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Contents of mesorectum are all except
Mesorectum is enclosed by mesorectal fascia which is derived from the visceral peritoneum, and is also known as visceral fascia of mesorectum, fascia propria of rectum or presacral wing of hypogastric sheath Upper rectum is derived from the embryological hind gut, it is surrounded by mesorectum and its contents namely superior rectal aery and its branches, superior rectal vein and tributaries, lymphatic vessels and nodes along superior rectal aery, branches from inferior mesenteric plexus to innervate rectum and loose adipose connective tissue down to the level of levator ani (pelvic floor). Reference : I B Singh's Embryology, 10th edition)
1
Inferior rectal vein
Superior rectal vein
Pararectal node
Inferior mesenteric plexus
Anatomy
General anatomy
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A 24-year-old male law student presents with a 3-wk history of increasing dyspnea. He has a history of chronic sputum production of about 100 cc of purulent material each day for many years. In the past, he was hospitalized for a left pneumothorax. He is on inhaled bronchodilator as an outpatient. CXR is shown below.The most helpful treatment option would be
This x-ray shows a bilateral cystic-appearing lesion with airfluid levels consistent with cystic bronchiectasis. The opacities are predominantly in the upper zones. There is hyperinflation with flattened diaphragm and areas of hyperlucency in the left upper lobe peripherally. This is consistent with chronic bronchiectasis and/or cystic fibrosis; the latter is more likely due its upper zone predominance. The history and chest x-ray are consistent with cystic fibrosis with bilateral cystic upper zone predominance. Physical exam would reveal clubbing; spirometry would show a mixed obstructive with restrictive picture. The best option would be to initiate anti-pseudomonas antibiotics. Cystic fibrosis is an autosomal recessive disease characterized by exocrine gland dysfunction with viscous secretions. It is the most common inherited lung disease in whites with associated gene mutation. Diagnosis is usually based on clinical presentation and excessive chloride secretion in the sweat glands. Pulmonary manifestations include recurrent pneumonia with mucus plugging and increased morbidity and moality due to staphylococcal and pseudomonas infection. Complications may include pneumothorax, rupture of a subpleural bleb, hemoptysis, lung abscesses, and empyema. Massive hemoptysis and cor pulmonale may cause respiratory failure and increase moality
3
Increase bronchodilator therapy
Sta broad-spectrum antibiotic therapy
Initiate anti-pseudomonas antibiotic regimen
Sta oral steroids
Radiology
Respiratory system
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multi
Radiomimetric BACTEC detect growth of M tuberculosis in how much time ?
Ans. is `b' i.e., 2-3 weeks
2
1 week
2-3 week
4-8 week
> 10 weeks
Microbiology
null
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a benign epithelial cell neoplasm derived from non-glandular surfaces is referred to as:
Papillomas are benign, outward-growing lumps that may cause problems in some locations. Papillomas do not spread. They are not aggressive or cancerous. It is important to get any lump or skin lesion seen by a doctor, though. This is to be sure that it is benign and not something to worry about. If a lump turns out to be a more worrying problem, it is important to have had it diagnosed and treated. Another reason for getting medical attention is that papillomas can cause problems and may need treating, even though they are not cancer. While papillomas are not cancerous, some are linked with a higher risk of cancer. Women who have been treated for multiple breast papilloma, for example, may be monitored just in case cancer also occurs.
1
papilloma
sarcoma
adenoma
hamartoma
Pathology
null
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single
All of the following are reasons for reducing drug dosage in elderly, EXCEPT:
Baroreceptor sensitivity decreases with aging. This decline in baroreceptor sensitivity alters the central nervous system control of sympathetic nervous outflow. Due to this insensitive baroreceptor, large change in blood pressure is needed to activate the baroreceptor and produce an appropriate compensatory response. So for bringing out a desired effect, the drug dosage should be increased in elderly. Ref: Essentials of Medical Pharmacology By KD Tripathi, 5th Edition, Page 53-4; Geriatric Medicine: An Evidence-Based Approach By Christine K. Cassel, 4th Edition, Page 546.
3
They are lean and have low body mass
Have reduced renal function with age
Have increased baroceptor sensitivity
Have reduced hepatic metabolism
Pharmacology
null
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multi
Egg is ideal protein because it has –
Egg is ideal protein because it has high biological efficiency and NPU : NPU for egg : 100    Fish : 77    Wheat : 51 NPU for meat : 80   Rice : 65    Pulses : 45-50 NPU for milk : 75    Soyabean : 55
3
High cholesterol
High protein per 100 gm
High biological efficiency and NPU
No limiting amino acid
Social & Preventive Medicine
null
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single
Transpo of drug through biological membrane is through ?
Ans. is 'd' i.e., All of the above
4
Passive diffusion
Fascilitated diffusion
Active transpo
All of the above
Pharmacology
null
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All of the following are true about peritoneal fluid, EXCEPT:
Normal amount of peritoneal fluid is less than 50 mL of free peritoneal fluid, with the following characteristics: Specific gravity below 1.016 Protein concentration less than 3 g/dL White blood cell count less than 3000/microL Complement-mediated antibacterial activity Lack of fibrinogen-related clot formation Peritoneal fluid that lubricates the peritoneal surfaces, enabling the intraperitoneal organs to slide across one another with minimal friction. The circulation of peritoneal fluid is directed toward lymphatics in the undersurface of the diaphragm. There, paiculate matter--including bacteria up to 20 micrometer in size--is cleared stomas in the diaphragmatic mesothelium and lymphatics and discharged mainly into the right thoracic duct. Ref: Dohey G.M. (2010). Chapter 22. Peritoneal Cavity. In G.M. Dohey (Ed), CURRENT Diagnosis & Treatment: Surgery, 13e.
2
Lack of fibrinogen-related clot formation
Peritoneal fluid is directed toward aerial flow
Free movement of viscera
Removes excess fluid and paiculates
Physiology
null
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Delayed wound healing is seen in all except-
null
2
Malignancy
Hypertension
Diabetes
Infection
Surgery
null
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Most common nodule found in the liver is
Hemangioma Most common benign tumor of the liver Mainly seen in women of 45 years Small capillary hemangiomas(no clinical significance), larger cavernous hemangioma Usually single and <5 cm in diameter, occur equally in right and left liver Giant hemangioma: lesion>5cm Ref:Sabiston 20th edition Pgno :1456-1457
3
Hepatoma
Haraoma
Hemangioma
Cholangiodenoma
Anatomy
G.I.T
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True about pyogenic liver abscess -
About 50% of hepatic abscesses are solitary. Their size may vary from less than a millimetre to several centimetres in diameter. It can be multiloculated or a single cavity. It usually involves the right lobe (~75%) Clinical features the classical description of the hepatic abscess is - fever, jaundice and . upper quadrant pain; but this is rarely seen (~10% cases) the most common presentation includes - fever with chills and abdominal pain (Fever is MC symptom) Nonspecific symptoms like malaise and anorexia are also seen Laboratory investigations Abnormalities of LFTs are generally seen but are not severe. Alkaline phosphatase & transaminases are mildly elevated Bilirubin is elevated in 20-50% patients. (Severe abnormalities of LFT are not seen in pyogenic liver abscess and if present, indicate underlying biliary pathology.) X-ray features are not diagnostic. They at the most can be suggestive of some subdiaphragmatic pathology (because of elevated . hemidiaphragm, . pleural effusions or atelectasis). Ultrasound and CT are the main diagnostic modalities. Diagnosis is confirmed by aspiration and culture. (Serology tests are helpful for diagnosing amoebic abscess, not a pyogenic liver abscess.) Treatment involves antibiotics and percutaneous catheter drainage. (Ref: Sabiston 18/e) Ref : Bailey & Love 25/e p1094
1
Single & large abscess
Systemic complaints, fever & jaundice common
X-ray features are diagnostic
Liver enzyme abnormalities are common & severe
Anatomy
G.I.T
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multi
Which of the following drugs requires a dose adjustment in patient during radiotherapy in order to prevent radiation toxicity: March 2013 (h)
Ans. B i.e. Dactinomycin
2
Vincristine
Dactinomycin
Cyclophosphamide
6-Mercaptopurine
Radiology
null
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Which is most common side effect of inhaled beclomethasone dipropionate?
* Most of the side effects of steroids are mainly hoarseness, orophyrangeal candidiasis, decreased growth in children with adrenal suppression.* The plausible explanation is that since these drugs are inhaled, they avoid the first pass metabolism that orally administered steroids undergo and hence have preponderance to cause the usual manifestations of steroid toxicity.
2
Pneumonia
Oropharyngeal candidiasis
Atrophic rhinitis
Pituitary adrenal suppression
Pharmacology
G.I.T
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Long acting insulin is ?
null
1
Insulin glargine
Insulin lispro
Insulin aspart
Insulin glulisine
Pharmacology
null
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All are true regarding bleaching powder, except -
Bleaching powder (Chlorinated lime) CaOCl2 It is a white amorphous powder with a pungent smell which contains 33% of available chlorine. It is an UNSTABLE compound. It can be stabilised by mixing with an excess of lime. It should be stored in dark, cool and dry place in a closed container that is resistant to corrosion. Park's Textbook of Preventive and Social Medicine, 25th edition, Page No. 776
2
Contains about 33% of available chlorine
It is stable compound
White amorphous compound
Strong bleaching agent
Social & Preventive Medicine
Environment and health
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Three layers of embryo are formed at what age?
Ans. (d) 21 daysRef: Langmanris embryology 10th ed ch:5
4
8 days
12 days
16 days
21 days
Anatomy
Fertilization and Development of Embryo
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Drug which does not cause hemolysis in G6PD deficiency is ?
null
3
Primaquine
Dapsone
Corticosteroids
Methylene Blue
Pharmacology
null
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single
If a doctor gives a -false medical certificate to a patient, he is liable to be prosecuted under which section of the IPC -
197 IPC: Issuing or signing (attesting) false certificate by a doctor is a criminal offence.
4
137
147
167
197
Forensic Medicine
null
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Isotretinoin to be stopped before pregnancy
Isotretinoin iseffective for treating severe acne but it is is category X drug in pregnancy. It is recommended that a woman should wait at least 1 month after stopping Isotretinoin before trying to became pregnant but the desirable time is 3 months.
3
3 days
2 week
3 month
3 years
Gynaecology & Obstetrics
Drugs in Pregnancy
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All of the following are advantages of using raloxifene over estrogen in post-menopausal women EXCEPT:
null
3
Reduces fracture rates
Avoids endometrial hyperplasia
Reduces incidence of venous thrombosis
No increase in incidence of breast carcinoma
Pharmacology
null
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The doctrine of resipsa loquitur means -
Ans-C Doctrine of res ipsa loquituro It means "the thing or fact speaks for itself".o In a case of professional negligence of a physician, the patient need not prove negligence.o It is applied when the following conditions are fulfilled :That is the absence of negligence the injury would not have occurred ordinarily.That the doctor had exclusive control over the injury-producing instrument or treatment.That the patient was not guilty of contributory negligence.
3
Common knowledge
Medical maloccurance
Fact speaks for itself
Oral evidence
Unknown
null
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Self breast examination by females is advisable to be done at which of the following time?
Ans. C. 7-10 days after menses. (Ref Textbook of Gynaecology by D C Dutta 5th/pg. 538).Textbook of Gynaecology by D C Dutta 5th/pg. 53S....under the heading "Breast self examination":"Breast self examination should be made into a habit, certainly by the age of 20. The examination should be made on a monthly basis following the menses as the breasts become less tender and less engorged/'Breast self examination# Inpsection should be done standing in front of a mirror in a well lit-room. The patient should palpate her breasts with the opposite hand both in sitting and lying supine with a pillow beneath her back.# Axillary and supraclavicular areas to be palpated.# The nipples should be compressed for any discharge.# She is instructed to contact physician whenever there is any abnormal finding.
3
Premenstrual period
During menses
7-10 days after menses
Ovulatory period
Gynaecology & Obstetrics
Miscellaneous (Gynae)
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Which of the following are bounded by membrane containing sterols: March 2011
Ans. D: Mycoplasma Mycoplasma are devoid of cell walls The cells are bounded by a soft trilaminar unit membrane containing sterols
4
Klebsiella
Staphylococcus
Mycobacteria
Mycoplasma
Microbiology
null
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Which of the following is the most appropriate treatment for panic disorder?
Management plan for panic disorder Psychological treatment Self-help books, computerized cognitive behavioral therapy Cognitive behavioral therapy Pharmacotherapy Antidepressants Social interventions
3
Buspirone plus benzodiazepines
Benzodiazepines plus suppoive therapy
Sho - term benzodiazepine plus SSRI plus CBT
Long - term benzodiazepine plus venlafaxine
Psychiatry
Neurotic, Stress Related and Somatoform Disorders
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The earliest sign of tuberculosis of vocal cords is
The weakness of voice is the earliest symptom followed by hoarseness of voice. Ulceration of larynx produces severe pain, which may radiate to ears. Pain during swallowing is seen in later stages. On examination, hyperemia of the vocal cord in its whole extent or confined to posterior pa with impairment of adduction is the first sign. Note the hyperaemia Ref : www.ncbi.nlm.gov
2
Mouse nibbled appearance
Hyperemia of the free margin
Turban epiglotitis
Ulceration of vocal cord
ENT
Larynx
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Richest source of retinoids is?
Ans. (b) Halibut liver oilRef: Harper's Biochemistry 27/e, chapter 44, Textbook of medical biochemistry S. Ramakrishnan 3/e, p 393
2
Cod liver oil
Halibut liver oil
Butter
Margarine
Biochemistry
Vitamins
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Erethism occur in -
Erethism is seen in mercury poisoning.
1
Hg
As
Pb
Cu
Forensic Medicine
null
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"Cobblestone" appearance seen on colonoscope is cheracteristic of the following disease
.in crohn&;s disease,Fibrosis, stricture formation, deep ulcers, oedema of mucosa between ulcer areas which looks like 'cobble stone', skipped normal areas in between, serosal opacity, mesen-teric fat stranding, enlarged mesenteric lymph nodes, abscesses in the mesentery, fistula are the pathology. Small mucosal aphthous ulcers are earliest gross feature. ref:SRB&;s manual of surgery,ed 3,pg no 800
1
Crohn's disease
Ulcerative colitis
TB colitis
Irritable bowel syndrome
Surgery
G.I.T
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The mechanism of action of Sofosbuvir?
Sofosbuvir is used orally for Hep C. Orally given once daily in combination with ledipasvir or ribavirin or PEG-interferon for 24 weeks. It is a Hep C NS5B polymerase inhibitor. Ref: HL.Sharma 3rd ed. Pg 800
1
Inhibits RNA dependent RNA polymerase of HCV
Inhibits DNA dependent RNA polymerase of HCV
Inhibits RNA dependent RNA polymerase of HBV
Inhibits DNA dependent RNA polymerase of HBV
Pharmacology
Gastrointestinal tract
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Which of the following is porphyrines gives stools their characteristics brown color?
Stercobilin is a tetrapyrrolic bile pigment and is one end-product of heme catabolism. It is the chemical responsible for the brown color of human feces and was originally isolated from feces in 1932Urobilinogen is a colourless by-product of bilirubin reduction.Heme or haem is a cofactor consisting of a Fe2+ (ferrous) ion contained in the centre of a large heterocyclic organic ring called a porphyrin
4
Biliverdin
Urobilinogen
Heme
Stercobilin
Biochemistry
Metabolism of nucleic acids
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The following is true about Nesidioblastosis except?
Nesidioblastosis In 1938, Laidlow coined the term nesidioblastosis to describe the neodifferentiation of islets of Langerhans from pancreatic ductal epithelium. Severe recurrent hypoglycemia associated with an inappropriate elevation of serum insulin, C-peptide and proinsulin defines this disorder. The disorder later was called persistent hyperinsulinemic hypoglycemia of infancy (PHHI); currently many authors prefer the term congenital hyperinsulinism (CI). PHHI is the most common cause of hyperinsulinemic hypoglycemia in neonates. usually affects the infants and children. Adults can also be affected but at a much lower incidence. Histopathology Microscopically, pheochromocytomas are composed of polygonal to spindle-shaped chromaffin cells and their supporting cells, compartmentalized into small nests or "Zellballen," by a rich vascular network. The cytoplasm of the neoplastic cells often has a finely granular appearance, highlighted by a variety of silver stains, because of the presence of granules containing catecholamines. Electron microscopy reveals variable numbers of membrane-bound, electron-dense granules, representing catecholamines and sometimes other peptides. The nuclei of the neoplastic cells are often quite pleomorphic. Presentation Most patients with PHHI present shortly after birth with symptoms of hypoglycemia (e.g. hunger, jitteriness, lethargy, apnea, seizures). Older children, in addition to above symptoms, may also show diaphoresis, confusion, or unusual mood or behaviour changes. The symptoms may be exacerbated by fasting and may improve after eating. Treatment Immediate treatment of hypoglycemia is essential. Patients may require continuous IV glucose infusion. Glucagon may also be administered. Other drugs used are diazoxide, octeride and nifedipine. Surgical treatment is indicated if medical therapy does not maintain normoglycemia.
4
Presents with hypoglycemic attacks
Histopathology shows hyperplasia of islet cells
Diazoxide is used for treatment
More common in adults than in children
Pediatrics
null
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Most common cause of acute epididymitis in young males
Young males most common organism is chlamydia Age > 40 most common organism is E Coli
1
Chlamydia
E Coli
N. Gonorrhoea
Proteus
Surgery
null
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Vanilloid receptors are activated by
Vanilloid receptors are VR 1 and VRL 1 for painful temperature.
1
Pain
Vibration
Touch
Pressure
Physiology
null
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Source of ATP in RBCs is -
Ans. is 'a' i.e., Glucose* RBCs don't have mitochondria* RBC membrane integrity is maintained by Na+K+ATPase. This pump pumps out 3 sodium ions and reciprocally pumps in 2 potassium ions. In other words, this pump helps in maintaining low sodium concentration within RBCs. Sodium accumulation is avoided, as sodium attracts water, cells swell and rupture. This pump needs ATP.* The required ATP is to be provided by anaerobic metabolism* The only pathway that provides ATP even in anaerobic conditions is glycolysis.* The only fuel which can be utilized in glycolysis is glucose.* Hence RBCs utilize glucose as their fuel through glycolysis.* This is principally why glycolytic enzyme defects present with hemolytic anemia.
1
Glucose
Fatty acid
Aminoacid
Ketone body
Biochemistry
Miscellaneous (Bio-Chemistry)
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Location Hasner's of valve?
Opening of nasolacrimal ductNasolacrimal duct opens into inferior meatus and is closed by a mucosal flap called Hasner's valve
1
Opening of nasolacrimal duct
Sphenoidal sinus opening
Frontal sinus opening
Ethmoidal sinus opening
Anatomy
null
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Deficiency of cortisol causes:
Addison’s Disease: Addison’s disease results from an inability of the adrenal cortices  to  produce  sufficient  adrenocortical  hormones. In  Addison’s  disease,  either  glucocorticoid  or mineralocorticoid deficiency may come first, but eventually all patients fail to secrete both classes of corticosteroid.
3
Cushing syndrome
Graves disease
Addison disease
Acromegaly
Physiology
null
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All of the following are inhalational anesthetic agents except
null
2
Halothane
Ketamine
Enflurane
Isoflurane
Pharmacology
null
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Features of healthy gallbladder on laparotomy are all except
Healthy Gallbladder Greenish blue or sea-green color Thin and elastic wall Can be emptied by squeezing Ref: Sabiston 20th edition Pgno : 1494
4
Typical "sea-green" coloured
Wall is thin and elastic
Can be emptied
Not easily visible
Anatomy
G.I.T
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Immediate source of energy is -
Ans. is 'c' i.e., ATP o There are three energy systems to provide energy for muscular activities.Immediate energy system : Energy is provided by stored ATP and creatine phosphate.Anaerobic glycolytic system (lactic acid system) : Energy is generated by utilization of glucose or glycogen by anaerobic glycolysis. This energy is also generated early.Aerobic or oxidative system : Energy is generated by utilization of glucose/glycogen, and fatty acids through oxidative pathways, e.g. TCA cycle.o These three energy systems operate as a continuum: each system is always functioning, even at rest,o What varies is the relative contribution each system makes to total ATP production at any given time. Immediate energy systemAnerobic gly colytic systemOxidative (aerobic) sy stemSubstratesATP, creatine phosphateGlucose or glycogenGlucose or glycogen, fatty acidsEnergy productionVery fastFastSlowPeak at0-30 sec.20-180 sec.>3 minLimiting factorDepletion of CrP, ATPLactic acid accumulationGlycogen depletionActivity examplePowerlifting & weight lifting, short sprints Jumping, throwingLonger sprints Middle distance team sports Ball games (Soccer, rugby)Endurance events Team sports Bail games (Soccer, field hockey)
3
Corps cycle
HMP
ATP
TCA cycle
Biochemistry
Respiratory Chain
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Regular drinking of which of the following can help prevent Urinary Tract infection (UTI)
Cranberry juice Mechanism of prevention of UTI: Proanthocyanidis in cranberry juice prevent bacterial fimbriae from attaching to wall of Urinary Bladder and urinary tract Ref: How cranberry juice can prevent Urinary tract Infections, Science daily, July 21,2008)
3
Grape juice
Orange juice
Cranberry juice
Raspberry juice
Social & Preventive Medicine
Nutrition and health
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Vit B 12 is absorbed in
The  cobalamin-lF complex travels through the gut. The complex binds to specific receptors on the surface of the mucosal cells of the ileum. The binding of the complex and entry of B12 into the mucosal cells is mediated by Ca2+ ions. In the  mucosal  cells,  B12  is  converted  to methyf cobalamin. lt is then transported in the circulation in  a  bound form to  proteins namely  transcobalamins.
3
Stomach
Deudenum
Ileum
Colon
Biochemistry
null
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Height of contour of tooth is determined by
null
1
Survey line
Non undercut area
Undercut area
None of the above
Dental
null
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All of the following are true about Raynaud\'s disease except -
null
2
More cormnon in females
Positive antinuclear antibodies
Most common cause of raynaud's phenomenon
Has good prognosis
Medicine
null
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The ducts of all the following glands consist of stratified cuboidal epithelium except
Sebaceous glands are microscopic exocrine glands in the skin that secrete an oily or waxy matter, called sebum, to lubricate and waterproof the skin and hair of mammals. In humans, they occur in the greatest number on the face and scalp, but also on all pas of the skin except the palms of the hands and soles of the feet. The type of secretion of the sebaceous glands is referred to as holocrine.
2
Sweat gland
Sebaceous glands
Salivary glands
Pancreas
Anatomy
General anatomy
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Gingival enlargement with leathery consistency with characteristic minutely pebbled surface is seen in
null
1
Idiopathic gingival enlargement
Drug induced gingival enlargement
Pregnancy gingival enlargement
Puberty gingival enlargement
Dental
null
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Regarding medullary sponge kidney-a) Autosomal dominantb) Nephrocalcinosisc) Minimal proteinuriad) More common in females
null
3
acd
abd
abc
ab
Medicine
null
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Childbirth trauma leading to Urinary incontinence is seen least in females with:
Childbirth trauma causes damage of the pelvic floor and pubocervical fascia leading to urinary incontinence. The injury is more common in gynecoid and least in android pevis.
1
Android pelvis
Anthropoid pelvis
Gynecoid pelvis
Platypelloid pelvis
Gynaecology & Obstetrics
null
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A person laughs to a joke, then suddenly loses tone of all muscles. Diagnosis is: DNB 09; JIPMER 13
Ans. Cataplexy
1
Cataplexy
Catalepsy
Sleep attack
Sleep paralysis
Psychiatry
null
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The following tests are related to blood coagulation disorders in obstetrics except:
A complete coagulation profile is done which includes fibrinogen,fibrin degradation products,paial thromboplastin time,prothrombin time,platelet count.The best marker of severity is the fibrinogen level (refer pgno:137 sheila textbook of obstetrics 2 nd edition)
1
Thrombocytopenia is a feature of fibrinolytic process and not of DIG
In Die, RBC will be 'helmet' shaped or fragmented in fibrinolytic process, the cell morphology is nominal
Weiner clot observation test gives a rough estimstfi of total blood fibrinogen level
Thrombocytopenia can be diagnosed from the peripheral smear
Gynaecology & Obstetrics
General obstetrics
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multi
Fibrocystic disease of the breast has been associated with elevated blood levels of
Fibrocystic disease (chronic cystic mastitis) is a common disorder of the adult female breast. It is rare after cessation of ovarian function, either natural or induced. Its association with estrogens is inferential. In postmenopausal women it only occurs when replacement estrogen therapy is in use. Its main clinical significance relates to the need to differentiate irregular breast tissue from cancer. Patients afflicted with this disorder are often frustrated by the repeated biopsies that may be recommended.
3
Testosterone
Progesterone
Estrogen
Luteinizing hormone
Surgery
Breast
5384dff9-e736-4a83-8ef9-cf018e116e30
single
ATP synthetase is a marker of ?
Ans. is 'b' i.e., Mitochondria
2
Golgi apparatus
Mitochondria
Cytosol
Endoplasmic reticular
Biochemistry
null
a9183147-03ed-47be-ac0a-9f082fe10007
single
DNA topoisomerase 1 autoantibody is specific for?
Scl-70 antibodies are associated with more severe scleroderma disease. Anti-topoisomerase antibodies can be classified according to their immunoglobulin class (IgM, IgG or IgA). IgG-ATA is found most frequently in scleroderma, with IgA being quite common but IgM very infrequent. Ref Robbins 9/e pg 230
3
Limited cutaneous systemic sclerosis
Mixed connective tissue disease
Diffuse scleroderma
SLE
Medicine
Genetics
84b9a379-4f63-47b3-81ef-adbcc526e38c
single
What is the abnormality shown in this shoulder Radiograph?
Electric Bulb/Light Bulb Appearance on Shoulder Radiograph Is suggestive of posterior Dislocation of Shoulder.
2
Anterior Dislocation Of Shoulder
Posterior Dislocation Of Shoulder
Chondrosarcoma
Simple Bone cyst
Radiology
Musculoskeletal Radiology
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single
Most common vasculitis in children
UPDATE- Most common vasculitis in children Kawasaki Disease.
2
Henoch Schonlein purpura
Kawasaki disease
Wegener's granulomatosis
Polyarteritis nodosa
Pediatrics
null
1dfc394e-ee21-4767-97eb-b8b48d35752d
single
Foraminal brain herniation leads to?
Foraminal brain herniation leads to compression of the medulla leading to respiratory arrest. Third nerve palsy causing ipsilateral pupillary dilatation and ipsilateral hemiplegia occurs in uncal (midbrain) herniation Locked in state occurs due to a lesion of ventral pons.
3
Ipsilateral pupillary dilatation
Locked in state
Respiratory arrest
Ipsilateral hemiplegia
Medicine
Raised ICP and Brain death
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single
Random sampling is not done in?
Quota sampling is a method for selecting survey paicipants that is a non-probabilistic version of stratified sampling. Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 913
2
Cluster sampling
Quota sampling
Stratified sampling
Simple random
Social & Preventive Medicine
Epidemiology
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single
Cerebral Ischemia occur when cerebral blood flow is less than -
null
2
10 ml/100g/minute
20 ml/100g/minute
40 ml/100g/minute
50 ml/100g/minute
Medicine
null
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single
Regarding rabies, true is:
Ans. is 'a' i.e., Incubation period depends on the site of bite(Ref: PSM Park, 19th/e, p. 228)Variability of Incubation Period* Incubation period of rabies depends on:- The site of bite.- Number of wounds.- Species of biting animal.- Severity of bite.- Amount of virus injected.- Protection provided by clothing and treatment undertaken.ABOUT OTHER OPTIONS* Pathognomonic Negri bodies are intracytoplasmic (not intranuclear) eosinophilic inclusion bodies. Q* Rabies virus is a RNA virus.* It can be caused by many wild animals (not only by dogs).
1
Incubation period depends on the site of bite
Diagnosis is by eosinophilic intranuclear inclusion
It is a DNA virus
Caused only by dogs
Microbiology
Arboviruses
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multi
The commando operation is -
Ans. is 'd' i.e., Excision of carcinoma of the tongue, the floor of the mouth, pa of the jaw and lymph nodes enbloc
4
Abdomino-perineal resection of the rectum for carcinoma
Disaiculation of the hip for gas gangrene of the leg
Extended radical mastectomy
Excision of carcinoma of the tongue, the floor of the mouth, pa of the jaw and lymph nodes enbloc
Surgery
null
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single
Insulin resistance syndrome includes all of the following, Except:
Answer is C (Hyperuricemia): Hyperuricemia is not a feature of Insulin resistance metabolic syndrome. Insulin resistance syndrome refers to the metabolic syndrome associated with insulin resistance. Besides insulin resistance, the associated manifestations of the syndrome include hypeension, dyslipidemia Triglycerides & HDL) and obesity. Metabolic syndrome associated with Insulin Resistance (Insulin Resistance Syndrome) Abdominal obesity (Waist circumference) Dyslipidemia - | Triglycerides - HDL Hypeension Insulin Resistance
3
Dyslipidemia
Hypeension
Hyperuricemia
Low HDL
Medicine
null
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multi
A multigravida came for routine antenatal check up. She had a history of medical termination of pregnancy due to fetus with anencephaly. Anencephaly is best diagnosed in the present pregnancy by using:
Anencephaly is a lethal defect characterized by absence of the brain and cranium above the base of the skull and orbits. In the first half of pregnancy, the diagnosis made by elevated alpha-feto protein in amniotic fluid and confirmed by sonography. Inability to obtain a view of the biparietal diameter should raise suspicion. Hydramnios from impaired fetal swallowing is common in the third trimester. Ref: Leveno K.J., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 13. Prenatal Diagnosis and Fetal Therapy. In K.J. Leveno, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e.
3
Maternal Alpha fetoprotein
Amniotic fluid beta hCG
USG
X-ray
Gynaecology & Obstetrics
null
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single
False for pelvic congestion syndrome is
Pelvic congestion syndrome is a recognized cause of chronic pelvic pain in women that has been associated with lumbo-ovarian vein varices.Dyspareunia, when present, may be a poor prognostic indicator. Symptoms are often worse with fatigue, before menstruation, and in the upright position.
4
A recognized cause of chronic pelvic pain in women
Associated with lumbo-ovarian vein varices
Dyspareunia, when present, may be a poor prognostic indicator
Symptom are often worse after Menstruation
Microbiology
All India exam
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multi
True about Rabies a) Bats Transmit disease in some parts of the world b) Brainstem encephalitis is characteristic c) Negri bodies commonly found in thalamus and anterior pituitary d) Paraesthesia is not seen e) Recovery is the usual course
null
1
ab
abc
abd
bcd
Medicine
null
394b5069-dd7a-4a30-96a8-a13f0ab020ee
multi
Senile plaques in brain is a feature of
null
3
Multiple sclerosis
Parkinsonism
Alzheimer's disease
Wilson's disease
Medicine
null
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Stapedius muscle is supplied by:
(7th nerve): Ref: 225-LT (91-D 4th)STAPEDIUS MUSCLE - after emerging from the pyramid, is inserted into the neck of the stapes* It has an action of damping the movement of the stapes by tilting outwards the anterior end of the foot plate.* Supplied by facial nerveTENSOR TYMPANI MUSCLE - arise from the cartilaginous part of the auditory tube from the adjacent part of the greater wing of the sphenoid and from the bony canal* Its action is to tense the tympanic membrane by drawing it medially* Supplied by motor division of the trigeminal nerve, through the otic ganglion* Tympanic plexus is formed by the ramification of the tympanic nerve (Jacobson's nerve) which is a branch of the glassoparyngeal nerve.
3
5th nerve
6th nerve
7th nerve
8th nerve
ENT
Ear
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single
Synaptic transmission between pain fibers from the skin and spinal cord neurons is mediated by:
Substance P is found in neurons within the hypothalamus and spinal cord. It is released from small A delta and C fibers that relay information from nociceptors to neurons within the substantia gelatinosa of the spinal cord. Endorphins and other opioid neurotransmitters may paially inhibit the perception of pain by presynaptically inhibiting the release of substance P from nociceptor afferent fibers.
2
Acetylcholine
Substance P
Endorphins
Somatostatin
Surgery
null
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single
In a person who has fasted for 5 days, all are seen except:
null
1
GH levels decreased
Glucose tolerance decreased
Immunoreactive insulin decreased
Free fatty acids (Plasma) increased
Surgery
null
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multi
The bad prognostic factors of schizophrenia include
Age below 18years early age of onset, poor compliance to medications, poor insight, poor knowledge, attitude and practice among family members, expressed emotions among family members , male gender, insidious onset of illness , simple and hebephrenic type of schizophrenia are usually bad prognostic factors for schizophrenia Ref: Essentials of postgraduate psychiatry By JN Vyas 1st ed Pg: 370
1
Age 18 yrs
Age 40 yrs
Sudden onset
Female
Psychiatry
Schizophrenia and other psychotic disorders
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single
A 26-year-old lady, complains to her gynaecologist of discomfo during intercourse. Pelvic examination demonstrates a frothy, yellow-green vaginal discharge with a strong odour and small, red, ulcerations of the vaginal wall. A wet mount preparation demonstrates motile, flagellated protozoa. Which of the following is the most likely causative organism?
Trichomonas vaginalis, the causative organism of trichomoniasis, is a single-celled protozoan parasite with a predilection for infecting the vagina. The organism can be identified with intra-office wet mount preparations, cultured, or recognized on Pap smears (although this should be confirmed by culture, as the Pap smear is not a paicularly reliable method). Candida albicans is a spore- and hyphae -forming fungus that can affect the vagina, often producing a discharge with a white, "cheesy" appearance. Entamoeba histolytica is an amoeba that can infect the gut. Giardia lamblia is a flagellated parasite that can infect the gut.
2
Giardia lamblia
Trichomonas vaginalis
Candida albicans
Entamoeba histolytica
Gynaecology & Obstetrics
null
ff83d45c-c5fd-433c-bf96-426420d2afae
multi
Which personality disorder of DSM-IV is not classified as PD & is placed with schizophrenia in ICD 10 -
A schizotypal personality disorder is classified in cluster 'A' in DSM-IV-TR classification. In ICD- 10 classification schizotypal disorder is classified with schizophrenia and related disorder.
4
Schizoid
Paranoid
Narcissistic
Schizotypal
Psychiatry
null
eff7f46b-6784-48ca-a7af-217be3aad462
single
Which of the following TCA cycle intermediate is a part of heme metabolism?
Ans. (c) Succinyl CoARef: Harpers Biochemistry 30th Ed; Page No- 325Steps of Synthesis of Heme* To produce 1 molecule of heme, 8 molecules each of glycine and succinyl-CoA are required.* It is divided into1. Synthesis of Porphobilinogen (Monopyrrole)2. Synthesis of Uroporphyrinogen (Tetrapyrrole)3. Conversion of Uroporphyrinogen to Protoporphyrin4. Formation of Heme by incorporation iron.1. Synthesis of Porphobilinogen (Monopyrrole)ALA Synthase (ALAS)* Catalyse condensation reaction between succinyl-CoA and glycine to form a-amino-ketoadipic acid, which is rapidly decarboxylated to form S-aminolevulinate (ALA).* Synthesis of ALA occurs in mitochondria.* Two isoforms of ALAS# ALAS-I the Hepatic Form is the Key regulatory enzyme # ALAS-11 is the Erythropoietic formALA Dehydratase* Two molecules of ALA are condensed by the enzyme ALA dehydratase to form two molecules of water and one of porphobilinogen (PBG)* Takes place in the cytosol.* ALA dehydratase is a zinc-containing enzyme* This enzyme is sensitive to inhibition by lead, as can occur in lead poisoning.* Thus the first precursor pyrrole is formed.2. Synthesis of Uroporphyrinogen (Tetrapyrrole)* The formation of a cyclic tetrapyrrole-i.e. a porphyrin- occurs by condensation of four molecules of PBG.Uroporphyrinogen -I Synthase or HMB Synthase or PBG Deaminase* Four molecules of PBG condense in a head-to-tail manner to form a linear tetrapyrrole, hydroxymethylbilane (HMB).* 4 moles of NH3 , is released* Takes place in the cytosol.* The reaction is catalyzed by uroporphyrinogen I synthase, also named PBG deaminase or HMB synthase.Uroporphyrinogen III synthase* HMB is converted to Uroporphyrinogen III by Uroporphyrinogen III synthase.* Uroporphyrinogen is thus the first porphyrin precursor formed.* Under normal conditions, the uroporphyrinogen formed is almost exclusively the III isomer.But HMB cyclizes in certain porphyrias, spontaneously to form uroporphyrinogen I.3. Conversion of Uroporphyrinogen to Protoporphyrin* Uroporphyrinogen decarboxylase# Uroporphyrinogen II is converted to coproporphyrinogen III by decarboxylation of all of the acetate (A) groups, which changes them to methyl (M) substituents.# The reaction is catalyzed by uroporphyrinogen decarboxylase.# This is also capable of converting uroporphyrinogen I to coproporphyrinogen I# This also takes place in the cytosol# Coproporphyrinogen III then enters the mitochondria, where it is converted to protoporphyrinogen III.# The mitochondrial enzyme coproporphyrinogen Oxidase catalyzes the decarboxylation and oxidation of two propionic side chains to form protoporphyrinogen.# This enzyme is able to act only on type-III coproporphyrinogen, which would explain why type I protoporphyrins do not generally occur in nature.* Protoporphyrinogen Oxidase# The oxidation of protoporphyrinogen to protoporphyrin is catalyzed by another mitochondrial enzyme, protoporphyrinogen oxidase.4. Formation of Heme by incorporation of Iron* This is the final step in heme synthesis.* It involves the incorporation of ferrous iron into protoporphyrin in a reaction.* This step is catalyzed by ferrochelatase (heme synthase).* Takes place in mitochondria.
3
Alpha ketoglutarate
Fumarate
Succinyl CoA
Malate
Biochemistry
Proteins and Amino Acids
4a5bec2a-9a2e-495d-a684-b4f54e2b6c5b
single
Amiddle aged female presents with polyahritis with elevated rheumatoid factor and A.N.A. levels, which among the following will help you to differentiate rheumatoid ahritis from SLE?
Aicular erosions on X-ray Always remember this impoant point about SLE "Erosions on joint X-ray are rare, their presence suggests a non lupus inflammatory ahropathy such as rheumatoid ahritis". This fact has been asked so many times in various exams as : ? "Non erosive ahritis is a. feature of which of the following" On the other hand erosion is a characteristic X-ray feature of Rheumatoid ahritis. The pirmnary value of radiography in patients with Rheumatoid ahritis is to determine the extent of bone erosion and cailage destruction. The radiological hallmark of rheumatoid ahritis is : Juxtaaicular osteopeniaQ - Bone erosions? - Narrowing of joint space .from loss of aicular cailage?. Proximal interphalangeal joint can be involved in both Rheumatoid ahritis and SLE. The characteristic feature of Rheumatoid ahritis is sparing of the distal interphalangeal joint. . E.S.R. can be elevated in both Rheumatoid ahritis and SLE. Some SLE cases are even positive for Rheumatoid factor. According to current Rheumatology diagnosis and treatment "SLE may he confused with other connective tissue diseases especially Rheumatoid ahritis. SLE patients may even have positive Rheumatoid factor. The usual presentation of lupus ahritis is identical to that of Rheumatoid ahritis, but SLE ahritis is rarely erosive".
3
Soft tissue swelling at the proximal inter phalangial joint
Juxta aicular osteoporosis on X-ray
Aicularerosions on X-ray
Elevated ESR
Surgery
null
43230226-a96b-4340-bc41-b0b81193e710
single
Every 3 degree abduction of arm at shoulder region, the scapular rotation accounts to
null
1
1 degree
2 degrees
3 degrees
0.5 degrees
Orthopaedics
null
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single
Which of the following is a metastasis suppressor gene in relation to prostate cancer
Prostate cancers account for 43% of all cancers diagnosed in American men. It is estimated that in 1996, 317,000 new cases of prostate cancer were diagnosed and 41,000 men died of the disease. The challenge of treating prostate cancer lies in accurately distinguishing those histologically-localized cancers which will complete metastatic progression from those that will remain indolent. At this time, we lack appropriate histological markers to make such distinctions, therefore, it is often difficult to accurately predict the clinical course of an individual patient's disease. There is growing evidence that a critical event in the progression of a tumor cell from a non-metastatic to metastatic phenotype is the loss of function of metastasis-suppressor genes. These genes specifically suppress the ability of a cell to metastasize. Work from several groups has demonstrated that human chromosomes 8, 10, 11 and 17 encode prostate cancer metastasis suppressor activities. As a result of these effos the first prostate cancer metastasis-suppressor gene, KAI1, was identified and mapped to the p11-2 region of chromosome 11. In subsequent studies, an additional gene encoded by the same region, CD44 was also determined to have metastasis-suppressor activity. Recent studies have shown a correlation between decreased expression of KAI1 and CD44 and an increased malignant potential of prostate cancers. It is anticipated that the identification of other metastasis suppressor genes may allow for the development of diagnostic markers useful in the clinical substaging of individual tumors. This manuscript is intended to present our perspective on the impoance of these genes in the understanding of prostate cancer progression. More impoantly, we present new findings from our laboratory's effo to identify the metastasis-suppressor genes encoded by human chromosome 17. Specifically we repo the strategy currently being used to evaluate a series of candidate genes and the approach being utilized to pinpoint the metastasis-suppressor region on human chromosome 17.
1
KAI - 1
NM 23
KISS
p53
Pathology
General pathology
ac00affe-beec-46f7-96e8-6a041ece14a2
single
Hera lal a 35 year old man was found to be positive for HBsAg and HBeAg , accidentally during a screening for blood donation. On Lab examination SGOT and SGPT are normal. What should be the most appropriate next step?
Patient in the question is positive for HBsAg and HBeAg, so he is more likely to be highly infectious and must be associated with the presence of Hepatitis B virions and a detectable HBV DNA. Ref: Harrisons Internal Medicine, 18th Edition, Chapter 304, Page 2540 ; Review of Medical Microbiology and Immunology By Warren Levinson, 11th Edition, Chapter 41
4
Observation
Liver biopsy
Interferon therapy
HBV-DNA estimation
Medicine
null
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multi
True about CSF rhinorrhea is -a) Occurs due to break in cribriform plateb) Contains glucosec) Requires immediate surgeryd) Contains less protein
Let us see each option Separately Option a – Occurs due to break in cribriform plate. This is correct Option b – CSF contains glucose and option d It has less proteins In comparison to nasal secretions – CSF contains more of glucose and less of proteins (Turner 10/e, p 28) hence both options b and d are correct Option c – Requires immediate surgery This is not absolutely correct as: –– Early cases of post traumatic CSF rhinorrhea are managed conservatively. Only those cases where CSF rhinorrhea occurs persistently ––Surgical management should be done
4
acd
bcd
abc
abd
ENT
null
bd02b9d2-f6e7-4695-8cd3-ac784e0fe29d
multi
Enzyme defect in galactosemia
Galactosemia 1. There is deficiency of enzyme galactose-1phosphate uridyl transferase. It is an inborn error of metabolism. The incidence is 1 in 35,000 bihs. Hermann Kalckar described it in 1958. 2. Due to the block in this enzyme, galactose-1phosphate will accumulate in liver. This will inhibit galactokinase as well as glycogen phosphorylase. Hypoglycemia is the result (Box 10.4). 3. Bilirubin uptake is less and bilirubin conjugation is reduced; so unconjugated bilirubin level is increased in blood (for bilirubin, see Chapter 21). 4. There is enlargement of liver, jaundice and severe mental retardation. 5. Free galactose accumulates, leading to galactosemia. It is paly excreted in urineRef: DM Vasudevan, 7th edition
4
Uridyl transferase
Galactokinase
Epimerase
All of the above
Biochemistry
Metabolism of carbohydrate
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multi
Oral vancomycin can be used for treatment of ?
Ans. is 'b' i.e., Pseudomembranous colitis o Vancomycin is used orally to treat pseudomembranous colitis by clostridium difficile because it is not absorbed from the gastrointestinal tract and higher concentration reaches the colon.
2
Hepatic encephalopathy
Pseudomembranous colitis
Staphylococcal food poisoning
None of the above
Pharmacology
null
7d143b09-92bd-4f26-9ae1-23a7e2256441
multi
A 5-month-old pale and lethargic male infant is brought to emergency. On examination, HR is 240 bpm and it does not change with crying. Lungs are clear and no hepatomegaly present. His ECG is given below. Which of the following is the first step in management of this patient?
ECG s/o Supraventricular tachycardia Characterized by rapid hea rate (about 250 beats per minute)and a consistent P wave for each QRS complex. Prolonged SVT can lead to hea failure with hepatomegaly and respiratory compromise. Fetal SVT can lead to hydrops fetalis. The first-line treatment is to stimulate the vagus nerve using techniques such as carotid massage, immersion of the face in cold water, or voluntary straining. Rapid infusion of IV adenosine can affect resolution if the maneuvers are not successful. Verapamil is contraindicated in this age group, as it may cause acute hypotension and cardiac arrest. Synchronized DC cardioversion may be performed in patients in shock or with hea failure; it must, however, be synchronized to the QRS complex. Transthoracic pacing is useful in bradyarrhythmias.
3
Rapid verapamil infusion
Transthoracic pacing of the hea
Carotid massage
DC cardioversion
Pediatrics
Other hea diseases in children
105454a5-a5d9-4b04-9d3d-ab1d3d30a2a1
multi
Hydatid disease of liver is caused by -a) Strongloidesb) Echinococcus granulosusc) Taenia soliumd) Trichinella spiralise) Echinococcus multilocularis
Hydatid disease: Echinococcus granulosus: Causes Hydatid disease—Hepatomegaly (60—70% of cases), then lungs E. multilocularis: Causes Alveolar Hydatid disease (90%-liver involvement) E. oligarthrus and E.vogeli: Causes Polycystic Hydatid disease.
2
ab
be
bc
ce
Microbiology
null
ad1097d8-f219-494d-90be-54a04a7c4d40
single
Health care made universally accessible to individuals and acceptable to them is called
Ans. is 'a' i.e., Primary health care
1
Primary health care
Essential health care
Community health care
Social Medicine
Social & Preventive Medicine
null
eb06af68-520b-463c-828f-3d4bf4a923d0
multi
A child is receiving corticosteroids for medical therapy. The following is not a contraindication in this child for receiving a live viral vaccine:
d. Chronic asthmatic child receiving low dose inhaled steroid for 10 months(Ref: Ghai 8/e p 142)Low dose steroids are not a contraindication to live vaccines.
4
When child is receiving 2 mg/kg of prednisolone for at least 2 weeks at present
When child has received 2 mg/kg of prednisolone for at least 2 weeks in the past one month
Child receiving 4 mg/kg of prednisolone for 4 weeks, prior to 2 weeks
Chronic asthmatic child receiving low dose inhaled steroid for 10 months
Pediatrics
Immunization
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single
Kleptomania means
Disruptive, Impulse-Control & Conduct Disorder: include intermittent explosive disorder, pyromania, kleptomania, conduct disorder*, antisocial personality disorder* , oppositional defiant disorder*. (* - usually described as a type of personality disorders) Feature Of Impulse-Control Disorders failure to resist an impulse /drive temptation to perform the act of tension or arousal before the act Pleasure/relief after the act Regret/guilt following the act compulsive drive to reduce dysphoria Intermittent Explosive Disorder (1) repeated aggressive acts resulting in the destruction of propey, (2) the dispropoionate response to the stimulus that preceded the aggression. Kleptomania - the Pathological compulsion to steal Pyromania -a pattern of behavior, with more than one occasion of purposeful fire setting. it is not done for monetary or other gains. Pathological Gambling- Gambling with increasing amounts of money needed to achieve the same level of excitement (tolerance) and restlessness and irritability when attempting to stop or cut back on gambling (withdrawal) Impulse control disorders and obsessive compulsive disorders involves doing repeated motor acts. In impulse control disorders, there is an urge and the person is not able to control the temptation and he does the act and finally by finishing the act there is a pleasure that is experienced. in obsessive compulsive disorder there is a obsession that is denoted by recurrent, irrelevant, intrusive thought and this thought is stressful To overcome that thought the person has to do some motor acts that are called as compulsions by doing these compulsions there is no pleasure but, there is a sense of releif of tension. b Reference: Page No.925 chap 7.3 Signs and Symptoms in Psychiatry(Kaplan & Sadock's Comprehensive Textbook of Psychiatry, 9th Edition) DSM-5 section II Disruptive, Impulse-Control & Conduct Disorder P-461
2
Irresistible desire to set fire
Irresistible desire to steal things
Compulsive hair pulling
Pathological gambling
Psychiatry
All India exam
782b1cba-3ca2-4392-8cd3-5a1de1e79e2d
single
All of the following are zoonosis, except:
Zoonosis is defined by the Joint FAO/WHO Expe Committee as 'those diseases and infections which are naturally transmitted between veebrate animals and man'. There are more than 150 diseases and infections having reservoir as animals and is communicable to man. These zoonotic diseases may be caused by viruses, bacteriae, rickettisiae, protozoa, helminths, anthropods, fungi or insects. HIV is not a zoonotic disease while the other three infections are zoonotic diseases. The human immunodeficiency virus has only human as reservoirs. Ref: Park Textbook of Preventive and Social Medicine, 19th Edition, Pages 642, 688
3
Plague
Japanese Encephalitis (JE)
HIV
Tuberculosis (TB)
Social & Preventive Medicine
null
2b85df7c-ce14-4e4d-b329-0c35d85d9ed2
multi
Inherited coagulation defect with T coagulation is found in -
Ans. is 'a'i.e Protein C deficiency; 'b' i.e., Protein S deficiency; 'c' i.e., Antithrombin III deficiency
4
Protein C deficiency
Protein S deficiency
Antithrombin III deficiency
All
Pathology
null
2c7dc3f3-612c-4539-b8ed-1061da385314
multi
Paltauf's hemorrhages are seen in -
Paltauff's haemorrhages: Usually seen in the lower lobes of the lungs in drowning. They may be seen on the anterior surface and interlobar surfaces of lungs. They are red or grey patches. They may be seen on the surface due to interstitial emphysema. They may however be absent. This condition of the lung is called 'Emphysema aquosum' and 'trockenes oedema'. This drowning lung is fairly characteristic but not pathognomic. Reff: The synopsis of forensic medicine & Toxicology 28th edition pg: 193
3
Hanging
Strangulation
Drowning
Thermal injury
Forensic Medicine
Asphyxia
7843db8c-7967-4c20-8c73-5c065b8a3c96
single
Looser's zones are seen in which of the following ?
Condition where milkman's fracture may be seen *Rickets/osteomalacia *Renal osteodystrophy *Paget's disease *Fibrous dysplasia *Hereditary hyperphosphatasia *Idiopathic Looser&;s Zone ( Milkman&;s Pseudofractures ) Pathognomonic * Looser zones are radiolucent lines that are often penetrating through the coex perpendicular to the shaft and are most often seen in the medial coices of the femurs and in the pelvis and ribs, neck of scapula. Caused by rapid resorption and slow mineralisation / Looser&;s zone. * Linear areas of undermineralized osteoid that occur in a bilateral and symmetric distribution * Characteristic sites; inner margins of femoral neck, proximal ulna, axillary margin of the scapula, pubic rami, and ribs. * Differential diagnosis: ; Paget&;s disease or fibrous dysplasia. ref : maheswari 9th ed
4
Osteomalacia
Paget's disease
Renal osteodystrophy
All of the above
Anatomy
Metabolic and endocrine disorders
568b4f57-4cd4-4ced-a9e5-7bf037c5ff53
multi
Contributory negligence is related with:
Contributory Negligence: Negligence of both patient and doctors. For e.g Doctor puts tight plaster on patient (Doctor Negligent). The patient develops numbness but does not inform doctor and suffers injury (patient negligent). It is a defence only in civil negligence and has no place in criminal negligence. Other rules related to Contributory Negligence Last clear chance doctrine--Both doctor and patient are negligent but doctor had the last chance to avoid injury but he did not use this chance. Doctor will have to pay damages Avoidable consequences rule: Negligence of patient occurs after he has sued the doctor for negligence. The doctor will not be responsible for the fuher damaged caused by negligence of patient. Patient should have taken appropriate steps to reduce the fuher consequences of injury
3
Eggshell skull rule
Master servant rule
Avoidable consequences rule
Common knowledge rule
Forensic Medicine
Medical Jurisprudence
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Detection of aneuploidy in 1st trimester:
Ans. A. hCG and PAPP-ARef: William's 24th/ed, p289Table 2: Selected Down syndrome screening strategies and their detection rateStrategyAnalytesDetection Rate3 (%)First-trimester screenNT, PAPP-A, and hCG or free p-hCG79-87NTNT alone64-70Triple testMSAFP hCG OR free p-hCG, uE361-70Quadruple (Quad) testMSAFP, hCG or free p-hCG, uE3, inh74-81Integrated screenFirst-trimester screen and Quad test; results withheld until Quad test completed94-96Stepwise sequentialFirst-trimester screen and Quad test 1% offered diagnostic test after first-trimester screen 99% proceed to Quad test, results withheld until Quad test completed90-95Contingent sequential screenFirst-trimester screen and Quad test 1 % offered diagnostic test after first-trimester screen 15% proceed to Quad test; results withheld until Quad test completed84% have no additional test after first trimester screen88-94Cell-free fetal DNA testing (high-risk pregnancies)No analytes--massively parallel genomic sequencing98aBased on a 5% positive screen rate.Free b-hCG = free b-subunit hCG; hCG = human chorionic gonadotropin, inh = dimeric inhibin a;MSAFP = maternal serum alpha-fetoprotein; NT = nuchal translucency; PAPP-A = pregnancy-associated plasma protein-A; uE3 = unconjugated estriol.
1
hCG and PAPP-A
hCG and AFP
hCG, PAPP-A and AFP
AFP and estriol
Gynaecology & Obstetrics
Diagnosis in Obstetrics
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Deficiency of zinc causes all of the following except: March 2010
Ans. D i.e. None
4
Growth retardation
Sexual infantilism
Alopecia
null
Social & Preventive Medicine
null
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Epulis is?
ANSWER: (A) BenignREF: Textbook of Surgery by Roshan Lai Gupta 2nd ed Page 471EPULISEpulis represents a family of benign tumors of gingiva. The classification includes:Granulomatous epulis, pyogenic granulomaGiant cell epulis (Myeloid epulis)Fibrous epulis (Most common)
1
Benign
Malignant
Reactive process
Precancerous
Surgery
Oral Cavity
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Community health centres covering a population of -
As on march 31st 2014 ,5363 community health centers were established by upgrading the primary health care covering a population of 80,000 to 1.20 lakh with 30 beds and specialist in surgery,medicine,obstetrics,gynaecology and paediatrics with x- ray and laboratory facilities (refer pgno:907 park 23 rd edition)
3
40-60,000
60-80,000
80-1,20,000
More than 1,20,000
Social & Preventive Medicine
Health care of community & international health
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Which of the following medications essential for ameliorating the toxicity of pemetrexed:
Ans. b. Folic acid and vitamin B12 Pemetrexed Toxicity Pemetrexed toxicity mirrors that of methotrexate, with the additional feature of a prominent erythematous and pruritic rash in 40% of patientsQ. Dexamethasone, 4 mg twice daily on days -1, 0 and +1, markedly diminishes this toxicity. Unpredictably, severe myelosuppression with pemetrexed, seen especially in patients with pre-existing homocysteinemia and possibly reflecting folate deficiency, is largely eliminated by concurrent administration of low dosages of folic acid, 350-1000 mg/day, beginning 1-2 weeks prior to pemetrexed and continuing while the drug is administered. Patients should receive intramuscular vitamin B12 (1 mg) with the first dose of pemetrexed to correct possible B12 deficiency. These small doses of folate and B12 do not compromise the therapeutic effects.
1
Folinic acid and vitamin B6
Folic acid and vitamin B12
Vitamin 136 and Vitamin B1,
Folic acid and dexamethasone
Pharmacology
null
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single
Pyridoxine is used in treatment of ?
Ans. is 'd' i.e., Homocystinuria Inborn error of metabolism and Treatment Alkaptonuria Vitamin C, Folic acid Homocystinuria Pyridoxine + Folic acid Cystinuria Alkalization of urine + d-Penicillamine, Captopril Hanup disease Nicotinamide Multiple carboxylase eficiency Biotin Methyl malonic academia Vitamin B 12 Hyperoxaluria Pyridoxine Tyrosinemia NTBC, Liver Transplantation
4
Galactosemia
Phenylketonuria
Propionic acidemia
Homocystinuria
Biochemistry
null
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single
Benedict's hand is due to injury to -
Ans. is'b'i.e., Median nerveBenediction deformity of hand (Benedict hand) and positive Benediction test are seen in median nerve injury.
2
Ulnar nerve
Median nerve
Axillary nerve
Radial nerve
Anatomy
null
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single
The crescent formation is characteristic of the following glomerular disease -
Regardless of the cause, the classical histological picture of RPGN is characterized by the presence of crescents in most of the glomeruli. So, RPGN is also known as crescentic glomerulonephritis. Crescent formation Despite the wide variety of diseases that causes RPGN, all types of RPGN are characterized by glomerular injury and the formation of crescents. Severe injury and GBM rupture lead to the leakage of plasma proteins through the GBM. Of these proteins, fibrin is thought to contribute most strongly to the crescent formation. Parietal epithelial cells lining the bowman capsule respond to the leaked fibrin and proliferate. Infiltrating white blood cells such as monocytes and macrophages also proliferate. These proliferating cells surround and compress the glomerulus, forming a crescent-shaped scar that is readily visible on light microscopy of a renal biopsy.
2
Minimal change disease
Rapidly progressive glomerulonephritis
Focal and segmental glomerulosclerosis
Rapidly non progressive glomerulonephritis
Pathology
null
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All are true about Mastoid antrum except
(B) It does not communicate with middle ear# Mastoid Antrum:> Is a large, air-containing space in the upper part of mastoid and communicates with the attic through the aditus.> Its roof is formed by the tegmen antri and is a continuation of the tegmen tympani and separates it from the middle cranial fossa.> The lateral wall of antrum is formed by a plate of bone which is on an average 1.5 cm thick in the adult.> It is marked externally on the surface of mastoid by suprameatal (MacEwen's) triangle.
2
Thickness of bone of lateral wall is about 1.5 cm
It does not communicate with middle ear
Air cells are present in the upper part
Surface marking done by Me Ewen's Traingle
Anatomy
Neuroanatomy
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multi
All are absolute contraindications for regional anesthesia Except
INR > 2 is a relative contraindication for ophthalmic anaesthesia
4
Patient refusal
Lack of nerve stimulator
Lack of resuscitation facilities
INR > 2 in ophthalmic procedures
Anaesthesia
Regional anaesthesia
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Which among the following appears as spinal cord edema in MRI scan?
Most spinal cord infarctions are detected by MRI. After a few days, there are obvious lesions on the T2 sequences, presumably reflecting edema that extends over several levels. There may be slight enhancement after infusion of gadolinium. MRI taken in the first hours or day is often normal. In the chronic stages, the infarcted region collapses and has an attenuated signal on MRI. Ref: Ropper A.H., Samuels M.A. (2009). Chapter 44. Diseases of the Spinal Cord. In A.H. Ropper, M.A. Samuels (Eds), Adams and Victor's Principles of Neurology, 9e.
2
Myelodysplasia
Spinal cord infarctions
Myeloschisis
Cord tumors
Radiology
null
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single
Digitalis acts in CHF by:
null
1
Na+ K+ ATPase inhibition
Na+ K+ ATPase stimulation
Blockade of calcium channels
Increasing the refractory period of AV node
Pharmacology
null
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