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Most frequent cause of neonatal thrombocytopenic purura is -
|
Ans. is 'a' i.e., Infection o Amongst the given options, only infection causes neonatal thrombocytopenia.
| 1
|
Infection
|
Drug idiosyncrasy
|
Large haemangiomas
|
Erythroblastosis
|
Pediatrics
| null |
20a6b6da-7205-42db-85c8-f95e09798423
|
single
|
Which of the following disease is caused by inflammatory reaction involved by neutrophils?
|
Diseases Caused by Inflammatory ReactionsDisordersCells and Molecules involved in injuryAcute Acute respiratorydistress syndromeNeutrophilsAsthmaEosinophils; IgE antibodiesGlomerulonephritisAntibodies and complement; neutrophils, monocytesSeptic shockCytokinesChronicAhritisLymphocytes, macrophages; antibodies?AsthmaEosinophils; IgE antibodiesAtherosclerosisMacrophages; lymphocytesPulmonary fibrosisMacrophages; fibroblastsRef: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 3; Inflammation and Repair; Page no: 71; Table: 3-1
| 1
|
Acute respiratory distress syndrome
|
Septic shock
|
Asthma
|
Ahritis
|
Pathology
|
General pathology
|
7bb78cdf-b65a-4e4b-b12f-0eb233c29c8b
|
single
|
Best way to dispose e-waste is?
|
ANSWER: (D) RecyclingREF: With textElectronic waste, popularly known as 'e-waste* can be defined as electronic equipments/ products connects with power plug, batteries which have become obsolete due to: advancement in technology, changes in fashion, style and status, nearing the end of their useful life. (REF: Indian Institute of Materials Management (IIMM); weste-managemen t. htm)E-waste is not hazardous if it is stocked in safe storage or recycled by scientific methods ortransported from one place to the other in parts or in totality in the formal sector. The e-waste can, however, be considered hazardous if recycled by primitive methods. (REF: style="color: rgba(0, 0, 0, 1); font-family: Times New Roman, Times, serif">. in/site s/upload_files/ di t/files/ E Waste_S ep 11_892011. p df)"Recycling raw materials from end-of-life electronics is the most effective solution to the growing e- waste problem. Most electronic devices contain a variety of materials, including metals that can be recovered for future uses. By dismantling and providing reuse possibilities, intact natural resources are conserved and air and water pollution caused by hazardous disposal is avoided. Additionally, recycling reduces the amount of greenhouse gas emissions caused by the manufacturing of new products. It simply makes good sense and is efficient to recycle and to do our part to keep the environment green. (http://en.wikipedia.org/wiki/Electronic_waste)The e-waste inventory based on this obsolescence rate in India for the year 2005 has been estimated to be 1,46,180 tonnes which is expected to exceed 8,00,000 tonnes by 2012.1n India, there are no specific environmental laws or Guidelines for e-waste. None of the existing environmental laws have any direct reference to electronic waste or refer to its handling as hazardous in nature. However several provisions of these laws may apply to various aspects of electronic wastes. Since e-waste or its constituents fall under the category of 'hazardous" and "non hazardous waste", they shall be covered under the purviewT of "The Hazardous Waste Management Rules, 2003". Iron and steel constitutes about 50% of the e-waste followed by plastics(21%), non ferrous metals (13%) and other constituents. There is no large scale organized e-waste recycling facility in India and there are two small e-waste dismantling facilities are functioning in Chennai and Bangalore, while most of the e-waste recycling units are operating in un-organized sector. (REF: Ministry of environment forests, central pollution control board Delhi; style="color: rgba(0, 0, 0, 1); font-family: Times New Roman, Times, serif"> 27.06.08%20guidelines%20for%20E-Waste.pdf)
| 4
|
Burning
|
Incineration
|
In a landfill
|
Recycling
|
Social & Preventive Medicine
|
Hospital Waste
|
89f8a4d6-b6a3-4159-bfb8-4f8e710aa5cb
|
single
|
Which of the following structure develop in ventral pa of ventral mesentery of stomach?
|
- Falciform ligament develops in the ventral pa of the ventral mesentery - Lesser omentum (hepatogastric ligament) in the dorsal pa of ventral mesentery.
| 1
|
Falciform ligament
|
Hepatogastric ligament
|
Lesser omentum
|
Splenogastric ligament
|
Anatomy
|
Mesentry, neurovascular bundle
|
7b274121-4971-47ab-8d24-2bfa58eebd1c
|
single
|
ATP yield in Beta oxidation of palmitic acid ?
|
Energetics of Beta Oxidation (ATP Yield) - Palmitic acid (16 C) needs 7 cycles of beta oxidation. So, it gives rise to 8 molecules of acetyl CoA. Every molecule of acetyl CoA when oxidised in the TCA cycle gives 10 molecules of ATP. Each molecule of FADH2 produces 1.5 molecules of ATP and each NADH generates 2.5 molecules of ATP, when oxidised in the electron transpo chain. Hence, the energy yield from one molecule of palmitate may be calculated as: 8 acetyl CoA x 10 = 80 ATP 7 FADH2 x 1.5 = 10.5 ATP 7 NADH x 2.5 = 17.5 ATP Gross total = 108 ATP Net yield = 108-2 = 106 ATP. Ref: DM VASUDEVAN TEXTBOOK OF BIOCHEMISTRY, EIGHTH EDITION,PG.NO.,196.
| 1
|
106 ATP
|
102 ATP
|
120 ATP
|
110 ATP
|
Biochemistry
|
Metabolism of carbohydrate
|
8963e63d-f43e-4f28-aa48-1060390490ee
|
single
|
Immunoprophylaxis of leprosy includes -
|
For immunoprophylaxis , trials in different population groups with BCG vaccine either alone or in combination with other vaccine have shown protective efficacy ranging between 28% and 60%. Reference; Park&;s Textbook of preventive and social medicine, 24th edition.Pg no. 344
| 1
|
BCG
|
MMR
|
ICRC bacillus
|
Anthrax vaccine
|
Social & Preventive Medicine
|
Communicable diseases
|
49453b8e-5511-47da-bab8-98cf7f95f97e
|
single
|
A baby can follow an object till 180o, can hold neck, can sit with suppo but cannot sit without suppo. The age of the baby is:
|
Following an object up to 180deg comes at 2 months, Neck holding comes at 3 months, Sitting with suppo is attained at 6 months; So, the age of this baby is 6 months
| 4
|
1 month
|
2 months
|
4 months
|
6 months
|
Pediatrics
|
Impoant Motor Milestones
|
71a63683-ada1-4288-ab94-31bb1a060ecc
|
single
|
Misoprostol has been found to be effective in all of the following except
|
Misoprostol is not used. Treatment modalities include eostrogrn therapy ,progesterone initial dose of 10-30 mg a day,should arrest bleeding in 24-48 hrs,after which 5 mg given daily for 20 days,ethamsylate,NSAID,antifibrinolytic agents like tranexamic acid,Gnrh is employed if the above fail,SERM like ormeloxifene etc.. Refer page no 344-345 of Shaw's textbook of gynaecology.
| 3
|
Missed aboion
|
Induction of labour
|
Menorrhagia
|
Prevention of postpaum hemorrhage (PPH)
|
Gynaecology & Obstetrics
|
Abnormal labor
|
1978f2a8-8baa-425e-96fa-cd8b2f2a5635
|
multi
|
All of the following are usual features of left atrial Myxoma, except -
| null | 3
|
Raised ESR
|
Pyrexia
|
Markedly enlarged left atrium
|
Systemic Embolism
|
Medicine
| null |
7c414ff4-1c98-4468-975d-76a984e8f45b
|
multi
|
True about choledochal cyst is -
| null | 3
|
Always extrahepatic T/t
|
T/t is cystojejunostomy
|
Excision is ideal t/t
|
Drainage is t/t of choice
|
Surgery
| null |
f54414ac-ee26-429e-aa67-50d4f3a2112f
|
multi
|
Bland cholestasis is caused by all of the following drugs, except
|
Answer is D (Chlorpromazine) Chlorpromazine is associated with inflammatory cholestasis and not with Bland (non inflammatory) cholestasis.
| 4
|
Androgen
|
OCP
|
Cyclosporine
|
Chlorpromazine
|
Pharmacology
| null |
7fce1e4c-cf9c-416b-8f8d-366aa549c933
|
multi
|
Cerebral Cysticercosis
|
(A) Commonly manifests with localizing signs # "These is wide variety of presentation of Neurocysticercosis depending on the intensity of the infestation, the localization of cystecerci and the degree of inflammatory reaction.> Epilepsy (seizure activity) is the most common manifestation occuring in upto 50% cases.> Cysticercosis is infection with the larval stage (cysticercus) of T. solium.> These cysts are located in order of frequency in: CNS (Neurological manifestations are the most common) Subcutaneous tissue Striated muscle Globe of the eye
| 1
|
Commonly manifests with localizing signs
|
May present with dementia
|
Rarely occurs in children
|
Usually presents with generalized seizures
|
Medicine
|
Miscellaneous
|
9f6cb4ba-4eb8-4f19-8aa6-bcf66a710131
|
multi
|
In a patient if administration of exogeneus vasopressin does not increase the osmolality of urine the likely cause is
|
Answer is C (Renal Hyposensitivity to ADH): Failure of urine osmolality to rise even after administration of exogenous ADH/vasopressin suggests a diagnosis of Nephrogenic Diabetes Insipidus due resistance to action of vasopressin on the Renal tubule (Renal Hyposensitivity to ADH).
| 3
|
SIADH
|
Psychogenic polydipsia
|
Renal Hyposensitivity to ADH
|
ADH Deficiency
|
Medicine
| null |
fe43aecd-b8ef-4660-bded-b6d31321c192
|
single
|
A child presents with recurrent bouts of severe cough followed by an audible whoop. Which of the following is considered the best type of specimen to isolate the organism and confirm the diagnosis.
|
Presence of recurrent bouts of severe cough followed by an audible whoop suggests a diagnosis of pertusis (Whooping cough).
Nasopharyngeal Swab is the single best specimen to isolate the organism from the options provided.
| 1
|
Nasopharyngeal swab
|
Cough plate
|
Throat Swabs
|
Anterior Nasal Swab
|
Pediatrics
| null |
424aa347-6be2-4ee5-a079-be9ae7c04dae
|
single
|
The vitamin deficiency implicated in metaplasia of respiratory epithelium is:
|
Factors that incriminated in the pathogenesis of lung cancer: Chromosome deletions (paicularly 11p, 13q, 17p, and 3p) Tumor suppressor gene mutations (p53, Hap-1, ErbAb, etc) High-level expression of both growth factor genes (insulinlike and transferrinlike growth factors) Epidermal growth factor receptors (HER2/neu,EGFR1, etc) Protooncogenes (c-, N- and L-myc; H-, N-, and K-ras; and c-myb) Vitamin A deficiency Air pollution Exposure to arsenic, cadmium, chromium, ether, and formaldehyde Employment as bakers, cooks, construction workers, cosmetologists, leather workers, pitchblende miners, printers, rubber workers, and pottery workers Ref: Theodore P.R., Jablons D. (2010). Chapter 18. Thoracic Wall, Pleura, Mediastinum, & Lung. In G.M. Dohey (Ed), CURRENT Diagnosis & Treatment: Surgery, 13e.
| 1
|
Vitamin-A
|
Vitamin-C
|
Vitamin-B
|
Vitamin-E
|
Physiology
| null |
6c65711e-aaf6-42b4-a1d8-a95d65d50cf4
|
single
|
A 40 year old female patient complains of excessive bleeding. Patient gives a history of road traffic accident 5 hours ago and had a lacerated wound on lower back region. Blood grouping test reveals presence of antigen A and antigen H. Anti Rh D antibody and anti B antibody are also present. This patient can receive transfusion from a donor with blood group?
|
→ Apart from A< B and O, RBC of type O contains large amount of another antigen called H substance.
→ H substance is genetically different from ABO, but is a precursor of A and B antigens.
→ An O group individual who inherits A or B genes, but fails to inherit H gene from either parent is called Oh phenotype or Bombay blood group.
| 4
|
A positive
|
O positive
|
B negative
|
Bombay blood group
|
Pathology
| null |
0210e35e-002b-4be0-8dbd-391973903c38
|
single
|
HTLV-1 is also known as:
|
Ans. b. ATLV
| 2
|
HIV
|
ATLV
|
RSV
|
ALV
|
Microbiology
| null |
f64ec9e0-6077-4547-9173-da0b7da7bf8b
|
single
|
Following are gastrointestinal hormones except :
|
C i.e. ChymotrypsinActivatorProenzyme/ EnzymeTrypsin (activates- Cliymotrypsinogens /chyinotrypsinQonly pancreatic- Pro carboxypeptidase A/enzymes)carboxypeptidase A - Procarboxypeptidase B/ carboxypeptidase B - Pro-colipase/colipase - Pro-elastase/elastase - Pro-phospholipase A2/phospholipase A2Enteroeptidase- Trypsinogen/TrypsinQHC1- Pepsinogens / pepsinQCl-- Salivary and pancreatic a amylase
| 3
|
CCK- PZ
|
GIP
|
Chymotrypsin
|
Motilin
|
Physiology
| null |
c89f1a97-f76f-4320-afa8-09db86a3f26b
|
multi
|
\r\nAll of the following are true about Aedes mosquito, except:
|
Aedes Aegypti are recurrent day time biters and breed in stagnant water. It transmits dengue fever. Aedes Aegypti eggs can remain ble for long periods under without water. Hence it is carried to many pas of the world as dry eggs in suitable containers. Ref: Physician's Guide to Ahropods of Medical Impoance, 4th Edition, Pages 265-66; Park's Textbook of Preventive and Social Medicine By K. Park, 19th Edition, Pages 625-26
| 4
|
It transmits dengue fever
|
It breed in stagnant water
|
They are recurrent day time biters
|
Its eggs cannot survive more than one week without water
|
Social & Preventive Medicine
| null |
45f7484d-4099-4c2f-ade9-c65c5294415f
|
multi
|
Percentage of renal stones which are radio opaque ?
|
Ans. is `d' i.e. 90%
| 4
|
10%
|
25%
|
37%
|
90%
|
Surgery
| null |
dba529ac-bc38-4ae0-b16e-e196ef384813
|
single
|
During pregnancy, fibroid may have all of the following complications except: March 2009
|
Ans. A: Metastasis Pregnant women with fibroids are at increased risk for: Pain Breech presentation Malposition Higher incidence of cesarean delivery Preterm bih Premature rupture of the membranes Postpaum hemorrhage Placental abruption Submucosal, fibroids located beneath the placenta, and fibroids 7 to 8 cm in diameter had the highest risk for abruption.
| 1
|
Metastasis
|
Pain
|
Post paum hemorrhage
|
Preterm labour
|
Gynaecology & Obstetrics
| null |
04fe126c-8138-494f-89fa-c09beb8530c2
|
multi
|
Which one of the following muscle protein plays an important role in contraction of both smooth and striated muscle?
|
Ans. D. Actina. In both smooth and striated muscle, contraction is produced by the cross- bridge cycle in which the cross-bridge on the thick filament binds to the actin molecule on the thin filament.b. In excitation-contraction coupling in striated muscle, calcium initiates contraction by binding to troponin.c. The calcium-activated troponin then acts to remove the tropomyosin-mediated inhibition of the actin-myosin interaction. In excitation-contraction coupling in smooth muscle, calcium initiates contraction by binding to calmodulin. The calcium-activated calmodulin then activates the myosin light chain protein kinase (MLCK) enzyme, which phosphorylates the myosin light chains. Actin-myosin interaction follows light-chain phosphorylation.
| 4
|
Calmodulin
|
Troponin
|
Tropomyosin
|
Actin
|
Physiology
|
General
|
62d0a735-88aa-491d-8388-57e657ccbc2d
|
multi
|
After birth, care of eye of newborn is by
| null | 1
|
AgNO3 eye drop
|
Antibiotics
|
Normal saline
|
Crede’s method
|
Social & Preventive Medicine
| null |
ae835e6f-2272-4558-bc39-ca6b214ae6de
|
single
|
Which of the following is not a feature of rheumatoid ahritis?
|
Heberden does is a feature of osteoahritis and not rheumatoid ahritisImpoant hand deformities of hand in RABoutonniere deformity: flexion contracture of PIP joint and extension DIP jointSwan neck deformity: hyperextension of PIP joint and flexion at DIP joint(Refer: Mohindra's Fundamentals of Ohopedics, 2nd edition, pg no. 88, 101, 127)
| 1
|
Heberden nodes
|
Swan neck deformity
|
Ulnar detion of fingers at metacarpopalyngeal joint
|
Symmetric reduction of joint space
|
Orthopaedics
|
All India exam
|
da1cf954-bff7-4e65-8e6d-68ce70c6988d
|
single
|
True regarding excitation contraction coupling in smooth muscles is :
|
D i.e. Presence of cellular calcium essential to cause muscle contraction
| 4
|
Presence of troponin is essential
|
Sustained contraction occurs with high calcium concentration
|
Phosphorylation of actin is required for contraction
|
Presence of cellular calcium is essential to cause muscle
|
Physiology
| null |
692b91a0-e29d-438c-b0a5-408f65adcfd1
|
multi
|
Most common symptom of symptom of alcohol withdrawal is
|
The most common withdrawal syndrome is a hangover on the next morning. Mild tremors, nausea, vomiting, weakness, irritability, insomnia and anxiety are the other common withdrawal symptoms. Sometimes the withdrawal syndrome may be more severe, characterised by one of the following three disturbances: delirium tremens, alcoholic seizures and alcoholic hallucinosis. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 37
| 2
|
Bodyache
|
Tremor
|
Diarrhoea
|
Rhinorrhea
|
Psychiatry
|
Substance abuse
|
4e4b1088-b359-440b-851c-1bcd4608e45a
|
single
|
Study of multiplication of proteins in disease process is called
|
Genomics is the branch of molecular biology concerned with the structure, function, evolution, and mapping of genomes.Glycomics is the comprehensive study of glycomes (the entire complement of sugars, whether free or present in more complex molecules of an organism), including genetic, physiologic, pathologic, and other aspects
| 1
|
Proteomics
|
Genomics
|
Glycomics
|
Nucleomics
|
Biochemistry
|
Metabolism of nucleic acids
|
aa9ca47c-703d-470d-b30a-2e04bc4a4365
|
multi
|
Skin grafting is absolutely C/I in which skin infection?
|
Ans is 'c' i.e. Streptococcus "The skin graft generally survives when placed over the wounds containing less than 105 organisms per gram of tissue unless the organisms are streptococci, which can rapidly dissolve transplanted skin." - S. Das 3/e, p 142
| 3
|
Staphylococus
|
Pseudomonas
|
Streptococus
|
Proteus
|
Surgery
| null |
f54992e3-6b45-4aa3-87b2-40658633ec6c
|
single
|
Most sensitive investigation for cystic fibrosis is?
|
Ans. (c) Sweat electrolytesRef: Harrison's Medicine 18th ed p 2149-50
| 3
|
CT scan
|
Ultrasound
|
Sweat electrolytes
|
Tomogram
|
Medicine
|
Genetics
|
03009447-dc4f-4ee3-9c35-1c9928a917c8
|
single
|
An Infant brought to the clinic with non-biliousf projectile vomiting. The investigation of choice includes\
|
(A) Barium meal # Clinical features of Hypertrophic pyloric stenosis:> Characteristically it is a first-born male child that is most commonly affected. The condition is most commonly seen at 4 weeks after birth ranging from the third week to, on rare occasions, the seventh.> Inexplicably, it is the time following birth that seems important and not the child's gestational age.> A premature infant will also develop the condition at about 4 weeks after birth.> Vomiting is the presenting symptom that after 2--3 days becomes forcible and projectile. The child vomits milk and no bile is present. Immediately after vomiting the baby is usually hungry. Weight loss is a striking feature and rapidly the infant becomes emaciated and dehydrated.> Diagnosis can usually be made with a test feed. This may produce characteristic peristaltic waves that can be seen to pass across the upper abdomen.> At the same time, using a warm hand, the abdomen is palpated to detect the lump. Ultrasound examination of abdomen reveals dome shaped, thickened pyloric sphincter.
| 1
|
Barium meal
|
Abdominal ultrasonograpy
|
Flexible Endoscopy
|
Sigmoidoscopy
|
Psychiatry
|
Miscellaneous
|
05211e03-6a60-475c-978a-9c721c2c352a
|
single
|
Extended spectrum beta lactamases (ESBLs) are characterized by activity against all except:
|
CARBAPENEMS: lmipenem :It is an extremely potent and broad-spectrum Beta-lactam antibiotic whose range of activity includes grampositive cocci, Enterobacteriaceae, Ps. aeruginosa, Listeri.
| 4
|
Penicillinases
|
Cephalosporinases
|
Oxyimino-cephalosporinases
|
Carbapenems
|
Pharmacology
|
Chemotherapy
|
6e9f9bd2-20a7-4e1e-b573-e0ef3794a864
|
multi
|
Increased LH:FSH ratio is found in :
|
Polycystic ovary syndrome
| 3
|
Premature menopause
|
Sheehan syndrome
|
Polycystic ovary syndrome
|
Turner's syndrome
|
Gynaecology & Obstetrics
| null |
cd04b14f-6f4c-4a3d-9bec-6f6477ddee5e
|
single
|
Type of graft, best suited for renal transplantation ?
|
Ans is 'd' i.e., Isograft Although the best graft is autograft, a renal graft can obviously not be an autograft. So the best renal graft is an isograft.
| 4
|
Allograft
|
Autograft
|
Xenograft
|
Isograft
|
Microbiology
| null |
56d9a1f7-b5c4-4604-a0ac-9dd5cf436cc5
|
multi
|
The ability of a test to detect true negatives is:
|
Ref: 21st edition Park. Pg 128Explanation:SensitivityAbility of the test to identify true positivesSpecificityAbility of the test to identify true negativesPositive predictive valueProbability that a patient with positive test result truly has the diseaseNegative predictive valueProbability that a patient with negative test result truly does not have the disease
| 2
|
Sensitivity
|
Specificity
|
PPV
|
NPV
|
Social & Preventive Medicine
|
Screening for Disease
|
39b81ed9-324d-458d-a067-07e0a8d4a241
|
multi
|
Which laser is used in the management of after cataracts -
|
After cataract, if thin, can be cleared centrally by a YAG laser capsulotomy.
| 3
|
Argon
|
Krypton
|
YAG
|
Excimer
|
Ophthalmology
|
Lens
|
43c1e6b0-0735-4c08-8d36-cac4733a2066
|
single
|
Superficial second degree burns heal by
|
Superficial second degree burns usually heal with minimum scarring in 10-14 days unless they become infected. Second degree burns are divided into superficial and deep burns. Superficial dermal burns: Erythematous and painful, blanch to touch and often blister. They heal in 10-14 days. Deep dermal burns : Involve the reticular dermis appear more pale and mottled, donot blanch to touch, but remain painful to pinprick. They heal in 4-8 weeks.
| 2
|
1 week
|
2 weeks
|
3 weeks
|
4 weeks
|
Anatomy
|
General anatomy
|
7a1a7792-bef9-4f5c-bd39-28846fefe15d
|
single
|
Syndrome characterized by an elaborate delusion that the patient is passionately loved by another person is also known as:
|
Erotomania (de Clerambault's syndrome): Condition in which a person holds a delusional belief that another person, usually of a higher social status, is in love with him/her. Erotomanic tries to get close to the person through telephone calls, e-mails, letters, gifts and visits. MC in women than in men. Ekbom syndrome (delusions of parasitosis): A form of psychosis wherein the patients acquire a delusional belief that they are infested with parasites, whereas in reality no such parasites are present. Cotard delusion/syndrome: Person holds a delusional belief that he is dead, does not exist, is putrefying or has lost his blood or internal organs. Delusion of infidelity/jealousy (Othello syndrome): Person holds a delusional belief that his spouse is unfaithful. Males are more affected.
| 2
|
Ekbom's syndrome
|
De Clerambault's syndrome
|
Querulous paranoia
|
Othello syndrome
|
Forensic Medicine
|
Forensic Psychiatry
|
7fbb5f1b-35ce-4cde-aeab-cb5a8d0622e8
|
single
|
Adrenaline in LA causes:
|
Ans: d (All of the above) Ref: KDT, 6th ed, p. 356; Bailey and Love, 24thed, p. 49* Addition of adrenaline (commonly 1:200000 to 1: 125000 concentration) to the local anaesthetic solution hastens the onset and prolongs the duration of action and permits a higher dose of drug to be used as it is more slowly absorbed into the circulation.* Duration of both sensory and motor blockade is increased by addition of epinephrine to lignocaine* Only sensory block is prolonged if epinephrine is added to bupivacaine with no effect on motor blockade.Contraindications for adrenaline with LAAbsoluteOther contraindicationsVasoconstrictor (adrenaline) should not be added for ring block of:* When other inhalational agents especially halothane which sensitizes myocardium to adrenaline* Myocardial ischemia patients* Hyperthyroid patients * Severe hypertensives* Intravenous regional anaesthesia * In patients taking either monoamine oxidase inhibitor or tricyclic antidepressant drug * Cardiac arrhythmia patients* Patients on beta blockersa. Handsb. Feetc. Fingersd. Toese. Penis (circumcision)f. PinnaNote. * Ropivacaine - Improved cardiovascular safety profile and provide relatively greater sensory th; motor blockade* Prilocaine- Presence of blue - brown skin colour indicates methaemoglobin toxicity* Bupivacaine - Has the highest local tissue irritancy, must never be injected into a vein and is absolutely contraindicated for use in intravenous regional anaesthesia
| 4
|
Increase the dose of LA
|
Less systemic absorption
|
More time of action
|
All of the above
|
Anaesthesia
|
Local and Regional Anesthesia
|
deb31985-fe35-436d-b463-1a9d1ef9b2de
|
multi
|
A drug used for Buerger's disease?
|
A drug used in Buerger's disease is Xanthinol nicotinate. Complamina retard (xanthine nicotinate) tablet was used daily once earlier. Now, graded injection of xanthine nicotinate 3000 mg from day 1 to 9000 mg on day 5 is used to promote ulcer healing.
It also helps to increase claudication distance as a temporary basis. Beta blockers such as propranolol & GTN have no ulcer healing property in case of Thromboangitis obliterans (Buerger's disease).
| 2
|
Propranolol
|
Xanthinol nicotinate
|
GTN
|
All the above
|
Surgery
| null |
f1644897-584b-4782-a359-90d6b28395ce
|
multi
|
Methotrexate is an example for which of the following class of drugs?
|
Ans: D (Folic acid analogue) Ref: The Pharmacological basis of therapeutics bv Goodman & Gilman - 12th edition, page no. 1669 -767/Explanation:"Methotrexate is an anti-metabolite which is a folic acid analogue." Ref: G&GClassification of Anti-Cancer DrugsAnti-metabolitesPemetrexed5 FUCapecitabineCytarabineGemcitabine5-aza-cytidineAlkylating agentsCyclophosphamideMelphalanChlorambucilProcarbazineBusull'anDacarbazineCisplatinOxaliplatinAntibioticsDoxorubicinDuunorubicinDactinomycinNatural products includeVinblastineVincristinePacliiaxelIrinotecanBiologic response modifiers includeInterferon alfaInterleukin-2Other categoriesTyrosine kinase inhibitors - imatinib, Sunitinib, DasatinibmTOR inhibitors - TemsirolimusProtea some inhibitors - Bortezomib
| 4
|
Antibiotic
|
Alkylating agent
|
Biologic response modifier
|
Folic acid analogue
|
Pharmacology
|
Anti-Neoplastic Agents
|
e0f37d7e-02dc-4cf7-86d3-f5c07899fb61
|
single
|
A 45-years-old man who works in textile company visited hospital for routine health check-up. He prepares dyes in company from last 18 years. Which of the following investigation would you recommend for this patient?
|
Dye stuffs & dyeing industries, rubber, gas & electric cable industries are associated with carcinoma of bladder (transitional cell carcinoma). Bladder cancer is caused by aromatic amines, which are metabolized in the body & excreted in the urine. Possible bladder carcinogens are: Beta-naphthylamines, benzidine, para-amino-diphenyl, auramine & magenta. In this case pt. is exposed to dyes for long duration and is at risk for developing bladder cancer. So, urine tests should be done to see if there is any hematuria, which is the mc symptom of bladder cancer.
| 3
|
Pulmonary function tests
|
Liver function tests
|
Urine examination
|
Complete blood count.
|
Social & Preventive Medicine
|
Environment
|
3103abb3-c4af-44b5-b618-40a0a935fa52
|
single
|
Which of the following joints findings Is most suggestive of an inflammatory, rather than an osteroahritis cause of joints pain?
|
The five classical signs of inflammation are heat, pain, redness, swelling, and loss of function (Latin calor, dolor, rubor, tumor, and functio laesa). Ref - Internet
| 4
|
Painful range of motion
|
Crepitus
|
Bony aicular enlargement
|
Swelling and warmth
|
Medicine
|
Immune system
|
53c4883e-86a2-44de-bb03-38aa0971cc1f
|
single
|
Nerves are not involved in ?
|
Ans. is 'c' i.e., Indeterminate leprosy
| 3
|
Tuberculoid leprosy
|
Lepromatous leprosy
|
Indeterminate leprosy
|
Borderline tuberculoid leprosy
|
Skin
| null |
326fefe4-25f7-401c-9112-38c211a822b1
|
single
|
Secretin is produced by which of the following duodenal cells?
|
Ans. D. S cells. (Ref. Guyton's Medical Physiology 11th/pg. 801; Ganong 23rd/ Chapter 36).GI secretory products1. Nitrous oxide: Causes smooth muscle relaxation (e.g., elower oesophageal sphincter (LES) relaxtion).2. Gastrin: Secreted in response to gastric distention, vagal stimulation, and amino acid entering the stomach; causes gastric H+ secretion.3. Secretin: Secreted in response to H+ and fatty acids entering the duodenum; causes pancreatid secretion of of HCO3 and inhibits gastrin H+ secretion. It is known as Nature's antacid as after being secreted by 'S' cells of duodenum it causes, secretion of bicarbonate from pancreas, which neutralises gastric acid.4. Cholecystokinin (CCK): Secreted in response to amino acids and fatty acids entering the duodenum; causes contraction of gallbladder and pancreatic secretion of enzymes and HC03 (AIIMS-99).5. Parasympathetic (ACh): Increases production of saliva; increased gastric H+ secretion; increases pancreatic enzyme and HCO3+ secretion; stimulates enteric nervous system to create intestinal peristalisis; relaxes sphincters.6. Vasoactive intestinal peptide (VIP): Secreted by smooth muscle and nerves of intestines. Relaxes intestinal smooth muscle causes pancreatic HC03 secretion and inhibits gastric H+ secretion.7. Sympathetic (NE): Increases production of saliva; deceases spalnchnic blood flow in fight-or-flight response: decreases motility; constricts sphincters.HormoneSourceActionRegulationNotesGastrinG cells, antrum of stomach| gastric H+ secretion, | growth of gastric mucosa, | gastric motility| by stomach distention, amino acids peptides, vagal stimulation; | by H+ secretion and stomach acid pH <1.5| | in Zollinger-Ellison syndrome; phenylalanine and tryptophan are potent stimulatorsCholecy- stokinin| cells, duodenum, jejunum| pancreatic secretion, | gallbladder contraction; |gasctic emptying, | growth of exocrine pancreas and gallbladder| by secretin and stomach pH < 1.5; | by fatty acids, amino acidsIncholelithiasis, pain woesens after fatty food ingestion due to| CCKSecretinS cells, duodenum| pancreatic HCO3' secretion, | gastric acid secretion| by acid, fatty acids in lumen of duodenum| HCO3 neutralizes gastric acid in duodenum, allowing pancrestic enzymes to functionSomatostainD cells, pancreatic islets; GI mucosa| gastric acid and pepsinogen secretion | pancreatic and small intestine fluid secretion | insulin and glucagon release| by acid; | by vagal stimulationInhibitory hormone; antigrowth hormone effects (digestion and absorption of substances needed for growth)Gastric inhibitory peptide (GIP)K cells, duodenum and jejunumExocrine: | gastric H+ secretionEndocrine: | insulin release| by fatty acids, amino acids, oral glucose (only GI hormone stimulated by all 3 nutrient classes)| GIP is why an oral glucose load is used more rapidly than the equivalent given by IVSecretin# Secretin is a polypeptide, containing 27 amino acids (molecular weight about 3400), present in an inactive form, prosecretin, in so-called S cells in the mucosa of the duodenum and jejunum. When acid chyme with pH less than 4.5 to 5.0 enters the duodenum from the stomach, it causes duodenal mucosal release and activation of secretin, which is then absorbed into the blood. The one truly potent constituent of chyme that causes this secretin release is the hydrochloric acid from the stomach.# Secretin in turn causes the pancreas to secrete large quantities of fluid containing a high concentration of bicarbonate ion (up to 145 mEq/L) but a low concentration of chloride ion. The secretin mechanism is especially important for two reasons: First, secretin begins to be released from the mucosa of the small intestine when the pH of the duodenal contents falls below 4.5 to 5.0, and its release increases greatly as the pH falls to 3.0. This immediately causes copious secretion of pancreatic juice containing abundant amounts of sodium bicarbonate.Cholecystokinin# The presence of food in the upper small intestine also causes a second hormone, cholecystokinin, a polypeptide containing 33 amino acids, to be released 'I cells', in the mucosa of the duodenum and upper jejunum. This release of cholecystokinin results especially from the presence of proteoses and peptones and long-chain fatty acids in the chyme coming from the stomach.# The differences between the pancreatic stimulatory effects of secretin and Cholecystokinin:- intense sodium bicarbonate secretion in response to acid in duodenum, stimulated by secretin,- a dual effect in response to soap (a fat), and- intense digestive enzyme secretion (when peptones enter duodenum) stimulated by CCK.Educational points:Basic Stimuli That Cause Pancreatic SecretionThree basic stimuli are important in causing pancreatic secretion:1. Acetylcholine, which is released from the parasympathetic vagus nerve endings and from other cholinergic nerves in the enteric nervous system2. Cholecystokinin, which is secreted by duodenal and upper jejunal mucosa when food enters small bowel3. Secretin, which is also secreted by duodenal and jejunal mucosa when highly acid food enters small bowel.The presence of acid, fat, protein breakdown products, hyperosmotic or hypo-osmotic fluids, or any irritating factor in the upper small intestine causes release of several intestinal hormones. One of these is secretin, which is especially important for control of pancreatic secretion. However, secretin opposes stomach secretion. Three other hormones--gastric inhibitory peptide, vasoactive intestinal polypeptide, and somatostatin--also have slight to moderate effects in inhibiting gastric secretion.
| 4
|
I cells
|
T cells
|
M cells
|
S cells
|
Physiology
|
G.I.T.
|
d536075a-2268-4e1a-817e-525f454cf251
|
single
|
First symptom in vulval cancer is-
|
Ans. is 'b' i.e., Pruritus o Women with VIN and vulvar cancer commonly present with pruritus and a visible lesion.# However, pain, bleeding, and ulceration may also be initial complaints.
| 2
|
Pain
|
Pruritus
|
Ulceration
|
Bloody discharge
|
Gynaecology & Obstetrics
|
Valva
|
1fb43edd-2cb2-44cb-84f3-313ac468e69e
|
single
|
Incised looking lacerated wound site is?
|
Ans. is 'a' i.e., forehead LACERATIONS (Tear or Rupture)o Lacerations are tears or splits of skin, mucous membrane and underlying tissue (e.g., muscle or internal organs). Lacerations are produced by application of blunt force to broad area of the body, which crush or stretch tissues beyond the limits of their elasticity. Localized portions of tissue are displaced by the impact of the blunt force, which sets up traction forces and causes tearing of tissues. Features of lacerations are:-i) Hair and hair bulb, nerves and blood vessels are crushed - There may be paralysis (nerve crushed) and hemorrhage is not pronounced (blood vessels crushed).ii) Site of injury is the site of impact.iii) Shape of injury is irregular, margins are irregular and contused/abraded and show tags of tissue.iv) Size of injury does not corresponds to impacting surface.o There are following types of laceration:-1) Split laceration : Splitting occurs by crushing of skin between two hard objects. Blunt force on areas where the skin is close to rigid structures like bone with scanty subcutaneous tissue, may produce a wound that by linear splitting of tissue may look like incised wound, i.e., incised like or incised looking wound. Examples of such area are scalp, eye brows, cheek bones (zygomatic), lower jaw, iliac crest, perineum and skin. A wound produced by a fall on knee or elbow with limb flexed and by a sharp stone also simulates incised wound.2) Strech lacerations: Overstretching of the skin, if it is fixed, will cause laceration, for example, by kicking, sudden deformity of bone occurs after fracture, making it compound.3) Avulsion (shearing laceration): An avulsion is a laceration produced by sufficient force (shearing force) delivered at an acute angle to detach (tear off) a portion of a traumatized surface or viscus from its attachment, the shearing and grinding force by a weight. Flaying is type of avulsion in which shearing and grinding force by weight (such as of lorry wheel passing over a limb) may produce avulsion (separation of skin from underlying tissue/degloving of a large area).4) Tears: Tears of the skin and tissues can occur from imact by a against irregular or semi-sharp objects, such as door handle of a car. This is another form of overstretching.5) Cut laceration: Cut lacerations may be produced by a heavy sharp edged instrument.
| 1
|
Forehead
|
Hand
|
Thorax
|
Abdomen
|
Forensic Medicine
|
Injuries by Sharp Force
|
0b85c902-0dc8-4c70-8799-e28b6dceb1e6
|
single
|
False about nerve entrapment syndromes
|
Nerve entrapment syndromes
Carpal tunnel syndrome - Median nerve
Cubital tunnel syndrome - Ulnar nerve
Guyon's canal syndrome - Ulnar nerve
Pyriformis syndrome - Sciatic nerve
Meralgia Paresthetica - Lateral cutaneous nerve of thigh
Cheiralgia Paresthetic - Superficial Radial nerve
Tarsal tunnel syndrome - Posterior tibial nerve
| 3
|
Guyon's canal syndrome - ulnar nerve
|
Cubital tunnel syndrome - ulnar nerve
|
Cheiralgia paresthetica - femoral nerve
|
Tarsal tunnel syndrome - posterior tibial nerve
|
Orthopaedics
| null |
210e857c-b23b-4f78-96fe-d226f3b11dc8
|
multi
|
Keshan's disease is due to deficiency of:
|
Keshan's Disease Deficiency of Selenium (Se) Affects: Children Women of child bearing age CLINICAL FEATURES: Cardiomyopathy Muscle weakness Hypothyroidism Eczema Increased risk of stroke Hypeension Cancer Selenium Sources- seafood and meat, nuts Deficiency - Keshan's disease Toxicity - Selenium toxicity lead to Selenosis
| 1
|
Selenium
|
Zinc
|
Copper
|
Iron
|
Biochemistry
|
FMGE 2019
|
a2f01d80-2049-4155-8ba7-68aa1a47ef94
|
single
|
Bones ossified at bih:
|
A i.e., Lower end femur B i.e., Calcaneum C i.e., Upper end tibia
| 4
|
Lower end of femur
|
Calcaneum
|
Upper end tibia
|
All
|
Anatomy
| null |
8b4a033b-5e7d-4e2e-86df-8e527eda696b
|
multi
|
The largest component of amalgam alloy is:
| null | 1
|
Silver
|
Tin
|
Zinc
|
Copper
|
Dental
| null |
837bc195-b0a2-4739-af7a-a58e6b50d665
|
multi
|
Localized myogenic infection is caused by which bacteria?
|
ANSWER: (A) StaphylococcusREF: Harrisons 18th ed chapter 125Important causes of muscle infections:Most common cause of pyomyositis : staphylococcus aureusGas gangrene : CL PerferingensSevere muscle pain : pleurodynia due to coxsackie B, trichinosisRhabdomyolysis : clostridium , streptococcal
| 1
|
Staphylococcus
|
Clostridium
|
Cornybacterium
|
Streptococcal
|
Microbiology
|
Staphylococci
|
f79d62c5-a436-4a26-8643-7ba3d8ae75ee
|
single
|
A56 years old patient presents after three days of cataract surgery with a history of increasing pain and decrease of vision after an initial improvement the most likely cause would be
|
Pain which is increasing along with decrease in vision paicularly after only three days of cataract surgery strongly suggest endophthalmitis
| 1
|
Endophthalmitis
|
After cataract
|
Central retinal vein occlusion
|
Retinal detachment
|
Ophthalmology
|
Lens
|
97bc6a1d-d772-43aa-bdbc-8528bcd42f51
|
single
|
Oedipus complex has been described by -
|
Oedipus complex is described by Freud in psychosexual stages of development.
| 3
|
Plato
|
Socartes
|
Freud
|
Huxley
|
Psychiatry
| null |
d6bb20bf-62cd-4156-bf97-0377b9a7c824
|
single
|
On microscopic examination, eggs are seen, but on saturation with a salt solution, no eggs are seen. The eggs are likely to be of -
| null | 2
|
Trichuris trichiura
|
Taenia solium
|
Ascaris lumbricoides
|
Ancylostoma duodenale
|
Microbiology
| null |
07cf326a-bb3e-43b9-9474-6b3f307f2313
|
single
|
Most frequent site of tubal ectopic pregnancy is
|
Nearly 95 percent of ectopic pregnancies are implanted in the various segments of the fallopian tube. The ampulla (70 percent) is the most frequent site, followed by isthmic (12 percent), fimbrial (11 percent), and interstitial tubal pregnancies (2 percent).The remaining 5 percent of non-tubal ectopic pregnancies implant in the ovary, peritoneal cavity, cervix, or prior cesarean scarReference: William's Obstetrics; 25th edition; Chapter 19; Ectopic pregnancy
| 3
|
Interstitial
|
Isthmic
|
Ampulla
|
Infundibulum
|
Gynaecology & Obstetrics
|
General obstetrics
|
f85038e4-e70b-4a63-b316-5642f0b3f4fc
|
single
|
A one year old child having leucocoria was detected to be having a unilateral, large retinoblastoma filling half the globe. Current therapy would involve:
|
A i.e. Enucleation
| 1
|
Enucleation
|
Chemotherapy followed by local dyes
|
Direct Laser ablation using photo dynamic cryotherapy
|
Scleral radiotherapy followed by chemotherapy
|
Ophthalmology
| null |
11ed1ae2-47ca-42ff-aac5-865f62508c55
|
single
|
After removal of granulation tissue from periodontal
pocket the hard structure seen is
| null | 2
|
Periosteum
|
Transseptal fibres
|
Sharpey's fibres
|
Organized granulation tissue
|
Dental
| null |
51233c9d-5d8b-488d-81b9-c3677501fa3d
|
single
|
All are true regarding folliculogensis and ovulation except
|
Peak level of LH is required for ovulation Peak level is 75ng/ml It lasts for 24 hours Ref: Shaw Gynecology 17 e pg 40.
| 4
|
Follicular development and differentiation takes about 85 days
|
AMH suppos follicular development and oocyte maturation
|
First phase of follicular growth is gonadotrophin insensitive
|
Elevated and static levels of estradiol is essential for ovulation
|
Gynaecology & Obstetrics
|
Reproductive physiology and hormones in females
|
c8bc7f56-e74e-4c48-855d-a62d58da30ba
|
multi
|
A 16-year-old boy arrives to your office soon after beginning basketball season. He states that he has had progressive pain in his knees. A physical examination reveals, in addition to tenderness, a swollen and prominent tibial tubercle. Radiographs of the area are unremarkable. Which of the following is the most likely diagnosis?
|
This history is typical of Osgood-Schlatter disease. Microfractures in the area of the insertion of the patellar tendon into the tibial tubercle are common in athletic adolescents. Swelling, tenderness, and an increase in size of the tibial tuberosity are found. Radiographs can be used to rule out other conditions. Treatment consists of rest.Legg-Calve-Perthes disease is avascular necrosis of the femoral head. This condition usually produces mild or intermittent pain in the anterior thigh but can also present as a painless limp. Gonococcal arthritis, although common in this age range, is uncommon in this anatomic site. More significant systemic signs and symptoms, including chills, fever, migratory polyarthralgia, and rash, are commonly seen. Slipped capital femoral epiphysis is usually seen in a younger, more obese child (mean age about 10 years) or in a thinner, older child who has just undergone a rapid growth spurt. Pain upon movement of the hip is typical. Popliteal (Baker) cysts are found on the posterior aspect of the knee. Observation is usually all that is necessary, as they typically resolve over several years. Surgical excision is indicated if the cyst progressively enlarges or if there are unacceptable symptoms associated with the cyst.
| 1
|
Osgood-Schlatter disease
|
Popliteal cyst
|
Slipped capital femoral epiphysis
|
Legg-Calve-Perthes disease
|
Pediatrics
|
Growth, Development, and Behavior
|
06a059e8-ce09-46d0-81ba-2bf989c7f059
|
multi
|
All of the following statements about Thrombotic thrombocytopenic purpura (TTP) are true, Except :
|
Answer is D i.e. (Grossly abnormal coagulation tests) Tests of coagulation are essentially normal in Thrombotic Thrombocytopenic Purpura (TTP). Clinical Pentad + Normal Tests for coagulation : TTP Clinical Pentad of TTP
| 4
|
Microangiopathic Hemolytic Anemia
|
Thrombocytopenia
|
Normal complement levels
|
Grossly abnormal coagulation tests
|
Medicine
| null |
fb00f2c4-c96c-4db3-97f4-01484ecef1b6
|
multi
|
Simple anchorage refers to
| null | 1
|
Closure by tipping
|
Closure by bodily movement
|
Closure by rotation
|
Closure by intrusion
|
Dental
| null |
3e58499f-3a81-4dcd-bc9f-6ca644779dd4
|
single
|
Prothombin Time (PT) of a patient is 26, Control PT is 13 seconds and Sensitivity index is 1.41. What will be the INR of this patient?
|
The INR calculation has become a standard method for monitoring the PT values. It is calculated as = (patient prothrombin time/mean prothrombin time)ISI. Patient prothrombin time = 26 Mean prothrombin time = 13 ISI (International Sensitivity Index) = 1.41 INR = (26/13)1.41 Ref: Laboratory Hematology Practice By Kandice Kottke-Marchant, Bruce Davis, Page 424; Goodman and Gilman's The Pharmacological Basis of Therapeutics, 11th Edition, Page 1479; Physician Assistant's Clinical Companion By Springhouse, Pages 89-91
| 4
|
26/13
|
(26/13) x 1.41
|
(26/13)+1.41
|
(26/13)1.41
|
Pharmacology
| null |
50ae24ac-c799-49e2-a820-8f39f295d517
|
single
|
Which event will NOT occur during depolarization phase?
|
Na+ channels open, increasing the permeability of the cell membrane to Na+. Sodiumions then diffuse into the cell, causing depolarization. This causes K+ channels to close quickly, decreasing the permeability of the cell membrane to K+. The decreased diffusion of K+out of the cell also causes depolarization. Ca2+ channels slowly open, increasing the permeability of cell membrane to Ca2+. Calcium ions then diffuse into the cell and cause depolarization.
| 3
|
Na+ channels open
|
Ca+ channels open
|
K+ channels open
|
None of the above
|
Medicine
| null |
c19a6f2a-938f-43f1-a6df-b89d72d4f418
|
multi
|
All the following are features of Endotoxins Except
|
Distinguishing features of exotoxins and endotoxinsExotoxinsEndotoxinsProteinsLipopolysaccharidesHeat-labileHeat StableActively secreted by cells; diffuse into surrounding mediumForm pa of the cell wall; do not diffuse into surrounding mediumReadily separable from cultures by physical means such as filtrationObtained only by cell lysisAction often enzymicNo enzymatic actionSpecific pharmacological effect for each exotoxinEffect nonspecific; action common to all endotoxinsSpecific tissue affinitiesNo specific tissue affinityActive in very minute dosesActive only in very large dosesHighly antigenicWeakly antigenicAction specifically neutralized by antibodyNeutralisation by antibody ineffectiveRef: Ananthanarayan; 7th edition; Page no: 67
| 2
|
Lipopolysaccharides
|
Proteins
|
Heat stable
|
No enzymic action
|
Microbiology
|
general microbiology
|
bcd6d29e-f27a-4d3d-87c5-9ab466aa3092
|
multi
|
The systolic blood pressure of 10 individuals was measured. The mean and median values were calculated to be 130 mmHg and 140 mmHg respectively. What is the shape of the frequency distribution curve?
|
A negatively skewed distribution is where most of the values are on the higher side and the tail is pointing left. The mean of a distribution is more affected by extreme values than is the median. Therefore, in a negatively skewed distribution with few values on the lower end of the distribution, the mean is pulled towards the tail or lower end and becomes less than the median. Ref: Park's Textbook Of Preventive And Social Medicine, By K. Park, 19th Edition, Pages 699-702; Essentials of Research Methods in Health, Physical Education, Exercise Science and Recreation, By Kris E. Berg, Richard W. Latin, Second Edition, Pages 85-87; High-Yield Biostatistics, By Anthony N. Glaser, Third Edition, Pages 10, 11.
| 4
|
Symmetrical distribution
|
Bimodal distribution
|
Positively skewed distribution
|
Negatively skewed distribution
|
Social & Preventive Medicine
| null |
a4fa4c0e-0bf8-4382-9dc9-81c339068c03
|
single
|
Insal-Salvati index is used for
|
a-length of patellar ligament b-length of patella INSAL-SALVATI index=a/b Normal range is 0.8 -1.2 If ratio increases it suggests patella is at a higher level-PATELLA ALTA If ratio decreases it suggests patella is at a lower level -PATELLA BAHA ref:apley's 9th edition pg no.565
| 2
|
Olecranon
|
Patella
|
Talus
|
Scaphoid
|
Orthopaedics
|
Thigh, Knee,Leg,Foot & Ankle injuries
|
306b45b9-f851-4dde-9e41-cd5e4aa1b201
|
single
|
Which of the following is true about imatinib
| null | 4
|
It acts by inhibition of tyrosine kinase
|
It is used to treat GIST
|
Side effect of imatinib is pedal edema
|
All of the above
|
Surgery
| null |
a94974d4-ffea-4ef2-acbe-35e3464b5c72
|
multi
|
A head injured patient, who opens eyes to painful stimulus, is confused and localizes to pain. What is the Glassgow coma score :
|
Answer is C (11): A head injury patient who opens eyes to painfid stimulus (2), is confused (4) and localizes pain (5) has a GCS `Glasgow coma scale' score of 11.
| 3
|
7
|
9
|
11
|
13
|
Medicine
| null |
296ad461-b419-4e1f-9e79-8c2fc9a94657
|
single
|
Vitamin D-resistant rickets is associated with all of the following, except
| null | 4
|
Hypophosphatemia
|
Increased calcium absorption
|
Osteomalacia
|
Osteoporosis
|
Medicine
| null |
8b5c9e93-1d6e-4a74-8d02-377884f51cfe
|
multi
|
Which is the middle and large carpal bone -
|
Ans. is 'd' i.e., Capitate o Among the given options only capitate lies in middle (not lateral or medial) and it is the largest carpal boneo Scaphoid is lateral most bone in proximal row, pisiform is medial most bone in proximal row and hamate is medial most bone in distal row.Carpal bonesProximal Row (Lateral to medial)Distal Row (Lateral to medial)o Scaphoido Lunateo Triquetralo Pisiformo Trapeziumo Trapezoido Capitateo Hamateo Capitate is the largest carpal bone, first carpal bone to ossify & articulates with maximum number of bones.
| 4
|
Scaphoid
|
Pisiform
|
Hamate
|
Capitate
|
Anatomy
|
Osteology of Upper Extremity
|
32ac22d6-81a3-427d-a556-c32af0037239
|
single
|
Which one of the following is a subcortical dementia?
| null | 2
|
Alzheimer's disease
|
Huntington's chorea
|
Normal pressure Hydrocephalus
|
Vit B12 deficiency
|
Psychiatry
| null |
8a14882e-69c2-44e2-99c1-511667e23548
|
single
|
Severe malnutrition is defined in adults with BMI less than
|
Body mass index (BMI) BMI = wt (kg)/ ht (m)2 Example: an adult of 70 kg with a height of 1.75 m has a BMI of 70/1.752= 22.9 kg/m2 * BMI is a useful way of identifying under- or over-nutrition but cannot discriminate between lean body or muscle mass and fat mass <img src=" /> Ref Harrison 20th edition pg 76
| 2
|
18.5
|
16
|
13
|
11
|
Medicine
|
Nutrition
|
2ceae270-cfa7-495b-a0f8-e1757891266d
|
single
|
First cell to migrate into a wound due to chemotaxis to sta the process of wound healing is -
|
. In healing 1.intial haemorrhage. 2.acute inflammatory response:this occurs withiwithin 24 hours with appearance of polymorphs from margin of incision by the 3rd day polymorphs are replaced by macrophages. Ref Robbins 9 /e pg62-65
| 4
|
Lymphocyte
|
Macrophage
|
Platelet
|
Neutrophil
|
Pathology
|
General pathology
|
5b48d5da-2c00-428c-85c8-5a75a15806f6
|
single
|
Most common ovarian tumour in less than 20 year old is:
|
Below 20 years, 60% ovarian tumours are of germ cell origin and in girls less than 105, 85% tumours are of germ cell origin. Ref: Shaw 15th edition: page; 376.
| 2
|
Epithelial tumour
|
Germ cell tumour
|
Metastatic tumour
|
Sex cord stromal tumour
|
Gynaecology & Obstetrics
| null |
4fc36e3f-57ff-431b-bd32-640ace3a0c71
|
single
|
Fohergill's repair is also known as :
|
Manchester operation
| 2
|
Khanna's sling operation
|
Manchester operation
|
Le Fo's repair
|
Shirodkar's abdominal sling operation
|
Gynaecology & Obstetrics
| null |
f19c0643-df6b-4782-a294-70d7dedde24e
|
single
|
All of the following are contraindications for rigid esophagoscopy Except
|
Regular oesophageal dilatation is done for stricture. Stricture is dilated endoscopically using guidewires. Dilators are solid type with gradual increase in diameters. Dilatation should be done up to minimum 16mm diameter. Reference: SRB's Manual of Surgery, 6th Edittion, page no= 792
| 3
|
Trismus
|
Aoic aneurysm
|
Stricture
| null |
Surgery
|
G.I.T
|
90084924-c94b-4541-8eec-83ca03bef490
|
multi
|
The Pearl index indicates the number of accidental pregnancies per -
| null | 4
|
1000 population
|
100 live births
|
100 women in the age group of 15 to 44 years
|
100 women years
|
Social & Preventive Medicine
| null |
37a43194-0b5c-4087-a8e2-466750f4dfee
|
single
|
Shoening of lower limb with abduction and internal rotation is observed in which of the following types of hip dislocation?
|
Ans. c. Central dislocation
| 3
|
Anterior dislocation
|
Posterior dislocation
|
Central dislocation
|
Lateral dislocation
|
Surgery
| null |
aa834504-8390-4132-b8c3-31acb3c9454c
|
single
|
Acantholysis is characteristic of:
|
A i.e. Pemphigus Vulgaris
| 1
|
Pemphigus vulgaris
|
Pemphigoid
|
Erythema multoforme
|
Dermatitis herpetiformis
|
Skin
| null |
e7f9a02e-ce69-4aef-a4bc-d3f8cc4edb67
|
single
|
In cirrhotic ascites, which diuretic is preferred ?
| null | 3
|
Furosemide
|
Acetazolamide
|
Spironolactone
|
Any of the above
|
Pharmacology
| null |
80db24b6-3bc5-4ef6-84aa-b934bc122eb6
|
multi
|
Which of the following peptides are not produced by the renal system?
|
The hormones produced in the kidneys are 1,25 Dihyrocholecalciferol, Renin and Erythropoetin. Angiotensin is an oligopeptide and is a hormone and a powerful dipsogen. It is derived from the precursor molecule angiotensinogen, a serum globulin produced in the liver. It plays an impoant role in the renin-angiotensin system. Ref: The Local Cardiac Renin-Angiotensin Aldosterone System By Edward D. Frohlich, Richard N. ; Ganong's Review of Medical Physiology, 22nd Edition, Pages 455, 459
| 2
|
Renin
|
Angiotensin I
|
Erythropoietin
|
1,25DHCC
|
Physiology
| null |
80baee15-1dbd-4143-a692-712feb3c74fc
|
single
|
All of the following drugs act by blocking calcium channels except:
| null | 1
|
Dantrolene
|
Nicardipine
|
Diltiazem
|
Verapamil
|
Pharmacology
| null |
906a2759-988e-4a96-8b5d-6c43df60204d
|
multi
|
Bone marrow depression is seen with chronic administration of
|
(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no.163-168)
| 2
|
Isoflurane
|
N2O
|
Ether
|
Halothane
|
Anaesthesia
|
All India exam
|
a223166e-c26f-480b-9450-980a9395053f
|
single
|
Which of the following statements about imipenem is most accurate?
|
Carbapenems are synthetic b-lactam antibiotics Imipenem, meropenem, doripenem and eapenem are the drugs of this group currently available. Imipenem : Effective against : Gm +ve, Gm -ve including pseudomonas and anaerobic. Dehydropeptidase by kidney metabolises imipenem rapidly. Cilastatin is a dehydropetidase inhibitor, which must be given along with imipenem for desired action. Side effect : Seizure
| 3
|
The drug has a narrow spectrum of antibacterial action
|
It is used in fixed dose combination with sulbactum
|
In renal dysfunction, dosage reductions are necessary to avoid seizures
|
Imipenem is active against methicillin-resistant staphylococci
|
Pharmacology
|
Cell Wall Synthesis Inhibitors
|
9d8662a8-555d-451d-8314-b4058a55534e
|
multi
|
The true statement about contrast induced acute kidney injury is:
|
Iodinated contrast agents are a leading cause of AKI. Increased risk is seen in Chronic kidney disease - paicularly diabetic nephropathy The most common clinical course of contrast nephropathy is A rise in SCr beginning 24-48 hours following exposure Peaking within 3-5 days Resolving within 1 week ALSO NOTE: More severe, dialysis-requiring AKI is uncommon Patients with multiple myeloma and renal disease are paicularly susceptible for severe renal failure. Low fractional excretion of sodium and without features of tubular necrosis are common findings. Ref: Harrison-E-18, P-2297.
| 3
|
Rise in the serum creatinine after 12 hours
|
Peak in serum creatinine in 2 weeks
|
Dialysis requirement is usually uncommon
|
High fractional excretion of Na is a common finding
|
Medicine
| null |
08866dee-aa08-4f9d-801c-e5fd8bd83180
|
multi
|
A pt. presents with hematuria of several days and dysmorphic RBC casts in urine. The site of origin is -
| null | 1
|
Kidney
|
Ureter
|
Bladder
|
Urethra
|
Surgery
| null |
4867e63b-976b-461d-b36e-f4f7a7e03119
|
single
|
Which Fully humanized antibody is used in treatment of rheumatoid ahritis?
|
MUMABs- are fully humanized monoclonal antibodies Omabs- derived from mice Zumabs- 80 % Human Adaliimumab: This recombinant monoclonal anti-TNF Antibody is administered s.c. 40 mg every 2 weeks. Injection site reaction and respiratory infections are common adverse effects. Combination with Mtx is advised to improve the response and decrease antibody formation. ESSENTIALS of MEDICAL PHARMOCOLOGY SIXTH EDITION -KD TRIPATHI Page:205
| 2
|
Anakira
|
Adalimumab
|
Infliximab
|
Leflunomide
|
Pharmacology
|
Immunomodulators
|
c4920168-0531-41d2-85fa-d66ff3019bf1
|
single
|
The drug of choice for mushroom poisoning-
|
Ans. is 'c' i.e., Atropine Mushroom poisoning o Depending on the toxic principal present in the paicular species, at least 3 types of mushroom poisoning is known. 1. Muscarine type (early mushroom poisoning) Due to Inocybe and related species. Symptoms are due to muscarinic action. T/t of choice is atropine. 2. Hallucinogenic type o It is due to muscimol and other isoxazole compounds which are present in A. muscaria. o These isoxazole compounds activate amino acid, receptors, and block muscarinic receptor in brain; and have hallucinogenic propey. o Manifestations are primarily central. o There is no specific treatment and atropine is contraindicated. o Another hallucinogenic mushroom is Psiloocybe mexicana whose active principal Psilocybine is a tryptaminergic compound (this has been added to 6th/e of KDT). 3.Phalloidin type (late mushroom poisoning) o Due to peptide toxin found in A. phalloides and Galerina. o These inhibit RNA & protein synthesis. o Symptoms are due to damage to the GI mucosa, liver and kidney. o Treatment is supppoive, Thiotic acid may be used.
| 3
|
Adrenaline
|
Physostigmine
|
Atropine
|
Carbachol
|
Pharmacology
| null |
6641a440-cdc6-482e-8d60-6c14e3a8abbb
|
single
|
Prerequisite for applying forceps are all except: September 2007
|
Ans. C: Saggital suture should be in line with transverse diameter of pelvis Conditions to be fulfilled prior to forceps operation: The fetal head must be engaged Cervix must be fully dilated Membranes must be ruptured The position and station of the fetal head must be known No major CPD Adequate analgesia Bladder must be emptied.
| 3
|
Aftercoming head of breech
|
There should be no CPD
|
Saggital suture should be in line with transverse diameter of pelvis
|
Foetal head should be engaged
|
Gynaecology & Obstetrics
| null |
d656a5a0-e620-4b57-826e-6a6b9b616ccb
|
multi
|
Amino acid involved in urea synthesis:
|
Ans:B.)Aspaic Acid Urea has 2 amino (-NH2) groups, one derived from NH3 and other from aspaate.UREA CYCLE* Location: Cytosol and mitochondria of hepatocytes.* Substrates: NH 3 (as derived from oxidative deamination of glutamate); CO2 ; aspaate; three ATP.* Products: Urea; fumarate; H2O.* Purpose: The urea cycle allows for the excretion of NH 4+ by transforming ammonia into urea, which is then excreted by the kidneys.* Impoant enzymes:Carbamoyl phosphate synthetase I: Conves ammonium and bicarbonate into carbamoyl phosphate. This is the rate-limiting step in the urea cycle. This reaction requires two ATP and occurs in the mitochondria.Ornithine transcarbamoylase: Combines ornithine and carbamoyl phosphate to form citrulline. Located in mitochondria.Argininosuccinate synthetase: Condenses citrulline with aspaate to form arginosuccinate. This reaction occurs in the cytosol and requires one ATP.Argininosuccinate lyase: Splits argininosuccinate into arginine and fumarate. Occurs in the cytosol.Arginase: Cleaves arginine into one molecule of urea and ornithine in the cytosol. The ornithine is then transpoed back into the mitochondria for entry back into the cycle.* Regulation: Carbamoyl phosphate synthetase I catalyzes the rate-limiting step of the cycle and is stimulated by N -acetylglutamate.* Diseases:Hyperammonemia occurs when there is a deficiency in one of more of the urea cycle enzymes, causing insufficient removal of NH 4+ .Ammonia intoxication leads to CNS deterioration in the form of mental retardation, seizure, coma, and death.
| 2
|
Glutamine
|
Aspaic acid
|
Valine
|
Phenylalanine
|
Biochemistry
| null |
10f7126b-41ba-4203-a3b0-9ff62b84165e
|
single
|
All are causes of pulmonary hypertension except-
| null | 1
|
Hyperventilation
|
Morbid obesity
|
High altitude
|
Fenfluramine
|
Medicine
| null |
775d2fd7-ae83-47e5-bfde-0131edf1a2b8
|
multi
|
Current mode of analgesia best for intrapartum pain relief:
|
Ans. a (Epidural analgesia)LUMBAR EPIDURAL ANALGESIAIndications for lumbar epidural analgesia :# Pain in labor, management of the patient with preeclampsia who does not have a coagulation abnormality, management of labor in patients with certain cardiac lesions, and management of breech delivery.# Of the various pharmacologic methods of pain relief used in labor and delivery, regional analgesia techniques--spinal, epidural and combined spinal epidural (CSE) are the most flexible, effective, and least depressing to the CNS, allowing for an alert, participating mother and an alert neonate.Absolute contraindications:# Patient refusal, hemodynamic instability, infection at the anticipated site of puncture, and absence of resuscitation equipment.Relative contraindications:# Fever, preexisting CNS disease, hypovolemia, hypotension, lack of experience by the anesthetist, and blood coagulation defects.# Although an arbitrary platelet count of 100,000 per mm3 has been advocated as the lower limit for safe lumbar epidural analgesia, successful blocks without epidural bleeding complications have been obtained with platelet counts as low as 50,000 per mm3.Three principal advantages of lumbar epidural analgesia:# The parturient remains awake and cooperative.# The incidence of complications is very low when the technique is used correctly.# Once an epidural catheter is in place, it can be used to provide analgesia or anesthesia for a vaginal or cesarean delivery.The disadvantages of lumbar epidural analgesia:# The possibility of poor perineal analgesia# The presence of "hot spots", where analgesia is insufficient# Delayed onset of action# Technical difficulty (Technical failure occurs in approximately 4% of cases)# Intravascular injection# Accidental dural puncture
| 1
|
Epidural analgesia
|
Spinal anaesthesia
|
Inhalational
|
Local analgesia
|
Anaesthesia
|
Local and Regional Anesthesia
|
a36597d8-c8b2-4eec-b36c-8c91c04ab87d
|
single
|
28 weeks pregnancy with abdominal pain and fever. Ultrasonographic examination shows presence of fibroid. What is the next line of management-
|
Ans. is 'b' i.e., Conservative management o The presence ofpain and fever in a female in her mid pregnancy with ultrasound examination showing presence offibroid supports the diagnosis of red degeneration.Red Degeneration (Also known as Carneous Degeneration)o Occurs in pregnant females with presence of fibroid because fibroid overgrows its blood supply (micronecrothrombosis).o Most commonly occurs in second trimester of pregnancy followed by in the puerperium.o Cut section : raw beefy appearance, fishy odor.o Patient presents with acute abdomen, vomiting, fever, and leukocytosis,o D/D : acute appendicitis, pyelonephritis, and abruption.Management:o Always conservative management (never surgery)o Hospitalizationo Bed resto Analgesicso IVfluidso IV antibiotics (SOS)Some important points about fibroidso Most common degeneration overall-Hyalineo Most common degeneration in pregnancy-Redo Cystic degeneration is most common in-Post menopausal wromen & interstitial fibroido Calcareous degeneration is most common in-Subserous fibroido Most common fibroid to undergo torsion-Subserous fibroid.o Pseudo Meigh syndrome is associated with-Subserous fibroid.o Wandering or parasitic fibroid-Subserous fibroid.o Most common type of fibroid-Intramural / interstitial.o Fibroid with maximum symptoms-Submucous.o Most symptomatic fibroid-Submucous,o Most common fibroid to undergo malignant change-Submucous.o Lantern on dome of St paul-Cervical fibroid.o Most common to cause urinary retention-Posterior cervical.o Most common menstrual symptom-Menorrhagea.o Inversion is associated with-Fundal fibroid.
| 2
|
Hysterectomy
|
Conservative management
|
Termination
|
Myomectomy
|
Gynaecology & Obstetrics
|
Treatment and Recurrence
|
84f81388-d7d7-4ab5-a651-d496c4c0e120
|
single
|
Which of the following is seen at high altitude:September 2011
|
Ans. A: Low PaO2With increasing altitude, barometric pressure decreases, so the total pressure of the air decreases and pH2O and pCO2 remains constant So p02 and pN2 decreases progressively with heightHigh-altitude illnessUsually occurs at altitudes of over 1,500 m (4,921 ft)Caused primarily by hypoxia but is compounded by cold and exposure.Hypoxia is the main contributor to high-altitude illness.Atmospheric pressure and the paial pressure of oxygen decrease rapidly at increasing levels above the eah's surfacepCO2 and pH2O remain constant, pN2 also decreasesIt presents as one of three forms: acute mountain sickness (AMS), high-altitude pulmonary edema (HAPE) and high-altitude cerebral edema (HACE).Cardinal symptoms include dyspnea on exeion and at rest, cough, nausea, difficulty sleeping, headache and mental status changes.Treatment requires descent, and gradual acclimatization provides the most effective prevention.Acetazolamide is an effective preventive aid and can be used in ceain conditions as treatment.
| 1
|
Low PaO2
|
High PaO2
|
Normal PaO2
|
High PaCO2, Low PaO2
|
Physiology
| null |
edd890f2-bd51-40c8-8d94-d2c8b46c5444
|
single
|
In a child presenting with obstructive jaundice all are seen except
|
.lab investigations in obstructive jaundice gamma glutamyl transpeptidase:>50IU/L Serum bilirubin:>1mg%direct is increased serum albumin globulin ratio prothrombin time serum alkaline phosphatase,SGOT,SGPT,5&;nucleotidase ERCP TLC BAILEY AND LOVE&;S SHO PRACTICE OF SURGERY,24 th edition, PG NO:696
| 3
|
Gamma glutamyl transpeptidase
|
Alkaline phosphatase
|
Glutamate dehydrogenase
|
5' Nucleotidase
|
Pediatrics
|
Gastrointestinal tract
|
c5bab489-5b35-4aee-a8c5-ea00f672d3fc
|
multi
|
Most common renal pathology in shock:
|
Ans: a
| 1
|
Acute tubular necrosis
|
Acute cortical necrosis
|
Renal vein thrombosis
|
Acute medullar necrosis
|
Medicine
|
Kidney
|
bae9624c-04f3-4ab0-a897-baef27f86a82
|
single
|
Which of these features is a classic radiologic feature of optic nerve glioma:
|
Ans. Kingking of optic nerve
| 2
|
Tram-track appearance of optic nerve
|
Kingking of optic nerve
|
Multiple cystic spaces in optic nerve
|
Adjacent bony erosion
|
Ophthalmology
| null |
c69fad1c-f13a-441f-b7f9-e28054049ac3
|
single
|
Treatment of Advanced Proliferative Diabetic Retinopathy with extensive vitreoretinal fibrosis and tractional retinal detachment involves all of the following except.
|
D i.e. Exophotocoagulation Treatment of advanced proliferative diabetic retinopathy with vitreoretinal fibrosis and tractional rectinal detachment involves previtrectomy pan retinal endophoto coagulation (not exophotocoagulation)Q, vitrectomy (pars plana or posterior route), reattachment of detached or torn retina and removal of epiretinal membraneQ. In most cases it is preferable to attempt panretinal photocoagulation, because the more laser a patient has previtrectomy the better he or she usually does after vitrectomy. An uncommon and unfounate complication of panretinal photocoagulation, paicularly in patients with vitreous hemorrhage & preexisting fibrosis, is acceleration or production of a tractional detachment by the laser treatment. Vitrectomy removes the scaffolding & possible stimuli (disintegrated blood products) for neovascular growth. Endophotocoagulation is used exclusively during a vitrectomy procedureQ. The endophotocoagulation probe may have a laser fiber +- an aspirating po to help remove subretinal fluid. To best treat retinal tears by endophotocoagulation, it is impoant that all subretinal fluids be removed from under the retina for the laser to take. If all traction is removed from the tear, once the fluid is removed from under the retina, it usually does not accumulate. Epiretinal membrane is a thin sheet of abnormal scar tissue that grows over the retina and causes distoion of vision due to macular puckering (s/t contracted epiretinal membrane), detachment (secondary to localized retinal traction) and opacification of membrane.
| 4
|
Reattachment of detached or torn retina
|
Removal of epiretinal membrane
|
Vitrectomy
|
Exophotocoagulation
|
Ophthalmology
| null |
625642a5-f65d-402f-b067-2abda34f6e6a
|
multi
|
Deficiency in globin synthesis
|
Ans. is 'a' i.e., ThalassemiaThalassemia Syndromes :?The thalassemia syndromes are a heterogeneous group of disorders caused by inherited mutations that decrease the synthesis of either the a-globin or (3-globin chains that compose adult hemoglobin, HbA (a2(32), leading to anemia, tissue hypoxia, and red cell hemolysis related to the imbalance in globin chain synthesis.
| 1
|
Thalassemia
|
Sickle cell disease
|
Hereditary spherocytosis
|
None of these
|
Pathology
| null |
2deecdc0-4f6b-40c9-b3dd-f3c1bbbc7423
|
multi
|
A alcoholics addicted presents in emergency with irrelevant talking & disoriented to time, place and person there is H/O not taking alcohol from last 3 days & no head injury. He also have visual hallucination. The diagnosis?
|
B i.e. Delirium tremens
| 2
|
Dementia praecox
|
Delirium tremens
|
Schizophrenia
|
Korsakoff psychosis
|
Psychiatry
| null |
ab84cb77-ab48-48dd-b078-2b5d50596fee
|
multi
|
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