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After a radiograph revealed a sialolith (stone) in a patient's right submandibular duct, the surgeon exposed the duct an intraoral approach. In this approach, what tissues or structures must be cut through?
|
The submandibular duct is found deep to the mucous membrane of the mouth, but superficial to the muscles of the tongue and the muscles on the floor of the mouth. So, genioglossus, mylohyoid, and hyoglossus are deep to the submandibular duct.
| 1
|
Mucous membrane only
|
Mucous membrane and genioglossus muscle
|
Mucous membrane and mylohyoid muscle
|
Mucous membrane and hyoglossus muscle
|
Anatomy
| null |
dfb6c882-8bb1-4d0f-8aa3-4ed533ea88e1
|
single
|
Most common location of Splenculi?
|
Ans. C. Splenic hilum. (Ref. LB 26th pg. 1089)"Splenunculi are single or multiple accessory spleen that are found approximately in 10-30% of the population. They are located near the hilum of the spleen in 50% of the cases and are related to the splenic vessels or behind the tail of pancreas in 30%. The reminder are located in the mesocolon or the spelnic ligaments. Their significance lies in the fact that failure to identify and remove these at the time of spelnectomy may give rise to persistent disease".Additional Educational points:FUNCTIONS OF SPLEEN# Immune# Filter function# Pitting# Reservoir# Cytopoiesis# Splenectomy harms the patientCONGENITAL ABNORMALITIES OF SPLEEN# Splenic agenesis is rare but is present in 10% of children with congenital heart disease.# Polysplenia is rare condition resulting from failure of splenic fusion.The 2 primary subtypes of situs ambiguous include :1) right isomerism, or asplenia syndrome, and2) left isomerism, or polysplenia syndrome.In classic right isomerism, or asplenia, bilateral right-sidedness occurs. These patients have bilateral right atria, a centrally located liver, and an absent spleen, and both lungs have 3 lobes. The descending aorta and inferior vena cava are on the same side of the spine. In left isomerism, or polysplenia, bilateral left-sidedness occurs. These patients have bilateral left atria and multiple spleens, and both lungs have 2 lobes. Interruption of the inferior vena cava with azygous or hemiazygous continuation is often present.The features of situs ambiguous are inconsistent; therefore, situs ambiguous cases are challenging and require thorough evaluation of the viscera. The location and relationships of the following should be reviewed carefully: abdominal viscera, hepatic veins, SVC, IVC, coronary sinus, pulmonary veins, cardiac atria, atrioventricular connections and valves, cardiac ventricles, position of the cardiac apex, and aortic arch and great vessels.SPENIC CYSTNon-parasitic splenic cysts are rare. Splenic cysts are classified as primary cysts (true) or pseudocysts (secondary) on the basis of the presence or absence of lining epithelium. True cysts form embryonal rests and include dermoid and mesenchymal inclusion cysts. True cysts of the spleen are very rare and are frequently classified as cystic hemangiomas, cystic lymphangiomas and epidermoid and dermoid cysts. Epidermoid cysts are thought to be of congenital origin and represent 10 % of the splenic cysts. They are lined by flattened squamous epithelium and are more frequent in children and young patients. Splenectomy or partial splenectomy is usually considered for cysts larger than 5 cm in diameter.
| 3
|
Behind the tail of pancreas
|
Splenic ligaments
|
Splenic hilum
|
Mesocolon
|
Surgery
|
Spleen
|
21d9fe08-5d30-4a65-815a-ea0dd970407b
|
single
|
Which of the following drug does not cause hypokalemia -
|
Ans. is 'd' i.e., Amiodarone Drugs causing hypokalemia agonist o Licorice o Penicillin derivatives o Amphotericin B o Theophylline o Steroids alpha Blockers o Toluene abuse o Gentamicin o Insulin o Vitamin B12 o Diuretics Carbenoxalone
| 4
|
Gentamicin
|
Diuretics
|
Amphotericin B
|
Amiodarone
|
Pharmacology
| null |
847da7bd-ea39-4f28-8619-17ae213fd83e
|
single
|
Which of the following tests is most sensitive for detecting early diabetic nephropathy -
| null | 3
|
Serum Creatinine
|
Creatinine clearance
|
Microalbuminuria
|
Ultra sonography
|
Medicine
| null |
7333688d-d3fc-46a0-b43f-56696026e571
|
single
|
Which of the following condition is associated with Cutis anserina?
|
Cutis anserina is a postmoem skin finding in drowning. In this the skin appears like an orange peel. This is due to the rigor mois of the erector pilorum muscles of hair follicles in the skin and subcutaneous tissues. Another postmoem skin finding of drowning is postmoem lividity, which is seen on the dependent pas of the body. It solely depends on the position in which body is floating. Common findings of drowning found in the hand are cadaveric spasm and washerwoman's hands. Ref: Textbook of Forensic Medicine and Toxicology By Jaypee Brothers, Medical Publishers, Rao, page 174.
| 1
|
Drowning
|
Suffocation
|
Lust murder
|
Electrocution
|
Forensic Medicine
| null |
cc69edda-e85b-40a7-8621-9c9bd7e0e07f
|
single
|
In a patient predisposed to glaucoma, the drug contraindicated is:
|
Ans. None of the above
| 4
|
Pilocarpine
|
Ecothiopate
|
Timolol
|
None of the above
|
Ophthalmology
| null |
e556a711-f37d-4e94-8736-a90f76e8b185
|
multi
|
A 41year old married female presented with a headache for the last 6 months. She had several consultations. All her investigations were found to be within normal limits. She still insists that there is something wrong in her head and seeks another consultation. The most likely diagnosis is -
|
Information in this questions
Preoccupation with fear of illness (something wrong in the head).
Preoccupation is due to misinterpretation (headache as something wrong in the head)
Normal investigations
Multiple consultations
Diagnosis is hypochondriasis
| 3
|
Phobia
|
Psychogenic headache
|
Hypochondriasis
|
Depression
|
Psychiatry
| null |
c2f35497-688a-4351-b4c7-382fa1c19eba
|
multi
|
For diagnosis of diabetes mellitus, Fasting blood glucose level should be more than -
|
Ans. is 'a' i.e., 126 mg/di DIAGNOSTIC CRITERIA FOR DIABETES1) Symptoms of diabeticsplusrandom blood glucose concentration >200 mg/dl.(Random is defined as without regard to time since last meal)or2) Fasting plasma glucoseQ > (126 mg/dl)or3)Two hour plasma glucoseQ > (200mg/dl) during an oral GTTor4) A1C > 6.5% (Added in 18th/ep. 2969)o The random blood sugar level does not meet the criteria for diabetes where as fasting blood glucose far exceeds the required level.o The diagnosis of diabetes cannot be made only with fasting blood glucose > 126 mg/dL.o So the next best step is to either repeat the test or perform oral G..1. T.o Harrison further adds that in the absence of unequivocal hyperglycemia and acute metabolic decompensation these criterias should be confirmed by repeat testing on a different day.o Benedicts test is a qualitative test for detecting the presence of sugar in urine so there is no use in repeating it.
| 1
|
126 mg/dl
|
140 mg/dt
|
100 mg/dl
|
200 mg/dl
|
Medicine
|
Endocrinology
|
8b4e4e47-4da5-4700-8ab8-b41ac8ed2c3e
|
single
|
The risk of carbamazepine induced Stevens-Johnson syndrome is increased in the presence of which of the following genes?
|
HLA DRUG DISEASE B1502 CARBAMAZEPINE STEVEN JOHNSON SYNDROME B5801 ALLOPURINOL SKIN REACTION B5701 ABACAVIR MI B53 MALARIA PROTECTION B27 ANKYLOSING SPONDYLITIS
| 2
|
HLA-B* 5801
|
HLA-B* 1502
|
HLA-B* 5701
|
HLA-B 27
|
Pharmacology
|
JIPMER 2017
|
9cf11a9a-eb54-458b-8fa0-5fada2947b0a
|
single
|
Characteristic features of rabies include all except-
| null | 2
|
Can manifest as ascending paralysis
|
Hemotogenous spread to brain
|
Can be transmitted by bites other than dogs also
|
In invariably fatal
|
Social & Preventive Medicine
| null |
15227e9b-9edd-400a-bf8d-d528821d4d60
|
multi
|
'Which of the following represents a non deliberate cultural practice leading to anti-mosquito effect -
|
Ans. is 'a' i.e., Use of alkaline detergent As the name suggests, nondeliberate antimosquito effect means mosquito control measure which is not intentional or deliberate. Mosquitoes do not grow in water with alkali. Since most soaps and detergents are alkali based, use of soaps and detergents has a nondeliberate antimosquito effect (because soaps and detergents are not intended to use as mosquito control measure). o Other methods, which are intended to be used as mosquito control measures are deliberate mosquito control measures. Deliberate mosquito control measures Anti-larval measures Anti-adult measures Protection against mosquito bites (a) Environmental control (a) Residual sprays (a) Mosquito net (b) Chemical control (b) Space sprays (b) Screening (c) Biological control (c) Genetic control (c) Repellents
| 1
|
Use of alkaline detergent
|
Use of larvicidal agents
|
Use of bed nets
|
Use of repellents
|
Social & Preventive Medicine
| null |
84b27bac-35df-4522-a9f1-b41518231794
|
single
|
Most common infections after splenectomy are:
|
Overwhelming post splenectomy infection MC late(after 2-5 years) fatal complication of splenectomy After splenectomy, ability to filter and phagocytose bacteria, paicularly encapsulated bacteria (Streptococcus pneumonia, Hemophilus influenza, Neisseria meningitides) and parasitized blood cells is lost. MC infection after splenectomy : Streptococcus pneumonia (50-90% cases) Neisseria meningitidis (Meningococcus) H. influenza type B Prevention- By vaccination Best time for vaccination 2 weeks before elective splenectomy * As early as possible after emergency splenectomy
| 2
|
Uncapsulated bacteria
|
Capsulated bacteria
|
Gram-positive sepsis
|
Gram-negative bacteria
|
Surgery
|
Spleen
|
d15573bd-dfa1-40e9-b734-c9528b8eb3a0
|
single
|
In a chronic smoker with mild haemoptysis. He also gave a history of hypertension and obesity. Lab data showed raised ACTH levels, which were not suppressed by dexamethasone. The cause for the Cushing's syndrome in the patient is -
|
Remember this
In normal person → Low dose dexamethasone suppresses cortisol secretion.
In Cushing's syndromes → Low dose dexamethasone is unable to suppress cortisol secretion.
When Cushing's syndrome is caused due to ectopic ACTH production → Even high dose dexamethasone is unable to suppress cortisol secretion.
| 4
|
MEN I
|
Pituitary adenoma
|
Adrenal cortical adenoma
|
Ectopic ACTH secreting tumor
|
Medicine
| null |
07ebe108-3779-43fe-a63a-2895740db9dd
|
single
|
True about non competitive in hibition are all except-
|
Ans. is 'a' i.e., Potency reduced Competitive antagonistNon comoetitive antagonist1. Antagonist bind to the same receptors as agonist2. Antagonist resembles chemically with the agonist3. The same maximal response can be obtained4. Potency is reduced (Right shift of DRC)5. Km is increased but Vmax is unchanged1. Binds to another site of receptor2. Does not resemble3. Maximal response is supressed4. Efficacy is reduced (Flattening of DRC)5. Km is unchanged but Vmax. is reduced.
| 1
|
Potency reduced
|
Km unchanged
|
V max reduced
|
Binds to another site of receptor
|
Pharmacology
|
Pharmacokinetics
|
675d538f-7d22-49ee-a7ef-1592273a6d62
|
multi
|
In pemphigus circulating antibodies attack:
|
Pemphigus
Is a skin and mucous membrane disease with autoimmune etiology.
Characterized histologically by intradermal blisters circulating IgG (IgG1 and IgG4) antibody against keratinocyte cell surface (attack Desmoglein 1 and 3).
| 2
|
Desmoglein 1&2.
|
Desmoglein1&3.
|
Desmoglein1&4.
|
Desmoglein2&4.
|
Pathology
| null |
43565b3e-113c-4357-aaec-c275c2fdf700
|
single
|
Brown type gallstones are formed due to:
|
Pigment stones are composed of calcium bilirubinate and are classified into "black" and "brown" types, the latter forming secondary to chronic biliary infection. Reference: Harrisons Principles of Internal Medicine, 18th Edition, Pages 2616-17
| 3
|
Hypercholesterolemia
|
Long standing hemolysis
|
Chronic biliary infection
|
Drugs
|
Medicine
| null |
a99103af-8fc4-4596-9fbf-886e265ad0a2
|
multi
|
Pathognomic lesion in HIV is: September 2011
|
Ans. B : Oral leukoplakia Oral hairy leukoplakia is viually pathognomic of HIV disease in the context of HIV risk factors. AIDS and HIV Infection with HIV-1 is associated with a progressive decrease of the CD4+ T cell count and an increase in viral load, the level of HIV in the blood. The stage of infection can be determined by measuring the patient's CD4+ T cell count and viral load. The stages of HIV infection are acute infection (also known as primary infection), latency and AIDS. Acute infection lasts for several weeks and may include symptoms such as fever, lymphadenopathy, pharyngitis, rash, myalgia, malaise, and mouth and esophageal sores. The latency stage involves few or no symptoms and can last anywhere from two weeks to twenty years or more, depending on the individual. AIDS, the final stage of HIV infection, is defined by low CD4+ T cell counts (fewer than 200 per microliter), various oppounistic infections, cancers and other conditions. When CD4+ T cell numbers decline below a critical level of 200 cells per uL, cell-mediated immunity is lost, and infections with a variety of oppounistic microbes appear. The first symptoms often include moderate and unexplained weight loss, recurring respiratory tract infections (such as sinusitis, bronchitis, otitis media, pharyngitis), prostatitis, skin rashes, and oral ulcerations. Common oppounistic infections and tumors, most of which are normally controlled by robust CD4+ T cell-mediated immunity then sta to affect the patient. Typically, resistance is lost early on to oral Candida species and to Mycobacterium tuberculosis, which leads to an increased susceptibility to oral candidiasis (thrush) and tuberculosis. Later, reactivation of latent herpes viruses may cause worsening recurrences of herpes simplex eruptions, shingles, Epstein-Barr virus-induced B-cell lymphomas, or Kaposi's sarcoma. Pneumonia caused by the fungus Pneumocystis jirovecii is common and often fatal. In the final stages of AIDS, infection with cytomegalovirus (another herpes virus) or Mycobacterium avium complex is more prominent.
| 2
|
Gingivitis
|
Oral leukoplakia
|
Herpes simplex
|
Aphthous ulcers
|
Medicine
| null |
21bf716c-485d-4d00-b120-8b7fd88cddbc
|
single
|
Which is not visualized on posterior rhinoscopy:
|
Posterior rhinoscopy: It is method of examination of the posterior aspect of nose and pharynx. Structures seen on posterior rhinoscopy: - Both choanae - Posterior end of nasal septum - Opening of Eustachian - Posterior end of superior/tube middle and inferior turbinates - Fossa of Rosenmuller - Torus Tubarius - Adenoids - Roof and posterior wall and nasopharynx.
| 2
|
Eustachian tube
|
Inferior meatus
|
Middle meatus
|
Superior concha
|
ENT
| null |
02799291-223f-4ad4-b9e3-b4e1cea3623b
|
single
|
Perimetry is a test to assess the –
|
The tests used to measure the field of vision are confrontation test and Perimetry.
| 3
|
Visual acuity
|
Intraocular pressure
|
Visual field
|
Depth of the anterior chamber
|
Ophthalmology
| null |
d8275833-5ac3-4f9d-8b30-4d17a37ce7f4
|
single
|
Which of the following amino acids can be phosphorylated?
|
The OH groups of serine, tyrosine, and threonine frequently serve as the points of covalent attachment for phosphoryl groups that regulate protein function Protein kinase enzymes catalyse the phosphorylation while protein phosphatase enzymes catalyse the dephosphorylation. Ceain protein kinases are specific to the amino acid e.g. tyrosine kinases specifically phosphorylate tyrosine residues.
| 4
|
Cysteine
|
Leucine
|
Methionine
|
Serine
|
Biochemistry
|
Basics of amino acids
|
1d7f79a0-54ea-487e-89af-a6e1340b589a
|
single
|
The veebral aery traverses all of the following except
|
Veebral aery is the first and largest branch of the first pa of the subclan aery, destined chiefly to supply the brain PAS OF VEEBRAL AERY: FIRST PA-The first pa extends from the origin of the aery to the transverse process of sixth cervical veebrae SECOND PA-The second pa runs through foramina transversaria of the upper sixth cervical veebrae THIRD PA-The third pa lies in the suboccipital triangle FOUH PA-The fouh pa extends from the posterior atlantooccipital membrane to the lower border of pons Ref BDC volume 3,6th edition pg 164
| 3
|
Foramen magnum
|
Subarachnoid space
|
Interveebral foramen
|
Foramen transversarium
|
Anatomy
|
Head and neck
|
1dce0ba1-cbb6-489c-bc61-31fc72379c30
|
multi
|
All are antiplatelet drugs Except :
| null | 4
|
Aspirin
|
Clopidogrel
|
Dipyridamole
|
Warfarin
|
Pharmacology
| null |
a294c329-6a31-4e69-b3c7-025b1bb3e6e7
|
multi
|
Which among the following is not seen in inflammatory ahritis?
|
New bone formation i.e osteophyte formation is seen in non inflammatory conditions like osteoahritis. Raised ESR, morning stiffness in and around the joints lasting for more than 30 minutes, periaicular osteoporosis are features of inflammatory ahritis. The joint space narrowing, and marginal erosions are also seen.
| 4
|
Raised ESR
|
Morning stiffness
|
Periaicular osteoporosis
|
New bone formation
|
Surgery
| null |
d7ddf832-2f66-4187-ad3f-c598d12ebe59
|
single
|
Various agents are used for local anaesthesia. The first local anaesthetic used in clinical anaesthesia was:
|
The first local anesthetic, cocaine, was serendipitously discovered to have anesthetic propeies in the late 19th century. Cocaine occurs in abundance in the leaves of the coca shrub (Erythroxylon coca). Cocaine was first isolated in 1860 by Albe Niemann. Ref: Catterall W.A., Mackie K. (2011). Chapter 20. Local Anesthetics. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e.
| 2
|
Bupivacaine
|
Cocaine
|
Lidocaine
|
Procaine
|
Anaesthesia
| null |
b0701dbc-311d-4118-a228-f14b14724865
|
single
|
Systemic effects of obstructive sleep apnea syndrome (OSAS) include all of the following except
|
Systemic sequelae of OSAS include hypertension, Cor Pulmonale, and cardiac arrhythmia.
| 3
|
Hypertension
|
Cor pulmonale
|
Aortic aneurysm
|
Cardiac arrhythmia
|
Surgery
| null |
0d003585-990f-4ae2-9a29-2bf0ae66a877
|
multi
|
Reye's Syndrome is cause by all except-
|
Ans. is 'b' i.e., RSV Reye's syndrome Reye's syndrome is a metabolic mitochondria! disorder characterized by - i) Fatty infiltration of liver ii) Encephalopathy iii) Sometimes fatty infiltration of kidney o So, it so also known as Encephalopathy with fatty degeneration of viscera. Etiology o It is an acute self limiting metabolic insult resulting in generalized mitochondrial dysfunction due to inhibition of fatty acid oxidation. o Precipitating factors - o Viral infection --> Influenza B & A, Varicella (Herpes type 3), Echovirus - 2, Adenovirus, EBV, Coxsackievirus A
| 2
|
Adeno virus
|
RSV
|
Herpes
|
Influenza
|
Pediatrics
| null |
6f90bb3b-f16b-496c-9394-413352b55e19
|
multi
|
Recptors for vibration sense-
|
Ans. is 'c' i.e., Paccinian corpuscle Tactile (touch) receptors* For touch (superfical touch) :- Meissner's corpuscle (detect texture of surface, i.e. rough or smooth), Merkel's disc (detect two point discrimination).* For pressure (deep touch) :- Ruffini's end organ (slowly adapting).* Vibrations :- Detected by Pacinian corpuscle (rapidly adapting).
| 3
|
Merkel's disc
|
Ruffini's end organ
|
Paccinian corpuscle
|
Meissner's corpuscle
|
Physiology
|
Nervous System
|
0b2d5b25-3af2-4e1f-bd2d-86cd51b96be2
|
single
|
Small cell Ca lung, DNA of the necrotic cells get deposited on vessels?
|
Ref: Internet SourcesExplanation:Azzopardi phenomenon:In necrotic areas of tumor, dark blue DNAliberated from dead cells sometimes coats vessel walls.The tumor cells surrounding the vessels show coagulative necrosis. The pink area at the lower right shows karyolysis of tumor nuclei.
| 2
|
Psammoma body
|
Azzopardy effect
|
Button collar lesion
|
Necrotic diathesis
|
Pathology
|
Lung Tumors
|
451ba665-6780-4fae-88c5-eba4afb68c48
|
multi
|
Mediator of acute inflammation not derived from cell is:
|
(Refer: Robbins & Cotran’s – Pathologic Basis of Disease, SAE, 1st edition, Vol I–pg no: 82-85)
Chemical mediators of inflammation
Cellular mediators
| 3
|
Histamine
|
Leukotrienes
|
Kinins
|
Cytokines
|
Unknown
| null |
16eb7ff7-d75c-486e-80ae-8a5ae4d6a0fa
|
single
|
Which of the following is/are not intermediate acting non depolarizing NMB -
|
Non depolarizing muscle relaxants are classified according to their structure and duration of action as: Stucture Clinical duration Long acting (>50 min) Intermediate (20-50 min) Sho (15-20 min) Ultra-sho (<10-12 min) Steroidal Pancuronium Pipecuronium Vecuronium Rocuronium Benzyliso- quinolinium d-Tubocurarine Metacurine Doxacurium Atracurium Cis-atracurium Mivacurium Onium chlorofumarate Gantacurium Phenolic ether Gallamine
| 1
|
Pancuronium
|
Vecuronium
|
Rocuronium
|
Atracurium
|
Anaesthesia
|
Neuromuscular Blocker
|
093564c5-eef6-4613-bfd2-15c0fe4c54ea
|
single
|
The amino acid cannot be used for glycogen synthesis -
|
Ans. is 'c' i.e., Leucine o Synthesis of glucose from non-carbohydrate precursors is called gluconeogenesis.o When the end product is glycogen instead of glucose, the process is called glyconeogenesis, i.e., synthesis of glycogen from noncarbohydrate precursors.o Terms gluconeogenesis and glyconeogenesis are used interchangeably as all reactions are same except for last where glucose-6-phosphate enters the glycogen synthesis pathway, instead of by being converted to glucose.Coming back to questiono Alanine, threonine, and methionine are glucogenic amino-acids, i.e. can be used as substrates for gluconeogenesis or glyconeogenesis.o Leucine is purely ketogenic amino acid, can not be used as a substrate for gluconeogenesis or glyconeogenesis.
| 3
|
Alanine
|
Threonine
|
Leucine
|
Methionine
|
Unknown
| null |
bfdc5682-9740-4f33-9f03-ec43faa3e9cb
|
single
|
Diplopia is characteristic feature of
|
Signs of paralytic squint:
1. Primary deviation.
2. Secondary deviation.
3. Restriction of ocular movements.
4. Compensatory head posture.
5. False protection.
| 3
|
Concomitant squint
|
Non-paralytic squint
|
Paralytic squint
|
Latent squint
|
Ophthalmology
| null |
0e8327f6-c48c-47db-a6ab-ba0e0f6b1ba5
|
single
|
Normal PCWP with pulmonary edema is seen in?
|
In Lv dysfunction and MS there will increase in pcwp with pulmonary edema . Normal pcwp withpulmonary edema is seen in Non cardiogenic pulmonary edema like ARDS,HIGH ALTITIDE ,Rapid evacuation of pneumothorax /hemothorax.
| 2
|
Left atrial myxoma
|
High altitude
|
Mitral stenosis
|
LV systolic dysfunction
|
Medicine
|
Respiratory system
|
3403b1ac-450c-45bb-903f-85630e8c6feb
|
single
|
All are indications for postoperative radiotherapy in a case of Carcinoma Endometrium Except
|
Pelvic postoperative radiotherapy (external) in a dose of 6000 cGy over a 6-week period is recommended in high-risk cases such as an undifferentiated tumor, myometrial infiltration, pelvic node involvement, and in serous, clear cell and adenosquamous carcinoma. The postoperative radiotherapy is required in Stages IA (Grade 3), IA2, IB and II. Whole-abdomen radiation is required when para-aoic lymph nodes are involved while protecting the liver and kidneys.The most impoant factors in considering the need for postsurgical radiotherapy are (1) histology; (2) grading as studied by biopsy and (3) depth of myometrial invasionas seen by ultrasound, MRI and at the time of surgery.Ref: Shaw&;s textbook of gynecology; 16th edition; Page no: 512
| 4
|
Myometrial invasion >1/2 thickness
|
Positive lymph nodes
|
Endocervical involvement
|
Tumor positive for estrogen receptors
|
Gynaecology & Obstetrics
|
Gynaecological oncology
|
59d71a4d-d7ad-4751-a68e-c26fdf13e320
|
multi
|
Allergic bronchopulmonary Aspergillosis is commonly a complication of:
|
ABPA represents a hypersensitivity to Aspergillus fumigatus. It is common in asthma and teenagers with cystic fibrosis.
| 3
|
TB
|
Bronchogenic carcinoma
|
Cystic fibrosis
|
Wegener's granulomatosis
|
Medicine
|
fungal infection
|
77c0589a-d3d9-48fa-bcb6-cf2461cf5edc
|
multi
|
Inferior mesenteric vein drains into:
|
Ans. B. Splenic veininferior mesenteric vein (IMV) is a blood vessel that drains blood from the large intestine. It usually terminates when reaching the splenic vein, which goes on to form the portal vein with the superior mesenteric vein.Tributaries of the inferior mesenteric vein drain the large intestine, sigmoid colon and rectum and include thea. left colic veinb. sigmoid veinsc. superior rectal veind. rectosigmoid veins
| 2
|
Portal vein
|
Splenic vein
|
Superior mesenteric vein
|
Renal vein
|
Anatomy
|
Abdomen & Pelvis
|
a2cc0687-2a1f-471d-9df4-1e02330b91d8
|
single
|
A lady has carcinoma in upper and outer quadrant of the breast. It usually metastasises to all of the following lymph nodes, EXCEPT?
|
Lymphatics from most of the breast drains into axillary lymph nodes. The medial most poion of the breast drain through the chest wall into the internal mammary lymph nodes. So carcinoma in this patient which is in the upper outer quadrant spreads to the anterior, central and lateral group of axillary nodes. Aerial supply of breast is derived from branches of internal thoracic aery, lateral thoracic aery, and posterior intercostal aery. Venous drainage is primarily into the axillary vein but also into internal thoracic vein, subclan and azygos vein.
| 4
|
Anterior axillary
|
Central
|
Lateral
|
Parasternal
|
Anatomy
| null |
f26d33cc-6a8c-4581-90d4-6bd358b80d2c
|
multi
|
Waste in yellow plastic bags are treated by
|
Waste such as anatomical waste , solid waste,soiled waste , chemical waste is collected in yellow coloured bag and treated and disposed by incineration
| 1
|
Incineration
|
Autoclaving
|
Microwaving
|
Shredding
|
Social & Preventive Medicine
|
Hospital waste and disaster management, Occupational health
|
978e9f6e-71ee-4060-8729-6e0fea0c5c95
|
single
|
Treatment of metastatic prostate carcinoma is:
|
Ref: The Washington Manual of Surgery, 6th editionExplanation:"Hormonal therapy with either bilateral orchiectomy or luteinizing hormone-releasing hormone agonists usually is reserved for men with locally advanced or metastatic disease"Management of Prostate cancerIncidentally diagnosed Tla and T1b disease.For men >70 years: Conservative treatment would usually he the correct approach.For men < 65 years: Radical surgical treatmentLocalised T2 disease.In younger fitter men (<65 years): Radical prostatectomy or radical radiotherapy.In patients with outflow obstruction: Transurethral resection +- hormone therapyLocally advanced T3 and T4 disease.These patients are at significant risk of disease progression.Early androgen ablation is favouredFor the sexually active: Conservative approach with the adoption of androgen ablationMetastatic disease.Once nietastases have developed the out-look is poor.For patients with symptoms: androgen ablation will provide symptomatic reliefGnrH analoguesTreatment options for men with organ-confined prostate cancer includeRadical prostatectomyExternal-beam radiation therapyInterstitial radiotherapy (brachytherapy)Hormonal therapy with either bilateral orchiectomy orLuteinizing hormone-releasing hormone agonists (reserved for men with locally advanced or metastatic disease)Staging using the Ca ProstateT1a, T1b and T1c:These are incidentally found tumours in a clinically benign gland after histological examination of a prostatec-tomy specimen.T1a is a well or moderately well- differentiated tumour involving less than 5 per cent of the resected specimen.T1b is a poorly differentiated tumour or a tumour involving >5 percent of the resected specimen.T1c tumours are impalpable tumours found following PSA screeningT2a disease presents as a suspicious nodule on rectal examination of <2 cmT2b disease is a nodule involving greater than 2 cmT2e is tumour in both lobes but still clinically confinedT3 is a tumour involving the seminal vesicles or bladder neckT4 is a tumour involving the rectum or pelvic side wall
| 3
|
Radiotherapy
|
Estrogen therapy
|
GnRH analogs
|
Radiotherapy with chemotherapy
|
Surgery
|
Prostate Cancer
|
ff73ac06-3957-4951-9053-be3f9644b085
|
single
|
Examination of arrested person by medical practitioner at the request of the arrested person. Is defined under which section of the Code Of Criminal Procedure
|
Section 54 in The Code Of Criminal Procedure, 1973 54. Examination of arrested person by medical practitioner at the request of the arrested person. When a person who is arrested, whether on a charge or otherwise alleges, at the time when he is produced before a Magistrate or at any time during the period of his detention in custody that the examination of his body will afford evidence which will disprove the commission by him of any offence or which will establish the commission by any other person of any offence against his body, the Magistrate shall, if requested by the arrested person so to do direct the examination of the body of such person by a registered medical practitioner unless the Magistrate considers that the request is made for the purpose of vexation or delay or for defeating the ends of justice. CrPC 53: Section 53 of the Criminal Procedure Code Examination of accused by medical practitioner at the request of police officer I.P.C. 82. < 7 years : Not liable 83. 7-12 years : Liable/Not liable (Depends on mental maturity) 84. Mental ill person : Not liable 85. Involuntary intoxication : Not liable 86. Voluntary intoxication : Liable 87. A child below the age of 18 years can not give consent for an act not intended and not known to be likely to cause death or grievous hurt, e.g.- For surgical procedure. 89. A child below the age of 12 years can not give consent even for general physical examination; parent or guardian has to consent. *That means a child between the age of 12 and 18 can give consent only for general physical examination (Not for PV/PR) 90. Invalid consent 92. In emergency : Consent is not required 88. Act not intended to cause death, done by consent in good faith for person's benefit 93. Communication made in good faith (E.g.- A surgeon, in good faith, communicates to a patient his opinion that he cannot live. The patient dies in consequence of the shock. A has committed no offence, though he knew it to be likely that the communication might cause the patient's death. 290. Public nuisance (Frotteurism) 294. Obscene acts (Exhibitionism) 297. Indignity to human corpse (Necrophilia, Necrophagia, Embalming without consent, etc.) 354. Indecent assault (Outrage the modesty of a girl) 354A. Sexual harassment 354B. Disrobe 354C. Voyeurism 354D. Stalking 497. Adultery 375. Rape - Definition 376. Rape - Punishment (10 years - Life imprisonment) Custodial Rape (10 years - Life imprisonment) 376A. Rape resulting in Death or PVS (20 y - Death sentence) 376B. Sexual Intercourse by husband during separation (2 - 7 y) (Without her consent and on her complaint) 376C. Sexual Intercourse by a person in authority (5 - 10 Y) (Induces or seduces a woman to has sexual intercourse not amounting to Rape) 376D. Gang Rape (20 y - Life imprisonment) 376E. Repeat offenders (Life imprisonment - Death sentence) (Already convicted under Sec. 376/376A/376D) 377. Unnatural sexual offences (Up to life imprisonment) 509. Word, gesture or act intended to insult the modesty of a woman 304B. Dowry Death (7 y - Life imprisonment) 498A. Dowry harassment 317. Abandonment of child under 12 years by parent/guardian 318. Concealment of birth by secret disposal of dead body 312. Causing miscarriage (with consent) 313. Causing miscarriage without consent 314. Death of mother due to miscarriage 315. Preventing the child being born alive or to cause it to die after Birth 316. Causing death of quick unborn child by act amounting to culpable homicide. 166B. Non Treatment of victim of Rape 172. Absconding to avoid service of summons 174. Non-attendance to an order from public servant (summons) 176. Omission to give information to public servant 177. Furnishing false information 191. Giving false evidence (Perjury - definition) 192. Fabricating false evidence 193. Punishment for false evidence (Perjury) 197. Issuing or signing false certificate 201. Causing disappearance of evidence 202. Intentional omission to give information 204. Destruction of document or electronic record 269. Negligent act likely to spread infection/disease dangerous to life 270. Malignant act likely to spread infection/disease dangerous to life 299. Culpable homicide 300. Murder (Culpable homicide not amounting to murder is also defined under this section) 302. Punishment for murder 304. Punishment for Culpable homicide not amounting to murder 307.Attempt to murder 308. Attempt to commit culpable homicide 334. Voluntarily causing hurt on provocation (Up to 1 month imprisonment/Up to Rs.500 fine/Both) 335. Voluntarily causing grievous hurt on provocation (Up to 4 y imprisonment/Up to Rs.2,000 fine/Both) 326A. Voluntarily causing grievous hurt by use of acid (10 y - Life imp) 326B. Voluntarily throwing or attempting to throw acid (5-7 y) 319. Hurt 320. Grievous Hurt 324. Voluntarily causing hurt by dangerous weapons/means 326. Voluntarily causing grievous hurt by dangerous weapons/means 304A. Causing death by rash and negligent act 336. Endangering life by rash and negligent act 337. Causing hurt by rash and negligent act 338. Causing grievous hurt by rash and negligent act 351. Assault (Technically, operation without consent amounts to assault) 510. Misconduct in public by a drunken person 45. Life: The word "life" denotes the life of a human being 46. Death: The word "death" denotes the death of a human being 51. Oath/Solemn affirmation 228A. Punishment for disclosure of identity of the victim of Rape Criminal Procedure Code 39. Duty to give information 53(1). Examination of an accused (arrested person) by medical practitioner at the request of police officer not below the rank of S.I. of police (Doctor can examine even without consent). 53(2). Examination of a accused female by female medical practitioner 53 A. Examination of person accused of rape by medical practitioner 54. Examination of arrested person by medical practitioner at the request of the arrested person. 164A. Examination of the victim of Rape (Protocol) 174. Police inquest 176. Magistrate inquest 327. In camera trial 357C. All hospitals should give free first aid treatment to victims of rape and should inform the police. 416. Commutation of capital sentence on pregnant woman
| 2
|
Section 53
|
Section 54
|
Section 56
|
Section 57
|
Unknown
| null |
ef58a5af-2f27-4fce-878f-5df3990bfc0f
|
single
|
All are true about achalasia except:
|
Ans. (b) Body peristalsis is normalRef: Sabiston 20th Edition, Pages 1015-1018Salient Points in Achalasia:* Achalasia - Meaning failure to relax* Men = women affected equally* Dysphagia, regurgitation and weight loss are the triad of symptomsPathogenesis:* Progressive inflammation and selective loss of Inhibitory myenteric neurons in Auerbach's Plexus of the esophagus that normally secretes VIP and Nitric oxide and relaxes the LES. Because of this the excitatory neurons acts and contracts the LES by Ach.* Aperistalsis in Esophagus, dilated esophagus and obstructed LES happens.
| 2
|
It predisposes to malignancy
|
Body peristalsis is normal
|
LES pressure is increased
|
Dilatation of proximal segment
|
Surgery
|
Oesophagus
|
5463e817-3044-45c1-b880-0ac0f345f887
|
multi
|
Which of the following vaccine is routinely given in pregnancy?
|
Td vaccine should be given to pregnant women in the second or third trimester if they had not been vaccinated in the past 10 years. If a pregnant women received Td in the past 10 years Tdap should be given postpaum. American College of Obstetricians and Gynecologists recommend that influenza vaccine should be given only to pregnant women with serious underlying diseases such as chronic diseases or pulmonary problems. Ref: The Vaccine Handbook: A Practical Guide for Clinicians: the Purple Book By Gary S. Marshall page 252.
| 3
|
Influenza
|
Oral polio
|
Tetanus
|
Rabies
|
Gynaecology & Obstetrics
| null |
62646e23-4278-451a-b589-04585b286644
|
single
|
D1C is common in which AML-
|
Ans. (b) Promyelocytic (M3)(Ref: Robbins 9th/pg 612; 8th/pg 622)Acute Promyelocytic Leukemic (APML, M3) cells can induce Disseminated intravascular coagulation (DIC)
| 2
|
Monocytic (M5)
|
Promyelocytic (M3)
|
Erythrocytic (M6)
|
Megakaryocytic (M7)
|
Pathology
|
Misc. (W.B.C)
|
6daf8a6e-9fc6-4d51-a878-b83f4e9d2637
|
single
|
Which of the following cannot be done by a 3 year old child?
|
A child can draw a rectangle by the age of 4 years. All other options can be performed by a 3 year old child. Ref: O P Ghai, 7th Edition, Pages 26-29, 6th Edition, Page 44; Nelson, 18th Edition, Page 44.
| 2
|
Draw a circle
|
Draw a rectangle
|
Telling a story
|
Riding tricycle
|
Pediatrics
| null |
65bb604d-f85f-4302-b6f4-e180fedb0805
|
single
|
Which of the following is not a pyrogenic cytokine
|
Ref Harrison 18/e p 144;9/e p99 Interleukin-18 is a protein which in humans is encoded by the IL18 gene. The protein encoded by this gene is a proinflammatory cytokine. This cytokine is produced by many immune cells and can modulate both innate and adaptive immunity and dysregulation can cause autoimmune or inflammatory diseases
| 4
|
Il_1
|
TNF
|
IFN _alpha
|
IL -18
|
Anatomy
|
General anatomy
|
12c2d9c1-25fa-476c-bb40-72cc36f7c414
|
single
|
Basilar migraine differs from classic migraine in the
|
In both classic migraine and basilar migraine ,women are more susceptible. aura and visual disturbances are seen in both. But it is more severe in basilar migraine that it may lead to complete blindness, frank psychosis, quadriplegia and coma.
| 3
|
Sex of persons affected
|
Duration of aura
|
Severity of symptoms
|
Sequence of neurologic deficits
|
Medicine
| null |
ba3aaf54-0014-4065-b561-e0d241907b1a
|
single
|
Most common physiologic cause of hypoxemia is-
|
Ans- C Ventilation-perfusion inequality a. Although hypoventilation, incomplete oxygen diffusion, and pulmonary shunts all are causes of hypoxemia, the most common cause is ventilation-perfusion inequality. b. The mismatch of ventilation and blood flow occurs to some degree in the normal upright lung but may become extreme in the diseased lung. c. The three indices used to measure ventilation-perfusion inequality are alveolar arterial PO2 difference, physiologic shunt (venous admixture), and alveolar dead space. d. Elevated 2,3-diphosphoglycerate (2,3-DPG) levels shift the oxygen dissociation curve to the right and thereby augment tissue oxygenation. This elevation does not result in hypoxemia.
| 3
|
Hypoventilation
|
Incomplete alveolar oxygen diffusion
|
Ventilation-perfusion inequality
|
Pulmonary shunt flow
|
Unknown
| null |
23fbb2a0-5d66-4989-8b9b-00240f6387c3
|
single
|
Which of the following is not a cause for neonatal jaundice manifesting for the first time in the second week: September 2008
|
Ans. A: Rhesus Incompatibility Jaundice appearing after 72 hours: Sepsis neonatorum' Neonatal hepatitis Extra hepatic biliary atresia Breast milk jaundice Metabolic disorders
| 1
|
Rhesus incompatibility
|
Hypothyroidism
|
Jaundice due to breast milk
|
Galactosemia
|
Pediatrics
| null |
2f10fb55-83cd-4a57-a7c8-274bd3d4d4a5
|
single
|
Disease rate is -
|
Disease rate is a measure of incidence or occurrence of disease in a population.
In other words, it is synonymous for incidence rate.
| 4
|
Risk of susceptibility
|
Usually expressed a percentage
|
Time period in a calendar year
|
Disease occurrence in a specified time period
|
Social & Preventive Medicine
| null |
41156fc8-8c61-4cd6-b3c2-2c6986fba3fe
|
multi
|
Which of the following antitubercular drug is not hepatotoxic :
|
Streptomycin and ethambutol are not hepatotoxic. Read carefully, option (c) is ethionamide, not ethambutol.
| 4
|
Isoniazid
|
Rifampicin
|
Ethionamide
|
Streptomycin
|
Pharmacology
| null |
cf2753e3-c36f-42e6-8797-1d04c8a07a1f
|
single
|
Which of the following organs obtained from cadaver is not used for transplant? AI 11
|
Ans. Urinary bladder
| 4
|
Blood vessels
|
Lung
|
Liver
|
Urinary bladder
|
Forensic Medicine
| null |
3e77095e-d6a1-4ed6-9f87-3d24b5b026f2
|
single
|
Fracture of the 5th metatarsal is called as -
|
Ans. is 'b' i.e., Jones fracture [Ref: Maheshwari 4th/e p. 2, 3EponymFractures of lower limbBumper fractureComminuted, depressed fracture of the lateral tibial condylePott's fractureBimalleolar ankle fractureCotton's fractureTrimalleolar ankle fracturePilon fractureComminuted intra-articular fracture of distal tibial endMarch fractureFatigue fracture of the shaft of 2nd and 3rd metatarsalRonaldo fractureFracture of the base of first metacarpal (extra-capsular)Maisonneuve's fractureAn ankle fracture associated with spiral fracture of neck of the fibulaPilon fracture (Explosion fracture)A comminuted intra-articular fracture of the distal end of the tibia and fibulaAviator's fractureFracture of neck of the talusLisfranc's fracture-dislocationA fracture dislocation through tarso-metatarsal joints.Chopart fracture-dislocationA fractue dislocation through inter-tarsal jointsMalagaigne's fractureA fracture of pelvis having a combination of ipsilateral fracture of pubic rami anteriorly and sacro-iliac joint disruption posteriorly.Mallet fingerAvulsion of extensor tendon from the base of distal phalanx.Dashboard fractureFracture of posterior lip of acetabulum with posterior dislocation of hip.Straddle fractureBilateral superior and inferior pubic rami fractures of the pelvis.Jones fractureAulsion fracture at the base of 5th metatarsal
| 2
|
Malgaigne's fracture
|
Jones fracture
|
Cotton's fracture
|
Pott's fracture
|
Orthopaedics
|
Injuries to the Leg, Ankle & Foot
|
3ee07657-dbec-4a78-9ca3-47c19907fac5
|
multi
|
All are true about epistaxis except:
|
Answer- C. Anterior nasal pack is easy to inse and less traumatic than balloon temponadeKeisselbach's plexus: This plexus is the commonest site of bleeding (90% of cases)Anterior nasal packing- Prophylactic antibodies should be used it pack is in a place for more than 24 hours.A balloon tamponade may be used as an alternative to anterior nasal packing and This is less traumatic as it is best suited fpr epistaxis.Trotter's method- Patient may put in the sitting position with the head bending forwards with mouth open.Nasal endoscopy assisted bipolar cauterization under general anaesthesia may be done to coagulate the bleeder in case ofepistaxls is refractory to conservative measures.
| 3
|
Keisselbach's plexus is source in 90% cases
|
If anterior packing is left in nose for more than 48hrs antibiotic coverage is given
|
Anterior nasal pack is easy to inse and less traumatic than balloon temponade
|
Trotter method is first aid method
|
ENT
| null |
8f855e88-dab4-496a-a43e-16a8ab963bbe
|
multi
|
Antimalarial agent safe for use in pregnancy is :
| null | 4
|
Atovaquone
|
Pyrimethamine
|
Primaquine
|
Proguanil
|
Pharmacology
| null |
1ebe787d-119a-4dd5-8f44-0ae9e684a3ee
|
single
|
All are true about Rt kidney except :
|
C. i.e. Rt kidney is preferred over left kidney for transplantation- Left kidney is usually choosen for transplantation because it has longer renal vein which simplifies transplant operation.Q- Transplanted kidney is placed in iliac fossa, in the retroperitoneal position leaving native kidney in situ.- Renal vein is anastomosed to external iliac vein (end to side manner)Renal aery is anastomosed to external iliac aery (end to side, if carrel patch of donar aoa is present) or internal iliac aery (end to end anastomosis when carrel patch is not present)Ureter is kept sho to avoid distal ischemia.>- - Right kidney is faher from diaphragm (lower) & faher from median plane as compared to leftQ
| 3
|
Rt renal vein is shoer then left
|
Related to duodenum
|
Rt kidney is preferred over left for transplantation
|
Rt kidney is placed at the lower level than left.
|
Anatomy
| null |
e57d424d-24f5-4117-9bba-a57a2cf8afe3
|
multi
|
Defect in collagen formation is seen in:
|
A i.e. Scurvy Collagen show triple helixQ and is never present free inside the cytoplasmQ. Scurvy, osteogenesis imperfectaQ, Ehler - Danlos syndrome & Alpo syndrome occurs d/t its deficient synthesis.
| 1
|
Scurvy
|
Hunter's syndrome
|
Marfan's syndrome
|
All
|
Physiology
| null |
dbdd9093-ec5d-473b-9fad-5b191a52aaad
|
multi
|
Preterm babies:
|
(Born before 37 weeks of gestations): Ref: (460-Park 20th)1. Preterm babies - babies bom too early before 37 weeks of gestations (259 days)2. Small for date (SFD) babies - bom at term or preterm. They weight less than the 10th percentile for the gestational age.3. Term: babies bom from 37 completed weeks to less than 42 completed weeks (259 to 293 days) of gestations4. Post term: - Babies bom at 42 completed weeks or anytime thereafter (294 days and over) of gestation
| 1
|
Bom before 37 weeks of gestations
|
Bom before 38 weeks of gestations
|
Bom before 39 weeks of gestations
|
Bom before 40 weeks of gestations
|
Social & Preventive Medicine
|
Obstetrics, Paediatrics and Geriatrics
|
34476f87-48fb-41ea-9f2f-26b467624a38
|
single
|
42 yrs male with frequent attacks of joint pain, underwent an X-ray showing soft tissue swelling. The likely diagnosis is:
|
Tophi appear as characteristic punched out cysts or deep erosions with over hanging bony edges -Mael's or G' sign. GOUT:- Sometimes only feature is acute pain and tenderness. hyperuricemia is not diagnostic and is often seen in normal middle aged men. During acute attack X-rays show only soft tissue swelling. Chronic gout may result in joint space narrowing and secondary OA.
| 1
|
Gout
|
Parathyroid adenoma
|
Psoriasis
|
RA
|
Orthopaedics
|
Joint disorders
|
0bd68318-07fa-424e-bea6-9ae7365387a3
|
single
|
The drug of choice in Chorio ' Carcinoma is:
|
Methotrexate
| 1
|
Methotrexate
|
Actinomycin-D
|
Vincristine
|
6-thioguanine
|
Pharmacology
| null |
3af1e872-1c6a-4aee-ac36-b071a5090257
|
single
|
Antimalarial month is –
|
Antimalarial month is observed every year in month of June throughout the country, prior to the onset of mansoon and transmission season, to enhance the level of awareness and encourage community participation.
| 4
|
April
|
May
|
September
|
June
|
Social & Preventive Medicine
| null |
2df07de1-15f1-4261-b60f-2195f312f6ce
|
single
|
In which of the following immunodeficiencies, this chest X-ray finding is usually seen?
|
Chest X-ray: pneumonia with multiple pneumatoceles, suggestive of Staphylococcal pneumonia. Recurrent abscesses and staphylococcal infection is a feature of Hyper IgE syndrome. Wiskott-Aldrich syndrome- eczema, thrombocytopenia, recurrent infections Di George syndrome- cardiac anomaly, abnormal face, thymic hypoplasia, hypocalcemia Chediak Higashi syndrome- hypopigmented hairs, recurrent infections, ataxia
| 3
|
Wiskott-Aldrich syndrome
|
Di George syndrome
|
Hyper IgE syndrome
|
Chediak Higashi syndrome
|
Pediatrics
|
Primary Immunodeficiency
|
66eff514-c68d-4a74-bfca-3f2780b8a0f0
|
multi
|
Special visceral efferent DOES NOT involve
|
(D) Dorsal nucleus of X cranial nerveNUCLEI BELONGING TO COLUMNSGSEOculomotor, Trochlear, Abducent, Hypoglossal nucleiSVEMotor nucleus of V nerve Motor nucleus of VII nerve Nucleus AmbiguusGVEEW nucleus, Lacrimatory nucleus, Superior & Inferior salivatory nuclei, Dorsal vagal nucleusGVA/SVANucleus of Tractus solitariusGSASpinal, Principal sensory & Mesencephalic nuclei of V nerveSSAVestibular & Cochlear nuclei[?]III-Special Visceral (Branchial)Efferent (SVE) Column:Motor nuclei which supply musclesdeveloped from the pharyngeal arches, (Branchiomotor cell column).These are (5,7,9 & 10)Ambiguus nucleus, in Medulla (9,10 & cranial part of Accessory nerve)Motor Nucleus of the Trigeminal nerve, in the Mid pons.Motor nucleus of the Facial nerve in the Caudal pons.CRANIAL NERVE FUNCTIONAL COMPONENTSFunctional componentAbbreviation General FunctionCranial nerves containing componentGeneral somatic afferentGSAPerception of touch, pain, temperatureTrigeminal nerve (V); Facial nerve (VII); Vagus nerve (X)General visceral afferentGVASensory input from visceraGlossopharyngeal nerve (IX); Vagus nerve (X)Special afferentSASmell, taste, vision, hearing & balanceOlfactory nerve (1); Optic nerve (II); Facial nerve (VII); Vestibulocochlear nerve (VIII); Glossopharyngeal nerve (IX), Vagus nerve (X)General somatic efferentGSEMotor innervation to skeletal (voluntary) musclesOculomotor nerve (II); Trochlear nerve (IV); Abducent nerve (VI); Hypoglossal nsrve (XII)General visceral efferentGVEMotor innervation to smooth muscle, heart muscle & glandsOculomotor nerve (III); Facial nerve (VI); Glossopharyngeal nerve (IX); Vagus nerve (X)Branchial efferent**BEMotor innervation to skeletal muscles derived from pharyngeal arch mesodermTrigeminal nerve (V); Facial nerve (VII), Glossopharyngeal nerve (IX); Vagus nerve (X); Accessory nerve (XI)* Special sensory or Special Visceral Afferent (SVA) - smell, taste; special somatic afferent (SSA) - vision, hearing, balance.** Special Visceral Efferent (SVE) or branchial motor.Other Option[?]Nucleus AmbiguusRuns in a rostral to caudal direction in the medulla & is located in the ventrolateral reticular formation, posterior to the inferior olivary nuclear complex and anteromedial to the spinal trigeminal nucleus.[?]Dorsal nucleus of the Vagus nerve (or Posterior motor nucleus of Vagus)Is a cranial nerve nucleus for the vagus nerve in the medulla that lies ventral to the floor of the fourth ventricle.It mostly serves parasympathetic vagal functions in the gastrointestinal tract, lungs, and other thoracic and abdominal vagal innervations.The cell bodies for the preganglionic parasympathetic vagal neurons that innervate the heart reside in the nucleus ambiguus.Additional cell bodies are found in the nucleus ambiguus, which give rise to the branchial efferent motor fibers of the vagus nerve (CN X) terminating in the laryngeal, pharyngeal muscles & musculus uvulae.
| 4
|
Nucleus ambiguus
|
Motor nucleus of V cranial nerve
|
Motor nucleus of VII cranial nerve
|
Dorsal nucleus of X cranial nerve
|
Anatomy
|
Neuroanatomy
|
63fe1814-a414-4c20-8f21-03d23f0fefef
|
single
|
A 65 year old man was seen as an outpatient complaining of central chest pain on exeion. His son tells you that 5 years ago he had been admitted for MI in the CCU of the same hospital. His vitals are stable and chest is clear. No added hea sounds are heard. What is the next best step?
|
The ECG shows a hea of 60/min with normal sinus rhythm. Prominent Q waves are noted in lead III, AVF indicating a previous inferior wall MI. Markedly Peaked T waves are noted in V2 and V3. Known case of ASCVD and currently is having chronic stable angina. He needs stress tests to decide the need for revascularization procedure like PCI with Stenting or CABG.cardiac biomarkers will not be elevated since angina is going on .infarction has not yet occured. stress test will decide whether patient need cardiac intervention or not Check for daily intake of aspirin, Statins, Long acting nitrates and cardio-selective Beta Blockers
| 1
|
Perform Stress tests
|
Perform Cardiac biomarkers
|
Perform PCI
|
Perform Transvenous Pacing
|
Medicine
|
Acute coronary syndrome
|
6067c1c4-9eec-41c9-8799-c5361a25738d
|
multi
|
Swine flu is caused most commonly by -
|
<p> SWINE FLU:- Pandemic influenza A (H1N1). This differs from seasonal influenza in two ways. 1. Majority of population has little/no pre existing immunity to virus,the impact of the infection thus leading to wider range. 2. The virus infect the lower respiratory tract and can cause progressive pneumonia. Incubation period:- 2-3 days but can range upto 7 days. {Reference: park&;s textbook of preventive and social medicine, 23rd edition, pg no.156}</p>
| 1
|
H1N1
|
H5N1
|
H3N2
|
B virus
|
Social & Preventive Medicine
|
Communicable diseases
|
6f7bb4d4-e327-4710-8dc7-21992f14fadb
|
single
|
Uterine blood flow at term is?
|
The massively increased uterine blood flow necessary to maintain pregnancy is made possible by significant hyperophy and remodeling of all pelvic vessels. After delivery, their caliber diminishes to approximately the size of the pre pregnant state. Uterine blood flow is increased from 50 ml/min in non pregnant states to about 750 ml near term. The increase is due to the combined effect of utero-placental an feto-placental vasodilation. The vasodilation is due to smooth muscle relaxing effects of progesterone, oestrogen, nitric oxide, prostaglandins and ANP. Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 30. The Puerperium. In F.G. Cunningham, K.J. Leveno, S.L. Bloom, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e.
| 4
|
800-1200 ml/min
|
50-70 ml/min
|
175-200 ml/min
|
500-750 ml/min
|
Gynaecology & Obstetrics
| null |
05b03ceb-6996-4e75-b1d1-5d4b41ce004f
|
single
|
Area of brain involved in OCD: March 2004
|
Ans. A i.e. Basal ganglia
| 1
|
Basal ganglia
|
Temporal lobe
|
Cerebellum
|
All of the above
|
Psychiatry
| null |
787b6d79-57a0-429a-b339-c695354b2721
|
multi
|
All are true about congenital lymphedema except?
|
Ans. is 'None' Primary lymphedema has been classified on the basis of the age at onset and presence of familial clustering. a) Congenital lymphedema - has onset before the 1st year of life (according to Schwaz and Bailey onset is - congenital lymphedema can involve a single lower extremity, multiple limbs, the genitalia or the face (it is more likely to be bilateral & involve whole leg) the familial version of congenital lymphedema is k/a Milroy's ds. b) Lymphedema praecox primary lymphedema with onset b/w the age of 1 and 35 yrs is called lymphedema praecox this is the most common form of primary lymphedema accounting for 90% of cases praecox is far more common in women (10:1) - praecox lymphedema more likely to be unilateral and usually extends only to the knees (i.e. involves foot & calf) the familial version of lymphedema praecox is k/a Meige's ds. c) Lymphedema tarda primary lymphedema with onset after the age of 35 yrs is called lymphedema tarda
| 4
|
It is bilateral
|
Involve lower limb
|
Almost always manifests before pubey
| null |
Surgery
| null |
7dff67fd-cd99-4a0e-9fab-df5fa159d090
|
multi
|
Type of collagen in brain
|
Type XXV is present in the brain Reference: Harper; 30th edition; Page no: 628 Table no: 50-1
| 3
|
Type IV
|
Type VII
|
Type XXV
|
Type XXVI
|
Biochemistry
|
miscellaneous
|
1f3ac1ac-7607-46a1-9e9e-735a4c53d1ef
|
single
|
Which Congenital malformation of the fetus can be diagnosed in first trimester by ultrasound?
|
Ans. A. AnencephalyUltrasound can be used to detect anencephaly as early as 10 weeks' gestation. With an abnormal head/trunk ratio and abnormally large orbits, the absence of the superior vault is associated.The length of crown-rump is normal in most anencephalic fetuses.
| 1
|
Anencephaly
|
Iniencephaly
|
Microcephaly
|
Holoprosencephaly
|
Gynaecology & Obstetrics
|
Antenatal Care & Assessment of Fetal Well Being
|
ad8fe151-86ac-4b28-919f-5ee6f1fdc28a
|
single
|
Umbilical vesicle attains full development in -
| null | 2
|
2 week
|
4 week
|
6 week
|
7 week
|
Anatomy
| null |
46a4c1ed-9c91-4209-bce2-5dbb1eccff6f
|
single
|
A 44-year-old woman comes to her physician and complains of headache and backache. On examination, she is found to have fluid accumulated in the spinal epidural space because of damage to blood vessels or meninges. Which of the following structures is most likely ruptured?
|
The Internal Veebral Venous Plexus is located in the spinal epidural space. The veebral aery and vein occupy the transverse foramina of the upper six cervical veebrae. The external veebral venous plexus consists of the anterior pa, which lies in front of the veebral column, and the posterior pa, which lies on the veebral arch. The lumbar cistern is the enlargement of the subarachnoid space between the inferior end of the spinal cord and the inferior end of the subarachnoid space.
| 4
|
Veebral aery
|
Veebral vein
|
External veebral venous plexus
|
Internal veebral venous plexus
|
Anatomy
|
Back region
|
2e97b71e-5a3d-4593-9592-9929f2c6d4e3
|
single
|
The resting membrane potential depends mainly on gradient of
|
Ans. b (Potassium). (Ref. Ganong Physiology, 21st ed., 55, 56)Myocardial action potentialPhase 0Rapid upstrokeVoltage-gated Na-channels open.Phase 1Initial repolarizationInactivation of voltage-gated Na+ balances K+ effiux.Phase 2PlateauCa2+ influx through voltage-gated Ca2+ channels balances K+ efflux.Ca2+ influx triggers myocyte contraction.Phase 3Rapid repolarizationMassive K+ efflux due to opening of voltage gated slow K+ channels and closure of voltage-gated Ca2+ channelsPhase 4Resting potentialHigh K+ permeability through K+ channels
| 2
|
Sodium
|
Potassium
|
Chloride
|
Calcium
|
Physiology
|
General
|
b735bf17-7282-426a-afbc-0e8b1335bea1
|
single
|
Which hypolipidemic drug acts primarily by decreasing VLDL -
|
Ans. is'a'i.e., FibratesRef: KDT 6h/e p. 614; Harrison 18th/e ch. 356Fibrates (e.g. clofibrate) activate lipoprotein lipase, therefore, enhance lipolysis of triglycerides in VLDL.Statins and nicotinic acid also decrease VLDL but it is not their main mechanism of action.
| 1
|
Fibrates
|
Nicotinic acid
|
Statins
|
Cholestyramine
|
Pharmacology
| null |
72fac339-edf2-45f2-bc84-8a0a77043825
|
single
|
Chromic catgut suture has added advantage that is:
|
The chromic catgut contains the chromic salt solution to delay absorption.
| 1
|
Delayed resorption.
|
No resorption.
|
Early resorption.
|
Greater adherence.
|
Surgery
| null |
dfa14f0f-beb7-480e-a805-3af9376d968a
|
single
|
A homosexual person feels that "he is a woman trapped in a man's body" and has persistent discomfo with his sex. Most likely diagnosis is:
|
As mentioned in the question, the person is uncomfoable with his sex and feels that he is imposed by a female body (i.e., he is of another sex). Both are characteristics of gender identity disorder. TRANSEXUALISM: It is the severest form of gender identity disorders There is a sense of discomfo with anatomical sex organs & desires to get rid of them i.e., dissatisfaction with allotted sex. Phrases like - I am a male in female body or vice versa are quite characteristic of it. Observation for a long period of time is needed to be very ceain of diagnosis Treatment: Sex Reassignment Surgery (SRS) with hormonal treatment TRANSVESTISM: episodic cross dressing to have a sense of belonging to opposite sex-Dual role Transvestism Cross dressing to attain sexual excitement-Fetishistic Transvestism(occurs exclusively in heterosexual males) VOYEURISM: Also known as scopophilia. This is a persistent or recurrent tendency of watching others in the act of sex or undressing This is often followed by masturbation to achieve orgasm Almost always seen in males Watching pornography is not included here. PARAPHILIAS: These are disorders of sexual preference in which sexual arousal occurs persistently and significantly in response to objects which are not a pa of normal sexual arousal.
| 1
|
Trans - sexualism
|
Transvestism
|
Voyeurism
|
Paraphilias
|
Psychiatry
|
Sexual Disorders
|
7a574efa-6ad2-461e-aa8c-56606a9e2541
|
single
|
Targeted intervention programmes for HIV are done among the following group of people, EXCEPT:
|
The basic purpose of the targeted interventions for HIV is to reduce the rate of transmission of HIV among the most vulnerable population such as, Sex workers Intravenous drug users Homosexual men Truckers Migrant laborers Street children The main activities under these intervention projects are behaviour change, communication, treatment for STDs and creating an enabling environment that will facilitate behaviour change. Ref: Park's Textbook of Preventive and Social Medicine, 19th edition, Page 359.
| 4
|
Commercial sex worker
|
Migrant laborers
|
Street children
|
Industrial worker
|
Social & Preventive Medicine
| null |
09217876-b46a-447d-80bc-579c83b70eab
|
multi
|
Hypophosphatemia is seen in -
|
<p>Vitamin D-dependent rickets type I Rickets can be due to resistance to the action of vitamin D as well as to vitamin D deficiency. Vitamin D-dependent rickets type I, previously termed pseudovitamin D-resistant rickets , differs from true vitamin D-resistant rickets (vitamin D-dependent rickets type II, see below) in that it is less severe and the biochemical and radiographic abnormalities can be reversed with appropriate doses of the vitamin's active metabolite, 1,25(OH) 2 D 3 . Physiologic amounts of calcitriol cure the disease This finding fits with the pathophysiology of the disorder, which is autosomal recessive, and is now known to be caused by mutations in the gene encoding 25(OH)D-1a-hydroxylase. Both alleles are inactivated in all patients, and compound heterozygotes, harboring distinct mutations, are common. Clinical features include hypocalcemia, often with tetany or convulsions, hypophosphatemia, secondary hyperparathyroidism, and osteomalacia, often associated with skeletal deformities and increased alkaline phosphatase. Treatment involves physiologic replacement doses of 1,25(OH) 2 D 3 Vitamin D-dependent rickets type II Vitamin D-dependent rickets type II results from end-organ resistance to the active metabolite 1,25(OH) 2 D 3 . The clinical features resemble those of the type I disorder and include hypocalcemia, hypophosphatemia, secondary hyperparathyroidism, and rickets but also paial or total alopecia. Plasma levels of 1,25(OH) 2 D are elevated, in keeping with the refractoriness of the end organs. This disorder is caused by mutations in the gene encoding the vitamin D receptor; treatment is difficult and requires regular, usually nocturnal calcium infusions (harrison 18 pg 3117)</p>
| 3
|
Pseudohypoparathyropdism
|
CRF
|
Rickets
|
Hyperparathyroidism
|
Medicine
|
Endocrinology
|
8c361301-25cb-4ea5-9059-06ae62cc1dbf
|
single
|
X in the graph represents
|
Therapeutic index : LD50/ED50 Therapeutic window Range of steady-state concentrations of drug that provides therapeutic efficacy with minimal toxicity Therapeutic efficacy: Ability of a drug to activate a receptor and generate a clinical response is Therapeutic efficacy Therapeutic dose: Dose of a drug required to have a clinical response
| 3
|
Therapeutic index
|
Therapeutic dose
|
Therapeutic window
|
Therapeutic efficacy
|
Pharmacology
|
Pharmacodynamics
|
f2ec9119-f005-4471-ab60-e84a9c78a78f
|
single
|
True about valves in portal venous system -
|
Although demonstrable during fetal and early neonatal period, there are no valves in a portal vein and its tributaries in the postnatal period.
| 3
|
Present at the junction of superior mesenteric artery with the splenic artery
|
Within the portal vein only
|
The whole system is valveless
|
In the intrahepatic portion of portal vein
|
Anatomy
| null |
6c1460fc-3202-4530-968b-bb1a7b798c83
|
multi
|
All of the following are true regarding fluid resuscitation in burn patients except:
|
Ans. (a) Consider intravenous resuscitation in children with burns greater than 15% TBSA* More than 10% burns in children need fluid resuscitation.
| 1
|
Consider intravenous resuscitation 1 children with burns greater than 15% TBSA
|
Oral fluids must contain salts
|
Most preferred fluid is Ringer's lactate
|
Half of the calculated volume of fluid should be given in first 8 hours
|
Surgery
|
Plastic & Reconstructive Surgery
|
40cbab88-9b84-41c6-b2ea-d3bdfd4d24bb
|
multi
|
APC gene exes its effect in combination with which of the following
|
Regulation of beta-catenin preventsgenes that stimulate cell division from being turned on too often and prevents cell overgrowth. The humanAPC gene is located on the long (q) arm of chromosome 5 in band q22.2 (5q22.2). The APC gene has been shown to contain an internal ribosome entry site. Refer robbins
| 1
|
Beta catenin
|
E cadherin
|
Alpha catenin
|
BCX
|
Pathology
|
General pathology
|
5c7ee598-f85d-42c2-b848-eaab77d72301
|
single
|
Case notification under international health regulations is done for which of the following: September 2009
|
Ans. C: Yellow fever
| 3
|
Hepatitis B
|
HIV
|
Yellow fever
|
All of the above
|
Social & Preventive Medicine
| null |
4c0a6811-f929-4d9f-99a6-8348baad3947
|
multi
|
Delusion of grandeur, persecution and reference is seen in: PGI 09; UP 11
|
Ans. Paranoid schizophrenia
| 2
|
Catatonic schizophrenia
|
Paranoid schizophrenia
|
Simple schizophrenia
|
Disorganized schizophrenia
|
Forensic Medicine
| null |
b0d160be-07bf-435f-aee4-2b93d515c15e
|
single
|
Your patient with chronic renal failure reports pruritus. Which instruction should you include in this patient’s teaching plan?
|
Calcium-phosphate deposits in the skin may cause pruritus.
Scratching leads to excoriation and breaks in the skin that increase the patient’s risk of infection.
Keeping fingernails short and clean helps reduce the risk of infection.
| 4
|
Rub the skin vigorously with a towel
|
Take frequent baths
|
Apply alcohol-based emollients to the skin
|
Keep fingernails short and clean
|
Pathology
| null |
beb0adc6-f9df-47d6-bd5c-15f35d5365d2
|
single
|
During progression of normal pregnancy, S/D ratio in umblical aery ?
|
Ans. is 'a' i.e., DecreasesThe commonly used parameters in the umbilical aery doppler are:SD ratio: systolic velocity/diastolic velocityPulsatility index (PI) (Gosling index): (PSV - EDV)/ TAVResistive index (RI) (Pourcelot index): (PSV - EDV) / PSVNormally the parameters mentioned above should decrease progressively as the pregnancy advances, as there is increase in the end diastolic velocity due to growth and dilatation of umbilical circulation.Any detion in the parameters is suggestive of either IUGR or pre - eclampsia .Thus, during progressive monitoring of the umbilical aery Doppler, as the severity of the disease increases, we observe first:The decreased velocity in the end diastolic phaseThen absent flow in the end diastolic phase followed byReversal of flow in the end diastolic phase.
| 1
|
Decreases
|
Increases
|
Plateau
|
Not significant
|
Gynaecology & Obstetrics
| null |
dc9d097d-44a0-46a9-b056-b404482bb6ed
|
single
|
Most common site for carcinoma pharynx in females suffering from plummer vinson syndrome is
|
Ans. is 'a' i.e., Post cricoid Plummer-Vinson syndrome Plummer-Vinson syndrome, also known as Brown-Kelly-Paterson syndrome or sederopenic dysphagia, seen in middle aged edentulous women. The plummer Vinsion Paterson Brown Kelly Syndrome is characterized by : - Dysphagia Chronic iron deficiency anemia Atrophic oral mucosa and glossitis Brittle, spoon-shaped fingernails (Koilonychia) The cause of dysphagia is usually a cervical esophageal web, but abnormal pharyngeal and esophageal motility may play a role. The syndrome characterstically occurs in middle aged edentulous (without teeth) women. It is a premalignant lesion. Approximately 10% of patient develop squamous cell Ca of esophagus, oral cavity or the hypopharynx. As iron-deficiency anemia is a common finding, it is also known as sideropenic dysphagia. Carcinoma develops in post-cricoid region.
| 1
|
Post cricoid region
|
Posterior wall
|
Lateral wall
|
Pyriformis fossa
|
ENT
| null |
af688c5f-be15-4099-9c0c-14ffceea6ace
|
multi
|
All of the following are the movements taking place during abduction of shoulder joint, EXCEPT?
|
Abduction of the shoulder joint is a complex movement in which the arm is carried forwards and laterally in the plane of scapula and then raised until it is directed veically above the shoulder thereby completing a movement of 180 degree. The movement involves not only the shoulder joint but requires the lateral rotation of scapula on the chest wall which is accompanied by associated movements at the sternoclavicular and acromioclavicular joints of the shoulder girdle and elevation of humerus.
| 1
|
Medial rotation of scapula
|
Axial rotation of humerus at acromioclavicular joint
|
Elevation of humerus
|
Movements at clavicular end of sternoclavicular joint
|
Anatomy
| null |
26d89146-7348-4353-bf18-6e99b52718fb
|
multi
|
A 25 year old woman complaints of bilateral hearing loss since 4 years which worsened during pregnancy. Type of tympanogram will be
|
answer: b) As (DHINGRA 6TH ED, P-24* Type A- normal tympanogram* Type As- (Low compliance) otosclerosis, malleus fixation* Type AD- (High compliance) ossicular discontinuity or thin and lax tympanic membrane* Type B- (No Change in compliance with pressure changes) middle ear fluid, thick tympanic membrane.* Type C- (Maximum compliance occurs with negative pressure in excess of 100 mm of H2O) retracted tympanic.OTOSCLEROSIS or OTOSPONGIOSIS* Disease of bony labyrinth where spongy bone replaces normal enchondral layer of bony otic capsule* Most often the otosclerotic focus involves stapes leading to stapes fixation and CHLEtiology* Family history present* Autosomal dominant* Common in Indians; Age 20-30 yrs* Females affected twice more than males.* But in India males are more affected* May be initiated or made worse by pregnancy, menopause, after an accident or a major operation* Van der hoeve syndrome- triad of Osteogenesis imperfecta, Blue sclera and Otosclerosis* Virus involved - Measles virusTypes* Stapedial otosclerosis causing stapes fixation and CHL is the most common variety* Fistula ante fenestrum - in front of oval window is the site of predilection (anterior focus)* Cochlear otosclerosis - causes SNHLMicroscopic* Immature focus - vascular spaces, osteoclasts, osteoblasts & fibrous tissue - stains blue on HE staining (Blue mantles of Manasse)* Mature focus - less vascular with lot of fibrous tissue and few osteoblasts - stains red on HE stainingSymptoms and Signs* Hearing loss - painless progressive bilateral CHL* Paracusis willisi - hears better in noisy surroundings* Tinnitus, Vertigo, Monotonous soft speech* TM - normal and mobile* Schwartz sign - flamingo pink blush or reddish hue seen on the promontory through TM - indicates active focus* TFTs- negative Rinne, Weber lateralized to the ear with greater hearing loss* In some cases a dip in the bone conduction curve appear at 2000Hz which disappears after successful stapedectomy (Carhart's notch)* Bezold's triad - absolute negative Rinne's, raised lower tone limit, prolonged bone conductionTreatment* Medical- Sodium fluoride* Surgical: Stapedectomy/ Stapedotomy with a placement of prosthesis - treatment of choiceSelection of patients for Stapes surgery* Hearing threshold for air conduction should be > 30 DB* Average air-bone gap should be atleast 15 DB* Rinne negative for 256 and 512 Hz* Speech discrimination score > 60%
| 2
|
Ad
|
As
|
C
|
B
|
ENT
|
Ear
|
926ee788-b6a0-415a-ac99-06338e814400
|
single
|
Peripoal fatty infiltration of liver is seen with
|
MORPHOLOGIC FEATURES. The pathologic features are common to both HBV and HCV infection and include the following lesions 1.Piecemeal necrosis. Piecemeal necrosis is defined as peripoal destruction of hepatocytes at the limiting plate (piecemeal = piece by piece). Its features in chronic hepatitis are as under: i)Necrosed hepatocytes at the limiting plate in peripoal zone. ii)Interface hepatitis due to expanded poal tract by infiltration of lymphocytes, plasma cells and macrophages. iii)Expanded poal tracts are often associated with proliferating bile ductules as a response to liver cell injury. 2.Poal tract lesions. All forms of chronic hepatitis are characterised by variable degree of changes in the poal tract. i)Inflammatory cell infiltration by lymphocytes, plasma cells and macrophages (triaditis). ii)Proliferated bile ductules in the expanded poal tracts. iii)Additionally, chronic hepatitis C may show lymphoid aggregates or follicles with reactive germinal centre TEXT BOOK OF HARSH MOHAN SIXTH EDITION PAGE.611 IMAGE REF: TEXTBOOK OF HARSH MOHAN SIXTH EDITION FIG:21-13 PAGE 612
| 2
|
Alcoholism
|
Viral hepatitis
|
Malnutrition
|
Tetracycline
|
Pathology
|
G.I.T
|
272af7f7-d14e-4d0e-a171-2edf05820529
|
single
|
Which among the following is the smallest diameter of true pelvis?
|
Interspinous or bispinous diameter is the distance between the tip of the two ischial spines. It measures 10.5 cm. Diagonal conjugate is the distance between the lower border of symphysis pubis to the midpoint on the sacral promontory. It measures 12 cm. True conjugate or anatomical conjugate or conjugate vera is the distance between the midpoint of the sacral promontory to the inner margin of the upper border of symphysis pubis. It measures 11 cm. Inteuberous diameter is the distance between the inner borders of ischial tuberosities. It measures 11 cm. Ref: Textbook of Obstetrics by D C Dutta, 6th edition, Page 91.
| 1
|
Interspinous diameter
|
Diagonal conjugate
|
True conjugate
|
Inteuberous diameter
|
Gynaecology & Obstetrics
| null |
ba4f4eb8-32d2-4e6c-a39e-cd3b2a7e168e
|
multi
|
A 25-yr man C/O recurrent episodes of flexural eczema, contact urticaria, recurrent skin infections & severe abdominal cramps & diarrhea upon taking sea foods. He is suffering from:
|
Ans. B. Atopic dermatitisAtopic dermatitis is a very common, extremely itchy disorder of unknown cause which characteristically, but not always, affects the face and flexures of infants, children, adolescents and young adults. Foods, inhaled allergens, bacterial infection, reduced humidity; excessive sweating and irritants cart exacerbate pruritus and scratching.
| 2
|
Seborrheic dermatitis
|
Atopic dermatitis
|
Airborne contact dermatitis
|
Nummular dermatitis
|
Skin
|
Dermatitis Erythema
|
7764514c-7847-45c0-b3ff-130210105bab
|
single
|
The following is used for testing absorption in intestine-
|
Ans. is 'a' i.e.. Xylose D-xylose test : Xylose absorption test is the most commonly employed test for carbohydrateQ absorption.D - Xylose TestAim :o Assessment ofproximal small intestinal mucosal function6.Principle :o D - Xylose is a carbohydrate absorbed almost exclusively in the small intestineQ.o It does not require pancreatic enzymes for its digestion. So. if there is any decrease in its level in urine. It indicates abnormalityQ in carbohydrate absorption in proximal intestine.Procedure:o 25g of D - xylose is given to the patient, then urine is collected after 5 hours Xylose le\>el is measured in the urine.Result:o Presence of D- xylose less than 4.5g reflects the presence of duodenal jejunal mucosal disease.Clinical implication of D - Xylose TestUrine D - Xylose is decreased inD - Xylose Test is normal in the following conditionso Intestinal malabsorptionQo Impaired renal functionQo Small bowel ischemiaQo Whipple s diseaseo Viral gastroenteritiso Bacterial overgrowthQ in small intestineo Malabsorption due to pancreatic insufficiencyQo Post gastrectomyQo Malnutrition
| 1
|
Xylose
|
Sucrose
|
Fructose
|
Maltose
|
Medicine
|
Intestine
|
3ab8036b-559a-4de6-92ed-c36ce4a90d0d
|
single
|
Arrange the following statements in order: Regarding slit skin smear steps: 1. Clean the site with methyl alcohol and pinch the skin tightly using thumb and index finger. 2. Fix the smear by moving the slide briefly over flame. 3. Make a cut on the skin fold using a scalpel and scrape out the fragments of tissue and fluid. 4. Spread the material obtained on a clean slide to make a smear of 8-10mm diameter. 5. Mark the slide with patient's identification number.
|
Steps of slit skin smear: 1. Mark the slide with patient's identification number. 2. Clean the site with methyl alcohol and pinch the skin tightly using thumb and index finger. 3. Make a cut on the skin fold using a scalpel and scrape out the fragments of tissue and fluid. 4. Spread the material obtained on a clean slide to make a smear of 8-10mm diameter. 5. Fix the smear by moving the slide briefly over flame.
| 1
|
5-1-3-4-2
|
2-4-3-5-1
|
5-1-3-2-4
|
4-3-5-2-1
|
Dental
|
Mycobacterial Infections
|
a523a8a3-e953-4451-bf4b-1446d5ecb310
|
multi
|
Which of the following is seen in APGAR score?
|
Ans: a (Colour) Ref: Nelson, 18th ed, p. 879; OPGhai, 6th ed, p. 144Parameters used in APGAR score* Respiratory effort* Heart rate / min* Colour of the body* Muscle tone* Reflex stimulationAPGAR score is a semi objective measure of assessing the infants respiratory, circulatory and neurological status at birthNormal babies have an APGAR score of 9 at one and five minutesAPGAR score between 4-8 is moderately low while that less than 4 is very lowMost important cause of cardiopulmonary, neurological depression indicated by low APGAR score is birth asphyxiaInfants with low 5 minute APGAR score should be monitored for manifestation of hypoxic ischaemic encephalopathy.
| 1
|
Colour
|
Bilirubin
|
Blood group
|
Respiratory rate
|
Pediatrics
|
New Born Infants
|
21406f7e-2534-494b-9768-fcd09535ea51
|
single
|
Retinal detachment occurs in which layer?
|
Sensory retina REP: Khurana 4th ed p. 275 "Retinal detachment is defined as separation of neurosensory retina from pigmentary retina"
| 1
|
Sensory retina
|
Pigmentary retina
|
Inner nuclear layer
|
Outer plexiform layer
|
Ophthalmology
| null |
25e9e3df-46e0-46e2-bc21-3f0d22287e24
|
single
|
Culture media used for O157 : H7 Entero- hemorrhagic E coli -
|
Ans. is 'a' i.e.. Sorbitol containing agar Culture of 0157: H7 E.colio E.coli 0157:H7 is not identified on routine stool cultures.o E.coli 0157:H7 can be specifically detected by the use of modified Mac Conkey media which containssorbitol in place of lactose (SMAC).o Sorbitol Mac Conkey media is specifically useful for the detection of E.coli 0157:H7 as unlike most strains of E. coli, the 0157: H7 strain does not ferment sorbitol.o Non fermenting colonies on a Sorbitol Mac Conkey plate (SMAC) therefore suggest the diagnosis of E.coli 0157:H7.o Sorbitol Mac Conkey media is the screening method of choice for E.coli Ol57:H7.
| 1
|
Sorbitol containing agar
|
Mannitol containing agar
|
Sucrose containing agar
|
Dextrose containing agar
|
Microbiology
|
Enterobecteriaceae
|
7d8f3fae-a714-4421-9210-fe57988606d6
|
single
|
Mechanism of action of Acyclov ir is
|
(D) Inhibitor of HSV polymerase # Mechanism of action:> Acyclovir differs from previous nucleoside analogues in containing only a partial nucleoside structure: the sugar ring is replaced with an open-chain structure. It is selectively converted into acyclo-guanosine monophosphate (acyclo-GMP) by viral thymidine kinase, which is far more effective (3000 times) in phosphorylation than cellular thymidine kinase.ANTIVIRAL AGENTS ACTIVE AGAINST HERPESVIRUSESAgentDescription* AcyclovirInhibits HSV polymerase* FamciclovirProdrug of penciclovir (a guanosine analogue)* ValacyclovirProdrug of acyclovir; better absorption* GanciclovirMore potent polymerase inhibitor; more toxic than acyclovir* ValganciclovirProdrug of ganciclovir; better absorption* CidofovirNucleotide analogue of cytosine* FoscarnetPhosphonoformic acid; inhibits viral DNA polymerase
| 4
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Inhibitor of viral DNA polymerase
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Inhibitor of viral thymidine kinase
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Inhibitor of viral reverse transcriptase
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Inhibitor of HSV polymerase
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Pharmacology
|
C.N.S
|
8e840bab-f4a2-47a6-a9c1-a2d4087343ee
|
single
|
If the tooth has not erupted to the line of occlusion it is called:
| null | 4
|
Supraversion
|
Torsiversion
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Rotated
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Infraversion
|
Dental
| null |
b9991123-5d85-4a48-932d-a5045edf0cef
|
multi
|
42 years old female presents diagnosed as iron deficiency anemia was staed on oral iron therapy and her Hb condition during review was 8 g%. The cause for failure of treatment is
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. Poor compliance to oral iron
| 3
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Acquired sideroblastic anemia
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Inadequate iron dosage
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Poor compliance to oral iron
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Folate deficiency
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Pathology
| null |
a53546c7-1ea7-46bd-b171-8bb4e763ce9e
|
single
|
The structure marked with arrow is:
| null | 1
|
Coronary artery
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Pulmonary artery
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Arch of aorta
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Pulmonary vein
|
Medicine
| null |
09ebf14f-a01f-48ff-a70d-b6d14ba6b026
|
single
|
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