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Which of the following type of malignancy is associated with Marjolin's ulcer?
Marjolin's ulcer is an aggressive transformation of a chronic wound in to a malignant lesion. They are usually present in chronic wounds resulting from burns, chronic inflammation or trauma. The most common malignancy found in Marjolin's ulcer is squamous cell carcinoma. Basal cell carcinomas can occur occasionally. Rarely, malignant fibrous histiocytoma, sarcoma and neurotropic malignant melanoma, have also been associated with it. Ref: Schwaz's Principles of Surgery, 9th Edition, Chapter 9; Trends in Bone Cancer Research By E. V. Birch, Volume 24, Page 58; Cancer Symptom Management By Connie Henke Yarbro, 3rd Edition, Page 295; Atlas of Head and Neck Imaging: The Extracranial Head and Neck By Suresh K. Mukherji, Chapter 11.
2
Basal cell carcinoma
Squamous cell carcinoma
Malignant fibrous histiocytoma
Neurotrophic malignant melanoma
Surgery
null
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single
Clavulanic acid is given in combination with amoxicillin in order to
null
4
Reduce the risk of allergic reactions
Prolong amoxicillin's half-life
Reduce the severity of diarrhea
Extend amoxicillin's antibacterial spectrum
Pharmacology
null
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multi
A 5 year old male child has multiple hyperprigmented macules over the trunk. On rubbing the lesion with the rounded end of a pen, he developed uicarial wheal, confined to the border of the lesion. The most likely diagnosis is
Darriers sign : uicarial wheal produced in a lesion after it is firmly rubbed with a finger or rounded end of a pen, the wheal is strictly confined to the borders of the lesion. Seen in uicarial pigmentosa, and rarely with cutaneous lymphoma or histiocytosiS FITZPATRICK TEXTBOOK OF DERMATOLOGY , PAGE 12.
3
Fixed drug eruption
Lichen planes
Uicaria pigmentosa
Uicarial vasculitis
Dental
Dermatitis
720afc18-c097-4084-8974-4e948c9a4462
single
Proteins whose levels are decreased during inflammation are all except:
Negative Acute phase reactants - Albumin, transferrin, antithrombin.
4
Albumin
Transferrin
Antithrombin
Mannose binding protein
Microbiology
null
f69dc0fd-9374-4414-9660-3371189c6472
multi
Stretch laceration is seen in
Stretch laceration These lacerations occur from over stretching of the skin and soft tissues due to heavy forceful impact exercising a localised pressure. Stretching of tissues can occur in run over by a motor vehicle. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 121
1
Blunt tangential impact
Blunt perpendicular impact
Horizontal crushing
Impact by sharp objects with heavy base
Forensic Medicine
Mechanical injuries
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A 45-year-old woman with Crohn disease and a small intestinal fistula develops tetany during the second week of parenteral nutrition. The laboratory findings include Na: 135 mEq/L K: 3.2 mEq/L Cl: 103 mEq/L HCO3 : 25 mEq/L Ca: 8.2 mEq/L Mg: 1.2 mEq/L PO4 : 2.4 mEq/L Albumin: 2.4 An aerial blood gas sample reveals a pH of 7.42, PCO2 of 38 mm Hg, and PO2 of 84 mm Hg. Which of the following is the most likely cause of the patient's tetany?
Magnesium deficiency is common in malnourished patients and patients with large gastrointestinal fluid losses. The neuromuscular effects resemble those of calcium deficiency--namely, paresthesia, hyperreflexia, muscle spasm, and, ultimately, tetany. The cardiac effects are more like those of hypercalcemia. An electrocardiogram therefore provides a rapid means of differentiating between hypocalcemia (prolonged QT interval, T-wave inversion, hea blocks) and hypomagnesemia (prolonged QT and PR intervals, ST segment depression, flattening or inversion of p waves, torsade de pointes). Hypomagnesemia also causes potassium wasting by the kidney. Many hospital patients with refractory hypocalcemia will be found to be magnesium deficient. Often this deficiency becomes manifest during the response to parenteral nutrition when normal cellular ionic gradients are restored. A normal blood pH and aerial PCO2 rule out hyperventilation. The serum calcium in this patient is normal when adjusted for the low albumin (add 0.8 mg/dL per 1 g/dL decrease in albumin). Hypomagnesemia causes functional hypoparathyroidism, which can lower serum calcium and thus result in a combined defect.
3
Hyperventilation
Hypocalcemia
Hypomagnesemia
Essential fatty acid deficiency
Anaesthesia
Preoperative assessment and monitoring in anaesthesia
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multi
All are indicators for air pollution, except -
Indicators of air pollution: Smoke (soiling) index Sulphur dioxide Grit and dust measurement Coefficient of Haze Air pollution index CO is not an index! Park's Textbook of Preventive and Social Medicine, 25th edition, Page No.796
1
CO
SO2
Soiling Index
Smoke index
Social & Preventive Medicine
Environment and health
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multi
Social Deviance among the following is
null
1
Suicide
Illiteracy
Migration
Child abandoning
Social & Preventive Medicine
null
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Fructose 2-6 bisphosphate (F26BP) regulates glycolysis at the level of ?
Regulation of glycolysis Glycolysis is regulated at 3 steps which are irreversible. These reactions are catalyzed by following key enzymes : (1) Hexokinase and glucokinase, (2) Phosphofructokinase I, and (3) Pyruvate kinase.Hexokinase and glucokinaseThese enzymes catalyze the first step of glycolysis, i.e., Glucose --> Glucose-6-phosphate. Glucokinase is found in liver, Whereas hexokinase is found in all tissues. Kinetic propeies of these two are different.Hexokinase has low Km, i.e., high affinity for glucose, low Vmax, and is subjected to feedback inhibition by the reaction product, glucose-6-phosphate. Hexokinase is found in most of the tissue except liver and comes into play when blood glucose is low. It is not affected by feeding or insulin. Hexokinase is not specific for glucose metabolism, it is also involved in metabolism of fructose and galactose.Glucokinase, on the other hand, is specific for glucose. It has high Km (i.e., low affinity for glucose), high Vmax and unlike hexokinase, it is not inhibited by glucose-6-phosphate. As it has low affinity for glucose (high km), it comes into play only when intracellular glucose concentration is high. It is induced by feeding and insulin. Glucagon inhibits glucokinase.Function of hexokinase is to provide glucose-6-phosphate at a constant rate, according the needs of cells, i.e., function of hexokinase is to provide constant glucose utilization by all tissues of body even when blood sugar is low. Function of glucokinase in the liver is to remove glucose from blood after a meal, providing glucose-6phosphate in excess of requirement for glycolysis so that it can be used for glycogen synthesis and lipogenesis.Phosphofructokinase IPhosphofructokinase I is the major regulatory enzyme of glycolysis. It catalyzes the 3rd reaction of glycolysis, i.e., fructose-6-P Fructose 1,6 bis-P. This reaction is irreversible and is the "rate -limiting step" for glycolysis. It is also the "commeted step", meaning that once fructose 1,6 bisphophate is formed it must go for the glycolytic pathway only. So, most impoant control point for glycolysis is through regulation of phosphofructokinase I.Phosphofructokinase - I is allosterically activated by : Fructose-6-phosphate, fructose 2,6-bisphophate, AMP, ADP, K+ and phosphate. It is allosterically inhibited by : ATP, citrate, Ca+2, Mg+2, and low pH. Phosphofructokinase is an inducible enzyme that increases its synthesis in response to insulin and decreases in response to glucagon.Fructose 2,6-bisphosphate (F-2,6-BP) is the most impoant allosteric modulator (activator) of phosphofructokinase-I. Fructose 2,6-bisphosphate is synthesized as a side product of glycolysis. A bifunctional enzyme named PFK-2/Fructose 2,6 bisphosphatase is responsible for regulating the level of fructose 2,6 bisphosphate in the liver. Phosphofuctokinase-2 (PFK-2) activity of this bifunctional enzyme is responsible for synthesis of F-2,6-BP from fructose-6-phosphate and fructose 2,6 bisphosphatase activity is responsible for hydrolysis of F-2,6-BP back to fructose-6-phosphate.
2
Glucose -6- phosphate
Fructose -6- phosphate
Glyceraldehyde -3- phosphate
Phosphoenol pyruvate
Biochemistry
null
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All of the following structures are removed in right hemicolectomy except
Answer- C. Transverse colonStructures removed in right hemicolectomy:Caecum with appendixAscending colonHepatic flexureProximal transverse colonPa of terminal ileumFat and lymphnodes
3
Caecum
Ascending Colon
Transverse colon
Hepatic Flexure
Surgery
null
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Causative factor for acne are all except.
B i.e. Only food
2
Androgen
Only food
Bacterial contamination
Hypercornification of duct
Anaesthesia
null
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multi
In which case homologus artificial insemination is used in females:
null
3
Hormonal disturbance
Tubal block
Cervical factor
All of the above
Gynaecology & Obstetrics
null
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multi
A patient on Phenytoin therapy develops depression, for which he was prescribed tricyclic anti-Depressants. He now complains of lassitude and his Hb reading is 8gm/dl, the next step in the management of this patient is:
phenytoin can induce folate deficient megaloblastic anemia that can be diagnozed by measuring MCV. REF: KD TRIPATHI 8TH ED.
2
Chest X ray
MCV should be estimated
GGT should be estimated
None of the above
Pharmacology
Central Nervous system
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Nodules seen near the collarette are called -
The pathological reaction in granulomatous uveitis is characterised by infiltration with lymphocytes, plasma cells, with mobilization and proliferation of large mononuclear cells which eventually become epithelioid and giant cells and aggregate into nodules. Iris nodules are usually formed near pupillary border (Koeppe's nodules). and sometimes near collarette (Busacca nodules).
1
Busacca nodules
Koeppe's nodules
Lisch nodules
Dalen Fuch's nodules
Ophthalmology
Uveal tract
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Among patients who require nutritional resuscitation in an intensive care unit, the best evidence that nutritional suppo is adequate is
.Because of its relationship to inflammation, serum albumin is no longer considered a good indicator of malnutrition or protein repletion. .However, a decreased serum albumin is considered an indicator of morbidity and moality and persons with low albumin levels are sometimes at nutritional risk for other reasons. ref Robbins 9/e pg 345
3
Urinary nitrogen excretion levels
Total serum protein level
Serum albumin level
Serum transferrin levels
Pathology
All India exam
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single
Antidepressant causing Tardive dyskinesia is ?
Ans. is 'd' i.e., Amoxapine Amoxapine is the only antidepressant which blocks D2 receptors along with inhibition of NA reuptake - has mixed antidepressant + neurolepic propey. Due to blockade of D, receptors it causes extrapyramidal side effects -4 Parkinsonism, Tardive dyskinesia, Akathesia, neuropeptic malignant syndrome.
4
MAO inhibitors
Mianserin
Imipramine
Amoxapine
Pharmacology
null
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All are true about glomus jugulare tumors except:
Ans. C It is a disease of infancyLet us see each option separatelyOption a - Common in femalesIt is correct as females are affected five times more than males.Option b - Causes sensorineural deafnessThis is paially correct as glomus tumor leads to mainly conductive type hearing loss. Sensorineural hearing loss is uncommon but can occur if the tumor erodes the dense otic capsule bone and invades the inner ear.Option c - It is a disease of infancyThis is incorrect as Glomus tumor is seen in middle age (40-50 years)Option d -It invades labyrinth, petrous pyramid and mastoid.
3
Common in female
Causes sensory neural deafness
It is a disease of infancy
It invades labyrinth, petrous pyramid and mastoid
ENT
null
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multi
Which of the following anaesthetic agent lacks analgesic effect – a) N2Ob) Thiopentonec) Methohexitoned) Ketaminee) Fentanyl
Barbiturates (methexitone, thiopentone) do not have analgesic action. Rather they can cause hyperalgesia.
4
a
c
ac
bc
Anaesthesia
null
57b77163-3637-40fe-af0f-3ac8c5baf48d
single
To increase awareness of rural population towards small family norm, the best method is –
The health educator should set a good example in the things he is teaching. If he is explaining the hazards of smoking, he will not be very successful if he himself smokes. If he is talking about the "small family norm" he will not get very far if his own family size is big.
4
Film show
Charts Exhibitions etc
Role playing
Setting on example
Social & Preventive Medicine
null
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Bronchial artery supplies all except:
Ans: d (Alveolar sac)Ref: Essentials of Human Anatomy By AK Dutta-Thorax & Abdomen, 3rd edi., Observations on the normal anatomy of the bronchial arteries by L. Cudkowicz* And J. B. Armstrong, Chaurasia, 4th edi., Pg. 227.Arterial supply of the lungs: The bronchial arteries supply nutrition to the bronchial tree and to the pulmonary tissue. On the right, there is one bronchial artery and on the left, two which arise from the descending thoracic aorta.Each bronchial artery arises from descending thoracic aorta.Bronchial artery supplies:Bronchial tree up to terminal bronchial tubeThe walls of pulmonary vesselsFibro elastic septa &Hilar lymph nodesRespiratory bronchiole, alveolar duct and sac are supplied by pulmonary artery. Up to alveolar duct it gets anastomotic branch from bronchial artery.Therefore alveolar sac is the answer of exception.
4
Bronchus
Bronchioles
Alveolar duct
Alveolar sac
Anatomy
Thorax
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In splenic injury conservative management is done in
Most serious complications after splenectomy are OPSI (Oppounistic Post Splenectomy Infections) it is most common in young children and immunocompromised adults. "Therefore it is essential to save the spleen in children." Now spleen salvage methods are the management of choice even in adults. Splenectomy is usually indicated under the following circumstances (Ref: Sabiston 18/e pi639 (17/e} p 1694) 1. the pt. is unstable 2. the spleen is extensively injured with continuous bleeding 3. bleeding is associated with hilar injury 4. other injuries require prompt attention SRB 5th edition page no. 672 & 671
2
Hemodynamically unstable
Young patients
Shattered spleen
Extreme pallor and hypotension b
Surgery
G.I.T
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True about mycetoma -
Mycetoma Commonly occurs in the foot. The infection runs as a relentless course over many years, with the destruction of contiguous bone and fascia. Spread to distant sites does not take place (does not drain through lymphatics). Actinomycetoma may respond to prolonged combination chemotherapy eg. streptomycin and dapsone. Treatment Actinomycetoma May respond to prolonged combination chemotherapy - Streptomycin and dapsone or streptomycin and cotrimoxazole. Eumycetoma Rarely respond to chemotherapy. Some cases caused by madurella mycetomatis may respond to ketoconazole or itraconazole.
2
Commonly occurs in hands
Commonly erodes bone
Drains through lymphatics
Antibiotics has no role
Microbiology
null
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In all of the following conditions, prostanoid may be used, except
(Refer: Rang and Dale's Clinical Pharmacology, 7th edition, pg no: 214-215)
4
Glaucoma
Platelet coagulation disorders
Gastric ulcer
Closure of PDA
Anatomy
All India exam
94d76639-b416-4d22-affb-b210c0c90eed
multi
Scorpion venom resembles venom of -
scorpion venom is clear toxalbumin and can be classified as hemlolytic or neurotoxic small quantity is injected REF;THE SYNOPSIS OF FORENSIC MEDICINE:KS NARAYANA REDDY;28th EDITION;PAGE NO 324
4
Cobra
Viper
Krait
All of the above
Forensic Medicine
Poisoning
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Dialysis can not be done for
Dialysis can not be done for these drugs because of large volume of distribution (Vd).
4
Amphetamine
Digoxin
Propanalol
All of the above
Pharmacology
null
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multi
Highest chance of success in renal transplant is seen when the donor is the -
null
1
Identical twin
Father
Mother
Sister
Surgery
null
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single
Use of Thiopentone
D i.e. All
4
Seizure
Truth spell
Reduction of ICP
All
Anaesthesia
null
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True about legionella-
Ans. is 'b' i.e., There is no man to man transmission o The nature habitats for L. pneumophila are aquatic bodies, including lakes and streamso The legionellae survive and multiply inside freeliving amebae and other protozoao Mode of transmissions :1) Aerosolization : Inhalation of aerosols produced by cooling towers, air conditioners and shower heads which act as disseminators.2) Aspiration : Is the predominant mode of transmission.3) Direct instillation in to the lungo The source of legionella is watero No animal reservoir existso No carrier state is estabilishedo Man to man transmission does not occur.
2
Most common mode of transmission is aerosal inhalation
There is no man to man transmission
Prolonged carrier are common
All are true
Microbiology
Bacteria
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multi
Marquis test is done for: BHU 08
Ans. Morphine poisoning
3
Mercury poisoning
Arsenic poisoning
Morphine poisoning
Cyanide poisoning
Forensic Medicine
null
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single
What is the MOST common radiographic manifestation of acute papillary muscle rupture?
The papillary muscles are connected to the mitral valve leaflets by the chordae tendinae. When there is rupture of the chordae tendinae or the papillary muscle itself, the mitral valve is unable to function properly, resulting in mitral regurgitation. Because this is an acute process, accommodation does not occur, resulting in acute pulmonary edema. Edema predominantly affecting the right upper lobe can be seen if the jet of regurgitant blood is directed into the right superior pulmonary vein, which drains the right upper lobe. The left atrium will enlarge over time in the setting of mitral valve regurgitation due to the increased volume of blood that is directed into the left atrium during systole. However, this change occurs over time and will not be seen in the setting of acute papillary muscle rupture. The left ventricle will enlarge oveime in the setting of mitral valve regurgitation because it receives an increased volume of blood from the left atrium - both the volume of blood returning from the lung as well as the regurgitant volume of blood through the mitral valve. As with left atrial enlargement, left ventricular enlargement will occur over time but will not be seen in the setting of acute papillary muscle rupture. Pericardial effusion can occur in the setting of an acute myocardial infarction due to inflammation of the pericardium. Dressler syndrome, thought to be an autoimmune inflammatory response to myocardial neo-antigens, is not an acute process and, when present, occurs several weeks following a myocardial infarction. However, it is not the most common radiographic manifestation of acute papillary muscle rupture.
1
Pulmonary edema
Left atrial enlargement
Left ventricular enlargement
Pericardial effusion
Radiology
Cardiovascular system
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Full-term, Small for Date babies are at high risk of –
Small for date babies are prone to hypoglycemia. Intraventricular hemorrhage occurs in preterm infants (not in full term, small for date babies).
1
Hypoglycemia
Intraventricular haemorrhage
Bronchopulomonary dysplasia
Hyperthermia
Pediatrics
null
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In Glycinuria, glycine is excreted as
(D) Oxalate # Diseases associated with glycine metabolism: are 1. Glycinuria and 2. Primary hyperoxaluria> In Glycinuria there is excessive urinary excretion of glycine with a tendency to form oxalate renal stones. This disease is inborn and very rare.> Primary hyperoxaluria is a metabolic disease characterized biochemically by a continuous and high excretion of oxalate in urine, the excess oxalate probably coming from glycine.> There is recurrent infection of the urinary tract.> In vitamin B6 deficiency also, increased quantities of oxalate are excreted
4
Urea
Glutathione
Formate
Oxalate
Biochemistry
Miscellaneous (Bio-Chemistry)
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Virchow method of organ removal is
In Virchows method organs are removed one by one. Cranial cavity is exposed first then thoraxic, cervical and abdominal organs. Dr. Narayana Reddys Synopsis of Forensic Medicine & Toxicology 27 th edition pg. 57.
2
Organs removed en masse
Organs removed one by one
In-situ dissection
En-block removal of viscera
Forensic Medicine
Death and postmortem changes
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single
Vaginal wall is derived from ?
Ans. is 'c' i.e., Endoderm and mesoderm Vagina is derived from two sources :? Upper 2/3" : It is derived from Utero-Vaginal Canal, i.e. the fused pa of paramesonephric duct. Therefore, this pa is mesodermal in origin. Lower 1/3" : It is derived from sinovaginal bulb which inturn is derived from urogenital sinus. Thus, this pa is endodermal in origin.
3
Endoderm
Mesoderm
Endoderm and mesoderm
Ectoderm and mesoderm
Anatomy
null
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Blood is stored at what temperature in blood bank?
Ans. is 'c' i.e., 1 to 6 degrees Celsius
3
-2 to -4 degrees Celsius
-2 to 0 degrees Celsius
1 to 6 degrees Celsius
6 to 12 degrees Celsius
Pathology
null
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Multiple Hypoaestetic, hypopigmented macules on right lateral forearm without acid fast bacilli is indicative of -
indeterminate leprosy seen in children with immature immunological response. Common in 1-5 years of age 1-3 ill defined hypopigmented macules ranging in size from 1-5cm most common sites: outer side of extremities, buttocks,face and trunk sensations may be impaired. Nerve thickening may be present skin smears : shows acid fast bacilli on serial sections iadvl textbook of dermatology, page 2035
3
Tuberculoid leprosy
Lepromatous leprosy
Indeterminate leprosy
Borderline leprosy
Dental
Bacterial infections
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Burking includes
Burking is a method of homicidal smothering & traumatic asphyxia. Named after Burke & Hare who killed 16 persons. They give the victim alcohol. Then Burke used to kneel or sit on the chest and close the nose & mouth with his hands then Hare used to pull him around the room by the feet. Ref: The synopsis of forensic medicine & Toxicology 28th edition pg:190
4
Choking
Ligature
Overlaying
Traumatic asphysia
Forensic Medicine
Asphyxia
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Most common site of gall stone impactation is -
Ans is 'b' i.e., Proximal to Ileocaecal junction
2
Duedenojejunal junction
Proximal to iliocaecal junction
Distal to iliocaecal junction
Colon
Surgery
null
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Muscle of expiration is/are -a) Diaphragmb) Internal intercostalc) External intercostald) Rectus Abdominis
Muscles of expiration -        Quite breathing- Elastic recoil of lung and chest wall. -        Forced expiration- o   Internal intercostal o   Intercostalis intimi o   Transversus thoracis o   Serratus posterior inferior o   Subcostalis o   Latissimus dorsi o   Abdominal muscles §  Rectus abdominis §  Transversus abdominis §  Internal oblique §  External oblique
2
ac
bd
cd
ab
Anatomy
null
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Recommended interventions to reduce the incidence of Coronary aery disease include the following except-
The reduction of fat intake to 20 to 30 % of total energy intake. Ref- Park&;s textbook of Preventive and Social Medicine 24th edition.
4
Dietary cholesterol < 100/mg/1000kcal/day
Salt intake <5gm
No alcohol
Fat intake<10% of total energy
Social & Preventive Medicine
Non communicable diseases
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Treatment of choice in 11 years old children with hepatitis C infections ?
Treatment of Hepatitis C : Sustained virologic response are achieved in only 8-35%of patients given recombinant interferon monotherapy. However significantly higher sustained virologic responses are attained(30-40%)by combining interferon with Ribavarin at 15mg/kg/day Long acting pegylated interferons have been subsequently developed based on the premise that more sustained drug levels would result in greater antiviral activity Interferons have been well tolerated in children Ref : ESSENTIAL PEDIATRICS,O.P.GHAI, PG NO:195,7th edition
2
Vaccine
Interferon
Gamma-globulin
Coicosteroids
Pediatrics
Gastrointestinal tract
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Aerial supply to epistaxis area are all except
Epistaxis area is Little's areaFour aeries contribute to little's area:Anterior ethmoidal aerySeptal branch of the superior labial aery (Branch of facial Aery)Septal branch of sphenopalatine aery (Branch of maxillary Aery)Greater palatine aery (Branch of maxillary Aery)Ref: PL Dhingra, Diseases of Ear, Nose & Throat, 7th edition, pg no.165
3
Greater palatine
Anterior ethmoidal
Posterior ethmoidal
Sphenopalatine
ENT
Nose and paranasal sinuses
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Natural method of contraception is: September 2005
Ans. D: All of the above Natural methods of contraception are: Abstinence Refraining from penetrative sex provides 100% protection from pregnancy, and offers effective prevention of transmission of sexually transmitted infections as well. Withdrawal or Coitus interruptus The withdrawal method of family planning is unlike other natural methods in that it is male-controlled. Calendar methods - based on calculations of cycle length In calendar rhythm methods, a woman makes an estimate of the days she is feile based on past menstrual cycle length. This involves setting the days of avoidance of unprotected intercourse. Methods based on symptoms and signs - Ovulation Method, Billings Method, Cervical Mucus Method These methods are based on the changes in cervical secretions due to the effects of circulating levels of estrogen and progesterone - Basal Body Temperature (BBT) Method Due to the actions of progesterone on the hypothalamus, a woman's body temperature rises slightly after she ovulates (0.2 to 0.5 degrees C) and remains elevated until the end of the cycle, until menstruation. Women who use this method must cha their temperature every day, immediately after waking up and before getting out of bed or drinking any liquids. - Sympto-Thermal Method - This method combines several techniques to predict ovulation. It typically includes monitoring and chaing cervical mucus and position and temperature changes on a daily basis and may include other signs of ovulation, such as breast tenderness, back pain, abdominal pain or "heaviness," or light intermenstrual bleeding. Lactational Amenorrhea Method (LAM) Breastfeeding to achieve contraception, called the lactational amenorrhea method, or LAM, is more than 98% effective during the first 6 months following delivery.
4
Rhythm method
Coitus interruptus
Breast feeding
All of the above
Social & Preventive Medicine
null
9b596fa6-bbb6-4ee0-9868-a4358d7e29b7
multi
When do you operate for prolapsed disc -
Ans. is 'c' i.e., Severe pain interfering with activity and not relieved by rest and treatment of 8 weekso Indications for surgery in cases of Prolapsed intervertebral disc areFailure of conservative treatment (even after 8 weeks of treatment).Progressive neurological deficit.Cauda - equina syndrome.Severe sciatic tilt.
3
Busy executive needs quick surgery
Only with weakness no pain
Severe pain interfering with activity and not relieved by rest and treatment of 8 weeks
Patient of P1D with difficulty in ambulation
Orthopaedics
Management In Orthopedics
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single
"a" wave in JVP indicates:
A wave: Arc positive waves due to distention producedby right atrial contraction Large a waves: Indicate atrium is contracting against increased resistance tricuspid stenosis, pulmonary stenosis, pulmonary hypertension. Cannon S waves Regularly: During junctional rhythm. Irregularly: complete Heart Block. Absent a waves: Atrial Fibrillation
1
Atrial systole
Ventricular systole
Atrial relaxation
Tricuspid regurgitation
Unknown
null
14f3b60a-92a0-4725-b367-dfe7ef40bc93
single
Isthmus of thyroid gland corresponds to which of the following tracheal rings?
Isthmus of the thyroid gland lies in front of the second, third and fouh tracheal rings. It is covered in front by skin and fascia, and by sternothyroid and sternohyoid muscles and by the anterior juglar veins. Upper end of each lobe of thyroid lies opposite C5 veebrae. The lower end of the lobe lies at the level of 5th or 6th tracheal ring corresponding to T1 veebrae.
2
3-Jan
4-Feb
6-Apr
8-Jun
ENT
null
8b6f8d43-f5a7-461c-be54-8a2c878335ae
single
Which of the following is used in management of diabetes?
Answer- A. BromocriptineBromocriptine is recently included as antidiabetic.
1
Bromocriptine
Octreotide
Prednisolone
Pegvisomant
Medicine
null
8ffb4534-6bf9-4d4b-8fa9-703257502f19
single
Rice watery stool is indicative of which organism-
Ans. (a) Vibrio cholerae OlRef: Microbiology by Ananthanarayan and Paniker 8th ed. /302-305* Though the various strains of cholera may present with rice watery diarrhea, the classic rice watery diarrhea is usually associated with strains Ol and strain 0139.* In these strains the more common strain to find is strain Ol.
1
Vibrio cholerae Ol
Vibrio cholerae 0139
Vibrio vulnificus
Shigella
Microbiology
Vibrio
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single
Octreotide is, except -
Ans. is 'd' i.e., An absorbent
4
Somatostatin analogue
Used in refractory diarrhoea in AIDS
Used in carcinoid
An absorbent
Pharmacology
null
cc7ab6ee-b31b-4da9-a22b-1b73362a275a
multi
Anterior choroidal aery is a branch of
After piercing the dura mater forming the roof of the cavernous sinus, the internal carotid aery gives off three large branches. These are the following. (i) Ophthalmic aery (which supplies the orbit), and the (ii) Anterior and Middle cerebral aeries to the brain.It also gives off two smaller branches that take pa in supplying the brain: these are the (iv) Posterior communicating aery and the (v) Anterior choroidal aery.Ref: BD Chaurasia; volume 3; 6th edition; Page no: 384
4
Anterior cerebral aery
Middle cerebral aery
Posterior cerebral aery
Internal carotid aery
Anatomy
Brain
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single
The most common oppounistic infection observed in patients with AIDS is -
The symptoms of PCP include Fever Cough Difficulty breathing Chest pain Chills Fatigue (tiredness) In people with HIV/AIDS, PCP symptoms usually develop over several weeks and include a mild fever. In people who have weakened immune systems for reasons other than HIV/AIDS, PCP symptoms usually develop over a few days, often with a high fever. Ref Harrison20th edition pg 1078
4
Atypical mycobacteria
Haemophilus influenzae
Pseudomonas aerugiosa
Pneumocystis carinii
Medicine
Infection
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single
A 28-year-old taxi driver is chronically consumed by fears of having accidentally run over a pedestrian. Although he tries to convince himself that his worries are silly, his anxiety continues to mount until he drives back to the scene of the "accident" and proves to himself that nobody lies hu in the street. This behavior is an example of which of the following? NOT RELATED - PSYCHIATRY
.
1
A compulsion secondary to an obsession
An obsession triggered by a compulsion
A delusional ideation
A typical manifestation of obsessive-compulsive personality disorder
Pharmacology
All India exam
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multi
All the following are characteristic of classic tetrad of TOF except
Anatomically TOF is characterized by the classic tetrad: Severe right ventricle outflow obstruction, Large VSD, Aoa that overrides the VSD and Right ventricular hyperophy Reference: Essential Paediatrics; O.P. Ghai; Page no: 420
4
Large VSD
Aoa that overrides the VSD
Severe right ventricle outflow obstruction
Left ventricular hyperophy
Pediatrics
C.V.S
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multi
The maxillary nerve arises from the trigeminal ganglion in the middle cranial fossa. It passes forward in the lateral wall of the cavernous sinus and leaves the skull through which of the following foramen to enter the pterygopalatine fossa
(Foramen rotundum) (236 - BDC - 3)STRUCTURE PASSING THROUGH.Foramen spinosumForamen ovaleForamen lacerum1. Middle meningeal artery2. Meningeal branch of the mandibular nerve or nervus spinosus3. Posterior trunk of the middle meningeal vein1. Mandibular nerve 2. Acessory meningeal artery 3. Lesser petrosal nerve 4. Emissary vein Internal carotid artery Foramen rotundumSuperior orbital fissureJugular foramenMaxillary division of the trigeminal nerveLacrimal, frontal, trochlear occulomotor, nasociliary and abducent nerve, superior ophthalmic vein* Glossopharyngeal* Vagus* Acessory nerve* Sigmoid sinus becomes internal jugular vein
3
Foramen ovale
Foramen spinosum
Foramen rotundum
Formen lacerum
Anatomy
Head & Neck
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multi
Which of the following are NOT associated with complex tongue thrusting activity?
null
2
Naso-respiratory distress
Contraction of the teniporalis muscle
Contraction of the mentalis and lower lip during swallow
Absence of contact of teeth during swallow
Dental
null
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multi
The sputum examination under TP is done when the patient present with -a) Cough of 1-2 weeks durationb) Persistent cough of 1-2 weeks durationc) Hemoptysisd) Chest paine) Intermittent fever
null
4
ab
bc
bd
cd
Social & Preventive Medicine
null
9de294e1-9bb1-4719-9fd0-69db91d292c0
single
Drug which is used to control status epilepticus is
null
1
Diazepam
Sodium nitroprusside
Glyceryl trinitrite
Pheno barbital
Pharmacology
null
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single
Multifactorial inheritance is most likely to play a role in?
A quantitative trait locus (QTL) is a section of DNA (the locus) that correlates with variation in a phenotype (the quantitative trait). Usually the QTL is linked to, or contains, the genes that control that phenotype. QTLs are mapped by identifying which molecular markers (such as SNPs or AFLPs) correlate with an observed trait. This is often an early step in identifying and sequencing the actual genes that cause the trait variation. Quantitative traits are phenotypes (characteristics) that vary in degree and can be attributed to polygenic effects, i.e., the product of two or more genes, and their environment.
1
Cleft lip
Marfan's syndrom
Erythroblastis fetalis
Down's syndrome
Pathology
General pathology
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single
Intestional absorption of Calcium is decreased by
null
3
Proteins
Lactose
Phytic Acid
Acidity
Pathology
null
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single
Drugs commonly used in Non-Hodgkin lymphoma except
Combination chemotherapy is the treatment standard for patients with diffuse non-Hodgkin's lymphoma. The anthracycline-containing regimen CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) has been considered the best treatment in terms of initial therapyHodgkin's lymphoma - MOPP (mechlorethamine, vincristine, procarbazine, and prednisone) regimenMore recently, ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) has been shown to be more effective and less toxic than MOPPKatzung 12e pg: 970
4
Doxorubicin
Cyclophosphamide
Vincristine
Cisplatin
Pharmacology
Chemotherapy
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multi
A person with 'Inappropriate speech' evaluated by the 'Glasgow Coma Scale' will have a verbal score of:
Answer is B (3): Use of Inappropriate words (Inappropriate speech) carries a score of '3' under the 'Verbal Response' according to the Glasgow Coma scale.
2
4
3
2
1
Medicine
null
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single
True about wound healing
• Epidermal appendages do not regenerate • There remains a connective tissue scar in place of the mechanically efficient meshwork of collagen in the unwounded dermis. • Very superficial wounds: Little scar formation. • In marked contrast with wound healing in adults, fetal cutaneous wounds heal without scar formation, up to mid-gestation age in some animals. These wounds show little inflammation and practically no fibrosis. Cutaneous wound healing is divided into three phases • Inflammation (early and late) • Granulation tissue formation and re-epithelialization • Wound contraction, ECM deposition and remodeling
2
Infected wound heal by primary intention
Deep dermal wound heal by scar formation
Wound contraction is found in healing by secondary intention
More intense inflammatory response in primary intention
Surgery
null
1a0a79fb-36b8-419c-a87f-a18f06a6a9c8
multi
Gastrectomy produces deficiency of which vitamin -
Ans. is 'b' i.e.. Vitamin B12 o The intestinal absorption of vitamin Bu requires intrinsic factor (IF), secreted by parietal cells of the stomach.o In stomach vitamin Bt2 binds to IF to form vitamin Bn-IF complex which intum is absorbed by sepecific receptors on mucosal cells of the ileum.o Vitamin Buis also called as 'extrinsic factor' of castle.
2
VitaminB6
Vitamin B12
Vitamin B2
Vitamin B1
Biochemistry
Vitamins
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single
Which of the following is true about diazoxide except
Causes severe hypoglycemia Diazoxide Diazoxide is a direct acting aeriolar dilator. Diazoxide causes aeriolar dilatation with little effect on veins. Diazoxide prevents smooth muscle contraction and relaxes the aerioles Diazoxide is a potassium channel activator which causes local relaxation in smooth muscle by increasing membrane permeability to potassium ions. This switches off voltage gated calcium ion channel which inhibits the generation of action potential. When used as an intravenous antihypeensive agent diazoxide causes excessive hypotension. Diazoxide was formerlyused as an intravenous bolus dose for the at of hypeensive emergencies. But the dangers of excessive hypotension are now recognized to outweigh the benefit, and its emergency use is obsolete. Hypotension due to diazoxide has resulted in stroke and myocardial infarction. - The reflex sympathetic response due to hypotension can provoke angina, electrocardiographic evidence of ischemia and cardiac failure in patients with ischemic hea disease and diazoxide should be avoided in this situation. Diazoxide produces hyperglycemia by increasing insulin secretion, therefore it is used to treat various forms of hypoglycemia Diazoxide activates the same potassium channel in the pancreatic islet cells that is blocked by sulfonylureas. SullOnylureas close the potassium channels and increase insulin secretion whereas diazoxide opens the potassium channel in pancreatic islet cells and decrease insulin secretion. Due to its hyperglycemic action it is a useful drug for patients with chronic hypoglycemia from excess endogenous insulin secretion, either from an iselt cell tumour (insulinoma) or islet cell hyperplasia. According to Lawerence Diazoxide stimulates the ATP dependent r channel that is blocked by the sulphonylureas. Therefore its chronic use as an antihypeensive agent is precluded by the development of diabetes. Indeed its use in therapeutics should now be confined to rare indication of treating hypoglycemia due to islet cell tumour (insulinoma). Diazoxide is chemically related to thiazide diuretics. But in contrast to the structurally related thiazide diuretics, diazoxide causes renal salt and water retention.
3
K+ channel opener
>Can be used as antihypeensive agent
>Causes severe hypoglycemia
>Used in insulinoma
Pharmacology
null
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multi
Duration of treatment is multibacillary leprosy according to WHO is -
For multibacillary cases, adequate treatment implies that the patient has recieved 12 monthly doses of combined therapy within 18 months. Reference; Park&;s Textbook of preventive and social medicine, 24th edition.Pg no. 340
2
6 months
1 year
2 years
5 years
Social & Preventive Medicine
Communicable diseases
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single
Megaloblasticanemia occur due to deficiency of
null
2
Iron deficiency
Folate deficiency
Protein deficiency
Vitamin C deficiency
Pathology
null
6f76af2e-c1b8-4b85-98a6-46d5a697faa8
single
Triple helix is found in ?
Ans is 'b' i.e., Collagen Collagen Collegen is the most common protein in the animal world. It is a component of ECM. The collegens are composed of a triple helix of three polypeptide a-chains. It provides tensile strength to tissues. Collegen type IV with laminin is the main component of basement membrane. Fibrillar collegen is synthesized from procollegen. First there is hydroxylation of lysin & proline residues of procollegen. After hydroxylation of lysine and proline residues of procollegen three procollegen chains align in phase to form triple helix. After that oxidation of lysine & hydroxylysine by lysyl oxidase, and proline & hydroxyproline by prolyl oxidase, take place - this results in cross-linking between the chains of adjacent molecules, thus stabilizing the array that is characteristic of collegen. Cross-linking is a major contributor of the tenile strength of collegen. Vit 'c' is required for hydroxylation of lysine & proline residues ofprocollegen - In scurvy (Vit 'c' deficiency) poor wound healing is due to inhibition of this step.
2
Cystine
Collagen
Pectin
DNA
Pathology
null
6acf449d-82a9-4ece-8355-8987cc78544c
single
Hypoxia due to slowing of circulation is seen in which type of hypoxia?
Ischemic hypoxia or stagnant hypoxia is due to slow circulation and is a problem in organs such as kidneys and hea during shock.Hypoxia due to anemia is not severe at rest unless Hb deficiency is marked. Anemic patients may have considerable difficulty during exercise because of limited ability to increase O2 supply to active tissues. In histotoxic hypoxia, hypoxia is due to inhibition of tissue oxidative processes. Most commonly seen with cyanide poisoning. Ref: Ganong&;s Review of medical physiology, 25th edition.Pg no.650,651
4
Anemic hypoxia
Histotoxic
Hea disease
Stagnant
Physiology
Cardiovascular system
652ec97a-4bb2-44c8-8c81-aee9cab205ab
single
Which process establishes the three definitive germ layers?
Gastrulation - three primary germ layers from epiblast during week 3 of development i.e dorsal ectoderm, middle mesoderm, ventral endoderm. Neurulation is the process by which neuroectoderm forms the neural plate, which eventually folds to form the neural tube.
2
Neurulation
Gastrulation
Craniocaudal folding
Lateral folding
Anatomy
Development period- week 1,2,3,4
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single
What is the mode of action of local anesthetics?
Sodium channels are membrane bound proteins that are composed of one large and subunit through which Na ions pass, and one or two smaller b subunits. Voltage - gated Na channels exist in three stages - resting, open and inactivated local anesthetics bind a specific region of the & subunit and inhibit voltage - gated Na channels preventing channel activation and Na influx associated with membrane depolarization. Main mechanism of action of local anesthetics is through inhibition ofActivated, voltage-gated Na channel. Local anesthetics have a greater affinity for the channel in the open or inactivated state than in the resting state. Local anesthetic binding to open or inactivated channels, or both, is facilitated by depolarization. The fraction of Na channels that have bound a local anesthetic increases with frequent depolarization (eg, during trains of impulses).This phenomenon is termed use-dependent block Local anesthetic inhibition is both voltage and frequency dependent, and is greater when nerve fibers are firing rapidly than with infrequent depolarizations Sodium passess through voltage gated sodium channel and cause change in membrane potential and cause depolarization. Local anesthetic attaches to sodium channel and prevents propogation & depolarization
1
Prevents Na+ channel activation and the Na+ influx associated with membrane depolarization.
Change the voltage gated Na+ channel from conducting to non conducting
Destroys the Na+ channel
Close the Na+ channel
Anaesthesia
Regional Anesthesia
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single
Which of the following is most acceptable theory explaining development of endometriosis
Sampson's Theory of Retrograde menstruation is the most favoured theory explaining endometriosis.
2
Coelomic metaplasia
Retrograde menstruation
Lymphatic spread
Mullerian remnants outside uterus
Gynaecology & Obstetrics
null
86b8f4a7-7f41-45f5-ace8-aac6055619f3
single
Laproscopic cholecystectomy is largely preferred for all of the following reasons to conventional laparotmy EXCEPT -
null
2
Decrease pain
Decresed incidence of bile duct injuries
Smaller scar
Decreased stay in hospital
Surgery
null
5a053b25-f508-44af-ba74-df2a52efa2e7
multi
60 yrs old male with poor stream of urine, post void residual urine is 400m1, bA hydronephrosis and prostate weighing 70 g. His urea is 120 and creat 3.5. Ideal "next immediate" step :
Catheterize with Foley catheter [Ref: Bailey and Love 25/e p1316, 1349; CSDT I 3/e p922/ "Catheterization is mandatory for acute urinary retention. Spontaneous voiding may return, but a catheter should be left indwelling.for 3 days while detruson tone returns."- CSDT I 3/e This is a case of bladder outlet obstruction most likely due to BHP (can also he due to ca). So the immediate next step is to drain the bladder a transurethral Foley catheter. If this fails suprapubic drainage can be done
1
Catheterize with Foley catheter
bA PC Nephrostomies
CT to rule out ca
MRI pelvis
Surgery
null
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multi
Optimal timing of administration of prophylactic antibiotic for surgical patients is:
IV administration at induction of anesthesia is optimal. If induction is not mentioned in the option go for 30 minutes to 1 hours before surgery.
1
At the induction of anesthesia
Any time during the surgical procedure
One hour after induction
One hour prior to induction of anesthesia
Surgery
Trauma
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single
An infant should be exclusively breastfed till
An infant should be exclusively breastfed till six months of age Cardinal principles of breastfeeding practice Initiation of breastfeeding within an hour after bih Exclusive breastfeeding up to 6 months of age Continuation of breastfeeding along with complementary feeding for up to 2 yr of age Reference: Paediatrics; O.P Ghai; 8th edition; Page no: 90
2
4 months
6 months
12 months
24 months
Pediatrics
Nutrition
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single
Trauma and Injury Severity Score (TRISS) includes:
TRISS (Trauma and Injury Severity Score) : Injury Severity Score Revised Trauma Score Age Mechanism of Injury (blunt/penetrating) Ref : Bailey and love surgery text book 27th Ed.
2
GCS + BP + RR
S + ISS + Age
S + ISS + GCS
S + GCS + Age
Surgery
All India exam
260f3e77-9e84-4206-be45-3946d5193d16
single
All the following are feature of polycystic disease of kidneys except:-
PKD is autosomal dominant; 2 chromosomes involved - 16 & 4; abnormal protein involved is Polycystin. Bilateral kidneys are replaced with multiple cyst.
4
Hematuria
Hypeension
Renal failure
Erythrocytosis
Surgery
FMGE 2018
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multi
Syndrome characterized by proteinuria, hematuria and hypeension: March 2007
Ans. B: Acute nephritis Nephritic syndrome is characterized by; Proteinuria Hematuria Hypeension Variable renal insufficiency, with; -- Azotemia (elevated blood nitrogen) Oliguria (low urine output The main features are hypeension and RBC casts. Nephritic syndrome causes are usually grouped into 'focal proliferative' and 'diffuse proliferative' on the basis of histology (obtained by a renal biopsy). Focal proliferative IgA nephropathy Chronic liver failure Celiac sprue Dermatitis herpetiformis Henoch-Schoenlein purpura Alpo syndrome SLE Diffuse proliferative Focal glomerulosclerosis Membranoproliferative glomerulonephritis (malaria, hepatitis B, hepatitis C, chronic infection, sickle-cell disease, SLE, hemolytic uremic syndrome/thrombotic thrombocytopenic purpura) Cryoglobulinemia SLE Rapidly progressing glomerulonephritis (RPGNs) - several.
2
Nephrotic syndrome
Acute nephritis
Renal cell carcinoma
Nephroclacinosis
Medicine
null
5100d53b-82d6-4935-8ef5-ea84fc40597c
single
A latent, measles-like viral infection and, presumably, a defect in cellular immunity is associated with which of the following diseases?
Measles-like virus has been isolated from the brain cells of patients with subacute sclerosing panencephalitis (SSPE). The role of the host immune response in the causation of SSPE has been supported by several findings including the following: (1) progression of disease despite high levels of humoral antibody; (2) presence of a factor that blocks lymphocyte-mediated immunity to SSPE-measles virus in SSPE cerebrospinal fluid (CSF); (3) lysis of brain cells from SSPE patients by SSPE serum or CSF in the presence of complement (a similar mechanism could cause in vivo tissue injury).Higher-than-normal levels of serum antibodies (Ab) to measles virus and local synthesis of measles Ab in CSF, as evidenced by the oligoclonal IgG, imply a connection between the virus and multiple sclerosis (MS). However, the other studies have implicated the other viruses. Several studies of cell-mediated hypersensitivity to measles and other viruses in MS have been done, but the results have been conflicting. Definite conclusions regarding defects in cellular immunity in this disease cannot be reached until further research is completed.
4
Progressive multifocal leukoencephalopathy (PML)
Multiple sclerosis (MS)
Creutzfeldt-Jakob disease
Subacute sclerosing panencephalitis (SSPE)
Microbiology
Immunology
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single
The main goal of treating septic shock is
Prevention through identifying and eliminating the cause of infection could prevent the development of sepsis that could fall into septic shock. Option A: Preservation of the myocardium is the main goal of cardiogenic shock management. Option B: Restoration of fluid status is the goal in the treatment of hypovolemic shock. Option D: To prevent anaphylactic shock, identification and elimination of the cause of allergy are necessary.
3
Preserving the myocardium
Restoring adequate fluid status
Identification and elimination of the cause of infection
Identification and elimination of the cause of allergy
Medicine
null
4c4919be-1c88-4801-b0a9-20521d8dce1d
multi
The first step in the management of hirsutism due to stein leventhal syndrome is :
Ans. is a i.e. OCP Friends, all the options given in the question are used for treatment of PCOS but only OCP and spironolactone are used for managing hirsutism. The first step done in general practise in OPD's when a patient of PCOS comes is : Advise : Weight reduction. 'Weight reduction in obese patients is the initial recommendation because it reduces insulin, SHBG and androgen levels (mainly calculated or bioavailable testosterone) and may restore ovulation either alone or combined with ovulation induction agents." Drug therapy If a patient has hirsutism primary goal is lowering androgen levels to halt futher conversion of vellus hairs to terminal ones. Drugs used are : i. OCP's ? "Combination OC's decrease adrenal and ovarian steroid production and reduce hair growth in nearly two - third of hirsute patients." "Combined oral contraceptive - COC's are effective in establishing regular menses and lowering ovarian androgen production. As an additional effect, the estrogen component of these pills leads to increased SHBG levels. With higher SHBG levels, a greater amount of free testosterone is bound and thus becomes biologically unavailable at the hair follicle." Gonadotropin releasing horomone agonists - "GnRH agonists effectively lower Gonadotropin levels over time, and in turn subsequently lower androgen levels. Despite their effectiveness in treating hirsutism, administration of these agents is not a preferred long term treatment method due to associated bone loss. high cost and menopausal side effects." iii Androgne receptor antagonists - like spirono lactone, cyproterone acetate and flut amide. These antiandrogens are competitive inhibitors of androgen binding to the androgen receptor. "Although these agents are effective in the treatment of hirsutism, they carry a risk of several side effects. Metrorrhagia may frequently develop. In addition, as antiandrogens, these drugs bear a theoretical risk of pseudo hermaphroditism in male fetuses of women using such medication in early pregnancy. None of these antiandrogen agents are approved by the FDA for treatment of hyperandrogenism and thus are used off-label." iv. 5 a reductase inhibitor : Conversion of testosterone to dihydro testosterone can be decreased by 5 a reductase inhibitor, Finasteride. It is modestly effective in treating hirsutism and similar to other antiandrogens the risk of male fetus teratogenecity is present. So, friends after such a detailed discussion on the management of hirsutism. You can very well understand that the first line therapy for management of hirsutism are combined oral contraceptive pills. Also know Other methods of treating hirsutism : Eflornithine hydrochloride cream : It is an irreversible inhibitor of ornithine decarboxylase enzyme. This enzyme is necessary for hair follicle cell division and function, and its inhibition results in slower hair growth. Its main disadvantage is that it does not permanantly remove hair. Mechanical methods : -- In includes : depilation creams Depilation methods i.e. hair removal Epilation methods i.e. methods which remove the above the skin surface eg. - entire hair shaft and root. -- shaving Mechanical methods Thermal destruction using -- plucking electrolysis or laser -- waxing Note : While prescribing OCP's in a case of hirsutism : Do not prescribe OCP's containing norgestrel and norethindrone acetate as they have androgenic activity. OCP's containing Illrdeg generation progestins like gestodene, Desogestrel, norgestimate drospirenone are the best, as they have minimum androgenic activity.
1
OCP
HMG
Spironolactone
Bromocriptine
Gynaecology & Obstetrics
null
5f132ea6-6f31-4840-9460-3b0a3d305b7f
multi
The stapes is embryologically derived from the following pharyngeal arch?
The second pharyngeal arch gives rise to,Reiche cailage, which eventually forms the manubrium of the malleusLong process of the incusStapes suprastructureTympanic poion of the stapes footplate (ossicle poions below upper limit tympanic membrane)The stapes requires the longest period of development and is therefore the most frequently malformed. The earliest stages of development begin at 4 weeks, and ossification does not occur until week 26. The vestibular poion of the stapes footplate derives from the otic capsule.
2
1st arch
2nd arch
3rd arch
4th arch
Anatomy
null
156accc3-6b95-4ed6-9957-feed56b0d79b
multi
When a patient is admitted with severe upper abdominal pain, the diagnosis of acute pancreatitis should not be accepted until each of the following conditions has been ruled out except:
Acute pancreatitis is a diagnosis of exclusion. Its symptoms and signs are not readily distinguishable from other severe upper abdominal problems. Adhesive small bowel obstruction does not present marked peritoneal signs unless bowel gangrene is also present.
3
Acute cholecystitis
Acute renal colic
Adhesive small bowel obstruction
Mesenteric embolization
Surgery
null
e9d38007-5f34-486f-add5-d7ea2290ae4d
multi
Duodenal blow out following Billroth gastrectomy most commonly occurs on which day -
Duodenal blow out is massive leakage from duodenal stump following Bilroth II gastrectomy. Clinical features: - It usually occurs on 2nd to 7th postoperative days. (In Bailey 22nd/e on page 689. it is specifically written that it occurs on 4th day). It usually presents as: - Sudden intense thoracoabdominal pain Sudden elevation in pulse and temperature General deterioration of condition T/T Adequate drainage must be instituted immediately which is done by putting a catheter through an incision below the right costal margin. Total parenteral nutrition should be instituted and attention should be directed towards fluid and electrolyte therapy. Fistula closure can be anticipated within 2-3 weeks. Ref : Love & Bailey 22/e page 689
2
2nd day
4th day
6thday
12th day
Anatomy
null
5f92f186-0c2e-498c-9b50-319e4ecf1295
single
What happens in hyperophy ?
Ans. is `b' i.e., Increase in size of cells
2
Increase no. of cells
Increase size of cells
Increase protein in cells
Decrease in cell number
Pathology
null
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Frequency of renal involvement in HSP?
Henoch-Schonlein purpura, also referred to as anaphylactoid purpura, is a small-vessel vasculitis characterized by palpable purpura (most commonly distributed over the buttocks and lower extremities), ahralgias, gastrointestinal signs and symptoms, and glo merulonephritis. Gastrointestinal involvement, which is seen in almost 70% of pediatric patients, is characterized by colicky abdominal pain usually associated with nausea, vomiting, diarrhea, or constipation and is frequently accompanied by the passage of blood and mucus per rectum; bowel intussusception may occur. Renal involvement occurs in 10-50% of patients and is usually characterized by mild glomerulonephritis leading to proteinuria and microscopic hematuria, with red blood cell casts in the majority of patients (Harrison&;&;s principle of internal medicine,18th edition,pg no.2797)
4
<10%
>80%
>6O%
1O% - 50%
Pathology
Cardiovascular system
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Anti-depressant drug which is used for smoking cessation is?
Bupropion is antismoking drug Buspirone is a drug which is used for anxiety
3
Venlafaxine
Topiramate
Bupropion
Amitriptyline
Pharmacology
Psychiatric Illness
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A 3 month old child has moderate fever and non productive cough and mild dyspnea. After course of mild antibiotic the condition of the child improved transiently but he again develops high fever, productive cough and increased respiratory distress. Chest X ray shows hyperluscency and PFT shows obstructive pattern. Most probable diagnosis is
Bronchiolitis obliterans Repeat from Nov 08 Q no.130
4
Alveolar microlithiasis
Post viral syndrome
>Follicular bronchitis
>Bronchiolitis obliterans
Pediatrics
null
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Patients suffering from which of the following disease as per ICD/DSM criteria are eligible for disability benefit as per the National Trust Act?
National Trust Act (1999) is an act to provide for the constitution of a body at the national level for the welfare of persons with Autism, Cerebral palsy, Mental retardation, and Multiple disabilities and for matters connected therewith or incidental thereto.
4
Schizophrenia
Bipolar disorder
Dementia
Mental retardation
Psychiatry
null
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A 50 year old diabetic patient with asymptomatic gallstone (>3 cm) will be best treated by
Prophylactic cholecystectomy should be conducted in this patient even though it is a silent gallstone with no symptoms as he is a diabetic & stone size is more than 3 cm.Such patients are at increased risk of complications from gallstones. Reference:Bailey & Love's sho practise of surgery,25 th edition,page no:1121.
1
Early surgery
Bile salt treatment
ESWL
Waiting till it becomes symptomatic
Surgery
G.I.T
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Following are features of ischemia in Anterior choroidal artery territory except -
null
4
Hemiparesis
Hemisensory loss
Homonymous hemianopia
Predominant involvement of the anterior limb of internal capsule
Medicine
null
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Which of the following is not a framingham major criteria for the diagnosis of hea failure ?
Ref: R Alagappan - Manual of Practical Medicine 4th Edition.pg no:164 Framingham Criteria for Diagnosis of CCF Major Criteria: Paroxysmal nocturnal dyspnoea Neck vein distension Crackles - lung fields Cardiomegaly Acute pulmonary oedema Third hea sound - gallop Increased venous pressure (>16 cm H2O) Positive hepato-jugular reflex Minor Criteria: Extremity oedema Nocturnal cough Dyspnoea on exeion Hepatomegaly Pleural effusion Tachycardia (>120 bpm) Decreased vital capacity by 1/3
3
Paroxysmal nocturnal dyspnea
Cardiomegaly
S3 gallop
Hepatomegaly
Medicine
C.V.S
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Which of the following antiarrhythmic drugs can decrease the slope of Phase 0 and prolong the action potential duration?
Na+ channel blockers reduce the slope of phase 0 whereas K+ channel blockers prolong the APD. Both of these propeies are present in class Ia antiarrhythmics like quinidine and procainamide.
3
Lignocaine
Propanolol
Quinidine
Adenosine
Pharmacology
Hematology and CVS
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Which bacteria show this kind of growth pattern in Ghee broth
In ghee broth , Yersinia pestis shows a characteristic growth which hangs down into broth from the surface , resembling stalactites ( stalactite growth )
1
Yersinia Pestis
Acinetobacter
Aeromonas
Nocardia
Microbiology
Systemic Bacteriology (Haemophilus, Yersinia, Spirochaetes, Ricketssia, Chlamydia, Mycoplasma and Miscellaneous Bacteria)
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Podophyllin is treatment of choice in
Podophyllin Mech of action:- Antimitotic, arrest cells in metaphase by binding tubulin. Uses:- Used for condyloma acuminata . Contraindication:- Contraindicated in pregnancy . Ref:- Sima Jain; pg num:-332
3
Plantar was
Condyloma lata
Condyloma accuminata
Plain was
Dental
Sexually transmitted diseases
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Specific protection is a type of
(A) Primary prevention LEVELS OF PREVENTION* Primordial preventionPrevention of emergence of risk factor, through education* Primary preventionElimination or modification of risk factors throughPopulation (Mass) strategyHigh risk strategy* Secondary preventionActions which halts the progress of the disease at its incipient stage and prevent complication through early diagnosis of adequate treatment* Tertiary preventionIntervention in the late pathogenesis phase - to reduce or limit impair-ment and disabilities through rehabilitation-- psychosocial, vocational etc.
1
Primary prevention
Early secondary prevention
Late secondary prevention
Tertiary prevention
Social & Preventive Medicine
Miscellaneous
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Cross cylinders is
A i.e. One plus cylinder and one minus cylinder of equal strength Cross cylinder is a combination of two cylinders of equal strength but with opposite sign placed with their axis at right angles to each otherQ and mounted in a handle. Jackson's cross cylinder test is used to verify the strength & axis of the cylinder prescribed. The commonly used cross cylinders are of +- 0.25 D and -0.5 D.
1
One plus cylinder and one minus cylinder of equal strength
One plus cylinder and one minus cylinder of unequal strength
Two plus cylinders
Both minus cylinders
Ophthalmology
null
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Which of the follow ing lesion is characteristic of diabetic nephropathy?
Ans: B (Nodular glomerulosclerosis) Ref: Robbins Pathologic Basis of Disease, 8th editionExplanation:Diabetic NephropathyThe term diabetic nephropathy is applied to the conglomerate of lesions that occur in the diabetic kidney.Most common lesions involve the glomeruli and are associated clinically with three glomerular syndromes;Non-nephrotic proteinuriaNephrotic syndromeChronic renal failureDiabetes also affects the arterioles (causing hyalinizing arteriolar sclerosis), increases susceptibility to the development of pyelonephritis and particularly papillary necrosis, and causes a variety of tubular lesions.The morphologic changes in the glomeruli includeCapillary basement membrane thickeningDiffuse mesangial sclerosisNodular glomerulosclerosis (Kimme- Istiel-Wilson lesions). Expansions non-coding regionsDiseaseProteinRepeatingSequenceSpinobulbar muscular atrophy (Kennedy Disease)Androgen ReceptorCAGHuntington DiseaseHuntingtonCAGDentatorubral-palidoluysian atrophy (Haw River Syndrome)Atrophin - 1CAGSpinocerebellar ataxia type 1Ataxin 1CAGSpinocerebellar ataxia type 2Ataxin-2CAGSpinocerebellar ataxia type 3 (Machado Joseph Disease)Ataxin 3CAGSpinocerebellar a taxia type 6Alpha 1a-Voltage-dependant calcium channel subunitCAGSpinocerebellar ataxia type 7Ataxin-7CAGThe morphology is identical in type 1 and type 2 diabetesThe Armanni-Ebstein change tor Armanni- Ebstein cells) consists of deposits of glycogen in the tubular epithelial cells (pars straight of proximal convoluted tubule and loop of Henle).
2
Hyaline arteriosclerosis
Nodular glomerulosclerosis
Renal Amyloid deposits
Fibrinoid necrosis
Pathology
Glomerular Diseases
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Declaration of oslo deals with -
Ans. is 'c' i.e., Therapeutic abortion Declaration of GenevaScope of medical practiseDeclaration of Helisinki (Revised in 1975)Clinical research and human experimentationDeclaration of Tokyo (1975)Doctors approach to torture and other inhuman cruel degrading treatment or punishment in relation to detention or imprisonmentDeclaration of Oslo (1970)o Deals with Abortiono It is a clear example of possibility of codes of conduct based not on absolute values but on consensus opinion changing with time.
3
Organ donation
Right to death
Therapeutic abortion
Human experiments
Gynaecology & Obstetrics
Gynaecological Diagnosis
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A young male presents with painful ulcers on the mouth and glans penis with blurred vision and history of recurrent epididymitis. Which of the following is the most probable diagnosis?
Ans. a. Behcet's syndromeHistory of painful oral and penile ulcers with ocular involvement in form of blurring of vision points towards Behcet's disease but confusion arises out of history of recurrent epididymitis, which is solved by Harrison's which states; "Epididymitis is seen in 5% of patients of Behcet's syndrome"Behcet's syndrome is a multisystem disorder presenting with recurrent oral and genital ulcerations as well as ocular involvement.
1
Behcet syndrome
Oculocutaneous aphthous ulcer syndrome
Fabry's disease
Epidermolysis bullosa
Skin
Neutrophilic Dermatoses
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