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A patient died and relatives complain that it is due to the negligence of the doctor. According to a recent Supreme court judgment, the doctor can be charged for Medical Negligence under section 304-A, only
|
According to a recent supreme court judgment, the doctor can be charged for medical negligence
Under section 304-A IPC (i.e. criminal negligence), only if he shows gross lack of competence/skill, gross inattention, or inaction or recklessness or wanton (gross) indifference to the patient's safety or, gross negligence.
| 3
|
If he is from corporate hospital
|
If negligence is from inadvertent error
|
Gross negligence
|
Res ipsa Loquitur
|
Forensic Medicine
| null |
9dcd42c3-2a9c-488b-92dc-a850cf24aefc
|
single
|
Arsenic poisoning presents with symptoms mimicking -
|
Arsenic poisoning present with symptoms mimicking cholera. The differences are -
| 1
|
Cholera
|
Dhatura poisoning
|
Barbiturates poisoning
|
Morphine poisoning
|
Forensic Medicine
| null |
9cf16220-eae1-4074-8bfd-bf736c92ccda
|
single
|
The length of a muscle at which tension is maximum is called:
|
When a muscle at rest is stretched, its sarcomere length is changed. When this muscle is made to contract from the various lengths at rest, contractile force developed varies according to the actin-myosin interaction possible within the sarcomere. Resting length of sarcomere = 2 m. This is Li or length initial. Contractile force increases as muscle length is increased up to a point. Sarcomere length of 2.2 m obtains maximum force of contraction. (Starling's law: Greater the fiber length, stronger will be the contractile force). This is Lo or length optimum. At this length, there is optimum interdigitation between actin and myosin.
| 3
|
Active length
|
Resting length
|
Optimal length
|
Maximal length
|
Physiology
|
Muscle
|
05adec56-c65d-4f70-a86a-639c94297271
|
multi
|
All of the following are the diseases occurring due to disturbance in lipid metabolism except:
|
Hurler syndrome is due to the disturbance in mucopolysaccharide metabolism.
| 3
|
Gaucher’s Disease
|
Niemann-Pick Disease .
|
Hurler syndrome.
|
Letterer-Siwe Disease.
|
Pathology
| null |
09c835b3-838d-44b9-ae64-78e69984e51c
|
multi
|
in bogorad syndrome damage to the parasympathetic fibres of fascial nerve takes place ?
|
BOGORAD SYNDROME OR CROCADILE TEAR SYNDROME : damage to Para sympathetic fibres occurs before the geniculate ganglion APPLIED ASPECTS Crocodile tears syndrome/ Bogorad&;s syndrome" uncommon consequence of nerve regeneration subsequent to Bell&;s palsy or other damage to the facial nerve in which efferent fibers from the superior salivary nucleus become improperly connected to nerve axons projecting to the lacrimal glands (tear ducts), causing one to shed tears (lacrimate) during salivation while smelling foods or eating. Presumed that one would also salivate while crying due to the inverse improper connection of the lacrimal nucleus to the salivary glands, but less noticeable. ref : bd chaursia/ harrisons 21st ed
| 2
|
at parotid gland
|
before entering in to stylomastoid foramen
|
just before geniculate ganglion
|
before entering into internal auditory meatus
|
Anatomy
|
All India exam
|
e8aa49e5-8e21-4ef4-9692-f4fa11e3139d
|
single
|
In cotrimoxazole, sulphamethoxazole and trimethoprim are in ratio of:
|
5:01
| 3
|
2:01
|
1:01
|
5:01
|
4:05
|
Pharmacology
| null |
1f034f37-1169-460b-b588-3f9f4001284f
|
single
|
What is Ranula -
|
Ans. is 'a' i.e., Retention cyst of sublingual gland
| 1
|
Retention cyst of sublingual gland
|
Retention cyst of submandibular gland
|
Extravasation cyst of sublingual glands
|
Extravasation cyst of submandibular glands
|
Surgery
| null |
2d0272fa-58e4-4efa-950b-070732fff29c
|
single
|
What is the significance of mutation of CCR5 protein?
|
The answer to this question is definitely 'A'.Let me explain why. HIV infects T cells that carry CD4 antigen on their surface i.e CD4 T cells.In addition HIV can also affect macrophages that bear CD4 on their surface. The first step in the HIV infection is the binding of envelope glycoprotein of HIV to the CD4 receptor on the T cells/macrophages.How ever this interaction alone is not sufficient for entry and infection of the virus. It needs a second receptor i.e a co-receptor.HIV has two coreceptors- CCR5 CXCR4. Therefore HIV must bind to CD4 receptor and one of the above coreceptor to enter into the cell. Any damage to these coreceptors will prevent HIV from entering the cell, thus leading to resistance to HIV infection. A well known example is a mutation of CCR5 which is called delta 32 mutation. Those persons with this mutation is resistant to HIV infection because HIV virus cannot bind to this mutated CCR5 and therefore cannot enter the cell.
| 1
|
High resistance to HIV infection
|
High susceptibility to HIV infection
|
Causes resistance to anti retroviral therapy
|
Causes increased virulence of the virus
|
Medicine
| null |
ec0f647a-3c8b-4522-9e3a-79dd029cb8fe
|
single
|
Neonatal polycythemia with hyperviscosity is associated with all except
|
Fetal macrosomia in gestational diabetes is associated with neonatal polycythemia.
| 2
|
Twin - Twin transfusion syndrome
|
Fetal microsomia in gestational diabetes
|
Fetal and placental growth restriction
|
Transfusion at delivery
|
Gynaecology & Obstetrics
| null |
6b64b566-0b14-4001-aced-aba6dfdcda2c
|
multi
|
What is the diagnosis in this patient with abdominal pain?
|
Answer C. Lead poisoningThe blue lines evident on the gums are Burton's lines, which can be present in patients with lead poisoning. The diagnosis of occupational lead poisoning was confirmed by an elevated serum lead level. The patient recovered following chelation therapy.
| 3
|
Amyloidosis
|
Familial Mediterranean fever
|
Lead poisoning
|
Leukemia
|
Medicine
|
Disorder of Metabolism & Connective Tissue
|
eb4ad003-cabb-488c-9087-e897a93e34ea
|
single
|
Selective grinding for equilibrating complete dentures is best accomplished after processing when the dentures are:
| null | 2
|
Rearticulated using original jaw relation record
|
Rearticulated with a new series of jaw relation
|
Equilibrated in the patients mouth
|
Spot ground in the patients mouth
|
Dental
| null |
26488059-0733-4568-9ff9-50ba17756bc3
|
single
|
A hypeensive patient Sattu already receiving a drug 'X' to control his BP was prescribed a tricyclic antidepressant. This resulted in the abolition of the antihypeensive action of 'X'. Which of the following drug can be 'X'?
|
(Ref: KDT 6/e p444) TCAs abolish the antihypeensive effect of guanethidine and Clonidine by inhibiting their transpo into the adrenergic neurons.
| 2
|
Enalapril
|
Clonidine
|
Atenolol
|
Diltiazem
|
Anatomy
|
Other topics and Adverse effects
|
8e5c45c9-01f3-4764-bf9f-ab40adb73dd1
|
single
|
Methylene blue test is used to detect
|
Methylene blue test is used to detect Microorganisms.
| 1
|
Microorganisms
|
Sucrose
|
Fats
|
All of the above
|
Medicine
| null |
dc858177-b31e-4ba3-9be8-1523cda40740
|
multi
|
Post coital test detects all of the following. Except:
|
Ans. is 'a' fallopian tube block. (Shaws, 13/e, p 202, 210 (12/e, p. 158, 164))Postcoital test can be used to study the properties of cervical mucus i.e.,. its capability to allow sperm penetration and presence of antisperm antibodies and also about ovulation.Study of cervical mucus has nothing to do with fallopian tube patency.Fallopian tube patency is checked by -Hysterosalpingography*CO2 - insufflation test*Laparoscopic chromotubationSalpingographyHysteroscopyTranscervical fallo scopyAmpullary and fimbrial salpingoscopy
| 1
|
Fallopian tube block
|
Cervical factor abnormality
|
Sperm count
|
Sperm abnormality
|
Gynaecology & Obstetrics
|
Pathology of Conception
|
2c088222-33e6-41a8-8220-98193594e0a7
|
multi
|
All of the following are TRUE about ASO titre, EXCEPT:
|
The antistreptolysin O (ASO) titer is the most commonly used streptococcal antibody test to establish a recent streptococcal infection. It is not a major criteria but, suppoing evidence of antecedent group A streptococcal infection. An ASO titer of 240 Todd units or higher in adults or 320 Todd units or higher in children is considered modestly elevated. ASO titers above 500 Todd units are uncommon in healthy individuals and therefore would serve as evidence of a recent streptococcal infection. Ref: Jaggi P., Shulman S.T. (2013). Chapter 52. Rheumatic Fever. In J.B. Imboden, D.B. Hellmann, J.H. Stone (Eds), CURRENT Diagnosis & Treatment: Rheumatology, 3e.
| 3
|
ASO can be increased in school children
|
May be negative in post streptococcal glomerulonephritis
|
ASO titre included in major criteria in jones criteria
|
May not be elevated in 20% cases of carditis
|
Pediatrics
| null |
b82939f5-7305-4d02-a8dc-69dc47fa015d
|
multi
|
Korner's septum is seen in:
|
Petrosquamous suture
| 1
|
Petrosquamous suture
|
Temporosquamous suture
|
Petromastoid suture
|
Frontozygomatic suture
|
Anatomy
| null |
7298623c-3f7d-4547-9195-7e4a2a95b705
|
single
|
True statement about Coarctation of the Aorta includes
|
(A) Lower limb pulses are barely palpable or absent> Coarctation of the aorta, or aortic coarctation, is a congenital condition whereby the aorta narrows in the area where the ductus arteriosus (ligamentum arteriosum after regression) inserts.> Coarctation is about twice as common in boys as it is in girls, it s common in girls who have Turner syndrome.Arterial hypertension in the arms with normal to low blood pressure in the lower extremities is classic.> Poor peripheral pulses in the legs and a weak femoral artery pulse may be found in severe cases.Post-stenotic dilation of the aorta results in a classic 'figure 3 sign' on x-ray.> An untreated coarctation may also result in hypertrophy of the left ventricle.
| 1
|
Lower limb pulses are barely palpable or absent
|
Blood pressure is elevated distal to the lesion and reduced proximal to it
|
The condition is twice as common in females as males
|
Hypertrophy of the lower ribs may be seen in older children
|
Medicine
|
Miscellaneous
|
e49ed7cd-aabd-476e-8d7e-fab251f39b6d
|
multi
|
Outdated drugs and cytotoxic wastes are disposed by:
|
Destruction and disposal
| 2
|
Dumping
|
Destruction and disposal
|
Store for month and burial
|
Incineration
|
Social & Preventive Medicine
| null |
2187f3e4-b243-41cd-856c-5b8327b5540e
|
single
|
10 year old boy complaints of pain in right arm near the shoulder, x-ray shows expansile lytic lesion in upper third of humerus, what is the likely diagnosis.
| null | 2
|
Aneurysmal Bone cyst
|
Simple bone cyst
|
Giant cell tumor
|
Osteosarcoma
|
Orthopaedics
| null |
77bdb7cc-11c1-4571-9405-86e0674b6c83
|
single
|
Abandoning a child is punishable under which section of IPC ?
|
Ans. is 'b' i.e., 317 317 IPC: Abandoning a child (7 years imprisonment +- fine)Offences related to abortion and child birth* 312,313, 314 and 315IPC: For causing voluntary miscarriage (criminal abortion).# 312 IPC: Causing miscarriage with consent (3 years of imprisonment +- fine).# 313 IPC : Causing miscarriage without consent of lady (10 years of imprisonment which can extend up to life +- fine).# 314 IPC: Death of patient caused by miscarriage (10 years of imprisonment +- fine).# 315 IPC: Death of child during miscarriage (10 years imprisonment +- fine).* 316 IPC: Death of quick unborn child by act amouting to culpable homicide (10 years imprisonment + fine).* 317 IPC: Abandoning a child (7 years imprisonment +- fine).* 318 IPC: Concealment of birth by secret disposal of dead body (2 years imprisonment +- fine).Other options* Kidnapping & abduction - IPC 361-369* Voluntary causing grievous hurt - IPC 322* Attention & abetment to suicide- IPC 306
| 2
|
320
|
317
|
323
|
84
|
Forensic Medicine
|
Law & Medicine, Identification, Autopsy & Burn
|
de70db00-1d5a-4c9b-8a76-d32115c813c3
|
single
|
All the following decrease skeletal muscle tone by CNS effects except:
| null | 1
|
D-tubocurarin
|
Diazepam
|
Beclofen
|
Mephensin
|
Pharmacology
| null |
4bc83351-c735-49df-8ebb-be694e94b631
|
multi
|
Only mycobacteria which produces exotoxin -
|
Ans. is 'c' i.e., M. Ulcerans * Buruli ulcer is caused by M. ulcerans.* It is the only mycobacteria producing a toxin.
| 3
|
M. tuberculosis
|
M. Ajarinum
|
M. Ulcerans
|
M.Bavis
|
Microbiology
|
Bacteria
|
45c775dc-00dd-4526-b78e-3a440ec6477b
|
single
|
Arrange following pas of Anesthesia machine according increasing pressure system wise i) Vaporize mounting devices ii) Hanger yoke assembly iii) Flow indicators iv) Pipe line indicator
|
Anesthesia machine according increasing pressure system iii) Flow indicators i) Vaporize mounting devices iv) Pipe line indicator ii) Hanger yoke assembly
| 1
|
(iii), (i), (iv), (ii)
|
(i), (iv), (iii), (ii)
|
(ii), (i), (iii), (iv)
|
(iii), (iv), (ii), (i)
|
Anaesthesia
|
Anesthesia Machine
|
5a2a168a-f486-43b3-9e20-e08790893530
|
single
|
Most common cause of Genital Herpes
|
Both HSV-1 and 2 can cause genital and oral - facial infection but reaction at oral - facial site is more common with HSV-1 and at the genital site with HSV-2
| 2
|
HSV-1
|
HSV-2
|
HSV-3 (VZV)
|
HSV-4 (EBV)
|
Microbiology
| null |
fa72a3bf-43ec-48f2-b193-8087cf123183
|
single
|
Forced diuresis with acidification or alkalinization of urine is a common method for elimination of certain poisons/drugs from the body. The elimination of which of the following drugs is commonly enhanced by alkaline diuresis -
|
Amongst the give options, alkaline diuresis is used in barbiturate (phenobarbitone) poisoning.
| 2
|
Amphetamines
|
Phenobarbitone
|
Phencyclidine
|
Theophylline
|
Forensic Medicine
| null |
8940eb7b-eff3-48d7-933b-fff98c87c48b
|
single
|
Fluent Aphasia with preserved comprehension and impaired repetition is:
|
Answer is D (conduction): Conduction Aphasia is a 'Fluent' Aphasia with preserved comprehension and impaired Repetition. Clinical Syndrome Non-Fluent Aphasias Fluent Aphas'as Features Transcoical Motor Wernicke's Transcoical Sensory Fluent No No No No Yes Yes Yes Yes Comprehension No No Yes Yes Yes Yes No No Repeat No Yes Yes No Yes No No Yes
| 4
|
Broca's
|
Wernicke's
|
Anomie
|
Conduction
|
Medicine
| null |
dd09d3bf-b2c9-4863-9265-d1cd15dcba0a
|
single
|
Dosage of Vitamin-A for children between 1-3 years
|
In settings where vitamin A deficiency is a public health problem** (prevalence of night blindness is 1% or higher in children 24-59 months of age or where the prevalence of vitamin A deficiency (serum retinol 0.70 umol/l or lower) is 20% or higher in infants and children 6-59 months of age), high-dose vitamin A supplementation is recommended in infants and children 6-59 months of age. Suggested vitamin A supplementation scheme for infants children 6-59 months of age Target group Infants 6-11 months of age (including HIV+) Children 12-59 months of age (including HIV+) Dose 100 000 IU (30 mg RE) vitamin A 200 000 IU (60 mg RE) vitamin A Frequency Once Every 4-6 months Route of administration Oral liquid, oil-based preparation of retinyl palmitate or retinyl acetatea Settings Populations where the prevalence of night blindness is 1% or higher in children 24-59 months of age or where the prevalence of vitamin A deficiency (serum retinol 0.70 mmol/l or lower) is 20% or higher in infants and children 6-59 months of age IU, international units; RE, retinol equivalent. a. An oil-based vitamin A solution can be delivered using soft gelatin capsules, as a single-dose dispenser or a graduated spoon (2). Consensus among manufacturers to use consistent colour coding for the different doses in soft gelatin capsules, namely red for the 200 000 IU capsules and blue for the 100 000 IU capsules, has led to much improved training and operational efficiencies in the field. Ref :
| 2
|
5,00,000 IU
|
2,00,000 IU
|
1,00,000 IU
|
3,00,000 IU
|
Pediatrics
|
Nutrition
|
2b40505c-97e3-4a91-8720-a5ecfdfe135f
|
single
|
'Ring sign' is seen in: September 2003
|
Ans. A i.e. Scurvy
| 1
|
Scurvy
|
Congenital syphilis
|
Gaucher's disease
|
All of the above
|
Surgery
| null |
e3a736e8-958d-469f-b48f-1dde766f914a
|
multi
|
The line joining ant. sup iliac spine to ischial tuberosity and passes a greater trochanter -
|
Nelaton's line :
With the hip in 90 degree of flexion, a line joining the ASIS and ischial tuberosity passes through the tip of the greater trochanter on that side.
In cases of supratrochanteric shortening the trochanter will be proximal to this line.
Shoemaker's line :
With the patient lying supine, the line joining ASIS and tip of the greater trochanter is extended on the side of the abdomen on both sides.
Normally these lines meet in the middle above the umblicus.
In case one of the greater trochanters has migrated proximally the lines will meet in the opposite side of the abdomen and below the umblicus.
Chiene's line :
With the patient lying supine, lines are drawn joining the two ASIS and the two greater trochanters.
Normally these make two parallel lines. In case one of the trochanters has moved proximally the lines will converge on that side.
Perkin's line :
When the congenital Dislocation of hip is mild in nature, the perkins lines are drawn to detect it.
A horizontal line is drawn through the triradiate cartilage and a vertical line is drawn down from the outer edge of the acetabulum on both sides.
The upper femoral epiphyses normally lies medial to the vertical line and below the horizontal line.
But in congenital dislocation of hip the epiphyses will lie on the outer aspect of the vertical line and above the horizontal line.
Bryants triangle :
The patient lies supine.
The tips of the greater trochanter and ASIS on both sides are marked.
A perpendicular is dropped from each ASIS on to the bed. From the tip of the greater trochanter, another perpendicular is dropped on to the first one. The tips of the greater trochanter are joined to the ASIS on the respective side. This forms a triangle ABC.
The side BC of the triangle measures supra trochanteric shortening of the hip.
| 1
|
Nelaton's line
|
Showmakers line
|
Chiene's
|
Perkins line
|
Orthopaedics
| null |
856a3c7c-cba6-41fd-946a-3931f03e1ee2
|
single
|
Ulceration of the vulva is commonly seen in all except :
|
ULCERS OF THE VULVA STD related idiopathic tuberculosis malignancy systemic syphilis herpes genitalis chancroid granulomainguinale lymphogranuloma venerum Bechet&;s disease aphthous ulcers lipschutz ulcers tubercular SCC Malignant melanoma basal cell carcinoma leukemia choriocarcinoma SLE Chron&;s disease Lichen planus lichen sclerosis sjogren&;s syndrome D.C.DUTTA&;S TEXTBOOK OF GYNAECOLOGY,Pg no:262,6th edition
| 1
|
Bacterial vaginosis
|
Syphilis
|
Chancroid
|
Behcet's disease
|
Gynaecology & Obstetrics
|
Infections of the genital tract
|
0a62be0c-2396-425d-83b4-54a2177105ba
|
multi
|
Which of the following is included as "proximate principles" of nutrition?
|
Macronutrients are also known as proximal principles of nutrition as they form the major bulk of food consumed by us. Macronutrients include carbohydrates, proteins and fats. Ref: Park's, 21st Edition, Page 562.
| 3
|
Iron
|
Vitamin A
|
Carbohydrate
|
Calcium
|
Social & Preventive Medicine
| null |
6e4b72c5-56c1-410f-b748-20124b00de98
|
single
|
A 40 year old patient has undergone an open cholecystectomy. The procedure was repoed as uneventful by the operating surgeon. She has 100 ml of bile output from the drain kept in the gallbladder bed on the first post operative day. On examination she is afebrile and anicteric. The abdomen is soft and bowel sounds are normally heard. As an attending physician, what should be your best possible advice?
|
Ans. is (d) i.e. Clinical observation 100 ml. of Bile output from the patient on the 1st postop. day without any other abnormality is of no clinical significance, so does not warrant any action from the surgeon. But remember if passing of 100 ml of bile continues for 5-6 days then it is considered abnormal. It denotes bile duct injury. Oxford textbook of Surgery writes ? "Even after a straightforward cholecystectomy there may be a little bile in the drain the following day." Textbook of Liver and Biliary Surgery writes ? 'A small amount of biliary drainage following cholecystectomy should cause no alarm because it usually disappears within 1 or 2 days. However, excessive biliary draingae through the wound or drain site, jaundice, sepsis, or a combination of these events early in the post op. period should suggest a bile duct injury, as should copious biliary drainage for more than a few post-op days".
| 4
|
Order an urgent endoscopic retrograde cholangiography and biliary stenting
|
Urgent laparotomy
|
Order an urgent hepatic imino diacetic acid scintigraphy (HIDA)
|
Clinical observation
|
Surgery
| null |
94b2dc99-8543-4aeb-a21c-7b11fb940d1f
|
multi
|
All is true about foreign body impaction in ear except-
|
Answer- B. Syringing is used for removal of vegetative foreign bodyMethods of removing a foreign body include: forceps removal, syringing suction, microscopic removal with special instruments and postaural approach.Foreign bodies of vegetable origin such as nuts, peas and beans, are hygroscopic and should not be syringed.No attempts should be made to remove smooth spherical objects such as beads by forceps.Beads which have a diameter less than that of the isthmus can be syringed; larger ones are better removed, with a hook.
| 2
|
Objects located medial to isthmus of canal is difficult to remove
|
Syringing is used for removal of vegetative foreign body
|
Syringing uses room temperature water
|
Blunt hook is used to remove rounded foreign body
|
ENT
| null |
afa27cc5-b6e9-4277-a77f-508dcbac4b16
|
multi
|
A 17 year old female presents with a pruritic rash localized to the wrist. Papules and vesicles are noted in a bandlike pattern, with slight oozing from some lesions. The most likely cause of the rash is NOT RELATED -DERMATOLOGY
|
Contact dermatitis causes pruritic plaques or vesicles localized to an area of contact. In this case, a bracelet or wristband would be the inciting agent. The dermatitis may have vesicles with weeping lesions. The process is related to direct irritation of the skin from a chemical or physical irritant. It may also be immune-mediated.
| 3
|
Herpes simplex
|
Shingles
|
Contact dermatitis
|
Seborrheic dermatitis
|
Pharmacology
|
All India exam
|
6b8d9266-d590-456f-b778-9f408d727e8d
|
single
|
True statement regarding this diagnosis is:
|
Ans. A Recurrence is a common complicationThere is incongruency between Glenoid (red arrow) and Humeral head (yellow arrow) which is lying inferior to Coracoid process (blue) - suggests Sub-coracoid/Anterior shoulder dislocation. Anterior shoulder dislocation is very common, often seen in adults and is recurrent. Associated with Bankart's lesion Q and Hill-Sach's defect Q.
| 1
|
Recurrence is a common complication
|
Common in children and rare in adults
|
May be overlooked as clinically occult
|
Is not associated with other bony/cartilagionus injury
|
Radiology
|
Miscellaneous
|
c53a7494-6352-4388-a310-5690f44561f2
|
multi
|
Dye for myelography is injected in which space :
|
Myelography is the radiographic investigation of the spinal canal for the diagnosis of space occupying an obstructive lesion. It requires the contrast agent to be injected into subarachnoid space.
MRI has replaced myelography, these days.
| 3
|
Subdural
|
Epidural
|
Subarachnoid
|
Extradural
|
Radiology
| null |
d44a96a0-f5be-4042-9cab-fe87c0ed61c3
|
single
|
Scottish terrier sign is seen in:
|
Ans. Oblique view
| 4
|
AP view
|
PA view
|
Lateral view
|
Oblique view
|
Radiology
| null |
72479ded-b52d-46fa-acef-a92017a3bdf2
|
single
|
A 17-year-old soccer player suffered a fracture to the left tibia. After his lower leg has been in a cast for 8 weeks, he found that the left gastrocnemius muscle is significantly smaller in circumference than it was before the fracture. What is the most likely explanation?
|
Skeletal muscle continuously remodels in response to its level of use. When a muscle is inactive for an extended period, the rate of synthesis of the contractile proteins in individual muscle fibers decreases, resulting in an overall reduction in muscle mass. This reversible reduction in muscle mass is called atrophy.
| 3
|
Decrease in the number of individual muscle fibers in the muscle.
|
Decrease in blood flow to the muscle caused by constriction from the cast.
|
Temporary reduction in actin and myosin protein synthesis
|
Progressive denervation.
|
Physiology
|
Muscle
|
36c69c35-1028-4614-901e-2161cf1f7525
|
multi
|
All are transmitted by fecal-oral route except ?
|
Ans. is 'd' i.e., Dracunculiasis
| 4
|
Polio
|
Typhoid
|
Ascaris
|
Dracunculiasis
|
Social & Preventive Medicine
| null |
b97e8604-812b-4240-be3d-5adf8d69236b
|
multi
|
KOH wet mount is prepared for
|
KOH preparation: Specimen is placed in a drop of 10%KOH on a slide and covered with a cover slip. It is heated gently and examined under a microscope. Yeast cells and hyphae may be observed. Reference: Textbook of Microbiology; Baveja; 4th edition .
| 3
|
Bacteria
|
Virus
|
Fungus
|
Parasite
|
Microbiology
|
mycology
|
f42ac82d-19bf-4717-a4fd-6b89a47b5029
|
single
|
All of the following 'Reforms' have been proposed by the world health repo (2008), EXCEPT:
|
The World Health Repo 2008 lists four sets of PHC (Primary Health Care) Reforms which are necessary to refocus health systems towards health for all. These are universal coverage reforms, service delivery reforms, public policy reforms and leadership reforms. Economic reforms are not included in this repo. Ref: The World Health Repo 2008: Primary Health Care: Now More Than Ever, World Health Organization 2008, Page xvi
| 4
|
Service Reforms
|
Leadership Reforms
|
Policy Reforms
|
Economic Reforms
|
Social & Preventive Medicine
| null |
304e23fb-47c2-4e0d-9340-21d0ae96edf7
|
multi
|
Fluoride is used in
|
The high energy compound phosphoenol pyruvate is generated from 2-phosphoglycerate by the enzyme enolase. This enzyme requires Mg2+ or Mn2+ and is inhibited by fluoride. For blood glucose estimation in the laboratory, fluoride is added to the blood to prevent glycolysis by the cells, so that blood glucose is correctly estimated.
| 1
|
Blood glucose estimation samples
|
Urine glucose estimation samples
|
Both 1 & 2
|
None of the above
|
Biochemistry
| null |
3f122b49-eaa9-4f50-93e3-fc8e707292bc
|
multi
|
Among the following, which of the following 5-PDE inhibitor has the longest duration of action?
|
Ans. is 'c' i.e., Tadalafil o Tadalafil is the longest acting phosphodiesterase inhibitor used for erectile dysfunction. Its half life is 17.5 hours.
| 3
|
Sildenafil
|
Vardenafil
|
Tadalafil
|
Udenafil
|
Pharmacology
| null |
28e3b5c4-6b89-4ef0-a7cc-02880830d62c
|
single
|
What is the naturally occurring form of vitamin D in the human skin?
|
Calciferol is a fat-soluble, crystalline unsaturated alcohol produced by ultraviolet irradiation of ergosterol in plants. It is used as a dietary supplement in the prophylaxis and treatment of rickets, osteomalacia, and other hypocalcemic disorders. Also called ergocalciferol, ole vitamin D2, vitamin D2. See also rickets, viosterol.Ref: Ganong&;s review of medical physiology; 24th edition; page no:-377
| 1
|
Calciferol
|
7 hydroeholesterol
|
25 hydroxy cholecalciferol
|
1,25 dihydroxy cholecalciferol
|
Physiology
|
Endocrinology
|
5535d3b5-4725-46a7-8c50-3a997ca933eb
|
multi
|
All of the following diuretics acts from luminal side of renal tubules except:
|
Aldosterone receptor antagonists acts from interstitial side.
| 3
|
Loop diuretics
|
ENAC blockers
|
Aldosterone antagonists
|
Mannitol
|
Pharmacology
| null |
7a4f97ef-4cd9-447b-b22c-4c17a685ca19
|
multi
|
The following is not an atypical antipsychotic
|
Ans. is 'a' i.e. Thioridazine The most important distinction in modem day classification of antipsychotic drug is between the classical agents (typical) agents such as chlorpromazine, haloperidol and Zuclopenthixol and the atypical antipsychotics which include clozapine, risperidone, olanzapine and quetiapine.The atypical antipsychotics are "atypical" in their mode of action and adverse effect profile.Classical antipsychoticsAtypical antipsychotics* Acts by blocking D2 receptors* Usually do not act on D2 receptors* Highly likely to cause extra-pyramidal* Acts on 5HT2, muscarinic acetylcholinesymptomreceptors and 0 3/4 adrenoceptors * Extrapyramidal symptoms less commonExamples PhenothiazinesExamples- Chlorpromazine- Clozapine- Thioridazine- Sulpiride- Trifluoperazine- Olanzapine- Fluphenazine- RisperidoneButyrophenones- Ziprasidone- Trifluperidol- Sertindole- Droperidol- Ami sulpiride- Penfluridol Thioxanthene - Thiothixene - Flupenthixol Others - Pimozide - Reserpine
| 1
|
Thioridazine
|
Clozapine
|
Olanzapine
|
Resperidone
|
Psychiatry
|
Pharmacotherapy Management of Children and Adolescents
|
d7f4f29c-0148-4f2e-81e8-de73e5921f2f
|
single
|
First to come in female pubey:
|
This question may cause a problem in the exam. If growth spu is in the choices then we must mark that s the first option since this is indeed the first event of pubey Pubey specific event which comes in first is Thelarche & then Pubarche, linear growth spu and Menarche In girls, pubeal development typically takes place over 4.5 years). The first sign of pubey is accelerated growth, and breast budding is usually the first recognized pubeal change, followed by the appearance of pubic hair, peak growth velocity, and menarche. The stages initially described by Marshall and Tanner are often used to describe breast and pubic hair development This is from Novaks gynecology and hence we should see what is asked in the question. Mostly the questions are asked for the 'first sign' specific of pubey and breast budding is the answer, but if "Growth spu' is given and the question is non-specific, then that's the option.
| 4
|
Thelarche
|
Menses
|
Adrenarche
|
Growth spu
|
Gynaecology & Obstetrics
|
Pubeal Changes
|
55134f03-7430-49dd-a5ce-c1e3c430e994
|
single
|
The disposal of night soil and refuse is by?
|
Ans. is 'c' i.e., Composting
| 3
|
Chemical sterilization
|
Burning
|
Composting
|
Any of the above
|
Social & Preventive Medicine
| null |
d3bc78f2-a6ac-4ba8-8275-99c764adf27e
|
multi
|
Components of 60 S subunit of ribosome are
|
The mammalian ribosome has a sedimentation consisting of 80s unitIt has larger 60s subunit and another smaller 40s subunit The larger ribosomal subunit has 28s, 5.8S, and 5S rRNA And small subunit has only 18SrRNA
| 1
|
5.8 S
|
23 S
|
16 S
|
18 S
|
Biochemistry
|
Metabolism of nucleic acids
|
e542fbf2-ed4f-4ab7-9740-b0c5d790c522
|
single
|
A 28-year-old lady has put on weight (10 kg over a period of 3 years) and has oligomenorrhoea followed by amenorrhoea for 8 months. The blood pressure is 160/100 mm of Hg. Which of the following is the most appropriate investigation?
|
Weight gain + Oligomenorrhea --->Cushing syndrome. Coisol inhibits gonadotropin release that explains the amenorrhea. Hypeension in these patients is secondary to increased coisol that has some mineralocoicoid activity also. Excess glucocoicoids also interfere with central regulatory systems, leading to suppression of gonadotropins with subsequent hypogonadism and amenorrhea, and suppression of the hypothalamic pituitary-thyroid axis, resulting in decreased TSH (thyroid-stimulating hormone) secretion. Weight gain + menorrhagia + isolated diastolic hypeension in the question would have prompted thyroid dysfunction as the first answer.
| 2
|
Serum electrolytes
|
Plasma coisol
|
Plasma testosterone and ultrasound
|
T3, T4 and TSH
|
Medicine
|
Cushing Syndrome
|
560f150b-bc8e-4860-b3eb-3caa6ea8e706
|
single
|
Some mRNA has self-splicing activity. The removal of introns is/are done by
|
In molecular biology and genetics, splicing is a modification of an RNA after transcription, in which introns are removed and exons are joined. This is needed for the typical eukaryotic messenger RNA before it can be used to produce a correct protein through translation. For many eukaryotic introns, splicing is done in a series of reactions which are catalyzed by the spliceosome a complex of small nuclear ribonucleoproteins (snRNAs), but there are also self-splicing introns.
Self-splicing
Self-splicing occurs for rare introns that form a ribozyme, performing the functions of the spliceosome by RNA alone.
There are three kinds of self-splicing introns, Group I, Group II and Group III. Group I and II introns perform splicing similar to the spliceosome without requiring any protein. This similarity suggests that Group I and II introns may be evolutionarily related to the spliceosome. Self-splicing may also be very ancient and may have existed in an RNA world present before protein.
Although the two splicing mechanisms described below do not require any proteins to occur, 5 additional RNA molecules and over 50 proteins are used and hydrolyzes many ATP molecules. The splicing mechanisms use ATP in order to accurately splice mRNA's. If the cell were to not use any ATP's the process would be highly inaccurate and many mistakes would occur.
Two transesterifications characterize the mechanism in which group I introns are spliced :
3' OH of a free guanine, nucleoside (or one located in the intron) or a nucleotide cofactor (GMP, GDP, GTP) attacks phosphate at the 5' splice site.
3' OH of the 5 'exon becomes a nucleophile and the second transesterification results in the joining of the two exons.
The mechanism in which group II introns are spliced (two transesterification reaction like group I introns) is as follows :
The 2'OH of a specific adenosine in the intron attacks the 5' splice site, thereby forming the lariat.
The 3'OH of the 5' exon triggers the second transesterification at the 3' splice site thereby joining the exons together.
Spliceosomal and self-splicing transesterification reactions occur via two sequential transesterification reactions. First, the 2' OH of a specific branch point nucleotide within the intron that is defined during spliceosome assembly performs a nucleophilic attack on the first nucleotide of the intron at the 5' splice site forming the lariat intermediate. Second, the 3' OH of the released 5' exon then performs a nucleophilic attack at the last nucleotide of the intron at the 3' splice site thus joining the exons and releasing the intron lariat.'
| 4
|
Occur in intron that from Ribozyme
|
Self-splicing introns
|
Lariats intermediates are formed
|
All of these
|
Biochemistry
| null |
7515a9d4-4e94-443a-b66a-24d3b980b5ba
|
multi
|
The risk factors of acute pelvic inflammatory disease (PID) are the following except:
| null | 3
|
Menstruating teenagers who have multiple sex partners
|
IUD users
|
Women with monogamous partner who had vasectomy
|
Previous history of acute PID
|
Gynaecology & Obstetrics
| null |
2e9cefeb-be0b-4d41-8013-bbaafbf35f1f
|
multi
|
Linear coefficient of thermal expansion of metal used for metal ceramic restoration range from:
|
Most porcelains have coefficients of thermal expansion between 13.0 and 14.0 × 10 −6 /°C, and metals between 13.5 and 14.5 × 10 −6 /°C. The difference of 0.5 × 10 −6 /°C in thermal contraction between metal and porcelain causes the metal to contract slightly more than does the ceramic during cooling. This condition places the porcelain under slight residual compression, which makes it less sensitive to the tensile stresses induced by mechanical loading.
Craig’s Restorative dentistry 14 ed page 222
| 3
|
11.5-12.5 x 10-6/°C
|
10.5-11.5 x 10-6/°C
|
13.5-14.5 x 10-6/°C
|
16.5-17.5 x 10-6/°C
|
Dental
| null |
db0f17bc-c137-4334-98ca-6fc7dae6de09
|
single
|
Most sensitive indicator of iron deficiency anemia
|
Ans. (c) Serum ferritin(Ref: Robbins 9th/pg 649-652)Among the options provided, most sensitive marker in iron deficiency anemia is Serum ferritin.Serum ferritin reflects the storage of Iron which is decreased even in the pre-latent stage of Iron deficiency Anemia and is the most sensitive marker.
| 3
|
Packed cell volume
|
Hemoglobin
|
Serum ferritin
|
Serum iron
|
Pathology
|
Misc. (R.B.C)
|
effbecff-c59b-467c-93de-385b6bde19e3
|
single
|
Assessment of malnutrition is done by:-
|
Assessment of: Nutritional status in children: weight for age (growth cha) > MAC Nutritional status in adults : body mass index Best indicator for growth & development in children - weight for age.
| 4
|
Mid-arm circumference (MAC)
|
Body mass index
|
Weight for age
|
All of the above
|
Social & Preventive Medicine
|
Growth and Development
|
0638a7ab-0848-4a71-85b9-0e640a776016
|
multi
|
Thoracic Sympathetic Chain is situated :
|
C. i.e. Near heads of 2nd to 10th rib Thoracic sympathetic trunk is a ganglionated chain situated on each side of thoracic veebraQ and crosses the neck of 1st rib, heads of 2" to 10th ribs and bodies of 11th & 12th rib.Q The whole chain descends in front of posterior intercostal vessels & intercostal nervesQ, and passes deep to medial arcuate ligament.Q
| 3
|
In front of posterior mediastinum
|
Passes superficial to medial arcuate ligament
|
Near heads of 2nd to 10th rib
|
In front of veebral column
|
Anatomy
| null |
fe471883-66aa-40ff-8892-ffc0d6faf3b6
|
single
|
A 30 year old lady c/o sudden onset breathlessness, anxiety, palpitation & feeling of impending doom. Physical examination is normal. What is the diagnosis -
|
Ans. is 'a' i.e., Panic attack DSM-IV Criteria for a Panic AttackA panic attack is a period of intense fear or discomfort, developing abruptly and peaking within 10 minutes, and requiring at least four of the followingChest pain or discomfortQChills or hot flushesDerealization (feeling of unreality) or depersonalization (being detached from oneself)Fear of losing controlFeeling of chokingNausea or abdominal distressPalpitations or tachycardia QParesthesiasSensations of shortness of breath Q or smotheringSense of impending doomQSweatingTrembling or shaking
| 1
|
Panic attack
|
PTSD
|
Conversion disorder
|
Acute psychosis
|
Unknown
| null |
cd6ff05f-adae-4d66-a110-6a00475e793a
|
single
|
The typical temperature of an autoclave (operating at 30 psi of pressure is)
|
Two types of autoclave are used in laboratories and hospitals. * Moist heat at 121 degree Celsius X 15-20 minutes (Pressure-15 psi) * Moist heat at 134 degree Celsius X 3 minutes (Pressure-30 psi)
| 4
|
121degC
|
100degC
|
63degC
|
134degC
|
Microbiology
|
General Microbiology (Sterilization and Bacterial Genetics)
|
238cc302-2725-4050-a53b-09b6b93ed482
|
single
|
Diagnosis of tularemia is confirmed using agglutination testing. In the standard tube agglutination test, what should be the single antibody titre for making the test positive?
|
A single antibody titer 1:160 is interpreted as a presumptive positive result for diagnosing tularemia. Agglutination test is used to confirm the diagnosis of tularemia. A fourfold increase in titer between paired serum samples collected 2-3 weeks apa is considered diagnostic. Late in infection, titers of 1:20-1:80 may persist for years. Tularemia is caused by F. tularensis, a gram-negative, pleomorphic, nonmotile, non-spore-forming bacillus. Ref: Jacobs R.F., Schutze G.E. (2012). Chapter 158. Tularemia. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds),Harrison's Principles of Internal Medicine, 18e.
| 4
|
1:40
|
0.097222222
|
0.125
|
0.152777778
|
Medicine
| null |
2333a97a-0a8b-42c3-abef-44268bce9ac6
|
single
|
Satellite nodules are seen in
|
o Features of fungal corneal ulcer are
| 1
|
Fungal corneal ulcer
|
Tuberculosis
|
Sarcoidosis
|
Viral ulcer
|
Ophthalmology
| null |
75dec336-846c-4432-8b7a-b50b769633df
|
single
|
Hamman's sign is seen in:
|
Hamman's sign is the Crunching sound heard with every heart beat because of heart beating against air fill.
| 3
|
Pulmonary thromboembolism
|
Pulmonary atelectasis
|
Pneumomediastinum
|
Intralobar pulmonary sequestration
|
Surgery
| null |
fe096cad-b07f-466a-b8c8-333162344754
|
single
|
Venom of sea snake is mostly -
| null | 3
|
Neurotoxic
|
Haemolytic
|
Myotoxic
|
Hepatotoxic
|
Forensic Medicine
| null |
d750e534-6c3a-42c3-9e72-3c31744961a4
|
single
|
Which of the following streptococcal antigen cross reacts with synol fluid?
|
Antigens cross reactivity between Streptococcus antigens and the corresponding human antigen Streptococcal component Human tissue Capsular hyaluronic acid Synol fluid Cell wall protein Myocardium Group A carbohydrate Cardiac valves Cytoplasmic membrane antigen Vascular intima Peptidoglycans Skin antigens
| 3
|
Carbohydrate (group A)
|
Cell wall protein
|
Capsular hyaluronic acid
|
Peptidoglycan
|
Microbiology
|
Systemic Bacteriology Pa 1 (Gram Positive Cocci, Gram Negative Cocci)
|
555916e5-6bb6-4646-83a4-02bd38c93338
|
multi
|
Drug of choice for primary prophylaxis for acute rheumatic fever?
|
Prophylaxis of ARF: 1.primary-To stop streptococcal pharyngitis to procede to ARF In this,Antibiotics are given for a week. DOC-injection benzathine penicillin-1.2 million units(wt>27kgs);0.6 million units(wt<27 kgs). if patient is allergic to penicillins then macrolides are preferred. 2.secondary prophylaxis-To prevent recurrence. given during patient suffering from ARF. DRUG SAME AS PRIMARY-But every (3-4) weeks. if allergic-SULFADIAZINE is given. if also allergic to saulfadiazone,macrolides are preferred.
| 4
|
Erythromycin-1.2 million units
|
Erythromycin-1.2 lakh units
|
Benzathine penicllin-1.2 lakh units
|
Benzathine penicillin-1.2 million units
|
Anatomy
|
General anatomy
|
e0c1c405-cb0c-4b44-9b76-53be27a44eee
|
single
|
A 48 year old woman has developed chronic renal failure, and a renal scan showed bilaterally enlarged kidneys with multiple cysts. She had a sudden onset severe headache. A cerebral angiogram demonstrated marked narrowing of cerebral aery branches near the base of the brain, consistent with vasospasm, but no intraparenchymal hemorrhage were present. Which of the following condition MOST likely produced these findings?
|
The blood irritates the aeries. This effect is often delayed by several days following the initial hemorrhagic event. Berry aneurysms are located in the circle of Willis at the base of the brain, and rupture leads to extravasation of blood into the subarachnoid space. Her renal scan suggests a diagnosis of dominant polycystic kidney disease (DPKD). About 10% of persons with ADPKD develop berry aneurysms.
| 4
|
Bacterial meningitis
|
Severe atherosclerosis
|
Malignant hypeension
|
Subarachnoid hemorrhage
|
Pathology
| null |
747dd49c-84ba-43b4-8634-c6894b6e7db7
|
multi
|
Commonest presentation of neurocysticercosis is:
|
Answer is A (Seizures): "These is wide variety of presentation of Neurocysticercosis depending on the intensity of the infestation, the localization of cystecerci and the degree of inflammatory reaction. Epilepsy (seizure activity) is the most common manifestation occurring in upto 50% cases - API text book of Medicine 6th/784 Cysticercosis is infection with the larval stage (cysticercus) of T. sollum. These cysts are located in order of frequency in : CNS (Neurological manifestations are the most common) - Harrison's' 15th/1249 Subcutaneous tissue Striated muscle Globe of the eye
| 1
|
Seizures
|
Focal neurological deficits
|
Dementia
|
Radiculopathy
|
Medicine
| null |
aa5ff81c-8e1b-48ae-a837-ddade00d50f8
|
single
|
Dermatophyte affecting the hair, nail, and skin is
|
The three genera of medically impoant dermatophytes (literally, skin-plants) are Epidermophyton, Microsporum, and Trichophyton.--Trichophyton: infects skin, hair, and nails-- Microsporum: infects hair and skin-- Epidermophyton: infects nails and skinRef: Sherris Medical Microbiology; 6th edition; Chapter 5; Medically Relevant Fungi; Page no: 335
| 1
|
Trichophyton
|
Epidermophyton
|
Microsporum
|
Malassezia
|
Microbiology
|
mycology
|
1f7c58ec-7687-4ac0-a058-5e134d926733
|
single
|
All are TRUE about protease activated receptors, EXCEPT:
|
Protease activated receptors (PARs), a family of four seven-transmembrane G protein-coupled receptors (PAR1, PAR2, PAR3, PAR4), act as targets for signalling by various proteolytic enzymes (thrombin, trypsin). PARs are characterized by a unique activation mechanism involving the proteolytic unmasking of a tethered ligand that stimulates the receptor. They release PGE2 and this inturn protects the epithelium. Ref: Ganong's Review of Medical Physiology, 21st Edition, Page 667
| 1
|
Family of three seven transmembrane protein
|
Activated by thrombin
|
Releases PGE2
|
Protects epithelial cells
|
Physiology
| null |
a4a6cc05-724d-4f09-914e-7d8578ea81e7
|
multi
|
A 10-year-old boy developed hoarseness of voice following an attack of diphtheria. On examination his right vocal was paralysed. The treatment of choice for paralysed vocal cord will be:
|
Diphtheria is known to cause cranial nerve palsies and peripheral neuritis. It may cause paralysis of palate, pharynx, larynx and face. Recovery may also occur in a few weeks or months. Thus patient has a chance to recover vocal cord paralysis and the wait and watch policy would be the right option. Also compensation by the left vocal cord is possible if recovery dose not take place. Thyroplasty type-I, i.e. medialisation of right vocal cord would be the option if even the compensation fails. Compensation by the healthy cord may take 6 months to 1 year.
| 4
|
Gel foam injection of right vocal cord
|
Fat injection of right vocal cord
|
Thyroplasty type-I
|
Wait for spontaneous recovery of vocal cord
|
ENT
|
Larynx
|
8dc69128-b495-4fc3-a3ab-a1958a437934
|
single
|
Floor of body of lateral ventricle is formed by
|
Floor of body of lateral ventricle is formed by
Caudate nucleus
Thalamostriate vein
Thalamus upper surface
Body of fornix upper surface
Rostrum of corpus callosum forms floor, septum pellucidum forms medial wall, and genu of corpus callosum forms anterior wall of anterior horn of lateral ventricle.
| 3
|
Septum pellucidum
|
Rostrum of corpus callosum
|
Thalamostriate vein
|
Genu of corpus callosum
|
Anatomy
| null |
373c97b2-3a16-4e6b-a515-c9c5f359d638
|
multi
|
Sensations which are appreciated in thalamus
|
Thalamus acts as the sensory relay station for all sensors Ref: guyton and hall textbook of medical physiology 12 edition page number:691,692,693
| 4
|
Propioception
|
Pain and temperature
|
Tactile sensations
|
All
|
Physiology
|
Nervous system
|
1d38c8ab-3725-429b-95f4-abbf87479984
|
multi
|
A 70-year-old man is evaluated in emergency department for symptoms of dyspnea, orthopnea, and paroxysmal nocturnal dyspnea. His past medical history is significant for hypertension, type 2 diabetes, chronic kidney disease, and hypothyroidism. Medications are furosemide, enalapril, atorvastatin, metformin, and insulin.On physical examination he has generalized cardiomegaly and pulmonary and systemic venous hypertension. The ECG is shown in Figure below. What is the cardiac rhythm seen on the ECG?
|
The cardiac rhythm is atrial flutter with 2:1 AV conduction. QRS complexes occur with perfect regularity at a rate of about 150/min. Their normal contour and duration indicate that ventricular activation occurs normally via the AV junction-His-Purkinje system. Flutter waves, regular ventricular rate at 150/min make the diagnosis of atrial flutter, rather than atrial fibrillation, sinus tachycardia, or ectopic atrial tachycardia.
| 2
|
ectopic atrial tachycardia
|
atrial flutter with 2 :1 AV conduction
|
sinus tachycardia
|
supraventricular tachycardia
|
Medicine
|
C.V.S.
|
3dcc2d48-f678-4bcf-adbf-102ccb0e4514
|
single
|
A young patient presents with history of dysphagia more to liquid than solids. The first investigation you will do is:
|
Ans. is 'a' i.e. Barium swallow H/O of dysphagia with more to liquids than solids suggests achalasia cardia. In all other obstructive causes of esophagus, dysphagia for solids is seen firstDiagnosis of Esophageal diseaseAny esophageal disease is first diagnosed by radiographic evaluation.Schwartz says that "The first diagnostic test in patients with suspected esophageal disease should be a barium swallow including full assessment of the stomach and duodenum"Diagnostic modalities for esophagusDiagnostic procedures to detect structural abnormalities of esophagus: -Radiographic evaluation EndoscopyTests to detect functional anomalies: -Stationary manometry 24 hour ambulatory manometry Video and cineradiography Esophageal transit scintigraphyTests to detect increased exposure to Gastric juice - 24hr. ambulatory pH monitoring- 24hr. ambulatory bile monitoring - Standard acid reflux test.Imp. Radiological findings of OesophagusBirds beak appearance*- Achalasia cardiaCork screw esophagus- Diffuse esophageal spasmCurling esophagus*- Diffuse esophageal spasmRat tailed appearance*- Achalasia cardia
| 1
|
Barium Swallow
|
Esophagoscopy
|
Ultrasound of the chest
|
C.T. Scan of the chest
|
Surgery
|
Diagnostic Evaluation of the Esophagus
|
eaa50c90-ebaf-4a95-9782-b6ab83432b7c
|
multi
|
A patient is suspected to have vestibular schwanomma. The investigation of choice for its diagnosis is
| null | 1
|
Gadolinum enhanced MRI
|
Contrast enhanced CT
|
SPECT
|
PET scan
|
Radiology
| null |
3707a2cf-27df-4b2a-9d16-6dbec86dfd7b
|
single
|
True about spinal cord:
|
A, B, C i.e. In adults spinal cord ends at lower border of Li veebra, In newborn may extend up to L3, Cauda equine extends from lumbar veebra to coccyx
| 4
|
In adults spinal cord ends at lower border of L1 veebra
|
In newborn may extend up to L3
|
Cauda equine extends from lumbar veebra to coccyx
|
All
|
Anatomy
| null |
c7e2dfd0-a3e5-4e45-9bd3-63086dce5da4
|
multi
|
Kerley B lines are seen in
|
Kerley A lines are 1-2mm non- branching lines radiating from the hilum, 2-6 cm long. They represent thickened deep interlobular septa. Kerley B lines are transverse non- branching 1-2 mm lines at the lung bases perpendicular to the pleura 1-3cm long. They represent thickened interlobular septa.
| 4
|
Pulmonary edema
|
Congenital hea disease
|
Sarcoidosis
|
All of the above
|
Radiology
|
Respiratory Radiology
|
6cc42404-d37c-472c-97a3-8bde5bbaa163
|
multi
|
All are causes of Antepartum hemorrhage (APH) except:
|
Causes of Antepartum Hemorrhage
Placenta previa
Abruptio placenta
Vasa previa
Circumvallate placenta
Local causes like:
Polyp
Carcinoma cervix
Varicose veins
Trauma
Unclassified or indeterminate
Circumvallate placenta
It is an uncommon cause of antepartum hemorrhage.
In this condition, the chorionic plate which is on the fetal side of the placenta is smaller than the basal plate on the maternal side.
The fetal surface of the placenta presents a central depression surrounded by a thickened grayish white ring.
These pregnancies may be complicated by IUGR and an increased chance of fetal malformations.
Bleeding is usually painless.
Antenatal diagnosis is unlikely and the diagnosis is usually made after examination of the placenta post delivery.
| 4
|
Placenta previa
|
Abruptio placenta
|
Circumvallate placenta
|
Battledore placenta
|
Gynaecology & Obstetrics
| null |
e44ef7eb-7130-4726-90e4-7d93d231d7e3
|
multi
|
An 11-year-old boy presents with pain in his right leg. A radiograph shows a "sunburst" appearance with bone destruction, soft tissue mass, new bone formation, and sclerosis limited to the metaphysis of the lower femur. select the type of bone lesion with which it is most likely to be associated (SELECT 1 LESION)
|
Osteosarcoma, or osteogenic sarcoma, usually is seen in patients between the ages of 10 and 25 years. The distal femur is the site most frequently involved. The radiograph has a blastic, or sunburst, appearance. The tumor is not sensitive to radiation but does respond well to combination chemotherapy followed by surgical resection or amputation.An osteoid osteoma typically presents with severe pain that is characteristically relieved by aspirin. On radiograph, the lesion appears as a small lucency (usually <1.0 cm) within the bone that is surrounded by reactive sclerosis. These lesions gradually regress over 5-10 years, but most are excised to relieve symptoms. Surgical extirpation is usually curative.
| 4
|
Osteoma
|
Osteoid osteoma
|
Osteoblastoma
|
Osteosarcoma
|
Surgery
|
Orthopedics
|
2e0de350-fa42-43c8-93be-88126bd1666c
|
single
|
The alveolar aerial gradient is highest in which of the following?
|
The alveolar aerial PO2 difference is obtained by subtracting the aerial PO2 from the alveolar PO2. The normal alveolar-arial PO2 gradient is between 5-15 mm Hg.The alveolar aerial gradient is useful measure of ventilation perfusion mismatch. ILD- Due to pulmonary fibrosis, diffusion defect will lead to significant reduction in value of paO2. Hence the gradient will show an increase. Pulmonary embolism- Due to V/P mismatch in PE, the value of paO2 is normal to reduced. In massive PE, the gradient is definitely increased. There is adequat ventilation but zero perfusion , the V/Q ratio is infinite.At a ratio of infinity, there is no exchange of gases through the respiratory membrane of affected alveoli. Acute severe asthma- Due to severe airflow limitation both paO2 and pAO2 are reduced leading to normal alveolar aerial gradient. FB leading to upper airway obstruction- Due to severe airflow limitation both paO2 and pAO2 are reduced leading t normal alveolar aerial gradient.
| 2
|
ILD
|
Pulmonary Embolism
|
Acute severe asthma
|
Foreign body leading to upper airway obstruction
|
Anatomy
|
Respiratory system
|
8aa70395-b1cc-4a6f-bb15-6e39f530f6c8
|
single
|
Most common cause of Fulminant hepatic failure?
|
Hepatitis D virus Hepatitis D accounts for maximum number of fulminant cases of viral hepatitis, a sizable propoion of which are associated with HBV infection. Superinfection with HDV in patients of chronic hepatitis B infection leads to fulminant hepatic failure
| 4
|
HAV
|
HBV
|
HCV
|
HDV
|
Medicine
|
Hepatic encephalopathy & hepatic failure
|
a6ccd759-4fda-4e2b-87f0-7a055fc2881c
|
single
|
White infracts are seen in which of the following
|
Ref Robbins 8/e p128; 7/e p138 see explanations of earlier question White infarcts occur with aerial occlusions in solid organs with end-aerial circulations (e.g., hea, spleen, and kidney), and where tissue density limits the seepage of blood from adjoining patent vascular beds (Fig. 3-17, B). Infarcts tend to be wedge-shaped, with the occluded vessel at the apex and the organ periphery forming the base (Fig. 3-17); when the base is a serosal surface, there is often an overlying fibrinous exudate. Lateral margins may be irregular, reflecting flow from adjacent vessels. The margins of acute infarcts typically are indistinct and slightly hemorrhagic; with time, the edges become better defined by a narrow rim of hyperemia attributable to inflammation. Infarcts resulting from aerial occlusions in organs without a dual circulation typically become progressively paler and sharply defined with time (Fig. 3-17, B). By comparison, hemorrhagic infarcts are the rule in the lung and other spongy organs (Fig. 3-17, A). Extravasated red cells in hemorrhagic infarcts are phagocytosed by macrophages, and the heme iron is conveed to intracellular hemosiderin. Small amounts do not impa any appreciable color to the tissue, but extensive hemorrhages leave a firm, brown residuum
| 4
|
Kidney
|
Spleen
|
Hea
|
All the above
|
Anatomy
|
General anatomy
|
c95bccfe-22cd-4bde-8574-167a4ce31877
|
multi
|
Which of the following is not a self-retaining urinary catheter: March 2011
|
Ans. D: Red rubber
| 4
|
Foley
|
Malecot
|
Gibbon
|
Red rubber
|
Surgery
| null |
82c1f862-fc83-47c8-a868-621c01f777ef
|
single
|
Complete unilateral congenital cataract should preferably be operated:
|
Ans. Within a few weeks of bih
| 1
|
Within a few weeks of bih
|
At the age of 6 months
|
At the age of 2 years
|
At the age of 5 years
|
Ophthalmology
| null |
ccdf8806-65e8-4a02-9182-e6991080f9f2
|
single
|
all the following are non-competitive inhibitors except ?
|
Enzyme Inhibitors * Competitive inhibitors bind to the active site of an enzyme, competing with the substrate ex: arsenate ,oxamate,malonate, sulfonamide,methotrexate,ethanol,dicumurol * Noncompetitive inhibitors bind to another pa of an enzyme, causing the enzyme to change shape and making the active site less effective * Examples of inhibitors include toxins, poisons, pesticides, and antibiotics = iodoactate,NaF, fluroacetate, arsenate,cyanide, disulfuram ref : vasudevan 9th ed
| 1
|
arsenate
|
fluoroacetate
|
arsenate
|
disulfuram
|
Biochemistry
|
All India exam
|
d4e32216-832c-4031-852b-5783c0aa08cc
|
multi
|
Which of the following is the LEAST common immunologic manifestation of HIV infection?
|
Anaphylactic reactions to drugs In contrast to the profound immunodeficiency that characterizes most manifestations of AIDS, a host of immunologic and rheumatologic disorders are common in patients with HIV infection. Ceainly the most common such reaction is cutaneous manifested sensitivity to the antibiotics required for treatment of the secondary infections so common in these patients. Some 65% of patients who receive trimethoprim-sulfamethoxazole develop an erythematous morbilliform pruritic eruption. Founately, anaphylaxis is very rare, and desensitization is possible. Patients infected with HIV may develop diseases that resemble classic autoimmune diseases in non-HIV-infected persons. A variant of Sjogren's syndrome characterized by dry eyes, dry mouth, and lymphocytic infiltrates of the salivary gland and lung may be seen. HIV -associated ahropathy is characterized by a nonerosive oligoaicular ahritis that generally involves the large joints. Widespread musculoskeletal pain of at least 3 months' duration with tender points, typical of fibromyalgia, may occur in up to 10% of HIV-infected IV drug abusers. Reactive ahritides, such as Reiter's syndrome or psoriatic ahritis, have also been described.
| 2
|
Cutaneous reactions to drugs
|
Anaphylactic reactions to drugs
|
Anticardiolipin antibodies
|
Oligoaicular ahritis
|
Surgery
| null |
7c928844-c0e5-4915-9835-da8ff12cdf90
|
single
|
Efferent from cerebellum is through
|
The outgoing Purkinje axons constitute the sole output from the cerebellar coex and exe an inhibitory influence on intracerebellar nuclei.granule cells are the only intrinsic neurons. of cerebellum which is excitatory.(Ref: Vishram Singh textbook of clinical neuroanatomy second edition pg 116)
| 3
|
Granule cells
|
Golgi cells
|
Purkinje cells
|
Basket cells
|
Anatomy
|
Brain
|
64eea1fd-2ddc-4254-8612-b187b3a7e22b
|
single
|
Which one given below is a DNA virus?
|
Adenovirus are grp of medium sized non envolped double stranded DNA REF:ANANTHA NARAYAN TEXT BOOK OF MICROBIOLOGY 9EDITION PGNO.480
| 2
|
Polio virus
|
Adenovirus
|
Parvovirus
|
Hepatitis A virus
|
Microbiology
|
Virology
|
9ab9e783-7515-4e31-84a4-215ff3cd01b5
|
single
|
Inquest for custodial death is held by: September 2005
|
Ans. B: Magistrate Simply stated, the death if a person in custody whether of the police or judicial will amount to Custodial Death. The Magistrate inquest is mandatory for any death of a person in custody to ensure examination of the circumstances leading to death.
| 2
|
Doctor
|
Magistrate
|
Sub-inspector
|
District attorney
|
Forensic Medicine
| null |
70fdbe86-3890-4a35-a1f9-0eb7d39d1abd
|
single
|
A 32 years old male has got clean wound without laceration. He had booster dose of TT 6 years back. What is next line of management?
|
Ans. is 'a' i.e., Wound care with single dose of tetanus toxoidThe given patients belongs to category B (Booster dose between 5-10 years back). Thus, the requires wound care and single dose of TT.
| 1
|
Wound care with single dose of tetanus toxoid
|
Wound care with Human Tet Ig with tetanus toxoid single dose
|
Wound care with complete course of tetanus toxoid
|
Wound care with no immunization
|
Social & Preventive Medicine
| null |
7c1ac5f3-4a4b-4639-9c62-a8e0dbc2a0c2
|
single
|
Most commonly abused opioid is
|
Heroine-brown sugar /diacetylmorphine is the most commonly abused opioid opiods works on mu, kappa and delta receptor. there is a new recpetor that is introduced that is called as orphanin receptor opiod withdrawl is a distressing experience for the patient that makes the patient to take the sunstance again the main clue for opiod withdrawl isALL ORIFICES BLEED there is lacrimation, sweating, vomiting, rhinorrhea, diarrhoea, muscle cramps and stomach ache the piloerection that occurs in opiod withdrawl is called as COLD TURKEY the tratment of opiod withdrawl can be doneby several means SUPPOIVE CARE: clonidine+benzodiazepines+dicyclomine+anti emetic+anti diarrhoeal AGONIST ASSOSIATED DETOXIFICATION: methadone and bupenorphine ANTAGONIST ASSOSIATED DETOXIFICATION: naltrexone Ref: Essentials of postgraduate psychiatry By JN Vyas 1st ed Pg 338
| 2
|
Morphine
|
Diacetyl morphine
|
Codeine
|
Fentanyl
|
Psychiatry
|
Substance abuse
|
7ddec216-bfc6-459f-871e-1cdb70f99366
|
single
|
Which stage of LGV infection is associated with bubos?
|
LGV infection:Primary stage:Small, painless, papulovesicular (Ext.genitalia)Usually unnoticedI/P: 3 days to 5 weeksSecondary stage:About 2 weeks later- lymphatic spread to draining lymph nodesMen -Inguinal L.N women -Intrapelvic & Para rectal nodesBubo(enlarge, suppurate, adherent to the skin)- break down- sinuses -discharging pusHemorrhagic proctitis with Regional L.NThird stage:Chronic (several years)Scarring & lymphatic blockageRectal strictures & elephantiasis of vulva (ESTHIOMENE)(Ref: Ananthanarayan 9th edition, p420-421)
| 2
|
First stage
|
Second stage
|
Third stage
|
Throughout all stages
|
Anatomy
|
All India exam
|
f6b76768-5b22-4ac4-8a17-6c9bff226961
|
multi
|
The true statement about the epidemiology of H.pylori is :
|
PREVALENCE OF H.PYLORI: The prevalence of H. pylori varies throughout the world In developing world, 80% of the population are infected by the age of 20. In the United States this organism is rare in childhood. The overall prevalence of H. pylori in the United States is 30% The rate of infection with H. pylori in industrialized countries has decreased in recent decades. ALSO NOTE: Two factors that predispose to higher colonization rates inare Poor socioeconomic status Less education. Other risk factors for H. pylori infection are (1) Bih or residence in a developing country (2) Domestic crowding (3) Unsanitary living conditions (4) Unclean food or water (5) Exposure to gastric contents of an infected individual. Ref: Harrison-E-18,P-2442.
| 4
|
In developed world 80 % of population is affected before the age of 20
|
The prevalence is increasing in developed world
|
Most of the infected are children in developed countries
|
Poor socioeconomic status and less education predisposes to higher colonization rates
|
Medicine
| null |
905d840e-5814-4e4b-94f4-67697f27586a
|
multi
|
Aspergilloma has -
| null | 1
|
Septate hyphae
|
Pseudohyphae
|
Metachromatic hyphae
|
No hyphae
|
Microbiology
| null |
73d855e2-11af-4a94-b253-3a7ad252efdc
|
single
|
Air embolism is best diagnosed by?
|
Transesophageal echocardiography (TEE):- has the highest sensitivity for detecting the presence of air in the right ventricular outflow tract or major pulmonary veins. - It can detect as little as 0.02 mL/kg of air administered by bolus injection. It also has the added advantage of identifying Paradoxical Air Embolism (PAE), and Doppler allows audible detection of venous air embolism (VAE). Overall highest sensitivity :- T.E.E > Doppler > E.T N2> E.T CO2
| 3
|
| End tidal CO2
|
| End tidal N2
|
Doppler study
|
Ultrasound
|
Medicine
|
Thromboembolism and Fat Embolism Syndrome
|
6727d45c-4f29-4459-acc2-cded534e3d5f
|
single
|
All of the following nutritional assessment methods indicate inadequate nutrition, except:
|
Hemoglobin Ref: CURRENT Medical Diagnosis and Treatment, 2008, Page 677; Essential Pediatrics By O P Ghai, 6th Edition, Page 101; Nelson's Textbook of Pediatrics, 18th Edition, Page 228; Park's Textbook of Preventive and Social Medicine, 19th Edition, Pages 515-518
| 1
|
Hb < 11.5 g/dl during 3rd trimester of pregnancy
|
Increased 1-4 year moality rate
|
Bih weight < 2500 gm
|
Decreased weight for height
|
Pediatrics
| null |
15fdc129-6689-47c2-9c85-92772476f7c7
|
multi
|
Most common type of vaginal carcinoma is :
|
Squamous cell carcinoma
| 1
|
Squamous cell carcinoma
|
Adenocarcinoma
|
Transitional cell carcinoma
|
Columnar cell Ca
|
Gynaecology & Obstetrics
| null |
49578c14-29db-427f-a970-e33b1a269802
|
single
|
PSA > 2Ong/mL is seen in:
|
Ans is a (Prostate cancer) Though increased levels of PSA is seen in Prostate cancer, BPH and Prostatitis; levels above 20 ng/mL would be seen almost only in Prostate cancer. BPH and prostatitis would not cause such a rise in PSA.
| 1
|
Prostate cancer
|
BPH
|
Prostatitis
|
Meatastatic carcinoma
|
Surgery
| null |
43424600-dbca-4794-b14e-92d49c4e46e4
|
single
|
First external sign of decomposition in a dead body: NEET 13
|
Ans. Greenish discoloration over right iliac fossa
| 2
|
Decomposition of liver and intestine
|
Greenish discoloration over right iliac fossa
|
Greenish discoloration over dependent pas
|
Bloodstained froth from mouth
|
Forensic Medicine
| null |
44c0dbf1-71f0-4037-b7ec-315f1a93d653
|
single
|
A 60-year-old man is in a car crash in which he is the driver. He did not have a seat belt or an airbag. He is found to have multiple rib fractures over his right chest. His pulse is weaker during inspiration. What are the most likely diagnoses?
|
Flail chest should be suspected in multiple rib fractures where the individual rib is divided in two places. Paradoxical movement results in lung compression as the flail segment moves inward during inspiration.
| 1
|
Flail chest
|
Empyema
|
Diaphragm rupture
|
Cervical rib
|
Surgery
|
Trauma
|
85023e0e-def4-4687-9ee3-71079f8c9daa
|
single
|
Which of the following structure is not supplied by uterine aeries ?
|
The uterus is supplied : (1) Chiefly by the two uterine aeries which are markedly enlarged during pregnancy; and (2) paly by the ovarian aeries. The uterine aery is a branch of the anterior division of the internal iliac aery. Apa from the uterus, the uterine also gives branches to: (1) The vagina; (2) the medial two-thirds of the uterine tube; (3) the ovary; (4) the ureter; and (5) to structures present in the broad ligament. Ref : B D Chaurasia's Human Anatomy , Seventh edition , volume 2, pg. no., 422.
| 4
|
vagina
|
ovary
|
urater
|
lateral one third of uterine tube
|
Anatomy
|
Abdomen and pelvis
|
69d2cb16-44d6-48a5-85c5-79d6b5511301
|
single
|
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