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The following enzyme is required for the hexose monophosphate shunt pathway:
Glucose-6-phosphate is oxidized by NADP+ dependent Glucose-6-phosphate dehydrogenase (GPD). 6-phospho glucono lactone is formed. One molecule of NADPH is formed in the reaction. This is the rate-limiting step. Regulation is effected by this enzyme   Reference: Vasudevan 7th  ed, pg 130
4
Glucose-6-phosphatase
Phosphorylase
Aldolase
Glucose-6-phosphate dehydrogenase
Biochemistry
null
55254e9d-0d82-4e84-b0db-54204312a9d2
single
Chronic Laxative abuse can result in the formation of which type of stone:
Ref. API Textbook of Medicine. Pg. 784   Urinary stones due to chronic laxative abuse is due to gastrointestinal loss of fluid and electrolytes leads to chronic depletion of urinary volume ,relative super saturation and many other pathophysiologic derangements . These calculi are generally radiolucent with uric acid and ammonium urate as major componenent.
3
Xanthine
Cysteine
Ammonium urate
Struvite
Unknown
null
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Following are side effects of Nimodipine except ?
Ans. is 'd' i.e., Marked changes in GI motility Hypotension, headache, drowsiness, nausea, ankle edema, palpitation and flushing are common side effects of DHPs (including nimodipine). o Change in GI motility (constipation) is more common with verapamil.
4
Hypotension
Flushing
Headache
Marked changes m GIT motility
Pharmacology
null
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multi
Fetal exsanguination can occur if -
Ans. is 'a' i.e., Vasa previa Vasa previao In it a leash of blood vessels happens to traverse through the membranes overlying the internal os, in front of presenting part. Rupture of membranes involving the overlying vessels leads to vaginal bleeding. As it is entirely fetal blood, this may result in fetal exsanguination and even death.Placenta previao When placenta is implanted partially or completely over the lower uterine segment (over and adjacent to the internal os) it is called the placenta previa. The blood is almost is almost always maternal when bleeding occurs.
1
Vasa previa
Placentaprevia
Polyhydramnios
Oligohydramnios
Gynaecology & Obstetrics
Hydramnios and Oligo Hydramnios
887c40ca-3a2b-43ba-ad61-bae6c5f06a00
single
First to be developed is -
null
4
Neural pit
Neural groove
Neural fold
Primitive streak
Anatomy
null
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single
A G2P1 female at 35 weeks experiences uterine contractions. No fetal distress is seen and membranes are not ruptured. Which of the following is to be done?
12 mg beta methasone injection is is indicated in all pregnancies at risk of preterm labour between 28 and 35 weeks to attain LUNG MATURITY. Since there is no indication of fetal distress it is not given. Tocolytics are used to inhibit contractions and keep the uterus quiescent in case of preterm labour.But it is not indicated after 34 weeks. Cervical cerclage is useful in some women with HISTORY OF preterm labour. Thus vaginal swab culture is can be used in this condition as presence of bacterial vaginosis has been found to be associated with preterm labour and most cases are asymptomatic. (TB of OBG sheila 2 and edition pg 193,194,573)
2
12 mg betamethasone injection
Vaginal swab culture
Tocolytic therapy
Cervical cerclage
Gynaecology & Obstetrics
Abnormal labor
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single
Corneal thickness is measured using -
Ans. is 'a' i.e., Pachymetry o Corneal Pachymetry: It is the method to measure the corneal thicknesso The following are the other methods of measuring corneal thickness:a) Ultrasoundb) Ultrasound biomicroscopy and very high frequency ultrasoundc) Optical slit lamp pachymetryd) Specular microscopy basede) Scanning slit based Orbscanf) Optical Coherence Tomography (OCT)g) Optical low coherence reflectometryh) Confocal microscopy through focusingi) Laser Doppler interferometry
1
Pachymetry
Keratometer
CT scan
Aesthisiometry
Ophthalmology
Cornea
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single
A hypeensive patient who is a chroic smoker presented with recurrent hemoptysis. On examination he had cushingoid features. Investigations revealed raised ACTH levels not suppressed by dexamethasone. The single diagnosis which can account for all his symptoms is
Harmonies produced by small cell carcinoma ACTH,ADH,CALCITONIN,GONADOTROPIN. Ref Davidson edition23rd pg 601
4
Multiple endocrine neoplasia I
Pituitary adenoma
Adrenocoical adenoma
Ectopic ACTH producing tumor
Medicine
Respiratory system
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The following neurotransmitter is synthesized from choline and acetyl-CoA:
Acetylcholine is seen in synaptic vesicles in high concentration in the terminals of cholinergic neurons. It is synthesized in the nerve terminal from choline and acetyl-CoA by the enzyme choline acetyltransferase (ChAT). Choline used in the synthesis of acetylcholine is transpoed from the extracellular space into the nerve terminal a Na+-dependent choline transpoer (CHT). Following its synthesis, acetylcholine is transpoed from the cytoplasm into vesicles by a vesicle-associated transpoer (VAT). Ref: Barrett K.E., Barman S.M., Boitano S., Brooks H.L. (2012). Chapter 7. Neurotransmitters & Neuromodulators. In K.E. Barrett, S.M. Barman, S. Boitano, H.L. Brooks (Eds), Ganong's Review of Medical Physiology, 24e.
1
Acetylcholine
Glutamine
Aspaate
NO
Biochemistry
null
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single
True about Trichotillomania is
(C) Associated with patchy hair loss # TRICHOTILLOMANIA (compulsive hair-pulling)> It is characterized by noticeable hair loss caused by person's persistent and recurrent failure to resists impulses to pull out hair.> There is an intense urge to pull out hair with mounting tension before the act and a sense of relief afterwards.> There is no pre-existent skin lesion or inflammation & hair pulling is not secondary to any delusion or hallucination. Irresistible desire to set fire ... Pyromania Irresistible desire to steal things ... Kleptomania Irresistible desire to pull hair... Trichotillomania Irresistible desire to drink ... Dipsomania Irresistible desire to dress like opposite sex ... Transvestism
3
Irresistible desire to set fire
Irresistible desire to steal things
Associated with patchy hair loss
Pathological gambling
Psychiatry
Miscellaneous
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A female patient with signs of meningitis and CSF showing gram positive cocobacilli, which is showing characteristic tumbling motility. Diagnosis is
Ans. is 'a' i.e., Listeria Information in this question are :- Gram positive Cocobacilli Tumbling motility Listeria is gram positive coccobacilli and shows characteristic tumbiling motility when grown at 25degC. Other options can easily be excludes as no one has tumbling motility (charactristic of Listeria) and no one is gram-positive coccobacillus :- Meningococci : Gram-negative cocci H. influenza : Gram-negative bacilli Pneumococcus : Gram-positive cocci
1
Listeria
Meningococcus
H. influenzae
Pneumococcus
Microbiology
null
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single
Sterilization is commonly performed at which site of fallopian tube:
I have given these 2 questions simultaneously so that you understand how the answer changes as the options of the question change. Sterilization is done at the junction of proximal and middle third—the loop formed consists mainly of isthmus and part of the ampullary region of the tube. Therefore, if in options isthmoampullary is given, it is the best choice but if isthmoampullary is not given Isthmus is the next best choice.
3
Ampulla
Infundibulum
Isthmus
Cornua
Gynaecology & Obstetrics
null
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multi
Pisiform bone articulates with?
Ans. (a) TriquetralRef: Snell's 8th ed / 402
1
Triquetral
Lunate
Scaphoid
Trapezoid
Anatomy
Hand
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single
Features of intestinal obstruction : clinically/investigation by :a) Abdominal distensionb) Vomitingc) Fluid level in X-ray > 4d) Localized tendernesse) Diarrhea
About option 'c' > 5 air-fluid levels in x-ray abdomen suggest intestinal obstruction Grainger's Diagnostic radiology writes - "3 to 5 fluid levels less than 2.5 cm in length may be seen, particularly in the right lower quadrant, without any evidence of intestinal obstruction or paralytic ileus."
4
ac
a
ad
ab
Surgery
null
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multi
Main drawback of calcium hydroxide apexification compared with MTA:
Apexification with calcium hydroxide is almost similar when compared with MTA about given options, except achieved physical strength of dentin, which is comparatively less in Ca(OH)2.
4
More treatment time
Incomplete apical barrier
Incomplete coronal barrier
Reduced physical strength of dentin
Dental
null
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single
Face bow measures relationship of maxilla to
null
1
Opening & closing axis
Mandible
Zygomatic bone
None of the above
Dental
null
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multi
All of the following statements about inhaled tooth fragment are true EXCEPT
null
4
It usually enters the right bronchus
It may cause Lung abscess
It may cause bronchiectasis
It will be coughed out spontaneously no treatment is necessary
Surgery
null
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An asymptomatic old patient presents with bruit in the carotid artery. Which of the following is the investigation of choice?
Bruit over carotid artery suggests carotid artery stenosis. Duplex scanning (B-mode scan and doppler ultrasonic velocimetry) is the method of choice for assessing the degree of carotid stenosis.
1
Doppler ultrasonography
Internal carotid angiography
Aortic arch angiography
Spiral CT angiography
Radiology
null
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Computer controlled injection system is called:
WAND: It is computer controlled injection system Dosage is controlled by computer.
2
CCD
WAND
CCI
JET
Dental
null
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Which of the following disease is seen only in females?
ANSWER: (C) Rett's diseaseREF: Kaplan 9th ed p. 1215RETT SYNDROMEIt is a neurodevelopmental disorder of the grey matter of the brain that almost exclusively affects females.Normal prenatal and post natal growth, normal psychomotor development through first 5 months of life.The clinical features include small hands and feet and a deceleration of the rate of head growth between 5-48 months (including microcephaly in some).Loss of previously acquired hand skillsRepetitive hand movements, such as wringing and/or repeatedly putting hands into the mouth, are also noted and also.People with Rett syndrome are prone to gastrointestinal disorders and up to 80% have seizures. They typically have no verbal skills, and about 50% of individuals affected are not ambulatory. Scoliosis, growth failure, and constipation are very common and can be problematic.ASPERGER SYNDROME:AKA Asperger's syndrome or Asperger disorder is an autism spectrum disorder (ASD) that is characterized by significant difficulties in social interaction, alongside restricted and repetitive patterns of behavior and interests.It differs from other autism spectrum disorders by its relative preservation of linguistic and cognitive development. Pursuit of specific and narrow areas of interest is one of the most striking features of AS.Individuals with AS often have excellent auditory and visual perception .Motor clumsiness and inability to appreciate finer nuances.
3
Autism
Asperger's syndrome
Retts disease
Colard'd disease
Psychiatry
Mood Disorders
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Drug distribution in tissue true is all except ?
Ans. is 'b' i.e., Ephedrine - bone
2
Chloroquine - eye
Ephedrine - bone
Digoxin - skeletal muscle
Minocycline - adipose tissue
Pharmacology
null
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A 25-year-old man presents 1 week after discovering that his left testicle is twice the normal size. Physical examination reveals a nontender, testicular mass that cannot be transilluminated. Serum levels of alpha-fetoprotein and human chorionic gonadotropin are normal. A hemiorchiectomy is performed, and histologic examination of the surgical specimen shows the cells grow inalveolar or tubular patterns, the neoplastic cells have an epithelial appearance,exhibit hyperchromatic nuclei with prominent nucleoli.. Compared to normal adult somatic cells, this germ cell neoplasm would most likely show high levels of expression of which of the following proteins?
The given histological examination is indicative of embryonal carcinoma. The tumor cells are large and have basophilic cytoplasm, indistinct cell borders, large nuclei, and prominent nucleoli.The neoplastic cells may be arrayed in undifferentiated, solid sheets or may form primitive glandular pattern. Somatic cells do not normally express telomerase,(enzyme that adds repetitive sequences to maintain the length of the telomere) Thus, with each round of somatic cell replication, the telomere shoens. The length of telomeres may act as a "molecular clock" and govern the lifespan of replicating cells. Cancer cells and embryonic cells express high levels of telomerase Embryonal carcinoma with papillary growth -The other choices are not involved in malignant transformation.
4
Desmin
Dystrophin
Cytochrome c
Telomerase
Pathology
General Concepts
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Tirofiban is a :
null
2
Monoclonal antibody
Antiplatelet drug
Anti-inflammatory drug
Antianginal drug
Pharmacology
null
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Aortic sinus of Valsalva contributes to left ventricular outflow tract (LVOT) function by
Ans. D (All of the above) (Ref. Gray's anatomy 39th ed., 1009, 1016)The right and left coronary arteries to originate from the right and left aortic sinuses (the sinuses of Valsalva), which are bulges at the origin of the ascending aorta immediately beyond, or distal to, the aortic valve.The left ventricular outflow tract extends from the tip of the anterior mitral valvar leaflet to the junction of the sinuses of Valsalva with the ascending aorta.VEINS OF THE HEART# The coronary sinus is the main vein of the coronary circulation.- It lies in the posterior coronary sulcus.- It drains to an opening in the right atrium.# All veins of the heart (including the great cardiac vein, the posterior vein of the left ventricle, the oblique vein of the left atrium, and the right marginal vein) except anterior cardiac and venae Cordis minimis (which open directly into the right atrium) drain into the coronary sinus which opens into the right atrium.Educational point:Ruptured sinus of Valsalva aneurysm# Any of the three aortic sinuses of Valsalva may become aneurysmal and rupture. The right and non-coronary cusps are most often affected; rupture of the non-coronary sinus aneurysm is nearly always into the right atrium and of the right coronary sinus into the right ventricle or atrium. Rupture usually occurs in early adulthood and may be precipitated by endocarditis. If sudden, it is accompanied by tearing chest pain, breathlessness, and congestive cardiac failure with a loud continuous murmur. The diagnosis and site of the rupture is confirmed angiographically prior to surg repair. Transcatheter closure has been reported.
4
Increasing aortic radius during ejection phase
Decreasing aortic regurgitation (normally)
Promoting non-turbulent flow in coronary arteries
All of the above
Unknown
null
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Uterine sarcomas constitute about.................................... % of all malignant growth of uterus :
Ans. is a i.e. 5% Uterine sarcomas are rare tumors comprising 4.5 % of all malignant growths of uterus. The tumour arises most frequently in female between 40 - 50 years, rare before 30 years. Types of Sarcomas : Intramuraldeg - tumour arises in the myometrium (most common) - Consistency is soft and friable. The cut surface shows haemorrhagic and irregular margins. There is no whorl appearance nor any capsule. Tumors with > 10 mitosis figures/10 hpf have poor prognosis. Mucosaldeg -Tumour arises in the endometrium. Tumour arising in pre-existing myoma. Rare - grape like sarcoma of cervix. Most common form of sarcoma uterus _Intramural type.deg Most common form of histological form -Spindle cell tumor.deg Rapid enlargement of a quiescent myoma in a female of postmenopausal age is almost pathognomonic of sarcomatous change. Spread - Most common is blood borne. Others lymphatic spread / Direct invasion. Symptoms : Irregular premenopausal/postmenopausal bleed Abnormal, offensive watery vaginal discharge Abdominal pain Pyrexia / weakness. Treatment : - TAH with BSO followed by full course of radiation therapy.deg - If cervix is involved - Radical hysterectomy should be done.deg - Prognosis depends on type of growth - worst in round cell variety where growth originates in the endometrium.deg - 5 years cure rate = 10 - 30 %.
1
5
10
15
20
Gynaecology & Obstetrics
null
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Glucose is reabsorbed in which pa?
Pa Reabsorption Secretion PCT Glucose 100% Amino acid 100% Na along with glucose by SGLT 2 Chloride (manly in late pa of PCT ) Bicarbonate Bile salts Hydrogen ion Creatinine Uric acid Drugs LOOP OF HENLE Descending limb - water Ascending limb - Na , k , Cl by 1NA 2Cl 1k cotranspoer , Slight reabsorption of cation such as Mg , Ca also Hydrogen ion by Na H PUMP DISTAL TUBULE 5% sodium and chloride by sodium chloride cotranspo LATE DISTAL TUBE & COLLECTING DUCT Principle cell - reabsorb sodium and water Intercalated cell - reabsorb potassium ions Principle cell secrete potassium ions Intercalated cell-hydrogen ions
1
Early PCT
Henle loop
Collecting duct
Distal convoluted tubule
Biochemistry
FMGE 2018
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Sterility is caused by -
Ans. is 'b' i.e., Alkylatings agents Alkylating agents may contribute to sterility by the following effects : Azoospermia in males Amenorrhea and ovarian atrophy in females Specific toxicity of impoant alkylating agents. o Cyclophosphamide ---> Cystitis, alopecia, SIADH o Ifosfamide ---> Cystitis, SIADH, neurotoxicity o Cisplatin ---> Nephrotoxicity, peripheral neuropathy, ototoxicity, vomiting. o Busulfan ---> Adrenal insufficiency, hyperpigmentation,pu/monaryfibrosis. o Procarbazine ---> Disulfiram like reaction, secondary leukemias, CNS effects.
2
Vinca alkaloids
Alkylating agents
Antimetabolites
Actinomycin D
Pharmacology
null
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Which of the following immunoglobulins shows homocytotropism -
IgE is an 8 S molecule. - resemble IgG structurally. - heat liable - an affinity for the surface of tissue cells paicularly mast cells of the same species. This feature is called homocytotropism. - the normal serum contains only traces of IgE ( a few nanograms per ml ) - greatly elevated levels in atopic conditions like asthma, hay fever. Reference : Anathanarayan & paniker's 9th edition, pg no: 98,98 <\p>
3
IgG
IgA
IgE
IgD
Microbiology
Immunology
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single
1st product of tryptophan Catabolism
Kynurenine is formed from tryptophan in presence of enzyme tryptophan pyrrolaseRef: DM Vasudevan - Textbook of Biochemistry, 7th edition, page no: 239, fig 18.8
1
Kynurenine
Xantheurenic acid
Bradykinin
Melatonin
Biochemistry
Metabolism of protein and amino acid
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Radiation induced cataract is
Radiation can cause Posterior subcapsular cataract Lens is the most sensitive pa of eye for radiation induced damage Miscellaneous Cataract impoant for PGMEE * Sunflower cataract: Wilson disease, chalcosis. * Polychromatic Lusture- Complicated cataract * Coicosteroid: Posterior subcapsular cataract. (Topical steroids cause glaucoma, systemic steroids cause cataract more) * Galactosemia: Oil drop cataract * Anterior lenticonus- Alpo * Posterior Lenticonus- Lowe Syndrome * Rosette Cataract: Blunt trauma * Shield cataract- Atopic dermatitis. * Radiation can cause PSC cataract. * Persistent hyaloid aery: Cause of Posterior polar cataract * Myotonic Dystrophy: Christmas Tree Cataract (mimics the lights on a christmas tree) * Posterior polar cataract: Persistent hyperplastic primary vitreous * Snow storm/Snow flake cataract: Diabetes
3
Shield cataract
Antrior polar cataract
Posterior Subcapsular cataract
Alpo syndrome
Ophthalmology
Cataract
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Which of the following is a characteristic of physiological jaundice of newborn?
Physiological jaundice- always unconjugated hyperbilirubinemia
4
Appears within 1st 24 hours of life
Involves palms and soles also
Clinical jaundice usually disappears after 1 month age
It is always unconjugated hyperbilirubinemia
Pediatrics
Neonatal Jaundice
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multi
A mother brought her 18 month boy to the pediatrician, with the complaint that her son did not have any teeth till now. All of the following can be the underlying causes EXCEPT:
Delayed Dentition QDef: When no Teeth Erupts By 13 Months of Age Impoant Causes Mnemonic - "FRIED Chop" - Familial - Rickets - Idiopathic - Endocrine (3 "hypos") 1. Hypo-pituitarism 2. Hypo-thyroidism 3. Hypo-parathyroidism - Down Syndrome - Cleido-cranial dysotosis (clavicles absent, large anterior fontanelle, supernumerary teeth)
1
Pierre Robin sequence
Cleidocranial dysostosis
Rickets
Hypothyroidism
Pediatrics
Paediatrics
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The drug of choice for the treatment of chlamydial infection is -
null
4
Ampicillin
Third generation cephalosporins
Metronidazole
Doxycycline
Medicine
null
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single
Galactorrheamy be associated with the use of all the following drugs except -
Lactation in the absence of breast feeding is known as galactorrhea. Drugs causing galactorrhea are dopamine antagonists like antipsychotics (phenothiazines,butyrophenones),antidepressants, antiemetics and dopamine depleting drugs like reserpine , methyldopa .These dopamine antagonists elevate prolactin concentrations and results in galactorrhea. Reference -Davison's principles and practice of Medicine , 22nd edition ,page no.790
3
Methyldopa
Tricyclic antidepressants
Pyridoxine
Phenothiazine
Medicine
Endocrinology
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Ketamine is safe in
D i.e. Severe Shock
4
Raised ICT
Open eye injury
Ischemic hea disease
Severe shock
Anaesthesia
null
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single
Commonest cause for hyperparathyroidism is
A parathyroid adenoma causes the affected gland to release more PTH than it should. This disrupts your calcium and phosphorus balance. This condition is called hyperparathyroidism. Ref ganong's review of medical physiology 25e
1
Single adenoma
Multiple adenomas
Single gland hyperplasia
Multiple gland Hyperplasia
Physiology
All India exam
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single
Which of the following is a Cluster B personality disorder?
Narcissistic personality disorder is a cluster B personality disorder. Schiziod personality disorder is a cluster A personality disorder. Dependant & Anankastic personality disorders are cluster C personality disorder.
2
Schiziod personality disorder
Narcissistic personality disorder
Dependant personality disorder
Anantastic personality disorder
Psychiatry
null
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A young man is with known heroin addiction is brought in the emergency in unconscious state. On examination, the patient has decreased bowel sounds, depressed respiration and pin point pupil. The treatment of choice for this patient is:
Ref: Kaplan & Sadock's Comprehensive Textbook of Psychiatry 9th/1375-76,1384 The decreased bowel sounds, respiratory depression,pin point pupil and history of heroin addiction strongly points toward the diagnosis of acute opioid poisoning. The drug of choice for acute poisoning is intravenous naloxone.
2
Oral natrexone
IV naloxone
Oral diazepam
Oral Buprenorphine
Pharmacology
Central Nervous system
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Maximum sterilizing action is shown by which anti TB drug
Refer Katzung 13th/819 Pyrizanimde is most effective against slow growing bacteria inside macrophages Thus it possesses strong sterilizing activity
3
Rifamipicin
INH
Pyrazinamide
Streptomycin
Pharmacology
Chemotherapy
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Main source of energy in 1 min is -
Ans. is 'a' i.e., Glycogen Source of energy for muscular activityo The immediate source of energy for all muscle contraction is ATP, followed immediately by creatine phosphate.o In stemous exercise ATP store is sufficient only for 1-2 seconds and creatine phosphate for another 5-7 seconds.o Thus, energy rich phosphagen stores (ATP and creatine phosphate) permit severe muscle contraction for 8-10 seconds only.o After this, energy is obtained from the metabolism of stored glycogen or from circulating glucose and free fatty- acids, depending upon the availability of oxygen.o Energy source during in exercise can be summarized by : -Short burst of intense activity (e.g., 100 meter sprint or weight lifting) : - All energy comes from ATP and creatine phosphate. Breakdow n of these compound is an anaerobic processes. Little longer intense exercise (e.g., 200 meter sprint or 100 meter swim)Besides ATP and creatine phosphate, glycogen is metabolised by anerobic glycolytic pathways to provide a ready source of energy. So, muscle work is anaerobic.Longer duration exercise (e.g., jogging, marathon run) : - The muscle work is aerobic and energy comes from aerobic utilization of glucose and free fatty acids. More glucose is utilized at the initial stage, but as the exercise is prolonged, free fatty acids become the predominant fuel. Immediate energy systemAnerobic glycolytic systemOxidative (aerobic) systemSubstratesATP, creatine phosphateGlucose or glycogenGlucose or glycogen, fatty acidsEnergy' productionVery fastFastSlowrPeak at0-30 sec.20-180 sec.>3 minLimiting factorDepletion of CrP. ATPLactic acid accumulationGlycogen depletionActivity examplePowerlifting & weight lifting, short sprintsJumping, throwingLonger sprintsMiddle distance team sportsBall games (Soccer, rugby)Endurance eventsTeam sportsBall games (Soccer, field hockey)
1
Glycogen
FFA
Phosphates
Glucose
Biochemistry
Respiratory Chain
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Definition of sleep apnoea
null
2
>10 apnoeas during 7 hours of sleep
>30 apnoeas during 7 hours of sleep
>10 apnoeas during 2 hours of sleep
>30 apnoeas during 2 hours of sleep
ENT
null
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A 26 year old lady has been on Olanzapine for the treatment of Schizophrenia. All of the following are the ATP III (Adult Treatment Panel) criteria for metabolic syndrome, except:
LDL is not included in metabolic syndrome criteria. All others are indicated. The new generation anti-psychotics like Olanzapine and Risperidone increases the risk of metabolic syndrome and increase the risks of cardiovascular disease. ATP III (Adult Treatment Panel) Criteria for Metabolic Syndrome is as follows: Abdominal obesity, given as waist circumference Men>102 cm (>40 in) Women>88 cm (>35 in) Triglycerides>=150 mg/dL HDL cholesterol Men<40 mg/dL Women<50 mg/dL Blood pressure>=130/>=85 mm Hg Fasting glucose>=110 mg/dL
4
Abdominal obesity
Triglyceride > 150 mg/dl
Blood pressure > 130/85
LDL > 150 mg/dl
Medicine
null
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multi
APGAR scale in infant measures
null
1
Respiratory, Neurological, and Circulatory system
Respiratory, Neurologic, renal system
Neurological, renal, digestive system
Respiratory, Neurological and digestive system
Medicine
null
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single
Cervical warts are seen with which HPV -
Genital warts (anogenital warts or condyloma acuminata) is most commonly caused by low risk HPV that is HPV-6,11. High risk HPV  that is HPV-16,18, 31, 33, 45 can lead to cervical carcinoma.
4
11,13
17,18
5, 8
6, 11
Dental
null
e12d08da-a002-45f6-bdae-09f9c7221bd8
single
Breast milk at room temperature stored for?
Ans. is 'b' i.e., 8 hrs
2
4 hrs
8 hrs
12 hrs
24 hrs
Pediatrics
null
bec41f8d-cdbe-4c46-b849-825117ec73cc
single
A women is exposed to multiple sex paners has 5 times increased risk for - Ca. Cx the attributable risk is -
Ans. is 'c' i.e., 80%
3
20%
50%
80%
100%
Social & Preventive Medicine
null
1ee37513-4c6b-48c6-8da8-fa7244695f67
single
Not included in cerebellar nuclei
There are 4 deep nuclei in cerebellum: dentate, globose, emboliform, & fastigial nuclei. Ref: Ganong&;s review of medical physiology; 23rd edition; pg:255
4
Dentate nuclei
Emboliform nuclei
Fastigial nuclei
Caudate nuclei
Physiology
Nervous system
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single
In reproductive and child health programme,districts are divided on the basis of –
null
2
Crude birth rate & infant mortality rate
Crude birth rate & female literacy rate
Crude death rate & crude birth rate
Couple protection rate & infant mortality rate
Social & Preventive Medicine
null
23b5b056-1c2e-4910-a464-1b4ce2111ee3
single
Which is not a NNRTI -
Ans. is 'a' i.e., Ritonavir Antiretroviral drugsa) Nucleoside reverse transcriptase inhibitors (NRTIs) - Zidovudin, Didanosine, Zalcitabine, Stavudine, Lamivudine, Abacavir.b) Nucleotide reverse transcriptase inhibitor - Tenofovirc) Nonucleoside reverse transcriptase inhibitors (NNRTIS) - Nevirapine, Efavirenz, Delavirdine, Etravirine Rilpivirine.d) Protease inhibitors - Ritonavir, Indinavir, Nelfinavir, Saquinavir, amprenavir, Lopinavir, Fosamprenavir, Atazanavir, Darunavir, Tipranavir.e) Fusion inhibitor - Enfuvirtide, Maraviroc.f) Integrase inhibitors - Roltegravir, Elvitegravir.
1
Ritonavir
Nevirapine
Efavirenz
Delavirdine
Pharmacology
Anti-Viral
27650550-8c24-402e-be1e-2c191c4d5766
single
Amrinone acts by-
Ans. is 'a' i.e., Inhibiting phosphodiesterase o Amrinone inhibits phosphodiesterase III
1
Inhibiting phosphodiesterase
ATPase inhibitor
Calcium channel blocker
IC/ channel opener
Pharmacology
null
84688a80-dd0f-4168-a1d9-1f6986f461cd
multi
"Annular herald patch" is found in
Pityriasis roses is characterised by herald patch/ mother patch it is the first manifestation of disease in 50% of patients it is a well defined erythematous oval or round lesion 2-10 cm diameter with typical colarette of scale at the margin Most common sites - chest back,abdomen extremities. widespread rash appear after herald patch in a span of 5-15 days.
2
Pityriasis alba
Pityriasis rosea
Tinea capitis
Psoriasis
Dental
Fungal infections, Scabies, Pediculosis
dde019be-3f6a-45e9-b4ac-8df223883316
single
Which of the following signs is classic for CT scanning in Graves ophthalmopathy:
Ans. Fusiform muscle enlargement with sparing of tendoms
3
Nodular muscle enlargement
Solitary muscle enlargement
Fusiform muscle enlargement with sparing of tendoms
Kinking of extraocular muscles.
Ophthalmology
null
c6c26c3f-5259-4bad-95de-ac25bcc12483
single
Neutropenia is seen in all except:
Ans: A (Scurvy) Ref: Harrison's Principles of Internal Medicine, 18 ed.Explanation:Severity of neutropenia based on the absolute neutrophil count (ANC) measured in cells per microliter of blood:Mild neutropenia (1000 < ANC < 1500) minimal risk of infectionModerate neutropenia (500 < ANC < 1000) -- moderate risk of infectionSevere neutropenia (ANC < 500) -- severe risk of infection.Causes of NeutropeniaCauses can be divided into the following groups:Decreased production in the bone marrow due to:Aplastic anemiaArsenic poisoningCancer, particularly blood cancersHereditary disorders (e.g. Congenital neutropenia. cyclic neutropenia)RadiationVitamin B 12, Folate or copper deficiency.Increased destruction:Autoimmune neutropenia.Chemotherapy treatments, such as for cancer and autoimmune diseasesMarginalisation and sequestration:HemodialysisMedications:ChloramphenicolPhenytoinIndomethacinPropylthiouracilCarbimazoleChlorpromazineTrimethoprim/sulfamethoxazoleClozapineTiclodipineInfectionsTuberculosisTyphoid feverBrucellosisTularemiaMeaslesInfectious mononucleosisMalariaViral hepatitisAIDS
1
Scurvy
Aplastic anemia
Typhoid fever
Chloramphenicol
Medicine
Blood
e74852ed-2a4b-4128-9294-151a214c8365
multi
Which of the following vessel is injured in Hemothorax patient?
"The most common cause of massive Hemothorax in blunt injury is continuing bleeding from torn intercostal vessels or occasionally from the internal mammary aery secondary to the fracture of ribs"
4
Pulmonary aery
Pulmonary vein
Bronchial aery
Intercostal aeries
Surgery
Thorax And Mediastinum
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single
Responsible for epidemic dropsy is-
Ans. is 'a' i.e., Sanguinarine DiseaseToxinAdulterantLathyrismBOAAKhesari Dal (Lathyrus sativus)Epidemic DropsySanguinarineArgemone mexicana (oil)Endemic AscitesPyrrolizidine alkaloidsCrotolaria seeds (Jhunjhunia)AflatoxicosisAflatoxinA spergillus fiavus/parasiticusErgotismClavine alkaloidsClaviceps Jusiformis
1
Sanguinarine
Ergot alkaloids
Pyrazolidine alkaloids
A flat ox in
Social & Preventive Medicine
Nutrition and Health
833ec321-bf7e-43af-a100-4b8860f9666e
single
Early strict toilet training can result in –
null
2
Nocturnal enuresis
Encopresis
Night terror
Temper tantrums
Pediatrics
null
33c4541a-d39d-4619-8a56-70195f3aee53
single
One of the following will always present with Bilious vomiting -
The CBD opens into the 2nd part of duodenum. So obstructions which are proximal to it like pyloric stenosis & esophageal atresia would not have bile in their associated vomits. Bilious vomiting would only occur if the obstruction is distal to CBD opening. Atresia of the 3rd part of duodenum would always produce bilious vomiting. Malrotation of the gut is a broad entity and may manifest clinically in several different ways. The vomiting may be bilious or nonbilious.
3
Pyloric stenosis
Esophageal atresia
Atresia of the 3rd part of the duodenum
Malrotation of the gut
Surgery
null
caaeafcc-5e2a-4e55-977b-562b973ecf2a
single
A 7 year old child presents with non productive cough, mild stridor since 6 months. On oral antibiotics, patient is improving but suddenly develops wheezing, productive cough, mild fever. X-ray shows hyperlucency and PFT shows obstructive curve. Most probable diagnosis is -
Ans. is 'b' i.e., Bronchiolitis obliterance
2
Post viral syndrome
Bronchiolitis obliterans
Follicular bronchitis
Pulmonary alveolar microlithiasis
Pediatrics
null
00dd6465-084b-44fd-b64f-dbb33bbde0e0
single
Human immunoglobulin is given in all except
null
1
Measles
Hepatitis B
Rabies
chickenpox
Social & Preventive Medicine
null
4492b962-da6e-4c98-97d2-d24f50ab6900
multi
Cerebellar connection to other parts of the brain is projected through which cell?
Ans. C Purkinje cellsRef Gray's, 41sted. pg. 335-336* The axons of purkinje cells are the only output through cerebellar cortex.* However, it should be kept in mind that the output from the cerebellum is through deep nuclei, and purkinje cells axons generally pass to deep nuclei.
3
Golgi cells
Basket cells
Purkinje cells
Oligodendrocytes
Anatomy
Neuroanatomy
e51c9b6a-414b-4ee7-b7b5-2f08efcffafd
single
Immediate sustained permeability in cells is increased by:
Direct endothelial injury, resulting in endothelial cell necrosis and detachment: This effect is usually encountered in necrotizing injury, and is due to direct damage to the endothelium by the injurious stimulus e.g. In severe burns or lytic lesions. Neutrophils adhere to the endothelium, and may also injure the endothelium. In most instances, leakage starts immediately after the injury and is sustained at a high level for several hours, until the damaged vessels are thrombosed or repaired. This reaction is immediate sustained response. All levels of microcirculation are affected, including venules, capillaries, and arterioles. Endothelial cell detachment is often associated with platelet adhesion and thrombosis.
1
Direct injury and necrosis
Endothelial gaps by histamine
Endothelial gaps by serotonin
Leucocyte mediated endothelial injury
Pathology
null
cd6a441e-c5cd-4b80-8662-9c0f318cabe5
single
Anal carcinoma is most commonly of type?
Epidermoid carcinoma of the anus includes squamous cell carcinoma, cloacogenic carcinoma, transitional carcinoma and basaloid carcinoma. The clinical behaviour and natural history of these tumors is similar. Ref: Schwaz 9/e, Page 1053; Maingot's 10/e, Page 1505.
2
Adenocarcinoma
Epidermoid
Mixed
None of the above
Surgery
null
b70c5df7-1f19-4f5d-ab49-452a5201b7ca
multi
Suprasellar calcification is a feature of:
Craniopharyngioma
1
Craniopharyngioma
Astrocytoma
Oligodendroglioma
Meningioma
Radiology
null
9fb5b789-3ea7-4450-b4b6-c3c57cbfb0cd
single
A patient present with dysphagia of 4 weeks duration. Now he is able to swallow liquid food only. Which of the following is the one investigation to be done
investigations of carcinoma oesophagus includes, Barium swallow: Shouldering sign and irregular filling defect. * Oesophagoscopy to see the lesion, extent and type. * Biopsy for histological type and confirmation. * Chest X-ray to look for aspiration pneumonia. * Bronchoscopy, to see an invasion in upper third growth. * Oesophageal endosonography, to look for the involvement of layers of oesophagus, nodes, cardia and left lobe of the liver. Nodes smaller than 5 mm can be very well visualised by EUS which may be missed in CT scan. EUS guided transmucosal nodal needle aspiration cytology can also be done. * CT scan, (95% accuracy) to look for a local extension, nodal status, perioesophageal/diaphragmatic/ pericardial (1%)/vascular infiltration, obliteration of mediastinal fat and status of the tracheo-bronchial tree in case of upper third growth. Ref: SRB&;s manual of surgery,3 rd ed, pg no 753
2
Barium studies
Upper GI endoscopy
CT scan
Esophageal manometry
Surgery
G.I.T
da23ad08-bea6-4687-a13a-0d9f46829408
multi
The posterolateral lesion in the head of humerus in cases of recurrent anterior shoulder dislocation is:
Complication of shoulder dislocation: Banka's anterior glenoid labrum: anterior tear in anterior dislocation Hill Sach's at head of Humerus: posterolateral defect in anterior dislocation Reverse Hill Sach's - anteromedial defect in posterior dislocation Light bulb signis seen on AP radiographs in theposterior dislocation shoulder, where the humerus head appears as a light bulb Note-M/c complication of ant. dislocation of shoulder is reccurent shoulder disclocation
2
Banka's lesion
Hill-Sachs lesion
Reverse Hill-Sachs lesion
Greater tuberosity avulsion fracture
Orthopaedics
Upper Limb Traumatology
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single
Dean's technique refers to a form of
null
3
Radicular surgery
Cyst removal
Intraseptal alveoplasty
Mucoperiosteal flap
Dental
null
9f598e0b-dedd-4abb-a18f-4541cd4453d2
single
The periphery of retina is visualized with:
A i.e. Indirect opthalmoscopy Peripheral retina is visualized by indirect opthalmoscopy Q and biomicroscopy examination by Goldmann's three mirror contact lens. Q
1
Indirect binocular ophthalmoscopy
Direct opthalmoscopy
Contact lens
All
Ophthalmology
null
5177654a-6b79-4977-8188-8386033f1cbe
multi
A case of severe mitral stenosis is associated with all of the following features, EXCEPT:
Severe mitral stenosis occurs with a valve area of less than 1 cm2 (The normal mitral valve orifice area is approximately 4-6 cm2). As the valve progressively narrows, the resting diastolic mitral valve gradient, and hence left atrial pressure, increases. This leads to transudation of fluid into the lung interstitium and dyspnea at rest or with minimal exeion. Hemoptysis may occur if the bronchial veins rupture and left atrial dilatation increases the risk for atrial fibrillation and subsequent thromboembolism. The length of the murmur, as opposed to the intensity, is used as a nonspecific guide to stenosis severity. Pulsatile liver may be present.
3
Pulsatile liver
Atrial fibrillation
Opening snap delayed from S2
Increase in the length of murmur
Medicine
null
691664a6-4a0e-4062-a5fc-4713afd75967
multi
The Cardinal movements in sequence in labour are :-
Cardinal movements in sequence in labour are - Head floating-Engagement-Descent- Flexion -->Internal rotation-Extension- External rotation- Anterior shoulder delivered- Posterior shoulder delivered
3
Engagement-flexion-descent-internal rotation-extension-ext. rotation
Engagement-flexion-descent-external rotation-expulsion
Engagement-descent-flexion-internal rotation-extension-external rotation
Engagement-extension-internal rotation-external rotation-expulsion
Gynaecology & Obstetrics
Labour - normal, abnormal, malposition, malpresentation and their management
d0d3d7b2-c404-436a-8353-8fe0eb287179
single
The spaces involved in ludwigs angina are
LUDWIG'S ANGINA APPLIED ANATOMY :- Submandibular space lies between mucous membrane of the floor of mouth and tongue on one side and superficial layer of deep cervical fascia extending between the hyoid bone and mandible on the other. It is divided into two compaments by the mylohyoid muscle: 1. Sublingual compament (above the mylohyoid). 2. Submaxillary and submental compament (below the mylohyoid). The two compaments are continuous around the posterior border of mylohyoid muscle. Ludwig's angina is infection of submandibular space. Ref:- Dhingra; pg num:-263,264
4
Sublingual
Submandibular
Submaxillary
All of the above
ENT
Pharynx
5bb03545-67cf-4549-a6f5-467caca1504e
multi
Drug of choice for Hairy cell leukemia
Cladribine is a purine analogue, which is  DOC for Hairy cell leukemia.
3
Methotrexate
Gemcitabine
Cladribine
Decitabine
Pharmacology
null
7d887bc4-619f-4b11-a235-c29044e6140c
single
Drugs used for Prophylaxis of migraine include the following except?
null
1
Sumitriptan
Valproate
Serotonergic drugs
TCAs
Medicine
null
79f8f128-76da-42d9-83cd-56237083dfb7
multi
To observe a recurrent caries under a class II amalgam restoration, vertical angulation of the central Xrays should be
null
3
Perpendicular to the film placed
Perpendicular to theocclusal surface of the tooth
Parallel to the buccolingual plane of gingival surface of restoration
Perpendicular to the cavosurface bevels in the proximal box
Dental
null
632be740-140b-4746-88b4-db3313f7408d
multi
Adult worm of Echinococcus granulosus is commonly seen in which of the given animals?
(A) Dog[?]Echinococcus granulosus:oOnly found in canine host (Dog or Wolf is Definitive Host)oIntermediate host - sheep or other ruminants. Human is accidental intermediate host.-Eggs ingested-Contaminated food or water-Objects contaminatedoDog becomes infected by eating raw meat containing hydatid cyst.[?]Life Cycle:oDogs are the definitive hosts:-Adult worm develops in the small intestine-Eggs are voided in the feces of the dogs.oSheep are intermediate hosts.oHumans are accidental intermediate hosts: Larval form develops mainly in the liver & lungs.oThe cycle is completed when a dog eats a cyst-infested liver or lungs.[?]Life Cycle: The adult is in the small intestines of the definitive host (dogs). Gravid proglottids release eggs that are passed in the feces.oThe intermediate hosts are infected by ingesting eggs, the egg hatches in the small bowel & releases an oncospherePARTIAL LIST OF ZOONOSESDisease in manAnimal principally involvedA. Bacterial infections*. Anthrax.*. Brucellosis*. Ornithosis*. Q fever*. Leptospirosis*. Tuberculosis*. Plague*. Cattle, sheep, goats, camels, pigs, dogs, horses, buffaloes*. Wild and domestic birds*. Cattle, sheep, goats, wild animals*. Cattle, sheep, goats, pigs, cats, dogsB. Viral infections*. Cowpox*. Monkeypox*. Easternequine encephalitis*. Ross river fever*. Monkeys, rodents*. Horses, rodents*. Horses, cattle, goats, sheep, dogs, rats, bats, pigsC. Protozoan infections*. Leishmaniasis*. Toxoplasmosis*. Trypanosomiasis*. Babesiosis*. D. Helminthic infections*. Clonorchiasis*. Fasciolopsis Schistosomiasis*. Echinococcosis*. Taeniasis, Trichinellosis*. Dogs, cats, swine*. Cats, mammals, birds*. Game animals, cattle*. Dogs, cats, swine, wild mammals, fish*. Swine, dogs*. Dogs, wild carnivores, domestic and wild ungulates*. Swine, rodents, wild carnivores, marine mammals
1
Dog
Cat
Sheep
Pig
Microbiology
Parasitology
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single
Administrative unit of ICDS project in rural area is
The administrative unit of an ICDS project is the community development block in rural areas, the tribal development block in tribal areas and a group of slums in urban areas.Park 23e pg: 592
2
PHC
Community development block
Zilla parishad
Gram panchayat
Social & Preventive Medicine
Maternal and child care
362b6c9a-e90e-4237-83d6-473d26f9af9d
single
Histiocytic necrotizing lymphadenitis is
Kikuchi-Fujimoto disease (KFD), or histiocytic necrotizing lymphadenitis, is a benign and self-limited disease that mainly affects young women. Patients present with localized lymphadenopathy, fever, and leukopenia in up to half of the cases.
2
Kimura disease
Kikuchi disease
Hodgkin's disease
Castleman's disease
Physiology
All India exam
ae229c51-781c-4cb7-a93c-1eb1d851b37f
single
What is the appropriate infusion time for the dialysate in your 38 y.o. patient with chronic renal failure?
Dialysate should be infused quickly. The dialysate should be infused over 15 minutes or less when performing peritoneal dialysis. The fluid exchange takes place over a period ranging from 30 minutes to several hours.
1
15 minutes
30 minutes
1 hour
2 to 3 hours
Pathology
null
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single
During assessment of an analog X-ray film, the lights of a well lit operatory should :
Optimal viewing conditions should allow one to collimate the light, so the light area is restricted to the size of the film. The viewer’s eyes should be blocked to surrounding light to ameliorate perception of details. Also, the ambient light in the room should be dimmed so that more details in the radiographic image can be seen. This is not always feasible in a dental office setting, but efforts should be made to place the view box in a dimmed area of the office.  It is clear that assessing radiographs in a brightly lit dental operatory increases the clinician’s potential to miss diagnostically useful information contained in a radiographic image. Despite the fact that the parents and patients appreciate viewing the radiographic images in the operatory, the initial diagnosis should not be made at the chairside monitor, but rather in an area of the office where the light is dimmed.
3
Be made brighter
Not be changed
Be dimmed
Be put off
Dental
null
596a85ef-ae82-4e4b-94b0-aa55a4d080ff
single
Comment on the diagnosis from the ECG shown below:
ECG shows a hea rate of 100/min with ST elevation in lead II, III , aVF and V4R. Indicates inferior wall MI and occlusion of Right coronary aery.
1
RCA occlusion by thrombus
LAD occlusion by thrombus
LCX occlusion by thrombus
Aefact
Medicine
ECG and Arrhythmias 1
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single
All of the following cells are present in cerebellum, EXCEPT:
The pyramidal cells are seen in cerebral coex. The coex of the cerebellum consists of only three layers. They are, (1) an outer, molecular layer, (2) a middle, Purkinje layer, and (3) an inner, granular layer. The molecular layer has the least cellular density and consists of two types of neurons, stellate cells and basket cells. The stellate cells have relatively sho dendrites and basket cells have more extensive dendritic processes. Purkinje layer is relatively thin but consists of the densely packed cell bodies of the Purkinje cells. These cell bodies are the largest in the cerebellum and, with their unique dendritic trees, are probably the most distinctive cells in the entire CNS. Granular layer consists of the cell bodies of the very densely packed granular cells and Golgi type II cells.
3
Purkinje cells
Stellate cells
Pyramidal cells
Basket cells
Anatomy
null
8dae3db1-b5b7-4a7e-be86-ace5ce84fd7a
multi
A 48-year-old male complains of abdominal pain that began about 6 months previously which is constant in nature, especially after meals and is located in the upper mid abdomen superior to the umbilicus. He also repos some heaburn that occurred during the previous year. He has been under significant stress and has been self-medicating himself with over-the-counter antacids, with some relief. He states that his stools have changed in colour over the previous 2 months and now are intermittently dark and tarry in consistency. The physician tests the patient's stool and finds following result. What organs are likely to be affected?
A- Stomach B- Gallbladder C- Distal Ileum and caecum This patient has a history typical for peptic ulcer disease, that is, constant mid epigastric pain after meals. The patient also has symptoms consistent with gastro-esophageal reflux disease. The dark and tarry stools reflect blood in the stools; that is, hemoglobin has been conveed to melena. This is suggestive of an upper gastrointestinal bleeding disorder. The next step would be an upper endoscopy to visualize the suspected ulcer. If the stomach is the site, a biopsy is usually performed to assess concurrent malignancy. Treatment includes a histamine-blocking agent, proton pump inhibitor, and antibiotic therapy. The bacterium Helicobacter pylori has been implicated in most cases of peptic ulcer disease. If an ulcer occurs in the duodenum, the posterior wall of the ampulla of the duodenum (duodenal cap) is the usual site. The gastro-duodenal aery lies posterior to the duodenum at this point and is at risk in the event of ulcer perforation.
3
NONE
C
A
B
Unknown
Integrated QBank
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multi
In which of these patients can a medial episiotomy be considered superior to a medio lateral episiotomy during delivery of fetus?
A midline episiotomy is associated with higher risk of third and fouh degree lacerations and following factors are associated with an increased risk.: Nulliparity Second-stage arrest of labor Persistent occiput-posterior position, Midorlowforceps Use of local anesthetics Asian race. A medio lateral episiotomy should beperformed in these mentioned situations A multiparous patient with anemia does not have increased risk for third or fouh degree laceration and since the patient is anemic, with a midline episiotomy, blood loss is less and healing is better, making it a better option.
3
Nulligravida with thick perineum
Second stage arrest
Second gravida with moderate anemia
Before application of forceps
Gynaecology & Obstetrics
Episiotomy
8ce2b9f4-658b-4d92-b130-94e6036ca7a2
single
When do you intubate a burns patient?
Ans. (a) Deep facial burns with singed nasal hairRef: Bailey 26th edition, Page 388Indication of intubation in burns* Change in voice* Stridor* Deep burns around the mouth and in the neck
1
Deep facial burns with singed nasal hair
Superficial facial burns
Pulse rate >100/min
Crepitations on auscultation
Surgery
Plastic & Reconstructive Surgery
91c19d7a-66a0-47cf-b360-16f3304822ef
single
Midostaurin is a new drug used for the treatment of:
Midostaurin : Multitargeted protein kinase inhibitor indicated along with standard cytarabine and daunorubicin for adult with newly diagnosed Acute Myeloid Leukemia (AML) who are FLT3 mutation positive.
3
CML
ALL
AML
CLL
Pharmacology
JIPMER 2017
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multi
Plasma levels of hCG during pregnancy doubles every: September 2010
Ans. B: 2 days Pregnancy tests may be used to determine the bility of a pregnancy. Serial quantitative blood tests may be done, usually 2-3 days apa. Below an hCG level of 1,200 mIU/ ml the hCG usually doubles every 48-72 hours, though a rise of 50-60% is still considered normal. Failure to increase normally may indicate an increased risk of miscarriage or a possible ectopic pregnancy.
2
Daily
2 days
4 days
6 days
Gynaecology & Obstetrics
null
6a673016-9cf2-46fb-aefe-71bce60af891
single
A pregnant woman with fibroid uterus develops acute pain in abdomen with low-grade fever and mild leukocytosis at 28 week. The most likely diagnosis is:
Ans. is c, i.e. Red degeneration of fibroidRef: Shaw 15th/ed p355; Dutta Ohs 6th/ed p314; High Risk Pregnancy 2nd/ed p77The answer is quite obvious but let's see how other options can be ruled out.Option "a" Preterm laborPoints in favorPoints against* Patient is pregnant* Pain in abdomen at 28 weeks (preterm labor is where labor starts before the 37th completed weeks. The lower limit is 28 weeks in developing countries and 20 weeks in developed countries* Preterm labor is diagnosed- When there are regular uterine contractions. (Not acute pain) With or without pain at least in every 10 minutes.- Dilatation of cervix is >2cm- Effacement of cervix =80%- Length of cervix as measured by TVS <2.5cm and funneling of the internal OS.- Pelvic pressure backache, vaginal discharge, or bleeding. None of the above criteria are being fulfilled* Presence of leukocytosis and fever can also go against it as even if there is intra-amniotic infection causing preterm labor features like--fever, leukocytosis, uterine tenderness, and fetal tachycardia are absent. Rather, if these features are present it means a final stage of uterine infection has reached. And here our patient is having fever, leukocytosis without regular uterine contractions (off and on pair) but with acute pain in abdomen, so it can be ruled outOption "b" Torsion of fibroidPoints in favorPoints against* Patient has fibroid (Though no mention has been made whether it is pedunculated or not, Remember torsion is seen in subserous pedunculated myomas)Q* Patient is complaining of acute pain in abdomen* Torsion is not associated with fever and leukocytosisOption "d" Infection of fibroidPoints in favorPoints against* Presence of fibroid (Remember. Infection is common in submucous fibroids)Q* Fever* Leukocytosis* Acute pain in abdomen (Infection of fibroid will not cause acute pain in abdomen).* Infection of fibroid occurs following abortion or labor (Here patient is pregnant but there is no history of abortion or labor)* Infection causes blood stained discharge (Not seen in this patient)So, from above discussion infection can be kept in +- status. If we have no better option, we can think about it.Option "c" i.e. Red degeneration of fibroid is the diagnosis-let's have a look.Red degeneration of fibroid* It is seen mostly during pregnancy and mid pregnancyQ* The myoma suddenly becomes acutely painfulQ, enlarged,Q and tender.Q* Patient presents with:- Acute abdominal painQ- VomitingQ- MalaiseQ- Slight feverQLab investigations: Show moderate leukocytosisQ and raised ESRQThus, all the features given in the question favor the diagnosis of red degeneration.
3
Preterm labor
Torsion of fibroid
Red degeneration of fibroid
Infection in fibroid
Gynaecology & Obstetrics
Gynaecological Disorders in Obs.
c89fa6fa-5791-4725-8f73-c5ff7eba2341
single
Socially attained behavior is:-
Culture: Is the learned behavior which is socially acquired. Acculturation: is 'cultural contact' or mixing of two cultures. Society: Is an organization of member agents characterized by 'system' - a system of social relationship between individuals. Socialization: is the process of inheriting norms, customs and ideologies; it may provide the individual with the skills and habits necessary for paicipating within their own society.
1
Culture
Acculturation
Socialization
Society
Social & Preventive Medicine
Definition and Concepts in Sociology & Psychology
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ASO titire Is diagnostic in ?
Ref: R Alagappan - Manual of Practical Medicine 4th Edition.pg no:146-147 Essential Criteria Evidence for recent streptococcal infection as evidenced by: 1. Increase in ASO titre a. > 333 Todd units (in children) b. > 250 Todd units (in adults). 2. Positive throat culture for streptococcal infection. 3. Recent history of scarlet fever. Two major (or) one major and two minor criteria, in the presence of essential criteria, is required to diagnose Acute Rheumatic Fever. A Positive Rheumatic Fever history is usually elicited in only 50% of patient with Rheumatic Hea Disease.
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SABE
Rheumatoid ahritis
Infective endocarditis
Acute rheumatic fever
Medicine
C.V.S
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Grynfeltt triangle not bounded by
Lumbar hernias- Hernias through the superior lumbar triangle (Grynfeltt triangle) are more common and bounded by the 12th rib, paraspinal muscles, and internal oblique muscle. Inferior Lumbar / Petit triangle- bounded by the iliac crest, latissimus dorsi muscle, and external oblique muscle.
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12th rib
Paraspinal muscles
Internal oblique muscle
External oblique muscle
Anatomy
All India exam
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Agar is prepared from:
Agar, a polysaccharide extracted from certain types of seaweed, is the main active ingredient in the material, while water is the major constituent in the agar impression material. Reference: PHILLIPS’ SCIENCE OF DENTAL MATERIALS, 12th ed page no 170
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Bullock heart
Chemicals
Seaweed
Chick cells
Dental
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Which is the first study on water fluoridation?
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Grand rapids (Michigan) & Muskegon
Newberg & Kingston
Brantferd & Sarnia
Evanston & Park
Dental
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All of the following features are seen in thrombotic thrombocytopenic purpura, except:
Thrombotic Thrombocytopenic Purpura is characterized by the pentad of hemolytic anemia, thrombocytopenia, neurologic symptoms, fever, and renal failure. It is not associated with hypeension. Ref: Harrison's Principle of Internal Medicine, 18th Edition, Pages 967, 969, Chapter 286
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Fever
Haemolysis
Hypeension
Low platelets count
Medicine
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Radioactive emissions used in radiotherapy are
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Gamma rays
Alpha particles
Beta particles
X-ray
Radiology
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Insulin secretion is inhibited by
Epinephrine (also known as adrenaline or adrenaline) is a hormone and a neurotransmitter. Epinephrine has many functions in the body, regulating hea rate, blood vessel and air passage diameters, and metabolic shifts; epinephrine release is a crucial component of the fight-or-flight response of the sympathetic nervous system.Ref: Ganong&;s review of medical physiology; 24th edition
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Secretin
Epinephrine
Growth hormone
Gastrin
Physiology
Endocrinology
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Most difficult site to remove cholesteatoma in sinus tympani is related with -
The sinus tympani (Posterior facial ridge) is the posterior extension of the mesotympanum and lies deep to both the promontory and facial nerve. The medial wall of sinus tympani becomes continuous with the posterior portion of the medial wall of the tympanic cavity. This is the worst region for access because it is above pyramid, posterior to intact stapes and medial to facial nerve. A retro facial approach via mastoid is not possible because the posterior semi circular canal blocks the access.
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Anterior facial ridge
Posterior facial ridge
Epitympanum
Hypotymparum
ENT
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All the following branches of the Vth nerve supply the dura mater except -
The anterior cranial fossa is supplied by Anterior and posterior ethmoidal nerves (major supply); Nervus meninges medius (a branch of maxillary nerve); and nervus spinosus (a branch of mandibular nerve).
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Anterior ethmoidal
Posterior ethmoidal
Auriculotemporal
Mandibular
Anatomy
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A four-fold increase in the titre obtained in Weil Felix reaction is diagnostic of -
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Rickettsial infection
Fungal infection
Spirochetal infection
Viral infection
Medicine
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Commonest posterior mediastinal tumour is:
Ans: b (Neurofibroma)Ref: Bailey & Love, 24th ed, p. 862, Fig (56.20) & 23rd ed p. 791, Schwartz, 7th ed p. 772
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Lung cyst
Neurofibroma
Dermoid
Thyroid
Surgery
Neoplasia
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All of the following are affected in Erb's palsy EXCEPT
(B) Lower trunk of brachial plexus # Erb's palsy: Most common type when the 5th and 6th cervical nerve roots are involved as in the upper trunk of brachial plexus.> Resulting paralysis causes the arm to lie on the side with extension of the elbow, pronation of the forearm and flexion of the wrist (waiter's tip).> Moro reflex & biceps jerks are absent on the affected side> Treatment consists of use of a splint so as to hold the arm abducted to a right angle and externally rotated> Forearm is flexed at right angle and supinated and the hand is dorisflexed.> Massage and passive movements are advocated.> Fully recovery takes weeks or even months.> Severe injury may produce permanent disability.# Upper root lesions (Erb's palsy): Due to injury of C5, C6 and (sometimes) C7. Abductors and external rotators of the shoulder and the supinators are paralysed. Arm is held to the side, internally rotated and pronated. There may also be loss of finger extension, Sensation is intact.
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Upper trunk of brachial plexus
Lower trunk of brachial plexus
Dorsal scapular nerve
Suprascapular nerve
Anatomy
Neuroanatomy
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String sign in angiography is suggestive of:
Traditional angiography remains the basis of diagnosis and characterization of aerial dissection. Angiographic abnormalities include stenosis of the true lumen, or "string-sign," visible intimal flaps, and the appearance of contrast in the false lumen. Four-vessel cerebral angiography should be performed when suspicion of dissection exists. Ref: Schwaz's principle of surgery 9th edition, chapter 42.
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Aerial dissection
Aoa aneurysm
Stroke
None of the above
Surgery
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