotic pressure of Bowman's capsule proteins-promotes filtration - Afferent aeriolar constriction will reduce renal blood flow and reduce PGC, causing a reduction in GFR. - Efferent aeriolar constriction will reduce renal blood flow but increase PGC; these changes act in opposite directions with respect to GFR and the net effect on GFR is minimal. - A reduction in Kf will reduce GFR (contraction of mesangial cells and reducing the area available for filtration) - Any given vasoactive agent may have a spectrum of effects (on afferent/efferent aeriolar tone or Kf), making the net effect on GFR difficult to predict. Thus, angiotensin II, a major regulator of glomerular function, causes constriction of both afferent and efferent aerioles, as well as reducing Kf. The overall outcome for GFR depends on the relative magnitudes of these actions, which vary in different pathophysiological conditions. A high protein intake increase renal blood flow and GFR - Large increase in blood glucose levels in uncontrolled D increase renal blood flow and GFR. Kf: Glomerular ultrafiltration coefficient, PGC: mean hydrostatic pressure in glomerular capillaries	3	Increased plasma oncotic pressure	Decreased glomerular hydrostatic pressure	Increased renal blood flow	Increased tubular hydrostatic pressure	Physiology	null	ad8bb997-1951-4647-92b8-bbb8028f4908	single
A 65-year-old woman undergoes a kidney transplant for CKD. 6 weeks after the transplant, she develops CMV infection characterized by fever, malaise, and myalgias. Which of the following is a potential sequela of CMV infection?	Viral infections are the most common infection post transplantation. These include infections by cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes simplex virus, and varicella zoster virus. CMV infections presents as fever, malaise, myalgia, ahralgia, and leukopenia. Organ involvement leads to pneumonitis; ulceration and hemorrhage in the stomach, duodenum, or colon; hepatitis; esophagitis; retinitis; encephalitis; or pancreatitis. Pyelonephritis, cholecystitis, intra-abdominal abscesses, and parotitis are caused by bacterial infections or GI perforation and not primarily by CMV infection.	4	Intra-abdominal abscess	Pyelonephritis	Cholecystitis	GI ulcers & hemorrhage	Surgery	Transplantation	bb636c46-8d5a-480b-b952-31cb9b07e973	single
Anterior lenticonus is found in –	Anterior lenticonus is seen in Alport's syndrome and posterior lenticonus is seen in Lowe's syndrome.	3	Lowe's syndrome	William's syndrome	Alport's syndrome	Down's syndrome	Ophthalmology	null	ecdb51ff-9d91-4916-93f5-a3619643eeaa	single
Procalcitonin is used as marker of	ref Harrison 18/e p3419 Procalcitonin is an acute phase reactant which is now useful for being a marker of sepsis Procalcitonin (PCT) is a biomarker that exhibits greater specificity than other proinflammatory markers (eg, cytokines) in identifying patients with sepsis and can beused in the diagnosis of bacterial infections	4	Cardiac dysfunction in acute coronary syndrome	Menstrual perodicity	Pituitary function	Sepsis	Anatomy	General anatomy	775c3602-1ecb-4cb6-9c6c-940558a97fef	single
If we say that here is no significant association between two variable and if truly an association exists. Then it is called:	Null hypothesis (H0) there is No significant association In the given question, In reality an association exists, So Null hypothesis is false We say no significant association exists, so we are accepting Null hypothesis Hence its Type II error	2	Type I error	Type II error	Systematic error	Random error	Social & Preventive Medicine	Biostats	ae204fe5-e395-4e02-b009-4bf556d7cb11	multi
In case of hanging neck ligature marks are example of -	The synopsis of forensic medicine & toxicology - Dr k.s.narayan reddy ;28th edition; Pg no. 105 Also called crushing or friction abrasion. The are caused by crushing of superficial layer of epidermis & are associated with bruise of the surrounding area . occurs when movement of instrument is around 90deg to the skin .hanging ,strangulation ,teeth bite marks are examples .	2	Contusion	Pressure abrasion	Lacerration	Bruise	Forensic Medicine	Mechanical injuries	caffa993-a9de-4768-a96c-0db2e0b12576	single
A 23 year old male who is otherwise normal complains of mild pain in his right iliac fossa in a waveform pattern which increases during the night and he becomes exhausted and is admitted in the hospital. On examination there is mild hematuria. Urine examination reveals plenty of RBCs, 50WBCs/hpf. Urine pH is 5.5. Most likely diagnosis is:	Ans. is 'c' ie. Ureteral calculus The patient's clinical picture is typical of ureteric calculus.Colicky renal pain associated with hematuria is suggestive of ureteric stone although a clot from a bleeding renal tumor can cause the same type of pain.A ureteric calculus pain is almost invariably associated with hematuria.Leukocytes in urine can be seen with urolithiasis.	3	Glomerulonephritis	Ca-Urinary bladder	Ureteral calculus	Cystitis	Surgery	Urolithiasis	f9fbafd4-304c-48a8-a0d1-2b099186c022	single
A 67-year-old, 60-kg homeless man has been in the intensive care unit (ICU) for a week after an emergency laparotomy and sigmoid resection for perforated diverticulitis. His serum albumin is 1.1 g/dL. He was just weaned from mechanical ventilation. His colostomy is not functioning. You start total parenteral nutrition (TPN) to deliver 1800 kcal/24 h. Two days later, the patient is in respiratory distress and requires reintubation and mechanical ventilation. You should check the level of serum	Rapid institution of full nutritional support can cause "refeeding syndrome" in malnourished patients. The hall mark of this condition is hypophosphatemia. Phosphate is taken up by phosphate-depleted cells trying to metabolize the nutrition and levels of ATP fall precipitously. This leads to respiratory failure. Refeeding syndrome can be avoided by starting nutritional support at low levels and increasing slowly. The other substances listed are not associated with respiratory failure after starting nutritional support.	1	Phosphate	Magnesium	Calcium	Selenium	Surgery	Fluid & Electrolyte	b8e7a175-ee98-40bd-b8ce-80e5e9b84fc3	single
All are USG findings of PCOS except	Cysts arrange around the periphery of ovary giving Necklace of pearl appearance on USG is Characteristic of PCOD Rotterdam PCOS Diagnostic Criteria for PCOS diagnosis : The presence of two of the three criteria is sufficient to diagnosis PCOS: menstrual cycle anomalies (amenorrhea, oligomenorrhea), clinical and/or biochemical HA, and/or Ultrasound appearance of polycystic ovaries after all other diagnoses are ruled out. The sonographic criteria for PCOS morphology Presence of 20 or more follicles (newer criteria mention 20 follicles instead of 12 since with better USGs, even smaller follicles can now be picked up) in either ovary measuring 2 to 9 mm in diameter and/or increased ovarian volume (>10 mL). A single ovary meeting these criteria is sufficient to affix the PCO morphology	2	>=20 Follicles which are <=9 mm in size in either ovary	Ovarian Volume <=10 cc	Necklace of pearl pattern of Follicles	Thick Ovarian Stroma	Gynaecology & Obstetrics	Polycystic Ovarian Syndrome	910dde72-8694-4445-b67b-4ecfc8d934fd	multi
Surfactant lining the alveoli	The low surface tension when the alveoli are small is due to the presence in the fluid lining the alveoli of surfactant, a lipid surface-tension-lowering agent. If the surface tension is not kept low when the alveoli become smaller during expiration, they collapse in accordance with the law of Laplace.	1	Helps prevent alveolar collapse.	Is produced in alveolar type I cells and secreted into the alveolus.	Is increased in the lungs of heavy smokers.	Is a glycolipid complex.	Physiology	null	50b227a6-853e-41be-afe9-302f63f46706	single
Immersion syndrome occurs due to ?	Ans. is 'a' i.e., Vagal inhibition Types of drowning Drowning is classified as (1) typical and (2) atypical. 1. Typical drowning (wet drowning) Typical drowning refers to obstruction of air passages and lungs by inhalation of water or other fluid. Therefore it is also called wet drowning and findings offluid and froth are present in PM examination. Typical drowning may be :- Fresh water drowning : In fresh water drowning large quantities of water cross the alveolar membrane into circulation causing hypervolaemia and hemodilution. RBCs imbibe water and burst (hemolysis) with liberation of potossium. Therefore, hea is exposed to volume overload, potassium excess, sodium deficit (hyponatremia), and anoxia. Anoxia and hyperkalemia cause ventricular fibrillation and death in 4-5 minutes. Salt water drowning : Hypeonicity of inhaled water causes loss of fluid from circulation into the lungs giving rise fulminating pulmonary edema with progressive hypovolaemia, circulatary shock, and eventually cardiac standstill (asystole) with death in 8-12 minutes. 2. Atypical drowning It refers to drowning in which even after submersion of body in water, little or no water anters respiratory passages and lungs. Hence typical findings of wet drowning in the form of froth and oedema aquosum of lungs are not found. Atypical drowning may be :- Dry drowning : On contact with water, especially cold water, there results intense laryngospasm, so that water does not enter the lungs. Death is due to asphyxia because of laryngospasm. Immersion syndrome (hydrocution/submersion inhibition/vagal inhibition) : Sudden death occurs due to vagal inhibition as a result of (a) sudden impact with cold water, (b) duck diving (falling in water with feet first), and (c) horizontal entry in water with impact on epigastrium. Submersion of unconscious : If person is unconscious since before submersion in water, little or no water enters respiratory passages. It may occur in MI, cerebrovascular accident, hypeension, epilepsy, cerebral aneurysm and in drunk state. Near drowning (secondary drowning syndrome/post immersion syndrome) : In this drowning is survived and death occurs at a later stage after removal from water. Either the person himself comes out of water or he is recovered alive, but due to complications of submersion, he dies at a later stage. It is due to hypoxic encephalopathy and fibrosing alveolitis. The death occurs due to combined effect of cerebral hypoxia, pulmonary edema, aspiration pneumonitis, electrolyte disturbances and metabolic acidosis.	1	Vagal inhibition	Vagal Stimulation	Sympathetic stimulation	Sympathetic inhibition	Forensic Medicine	null	aa2fd386-12d2-418c-ac28-5e2998be4ae9	single
True about anaplastic Ca of thyroid -a) Common in elderlyb) Surrounding neck tissues are freec) Lymphatic infiltration occursd) p53 mutation	null	1	acd	ad	bc	bde	Surgery	null	e22b61da-32e6-4821-96bc-afce60a5c915	multi
Oesophagus supplied by oesophageal branches of all except	Aerial Supply of esophagus:1. The cervical pa including the segment up to the arch of aoa is supplied by the inferior thyroid aeries.2. The thoracic pa is supplied by the oesophageal branches of the aoa.3.The abdominal pa is supplied by the oesophageal branches of the left gastric aery.Ref: BD Chaurasia; Volume 1; 6th edition; Page no: 268	4	Inferior thyroid aery	Descending thoracic aery	Left gastric aery	Right gastric aery	Anatomy	Thorax	feb2fcbe-0c58-4934-90a7-1548518bf704	multi
Single best parameter to assess gestational age in first trimester?	Best parameter to assess gestational age- First trimester - CRL (Crown Rump Length) Second trimester - BPD (Biparietal Diameter) Third trimester - BPD (Biparietal Diameter) Best Overall - CRL (Crown Rump Length)	1	CRL (Crown Rump Length)	BPD (Biparietal diameter)	HC (Head Circumference)	FL (Femur Length)	Gynaecology & Obstetrics	Obstetrics	54250735-15ee-4889-8770-690f35667ed0	single
All are the features of an acute attack of primary narrow-angle glaucoma except:	Ans. Disc shows glaucomatous cupping	3	Intraocular pressure is raised up to 940-70 mm of Hg	Eye is red, painful and tender	Disc shows glaucomatous cupping	Fellow eye also shows shallow anterior chamber	Ophthalmology	null	19668054-4d02-48dd-b0bd-e78a2dd09a8d	multi
All are true for sublingual route except ?	Ans. is 'b' i.e., All drugs can be given Sublingual route of administration The tablet or pellet containing the drug is placed under the tongue or crushed in the mouth and spread over the buccal mucosa. Only the lipid soluble and non-irritating drugs can be administered by this route Absoption is rapid and action can be produced in minutes Action can be easily terminated by spitting the drug after the desired effect is achieved. Liver is bypassed with this route, thus the drugs with high first pass metabolism can be easily given by this route. Drugs given by this route are: GTN, buprenorphine, desamino-oxytocin.	2	Escape first pass metabolism	All drugs can be given	Action can be terminated any time	Rapid absorption	Pharmacology	null	4f9f22fc-5035-401d-87fd-0b94264d0ac5	multi
Libmansach's endocaritis is associated with?	Ans. B. SLE. (Ref. Robbings pathology 8th/pg. 408).Robbin's pathology 8th/pg. 408# Libman-Sacks endocarditis refers to sterile vegetations that can develop on the valves of patients with systemic lupus erythematosus.Libman-Sacks Endocarditis# These lesions presumably occur because of immune complex deposition and thus have asso inflammation. With increasing use of steroids for Rx of lupus, Libman-Sacks endocarditis has become uncommon.# Morphology-Histology:- Small (1-4 mm in diameter) sterile, granular pink vegetations;- No special predilection for the lines of valve closure.- Can be located on the undersurfaces of the atrioventricular valves, on the cords, or even on the atrial or ventricular endocardium.- The lesions are finely granular, fibrinous eosinophilic vegetations containing nuclear debris. An intense valvulitis is often present, with fibrinoid necrosis of the valve substance adjacent to the vegetation. Subsequent fibrosis and serious deformity can result that resemble chronic RHD.# A]. The acute rheumatic heart disease (RHD) is marked by a row of small, warty verrucae along the lines of closure of the valve leaflets.# B]. Infective endocarditis (IE) typically shows large, irregular, and destructive masses that can extend onto the chordae.# C]. Nonbacterial thrombotic endocarditis (NBTE) typically shows small, bland vegetations, usually attached at the line of closure. One or many may be present.# D]. Libman-Sacks endocarditis (LSE) has small or medium-sized vegetations on either or both sides of the valve leaflets, or elsewhere on the endocardial surface.	2	Rheumatic heart disease	SLE	Carcinoma	null	Pathology	C.V.S	fafec6fb-8aef-42ad-9602-bc323c426bb9	multi
Epimers of glucose	When sugars are different from one another, only in configuration with regard to a single carbon atom, other than the reference carbon atom, they are called epimers. For example, glucose and mannose are an epimeric pair which differs only with respect to C2. Similarly, galactose is the 4th epimer of glucose. (Fig. 6.4). Galactose and mannose are not epimers but diastereoisomers.Ref: DM Vasudevan, 7th edition, page no: 77	1	Mannose	Glyceraldehyde	Fructose	null	Biochemistry	Metabolism of carbohydrate	116bec58-a434-48d5-8fba-2deb97a467dc	multi
Immediate treatment of hypercalcemia of malignancy is:	Ans. (A) IV fluids(Ref: Harrison 19th/610; KDt 8/e p370)Management of hypercalcemia of malignancyDrug of choiceBisphosphonatesImmediate treatmentIV fluids with furosemideFastest calcium lowering drugCalcitonin	1	IV fluids	Bisphosphonates	Calcitonin	Glucocorticoids	Pharmacology	Endocrinology	bbb9039f-619b-4731-8b3c-333ad5a37f50	single
Immunosuppressive drugs are less effective in which type of graft rejection ?	Ans. is 'b' i.e., Acute humoral rejectionBecause most clinically available immunosuppressive drugs target T-cells, they or inefective in antibody mediated rejection".	2	Acute cellular rejection	Acute humoral rejection	Chronic rejection	None of the above	Pharmacology	null	d9b5fdcd-1aa7-475f-a0ad-cf4ce0c87af2	multi
Reinke crystals are found in	Hilus cell tumor: Rare virilizing tumor Arises from cells in the ovarian hilum Presence of Reinke crystals in the cells is the distinguishing feature of leydig or interstitial cells of testis Ref: Shaw Gynecology 17e pg 449.	4	Arrhenoblastoma	Granulosa cell tumor	Dysgerminoma	Hilus cell tumor	Gynaecology & Obstetrics	Gynaecological oncology	6330085e-40a2-4fd8-8fc0-663e6ccb3ff1	single
Combination of Nifedipine with what other tocolytic agent can potentially cause dangerous neuromuscular blockade.	Magnesium sulphate when used with nifedipine can cause neuromuscullar blockade that can interfere with pulmonary and cardiac function.	2	Terbutaline	Magsulf	Indomethacin	Atosiban	Gynaecology & Obstetrics	null	2846a718-7458-43b9-853a-26ce9bfb87a0	multi
A 32 year old person comes to the hospital after 2 weeks of the onset of diarrhoea. Diagnosis of typhoid can be confirmed with	Diagnosis done in 1st week - Blood culture 2nd week - Widal / Antibodies level 2rd week - Stool culture 4th week - Urine culture	4	Urine culture	Stool culture	Blood culture	Widal test	Social & Preventive Medicine	null	7298a0f2-058e-4d40-86cc-1577c87f129f	single
Goodpasture's disease is characteraized by all except-	Goodpasture syndrome (GPS), also known as anti-glomerular basement membrane disease, is a rare autoimmune disease in which antibodies attack the basement membrane in lungs and kidneys, leading to bleeding from the lungs and kidney failure. It is thought to attack the alpha-3 subunit of type IV collagen, which has therefore been referred to as Goodpasture's antigen.Goodpasture syndrome may quickly result in permanent lung and kidney damage, often leading to death. It is treated with medications that suppress the immune system such as coicosteroids and cyclophosphamide, and with plasmapheresis, in which the antibodies are removed from the blood. The antiglomerular basement membrane (GBM) antibodies primarily attack the kidneys and lungs, although, generalized symptoms like malaise, weight loss, fatigue, fever, and chills are also common, as are joint aches and pains.60 to 80% of those with the condition experience both lung and kidney involvement; 20-40% have kidney involvement alone, and less than 10% have lung involvement alone.Lung symptoms usually antedate kidney symptoms and usually include: coughing up blood, chest pain (in less than 50% of cases overall), cough, and shoness of breath. Kidney symptoms usually include blood in the urine, protein in the urine, unexplained swelling of limbs or face, high amounts of urea in the blood, and high blood pressure GPS is caused by abnormal plasma cell production of anti-GBM antibodies The anti-GBM antibodies attack the alveoli and glomeruli basement membranes.These antibodies bind their reactive epitopes to the basement membranes and activate the complement cascade, leading to the death of tagged cells. T cells are also implicated, though it is generally considered a type II hypersensitivity reaction. Ref Harrison20th edition pg 277	2	Glomerulonephritish	Leukocytoclastic vasculitis	Presence ofantibodies to BM	Diffuse alveolar hemorrhage	Medicine	Kidney	f1a85886-672b-44cd-9cc6-ddd0947b1397	multi
Best diagnosis for dissecting aoa is:	Ans. MRI	2	CT scan	MRI	Angiography	X-ray	Radiology	null	c01f484d-1c96-494e-9b82-fa6f32ba663d	single
Myocardial isonzyme of CK which is specific for myocardial infarction is	within 4–6 hrs after development of acute MI, peaks during the 2nd day (4 fold rise) and disappears in 2–3 days. Other causes of total CK elevation: 1. Skeletal diseases – Polymyositis, Muscle dys- trophy, Myopathies 2. Electrical cardioversion 3. Skeletal muscle damage – trauma, convulsions, immobilisation 4. Hypothyroidism 5. Stroke 6. Surgery b. AST: Starts rising on the 1st day, peaks in 2–3 days (3 fold rise) and disappears by 3rd day. c. LDH1: Starts rising by second day, peaks around 3– 4 days ( 3 fold rise) and disappears in 10 days. d. Troponin T: Cardiac troponin T is a regulatory contractile protein not normally found in blood. Its detection in the circulation has been shown to be a sensitive and specific marker for myocardial cell damage. Troponin T and I reach a reliable diagnostic level in plasma by 12-16 hrs, maximal activity by 24-32 hrs, returns to normal in 10-12 days. Troponin I : 0-0.4 ng/ml Troponin T: 0-0.1 ng/ml Cardiac troponins are detected in the serum by using monoclonal antibodies. These antibodies have negligible cross reactivity to skeletal muscle. Cardiac troponins I and T start to rise within 3-4 hours after myocardial infarction and remain raised for 4-10 days	2	CK-BB	CK-MB	CK-MM	All of the above	Medicine	null	adf61454-050c-43af-8409-67a0d88b3e9b	multi
The shape of septal cailage is:	The septal nasal cailage, (cailage of the septum or quadrangular cailage) is composed of hyaline cailage. It is somewhat quadrilateral in form, thicker at its margins than at its center, and completes the separation between the nasal cavities in front.	2	Triangular	Quadrilateral	Oval	Hexagonal	ENT	null	5d561833-e9b9-420e-9e9d-30d58b9cd52f	single
Duret hemorrhage is seen in?	Ans. is 'b' i.e., Brain stem Duret hemorrhage is small areas of bleeding in the ventral and paramedian pas of the upper brain stem. Causes include acute trauma, edema following trauma, abscess or tumor	2	Brain	Brain stem	Eye	Medulla	Forensic Medicine	null	b78ed62e-3e27-4b6f-b81e-88e577a35f70	single
First step to be done in case of variceal bleeding-	Ans. is 'b' i.e., iv crystalloides Initial resuscitation is usually with isotonic crystalloid solutions. A minimum of 6 units of blood are typed and crossmatched for most patients. If PT is prolonged more than 3 seconds, fresh frozen plasma is a component of the resuscitation volume.Endoscopy to determine cause of bleeding - endoscopic sclerotherapy or endoscopoic variceal ligation and injection with cynoacrylate.iv antibiotics.Somatostatin/Octreotide.Balloon tamponade.	2	Blood transfusion	IV Crystal]oides	Endoscopy	Somatostatin	Surgery	Diagnostic Evaluation of the Esophagus	55ff2ac5-b8cf-4d3b-a5a0-43a89c998af2	multi
Excessive sunlight exposure can cause	null	3	BCC	Melanom	SCC	Leukemia	Pathology	null	7900db87-5168-4e14-b55a-8856f20dbe17	single
Bishop scoring is done for ?	Ans. is 'b' i.e., Induction of labour Bishop score, also Bishop's score, also known as cervix score is a pre-labor scoring system to assist in predicting whether induction of labor will be required. The total score is achieved by assessing the following five components on vaginal examination: Cervical dilation Cervical effacement Cervical consistency Cervical position Fetal station If the Bishop score is 8 or greater the chances of having a vaginal delivery are good and the cervix is said to be orable or "ripe" for induction. If the Bishop score is 6 or less the chances of having a vaginal delivery are low and the cervix is said to be unorable or "unripe" for induction.	2	Exchange transfusion in newborn	Induction of labour	Ventilation of Newborn	Gestation of Newborn	Pediatrics	null	7031f6ce-21a1-4843-b050-de9d5de5b369	single
The following condition of GB is precancerous -	Gallbladders containing stones or infectious agents develop cancer as a result of irritative trauma and chronic inflammation. Carcinogenic derivatives of bile acids also may play a role. Porcelain gallbladder increases the risk of cancer. Choledochal cysts predispose to stone formation, stenosis and stricture, pancreatitis, and obstructive biliary complications within the liver. In the older patient, the risk of bile duct carcinoma is elevated.	2	Cholesterosis	Porcelain gall bladder	Biliary atresia	Choledochal cyst	Pathology	null	baa72c37-2674-457a-a638-fb070f7c91da	multi
In Diabetes, What happens to RQ:	Respiratory Quotient (RQ) Calculation of RQ of Glucose (carbohydrates): Oxidation of glucose in body: C6H1206 + 602 - 6C02 + 6H20 So, RQ = 6/6 = 1 RQ VALUES for different food components: Carbohydrates - 1 Proteins - 0.8 Fats - 0.74 Mixed diet - 0.85 Brain - 0.97 - 0.99 RQ TELLS US Type of macromolecules used in the body Conversion of one macromolecule to another FASTING / STARVATION - RQ decreases RQ in Diabetics - RQ decreases On giving insulin - RQ Increases	4	RQ always increases in Diabetes	RQ increases & on giving Insulin it again decreases	RQ always decreases in Diabetes	RQ decreases & on giving Insulin it again increases	Biochemistry	Miscellaneous	9f0780b8-052e-4c1d-9d5a-3d8fbeba9efc	single
Which will the patient with following peripheral smear and X-ray spine present with?	Ref: Harsh Mohan, Textbook of Pathology, 7th ed. pg. 294-96The X-ray spine shows fish shaped vertebra with peripheral smear showing sickle shaped RBCs. The presence of sickling crisis lead to Hand-Foot syndrome is characterized by painful infarcts of the digits and dactylitis.	1	Hand Foot syndrome	Black urine	Elevated haptoglobin	Splenomegaly with gall stones	Pathology	Blood	9e88028b-2288-499a-9516-774967690060	multi
All form the boundaries of ovarian fossa, except ?	Each ovary lies in ovarian fossa an the lateral pelvic wall which is bounded :-i) Anteriorly : Obliterated umblical aeryii) Posteriorly : Ureter and internal iliac aery	2	Ureter	Internal pudendal aery	Obliterated umbilical aery	Internal iliac aery	Anatomy	null	81578a01-1729-40e7-94a6-88a73f7a7830	multi
Alzheimer's disease, which is involved?	Alzheimer's disease (AD), also referred to simply as Alzheimer's, is a chronic neurodegenerative disease that usually stas slowly and gradually worsens over time.It is the cause of 60-70% of cases of dementia.The most common early symptom is difficulty in remembering recent events.As the disease advances, symptoms can include problems with language, disorientation (including easily getting lost), mood swings, loss of motivation, not managing self-care, and behavioural issues.As a person's condition declines, they often withdraw from family and society.Gradually, bodily functions are lost, ultimately leading to death.Although the speed of progression can vary, the typical life expectancy following diagnosis is three to nine years.coical atrophy of temporal and parietal lobes Stages of Alzheimer's disease Effects of ageing on memory but not AD Forgetting things occasionally Misplacing items sometimes Minor sho-term memory loss Not remembering exact details Early stage Alzheimer's Not remembering episodes of forgetfulness Forgets names of family or friends Changes may only be noticed by close friends or relatives Some confusion in situations outside the familiar Middle stage Alzheimer's Greater difficulty remembering recently learned information Deepening confusion in many circumstances Problems with sleep Trouble determining their location Late stage Alzheimer's Poor ability to think Problems speaking Repeats same conversations More abusive, anxious, or paranoid Ref Harrison20th edition pg 2345	2	Frontal coex	Coical atrophy of temporoparietal coex	Frontal and parietal coex	Occipital coex	Medicine	C.N.S	3dd88978-a99b-4ee4-a51f-0712e9221cbb	single
True about vit–D deficiency rickets –a) Vit. D3 given at a dose of 50–150 mg/dayb) X–ray knee joint is diagnosticc) Rickety rosary is tenderd) Increased chances of respiratory tract infectione) Hyponatrernia	null	2	c	bd	ab	ac	Pediatrics	null	695ac3bb-0bc8-405b-8e82-f8cd834cda44	multi
Dupuytren's contracture is seen in	Dupuytren's contracture refers to localised thickening of palmar aponeurosis and later formation of nodules with severe permanent changes in metacarpophalangeal and proximal interphalangeal joints. It is often associated with the following conditions : * Plantar fasciitis 5%-Ledderhose's disease * Mediastinal and retroperitoneal fibrosis * Peyronie's disease of penis 3% * Nodules in the face and ear * Pellegrini-Stieda's disease. Reference : page 163 SRB's manual of surgery 5th edition	1	Peyronie's disease	Hypospadias	Epispadias	Exostrophy	Surgery	Urology	22b83e29-5406-4fb5-ad9c-175334db9419	single
Laparoscopy - pressure in the abdomen of children -	Ans. is 'b' i.e., 8-12 mm Hg * The optimal intrabdominal pressure for laproscopy in children has been established to be between 8-12 mm Hg, with neonates tolerating lower pressures than elders.	2	2-6 mm Hg	8-12 mm Hg	14 - 18 mm Hg	20 - 24 mm Hg	Surgery	Gall Bladder & Bile Ducts	901e7990-ff69-4885-99b6-fc045c5244a1	single
It is true about H. Pylori that it -	Ans. is 'd' i.e., Treatment prevent gastric lymphoma	4	Is gram -ve spiral organism	Is a protozoa	Causes chronic gastritis in adults due to reinfection	Treatment prevents gastric lymphoma	Microbiology	null	cb8ef202-d85f-4350-949e-e1672a94aaa6	multi
A 12-year-old girl with the mood and emotional liability has a golden brown discoloration in descemet membrane. Most likely diagnosis is:	b. Wilson's disease(Ref: Nelson's 20/e p 1939-1940, Ghai 8/e p 320-321)KF ring in Wilson disease is due to deposition of Copper in the Descemet membrane layer of cornea.	2	Fabry's disease	Wilson's disease	Glycogen storage disease	Acute rheumatic fever	Pediatrics	Inborn Errors of Metabolism	b153eaf7-cf1a-46db-8dbb-434a15eeeafe	single
Digitalis does not increase which parameter of heart-	Ans. is 'c' i.e., Myocardial oxygen demand Effect of digitalis on hearto Main mechanism of action of digitalis is to increase in force of contraction of heart - a positive inotropic action.o Amongst given options, option d is the best choice - heart rate is decreased by digitalis and there is increase myocardial contractility without a propartionate increase in O2 consumption.How does digitalis decrease heart rate?# Heart rate is decreased by digitalis mainly in patients with CHF.# In CHF there is sympathetic overactivity and i vagal tone because of \| CO2# Digitalis increases myocardial contractility (major action) - \| CO and better emptying of ventricle - improvement in circulation - restoration of diminished vagal tone and abolish sympathetic overactivity - \| Heart rate. Beside above main mechanism digitalis slows the heart rate by -A) Increased vagal tonei) Reflexly through nodosa ganglion.ii) Direct stimulation of vagal centre.iii) Sensitization of SA nodes to Ach.B) Extravagal - Direct depressant action on SA and AV nodes."The vagal action manifests early and can be blocked by atropine, whereas extravagal action becomes prominent later and cannot be reversed by atropine	3	Force of contraction	Myocordial contractility	Myocardial oxygen demand	Cardiac output	Pharmacology	Digitalis	7e206312-ea15-4a7d-ab6d-8c5b5b5885a5	single
Presbyopia occurs as a result of the following except	Presbyopia is multifactorial and is believed to result from poor ciliary muscle contraction with age and age-related sclerosis and loss of elasticity of the lens fibres and the lens capsule.	3	Loss of elasticity of the capsule	Sclerosis of lens fibres	Reduced anterior movement of the lens	Reduced contraction of the ciliary muscle	Ophthalmology	All India exam	0e3e3528-ae93-469f-8824-d569a18018b8	multi
Schistosoma japanicum resides in -	The adult worms of S.haematobium live primarily in the vesical and pelvic venous plexuses whereas S.japonicum and S.mansoni inhabit the superior mesentric vein and the inferior mesentric vein respectively (refer pgno:119 baveja 3 rd edition)	2	Vesical Plexus	Splenic Vein	Systemic Circulation	Gall bladder	Microbiology	parasitology	a93815f6-0e88-455e-bb07-3f5bafe22be6	multi

A patient having glaucoma develops blepharoconjunctivitis after instilling some anti-glaucoma drug. Which of the following drug can be responsible for it:

Allergic blepharoconjunctivitis is a side effect of beta blockers. Ref: Essentials of Medical Pharmacology By K D Tripathi, 4th Edition, Page 95

1

Timolol

Latanosprost

Dipiverine

Pilocarpine

Ophthalmology

null

7b3b3ac0-042c-4392-bcaf-7f6fe1774d40

single

Standard in perimetry ?

Ans. is 'c' i.e., Goldman type III Projected stimuli in perimetry are usually white and of variable size and intensity. There are five different sizes on Goldmann scale designated by Roman numeral Ito V. The standard used in both manual and automated perimetry is Goldman III (0.05" and area of 4mm2). o Failure to recognize target size III necessitates testing with stimulus V Goldman scale Stimulus size (mm2) I '/4 II 1 III 4 IV 16 v 64

3

Goldman type I

Goldman type II

Goldman type III

Goldman type IV

Ophthalmology

null

529c5ba7-062e-4c95-b8de-a46daa6a87eb

single

Visual acuity in infants is tested with the help of

.

1

Landolt's rings

'4' dot test

Perimeter

Slit lamp

Ophthalmology

All India exam

d30e7409-acbd-4324-9296-7aed34dc33f0

single

NOT a feature of hypothyroidism is ?

Ans. is 'a' i.e., Sho metacarpal in hands Hypothyroidism o Hypothyroidism results from deficient production of thyroid hormone or a defect in thyroid hormone receptor activity. o Hypothyroidism may be : - i) Congenital --> Present since bih ii) Acquired --> Symptoms appear after a period of apparently normal thyroid function. Hypothyroidism causes - i) Delayed bone growth (Bone age markedly delayed) ii) Delayed pubey & Alteration in upper and lower segment ratio (upper segment > lower segment) Hypothyroidism o Hypothyroidism results from deficient production of thyroid hormone or a defect in thyroid hormone receptor activity. o Hypothyroidism may be : - i) Congenital --> Present since bih ii) Acquired --> Symptoms appear after a period of apparently normal thyroid function. Hypothyroidism causes - i) Delayed bone growth (Bone age markedly delayed) ii) Delayed pubey & Alteration in upper and lower segment ratio (upper segment > lower segment)

1

Sho metacarpals in hands

Delayed pubey

Delayed bone age

Altered upper and lower segment ratio

Pediatrics

null

c1d57827-57f5-4711-bffc-256348da1eae

single

Dowry death is defined under section

Dowry death is defined under section 304 B *According to this if husband or his relative subjects the woman to cruelty or harassment in demand of dowry within 7 years of marriage,they shall be deemed to have caused her death *The punishment for such cases is improvement for not less than 7 years,but may be extended to life imprisonment OptionA :Section 304 A IPC:Causing death by negligence Option C:Section 174 Cr. P. C:Police inquest Option D:Section 176 Cr. P. C. Magistrate inquest Textbook of Forensic Medicine and toxicology 2nd edition pg333

2

304A IPC

304B

174Cr. P. C

176Cr. P. C

Forensic Medicine

Medical Jurisprudence

cb474535-6aaf-41fb-8cc9-e9c0c21e86a6

single

Renal transplantation is most commonly done in -

Renal transplantation is the preferred treatment for many patients with end stage renal disease (ESRD), because it provides a better quality of life for them than dialysis. The most common causes of ESRD (in decreasing order) are: Diabetes mellitus Hypertension Glomerulonephritis

1

Chr. glomerulonephritis

Bilateral staghorn calculus

Horse shoe kidney

Oxalosis

Surgery

null

d6ece7a6-6a6b-4086-9c6a-f8e09391bbe3

single

All of the following are derived from glycerol 3 phosphate, EXCEPT:

Impoant substances such as triacylglycerols, phosphatidylcholine, phosphatidylethanolamine, phosphatidylinositol, and cardiolipin, a constituent of mitochondrial membranes, are formed from glycerol-3-phosphate. Ref: Harper 28th edition, Chapter 24.

4

Phosphatidylcholine

Phosphatidylethanolamine

phosphatidylinosito

None of the above

Biochemistry

null

b52bb5b4-d475-4d42-8d63-992aa0ebe265

multi

Which inhalational agent is used in patients with raised intra cranial tension?

Isoflurane causes least vasodialation and hence helps to moderate the cerebral blood flow. It reduces the ICT and hence is useful in neurosurgery. It is more potent than halothane and has rapid onset of action and induction. Reference 1. Quick Review of Pharmacology, By Dr J G Buch, Page 204

2

Enflurane

Isoflurane

Desflurane

Sevoflurane

Anaesthesia

null

bafe9336-a7e4-4340-bf5d-5abf85243667

single

Which of the following statements about vigabatrin is TRUE?

(Ref: KDT 6/e p410) Vigabatrin act by inhibiting the enzyme GABA transaminase (involved in breakdown of CABA). It is used for the treatment of paial and generalized seizures. It is also used to treat infantile spasms. Visual disturbances are very impoant adverse effect of this agent.

4

Blocks neuronal reuptake of GABA

Drug of choice in absence seizures

Life threatening skin disorders may occur

Visual disturbances can occur

Anatomy

Other topics and Adverse effects

cd707b46-9a77-4796-9364-67cc81e1de1f

multi

Which of the following is used to study current flow across a single channel:

Patch clamp: measures ionic currents through a single ion channel. It has four configurations: Voltage clamp: whole cell voltage clamp measures currents across cell membranes. In using this apparatus, two electrodes are inseed into the nerve fiber. One of these electrodes is used to measure the voltage of the membrane potential, and the other is used to conduct electrical current into or out of the nerve fiber. Iontophoresis: a technique of introducing ionic medicinal compounds into the body through the skin by applying a local electric current.

1

Patch clamp

Voltage Clamp

Iontophoresis

Galvanometry

Physiology

Concepts in physiology

41c8d9b1-237b-4575-9403-fa2b807d0dda

single

In children with type IDM when is ophthalmologic evaluation indicated

Ophthalmologic examination should be conducted once the child is >10 yr of age and has had diabetes for 3 -5 year. Annual follow up should suggest. Reference: OP Ghai,essential paediatrics,8 th edition, page no 546

4

At the time of diagnosis

After 1 year

After 2 years

After 5 years

Pediatrics

Endocrinology

f61d4dca-1b53-40f8-84be-1cb742d717b7

single

Which among the following is considered as a hallmark of the fibrogenic repair:

Granulation tissue is the hallmark of the fibrogenic repair.

1

Granulation tissue

Neovascularization

Neutrophilic infiltration

All of the above

Pathology

null

8510d9f3-ec5f-45b3-85db-cf5ee9784068

multi

Incubation period of influenza -

null

1

18 - 72 hrs

1 - 6 hrs

5 - 10 days

< 1 hrs

Social & Preventive Medicine

null

53a574d0-e460-43ab-8b61-e68b6b99c567

single

A two–year–old boy is brought to emergency with severe anemia (Hb = 2 gm%) and features of congestive heart failure. The most appropriate immediate therapy for this boy would be –

null

1

Packed cell transfusion

Partial exchange transfusion

Whole blood transfusion

Parenteral iron injection

Pediatrics

null

e1b0fffe-edde-4b8e-960e-99ddcc840615

single

Parasympathetic supply to lacrimal glands are passed through -

Ans. is 'c' i.e., Greater petrosal nerve o Secretomotor (parasympathetic) fibers to lacrimal gland travel through greater petrosal nerve.GangliaSensory rootSympathetic rootSecretomotor rootMotor rootDistributionCiliaryFrom nasociliary nervePlexus along ophthalmic artery-Edinger-Westphal nucleus - oculomotor nerve - nerve to inferior obliqueCiliaris musclesSphincter pupillaeOticBranch from auriculotemporal nervePlexus along middle meningeal arteryInferior salivatory nucleus- pharyngeal nerve- tympanic branch- tympanic plexus- lesser petrosal nerveBranch from nerve to medial pterygoidto parotid gland via auriculotemporal nerveTensor veii palatini and tensor tympani via nerve to medial pterygoid (unrelated)Pterygopalatine2 branches from maxillary' nerveDeep petrosal from plexus around internal carotid arteryLacrimatory nucleus nervus intermedins - facial nerve - geniculate ganglion- greater petrosal nerve+ deep petrosal nerve= nerve of the pterygoid canal-Mucous glands of the nose, paranasal sinuses, palate nasopharynxSome fibers pass through zygomatic nerve -zygomaticotemporal branch to the lacrimal nerve-Lacrimal glandSubmandibular2 branches from lingual nervefromplexus around facial arterySuperior salivatory nucleus-facial nerve - chorda tympani joins the lingual nerve-Submandibular, Sublingual and Anterior lingual glands

3

Lesser petorsal nerve

Chorda tympani

Greater petorsal nerve

Lingual nerve

Unknown

null

21d74dc7-2925-48de-b68d-0cdeea41f325

single

Gold standard for reflux esophagitis is -

null

3

Manometry

Barium swallow

24 hours pH study

X-ray abdomen

Surgery

null

fb3aeb94-3b8b-45e5-8712-379e025657ed

multi

Quantity of current can be increased by

null

4

Increased milliamperage

Increased time

Increased tube current

All of the above

Radiology

null

71ec894e-cfbd-4e2d-932d-e8f1f157dfa1

multi

Samter's triad is related to -

Ans, is 'a' i.e., Ethmoid polypSamter-s triado Samtef s triad is a medical condition consisting of asthma, aspirin sensitivity-, and nasal/ethmoidal polyposis. It occurs in middle age (twenties and thirties are the most common onset times) and may not include any allergies,o Most commonly the first symptom is rhinitis.o The disorder typically progeses to asthma, then polyposis, with aspirin sensitivity coming last,o The aspirin reaction can be severe, including an asthma attack, anaphylaxis, and urticaria in some cases. Patients typically react to other NSAIDS such as ibuprofen, although paracetamol is generally considered safe,o Anosmia (lack of smell) is also typical, as the inflammation reaches the olfactory- receptors in the nose.

1

Ethmoid polyp

Nasopharyngial

Angiofibroma

Nasal glioma

ENT

Nose and PNS

db97f656-85a4-4097-b35d-044e1cac663e

single

The most common cause of seizures in a patient of AIDS is

Ans. is 'a' i.e., Toxoplasmosis Neurological manifestations of H.I.V. AIDS dementia complex (HIV encephalopathy) is a result of direct effects of HIV on CNS (not an oppounistic disease). It is subcoical dementia. Most common cause of seizures --> Toxoplasma Most common cause of meningitis --> Cryptococcus M.C. cause of focal neurological deficit --> Toxoplasma Toxoplasmosis is the most common CNS infection in AIDS. CNS lymphoma and prograssive multifocal leukoencephalopathy may occur.

1

Toxoplasmosis

Cryptococcal meningitis

Progressive multifocal leucoencephalopathy

CNS lymphoma

Medicine

null

c8d14b52-e2db-4eb4-bc6d-931743702710

single

Increased levels of alanine in serum after fasting is primarily due to:

Ans. a. Met loss of muscle protein due to increased breakdown (Ref: Ganong 24/e p21)Increased levels of alanine in serum after fasting are primarily due to net loss of muscle protein due to increased breakdown."The quantity of carbohydrate normally stored in the entire body can supply the energy required for body functions for 10-12 hours. Therefore, except for the first few hours of starvation, the major effects are progressive depletion of tissue fat and protein. Fat depletion is steady and continues unabated until most of the fat stores in the body are gone. Proteins undergo three phases of depletion-rapid depletion of mobilizable proteins at first, then greatly slowed depletion (during this time increased fat breakdown leads to a state of ketosis), and finally, rapid depletion again shortly before death. The major aim of protein catabolism during a state of starvation is to provide the glucogenic amino acids (especially alanine and glutamine) that serve as substrates for gluconeogenesis in the liver."

1

Net loss of muscle protein due to increased breakdown

Leakage from cells due to membrane damage

Renal dysfunction

Decreased rate of gluconeogenesis

Biochemistry

Amino Acid Metabolism

56e06587-92c2-448e-870b-c28fc78d5a6f

single

The thickness of the cornea is measured by using –

Pachymetry is used to measure thickness of cornea.

3

Schiotz tonometer

Keratometer

Pachymeter

Aesthesiometer

Ophthalmology

null

d03d9fd0-5c5f-4398-8cd6-aecbac14b09b

single

Which is not a substrate for gluconeogenesis?

Substrate for gluconeogenesis are: -glucogenic amino acids, lactate, glycerol, propionyl CoA Glucose cannot be produced from fatty acidRef: DM Vasudevan, 7th edition, page no: 120

2

Alanine

Fatty acid

Pyruvate

Lactate

Biochemistry

Metabolism of carbohydrate

3b7ddc8c-e912-4b50-ac48-237602b17ec5

single

What does indicate in the following partograph indicators?

Ans. B. Moderate uterine contractionsThe partograph is a graphical presentation of the progress of labor, and of fetal and maternal condition during labor.It is the best tool to help you detect whether labor is progressing normally or abnormally, and to warn you as soon as possible if there are signs of fetal distress or if the mother's vital signs deviate from the normal range. Research studies have shown that maternal and fetal complications due to prolonged labor were less common when the progress of labor was monitored by the birth attendant using a partograph.Different shadings on the squares drawn on partograph indicate the strength & duration of uterine contractions:

2

Mild uterine contractions

Moderate uterine contractions

Strong uterine contractions

Arrest of labor

Gynaecology & Obstetrics

Normal Labour

a0e0bc57-9c23-4d0a-9169-89049e62afda

single

Fenton reaction leads to free radical generation when -

Ans. is 'c' i.e., Ferrous ions converted to ferric ions o Free radicals are generated through Fenton's reaction.o In this reaction iron is converted from its ferrous to ferric form and a free radical is generated,o The effect of these reactive species relevant to cells injury include;Lipid peroxidation of membranesOxidative modification of proteins and lesions in DMA.

3

Radiant energy is absorbed by water

H202 is formed by myeloperoxidase

Ferrous ion converted to ferric ion

Nitric oxide is converted to peroxynitrite

Pathology

Mechanisms of Cell Injury

557547fc-eda8-4a30-9e03-c96b49f7fc5b

single

A 70 kg patient needs to be staed on nitroglycerine (NTG) infusion. A 5 ml ampoule contains 5 mg/ml NTG. One ampoule is added to normal saline and to make a total of 500 ml solution. Calculate the rate of infusion if NTG is required at a rate of 10 mcg/min. (1 micro drip = 60 drops/ml )

Dose to be given = 10 mcg/min As, one ampoule (5 ml) is mixed with normal saline to make 500 ml volume, Means 500 ml of solution contains = 5*5 = 25 mg NTG = 25000 mcg NTG 25mg -----500ml 1mg----500/25 10mcg -10*10 -3-----0.2ml So, we need to infuse 0.2 ml/min of the solution As, 1 ml = 60 drops So, 0.2 ml = 60/1 * 0.2 = 12 drops So, we need to infuse 12 drops/min

1

12 drops/min

14 drops/min

15 drops/min

16 drops/min

Pharmacology

Pharmacokinetics

ff76a738-7668-48ed-b8ef-2a4e83095d14

single

Methyl alcohol causes blindness by affecting which of the following structures?

Methyl alcohol is oxidized by alcohol dehydrogenase into formic acid and formaldehyde. Formic acid by inhibiting cytochrome oxidase is toxic to neurons especially retinal ganglion cells. In methanol poisoning vision loss begins 12 hours or more after ingestion and progress to complete blindness with unreactive pupils and optic disc hyperemia.

1

Retinal ganglion cells

Nerve fibers

Rods & Cones

Rods only

Ophthalmology

null

a93a10d2-fbfa-4c67-965e-b8ecbb52a277

single

Pemberton’s sign is elicited

It is used for or large retrosternal goitres.

2

Swallowing

Raising of arms

Extrusion of tongue

Extension of neck

Medicine

null

91a7f2fb-a4f2-4927-a3bb-05d0d8f1d2b1

multi

Most common part of larynx involved in TB -

Ans. is 4b' i.e., Posterior o Disease affects the posterior third of larynx more commonly than anterior part.o The parts affected in descending order of frequency are i) Interarytenoid fold, ii) Ventricular band, iii) Vocal cords,iv) Epiglottis.o Also see above explanation.

2

Middle

Anywhere

ENT

Larynx

d544a17b-a0a2-4e98-b42e-72f7878afc55

single

In Barter's Syndrome, what is seen-

Ans. is 'b' i.e., Hypokalemia o In Bartter's syndrome the B.P. is low to normal despite increased level of aldosterone.Pathogenesis of Bartter Syndrome|Defect in sodium chloride and potasium transportin the ascending loop of henle|Loss of sodium and chloride|Volume contraction|Stimulation of Renin angiotensin|Increased secretion of Aldosterone|Promotes sodium uptake and potassiumexcretion|Hypokalemia -(Polyuria & Nocturia)Increased prostaglandin E|Further activates the reninangiotensin axiso Classic Bartter *s syndrome presents during childhoodo Weakness and cramps occur secondary to hypokalemiaQo Polyuria and nocturia are common due to hypokalemiaQo Nephrocalcinosis (due to hvpercalciuria)Diagnosis of Bartter's Svndrome :o Hypo kalemiaQo Metabolic alkalosisQo Blood pressure is usually normalQo Urinary-potassium, calcium and sodium elevatedQ.o Serum renin, aldosterone and postaglandin E elevatedQ.o Renal function is typically normalQ.There are two types ofBartter syndromeAntenatalClassicBartter syndromeBartter syndromeo More severe o Presents in infancy o Polyhydramnios (associated) o Salt wasting o Severe dehydration Also know,Gitteman's Syndromeo Autosomal recessive traito Caused due to mutation in thiazide sensitive Na-Cl transporterQ.o Loss of activity of the thazide sensitive transporter increases tubular calcium reabsorption leading toclassic finding of hypoclaciuria in Gitleman's syndrome.o There is also decrease in Na+ reabsorptionQ leading to volume depletion and hypokalemia.Gitleman's syndrome is a close differential diagnosis of Barter's syndrome -SimilaritiesDifferenceso Hypokalemiao Hypomagnesemiao Metabolic acidosiso Hypocalciuriao Salt wasting o Elevated renin and aldosterone o Normal blood pressure It is usually diagnosed during adolescence or adulthood with fatigue, weakness, muscle cramps, nocturia.

2

Metabolic acidosis

Hypokalemia

Hyperkalemia

Decrease in urinary calcium

Medicine

Fluid & Electrolyte

d0405727-f3e3-482c-811c-ba26a9a94042

single

A 6 months old child woke up in night, crying with ahdominal pain, which got relieved on passing red stool. What is the most likely diagnosis?

Ans. b. Intussusception (Ref; Ghai 8/e p287; Sabiston 19/e p1851; Schwartz 9/e p1433-I434; Bailey 26/e 1184. 1187, 1193. 25/e p1191, 1196. 1198; Shackelford 7/e p1059-106)Most likely diagnosis in a 6 months old child, who woke up in night, crying with abdominal pain, which got relieved on passing red stool, is intussusception.'Intussusception refers to the telescoping of a proximal segment of intestine (intussusceptum) into a distal segment (intussuscipiens). This is a common cause of intestinal obstruction in children between 3 months and 6 years. Most cases occur in infants during the weaning period following introduction of a new food, vaccination or upper respiratory tract infection. The classic triad of abdominal pain, red current jelly stools (blood and mucus) and palpable mass is seen only in a small percentage of children. Ultrasound is the investigation of choice that confirms the diagnosis ('dough nut' sign) and provides information about presence of a mass as lead point. Early reduction either with saline (under ultrasound guidance), barium contrast (both diagnostic and therapeutic) or with air insufflation is advisable. Reduction with air is safer with lower recurrence rates. Failure of radiological reduction or suspected intestinal gangrene may necessitate surgery and resection.'- Ghai 8/e p287IntussusceptionTelescoping of one portion of the intestine into the other.Middle layer is isolated between two sharp bends and first to become gangrenousQ.Highest incidence between 4 and 10 monthsQ of ageApprox. 80-90% of cases occurs between 3 and 36 monthsQ.Mostly idiopathic in infants and toddlersQ (no clear etiology).MC type: IleocolicQEtiology and Predisposing Factors:Upper respiratory tract infections or gastroenteritisQ (adenovirus and rotavirus have been implicated) have been thought to be contributory to the development of 'idiopathic' intussusception. Hypertrophy of Peyer's patchesQ can be seen at surgery, but no single etiologic factor predominates.Approximately 5-10% of cases have a true pathologic lead point. The older the toddler, the more likely there will be a lead pointQ.MC lead point is Meckel's diverticulumQ.Other lead points include polyps, the appendix, intestinal duplication, foreign bodies, and tumors such as hamartomas associated with Peutz-Jeghers syndrome.Henoch-Schonlein purpura: Submucosal hemorrhage acts as a lead pointQ.Cystic fibrosis: Risk for recurrent intussusceptionQClinical Features:Typical history: Sudden, short-duration, cyclic crampy abdominal painQ.During these episodes the infant cries inconsolably with the knees drawn upQ.Between episodes the infant is asymptomaticQ.Vomiting is almost universalQ.Initially the passage of stools may be normal while later on blood mixed with mucus is evacuated- red currant jelly stool.An abdominal mass may be palpated- a sausage shaped abdominal massQ (increase in size and firmness during the paroxysm of pain)There may be an associated feeling of emptiness in the right iliac fossa (Sign of Dance)QOccult or gross blood in 60-90% of cases on rectal examinationQApex may be palpable or even protrude from anus in extensive ileocolic or colocoiic intussusceptionQDiagnosis:USG: Kidney-shaped mass in the longitudinal view or a target sign in the transverse viewHydrostatic reduction by contrast agent or air enema (preferred) is the diagnostic and therapeutic procedure of choiceQ.Successful reduction is confirmed by reflux of airQ (or barium) into the small bowel.Treatment:Hydrostatic reduction by contrast agent or air enema is the diagnostic and therapeutic procedure of choiceQ.The success rate with air or barium reduction should exceed 70%Q.Failure of reduction or the presence of peritonitis mandates operative interventionQ, which can be performed laparoscopically or by a standard approach.Definitive surgical procedure: Ileocolectomy with primary anastomosisQRecurrence:Recurrence after successful hydrostatic reduction is 5-10%, recurrence rate after operative reduction is 1-4%.Recurrence is usually managed by hydrostatic reductionQ.Third recurrenceQ is an indication for operative intervention to look for a lead point.

2

Meckel's diverticulum

Intussusception

Malrotation

Intestinal obstruction

Surgery

Intestinal Obstruction

b1a6bae4-34de-4940-ab0a-77b23ded91b7

single

Moure's sign can be detected in

Moure`s sign- Absence of Laryngeal click or crepitusClassical sign in post-cricoid malignancy.Bocca`s sign - is also an absence of post-cricoid click or crackle in cricoid malignancy.Ref: Hazarika; 3rd ed; Pg 534

3

Nasopharyngeal carcinoma

Oropharyngeal carcinoma

Postcricoid carcinoma

Supraglottic carcinoma

ENT

Larynx

86a83376-6be9-4ac9-9d63-8f7c206bb5a6

single

Which of the following is x-linked recessive

Ans. is 'a' i.e., G-6-PD deficiency

1

G-6-PD deficiency

Neurofibromatosis

Thalassemia

Alkaptonuria

Pathology

null

ba104887-69be-4795-aa00-af90304bcfb6

single

Heamorrhagic external otitis media is caused by:

Hemorrhagic external otitis media: (Otitis externa hemorrhagia) is caused by influenza virus. Characterised by formation of haemorrhagic bullae on tympanic membrane. Clinical features: severe pain and blood stained discharge. Treatment: Analgesics + antibiotics.

1

Influenza

Proteus

Staphylococcus

Streptococcus

ENT

null

2cedb88b-1300-40e0-8e93-e0e551abc71b

single

Passive cutaneous anaphylaxis detect:

Ans. (a)Passive cutaneous anaphylaxis-in vivo method for detection of antibodies.Antigen injection intradermally then same antigen with a dye injected IV - after 4 to 24 hours - wheal flare reaction occurs in intradermal site.Helps to detect IgG ab which is heterocytotropic, not for IgM which is homocytotropic.

1

Heterocytotropic ab

Wheal and flare reaction

Atopy

Cutaneous anaphylaxis

Microbiology

Immunology

692da2d0-f12d-4565-b17f-8bc6bd55a0ab

single

Gout can be precipitated by all of the following

Ans. is 'd' i.e., High dose salicylates High dose Salicylates are uricosuric and do not cause Hyperuricemia. Diuretics including Thiazides and Furosemide are known to cause Hyperuricemia. Cyclosporine and Tacrolimus are also associated with Hyperuricemia. High Doses of Salicylates > 3.0 g/day are uricosuric, while Low doses (0.3 to 3.0 g/day) are associated with uric acid retention and Hyperuricemia. Also know Causes of drug or diet induced hvperuricemia. Diuretics (thiazides and loop diuretics) Cyclosporine and tacrolimus. Low dose salicylates. Ethambutol. Pyrazinamide. Ethanol. Levodopa. Methoxyflurane. Laxative abuse (alkalosis). Salt restriction.

4

Thiazides

Furosemide

Cyclosporine

High dose salicylates

Medicine

null

1fe41867-7d8e-4d50-be6e-632c86c69e54

multi

All of the following feature may be seen in throm-botic thrombocytopenic purpura,except-

null

3

Fever

Haemolysis

Hypertension

Low platelets count

Medicine

null

db050c1e-6611-4672-afa9-b4454516a2e6

multi

The lacrimal gland is located in a groove which is overlap by

null

1

Levator palpebrae superioris muscle

Lateral rectus

Inferior oblique

Superior oblique

Anatomy

null

e7c0db27-c239-4e4b-be24-ee15bee6ea10

single

Most common pox virus infection in human is -

Ans. is 'd' i.e., Mulluscum contagiosum o Among the given options, smallpox (variola) virus and molluscum contagiosum affect human as their primary host.o Small pox has been eradicated,o Molluscum contagiosum is a common skin infection.Poxviruses causing disease in humansGenusVirusPrimary HostDisease VariolaHumanSmallpox (new eliminated)VacciniaHumansLocalized lesion; used for smallpox vaccinationBuffalopoxWater buffaloHuman infections rare; localized lesionOrthopoxvirusMonkeypoxRodents, monkeysHuman infections rare; generalized diseaseCowpoxCowsHuman infections rare; localized ulcerating lesion OrfSheepHuman infections rare; localized lesionParapoxvirusPseudocowpoxCows Bovine papular stomatitisCows Mol fuse ipoxvirusMotluscum contagiosumHumansMany benign skin nodulesYaiapoxvirusTanapoxMonkeysHuman infections rare; localized lesionYabpoxMonkeysHuman infections very rare and accidental; localized skin tumors

4

Smallpox

Monkeypox

Cowpox

Mulluscum contagiosum

Microbiology

Poxviruses

7ff5ad04-0ab4-4dea-9148-416203b9d2ef

multi

Wickham's striae are seen in

null

1

Lichen planus

Leukoplakia

Leukoedema

Erythema multiformae

Pathology

null

a5e904d7-25e2-4303-b74d-4065ee923f76

single

True about immunoglobulins -

Of IgE is typically the least abundant isotype--blood serum IgE levels in a normal individual are only 0.05% of the Ig concentration Ref: Ananthanarayan & Panikers textbook of microbiology 9th edition pf:98

1

IgE has minimum concentration

IgG has minimum concentration

IgA has minimum concentration

IgM has minimum concentration

Microbiology

Immunology

edd4ea8b-0e91-4a9c-bb16-dd49e9f402da

multi

Which of the following statements regarding ACE inhibitors is true?

Ans. (B) Omission of prior diuretic dose decreases the risk of postural hypotension(Ref: KDT 8th/e p531)Angiotensin Converting Enzyme Inhibitors (ACEI)*This group of drugs inhibits the enzyme kininase II or ACE. So, these drugs decrease the activity of RAAS and also potentiate the vasodilatory action of bradykinin. Because these are preventing the conversion of angiotensin I to angiotensin II, so these can decrease the action of the former but not the latter.*ACEI are used for the treatment of hypertension, CHF, evolving MI, diabetic nephropathy, diabetic retinopathy, non-diabetic renal disease and also in scleroderma crisis. These drugs reduce proteinuria in diabetic as well as non-diabetic renal disease and also prevent the manifestations of scleroderma crisis which are mediated by angiotensin II.*This group of drugs is more effective in sodium depleted states (like diuretic use) because activity of RAAS is more in such cases (to compensate for salt loss). These drugs may cause postural hypotension in diuretic treated patients, which otherwise is a relatively rare adverse effect.*Lisinopril is longer acting than enalapril. Former can be given once daily whereas latter is required twice a day.

2

These inhibit the conversion of angiotensinogen to angiotensin-1

Omission of prior diuretic dose decreases the risk of postural hypotension

Lisinopril is shorter acting than enalapril

These are contra-indicated in diabetic patients.

Pharmacology

C.V.S

f0a66bdc-a03c-431f-834e-882ef1c94e3c

multi

N-MYC amplification is associated with

null

4

Burkitt lymphoma

Squamous cell ca lung

Astrocytoma

Neuroblastoma

Pathology

General pathology

394937f1-ab23-4c7c-a871-43a701f1aa23

single

Serous Demilunes are present in large number in which gland

Serous demilunes are cellular formations in the shape of a half-moon on some salivary glands. It is a feature of mixed (seromucinous)glands like submandibular salivary glands. Theseare the serous cells at the distal end of mucous tubuloalveolar secretory unit of ceain glands. Type of glands: Parotid - serous gland Sublingual (major)- mucinous gland Submandibular and Sublingual- mixed

2

Parotid

Submandibular

Sublingual

Pituitary

Anatomy

Glands & Connective tissue

8b48f911-385f-4c6b-ae2e-cf03474d1231

single

Treatment of tetanus A/E-

null

4

Clindamycin

Doxycycline

Metronidazole

Penicillin

Medicine

null

104b4d46-9fad-4817-8b3a-e38625eb27d2

single

A 25-year-old student with 20/20 vision looks up from his book to view his girlfriend sitting on the other side of the room. Which of the following is most likely to occur when the student changes his view from his book to his girlfriend?

Light rays from distant objects do not require as much refraction (bending) as do light rays from objects close at hand. Therefore, a thinner lens with less curvature is required for viewing distant objects. The process of accommodation adjusts the thickness of the lens for near and far vision by contracting or relaxing the ciliary muscle that surrounds the lens of the eye; contraction of the ciliary muscle thickens the lens, and relaxation causes the lens to become thinner.

4

Thicker lens, contraction of ciliary muscle

Thicker lens, relaxation of ciliary muscle

Thinner lens, contraction of ciliary muscle

Thinner lens, relaxation of ciliary muscle

Physiology

Special Senses

7e89d38f-7a19-48b8-a170-ea432fed9886

single

Dilutional hyponatremia is seen in ?

Answer- B. VincristineAcute kidney injury (AKI) (ARF)CirrhosisNephrotic syndromeCardiac failureAnti cancer drugs

2

Addison's disease

Vincristine

Diuretic therapy

Craniphyrangioma

Medicine

null

0f6734fa-fb78-4dd3-84bb-9edff2f2f25c

single

Indication for relining of complete denture include alt, expect

null

3

Immediate denture at 3-6 months after their original construction

Patient cannot afford new denture

Abuse soft tissues are present

When the construction of new dentures with the multiple appointment cause physical and mental stress

Dental

null

aa4f0026-8f5b-4c4d-a37a-1943f3ca4bc1

single

A 7 year old boy presented with generalized edema. Urine examination revealed marked albuminuria. Serum biochemical examinations showed hypoalbuminaemia with hyperlipidemia. Kidney biopsy was undeaken. On light microscopic examination, the kidney appeared normal. Electron microscopic examination is most likely to reveal-

This is a case of minimal change disease(MCD) On biopsy-no lesion is seen by light microscopy, negative for deposits by immunofluorescent microscopy -so it is also called nil lesion. On electron microscopy -effacement of foot processes suppoing Glomerular cells(podocytes) with weakening of slit pore membranes is seen. Ref:Harrison 20 th edition pg no. 2142

1

Fusion of foot processes of yhe glomerular epithelial cells

Rarefaction of glomerular basement membrane

Deposition of electron dense material in the basement membrane

Thin basement membrane

Medicine

Kidney

efc0932a-558e-462a-bc93-75501d4d27b9

single

Yellow fever vaccination starts protection after how many days of injection -

null

2

5 days

10 days

15 days

20 days

Social & Preventive Medicine

null

50929cbe-d4e1-45c6-9752-eb9ae2fe6753

single

Virchows method of organ removal is

METHOD OF REMOVAL OF ORGANS. Virchow's technique- Organs are removed one by one, Cranial cavity is exposed first, followed by thoracic,cervical and abdominal organs. Spinal cord is removed from the back. Rokitansky's technique- It involves in situ dissection in pa, combined with en block removal. Letulle's technique- Cervical, thoracic, abdominal and pelvic organs are removed en masses and dissected as organ block. Ghon's technique- Cervical,thoracic,abdominal and urogenital system are removed as organ blocks, Neurobal system is removed as another block. Ref: K.S.Narayan Reddy's Synopsis of Forensic Medicine and Toxicology, 29th edition, Chapter 5, Page - 63.

2

Organs removed en masse

Organs removed one by one

In situ removal

Minimal invasive autopsy

Forensic Medicine

Death and postmortem changes

f6115abc-4025-4631-a2c1-e6d51f9b975f

single

A 36-year-old woman is admitted to the hospital with severe head injuries after a car crash. During neurologic examination it is noted that her uvula is deviated to the right. Which of the following muscles is paralyzed?

The uvula would move toward the intact right side. This is because the intact levator veli palatini would be unopposed by the opposite, paralyzed left levator veli palatini.

1

Left levator veli palatini

Left tensor veli palatini

Right levator veli palatini

Right tensor veli palatini

Anatomy

Head & Neck

7060a37b-45b7-4939-a93c-933e3052f9a2

single

All of the following occurs in adrenal deficiency except

null

2

Hypoglycemia

Hypocalcemia

Hypotension

Hyponatremia

Medicine

null

fbb489b9-4cca-42dc-bffb-3287ecd097f2

multi

Savita is 35 years female with Gravida-2 and parity 1+0 is suffering from hepatic encephalopathy. Likely cause will be -

Ans. is 'b' i.e. Hepatitis E (Ref. Dutta, 6/e, p 292 (5/e, p. 308), Robbins illustrated, 6/e, p. 862).Hepatitis E infection has a benign course in normal individuals just like hepatitis A but once it infects a pregnant female it shows its ugly face. It then causes fulminant hepatitis in a large % of pregnant females leading to hepatic coma and death.

2

Hepatitis B

Hepatitis E

Hepatitis D

Hepatitis A

Gynaecology & Obstetrics

Hepatic, Biliary, and Pancreatic Disorders

4354102e-3a13-4cb4-933c-b3bd6f535f6c

single

Which RNA has splicing activity

sn RNA (small nuclear RNA) acts as Ribozyme. (RNA with enzymatic activity) It has splicing activity and is involved in mRNA processing.

4

m RNA

mi RNA

r RNA

sn RNA

Biochemistry

null

1a64f235-feb2-434f-9bed-4bff844c6aaa

single

Which specimen shouldn't be refrigerated before primary innoculation?

Ref: Ananthnarayan R. Paniker CKJ. Textbook of Microbiology. 8th Edition. Hyderabad: Universities Press; 2009. Pg. 332Explanation:Haemophilus influenzae is an important cause of meningitis.The disease is more common in children between two months and three years of age. Infections are caused by the capsulated strains, type b accounting for most cases.CSF specimen from suspected children should be plated promptly on a suitable medium such as blood agar or chocolate agar and incubated in an environment of 5-10 per cent C()2 and high humidity.As this bacillus is very sensitive to low temperatures. CSF specimens should never be refrigerated before inoculation.

1

CSF

Urine

Sputum

Pus

Microbiology

Culture media and method

e33f9d6e-08d0-4781-baf9-a7a60aee4360

single

The Tongue:

null

1

Separated from the epiglottis by glossoepiglottic folds

Contains foramen caecum which is present on the dorsum of frenulum

Contains 6 — 10 circumvallate papilla located posterior to sulcus terminals

Embryologically derives from 1st branchial arch only

Anatomy

null

86a1484f-47b4-4e5a-8717-0ddb94151605

multi

Glomular filtration rate increases if: September 2005

Ans. C: Increased renal blood flow GFR = Kf x Net filtration pressure Net filtration pressure represents the sum of the hydrostatic and colloid osmotic forces that either our/oppose filtration across glomerular capillaries Hydrostatic pressure inside the glomerular capillaries (PGC) - Promotes filtration Hydrostatic pressure in the bowman's capsule outside the capillaries (PB)-opposes filtration Colloid osmotic pressure of glomerular capillary plasma proteins-Opposes filtration Colloid osmotic pressure of Bowman's capsule proteins-promotes filtration - Afferent aeriolar constriction will reduce renal blood flow and reduce PGC, causing a reduction in GFR. - Efferent aeriolar constriction will reduce renal blood flow but increase PGC; these changes act in opposite directions with respect to GFR and the net effect on GFR is minimal. - A reduction in Kf will reduce GFR (contraction of mesangial cells and reducing the area available for filtration) - Any given vasoactive agent may have a spectrum of effects (on afferent/efferent aeriolar tone or Kf), making the net effect on GFR difficult to predict. Thus, angiotensin II, a major regulator of glomerular function, causes constriction of both afferent and efferent aerioles, as well as reducing Kf. The overall outcome for GFR depends on the relative magnitudes of these actions, which vary in different pathophysiological conditions. A high protein intake increase renal blood flow and GFR - Large increase in blood glucose levels in uncontrolled D increase renal blood flow and GFR. Kf: Glomerular ultrafiltration coefficient, PGC: mean hydrostatic pressure in glomerular capillaries

3

Increased plasma oncotic pressure

Decreased glomerular hydrostatic pressure

Increased renal blood flow

Increased tubular hydrostatic pressure

Physiology

null

ad8bb997-1951-4647-92b8-bbb8028f4908

single

A 65-year-old woman undergoes a kidney transplant for CKD. 6 weeks after the transplant, she develops CMV infection characterized by fever, malaise, and myalgias. Which of the following is a potential sequela of CMV infection?

Viral infections are the most common infection post transplantation. These include infections by cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes simplex virus, and varicella zoster virus. CMV infections presents as fever, malaise, myalgia, ahralgia, and leukopenia. Organ involvement leads to pneumonitis; ulceration and hemorrhage in the stomach, duodenum, or colon; hepatitis; esophagitis; retinitis; encephalitis; or pancreatitis. Pyelonephritis, cholecystitis, intra-abdominal abscesses, and parotitis are caused by bacterial infections or GI perforation and not primarily by CMV infection.

4

Intra-abdominal abscess

Pyelonephritis

Cholecystitis

GI ulcers & hemorrhage

Surgery

Transplantation

bb636c46-8d5a-480b-b952-31cb9b07e973

single

Anterior lenticonus is found in –

Anterior lenticonus is seen in Alport's syndrome and posterior lenticonus is seen in Lowe's syndrome.

3

Lowe's syndrome

William's syndrome

Alport's syndrome

Down's syndrome

Ophthalmology

null

ecdb51ff-9d91-4916-93f5-a3619643eeaa

single

Procalcitonin is used as marker of

ref Harrison 18/e p3419 Procalcitonin is an acute phase reactant which is now useful for being a marker of sepsis Procalcitonin (PCT) is a biomarker that exhibits greater specificity than other proinflammatory markers (eg, cytokines) in identifying patients with sepsis and can beused in the diagnosis of bacterial infections

4

Cardiac dysfunction in acute coronary syndrome

Menstrual perodicity

Pituitary function

Sepsis

Anatomy

General anatomy

775c3602-1ecb-4cb6-9c6c-940558a97fef

single

If we say that here is no significant association between two variable and if truly an association exists. Then it is called:

Null hypothesis (H0) there is No significant association In the given question, In reality an association exists, So Null hypothesis is false We say no significant association exists, so we are accepting Null hypothesis Hence its Type II error

2

Type I error

Type II error

Systematic error

Random error

Social & Preventive Medicine

Biostats

ae204fe5-e395-4e02-b009-4bf556d7cb11

multi

In case of hanging neck ligature marks are example of -

The synopsis of forensic medicine & toxicology - Dr k.s.narayan reddy ;28th edition; Pg no. 105 Also called crushing or friction abrasion. The are caused by crushing of superficial layer of epidermis & are associated with bruise of the surrounding area . occurs when movement of instrument is around 90deg to the skin .hanging ,strangulation ,teeth bite marks are examples .

2

Contusion

Pressure abrasion

Lacerration

Bruise

Forensic Medicine

Mechanical injuries

caffa993-a9de-4768-a96c-0db2e0b12576

single

A 23 year old male who is otherwise normal complains of mild pain in his right iliac fossa in a waveform pattern which increases during the night and he becomes exhausted and is admitted in the hospital. On examination there is mild hematuria. Urine examination reveals plenty of RBCs, 50WBCs/hpf. Urine pH is 5.5. Most likely diagnosis is:

Ans. is 'c' ie. Ureteral calculus The patient's clinical picture is typical of ureteric calculus.Colicky renal pain associated with hematuria is suggestive of ureteric stone although a clot from a bleeding renal tumor can cause the same type of pain.A ureteric calculus pain is almost invariably associated with hematuria.Leukocytes in urine can be seen with urolithiasis.

3

Glomerulonephritis

Ca-Urinary bladder

Ureteral calculus

Cystitis

Surgery

Urolithiasis

f9fbafd4-304c-48a8-a0d1-2b099186c022

single

A 67-year-old, 60-kg homeless man has been in the intensive care unit (ICU) for a week after an emergency laparotomy and sigmoid resection for perforated diverticulitis. His serum albumin is 1.1 g/dL. He was just weaned from mechanical ventilation. His colostomy is not functioning. You start total parenteral nutrition (TPN) to deliver 1800 kcal/24 h. Two days later, the patient is in respiratory distress and requires reintubation and mechanical ventilation. You should check the level of serum

Rapid institution of full nutritional support can cause "refeeding syndrome" in malnourished patients. The hall mark of this condition is hypophosphatemia. Phosphate is taken up by phosphate-depleted cells trying to metabolize the nutrition and levels of ATP fall precipitously. This leads to respiratory failure. Refeeding syndrome can be avoided by starting nutritional support at low levels and increasing slowly. The other substances listed are not associated with respiratory failure after starting nutritional support.

1

Phosphate

Magnesium

Calcium

Selenium

Surgery

Fluid & Electrolyte

b8e7a175-ee98-40bd-b8ce-80e5e9b84fc3

single

All are USG findings of PCOS except

Cysts arrange around the periphery of ovary giving Necklace of pearl appearance on USG is Characteristic of PCOD Rotterdam PCOS Diagnostic Criteria for PCOS diagnosis : The presence of two of the three criteria is sufficient to diagnosis PCOS: menstrual cycle anomalies (amenorrhea, oligomenorrhea), clinical and/or biochemical HA, and/or Ultrasound appearance of polycystic ovaries after all other diagnoses are ruled out. The sonographic criteria for PCOS morphology Presence of 20 or more follicles (newer criteria mention 20 follicles instead of 12 since with better USGs, even smaller follicles can now be picked up) in either ovary measuring 2 to 9 mm in diameter and/or increased ovarian volume (>10 mL). A single ovary meeting these criteria is sufficient to affix the PCO morphology

2

>=20 Follicles which are <=9 mm in size in either ovary

Ovarian Volume <=10 cc

Necklace of pearl pattern of Follicles

Thick Ovarian Stroma

Gynaecology & Obstetrics

Polycystic Ovarian Syndrome

910dde72-8694-4445-b67b-4ecfc8d934fd

multi

Surfactant lining the alveoli

The low surface tension when the alveoli are small is due to the presence in the fluid lining the alveoli of surfactant, a lipid surface-tension-lowering agent. If the surface tension is not kept low when the alveoli become smaller during expiration, they collapse in accordance with the law of Laplace.

1

Helps prevent alveolar collapse.

Is produced in alveolar type I cells and secreted into the alveolus.

Is increased in the lungs of heavy smokers.

Is a glycolipid complex.

Physiology

null

50b227a6-853e-41be-afe9-302f63f46706

single

Immersion syndrome occurs due to ?

Ans. is 'a' i.e., Vagal inhibition Types of drowning Drowning is classified as (1) typical and (2) atypical. 1. Typical drowning (wet drowning) Typical drowning refers to obstruction of air passages and lungs by inhalation of water or other fluid. Therefore it is also called wet drowning and findings offluid and froth are present in PM examination. Typical drowning may be :- Fresh water drowning : In fresh water drowning large quantities of water cross the alveolar membrane into circulation causing hypervolaemia and hemodilution. RBCs imbibe water and burst (hemolysis) with liberation of potossium. Therefore, hea is exposed to volume overload, potassium excess, sodium deficit (hyponatremia), and anoxia. Anoxia and hyperkalemia cause ventricular fibrillation and death in 4-5 minutes. Salt water drowning : Hypeonicity of inhaled water causes loss of fluid from circulation into the lungs giving rise fulminating pulmonary edema with progressive hypovolaemia, circulatary shock, and eventually cardiac standstill (asystole) with death in 8-12 minutes. 2. Atypical drowning It refers to drowning in which even after submersion of body in water, little or no water anters respiratory passages and lungs. Hence typical findings of wet drowning in the form of froth and oedema aquosum of lungs are not found. Atypical drowning may be :- Dry drowning : On contact with water, especially cold water, there results intense laryngospasm, so that water does not enter the lungs. Death is due to asphyxia because of laryngospasm. Immersion syndrome (hydrocution/submersion inhibition/vagal inhibition) : Sudden death occurs due to vagal inhibition as a result of (a) sudden impact with cold water, (b) duck diving (falling in water with feet first), and (c) horizontal entry in water with impact on epigastrium. Submersion of unconscious : If person is unconscious since before submersion in water, little or no water enters respiratory passages. It may occur in MI, cerebrovascular accident, hypeension, epilepsy, cerebral aneurysm and in drunk state. Near drowning (secondary drowning syndrome/post immersion syndrome) : In this drowning is survived and death occurs at a later stage after removal from water. Either the person himself comes out of water or he is recovered alive, but due to complications of submersion, he dies at a later stage. It is due to hypoxic encephalopathy and fibrosing alveolitis. The death occurs due to combined effect of cerebral hypoxia, pulmonary edema, aspiration pneumonitis, electrolyte disturbances and metabolic acidosis.

1

Vagal inhibition

Vagal Stimulation

Sympathetic stimulation

Sympathetic inhibition

Forensic Medicine

null

aa2fd386-12d2-418c-ac28-5e2998be4ae9

single

True about anaplastic Ca of thyroid -a) Common in elderlyb) Surrounding neck tissues are freec) Lymphatic infiltration occursd) p53 mutation

null

1

acd

ad

bc

bde

Surgery

null

e22b61da-32e6-4821-96bc-afce60a5c915

multi

Oesophagus supplied by oesophageal branches of all except

Aerial Supply of esophagus:1. The cervical pa including the segment up to the arch of aoa is supplied by the inferior thyroid aeries.2. The thoracic pa is supplied by the oesophageal branches of the aoa.3.The abdominal pa is supplied by the oesophageal branches of the left gastric aery.Ref: BD Chaurasia; Volume 1; 6th edition; Page no: 268

4

Inferior thyroid aery

Descending thoracic aery

Left gastric aery

Right gastric aery

Anatomy

Thorax

feb2fcbe-0c58-4934-90a7-1548518bf704

multi

Single best parameter to assess gestational age in first trimester?

Best parameter to assess gestational age- First trimester - CRL (Crown Rump Length) Second trimester - BPD (Biparietal Diameter) Third trimester - BPD (Biparietal Diameter) Best Overall - CRL (Crown Rump Length)

1

CRL (Crown Rump Length)

BPD (Biparietal diameter)

HC (Head Circumference)

FL (Femur Length)

Gynaecology & Obstetrics

Obstetrics

54250735-15ee-4889-8770-690f35667ed0

single

All are the features of an acute attack of primary narrow-angle glaucoma except:

Ans. Disc shows glaucomatous cupping

3

Intraocular pressure is raised up to 940-70 mm of Hg

Eye is red, painful and tender

Disc shows glaucomatous cupping

Fellow eye also shows shallow anterior chamber

Ophthalmology

null

19668054-4d02-48dd-b0bd-e78a2dd09a8d

multi

All are true for sublingual route except ?

Ans. is 'b' i.e., All drugs can be given Sublingual route of administration The tablet or pellet containing the drug is placed under the tongue or crushed in the mouth and spread over the buccal mucosa. Only the lipid soluble and non-irritating drugs can be administered by this route Absoption is rapid and action can be produced in minutes Action can be easily terminated by spitting the drug after the desired effect is achieved. Liver is bypassed with this route, thus the drugs with high first pass metabolism can be easily given by this route. Drugs given by this route are: GTN, buprenorphine, desamino-oxytocin.

2

Escape first pass metabolism

All drugs can be given

Action can be terminated any time

Rapid absorption

Pharmacology

null

4f9f22fc-5035-401d-87fd-0b94264d0ac5

multi

Libmansach's endocaritis is associated with?

Ans. B. SLE. (Ref. Robbings pathology 8th/pg. 408).Robbin's pathology 8th/pg. 408# Libman-Sacks endocarditis refers to sterile vegetations that can develop on the valves of patients with systemic lupus erythematosus.Libman-Sacks Endocarditis# These lesions presumably occur because of immune complex deposition and thus have asso inflammation. With increasing use of steroids for Rx of lupus, Libman-Sacks endocarditis has become uncommon.# Morphology-Histology:- Small (1-4 mm in diameter) sterile, granular pink vegetations;- No special predilection for the lines of valve closure.- Can be located on the undersurfaces of the atrioventricular valves, on the cords, or even on the atrial or ventricular endocardium.- The lesions are finely granular, fibrinous eosinophilic vegetations containing nuclear debris. An intense valvulitis is often present, with fibrinoid necrosis of the valve substance adjacent to the vegetation. Subsequent fibrosis and serious deformity can result that resemble chronic RHD.# A]. The acute rheumatic heart disease (RHD) is marked by a row of small, warty verrucae along the lines of closure of the valve leaflets.# B]. Infective endocarditis (IE) typically shows large, irregular, and destructive masses that can extend onto the chordae.# C]. Nonbacterial thrombotic endocarditis (NBTE) typically shows small, bland vegetations, usually attached at the line of closure. One or many may be present.# D]. Libman-Sacks endocarditis (LSE) has small or medium-sized vegetations on either or both sides of the valve leaflets, or elsewhere on the endocardial surface.

2

Rheumatic heart disease

SLE

Carcinoma

null

Pathology

C.V.S

fafec6fb-8aef-42ad-9602-bc323c426bb9

multi

Epimers of glucose

When sugars are different from one another, only in configuration with regard to a single carbon atom, other than the reference carbon atom, they are called epimers. For example, glucose and mannose are an epimeric pair which differs only with respect to C2. Similarly, galactose is the 4th epimer of glucose. (Fig. 6.4). Galactose and mannose are not epimers but diastereoisomers.Ref: DM Vasudevan, 7th edition, page no: 77

1

Mannose

Glyceraldehyde

Fructose

null

Biochemistry

Metabolism of carbohydrate

116bec58-a434-48d5-8fba-2deb97a467dc

multi

Immediate treatment of hypercalcemia of malignancy is:

Ans. (A) IV fluids(Ref: Harrison 19th/610; KDt 8/e p370)Management of hypercalcemia of malignancyDrug of choiceBisphosphonatesImmediate treatmentIV fluids with furosemideFastest calcium lowering drugCalcitonin

1

IV fluids

Bisphosphonates

Calcitonin

Glucocorticoids

Pharmacology

Endocrinology

bbb9039f-619b-4731-8b3c-333ad5a37f50

single

Immunosuppressive drugs are less effective in which type of graft rejection ?

Ans. is 'b' i.e., Acute humoral rejectionBecause most clinically available immunosuppressive drugs target T-cells, they or inefective in antibody mediated rejection".

2

Acute cellular rejection

Acute humoral rejection

Chronic rejection

None of the above

Pharmacology

null

d9b5fdcd-1aa7-475f-a0ad-cf4ce0c87af2

multi

Reinke crystals are found in

Hilus cell tumor: Rare virilizing tumor Arises from cells in the ovarian hilum Presence of Reinke crystals in the cells is the distinguishing feature of leydig or interstitial cells of testis Ref: Shaw Gynecology 17e pg 449.

4

Arrhenoblastoma

Granulosa cell tumor

Dysgerminoma

Hilus cell tumor

Gynaecology & Obstetrics

Gynaecological oncology

6330085e-40a2-4fd8-8fc0-663e6ccb3ff1

single

Combination of Nifedipine with what other tocolytic agent can potentially cause dangerous neuromuscular blockade.

Magnesium sulphate when used with nifedipine can cause neuromuscullar blockade that can interfere with pulmonary and cardiac function.

2

Terbutaline

Magsulf

Indomethacin

Atosiban

Gynaecology & Obstetrics

null

2846a718-7458-43b9-853a-26ce9bfb87a0

multi

A 32 year old person comes to the hospital after 2 weeks of the onset of diarrhoea. Diagnosis of typhoid can be confirmed with

Diagnosis done in 1st week - Blood culture 2nd week - Widal / Antibodies level 2rd week - Stool culture 4th week - Urine culture

4

Urine culture

Stool culture

Blood culture

Widal test

Social & Preventive Medicine

null

7298a0f2-058e-4d40-86cc-1577c87f129f

single

Goodpasture's disease is characteraized by all except-

Goodpasture syndrome (GPS), also known as anti-glomerular basement membrane disease, is a rare autoimmune disease in which antibodies attack the basement membrane in lungs and kidneys, leading to bleeding from the lungs and kidney failure. It is thought to attack the alpha-3 subunit of type IV collagen, which has therefore been referred to as Goodpasture's antigen.Goodpasture syndrome may quickly result in permanent lung and kidney damage, often leading to death. It is treated with medications that suppress the immune system such as coicosteroids and cyclophosphamide, and with plasmapheresis, in which the antibodies are removed from the blood. The antiglomerular basement membrane (GBM) antibodies primarily attack the kidneys and lungs, although, generalized symptoms like malaise, weight loss, fatigue, fever, and chills are also common, as are joint aches and pains.60 to 80% of those with the condition experience both lung and kidney involvement; 20-40% have kidney involvement alone, and less than 10% have lung involvement alone.Lung symptoms usually antedate kidney symptoms and usually include: coughing up blood, chest pain (in less than 50% of cases overall), cough, and shoness of breath. Kidney symptoms usually include blood in the urine, protein in the urine, unexplained swelling of limbs or face, high amounts of urea in the blood, and high blood pressure GPS is caused by abnormal plasma cell production of anti-GBM antibodies The anti-GBM antibodies attack the alveoli and glomeruli basement membranes.These antibodies bind their reactive epitopes to the basement membranes and activate the complement cascade, leading to the death of tagged cells. T cells are also implicated, though it is generally considered a type II hypersensitivity reaction. Ref Harrison20th edition pg 277

2

Glomerulonephritish

Leukocytoclastic vasculitis

Presence ofantibodies to BM

Diffuse alveolar hemorrhage

Medicine

Kidney

f1a85886-672b-44cd-9cc6-ddd0947b1397

multi

Best diagnosis for dissecting aoa is:

Ans. MRI

2

CT scan

MRI

Angiography

X-ray

Radiology

null

c01f484d-1c96-494e-9b82-fa6f32ba663d

single

Myocardial isonzyme of CK which is specific for myocardial infarction is

within 4–6 hrs after development of acute MI, peaks during the 2nd day (4 fold rise) and disappears in 2–3 days. Other causes of total CK elevation: 1. Skeletal diseases – Polymyositis, Muscle dys- trophy, Myopathies 2. Electrical cardioversion 3. Skeletal muscle damage – trauma, convulsions, immobilisation 4. Hypothyroidism 5. Stroke 6. Surgery b. AST: Starts rising on the 1st day, peaks in 2–3 days (3 fold rise) and disappears by 3rd day. c. LDH1: Starts rising by second day, peaks around 3– 4 days ( 3 fold rise) and disappears in 10 days. d. Troponin T: Cardiac troponin T is a regulatory contractile protein not normally found in blood. Its detection in the circulation has been shown to be a sensitive and specific marker for myocardial cell damage. Troponin T and I reach a reliable diagnostic level in plasma by 12-16 hrs, maximal activity by 24-32 hrs, returns to normal in 10-12 days. Troponin I : 0-0.4 ng/ml Troponin T: 0-0.1 ng/ml Cardiac troponins are detected in the serum by using monoclonal antibodies. These antibodies have negligible cross reactivity to skeletal muscle. Cardiac troponins I and T start to rise within 3-4 hours after myocardial infarction and remain raised for 4-10 days

2

CK-BB

CK-MB

CK-MM

All of the above

Medicine

null

adf61454-050c-43af-8409-67a0d88b3e9b

multi

The shape of septal cailage is:

The septal nasal cailage, (cailage of the septum or quadrangular cailage) is composed of hyaline cailage. It is somewhat quadrilateral in form, thicker at its margins than at its center, and completes the separation between the nasal cavities in front.

2

Triangular

Quadrilateral

Oval

Hexagonal

ENT

null

5d561833-e9b9-420e-9e9d-30d58b9cd52f

single

Duret hemorrhage is seen in?

Ans. is 'b' i.e., Brain stem Duret hemorrhage is small areas of bleeding in the ventral and paramedian pas of the upper brain stem. Causes include acute trauma, edema following trauma, abscess or tumor

2

Brain

Brain stem

Eye

Medulla

Forensic Medicine

null

b78ed62e-3e27-4b6f-b81e-88e577a35f70

single

First step to be done in case of variceal bleeding-

Ans. is 'b' i.e., iv crystalloides Initial resuscitation is usually with isotonic crystalloid solutions. A minimum of 6 units of blood are typed and crossmatched for most patients. If PT is prolonged more than 3 seconds, fresh frozen plasma is a component of the resuscitation volume.Endoscopy to determine cause of bleeding - endoscopic sclerotherapy or endoscopoic variceal ligation and injection with cynoacrylate.iv antibiotics.Somatostatin/Octreotide.Balloon tamponade.

2

Blood transfusion

IV Crystal]oides

Endoscopy

Somatostatin

Surgery

Diagnostic Evaluation of the Esophagus

55ff2ac5-b8cf-4d3b-a5a0-43a89c998af2

multi

Excessive sunlight exposure can cause

null

3

BCC

Melanom

SCC

Leukemia

Pathology

null

7900db87-5168-4e14-b55a-8856f20dbe17

single

Bishop scoring is done for ?

Ans. is 'b' i.e., Induction of labour Bishop score, also Bishop's score, also known as cervix score is a pre-labor scoring system to assist in predicting whether induction of labor will be required. The total score is achieved by assessing the following five components on vaginal examination: Cervical dilation Cervical effacement Cervical consistency Cervical position Fetal station If the Bishop score is 8 or greater the chances of having a vaginal delivery are good and the cervix is said to be orable or "ripe" for induction. If the Bishop score is 6 or less the chances of having a vaginal delivery are low and the cervix is said to be unorable or "unripe" for induction.

2

Exchange transfusion in newborn

Induction of labour

Ventilation of Newborn

Gestation of Newborn

Pediatrics

null

7031f6ce-21a1-4843-b050-de9d5de5b369

single

The following condition of GB is precancerous -

Gallbladders containing stones or infectious agents develop cancer as a result of irritative trauma and chronic inflammation. Carcinogenic derivatives of bile acids also may play a role. Porcelain gallbladder increases the risk of cancer. Choledochal cysts predispose to stone formation, stenosis and stricture, pancreatitis, and obstructive biliary complications within the liver. In the older patient, the risk of bile duct carcinoma is elevated.

2

Cholesterosis

Porcelain gall bladder

Biliary atresia

Choledochal cyst

Pathology

null

baa72c37-2674-457a-a638-fb070f7c91da

multi

In Diabetes, What happens to RQ:

Respiratory Quotient (RQ) Calculation of RQ of Glucose (carbohydrates): Oxidation of glucose in body: C6H1206 + 602 - 6C02 + 6H20 So, RQ = 6/6 = 1 RQ VALUES for different food components: Carbohydrates - 1 Proteins - 0.8 Fats - 0.74 Mixed diet - 0.85 Brain - 0.97 - 0.99 RQ TELLS US Type of macromolecules used in the body Conversion of one macromolecule to another FASTING / STARVATION - RQ decreases RQ in Diabetics - RQ decreases On giving insulin - RQ Increases

4

RQ always increases in Diabetes

RQ increases & on giving Insulin it again decreases

RQ always decreases in Diabetes

RQ decreases & on giving Insulin it again increases

Biochemistry

Miscellaneous

9f0780b8-052e-4c1d-9d5a-3d8fbeba9efc

single

Which will the patient with following peripheral smear and X-ray spine present with?

Ref: Harsh Mohan, Textbook of Pathology, 7th ed. pg. 294-96The X-ray spine shows fish shaped vertebra with peripheral smear showing sickle shaped RBCs. The presence of sickling crisis lead to Hand-Foot syndrome is characterized by painful infarcts of the digits and dactylitis.

1

Hand Foot syndrome

Black urine

Elevated haptoglobin

Splenomegaly with gall stones

Pathology

Blood

9e88028b-2288-499a-9516-774967690060

multi

All form the boundaries of ovarian fossa, except ?

Each ovary lies in ovarian fossa an the lateral pelvic wall which is bounded :-i) Anteriorly : Obliterated umblical aeryii) Posteriorly : Ureter and internal iliac aery

2

Ureter

Internal pudendal aery

Obliterated umbilical aery

Internal iliac aery

Anatomy

null

81578a01-1729-40e7-94a6-88a73f7a7830

multi

Alzheimer's disease, which is involved?

Alzheimer's disease (AD), also referred to simply as Alzheimer's, is a chronic neurodegenerative disease that usually stas slowly and gradually worsens over time.It is the cause of 60-70% of cases of dementia.The most common early symptom is difficulty in remembering recent events.As the disease advances, symptoms can include problems with language, disorientation (including easily getting lost), mood swings, loss of motivation, not managing self-care, and behavioural issues.As a person's condition declines, they often withdraw from family and society.Gradually, bodily functions are lost, ultimately leading to death.Although the speed of progression can vary, the typical life expectancy following diagnosis is three to nine years.coical atrophy of temporal and parietal lobes Stages of Alzheimer's disease Effects of ageing on memory but not AD Forgetting things occasionally Misplacing items sometimes Minor sho-term memory loss Not remembering exact details Early stage Alzheimer's Not remembering episodes of forgetfulness Forgets names of family or friends Changes may only be noticed by close friends or relatives Some confusion in situations outside the familiar Middle stage Alzheimer's Greater difficulty remembering recently learned information Deepening confusion in many circumstances Problems with sleep Trouble determining their location Late stage Alzheimer's Poor ability to think Problems speaking Repeats same conversations More abusive, anxious, or paranoid Ref Harrison20th edition pg 2345

2

Frontal coex

Coical atrophy of temporoparietal coex

Frontal and parietal coex

Occipital coex

Medicine

C.N.S

3dd88978-a99b-4ee4-a51f-0712e9221cbb

single

True about vit–D deficiency rickets –a) Vit. D3 given at a dose of 50–150 mg/dayb) X–ray knee joint is diagnosticc) Rickety rosary is tenderd) Increased chances of respiratory tract infectione) Hyponatrernia

null

2

c

bd

ab

ac

Pediatrics

null

695ac3bb-0bc8-405b-8e82-f8cd834cda44

multi

Dupuytren's contracture is seen in

Dupuytren's contracture refers to localised thickening of palmar aponeurosis and later formation of nodules with severe permanent changes in metacarpophalangeal and proximal interphalangeal joints. It is often associated with the following conditions : * Plantar fasciitis 5%-Ledderhose's disease * Mediastinal and retroperitoneal fibrosis * Peyronie's disease of penis 3% * Nodules in the face and ear * Pellegrini-Stieda's disease. Reference : page 163 SRB's manual of surgery 5th edition

1

Peyronie's disease

Hypospadias

Epispadias

Exostrophy

Surgery

Urology

22b83e29-5406-4fb5-ad9c-175334db9419

single

Laparoscopy - pressure in the abdomen of children -

Ans. is 'b' i.e., 8-12 mm Hg * The optimal intrabdominal pressure for laproscopy in children has been established to be between 8-12 mm Hg, with neonates tolerating lower pressures than elders.

2

2-6 mm Hg

8-12 mm Hg

14 - 18 mm Hg

20 - 24 mm Hg

Surgery

Gall Bladder & Bile Ducts

901e7990-ff69-4885-99b6-fc045c5244a1

single

It is true about H. Pylori that it -

Ans. is 'd' i.e., Treatment prevent gastric lymphoma

4

Is gram -ve spiral organism

Is a protozoa

Causes chronic gastritis in adults due to reinfection

Treatment prevents gastric lymphoma

Microbiology

null

cb8ef202-d85f-4350-949e-e1672a94aaa6

multi

A 12-year-old girl with the mood and emotional liability has a golden brown discoloration in descemet membrane. Most likely diagnosis is:

b. Wilson's disease(Ref: Nelson's 20/e p 1939-1940, Ghai 8/e p 320-321)KF ring in Wilson disease is due to deposition of Copper in the Descemet membrane layer of cornea.

2

Fabry's disease

Wilson's disease

Glycogen storage disease

Acute rheumatic fever

Pediatrics

Inborn Errors of Metabolism

b153eaf7-cf1a-46db-8dbb-434a15eeeafe

single

Digitalis does not increase which parameter of heart-

Ans. is 'c' i.e., Myocardial oxygen demand Effect of digitalis on hearto Main mechanism of action of digitalis is to increase in force of contraction of heart - a positive inotropic action.o Amongst given options, option d is the best choice - heart rate is decreased by digitalis and there is increase myocardial contractility without a propartionate increase in O2 consumption.How does digitalis decrease heart rate?# Heart rate is decreased by digitalis mainly in patients with CHF.# In CHF there is sympathetic overactivity and i vagal tone because of | CO2# Digitalis increases myocardial contractility (major action) - | CO and better emptying of ventricle - improvement in circulation - restoration of diminished vagal tone and abolish sympathetic overactivity - | Heart rate. Beside above main mechanism digitalis slows the heart rate by -A) Increased vagal tonei) Reflexly through nodosa ganglion.ii) Direct stimulation of vagal centre.iii) Sensitization of SA nodes to Ach.B) Extravagal - Direct depressant action on SA and AV nodes."The vagal action manifests early and can be blocked by atropine, whereas extravagal action becomes prominent later and cannot be reversed by atropine

3

Force of contraction

Myocordial contractility

Myocardial oxygen demand

Cardiac output

Pharmacology

Digitalis

7e206312-ea15-4a7d-ab6d-8c5b5b5885a5

single

Presbyopia occurs as a result of the following except

Presbyopia is multifactorial and is believed to result from poor ciliary muscle contraction with age and age-related sclerosis and loss of elasticity of the lens fibres and the lens capsule.

3

Loss of elasticity of the capsule

Sclerosis of lens fibres

Reduced anterior movement of the lens

Reduced contraction of the ciliary muscle

Ophthalmology

All India exam

0e3e3528-ae93-469f-8824-d569a18018b8

multi

Schistosoma japanicum resides in -

The adult worms of S.haematobium live primarily in the vesical and pelvic venous plexuses whereas S.japonicum and S.mansoni inhabit the superior mesentric vein and the inferior mesentric vein respectively (refer pgno:119 baveja 3 rd edition)

2

Vesical Plexus

Splenic Vein

Systemic Circulation

Gall bladder

Microbiology

parasitology

a93815f6-0e88-455e-bb07-3f5bafe22be6

multi