falan42/meta_data · Datasets at Hugging Face

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A thirty year man presented with nausea, fever and jaundice of 5 days duration. The biochemical tests revealed a bilirubin of 6.7 mg/dl (conjugated 5.0 mg/dl) with SGOT/SGPT (AST/ALT) of 1230/ 900 IU/ml. The serological tests showed presence of HBsAg, IgM anti HBc and HBe Ag. The most likely diagnosis -	null	2	Chronic hepatitis B infection with high infectivity	Acute hepatitis B infection with high infectivity	Chronic hepatitis B infection with low infectivity	Acute hepatitis B infection with low infectivity	Microbiology	null	80743579-7b0b-4df2-a10a-04e4f2311aa7	single
In computed tomography (CT), the attenuation values are measured in Hounsfield units (HU). An attenuation value of '0' (zero) HU corresponds to:	Ans. Water	1	Water	Air	Very dense bone structures	Fat	Radiology	null	320ab1f4-4aa3-4da3-b174-c7c89e6d6230	single
SSRI is first line treatment for :	Ans:D.)All Selective serotonin reuptake inhibitors (SSRIs) are US-FDA approved drugs of first choice (line) for major Depression, Obscessive - compulsive disorder (OCD), Premenstrual dysphoric disorder, Post traumatic stress disorder (PTSD), Panic disorder, Eating disorder (bulimia nervosa), and Social phobia (social anxiety disorder)Q. Mn-SSRI for "DOPES" is 1st choice. SSRIs are also used in generalized anxiety disorder, treatment of premature ejaculation (paroxetiene is most useful), body dysmorphic disorders, compulsive buying, & kleptomania. Psychotherapy (group, suppoive) remains the treatment of choice for adjustment disordersQ. And medications are used only to treat specific symptoms for brief periods. Patients with severe anxiety bordering on panic can benefit from anxiolytics (diazepam); those in withdrawn or inhibited states may benefit from sho course of psychostimulant drugs; those with signs of decompensation or impending psychosis may be helped by antipsychotic drugs; whereas, SSRIs are useful in treating symptoms of traumatic grief. There is recent trend of increased antidepressant use, however, to augment psychotherupy in adjustment disorder rather than serving as the primary modality. All SSRIs (except fluvoxamine) are US-FDA approved for treatment of major depression. Fluvoxemine is only used for treatment of OCD in US (b/o commercial reasons not d/t therapeutic profile as it is used for major depression in other countries). In US, citalopram is used only in major depression; escitalopram in major depression & GAD; paroxetine is only not used in bulimia nervosa; and setraline is not used in bulimia & GAD. Fluoxetine is not used in GAD, PTSD and social anxiety but is approved for treatment of bipolar depression (with olanzapine).	4	OCD	Panic disorder	Social phobia	All	Psychiatry	null	1fb4d597-8906-45b2-89e9-f586da6fae63	multi
Mees lines are characteristic of which poisoning?	Mes line(Aldrich mees line) are very charactristic of Arsenic poisoning.They are white bands of opacity in the nails of fingers and toes.	2	Phosphorus	Arsenic	Lead	Thalliam	Forensic Medicine	null	392f4faa-d522-4586-b288-0a5d691f04b9	multi
Glutamic acid is formed from which of the following amino acid?	Glutamic acid is formed by the transamination of alanine and vice versa. Alanine aminotransferase is the enzyme and pyridoxal phosphate is the coenzyme.Ref: DM Vasudevan - Textbook of Biochemistry, 7th edition, page no: 201, fig.15.8.	3	Threonine	Proline	Alanine	Lysine	Biochemistry	Metabolism of protein and amino acid	a67a0110-ea4a-49a7-b0f2-8deba91f86ab	single
Which disease comes under International Surveillance?	Diseases under WHO surveillance Polio Rabies Relapsing fever Influenza Salmonellosis Malaria Louse born typhus Ref : Park's Textbook of Preventive and Social Medicine; 24th edition	2	Typhoid fever	Salmonellosis	Chikungunya fever	Hepatitis B	Social & Preventive Medicine	Concept of health and disease	d182c30f-06a5-4d0a-9f0b-a1b5e0254767	single
Coenzyme used in Kreb's cycle ?	Niacin is used as coenzyme nicotinamide adenine dinucleotide (NAD') for transfer of hydrogen.	1	NAD	NADP	NADPH	NADH	Biochemistry	null	a85db1d4-b089-4fc1-af3b-a5c6ab715ebe	single
Apolipoprotein activating L-CAT (LQ) is	A-1 is the integral apoprotein of HDL.LCAT binds to discoidal HDL activated by A1 conves discoidal HDL to HDL 3Harpers Biochemistry; 30th edition	2	B - 48	A - I	A - II	B-100	Biochemistry	Metabolism of lipid	52cd5175-0cc3-4176-8f64-90ef08fefd33	single
B-type tympanogram is seen in -	Ans. is 'a' i.e., Serous otitis media Type of curseConditionA curve (Normal peak height and pressure)NormalEustachian tube obstructionAs curve (It is also a variant of normal tympanogram but may be shallow)OtosclerosisTumors of middle earFixed malleus syndromeTy mpanosclerosi sAd curve(Variant of normal with high peak)Ossicular discontinuityPost stapedectomyMonometric ear drumB curve(Flat or dome shaped curve)Indicating lack of complianceFluid in middle earSecretory otitis mediaTympanic membrane perforationGrommet in earC curve (negative peak pressure)Retracted tympanic membraneFaulty function of eustachian tube,' eustachian tube obstruction	1	Serous otitis media	Ossicular discontinuity	Otosclerosis	All of the above	ENT	Ear	ccd9d635-f050-4da3-9fa6-56249b61d43a	multi
In adults, circulatory collapse occurs after a minimum of what percentage burns of total body surface area: NIMHANS 08; TN 11	Ans. 15%	3	5%	10%	15%	20%	Forensic Medicine	null	42b701a2-2fba-46bf-ba6e-428f68796c70	single
What passes through diaphragm at T12 level ?	Ans. is 'c' i.e., Thoracic duct	3	Esophagus	IVC	Thoracic duct	Phrenic nerve	Anatomy	null	a9ddd372-4af2-4aff-b9c2-50d296a6d368	single
Beri-Beri is caused by -	- beri beri is due to the deficiency of thiamine. - it has 3 main forms. Dry form characterised by nerve involvement. Wet firm characterised by hea involvement and infantile beri beri. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no:618 <\p>	1	Thiamine	Folic acid	Riboflavin	Niacin	Social & Preventive Medicine	Nutrition and health	72f55aa7-5242-4823-80dd-078c86964a1e	single
A 58 year old male presents with hematuria. He s diagnosed of having bladder cancer which extends muscle deep. The best treatment is	Answer- B. Neoadjuvant chemotherapy followed by radical cystectomy	2	Intravesical Chemotherapy	Neoadjuvant chemotherapy followed by radical cystectomy	Radiotherapy	Tranurethral resection	Surgery	null	bdc6cc31-cae1-4f47-9e81-d15797979283	single
The condition in which patient present with normal leucocyte count or less than normal and shows WBC in the peripheral blood:	null	1	Aleukemic Leukemia	Subleukemic leukemia	Acute leukemia	Chronic leukemia	Medicine	null	b769362b-ea8c-4d85-87ff-a24724277a31	single
The most common cause of a pleural effusion is	The most common cause of pleural effusion is left ventricular failure. Pleural effusions occur in hea failure when there are increased hydrostatic forces increasing the pulmonary interstitial fluid and the lymphatic drainage is inadequate to remove the fluid.Right-sided effusions are more common than left-sided effusions in hea failure. Thoracentesis would show a transudative fluid.Pneumonia can be associated with a parapneumonic effusion or empyema. Parapneumonic effusions are the most common cause of exudative pleural effusions and are second only to hea failure as a cause of pleural effusions.Empyema refers to a grossly purulent pleural effusion. Malignancy is the second most common cause of the exudative pleural effusion. Breast and lung cancers and lymphoma cause 75% of all malignant pleural effusions.On thoracentesis, the effusion is exudative. Cirrhosis and pulmonary embolus are far less common causes of pleural effusions.	2	Cirrhosis	Left ventricular failure	Pulmonary embolism	Pneumonia	Microbiology	All India exam	106d53c8-ff8d-4e36-8ddd-b945d34f3de4	single
M/c cause of chronic laryngeal stenosis ?	Ans. is 'a' i.e., Trauma Laryngeal stenosis (LS) is a congenital or acquired narrowing of the larynx causing airway compromise. The acquired causes may be due to endotracheal intubation, trauma, burns, inflammation, neoplasms, autoimmune disorders and collagen vascular disease.	1	Trauma	TB	Wegeners	Tumor	ENT	null	7b48008c-80f5-4d6b-be71-0abe857dc31c	single
Child knows his/her sex at the age of:	A child knows her full name and gender by the age of 3 years.	2	1 year	3 years	5 years	7 years	Pediatrics	Social and Language Milestones	b4814935-96ed-49a2-9b76-0072069b8292	single
Early stage of trauma is characterized by	Injury Phase (Phase of catabolism):-- Begins at the time of injury and lasts for 2-5 days-- Phase of hypermetabolism-- Stress hormones (coisol, catecholamines and glucagon) and volume control hormones (renin-angiotensin, aldosterone and ADH) are increased. This leads to proteolysis, lipolysis, hyperglycemia and wound healing despite of negative nitrogen balance.* Turning Point:-- Transient period marked physiologically by turning off of the neuroendocrine response and clinically by the appearance of getting well. * Early Anabolic Phase:-- Marked by gain in muscular strength or positive nitrogen balance.* Late Anabolic Phase:-- Marked by gain in weight and body fat or positive caloric balance	1	Catabolism	Anabolism	Glycogenesis	Lipolysis	Surgery	Trauma	4ee59051-7c07-46df-ab93-49ca6d608e76	single
Example for Denticulate suture	Types of sutures:Plane: Internasal sutureSerrate: Coronal sutureDenticulate: Lambdoid sutureSquamous: Parieto-Temporal sutureReference: Chourasia; 6th Edition; 4th page	3	Internasal suture	Coronal suture	Lambdoid suture	Parietotemporal suture	Anatomy	General anatomy	4456e5b2-9887-434f-8f27-e0f5e9a330de	single
A 29-year-old female diagnosed with AIDS has been suffering from a progressive blurring of vision in her right eye. On funduscopic examination, a small white opaque lesion is noted on the retina of her right eye. Which of the following is the most appropriate therapy for this patient?	This patient is most likely suffering from cytomegalovirus (CMV) retinitis. The best drug treatment for this infection is ganciclovir. Acyclovir is not effective in CMV infections. It is used more for HSV type 1 and 2 infections. Amantadine is used either therapeutically or prophylactically for the influenza A virus. Flucytosine is an antifungal agent. Ref: Safrin S. (2012). Chapter 49. Antiviral Agents. In B.G. Katzung, S.B. Masters, A.J. Trevor (Eds), Basic & Clinical Pharmacology, 12e.	4	Acyclovir	Amantadine	Flucytosine	Ganciclovir	Microbiology	null	432865e6-cbb2-40ed-9a93-84760fe5da35	multi
Denominator of MMR if MMR is expressed as 167 is:-	Ans. is 'a' i.e. 1000 live births It's a ratio: Denominator is Per 100000 live births. It will be rate : if the denominator is reproductive women. But still some books write it as rate. But in Park it's clearly differentiated. The data we express MMR as 167 is a ratio.	1	Per 100000 live births	Per 1000 total birth	Per 10000 total birth	Total number of women of reproductive age group in the population	Social & Preventive Medicine	Obstetrics	458239ed-e5e5-4f12-bc31-848ac81d2fd3	single
Kamli Rath 75 yrs old woman present with post-myocardial infarction after 6 weeks with mild CHF. There was past H/O neck surgery for parathyroid adenoma 5 years ago, EKG shows slow atrial fibrillation. Serum Ca+2 13.0 mg/L and urinary Ca2+ is 300 mg/ 24 hr. On examination, there is small mass in the Para tracheal position behind the right clavicle. Appropriate management at this time is -	This patient operated previously for parathyroid adenoma, is having recurrent hyperparathyroidism. In the setting of recent myocardial infarction, CHF and atrial fibrillation, any operation carries a high risk. Furthermore, an operation on a previously operated neck is quite difficult. Alcohol ablation of the mass with ultrasound guidance or angiographic embolization is preferred in this setting.	4	Repeat neck surgery	Treatment with technetium - 99	Observation and repeat serum Ca+2 in two months	Ultrasound-guided alcohol injection of the mass	Surgery	null	bf199fef-d8ed-48de-b510-837e5dc8cadf	multi
Polyariticular rheumatoid ahritis is diagnosed when more than............. Joints are involved	The initial pattern of disturbution of joint involvement may be monoaicular,oligoaicular(less than 4 joints),or Polyariticular (,greater than 5 joints ) usually on a symmetric distribution Ref, :Robbins page no 1209 8th edition	4	One	Two	Four	Five	Anatomy	Musculoskeletal system	3858506b-a4de-4902-8dd4-7dbcb6229dbf	single
A 56-year-old woman with a history of breast cancer that was treated 5 years ago with lumpectomy and radiation but with no chemotherapy returns with bone pain, fatigue, and weakness. A complete blood count reveals severe anemia, as well as decreased white blood cells and platelets. Examination of a peripheral blood smear reveals small numbers of nucleated red cells, as well as an occasional "blast" cell and myelocyte. A likely cause of the hematologic abnormalities is	- Infiltration of tumor cells from cancers, those of breast & prostate - displaces bone marrow elements, thereby causing myelophthisic anemia. OTHER OPTIONS: - Chloramphenicol causes aplastic anemia in some individuals. - Diphyllobothrium latum infestation can result in megaloblastic anemia due to vitamin B12 deficiency.	4	chloramphenicol.	Diphyllobothrium latum infestation.	megaloblastic anemia.	myelophthisic anemia.	Pathology	Hematopoeisis: Basic concepts	54b334c8-07f4-47ea-a320-12eb9f201180	multi
Which is the first permanent tooth to erupt ?	First and the last tooth to erupt in permanent dentition is Molars.	2	Canine	Molar	Incisors	Premolar	Forensic Medicine	null	9dd4a0f1-3e68-48f5-8ea3-9c96505ef8c2	single
The limit of loudness (expressed as decibels) that workers can tolerate without substantial damage to their hearing, during their work hours, is:	A noise of 90 dB (A) SPL, 8 hours a day for 5 days per week is the maximum safe limit as recommended by Ministry of Labour, Govt. of India-Model rules under Factories act Noise induced hearing loss Hearing loss can result from damage to structures or nerve fibers in the inner ear that respond to sound. This type of hearing loss, termed "noise-induced hearing loss," is usually caused by exposure to excessively loud sounds and cannot be medically or surgically corrected. Noise-induced hearing loss can result from a one-time exposure to a very loud sound (at or above 120 decibels), blast, impulse, or by listening to loud sounds (at or above 85 decibels) over an extended period. The louder the sound, the shoer the time period before hearing damage occurs.	4	55	65	75	85	ENT	null	479cc91e-7fda-48cc-a5f0-8607756a620a	single
Among the following the least common cause of acute upper GI bleeding is?	Source of bleeding Propoion of patients, % Ulcers 31-67 Varices 6-39 Mallory Weiss tears 2-8 Gastroduodenal erosions 2-18 Erosive esophagitis 1-13 Neoplasm 2-8 Vascular ectasia 0-6 No source identified 5-15	4	Mallory Weiss tear	Ulcer	Varices	Vascular ectasia	Medicine	Bleeding from the GUT and diseases of esophagus	ea7ba72f-8a5b-4e72-9086-6543d51173f4	multi
HHV-6B causes -	HHV 6B is the cause of mild but common childhood illness exanthem subitum. In older age groups ,it has been associated with infectious mononucleosis syndrome,focal encephalitis and in the immunodeficient,with pneumonia and disseminated disease. REF:ANATHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 8TH EDITION PAGE NO:477	4	Carcinoma cervix	Carcinoma endometrium	Clear cell carcinoma	Focal encephalitis	Microbiology	Virology	0f277307-23ec-4f1b-aca5-eac0765a3fa5	single
Anatomical structure injured in excision of ranula -	null	3	Lingual vein	Lingual artery	Submandibular duct	Parotid duct	Surgery	null	79abf7b1-69e7-4fcc-a952-763a6661ba44	single
Which of the following findings is suggestive that ovulation has taken place?	Endometrial biopsy Early secretory Subnuclear vacuolation (Ist HPE evidence of progesterone secretion) Seen on D16 of cycle Nuclei of glands gone up Stromal edema Late secretory Toous/ coiled glands All secretions in lumen of gland Cork screw glands( on D20 of cycle) Max stromal edema seen around D22of cycle) HPE of Proliferative endometrium Pseudostratification Long tubular glands Spinnbarkeit effect: ovulation mucus has the propey of great elasticity and will withstand stretching up to 10 cm. This phenomenon is called spinnbarkeit or the thread test for oestrogen activity. During the secretory phase, the cervical mucus becomes tenacious and its viscosity increases under the influence of progesterone so that it loses the propey of spinnbarkeit and fractures when put under tension. This propey is called tack. THIS LOSS OF SPINNBARKEIT EFFECT IS USED TO DIAGNOSE OVULATION RETROSPECTIVELY. Ultrasound: shows sudden reduction of follicle size (on serial USGs) and free fluid in Pouch of douglas. Endometrial thickness varies as follows early proliferative: thin bright echogenic stripe late proliferative: trilaminar appearance secretory phase: thick and uniformly echogenic	3	Pseudostratification in endometrium	Presence of Spinnbarkeit Phenomenon in cervical mucous	Sudden reduction in size of follicle and free fluid in Pouch of Douglas on USG	Trilamilar endometrium on USG	Gynaecology & Obstetrics	Tests of Ovulation	c82ed37e-c89d-416e-8cbc-6c57c8fe1968	single
Sedative with GABA facilitating action but without anticonvulsant and muscle relaxant propeies and no effect on sleep ?	Ans. is 'b' i.e., Zolpidem Among the given options, three are sedative-hypnotic with GABA facilitatory action - Diazepam (a benzodiazepine) - But it also has anticonvulsant and muscle relaxant propey. it) Phenobarbitone - But it has anticonvulsant propey. Zolpidem Has no anticonvulsant and muscle relaxant propey and have no effect on sleep architecture. Zolpidem Zolpidem is a non-benzodiazepine hypnotic. Minimal suppressive effect on REM sleep architecture is not disturbed.	2	Diazepam	Zolpidem	Phenobarbitone	Buspirone	Pharmacology	null	b47511f8-1071-4c03-bb03-ad8f1ddbe67a	single
First branch of Facial nerve is:	Ans. C. Greater petrosal nerveFacial nerve is the 7th cranial nerve. It is a mixed (i.e., motor and sensory) nerve, but predominantly it is motor. It is named facial nerve because it supplies the muscles of facial expression.Branchesa. Greater petrosal nerve--arises from the geniculate ganglion. It is the first branch of facial nerveb. Nerve to stapedius--arises from the vertical part of the facial nerve opposite the pyramidal eminence, runs forward through a short canal within it to reach the stapedius muscle to supply it.c. Chorda tympani nerve--arises from the vertical part of the facial nerve about 6 mm above the stylomastoid foramen.d. Posterior auricular nerve--supplies the occipital belly of occipitofrontal is.e. Nerve to the posterior belly of digastric--supplies the concerned muscle.f. Nerve to stylohyoid--supplies the concerned muscle.g. Five terminal branches (temporal, zygomatic, buccal, marginal, mandibular, and cervical)--supply the muscles of facial expression.	3	Nerve to stapedius	Chorda tympani nerve	Greater petrosal nerve	Lesser petrosal nerve	Anatomy	Head & Neck	ed92f823-56fd-4381-b2a3-a061921084ac	single
The demographic goal of Net Reproduction Rate is equal to one (NPR=1) can be achieved only if the Couple Protection Rate exceeds	(C) 60%[?]Couple protection rate (CPR)oCouple protection rate (CPR) is an indicator of the prevalence of contraceptive practice in the community.oIt is defined as the per cent of eligible couples effectively protected against childbirth by one or the other approved methods of family planning, viz. sterilization, IUD, condom or oral pills.oSterilization accounts for over 60 per cent of effectively protected couples.oCouple protection rate is based on the observation that 50 to 60 per cent of births in a year are of birth order 3 or more.oThus attaining a 60 per cent CPR will be equivalent to cutting off almost all third or higher order births, leaving 2 or less surviving children per couple.oTherefore, the previous National Population Policy was to attain a CPR of 42 per cent by 1990 (end of Seventh Five Year Plan), and 60 per cent by the year 2000.oHowever about 60 per cent eligible couples are still unprotected against conception.oA state-wise break-up of the figures reported indicates that while some states notably Punjab, Gujarat, Maharashtra, Karnataka, Haryana and Tamil Nadu etc. are forging ahead to cover more than half of their fertility level population by contraception.oDifferent Family Planning methods used for Acceptors of Couple Protection Rate include:-Sterilization-Vasectomy-Tubectomy-IUD insertion-Condom users-Oral Contraceptive Pill UsersoNRR = 1 can be achieved only if the CPR >60%[?]Net Reproduction Rate (NRR)oNet Reproduction Rate (NRR) is defined as the number of daughters a newborn girl will bear during her lifetime assuming fixed age-specific fertility and mortality rates.oNRR is a demographic indicator. NRR of 1 is equivalent to attaining approximately the 2-child norm.oIt is 'the number of daughters a newborn girl will bear during her lifetime assuming fixed age-specific fertility and mortality rates'.oIt is a demographic indicator.oNRR of 1 is equivalent to attaining approximately the 2-child norm. If the NRR is less than 1, then the reproductive performance of the population is said to be below replacement level.oThe average number of Daughters a women would bear in her life if she experiences the age-specific fertility (fro daughters) prevailing at the study period, & if her daughters experienced the prevailing rates of mortality.oIf the age schedules of both fertility & mortality remain constant, the Net Reproduction Rate would be a measure of generational Replacement.oE.g.-NRR =1.1 - Next generation will be 10% larger than the present generation (growth)-NRR =1.0 - Next generation will be the same as the present generation (replacement level)-NPR =0.9 - next generation will be 10% smaller than the present generation (depopulation)[?]Net Reproduction Rate, Pros & Cons.oPros-Taking into account both fertility & survival in getting one indicator of reproductivity of a PopulationoCons-Requires detailed data on fertility & survival of women, up to age 50 years-Does not take into account that women born in different years may have different fertility & survival.	3	40%	50%	60%	70%	Social & Preventive Medicine	Demography and Family Planning	3b7b57b8-3c7d-4020-ac31-7020d9bc40e3	single
Paraneoplastic syndrome associated with RCC are all of the following, except:	RCC is associated with wide range of paraneoplastic syndromes, ? Erythrocytosis (polycythemia ? Hypercalcemia ? Hypeension ? Non metastatic hepatic dysfunction Cushing syndrome is rarely seen in RCC. Ref: Emil A. Tanagho, Jack W. McAninch, (2004), Chapter 21, "Renal paranchymal neoplasm", In the book, "Smith's General Urology", LANGE SERIES, USA, Page 351; Harrison's Principles of Internal Medicine, 17th Edition, Page 592; Robbin's Basic Pathology , 7th Edition, Page 1018; Smith's Urology, 16th Edition, Page 351	4	Polycythemia	Hypercalcemia	Hypeension	Cushing syndrome	Pathology	null	66953b23-4e19-43a9-9e9f-a04197e66001	multi
Red flag sign in child development if not attained by __________	Red Flags in Developmental Screening and SurveillanceThese indicators suggest that development is seriously disordered and that the child should be promptly referred to a developmental or community pediatrician. Note: Most children do not have "red flags" and thus require quality screening to detect any problems. POSITIVE INDICATORS (THE PRESENCE OF ANY OF THE FOLLOWING) Loss of developmental skills at any ageParental or professional concerns about vision, fixing, or following an object or a confirmed visual impairment at any age (simultaneous referral to pediatric ophthalmology)Hearing loss at any age (simultaneous referral for expe audiologic or ear, nose, and throat assessment)Persistently low muscle tone or floppinessNo speech by 18 mo, especially if the child does not try to communicate by other means such as gestures (simultaneous referral for urgent hearing test)Asymmetry of movements or other features suggestive of cerebral palsy, such as increased muscle tonePersistent toe walkingComplex disabilitiesHead circumference above the 99.6th centile or below 0.4th centile. Also, if circumference has crossed 2 centiles (up or down) on the appropriate cha or is dispropoionate to parental head circumferenceAn assessing clinician who is unceain about any aspect of assessment but thinks that development may be disordered NEGATIVE INDICATORS(ACTIVITIES THAT THE CHILD CANNOT DO) Sit unsuppoed by 12 months Walk by 18 mo (boys) or 2 yr (girls) (check creatine kinase urgently)Walk other than on tiptoes Run by 2.5 yr .Hold object placed in hand by 5 months (corrected for gestation)Reach for objects by 6 mo (corrected for gestation)Point at objects to share interest with others by 2 yr Ref.nelson 20th edition pg100	4	No single word at 18 month	Not able sit with unsuppoed by 12 months	Not walking alone by 18 month in boys	All of the above	Pediatrics	Growth and development	8288456d-7f27-427a-9284-d9751fa73ca8	multi
Michaelis Menten Hypothesis states that	Michaelis-Menten Theory (Enzyme-Substrate Complex Theory) Enzyme combines with a substrate to form a transient Enzyme-Substrate Complex which immediately break into Enzyme and products.	4	Rate of enzymatic reaction is independent of substrate concentration	Rate of non enzymatic reaction is proportional to substrate concentration	Km is the enzyme substrate complex association constant	Enzyme substrate complex formation is essential in enzymatic reaction.	Biochemistry	null	79a81298-e728-4081-b2b5-be965d210d7d	single
Function of Ig A is -	Question repeated	1	Acts as a mucosal barrier for infection	Circulating antibody	Kills virus infected cells	Activates macrophages	Microbiology	Immunology	d0c98786-10d6-447a-967d-5c49376dd1d7	single
Glycolytic enzymes(s) inhibited by Fluoride:	Inhibitors of Glycolysis: Inhibitors of Glycolysis Enzyme Inhibited Iodoacetate Glyceraldehyde - 3 - P Dehydrogenase Arsenate Glyceraldehye - 3 - P Dehydrogenase Sodium fluoride Enolase Oxamate Lactate Dehydrogenase	3	Hexokinase	Aldolase	Enolase	Pyruvate kinase	Biochemistry	Glycolysis	77db5401-a696-42c9-bbf6-136649ebe489	single
A patient is to undergo angiography for unstable angina. His routine evaluation revealed his serum creatinine to be elevated. All of the following can be used to prevent contrast nephropathy, EXCEPT:	Strategies for the Prevention of Contrast-Induced Nephropathy: Strategies that do not work: Mannitol Furosemide Dopamine Atrial natriuretic factor Fenoldopam Hemodialysis Strategies that may work: Calcium channel blockers Theophylline N-Acetylcysteine Hemofiltration Sodium bicarbonate Ascorbic acid Iso-osmolar contrast media Current recommended strategies: Employ non iodinated contrast studies Avoid nonsteroidal anti-inflammatory agents Space between contrast administrations Minimize contrast volume Hydration Low osmolar contrast media Ref: Brunelli S., Rudnick M.R. (2009). Chapter 12. Contrast-Induced Nephropathy. In E.V. Lerma, J.S. Berns, A.R. Nissenson (Eds), CURRENT Diagnosis & Treatment: Nephrology & Hypeension.	2	Haemofiltration	Fenoldopam	N-acetylcysteine	1/2 N saline	Radiology	null	a2a4182e-7356-4270-88e8-40626e40a414	multi
A lady wants LASIK surgery for her daughter. She asks for your opinion. All the following things are suitable for performing LASIK surgery except –	Patient selection criteria for LASIK Patients above 20 years of age Stable refraction for at least 12 months Motivated patients Myopia up to -12D The absence of corneal pathology Corneal thickness > 500 m Contraindications of LASIK Monocular patient Infections eg: conjunctivitis Glaucoma Autoimmune disease Thin cornea (< 450 microns) Keratoconus Poor endothelial cell count in the cornea (< 1500) Dry eye Diabetic retinopathy	2	Myopia of 4 Diopters	Age of 15 years	Stable refraction for 1 year	Corneal thickness of 600 microns	Ophthalmology	null	43044984-b711-4102-87e9-2a6b578e2699	multi
Cardiac index is the ratio of?	Cardiac index is the cardiac output corrected for the individual's size. For example, the cardiac output of a 50-kg woman will be significantly lower than that of a 90-kg man. It has been found, however, that cardiac output correlates better with body surface area than with body weight. Therefore, it is common to express the cardiac output per square meter of surface area. Under resting conditions, the cardiac index is normally approximately 3 L/min per m2. Ref: Mohrman D.E., Heller L.J. (2010). Chapter 4. Measurements of Cardiac Function. In D.E. Mohrman, L.J. Heller (Eds), Cardiovascular Physiology, 7e	2	Cardiac output and body weight	Cardiac output and surface area	Cardiac output and work of hea	Surface volume and surface area	Physiology	null	ffc2ba0a-f6c2-43fa-8000-cdc6ba408267	single
Carcinoma cervix involving upper 2/3rd of vagina. The stage would be: September 2009	Ans. A: Stage II a	1	Stage II a	Stage II b	Stage III a	Stage III b	Gynaecology & Obstetrics	null	c93bf9ab-61b8-41a4-91c8-1b6e6a5303d5	single
An 18-year-old pregnant woman receives no prenatal care, eats a diet containing mostly carbohydrates and fats, and does not take prenatal vitamins with iron. She feels increasingly tired and weak during the third trimester. The infant is born at 35 weeks' gestation and is listless during the first week of life. Laboratory studies show markedly decreased serum ferritin levels in the infant and the mother. Which of the following findings from a nutritional deficiency is most likely to be present in both the infant and the mother?	Iron deficiency, which gives rise to microcytic anemia, is common in women of reproductive age because of menstrual blood loss and in children with a poor diet. During pregnancy, women have greatly increased iron needs. Low serum ferritin is indicative of iron deficiency. Dermatitis can be seen in pellagra (niacin deficiency). A goiter results from iodine deficiency, but this is a rare occurrence today because of newborn testing and widely available foods with iodine. Peripheral neuropathy is more characteristic of beriberi (thiamine deficiency) and deficiencies in riboflavin (vitamin B2 ) and pyridoxine (vitamin B6 ). Bowing of the long bones and epiphyseal widening can be seen in rickets (vitamin D deficiency). Soft tissue hemorrhages can be seen in scurvy (vitamin C deficiency).	3	Dermatitis	Diffuse goiter	Microcytic anemia	Peripheral neuropathy	Pathology	Environment & Nutritional Pathology	a5b933d5-3c15-4e19-8d5f-5c814440c9f0	multi
Not a cause of Roth spots?	Roth spots Round retinal hemorrhages with white centers Seen in : Infective endocarditis SLE Serum sickness Polyaeritis nodosa Severe anemia Leukemia Prolonged anesthesia	4	Leukemia	Severe anemia	SLE	Hypersensitivity pneumonitis	Medicine	Rheumatic Hea disease & infective endocarditis	4f4ac24a-6f3a-4adc-a347-2fde996cae72	single
Which of the following is not true about the mechanism of action of benzodiazepines?	Ans. is 'd' i.e., It has GABA mimetic action Mechanism of action of benzodiazepines (BZDs)* Muscle relaxation is produced by action on medulla.* Ataxia is due to action on cerebellum.* BZDs acts on GABAA receptors.* GABAa receptor has 5 subunits a / b, b, a / g.* GABA binding site is on b. subunit, while BZDs binding site is on a / g subunit.* BZDs receptor increase the conductance of Cl channel.* BZDs do not themselves increase Cl conductance, i.e. they have only GABA facilitatory but no GABA mimetic action. (Barbiturates have both GABA facilitatory and GABA mimetic actions).Effect on CNS* In contrast to barbiturates, BZDs are not general depressant, but exert relatively selective anxiolytic, hypnotic, muscle relaxant and anticonvulsant effects.* The antianxiety action of BZDs is not dependent on their sedative property - with chronic administration relief of anxiety is maintained, but drowsiness wanes off due to development of tolerance.* Stage 2 sleep is increased, while REM, Stage 3 & 4 sleep are decreased.* Nitrazepam is the only benzodiazepine, which increases REM sleep.* Clonazepan and diazepam have more marked muscle relaxant property.* Clonazepam, diazepam, nitrazepam and flurazepam have more prominent anticonvulsant activity than other BZDs.* Diazepam (but not other BZDs) has analgesic action.* Diazepam produces short lasting coronary dilatation on i.v. injection.* Diazepam decreases nocturnal gastric secretion and prevents stress ulcers.	4	Acts on mid brain, ascending reticular formation and limbic system	It exerts effects through the GABA A receptors	It increases conductance of Cl- channels	It has GABA mimetic action	Pharmacology	C.N.S	dc3d07b8-2ade-4e3a-a868-5367d7bcf067	multi
Following are the findings in sickle cell Anemia, except -	Splenomegaly is found in the early stage of sickle cell anemia. By continued infarction and hypoxia leads to progressive scarring and shrinkage of the spleen, so that by adolescent or the adulthood, only a small nubbin of fibrous tissue may be left; this is called autosplenectomy. Bone changes in sickle cell anemia are : - Crew haircut appearance of skull bone. Fish mouth vertebrae. Cardiomegaly particularly increases in left ventricular dimension and mass results from the increase in cardiac output caused by chronic anemia and has its onset in early childhood. The WBC count is consistently elevated owing to an increase in the number of mature granulocytes. This increase is explained to a large extent by a shift of granulocytes from the marginated to the circulating compartments.	3	Fish vertebra	Enlarged heart	Splenomegaly usually seen	Leukocytosis	Pathology	null	d28eda9d-c7c7-4a84-80b1-6a57e3d3661b	multi
Which of the following conditions does not have a National Screening/Control Programme?	Ans. is 'b' i.e. Dental caries o No National programme for oral health is under implementation. About other options o There is Pilot Programme for prevention & control of DM. CVD and deafness. o The National Programme for control of blindness includes screening for refractive errors. o Cervical cancer screening programme is working in India.	2	Diabetes Mellitus	Dental caries	Refractive errors	Carcinoma cervix	Social & Preventive Medicine	null	fce245e5-d5db-4965-8c3c-cb0f4141ffe3	single
Which of the following contains sulphur?	Ans: b (Insulin) Ref: Harper, 25th ed, p. 347,115Insulin is a polypeptide consisting of two chains linked by two inter chain di sulphide bridges.Amino acids required for special products:> Creatine - glycine + arginine+ methionine> Glutathione - glycine + cysteine + glutamate> Purine - glycine + aspartate + glutamine + serine> Pyramidine - aspartate + glutamine (glycine not present)> Keratin - formed by histidine, arginine, lysine. Also note - keratin is rich in cysteine.> Histone - rich in arginine and histidine.> Camosine - P alanine, histidine.> Choline - glycine, serine, methionine (Vit B6 - lipotrophic factor)	2	Creatine	Insulin	Inulin	Creatinine	Biochemistry	Proteins and Amino Acids	faf871b0-801d-4561-84c8-0a20b3aeac7e	single
Which one of the following is the management of pancreatic abscess -	null	3	Needle aspiration	Gastro-cytostomy	External drainage	Jejuno-cystostomy	Surgery	null	44385d4e-be54-4e51-9011-f6fc395c7784	single
Sentinel lymph node biopsy is done in all except	null	4	ca breast	ca penis	malignant melanoma	ca colon	Surgery	null	0c4b30b7-5c22-429c-a5ab-05074aeb5dac	multi
During pregnancy the maternal blood volume increases by nearly :	Ans. is c i.e. 50% Friends, we have dealt with hemodynamic changes during pregnancy in detail earlier but here lets quickly revise a few changes asked quite often. Most impoant physiological changes during pregnancy (for 11th hour revision) Net weight gain in pregnancy is 11 kg (24 lb).deg Blood volume T's by 40-50%.deg Blood volume reaches maximum at 30-32 weeks.deg Plasma volume T's by 50%.deg RBC volume T's by 20-30%.deg TLC is increased, specifically Neutrophilic leucocytosis occurs.deg Total plasma proteins increase.deg Plasma protein concentration decreases.deg Albumin level decreases, globulin levels (specially IgA) slightly increase.deg Fibrinogen levels increase by 50%.deg ESR is increased.deg All clotting factors except XI and XIII increase.deg Platelet count decreases (Gestational Thrombocytopenia).deg Cardiac output (stroke volume) increases to 40-50% by 30-34 weeks.deg Peripheral vascular resistance decrease.deg Diastolic BP decreases.deg Uterine blood flow increases near term.deg Plasma insulin levels increase.deg S. Prolactin levels increase.deg Vital capacity and respiratory rate remain constant.deg Renal plasma flow and GFR increase.deg All LFT'S remain unchanged, with exception of alkaline phosphatase which increases (specially heat stable alkaline phosphatase produced by placenta).deg	3	5 - 10%	15 -- 20%	50%	70%	Gynaecology & Obstetrics	null	2c8b4eb9-743d-4d34-afa8-bac38347065d	single
Side effect of MgSo4 used in the treatment of eclampsia is	Complications : Pulmonary edema Anuria Hea failure Hyperpyrexia Psychosis Ref: Dutta Obs 9e pg 222.	4	Hypotension	Polyuria	Coma	Pulmonary edema	Gynaecology & Obstetrics	Medical, surgical and gynaecological illness complicating pregnancy	6ea437a5-7dd2-4909-85f8-c94745c3c296	single
True about Ischiorectal fossa Boundaries	Ans. (a) Anterior border is formed by inferior fascia of urogenital diaphragm.Ref: IB singh Anatomy 2nd ed. / fig. 25.12ANTERIOR* Fascia of Colles covering the Transversus perinea superficialis* Inferior fascia of the urogenital diaphragmPOSTERIOR* Gluteus maximus* Sacrotuberous ligamentLATERAL MEDIAL* Levator ani* Sphincter ani externus muscle* Anal fascia* Tuberosity of the ischium* Obturator internus muscle* Obturator fasciaSUPERIOR* Levator ani INFERIOR* Skin	1	Anterior border is formed by inferior fascia of urogenital diaphragm.	Superior border is formed by Gluteus Maximus	Lateral border is formed by Levator Ani	Posterior border is formed by obturator internus muscle.	Surgery	Rectum	8cf31e07-9e63-4edd-ac3c-e4179774fea1	multi
Hypehyroidism will present as all, except :	Hypehyroid symptoms include heat intolerance, increased sweating and thirst, and weight loss despite adequate caloric intake. Symptoms of increased adrenergic stimulation include palpitations, nervousness, fatigue, emotional lability, hyperkinesis, and tremors. The most common GI symptoms include increased frequency of bowel movements and diarrhea. Female patients often develop amenorrhea, decreased feility, and an increased incidence of miscarriages. Children experience rapid growth with early bone maturation, whereas older patients may present with cardiovascular complications such as atrial fibrillation and congestive hea failure. Common cardiovascular manifestations of hypehyroidism include palpitations, systolic hypeension, and fatigue. Sinus tachycardia is present in 40% of hypehyroid patients, and atrial fibrillation in 15%. On physical examination, weight loss and facial flushing may be evident. The skin is warm and moist and African American patients often note darkening of their skin. Tachycardia or atrial fibrillation is present with cutaneous vasodilation leading to a widening of the pulse pressure and a rapid falloff in the transmitted pulse wave (collapsing pulse). A fine tremor, muscle wasting, and proximal muscle group weakness with hyperactive tendon reflexes often are present. Ref : Lal G. (2010). Chapter 38. Thyroid, Parathyroid, and Adrenal. In T.R. Billiar, D.L. Dunn (Eds), Schwaz's Principles of Surgery, 9e.	1	Hypotension	Atrial fibrillation	Tremor	Panic attacks	Surgery	null	c32d489e-460b-4e30-a793-52cc30363063	multi
A patient presents in the causality with history of abdominal pain. On examination the person is in shock, with severe abdominal tenderness and guarding. There was also one episode of bloody diarrhoea. He gives a history of recurrent abdominal pain soon after taking food which persists for about 3 hours after food. He also has a history of MI about 5 years back. What is your diagnosis?	The person has had recurrent episodes of abdominal angina as shown by the pain after food intake. He also has a history of MI which also suggests that he has atherosclerosis. The bloody diarrhoea is again suggestive of mesenteric vascular occlusion in this patient. Ref: Manipal Millennium Edition, Page 429; S.Das, Edition 5, Page 354	1	Acute thrombotic mesenteric vascular occlusion	Acute pancreatitis	Acute duodenal ulcer perforation	Acute appendicitis	Surgery	null	512ce60e-6c09-417d-91b3-e1d2f0d539b6	single
Fick principle of calculation of cardiac output doesn't depend on-	Based on Fick principle	3	Whole body oxygen consumption	Oxygen content of arterial blood	Stroke volume	Oxygen content of venous blood	Physiology	null	31eb4e7f-b538-4d8d-9bfb-82533c0f311a	single
Example of type 4 hypersensitivity is:	Ans. b. Granulomatous reaction	2	Serum sickness	Granulomatous reaction	Schwazman reaction	Ahus reaction	Microbiology	null	55848125-05f7-43c4-8dba-74307c7c7964	single
A boy presented with prolonged jaundice, constipation and umbilical hernia. what is the probable diagnosis?	Prolonged jaundice, constipation, Umbilical hernia are all seen in congenital hypothyroidism.	3	Growth hormone deficiency	Kernicterus	Congenital hypothyroidism	Congenital adrenal hyperplasia	Pediatrics	null	ea048cfb-76c4-4754-a0c7-9aedc52664c2	single
Osteosarcoma can arise from:	Ans. c (Metaphysis). (Ref. to Radiology Review Manual, 5th/138; Essential orthopedics by Maheshwari 2nd/218)OSTEOSARCOMA* It is 2nd most common 1deg malignant tumor of bone (after multiple myeloma). Peak incidence in menl0-20 years of age. * It has bimodal age distribution: 10-25 years and > 60 years with M:F = 3:2 to 2:1. * Commonly found in the metaphysis of longbones, often around distal femur, proximal tibial region (knee). * Predisposing factors include Paget's disease of bone, bone infarcts, radiation, and familial retinoblastoma. Codman's triangle or sunburst pattern (from elevation of periosteum) on x-ray. * MRI is preferred modality. Clearly defines marrow extent (best on T1W1), vascular involvement and soft tissue component (best on T2W1). Radionuclide bone scan (NUC) shows intensity increased activity on blood flow, blood pool, delayed images (hypervascularity, new bone formation). Doughnut sign (peripherally increased uptake with central photopenia on bone scan) is a classical feature. Poor prognosis. * Standard management: Preoperative chemotherapy followed by limb-sparing surgery followed by postoperative chemotherapy (Sandwich Therapy). * Rx:Osteosarcoma is radio- resistant; radiation therapy has no role in the routine management.Ewing's sarcomaAnaplastic small blue cell malignant tumor. Most common in boys < 15. Extremely aggressive with early mets, but responsive to chemotherapy. Characteristic "onion-skin" appearance in bone ("going out for Ewings and onion rings"). Commonly appears in diaphysis of long bones, pelvis, scapula, and ribs. 11;22 translocation.ChondrosarcomaMalignant cartilaginous tumor. Most common in men aged 30-60. Usually located in pelvis, spine, scapula, humerus, tibia, or femur. May be of 1deg origin or from osteochondroma. Expansile glistening mass within the medullary cavity	3	Diaphysis	Epiphysis	Metaphysis	All of the above	Orthopaedics	Bone Tumour	b5aaeee7-5be6-46c8-b25f-62124b9313d9	multi
Episodic hypeension is a feature of	Classic triad: Headache + Diaphoresis+ Palpitation	3	Carcinoid tumor	Insulinoma	Pheochromocytoma	Zollinger-Ellison syndrome	Physiology	All India exam	5a2a4115-f381-4d10-a3ab-9ca6da93e27f	single
Acantholysis is:	Ans. (b) Separation of keratinocytesRef: Harrison 19th ed. / 370* Keratinocytes are connected to one another by intracellular desmosomal bridges.* If there is loss of these desmosomal bridges, it will lead to separation of keratinocytes and the condition is known as acantholysis.* If separation continues, there will be intracellular edema, and the condition is known as Ballooning.Also Know* Degeneration of stratum basale is seen in: Lichen planus* Acanthosis: thickening of stratum spinosum* Hypergranulosis: Thickening of stratum granulosum* Hyperkeratosis: Thickening of stratum corneum* Parakeratosis: persistence of nucleus in stratum corneum layer	2	Lysis of basale cell layer	Separation of keratinocytes	Thickening of granular layer	Thickening of corneum layer	Skin	General	81fbc82a-d070-4b72-a17a-a87b947c848a	single
High risk of malignancy is seen in?	Answer is option3, complex hyperplasia with atypia Endometrial hyperplasia with atypia is the least common type of hyperplasia, but is the type most likely to progress to type 1 endometrial carcinoma (1-3) which accounts for 97% of uterine cancers, whereas simple hyperplasia rarely progresses to carcinoma. >	3	Simple hyperplasia with atypia	Simple hyperplasia without atypia	Complex hyperplasia with atypia	Complex hyperplasia without atypia	Pathology	General pathology	565bc834-8a9d-497d-b30b-a72798a5265d	single
The Millennium Development Goals (MUG) is to be achieved by the year -	Ans. is 'b' i.e., 2015	2	2010	2015	2020	2030	Social & Preventive Medicine	null	1ae6bb17-5bc8-4c67-bac0-0a965653968e	single
Systemic causes of epistaxis are all except:	Hemophilia is secondary cause of epistaxis in children. Ref.Scott Brown 7/e,vol 2,p 1605	4	Hypeension	Anticoagulant treatment	Hereditary telangietasia	Hemophilia	ENT	Nose and paranasal sinuses	6fdacf93-d4c2-4666-8e45-a524e8ac38db	multi
Which of the following situations will lead to increased viscosity of blood:	C i.e. Multiple myeloma	3	Fasting state	Hypoglycemia	Multiple myeloma	Amyloidogenesis	Medicine	null	709dc647-846a-453f-9d73-31d9522220d6	single
A person is being treated for Human Immunodeficiency Virus-1. He developed hyperiglyceridemia and hypercholesterolemia. Most likely drug implicated for these adverse effects is	Ritonavir is a protease inhibitor and can cause hyperiglyceridemia and hypercholesterolemia. All protease inhibitors are metabolized by liver and all can cause metabolic abnormalities including hypercholesterolemia, diabetes mellitus, hyperlipidemia, insulin resistance and altered fat istribution (lipodystrophy). Atazanavir is devoid of this adverse effect. Tesamorelin is a synthetic analogue of growth hormone releasing factor indicated to reduce excess abdominal fat in HIV-infected patients with lipodystrophy.	1	Ritonavir	Raltegravir	Tenofovir	Eirenz	Pharmacology	Anti-HIV Drugs	ddf0d9e7-c8d4-4500-89ce-b1ef7e0ff3e7	single
Ropinirole is most useful for the treatment of:	Ans. (A) Parkinson's disease(Ref: KDT 8/e p457)Ropinirole is a non-ergot dopamine agonist useful for Parkinsonism. It is also used these days for restless leg syndrome.	1	Parkinson's disease	Wilson's disease	Hoffmann syndrome	Carpal tunnel syndrome	Pharmacology	C.N.S	c4caf996-8488-4544-8b77-cb583fb76e2e	single
Which of the following helminths primarily produces gastrointestinal symptoms, without lung involvement, during the course of its infection?	Trichuris humans acquire the infection by eating foods contaminated with infective eggs. Once eggs are swallowed, the larvae hatch in the small intestine, where they mature and migrate to the colon. Trichuris infections with a low worm burden are usually asymptomatic, but infections of moderate to heavy worm loads present with lower abdominal pain, distention, and diarrhea. Severe infection may lead to profuse bloody diarrhea, cramps, tenesmus, urgency, and rectal prolapse. Occasionally worms migrate to the appendix, causing appendicitis. Jawetz microbiology 27e 724.	3	Dirofilaria immitis	Strongyloides stercoralis	Trichuris trichiura	Ascaris lumbricoides	Microbiology	All India exam	e8ab8c32-a9b6-4c3d-8ef1-012831dea02d	single
In solitary thyroid nodule true is/are :	Ans. is 'd' i.e. Common in female A solitary thyroid nodule is a palpably discrete swelling within an otherwise apparently normal thyroid gland. Ceain imp. points about solitary thyroid nodules : STN are more common in women than in men The incidence of STN increases with age Solitary nodules, in general, are more likely to be neoplastic than are multiple nodules. Nodules in younger patients are more likely to be neoplastic than are those in older patients. Nodules in males are more likely to be neoplastic than are those in females. A history of radiation treatment to the head & neck region is associated with an increased incidence of thyroid malignancy. Functional nodules that take up radioactive iodine in imaging studies (hot nodules) are significantly more likely to be benign than malignant.	4	THR-Ab	Lined by columnar epithelium	Diffuse hyperplasia of thyroid	Common in female	Surgery	null	5b59a952-dfae-494b-a52a-2a60aa937de3	multi
Indications of celiotomy in blunt trauma:	Ans is C (Peritoneal air on imaging) Most spleen and liver injuries are managed non-operatively, if the patient is hemodynamically stable.	3	Grade I spleen damage	Grade II liver damage	Peritoneal air on imaging	All	Surgery	null	1081fe83-1f89-42f1-879c-592702c57f9c	multi
Two most impoant tests to be done in a comatose patient with blood glucose of 750 mg/dl will be -	Comatose patients with blood glucose level of 750 mg/dl suggests the possibility of hyperglycemic hyperosmolar state . Lab abnormality in this is marked hyperglycemia, hyperosmolarity, prerenal azotemia. Comatose patients with hyperglycemia is also seen in diabetic ketoacidosis. Thus blood ph ( to detect acidosis) and serum creatinine for azotemia are most impoant investigations.	1	Sr. creatinine	Sr. sodium	CSF examination	Blood pH	Medicine	Endocrinology	cb5d35ed-508b-48e1-934d-580e070e7330	single
A different sequence of amino acids having a similar structure of proteins is an example of	Divergence and convergence are two evolutionary processes by which organisms become adapted to their environments. Convergence has been defined as the acquisition of morphologically similar traits between distinctly unrelated organisms. Convergence occurs at every level of biological organization. Functional Convergence This refers to molecules that serve the same function but have no sequence or structural similarity and carry out their function by entirely different mechanisms. Mechanistic convergence Mechanistic convergence occurs when the sequence and structure of molecules are very different but the mechanisms by which they act are similar. Structural Convergence This refers to molecules with very different amino acid sequences that can assume similar structural motifs, which may carry out similar functions. Sequence Convergence In sequence convergence, one or more critical amino acids or an amino acid sequence of two proteins come to resemble each other due to natural selection. (In protein evolution, sequence divergence, rather than sequence convergence is the rule.)	2	Divergence	Convergence	Opportunistic	Incidental	Biochemistry	null	79fa4140-1f33-4167-a30b-7d6b1496c217	single
Shelf life of Platelets is	Shelf life of Platelets is < 5 days Cryoprecipitate is 2 years.	1	< 5 days	< 3 weeks	< 5 weeks	< 2 years	Medicine	null	f36fe1fd-bdae-4329-9ff2-8b96d7c92949	single
Phenomenon called anticipation is seen in?	Instablity of triplet repeats can lead to gradual expansion from generation to generation,a phenomenon called anticipation,Genetic anticipation is characterized by the reduction in the age of disease onset by successive genarations.	3	Mitochondrial inheritance	x - linked dominant disorders	Trinucleotide repeat expansion	Genomic imprinting	Pathology	null	2e67b5ca-2efe-432a-adec-6a21881c3bf3	multi
Lung is characteristically involved in -	Ans. is 'a' i.e., Churg-Strauss syndromeChurg- strauss syndrome o Also known as allergic granulomatosis and angitis.o It is a medium and small size vasculitis, invoves mainly the blood vessels of lungs, GIT, peripheral nerves, hea, skin, kidney.o As it is allergic, vasculitis it is associated with eosinophilia and asthma.o It is granulomatous necrotizing vasculitis.o It is associated with p-ANCA.StagesThis disease has three distinct stages ?o Stage l --> Involves the sinuses and the onset of allergies ---> nasal polyp, allergic rhinitis.o Stage 2 --> Acute asthma occurs.o Stage 3 --> The third and final stage involves the various organ systems -1. Peripheral nervous system --> Mononeuritis multiplex with severe neural pain.2. Skin -3 Palpable purpura, papules, ulcer, vesiculobillous lesion.3. Hea --> CHF4. Kidney Pauciimmune glomerulonephritis.5. Joints --> Migratory ahritis.6. Ear Conductive deafness.7. There is eosinophilia and raised IgE as occur with allergic conditions.8. Lung --> Nonfixed migratory pulmonary infiltrates.	1	Churg-Strauss syndrome	HSP	PAN	ITP	Pathology	null	41fffdb3-b7e1-4799-8baf-930e25362745	multi
Which of the following drugs is used for narcoanalysis -	Scopolamine is used as truth serum. Drugs commonly used in narcoanalysis are 1. Thiopentone sodium (Sodium pentothal) 2. Scopolamine hydrobromide 3. Sodium secnol 4. Benzodiazepines REF;THE SYNOPSIS OF FORENSIC MEDICINE:KS NARAYANA REDDY;28th EDITION	3	Atropine	Phenobarbitone	Scopolamine	Pethidine	Forensic Medicine	Poisoning	f73c5da1-ab29-4ca8-b670-268e8a9f2645	single
Commonest organism giving rise to urinary tract infection -	• Most UTIs are caused by a single bacterial species. • At least 80% of the uncomplicated cystitis and pyelonephritis are due to E. coli, with most of pathogenic strains belonging to the O serogroups. • Other less common uropathogens include Klebsiella, Proteus, and Enterobacter spp. and enterococci. • In hospital acquired UTIs, a wider variety of causative organisms is found, including Pseudomonas and Staphylococcus spp. • UTIs caused by S. aureus often result from hematogenous dissemination. • Group B beta-hemolytic streptococci can cause UTIs in pregnant women. • In children, Klebsiella and Enterobacter spp. are common causes of UTI. • Anaerobic bacteria, lactobacilli, corynebacteria, streptococci (not including enterococci) and S. epidermidis are found in normal periurethral flora. They do not commonly cause UTIs in healthy individuals and are considered common urinary contaminants.	1	E. coli	Proteus	Staphylococcus	Streptococcus	Surgery	null	ebd2773c-d81f-488e-b1d6-b8d4e5ba2ad3	single
Carbamide solution used for bleaching degrades into	null	3	0.3% sodium perborate	30% hydrogen peroxide	3% hydrogen peroxide	30% sodium perborate	Dental	null	38a3e1b8-705c-47cb-961b-8908e9d88503	single
Mechanism of action of sildenafil is	Ans. is 'c' i.e., Inhibits PDE 5 * Sildenafil (Viagra) acts to increase cGMP by inhibiting its breakdown by phosphodiesterase isoform 5 (PDE-5).	3	Inhibits PDE 2	Inhibits PDE 4	Inhibits PDE 5	Inhibits PDE 3	Pharmacology	Miscellaneous (Pharmacology)	13002cb8-942b-42bd-98b0-a85886c94c07	single
Intercourse can be cumbersome, annoying & also 'Noisy' with the use of which of the following :	Disadvantages of female condoms: 1. Intercourse is noisy, and slippage occurs in about one in 5-10 uses; however, female condom rarely breaks. 2. Occasionally the penis is introduced, by mistake, outside the female condom, which may lead to pregnancy and STDs including HIV. 3. It is an expensive method.	2	Male condom	Female condom	IUCD	Vaginal ring	Gynaecology & Obstetrics	Contraceptives	f4b84482-f856-4ea3-b60f-8a121ff1a49d	single
Which virus given below is not a teratogenic virus ?	Ans. is 'd' i.e., Measles Many viruses can be transmitted to the fetus and cause infection and tissure damage. Five viruses are known to be teratogenic in humans: cytomegalovirus, rubella, herpes simplex, Venezuelan equine encephalitis, and varicella viruses.	4	Rubella	Cytomegalovirus	Herpes simplex	Measles	Microbiology	null	3ab18fa0-d119-46e1-a38d-7888f854b14c	single
Vector for T.cruzi is -	T.cruzi passes its life cycle I two host Definitive host- humans Intermediate host-triatomine bugs Humans become infectious when reduviid bug bites and the infected faecal matter is discharged near bite wound (refer pgno:49 baveja 3 rd edition)	1	Reduvid bug	Tsetse fly	Sand fly	Hard tick	Microbiology	parasitology	dc0cd454-82f0-4b0d-82a2-70190cc41ea1	single
Which of the following is most commonly involved in Hypersensitivity vasculitis:	Answer is C (Post-capillary venules): Post-capillary venules are most commonly involved in Hypersensitivity vasculitis Hypersensitivity vasculitis Hypersensitivity vasculitis refers to small vessel vasculitis that is restricted to the skin and not associated with any other form of primary or secondary vasculitis. Implicit in the definition is that this condition is not associated with medium or large vessel disease at other sites, nor with small vessel disease in other organs (only skin) Microscopic polyangitis affects the skin and also internal organs and hence is not considered pa of hypersensitivity vasculitis The typical histopathological feature of cutaneous vasculitis is the presence of leukocytoclastic vasculitis of small vessels. Vasculitis is charachterized by Leukocytoclasis -- Harrison's Synonyms for Hypersensitivity vasculitis include: cutaneous small vessels vasculitis, leucocytoclastic vasculitis, cutaneous leucocytoclastic angitis etc. 'Post-capillary venules are the most commonly involved vessels. Capillaries and aerioles may be involved less frequently' -- Harrison American College of Rheumatology 1990 Criteria for the Classification of Hypersensitivity Vasculitis Laboratory and Radiographic Work-up of Patients with Possible Hypersensitivity Vasculitis Age at disease onset > 16 years Medication at disease onset Palpable purpura Maculopapular rash Biopsy including aeriole and venule, showing granulocytes in a perivascular or extravascular location For purposes of classification, hypersensitivity vasculitis may be diagnosed if the patient meets at least three of these five criteria.	3	Capillaries	Aerioles	Post-capillary venules	Medium sized aeries	Medicine	null	d08aa898-c9f8-421e-96cc-cd3272a9b5b9	single
Hallmarks of the hemophilia is	(Hemarthroses): Ref: 326-G, 1657-Nelson 17th (321-Ghai 7th)Hemophilia - X-1 inked recessive, The females carries the hemophilia trait but only male offspring suffers from the disease.Clinical features - Bleeding following tooth extraction, severe trauma or following surgery muscle hematoma, and bleeding in joints.* Prolonged bleeding following circumcision may be the first symptoms* Excessive bleeding episodes from umbilical cord may be the presenting features in newborns* As the child learns to walk, there are repeated episodes of hemarthrosis* Bleeding may occur in the any area of the body, the hallmark of hemophilia is the hemarthrosis. The earliest joint hemorrhages appears most commonly in the ankle, because of the lack of stability of this joint as the toddler assumed an upright posture (1657-Nelson 17th)	2	Epistaxis	Hemarthrosis	Abdominal pain	Anaemia	Pediatrics	Blood	8865278a-5360-4e66-b4dc-4d6013826241	multi
For central venous pressure monitoring all are true except	Pulmonary capillary wedge pressure in 4-12 mmHg normally.	3	Internal jugular vein is preferred site	Indicated to administer hyperosmolar drugs	Pulmonary capillary wedge pressure normally is 10-20 mmHg	Swan- ganz catheter entering pulmonary artery shows as dicrotic notch.	Anaesthesia	null	e0b946d9-d756-4716-8c87-c558792dd281	multi
Cranial end of Wolffian duct forms:	Ans: A (Epoophoron) Ref: Grays Anatomy 40th EdExplanation:Embryology of Reproductive SystemGonadMALES (Testis)FEMALES (Ovary)Gubernacular cord Mesonephros (Wolffian body)Gubernaculum testisOvarian and round ligamentsAppendix of epididymis (?)Appendices vesiculosae (?)Efferent ductulesEooophoronLobules of epididymis ParadidymisParoophoronAberrant ductules Mesonephric duct (Wolffian duct)Duct of epididymisDuct of epoopboron (Gartner's duct)Vas deferens Ejaculatory duct Part of the bladder and prcstatic urethraPart erf bladder and urethraParamesonephricDuct (Mullerian)Appendix of testsUterine tube UterusProstatic ulricteVaginaAllantoic ductUrachusUrachusCloaca: Dorsal partRectum and upper part of anal canalRectum and upper part of anal canalVentral partMost of bladderMost of bladder and urethra Part of the prostatic urethra Urogenital sinusProstatic urethra distal to the utricle Bulbo-urethral glandsGreater vestibular glandsRest of urethra to qlansVestibuleGenital foldsVentral penisLabia minoraGenital tuberclePenisClitorisUrethra in clans Genital ridgeTestisOvaryGenital swellingScrotumLabia majora	1	Epoophoron	Paraepoophoron	Gartner cyst	Bartholin cyst	Unknown	null	30f2f606-5278-45a2-9cf9-686ce1585e72	single
A 60-year old male presents with progressive difficulty in swallowing, vomiting and occasional regurgitation for the past 3 months. Barium studied showed marked dilatation of the upper esophagus with narrowing of the lower segment. Manometry showed absent esophageal peristalsis. This patient needs to have -	The most common cause of narrowing of the esophagus, or stricture, is scarring of the esophagus from reflux of stomach acid occurring in patients with heaburn. Patients with a narrowed poion of the esophagus often have trouble swallowing; food feels like it is "stuck" in the chest region, causing discomfo or pain. Less common causes of esophageal narrowing are webs or rings (which are thin layers of excess tissue), cancer of the esophagus, scarring after radiation treatment or a disorder of the way the esophagus moves . Esophageal Dilation. During esophageal dilation (also called pneumatic dilation), an endoscopic tube is inseed through the mouth and into the esophagus. A balloon is expanded inside the esophagus to stretch muscle fibers inside the lower esophageal sphincter (LES). Ref Davidson edition23rd pg 729	1	Ballon dilatation	Endoscopic banding	Sclerotherapy	Proton pump inhibitor	Medicine	G.I.T	a41e53bd-4ce6-4877-85ef-5ab8c27af288	multi
Regarding ranula, all are true except -	A ranula is a mucous retention cyst which arises from sublingual salivary gland and presents as fluctuant swelling with a bluish translucent colour. Types of Ranula Ranula may be of two types : - 1)Simple : - Situated in the floor of mouth without any cervical prolongation. 2)Deep/plunging : - Ranula with a cervical prolongation in submandibular region.	2	Retention cyst	Arises from submandibular gland	Translucent	Plunging may be a feature	ENT	null	b585feb4-9615-481a-bef2-fce2f9d5ea98	multi
Thinnest labial plate is found in the region of:	null	2	Upper central incisors	Lower central incisors	Upper canines	Lower canines	Dental	null	46f20a2a-755e-4562-bda4-cd3fd0c6731c	single
If thiopentone is injected accidently into an aery the first symptom is	D i.e. Pain	4	Analgesia	Paralysis	Skin ulceration	Pain	Anaesthesia	null	86799b51-64da-4c55-a02f-ab32d1504ec0	single
40 years old male patient came with complaint of dry cough and dyspnoea. On lung function tests, restrictive pattern of decreases lung function is seen. Chest x-ray showed few reticular opacities in bilateral lung. HRCT of lung was performed which shows GGO in bilateral lung fields sparing sub-pleural region. Most probable diagnosis is	Interstitial Lung Disease UIP (Usual interstitial pneumonia) NSIP (Non - specific interstitial pneumonia) Reticular opacities Traction bronchiectasis Subpleural honeycombing Subpleural sparing	2	UIP	NSIP	Hypersensitivity pneumonitis	Respiratory bronchiolitis	Radiology	Radiology Q Bank	68c63050-83c0-4669-8c29-9637d4061726	single
Malignant gastric ulcers are characterized by all except	In malignant ulcers mucosal rugae stop far of the ulcers whereas in benign ulcers mucosal rugae projects outwards front the margins of the ulcer	1	ulcer extends beyond the gastric wall.	Mucosal rugae stop far of ulcers	Eccentric crater	Margins are raised	Pathology	null	59faef49-7dda-434f-89be-2d9a2e4138cd	multi
The measure of strength of association between risk factor and outcome is:	It is a measure of the strength of association between risk factor and outcome. The derivation of the Odds ratio is based on three assumptions: a) The disease being investigated must be relatively rare. In fact, the majority of chronic diseases have a low incidence in the general population. b) The cases must be representative of those with the disease. c) The controls must be representative of those without the disease. For example, the odds ratio is estimated at 8.1. This implies that the risk of oral cancer was 8.1 times greater in individuals who chewed tobacco than in those who did not chew tobacco. Soben Peter Essentials of preventive and community dentistry 4th edition	1	Odds ratio	Attributable risk	Relative risk	Poisson's ratio	Dental	null	6105a32b-f642-4b65-bf6c-4847310d065b	single
The following affect enzyme activity except	Regulation of Enzymes Can be classified as: Regulation of Enzyme Quality (Intrinsic Catalytic Efficiency) • Allosteric Regulation • Covalent modification. Covalent modification • Phosphorylation/dephosphorylation • Methylation • Adenylation • ADP ribosylation • Acetylation. Regulation of enzyme quantity Control of Enzyme Synthesis By Induction and Repression Control of Enzyme Degradation Enzymes are degraded by Ubiquitin—Proteasome pathway.	3	Methylation	Acetylation	Induction	Phosphorylation	Biochemistry	null	378ae4f9-5261-4def-9ae3-afe4caa39adf	multi
Aggrecan is:	Aggrecan is a proteoglycan, also known as cailage-specific proteoglycan core protein (CSPCP) or chondroitin sulfate proteoglycan 1. It is encoded by the ACAN gene. Aggrecan is an integral pa of the extracellular matrix (ECM) in cailagenous tissue and it withstands compression in cailage.	4	A receptor over platelets	A molecule present in osteoid tissue	Granules in leukocytes	Impoant component of cailage	Physiology	Concepts in physiology	327a02c7-48b3-476d-99a2-628840d5d751	single
Feature of diabetes mellitus in pregnancy:a) Postdatismb) Hydramniosc) Neonatal hyperglycemiad) ↑congenital defecte) PPH	As explained in the previous question maternal hyperglycaemia leads to fetal hyperglycaemia, which in turn causes polyuria and thus causes polyhydramnios. Polyhydramnios leads to preterm delivery and not post datism. Excessive uterine enlargement because of polyhydramnios and macrosomia causes increased incidence of atonic PPH. Diabetes leads to increased incidence of congenital defects in fetus. Maternal hyperglycemia → to fetal hyperglycemia → hyperinsulinemia → to neonatal hypoglycemia at birth.	1	bde	ade	ace	bce	Gynaecology & Obstetrics	null	3a17848e-5035-41d7-b828-bd717f08c03d	single
Treatment of Mycobacteria avium complex include all except :	null	4	Ciprofloxacin	Clarithromycin	Rifabutin	Pyrazinamide	Pharmacology	null	dcc29e89-1737-4b7d-b358-2ebcbec9307f	multi
Specific antibody associated with primary biliary cirrhosis is:	Ans. C: Anti-mitochondrial Primary biliary cirrhosis is strongly associated with the presence of anti-mitochondrial antibodies (AMA), which are diagnostic PBC: Associated with CREST syndrome, sicca syndrome, auto-immune thyroiditis, type I DM and IgA deficiency IgG AMA is detected in more than 90% of patients with PBC 90% of women are between 35 - 60 years Earliest symptom is pruritis Eventually hepatocellular failure and poal hypeension develops Lab findings: - Increased serum alkaline phosphatase - Increased serum 5-nucleotidase activity - Increased gamma-glutamyl transpeptidase - Serum bilirubin is usually normal - Aminotransferase levels minimally increased - Treatment: Ursodiol	3	Anti-myosin	Anti-nuclear	Anti-mitochondrial	Anti-endomysial	Medicine	null	1ed4e42b-0cd6-4aa0-8429-59a2fe0c5edf	single
Long acting insulin is?	ANSWER: (A) Insulin glargineREF: Pharmacology ReCap 2.0 for Bachelor of Dentistry Students by Dr. J. G. Buch page 304, Harrison s 18m ed chapter 344INSULINS:Highly purifiedmono-componentinsulinPorcine Actrapid- RegularShort actingPorcine Monotard- LenteIntermediate actingPorcine Insulatard- NPH Porcine Mixtard30% regular, 70% IsophaneHuman insulinHuman Actrapid- RegularShort actingHuman Monotard- LenteIntermediate actingHuman Insulatard- NPH Human Mixtard30% regular, 70% IsophaneInsulin analoguesInsulin Lispro Insulin aspart Insulin glulisineUltra short actingInsulin glargineLong acting	1	Insulin glargine	Insulin Lispro	Insulin aspart	Insulin glulisine	Pharmacology	Endocrinology	69c8235c-e810-46f2-8a9f-23d5430f8940	single
Which of the following is not an alkylating agent?	5- Fluorouracil' Repeat from AI1MS 09	3	Cyclophosphamide	Busulfan	5-Fluorouracil	Melphalan	Pharmacology	null	4f2dd91a-9b19-4160-b450-7079c4f378cd	single

A thirty year man presented with nausea, fever and jaundice of 5 days duration. The biochemical tests revealed a bilirubin of 6.7 mg/dl (conjugated 5.0 mg/dl) with SGOT/SGPT (AST/ALT) of 1230/ 900 IU/ml. The serological tests showed presence of HBsAg, IgM anti HBc and HBe Ag. The most likely diagnosis -

null

2

Chronic hepatitis B infection with high infectivity

Acute hepatitis B infection with high infectivity

Chronic hepatitis B infection with low infectivity

Acute hepatitis B infection with low infectivity

Microbiology

null

80743579-7b0b-4df2-a10a-04e4f2311aa7

single

In computed tomography (CT), the attenuation values are measured in Hounsfield units (HU). An attenuation value of '0' (zero) HU corresponds to:

Ans. Water

1

Water

Air

Very dense bone structures

Fat

Radiology

null

320ab1f4-4aa3-4da3-b174-c7c89e6d6230

single

SSRI is first line treatment for :

Ans:D.)All Selective serotonin reuptake inhibitors (SSRIs) are US-FDA approved drugs of first choice (line) for major Depression, Obscessive - compulsive disorder (OCD), Premenstrual dysphoric disorder, Post traumatic stress disorder (PTSD), Panic disorder, Eating disorder (bulimia nervosa), and Social phobia (social anxiety disorder)Q. Mn-SSRI for "DOPES" is 1st choice. SSRIs are also used in generalized anxiety disorder, treatment of premature ejaculation (paroxetiene is most useful), body dysmorphic disorders, compulsive buying, & kleptomania. Psychotherapy (group, suppoive) remains the treatment of choice for adjustment disordersQ. And medications are used only to treat specific symptoms for brief periods. Patients with severe anxiety bordering on panic can benefit from anxiolytics (diazepam); those in withdrawn or inhibited states may benefit from sho course of psychostimulant drugs; those with signs of decompensation or impending psychosis may be helped by antipsychotic drugs; whereas, SSRIs are useful in treating symptoms of traumatic grief. There is recent trend of increased antidepressant use, however, to augment psychotherupy in adjustment disorder rather than serving as the primary modality. All SSRIs (except fluvoxamine) are US-FDA approved for treatment of major depression. Fluvoxemine is only used for treatment of OCD in US (b/o commercial reasons not d/t therapeutic profile as it is used for major depression in other countries). In US, citalopram is used only in major depression; escitalopram in major depression & GAD; paroxetine is only not used in bulimia nervosa; and setraline is not used in bulimia & GAD. Fluoxetine is not used in GAD, PTSD and social anxiety but is approved for treatment of bipolar depression (with olanzapine).

4

OCD

Panic disorder

Social phobia

All

Psychiatry

null

1fb4d597-8906-45b2-89e9-f586da6fae63

multi

Mees lines are characteristic of which poisoning?

Mes line(Aldrich mees line) are very charactristic of Arsenic poisoning.They are white bands of opacity in the nails of fingers and toes.

2

Phosphorus

Arsenic

Lead

Thalliam

Forensic Medicine

null

392f4faa-d522-4586-b288-0a5d691f04b9

multi

Glutamic acid is formed from which of the following amino acid?

Glutamic acid is formed by the transamination of alanine and vice versa. Alanine aminotransferase is the enzyme and pyridoxal phosphate is the coenzyme.Ref: DM Vasudevan - Textbook of Biochemistry, 7th edition, page no: 201, fig.15.8.

3

Threonine

Proline

Alanine

Lysine

Biochemistry

Metabolism of protein and amino acid

a67a0110-ea4a-49a7-b0f2-8deba91f86ab

single

Which disease comes under International Surveillance?

Diseases under WHO surveillance Polio Rabies Relapsing fever Influenza Salmonellosis Malaria Louse born typhus Ref : Park's Textbook of Preventive and Social Medicine; 24th edition

2

Typhoid fever

Salmonellosis

Chikungunya fever

Hepatitis B

Social & Preventive Medicine

Concept of health and disease

d182c30f-06a5-4d0a-9f0b-a1b5e0254767

single

Coenzyme used in Kreb's cycle ?

Niacin is used as coenzyme nicotinamide adenine dinucleotide (NAD') for transfer of hydrogen.

1

NAD

NADP

NADPH

NADH

Biochemistry

null

a85db1d4-b089-4fc1-af3b-a5c6ab715ebe

single

Apolipoprotein activating L-CAT (LQ) is

A-1 is the integral apoprotein of HDL.LCAT binds to discoidal HDL activated by A1 conves discoidal HDL to HDL 3Harpers Biochemistry; 30th edition

2

B - 48

A - I

A - II

B-100

Biochemistry

Metabolism of lipid

52cd5175-0cc3-4176-8f64-90ef08fefd33

single

B-type tympanogram is seen in -

Ans. is 'a' i.e., Serous otitis media Type of curseConditionA curve (Normal peak height and pressure)NormalEustachian tube obstructionAs curve (It is also a variant of normal tympanogram but may be shallow)OtosclerosisTumors of middle earFixed malleus syndromeTy mpanosclerosi sAd curve(Variant of normal with high peak)Ossicular discontinuityPost stapedectomyMonometric ear drumB curve(Flat or dome shaped curve)Indicating lack of complianceFluid in middle earSecretory otitis mediaTympanic membrane perforationGrommet in earC curve (negative peak pressure)Retracted tympanic membraneFaulty function of eustachian tube,' eustachian tube obstruction

1

Serous otitis media

Ossicular discontinuity

Otosclerosis

All of the above

ENT

Ear

ccd9d635-f050-4da3-9fa6-56249b61d43a

multi

In adults, circulatory collapse occurs after a minimum of what percentage burns of total body surface area: NIMHANS 08; TN 11

Ans. 15%

3

5%

10%

15%

20%

Forensic Medicine

null

42b701a2-2fba-46bf-ba6e-428f68796c70

single

What passes through diaphragm at T12 level ?

Ans. is 'c' i.e., Thoracic duct

3

Esophagus

IVC

Thoracic duct

Phrenic nerve

Anatomy

null

a9ddd372-4af2-4aff-b9c2-50d296a6d368

single

Beri-Beri is caused by -

- beri beri is due to the deficiency of thiamine. - it has 3 main forms. Dry form characterised by nerve involvement. Wet firm characterised by hea involvement and infantile beri beri. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no:618 <\p>

1

Thiamine

Folic acid

Riboflavin

Niacin

Social & Preventive Medicine

Nutrition and health

72f55aa7-5242-4823-80dd-078c86964a1e

single

A 58 year old male presents with hematuria. He s diagnosed of having bladder cancer which extends muscle deep. The best treatment is

Answer- B. Neoadjuvant chemotherapy followed by radical cystectomy

2

Intravesical Chemotherapy

Neoadjuvant chemotherapy followed by radical cystectomy

Radiotherapy

Tranurethral resection

Surgery

null

bdc6cc31-cae1-4f47-9e81-d15797979283

single

The condition in which patient present with normal leucocyte count or less than normal and shows WBC in the peripheral blood:

null

1

Aleukemic Leukemia

Subleukemic leukemia

Acute leukemia

Chronic leukemia

Medicine

null

b769362b-ea8c-4d85-87ff-a24724277a31

single

The most common cause of a pleural effusion is

The most common cause of pleural effusion is left ventricular failure. Pleural effusions occur in hea failure when there are increased hydrostatic forces increasing the pulmonary interstitial fluid and the lymphatic drainage is inadequate to remove the fluid.Right-sided effusions are more common than left-sided effusions in hea failure. Thoracentesis would show a transudative fluid.Pneumonia can be associated with a parapneumonic effusion or empyema. Parapneumonic effusions are the most common cause of exudative pleural effusions and are second only to hea failure as a cause of pleural effusions.Empyema refers to a grossly purulent pleural effusion. Malignancy is the second most common cause of the exudative pleural effusion. Breast and lung cancers and lymphoma cause 75% of all malignant pleural effusions.On thoracentesis, the effusion is exudative. Cirrhosis and pulmonary embolus are far less common causes of pleural effusions.

2

Cirrhosis

Left ventricular failure

Pulmonary embolism

Pneumonia

Microbiology

All India exam

106d53c8-ff8d-4e36-8ddd-b945d34f3de4

single

M/c cause of chronic laryngeal stenosis ?

Ans. is 'a' i.e., Trauma Laryngeal stenosis (LS) is a congenital or acquired narrowing of the larynx causing airway compromise. The acquired causes may be due to endotracheal intubation, trauma, burns, inflammation, neoplasms, autoimmune disorders and collagen vascular disease.

1

Trauma

TB

Wegeners

Tumor

ENT

null

7b48008c-80f5-4d6b-be71-0abe857dc31c

single

Child knows his/her sex at the age of:

A child knows her full name and gender by the age of 3 years.

2

1 year

3 years

5 years

7 years

Pediatrics

Social and Language Milestones

b4814935-96ed-49a2-9b76-0072069b8292

single

Early stage of trauma is characterized by

Injury Phase (Phase of catabolism):-- Begins at the time of injury and lasts for 2-5 days-- Phase of hypermetabolism-- Stress hormones (coisol, catecholamines and glucagon) and volume control hormones (renin-angiotensin, aldosterone and ADH) are increased. This leads to proteolysis, lipolysis, hyperglycemia and wound healing despite of negative nitrogen balance.* Turning Point:-- Transient period marked physiologically by turning off of the neuroendocrine response and clinically by the appearance of getting well. * Early Anabolic Phase:-- Marked by gain in muscular strength or positive nitrogen balance.* Late Anabolic Phase:-- Marked by gain in weight and body fat or positive caloric balance

1

Catabolism

Anabolism

Glycogenesis

Lipolysis

Surgery

Trauma

4ee59051-7c07-46df-ab93-49ca6d608e76

single

Example for Denticulate suture

Types of sutures:Plane: Internasal sutureSerrate: Coronal sutureDenticulate: Lambdoid sutureSquamous: Parieto-Temporal sutureReference: Chourasia; 6th Edition; 4th page

3

Internasal suture

Coronal suture

Lambdoid suture

Parietotemporal suture

Anatomy

General anatomy

4456e5b2-9887-434f-8f27-e0f5e9a330de

single

A 29-year-old female diagnosed with AIDS has been suffering from a progressive blurring of vision in her right eye. On funduscopic examination, a small white opaque lesion is noted on the retina of her right eye. Which of the following is the most appropriate therapy for this patient?

This patient is most likely suffering from cytomegalovirus (CMV) retinitis. The best drug treatment for this infection is ganciclovir. Acyclovir is not effective in CMV infections. It is used more for HSV type 1 and 2 infections. Amantadine is used either therapeutically or prophylactically for the influenza A virus. Flucytosine is an antifungal agent. Ref: Safrin S. (2012). Chapter 49. Antiviral Agents. In B.G. Katzung, S.B. Masters, A.J. Trevor (Eds), Basic & Clinical Pharmacology, 12e.

4

Acyclovir

Amantadine

Flucytosine

Ganciclovir

Microbiology

null

432865e6-cbb2-40ed-9a93-84760fe5da35

multi

Denominator of MMR if MMR is expressed as 167 is:-

Ans. is 'a' i.e. 1000 live births It's a ratio: Denominator is Per 100000 live births. It will be rate : if the denominator is reproductive women. But still some books write it as rate. But in Park it's clearly differentiated. The data we express MMR as 167 is a ratio.

1

Per 100000 live births

Per 1000 total birth

Per 10000 total birth

Total number of women of reproductive age group in the population

Social & Preventive Medicine

Obstetrics

458239ed-e5e5-4f12-bc31-848ac81d2fd3

single

Kamli Rath 75 yrs old woman present with post-myocardial infarction after 6 weeks with mild CHF. There was past H/O neck surgery for parathyroid adenoma 5 years ago, EKG shows slow atrial fibrillation. Serum Ca+2 13.0 mg/L and urinary Ca2+ is 300 mg/ 24 hr. On examination, there is small mass in the Para tracheal position behind the right clavicle. Appropriate management at this time is -

This patient operated previously for parathyroid adenoma, is having recurrent hyperparathyroidism. In the setting of recent myocardial infarction, CHF and atrial fibrillation, any operation carries a high risk. Furthermore, an operation on a previously operated neck is quite difficult. Alcohol ablation of the mass with ultrasound guidance or angiographic embolization is preferred in this setting.

4

Repeat neck surgery

Treatment with technetium - 99

Observation and repeat serum Ca+2 in two months

Ultrasound-guided alcohol injection of the mass

Surgery

null

bf199fef-d8ed-48de-b510-837e5dc8cadf

multi

Polyariticular rheumatoid ahritis is diagnosed when more than............. Joints are involved

The initial pattern of disturbution of joint involvement may be monoaicular,oligoaicular(less than 4 joints),or Polyariticular (,greater than 5 joints ) usually on a symmetric distribution Ref, :Robbins page no 1209 8th edition

4

One

Two

Four

Five

Anatomy

Musculoskeletal system

3858506b-a4de-4902-8dd4-7dbcb6229dbf

single

A 56-year-old woman with a history of breast cancer that was treated 5 years ago with lumpectomy and radiation but with no chemotherapy returns with bone pain, fatigue, and weakness. A complete blood count reveals severe anemia, as well as decreased white blood cells and platelets. Examination of a peripheral blood smear reveals small numbers of nucleated red cells, as well as an occasional "blast" cell and myelocyte. A likely cause of the hematologic abnormalities is

- Infiltration of tumor cells from cancers, those of breast & prostate - displaces bone marrow elements, thereby causing myelophthisic anemia. OTHER OPTIONS: - Chloramphenicol causes aplastic anemia in some individuals. - Diphyllobothrium latum infestation can result in megaloblastic anemia due to vitamin B12 deficiency.

4

chloramphenicol.

Diphyllobothrium latum infestation.

megaloblastic anemia.

myelophthisic anemia.

Pathology

Hematopoeisis: Basic concepts

54b334c8-07f4-47ea-a320-12eb9f201180

multi

Which is the first permanent tooth to erupt ?

First and the last tooth to erupt in permanent dentition is Molars.

2

Canine

Molar

Incisors

Premolar

Forensic Medicine

null

9dd4a0f1-3e68-48f5-8ea3-9c96505ef8c2

single

The limit of loudness (expressed as decibels) that workers can tolerate without substantial damage to their hearing, during their work hours, is:

A noise of 90 dB (A) SPL, 8 hours a day for 5 days per week is the maximum safe limit as recommended by Ministry of Labour, Govt. of India-Model rules under Factories act Noise induced hearing loss Hearing loss can result from damage to structures or nerve fibers in the inner ear that respond to sound. This type of hearing loss, termed "noise-induced hearing loss," is usually caused by exposure to excessively loud sounds and cannot be medically or surgically corrected. Noise-induced hearing loss can result from a one-time exposure to a very loud sound (at or above 120 decibels), blast, impulse, or by listening to loud sounds (at or above 85 decibels) over an extended period. The louder the sound, the shoer the time period before hearing damage occurs.

4

55

65

75

85

ENT

null

479cc91e-7fda-48cc-a5f0-8607756a620a

single

Among the following the least common cause of acute upper GI bleeding is?

Source of bleeding Propoion of patients, % Ulcers 31-67 Varices 6-39 Mallory Weiss tears 2-8 Gastroduodenal erosions 2-18 Erosive esophagitis 1-13 Neoplasm 2-8 Vascular ectasia 0-6 No source identified 5-15

4

Mallory Weiss tear

Ulcer

Varices

Vascular ectasia

Medicine

Bleeding from the GUT and diseases of esophagus

ea7ba72f-8a5b-4e72-9086-6543d51173f4

multi

HHV-6B causes -

HHV 6B is the cause of mild but common childhood illness exanthem subitum. In older age groups ,it has been associated with infectious mononucleosis syndrome,focal encephalitis and in the immunodeficient,with pneumonia and disseminated disease. REF:ANATHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 8TH EDITION PAGE NO:477

4

Carcinoma cervix

Carcinoma endometrium

Clear cell carcinoma

Focal encephalitis

Microbiology

Virology

0f277307-23ec-4f1b-aca5-eac0765a3fa5

single

Anatomical structure injured in excision of ranula -

null

3

Lingual vein

Lingual artery

Submandibular duct

Parotid duct

Surgery

null

79abf7b1-69e7-4fcc-a952-763a6661ba44

single

Which of the following findings is suggestive that ovulation has taken place?

Endometrial biopsy Early secretory Subnuclear vacuolation (Ist HPE evidence of progesterone secretion) Seen on D16 of cycle Nuclei of glands gone up Stromal edema Late secretory Toous/ coiled glands All secretions in lumen of gland Cork screw glands( on D20 of cycle) Max stromal edema seen around D22of cycle) HPE of Proliferative endometrium Pseudostratification Long tubular glands Spinnbarkeit effect: ovulation mucus has the propey of great elasticity and will withstand stretching up to 10 cm. This phenomenon is called spinnbarkeit or the thread test for oestrogen activity. During the secretory phase, the cervical mucus becomes tenacious and its viscosity increases under the influence of progesterone so that it loses the propey of spinnbarkeit and fractures when put under tension. This propey is called tack. THIS LOSS OF SPINNBARKEIT EFFECT IS USED TO DIAGNOSE OVULATION RETROSPECTIVELY. Ultrasound: shows sudden reduction of follicle size (on serial USGs) and free fluid in Pouch of douglas. Endometrial thickness varies as follows early proliferative: thin bright echogenic stripe late proliferative: trilaminar appearance secretory phase: thick and uniformly echogenic

3

Pseudostratification in endometrium

Presence of Spinnbarkeit Phenomenon in cervical mucous

Sudden reduction in size of follicle and free fluid in Pouch of Douglas on USG

Trilamilar endometrium on USG

Gynaecology & Obstetrics

Tests of Ovulation

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single

Sedative with GABA facilitating action but without anticonvulsant and muscle relaxant propeies and no effect on sleep ?

Ans. is 'b' i.e., Zolpidem Among the given options, three are sedative-hypnotic with GABA facilitatory action - Diazepam (a benzodiazepine) - But it also has anticonvulsant and muscle relaxant propey. it) Phenobarbitone - But it has anticonvulsant propey. Zolpidem Has no anticonvulsant and muscle relaxant propey and have no effect on sleep architecture. Zolpidem Zolpidem is a non-benzodiazepine hypnotic. Minimal suppressive effect on REM sleep architecture is not disturbed.

2

Diazepam

Zolpidem

Phenobarbitone

Buspirone

Pharmacology

null

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single

First branch of Facial nerve is:

Ans. C. Greater petrosal nerveFacial nerve is the 7th cranial nerve. It is a mixed (i.e., motor and sensory) nerve, but predominantly it is motor. It is named facial nerve because it supplies the muscles of facial expression.Branchesa. Greater petrosal nerve--arises from the geniculate ganglion. It is the first branch of facial nerveb. Nerve to stapedius--arises from the vertical part of the facial nerve opposite the pyramidal eminence, runs forward through a short canal within it to reach the stapedius muscle to supply it.c. Chorda tympani nerve--arises from the vertical part of the facial nerve about 6 mm above the stylomastoid foramen.d. Posterior auricular nerve--supplies the occipital belly of occipitofrontal is.e. Nerve to the posterior belly of digastric--supplies the concerned muscle.f. Nerve to stylohyoid--supplies the concerned muscle.g. Five terminal branches (temporal, zygomatic, buccal, marginal, mandibular, and cervical)--supply the muscles of facial expression.

3

Nerve to stapedius

Chorda tympani nerve

Greater petrosal nerve

Lesser petrosal nerve

Anatomy

Head & Neck

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single

The demographic goal of Net Reproduction Rate is equal to one (NPR=1) can be achieved only if the Couple Protection Rate exceeds

(C) 60%[?]Couple protection rate (CPR)oCouple protection rate (CPR) is an indicator of the prevalence of contraceptive practice in the community.oIt is defined as the per cent of eligible couples effectively protected against childbirth by one or the other approved methods of family planning, viz. sterilization, IUD, condom or oral pills.oSterilization accounts for over 60 per cent of effectively protected couples.oCouple protection rate is based on the observation that 50 to 60 per cent of births in a year are of birth order 3 or more.oThus attaining a 60 per cent CPR will be equivalent to cutting off almost all third or higher order births, leaving 2 or less surviving children per couple.oTherefore, the previous National Population Policy was to attain a CPR of 42 per cent by 1990 (end of Seventh Five Year Plan), and 60 per cent by the year 2000.oHowever about 60 per cent eligible couples are still unprotected against conception.oA state-wise break-up of the figures reported indicates that while some states notably Punjab, Gujarat, Maharashtra, Karnataka, Haryana and Tamil Nadu etc. are forging ahead to cover more than half of their fertility level population by contraception.oDifferent Family Planning methods used for Acceptors of Couple Protection Rate include:-Sterilization-Vasectomy-Tubectomy-IUD insertion-Condom users-Oral Contraceptive Pill UsersoNRR = 1 can be achieved only if the CPR >60%[?]Net Reproduction Rate (NRR)oNet Reproduction Rate (NRR) is defined as the number of daughters a newborn girl will bear during her lifetime assuming fixed age-specific fertility and mortality rates.oNRR is a demographic indicator. NRR of 1 is equivalent to attaining approximately the 2-child norm.oIt is 'the number of daughters a newborn girl will bear during her lifetime assuming fixed age-specific fertility and mortality rates'.oIt is a demographic indicator.oNRR of 1 is equivalent to attaining approximately the 2-child norm. If the NRR is less than 1, then the reproductive performance of the population is said to be below replacement level.oThe average number of Daughters a women would bear in her life if she experiences the age-specific fertility (fro daughters) prevailing at the study period, & if her daughters experienced the prevailing rates of mortality.oIf the age schedules of both fertility & mortality remain constant, the Net Reproduction Rate would be a measure of generational Replacement.oE.g.-NRR =1.1 - Next generation will be 10% larger than the present generation (growth)-NRR =1.0 - Next generation will be the same as the present generation (replacement level)-NPR =0.9 - next generation will be 10% smaller than the present generation (depopulation)[?]Net Reproduction Rate, Pros & Cons.oPros-Taking into account both fertility & survival in getting one indicator of reproductivity of a PopulationoCons-Requires detailed data on fertility & survival of women, up to age 50 years-Does not take into account that women born in different years may have different fertility & survival.

3

40%

50%

60%

70%

Social & Preventive Medicine

Demography and Family Planning

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single

Paraneoplastic syndrome associated with RCC are all of the following, except:

RCC is associated with wide range of paraneoplastic syndromes, ? Erythrocytosis (polycythemia ? Hypercalcemia ? Hypeension ? Non metastatic hepatic dysfunction Cushing syndrome is rarely seen in RCC. Ref: Emil A. Tanagho, Jack W. McAninch, (2004), Chapter 21, "Renal paranchymal neoplasm", In the book, "Smith's General Urology", LANGE SERIES, USA, Page 351; Harrison's Principles of Internal Medicine, 17th Edition, Page 592; Robbin's Basic Pathology , 7th Edition, Page 1018; Smith's Urology, 16th Edition, Page 351

4

Polycythemia

Hypercalcemia

Hypeension

Cushing syndrome

Pathology

null

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multi

Red flag sign in child development if not attained by __________

Red Flags in Developmental Screening and SurveillanceThese indicators suggest that development is seriously disordered and that the child should be promptly referred to a developmental or community pediatrician. Note: Most children do not have "red flags" and thus require quality screening to detect any problems. POSITIVE INDICATORS (THE PRESENCE OF ANY OF THE FOLLOWING) Loss of developmental skills at any ageParental or professional concerns about vision, fixing, or following an object or a confirmed visual impairment at any age (simultaneous referral to pediatric ophthalmology)Hearing loss at any age (simultaneous referral for expe audiologic or ear, nose, and throat assessment)Persistently low muscle tone or floppinessNo speech by 18 mo, especially if the child does not try to communicate by other means such as gestures (simultaneous referral for urgent hearing test)Asymmetry of movements or other features suggestive of cerebral palsy, such as increased muscle tonePersistent toe walkingComplex disabilitiesHead circumference above the 99.6th centile or below 0.4th centile. Also, if circumference has crossed 2 centiles (up or down) on the appropriate cha or is dispropoionate to parental head circumferenceAn assessing clinician who is unceain about any aspect of assessment but thinks that development may be disordered NEGATIVE INDICATORS(ACTIVITIES THAT THE CHILD CANNOT DO) Sit unsuppoed by 12 months Walk by 18 mo (boys) or 2 yr (girls) (check creatine kinase urgently)Walk other than on tiptoes Run by 2.5 yr .Hold object placed in hand by 5 months (corrected for gestation)Reach for objects by 6 mo (corrected for gestation)Point at objects to share interest with others by 2 yr Ref.nelson 20th edition pg100

4

No single word at 18 month

Not able sit with unsuppoed by 12 months

Not walking alone by 18 month in boys

All of the above

Pediatrics

Growth and development

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multi

Michaelis Menten Hypothesis states that

Michaelis-Menten Theory (Enzyme-Substrate Complex Theory) Enzyme combines with a substrate to form a transient Enzyme-Substrate Complex which immediately break into Enzyme and products.

4

Rate of enzymatic reaction is independent of substrate concentration

Rate of non enzymatic reaction is proportional to substrate concentration

Km is the enzyme substrate complex association constant

Enzyme substrate complex formation is essential in enzymatic reaction.

Biochemistry

null

79a81298-e728-4081-b2b5-be965d210d7d

single

Function of Ig A is -

Question repeated

1

Acts as a mucosal barrier for infection

Circulating antibody

Kills virus infected cells

Activates macrophages

Microbiology

Immunology

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single

Glycolytic enzymes(s) inhibited by Fluoride:

Inhibitors of Glycolysis: Inhibitors of Glycolysis Enzyme Inhibited Iodoacetate Glyceraldehyde - 3 - P Dehydrogenase Arsenate Glyceraldehye - 3 - P Dehydrogenase Sodium fluoride Enolase Oxamate Lactate Dehydrogenase

3

Hexokinase

Aldolase

Enolase

Pyruvate kinase

Biochemistry

Glycolysis

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single

A patient is to undergo angiography for unstable angina. His routine evaluation revealed his serum creatinine to be elevated. All of the following can be used to prevent contrast nephropathy, EXCEPT:

Strategies for the Prevention of Contrast-Induced Nephropathy: Strategies that do not work: Mannitol Furosemide Dopamine Atrial natriuretic factor Fenoldopam Hemodialysis Strategies that may work: Calcium channel blockers Theophylline N-Acetylcysteine Hemofiltration Sodium bicarbonate Ascorbic acid Iso-osmolar contrast media Current recommended strategies: Employ non iodinated contrast studies Avoid nonsteroidal anti-inflammatory agents Space between contrast administrations Minimize contrast volume Hydration Low osmolar contrast media Ref: Brunelli S., Rudnick M.R. (2009). Chapter 12. Contrast-Induced Nephropathy. In E.V. Lerma, J.S. Berns, A.R. Nissenson (Eds), CURRENT Diagnosis & Treatment: Nephrology & Hypeension.

2

Haemofiltration

Fenoldopam

N-acetylcysteine

1/2 N saline

Radiology

null

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multi

A lady wants LASIK surgery for her daughter. She asks for your opinion. All the following things are suitable for performing LASIK surgery except –

Patient selection criteria for LASIK Patients above 20 years of age Stable refraction for at least 12 months Motivated patients Myopia up to -12D The absence of corneal pathology Corneal thickness > 500 m Contraindications of LASIK Monocular patient Infections eg: conjunctivitis Glaucoma Autoimmune disease Thin cornea (< 450 microns) Keratoconus Poor endothelial cell count in the cornea (< 1500) Dry eye Diabetic retinopathy

2

Myopia of 4 Diopters

Age of 15 years

Stable refraction for 1 year

Corneal thickness of 600 microns

Ophthalmology

null

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multi

Cardiac index is the ratio of?

Cardiac index is the cardiac output corrected for the individual's size. For example, the cardiac output of a 50-kg woman will be significantly lower than that of a 90-kg man. It has been found, however, that cardiac output correlates better with body surface area than with body weight. Therefore, it is common to express the cardiac output per square meter of surface area. Under resting conditions, the cardiac index is normally approximately 3 L/min per m2. Ref: Mohrman D.E., Heller L.J. (2010). Chapter 4. Measurements of Cardiac Function. In D.E. Mohrman, L.J. Heller (Eds), Cardiovascular Physiology, 7e

2

Cardiac output and body weight

Cardiac output and surface area

Cardiac output and work of hea

Surface volume and surface area

Physiology

null

ffc2ba0a-f6c2-43fa-8000-cdc6ba408267

single

Carcinoma cervix involving upper 2/3rd of vagina. The stage would be: September 2009

Ans. A: Stage II a

1

Stage II a

Stage II b

Stage III a

Stage III b

Gynaecology & Obstetrics

null

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single

An 18-year-old pregnant woman receives no prenatal care, eats a diet containing mostly carbohydrates and fats, and does not take prenatal vitamins with iron. She feels increasingly tired and weak during the third trimester. The infant is born at 35 weeks' gestation and is listless during the first week of life. Laboratory studies show markedly decreased serum ferritin levels in the infant and the mother. Which of the following findings from a nutritional deficiency is most likely to be present in both the infant and the mother?

Iron deficiency, which gives rise to microcytic anemia, is common in women of reproductive age because of menstrual blood loss and in children with a poor diet. During pregnancy, women have greatly increased iron needs. Low serum ferritin is indicative of iron deficiency. Dermatitis can be seen in pellagra (niacin deficiency). A goiter results from iodine deficiency, but this is a rare occurrence today because of newborn testing and widely available foods with iodine. Peripheral neuropathy is more characteristic of beriberi (thiamine deficiency) and deficiencies in riboflavin (vitamin B2 ) and pyridoxine (vitamin B6 ). Bowing of the long bones and epiphyseal widening can be seen in rickets (vitamin D deficiency). Soft tissue hemorrhages can be seen in scurvy (vitamin C deficiency).

3

Dermatitis

Diffuse goiter

Microcytic anemia

Peripheral neuropathy

Pathology

Environment & Nutritional Pathology

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multi

Not a cause of Roth spots?

Roth spots Round retinal hemorrhages with white centers Seen in : Infective endocarditis SLE Serum sickness Polyaeritis nodosa Severe anemia Leukemia Prolonged anesthesia

4

Leukemia

Severe anemia

SLE

Hypersensitivity pneumonitis

Medicine

Rheumatic Hea disease & infective endocarditis

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single

Which of the following is not true about the mechanism of action of benzodiazepines?

Ans. is 'd' i.e., It has GABA mimetic action Mechanism of action of benzodiazepines (BZDs)* Muscle relaxation is produced by action on medulla.* Ataxia is due to action on cerebellum.* BZDs acts on GABAA receptors.* GABAa receptor has 5 subunits a / b, b, a / g.* GABA binding site is on b. subunit, while BZDs binding site is on a / g subunit.* BZDs receptor increase the conductance of Cl channel.* BZDs do not themselves increase Cl conductance, i.e. they have only GABA facilitatory but no GABA mimetic action. (Barbiturates have both GABA facilitatory and GABA mimetic actions).Effect on CNS* In contrast to barbiturates, BZDs are not general depressant, but exert relatively selective anxiolytic, hypnotic, muscle relaxant and anticonvulsant effects.* The antianxiety action of BZDs is not dependent on their sedative property - with chronic administration relief of anxiety is maintained, but drowsiness wanes off due to development of tolerance.* Stage 2 sleep is increased, while REM, Stage 3 & 4 sleep are decreased.* Nitrazepam is the only benzodiazepine, which increases REM sleep.* Clonazepan and diazepam have more marked muscle relaxant property.* Clonazepam, diazepam, nitrazepam and flurazepam have more prominent anticonvulsant activity than other BZDs.* Diazepam (but not other BZDs) has analgesic action.* Diazepam produces short lasting coronary dilatation on i.v. injection.* Diazepam decreases nocturnal gastric secretion and prevents stress ulcers.

4

Acts on mid brain, ascending reticular formation and limbic system

It exerts effects through the GABA A receptors

It increases conductance of Cl- channels

It has GABA mimetic action

Pharmacology

C.N.S

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multi

Following are the findings in sickle cell Anemia, except -

Splenomegaly is found in the early stage of sickle cell anemia. By continued infarction and hypoxia leads to progressive scarring and shrinkage of the spleen, so that by adolescent or the adulthood, only a small nubbin of fibrous tissue may be left; this is called autosplenectomy. Bone changes in sickle cell anemia are : - Crew haircut appearance of skull bone. Fish mouth vertebrae. Cardiomegaly particularly increases in left ventricular dimension and mass results from the increase in cardiac output caused by chronic anemia and has its onset in early childhood. The WBC count is consistently elevated owing to an increase in the number of mature granulocytes. This increase is explained to a large extent by a shift of granulocytes from the marginated to the circulating compartments.

3

Fish vertebra

Enlarged heart

Splenomegaly usually seen

Leukocytosis

Pathology

null

d28eda9d-c7c7-4a84-80b1-6a57e3d3661b

multi

Which of the following conditions does not have a National Screening/Control Programme?

Ans. is 'b' i.e. Dental caries o No National programme for oral health is under implementation. About other options o There is Pilot Programme for prevention & control of DM. CVD and deafness. o The National Programme for control of blindness includes screening for refractive errors. o Cervical cancer screening programme is working in India.

2

Diabetes Mellitus

Dental caries

Refractive errors

Carcinoma cervix

Social & Preventive Medicine

null

fce245e5-d5db-4965-8c3c-cb0f4141ffe3

single

Which of the following contains sulphur?

Ans: b (Insulin) Ref: Harper, 25th ed, p. 347,115Insulin is a polypeptide consisting of two chains linked by two inter chain di sulphide bridges.Amino acids required for special products:> Creatine - glycine + arginine+ methionine> Glutathione - glycine + cysteine + glutamate> Purine - glycine + aspartate + glutamine + serine> Pyramidine - aspartate + glutamine (glycine not present)> Keratin - formed by histidine, arginine, lysine. Also note - keratin is rich in cysteine.> Histone - rich in arginine and histidine.> Camosine - P alanine, histidine.> Choline - glycine, serine, methionine (Vit B6 - lipotrophic factor)

2

Creatine

Insulin

Inulin

Creatinine

Biochemistry

Proteins and Amino Acids

faf871b0-801d-4561-84c8-0a20b3aeac7e

single

Which one of the following is the management of pancreatic abscess -

null

3

Needle aspiration

Gastro-cytostomy

External drainage

Jejuno-cystostomy

Surgery

null

44385d4e-be54-4e51-9011-f6fc395c7784

single

Sentinel lymph node biopsy is done in all except

null

4

ca breast

ca penis

malignant melanoma

ca colon

Surgery

null

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multi

During pregnancy the maternal blood volume increases by nearly :

Ans. is c i.e. 50% Friends, we have dealt with hemodynamic changes during pregnancy in detail earlier but here lets quickly revise a few changes asked quite often. Most impoant physiological changes during pregnancy (for 11th hour revision) Net weight gain in pregnancy is 11 kg (24 lb).deg Blood volume T's by 40-50%.deg Blood volume reaches maximum at 30-32 weeks.deg Plasma volume T's by 50%.deg RBC volume T's by 20-30%.deg TLC is increased, specifically Neutrophilic leucocytosis occurs.deg Total plasma proteins increase.deg Plasma protein concentration decreases.deg Albumin level decreases, globulin levels (specially IgA) slightly increase.deg Fibrinogen levels increase by 50%.deg ESR is increased.deg All clotting factors except XI and XIII increase.deg Platelet count decreases (Gestational Thrombocytopenia).deg Cardiac output (stroke volume) increases to 40-50% by 30-34 weeks.deg Peripheral vascular resistance decrease.deg Diastolic BP decreases.deg Uterine blood flow increases near term.deg Plasma insulin levels increase.deg S. Prolactin levels increase.deg Vital capacity and respiratory rate remain constant.deg Renal plasma flow and GFR increase.deg All LFT'S remain unchanged, with exception of alkaline phosphatase which increases (specially heat stable alkaline phosphatase produced by placenta).deg

3

5 - 10%

15 -- 20%

50%

70%

Gynaecology & Obstetrics

null

2c8b4eb9-743d-4d34-afa8-bac38347065d

single

Side effect of MgSo4 used in the treatment of eclampsia is

Complications : Pulmonary edema Anuria Hea failure Hyperpyrexia Psychosis Ref: Dutta Obs 9e pg 222.

4

Hypotension

Polyuria

Coma

Pulmonary edema

Gynaecology & Obstetrics

Medical, surgical and gynaecological illness complicating pregnancy

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single

True about Ischiorectal fossa Boundaries

Ans. (a) Anterior border is formed by inferior fascia of urogenital diaphragm.Ref: IB singh Anatomy 2nd ed. / fig. 25.12ANTERIOR* Fascia of Colles covering the Transversus perinea superficialis* Inferior fascia of the urogenital diaphragmPOSTERIOR* Gluteus maximus* Sacrotuberous ligamentLATERAL MEDIAL* Levator ani* Sphincter ani externus muscle* Anal fascia* Tuberosity of the ischium* Obturator internus muscle* Obturator fasciaSUPERIOR* Levator ani INFERIOR* Skin

1

Anterior border is formed by inferior fascia of urogenital diaphragm.

Superior border is formed by Gluteus Maximus

Lateral border is formed by Levator Ani

Posterior border is formed by obturator internus muscle.

Surgery

Rectum

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multi

Hypehyroidism will present as all, except :

Hypehyroid symptoms include heat intolerance, increased sweating and thirst, and weight loss despite adequate caloric intake. Symptoms of increased adrenergic stimulation include palpitations, nervousness, fatigue, emotional lability, hyperkinesis, and tremors. The most common GI symptoms include increased frequency of bowel movements and diarrhea. Female patients often develop amenorrhea, decreased feility, and an increased incidence of miscarriages. Children experience rapid growth with early bone maturation, whereas older patients may present with cardiovascular complications such as atrial fibrillation and congestive hea failure. Common cardiovascular manifestations of hypehyroidism include palpitations, systolic hypeension, and fatigue. Sinus tachycardia is present in 40% of hypehyroid patients, and atrial fibrillation in 15%. On physical examination, weight loss and facial flushing may be evident. The skin is warm and moist and African American patients often note darkening of their skin. Tachycardia or atrial fibrillation is present with cutaneous vasodilation leading to a widening of the pulse pressure and a rapid falloff in the transmitted pulse wave (collapsing pulse). A fine tremor, muscle wasting, and proximal muscle group weakness with hyperactive tendon reflexes often are present. Ref : Lal G. (2010). Chapter 38. Thyroid, Parathyroid, and Adrenal. In T.R. Billiar, D.L. Dunn (Eds), Schwaz's Principles of Surgery, 9e.

1

Hypotension

Atrial fibrillation

Tremor

Panic attacks

Surgery

null

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multi

A patient presents in the causality with history of abdominal pain. On examination the person is in shock, with severe abdominal tenderness and guarding. There was also one episode of bloody diarrhoea. He gives a history of recurrent abdominal pain soon after taking food which persists for about 3 hours after food. He also has a history of MI about 5 years back. What is your diagnosis?

The person has had recurrent episodes of abdominal angina as shown by the pain after food intake. He also has a history of MI which also suggests that he has atherosclerosis. The bloody diarrhoea is again suggestive of mesenteric vascular occlusion in this patient. Ref: Manipal Millennium Edition, Page 429; S.Das, Edition 5, Page 354

1

Acute thrombotic mesenteric vascular occlusion

Acute pancreatitis

Acute duodenal ulcer perforation

Acute appendicitis

Surgery

null

512ce60e-6c09-417d-91b3-e1d2f0d539b6

single

Fick principle of calculation of cardiac output doesn't depend on-

Based on Fick principle

3

Whole body oxygen consumption

Oxygen content of arterial blood

Stroke volume

Oxygen content of venous blood

Physiology

null

31eb4e7f-b538-4d8d-9bfb-82533c0f311a

single

Example of type 4 hypersensitivity is:

Ans. b. Granulomatous reaction

2

Serum sickness

Granulomatous reaction

Schwazman reaction

Ahus reaction

Microbiology

null

55848125-05f7-43c4-8dba-74307c7c7964

single

A boy presented with prolonged jaundice, constipation and umbilical hernia. what is the probable diagnosis?

Prolonged jaundice, constipation, Umbilical hernia are all seen in congenital hypothyroidism.

3

Growth hormone deficiency

Kernicterus

Congenital hypothyroidism

Congenital adrenal hyperplasia

Pediatrics

null

ea048cfb-76c4-4754-a0c7-9aedc52664c2

single

Osteosarcoma can arise from:

Ans. c (Metaphysis). (Ref. to Radiology Review Manual, 5th/138; Essential orthopedics by Maheshwari 2nd/218)OSTEOSARCOMA* It is 2nd most common 1deg malignant tumor of bone (after multiple myeloma). Peak incidence in menl0-20 years of age. * It has bimodal age distribution: 10-25 years and > 60 years with M:F = 3:2 to 2:1. * Commonly found in the metaphysis of longbones, often around distal femur, proximal tibial region (knee). * Predisposing factors include Paget's disease of bone, bone infarcts, radiation, and familial retinoblastoma. Codman's triangle or sunburst pattern (from elevation of periosteum) on x-ray. * MRI is preferred modality. Clearly defines marrow extent (best on T1W1), vascular involvement and soft tissue component (best on T2W1). Radionuclide bone scan (NUC) shows intensity increased activity on blood flow, blood pool, delayed images (hypervascularity, new bone formation). Doughnut sign (peripherally increased uptake with central photopenia on bone scan) is a classical feature. Poor prognosis. * Standard management: Preoperative chemotherapy followed by limb-sparing surgery followed by postoperative chemotherapy (Sandwich Therapy). * Rx:Osteosarcoma is radio- resistant; radiation therapy has no role in the routine management.Ewing's sarcomaAnaplastic small blue cell malignant tumor. Most common in boys < 15. Extremely aggressive with early mets, but responsive to chemotherapy. Characteristic "onion-skin" appearance in bone ("going out for Ewings and onion rings"). Commonly appears in diaphysis of long bones, pelvis, scapula, and ribs. 11;22 translocation.ChondrosarcomaMalignant cartilaginous tumor. Most common in men aged 30-60. Usually located in pelvis, spine, scapula, humerus, tibia, or femur. May be of 1deg origin or from osteochondroma. Expansile glistening mass within the medullary cavity

3

Diaphysis

Epiphysis

Metaphysis

All of the above

Orthopaedics

Bone Tumour

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multi

Episodic hypeension is a feature of

Classic triad: Headache + Diaphoresis+ Palpitation

3

Carcinoid tumor

Insulinoma

Pheochromocytoma

Zollinger-Ellison syndrome

Physiology

All India exam

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single

Acantholysis is:

Ans. (b) Separation of keratinocytesRef: Harrison 19th ed. / 370* Keratinocytes are connected to one another by intracellular desmosomal bridges.* If there is loss of these desmosomal bridges, it will lead to separation of keratinocytes and the condition is known as acantholysis.* If separation continues, there will be intracellular edema, and the condition is known as Ballooning.Also Know* Degeneration of stratum basale is seen in: Lichen planus* Acanthosis: thickening of stratum spinosum* Hypergranulosis: Thickening of stratum granulosum* Hyperkeratosis: Thickening of stratum corneum* Parakeratosis: persistence of nucleus in stratum corneum layer

2

Lysis of basale cell layer

Separation of keratinocytes

Thickening of granular layer

Thickening of corneum layer

Skin

General

81fbc82a-d070-4b72-a17a-a87b947c848a

single

High risk of malignancy is seen in?

Answer is option3, complex hyperplasia with atypia Endometrial hyperplasia with atypia is the least common type of hyperplasia, but is the type most likely to progress to type 1 endometrial carcinoma (1-3) which accounts for 97% of uterine cancers, whereas simple hyperplasia rarely progresses to carcinoma. >

3

Simple hyperplasia with atypia

Simple hyperplasia without atypia

Complex hyperplasia with atypia

Complex hyperplasia without atypia

Pathology

General pathology

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single

The Millennium Development Goals (MUG) is to be achieved by the year -

Ans. is 'b' i.e., 2015

2

2010

2015

2020

2030

Social & Preventive Medicine

null

1ae6bb17-5bc8-4c67-bac0-0a965653968e

single

Systemic causes of epistaxis are all except:

Hemophilia is secondary cause of epistaxis in children. Ref.Scott Brown 7/e,vol 2,p 1605

4

Hypeension

Anticoagulant treatment

Hereditary telangietasia

Hemophilia

ENT

Nose and paranasal sinuses

6fdacf93-d4c2-4666-8e45-a524e8ac38db

multi

Which of the following situations will lead to increased viscosity of blood:

C i.e. Multiple myeloma

3

Fasting state

Hypoglycemia

Multiple myeloma

Amyloidogenesis

Medicine

null

709dc647-846a-453f-9d73-31d9522220d6

single

A person is being treated for Human Immunodeficiency Virus-1. He developed hyperiglyceridemia and hypercholesterolemia. Most likely drug implicated for these adverse effects is

Ritonavir is a protease inhibitor and can cause hyperiglyceridemia and hypercholesterolemia. All protease inhibitors are metabolized by liver and all can cause metabolic abnormalities including hypercholesterolemia, diabetes mellitus, hyperlipidemia, insulin resistance and altered fat istribution (lipodystrophy). Atazanavir is devoid of this adverse effect. Tesamorelin is a synthetic analogue of growth hormone releasing factor indicated to reduce excess abdominal fat in HIV-infected patients with lipodystrophy.

1

Ritonavir

Raltegravir

Tenofovir

Eirenz

Pharmacology

Anti-HIV Drugs

ddf0d9e7-c8d4-4500-89ce-b1ef7e0ff3e7

single

Ropinirole is most useful for the treatment of:

Ans. (A) Parkinson's disease(Ref: KDT 8/e p457)Ropinirole is a non-ergot dopamine agonist useful for Parkinsonism. It is also used these days for restless leg syndrome.

1

Parkinson's disease

Wilson's disease

Hoffmann syndrome

Carpal tunnel syndrome

Pharmacology

C.N.S

c4caf996-8488-4544-8b77-cb583fb76e2e

single

Which of the following helminths primarily produces gastrointestinal symptoms, without lung involvement, during the course of its infection?

Trichuris humans acquire the infection by eating foods contaminated with infective eggs. Once eggs are swallowed, the larvae hatch in the small intestine, where they mature and migrate to the colon. Trichuris infections with a low worm burden are usually asymptomatic, but infections of moderate to heavy worm loads present with lower abdominal pain, distention, and diarrhea. Severe infection may lead to profuse bloody diarrhea, cramps, tenesmus, urgency, and rectal prolapse. Occasionally worms migrate to the appendix, causing appendicitis. Jawetz microbiology 27e 724.

3

Dirofilaria immitis

Strongyloides stercoralis

Trichuris trichiura

Ascaris lumbricoides

Microbiology

All India exam

e8ab8c32-a9b6-4c3d-8ef1-012831dea02d

single

In solitary thyroid nodule true is/are :

Ans. is 'd' i.e. Common in female A solitary thyroid nodule is a palpably discrete swelling within an otherwise apparently normal thyroid gland. Ceain imp. points about solitary thyroid nodules : STN are more common in women than in men The incidence of STN increases with age Solitary nodules, in general, are more likely to be neoplastic than are multiple nodules. Nodules in younger patients are more likely to be neoplastic than are those in older patients. Nodules in males are more likely to be neoplastic than are those in females. A history of radiation treatment to the head & neck region is associated with an increased incidence of thyroid malignancy. Functional nodules that take up radioactive iodine in imaging studies (hot nodules) are significantly more likely to be benign than malignant.

4

THR-Ab

Lined by columnar epithelium

Diffuse hyperplasia of thyroid

Common in female

Surgery

null

5b59a952-dfae-494b-a52a-2a60aa937de3

multi

Indications of celiotomy in blunt trauma:

Ans is C (Peritoneal air on imaging) Most spleen and liver injuries are managed non-operatively, if the patient is hemodynamically stable.

3

Grade I spleen damage

Grade II liver damage

Peritoneal air on imaging

All

Surgery

null

1081fe83-1f89-42f1-879c-592702c57f9c

multi

Two most impoant tests to be done in a comatose patient with blood glucose of 750 mg/dl will be -

Comatose patients with blood glucose level of 750 mg/dl suggests the possibility of hyperglycemic hyperosmolar state . Lab abnormality in this is marked hyperglycemia, hyperosmolarity, prerenal azotemia. Comatose patients with hyperglycemia is also seen in diabetic ketoacidosis. Thus blood ph ( to detect acidosis) and serum creatinine for azotemia are most impoant investigations.

1

Sr. creatinine

Sr. sodium

CSF examination

Blood pH

Medicine

Endocrinology

cb5d35ed-508b-48e1-934d-580e070e7330

single

A different sequence of amino acids having a similar structure of proteins is an example of

Divergence and convergence are two evolutionary processes by which organisms become adapted to their environments. Convergence has been defined as the acquisition of morphologically similar traits between distinctly unrelated organisms. Convergence occurs at every level of biological organization. Functional Convergence This refers to molecules that serve the same function but have no sequence or structural similarity and carry out their function by entirely different mechanisms. Mechanistic convergence Mechanistic convergence occurs when the sequence and structure of molecules are very different but the mechanisms by which they act are similar. Structural Convergence This refers to molecules with very different amino acid sequences that can assume similar structural motifs, which may carry out similar functions. Sequence Convergence In sequence convergence, one or more critical amino acids or an amino acid sequence of two proteins come to resemble each other due to natural selection. (In protein evolution, sequence divergence, rather than sequence convergence is the rule.)

2

Divergence

Convergence

Opportunistic

Incidental

Biochemistry

null

79fa4140-1f33-4167-a30b-7d6b1496c217

single

Shelf life of Platelets is

Shelf life of Platelets is < 5 days Cryoprecipitate is 2 years.

1

< 5 days

< 3 weeks

< 5 weeks

< 2 years

Medicine

null

f36fe1fd-bdae-4329-9ff2-8b96d7c92949

single

Phenomenon called anticipation is seen in?

Instablity of triplet repeats can lead to gradual expansion from generation to generation,a phenomenon called anticipation,Genetic anticipation is characterized by the reduction in the age of disease onset by successive genarations.

3

Mitochondrial inheritance

x - linked dominant disorders

Trinucleotide repeat expansion

Genomic imprinting

Pathology

null

2e67b5ca-2efe-432a-adec-6a21881c3bf3

multi

Lung is characteristically involved in -

Ans. is 'a' i.e., Churg-Strauss syndromeChurg- strauss syndrome o Also known as allergic granulomatosis and angitis.o It is a medium and small size vasculitis, invoves mainly the blood vessels of lungs, GIT, peripheral nerves, hea, skin, kidney.o As it is allergic, vasculitis it is associated with eosinophilia and asthma.o It is granulomatous necrotizing vasculitis.o It is associated with p-ANCA.StagesThis disease has three distinct stages ?o Stage l --> Involves the sinuses and the onset of allergies ---> nasal polyp, allergic rhinitis.o Stage 2 --> Acute asthma occurs.o Stage 3 --> The third and final stage involves the various organ systems -1. Peripheral nervous system --> Mononeuritis multiplex with severe neural pain.2. Skin -3 Palpable purpura, papules, ulcer, vesiculobillous lesion.3. Hea --> CHF4. Kidney Pauciimmune glomerulonephritis.5. Joints --> Migratory ahritis.6. Ear Conductive deafness.7. There is eosinophilia and raised IgE as occur with allergic conditions.8. Lung --> Nonfixed migratory pulmonary infiltrates.

1

Churg-Strauss syndrome

HSP

PAN

ITP

Pathology

null

41fffdb3-b7e1-4799-8baf-930e25362745

multi

Which of the following drugs is used for narcoanalysis -

Scopolamine is used as truth serum. Drugs commonly used in narcoanalysis are 1. Thiopentone sodium (Sodium pentothal) 2. Scopolamine hydrobromide 3. Sodium secnol 4. Benzodiazepines REF;THE SYNOPSIS OF FORENSIC MEDICINE:KS NARAYANA REDDY;28th EDITION

3

Atropine

Phenobarbitone

Scopolamine

Pethidine

Forensic Medicine

Poisoning

f73c5da1-ab29-4ca8-b670-268e8a9f2645

single

Commonest organism giving rise to urinary tract infection -

• Most UTIs are caused by a single bacterial species. • At least 80% of the uncomplicated cystitis and pyelonephritis are due to E. coli, with most of pathogenic strains belonging to the O serogroups. • Other less common uropathogens include Klebsiella, Proteus, and Enterobacter spp. and enterococci. • In hospital acquired UTIs, a wider variety of causative organisms is found, including Pseudomonas and Staphylococcus spp. • UTIs caused by S. aureus often result from hematogenous dissemination. • Group B beta-hemolytic streptococci can cause UTIs in pregnant women. • In children, Klebsiella and Enterobacter spp. are common causes of UTI. • Anaerobic bacteria, lactobacilli, corynebacteria, streptococci (not including enterococci) and S. epidermidis are found in normal periurethral flora. They do not commonly cause UTIs in healthy individuals and are considered common urinary contaminants.

1

E. coli

Proteus

Staphylococcus

Streptococcus

Surgery

null

ebd2773c-d81f-488e-b1d6-b8d4e5ba2ad3

single

Carbamide solution used for bleaching degrades into

null

3

0.3% sodium perborate

30% hydrogen peroxide

3% hydrogen peroxide

30% sodium perborate

Dental

null

38a3e1b8-705c-47cb-961b-8908e9d88503

single

Mechanism of action of sildenafil is

Ans. is 'c' i.e., Inhibits PDE 5 * Sildenafil (Viagra) acts to increase cGMP by inhibiting its breakdown by phosphodiesterase isoform 5 (PDE-5).

3

Inhibits PDE 2

Inhibits PDE 4

Inhibits PDE 5

Inhibits PDE 3

Pharmacology

Miscellaneous (Pharmacology)

13002cb8-942b-42bd-98b0-a85886c94c07

single

Intercourse can be cumbersome, annoying & also 'Noisy' with the use of which of the following :

Disadvantages of female condoms: 1. Intercourse is noisy, and slippage occurs in about one in 5-10 uses; however, female condom rarely breaks. 2. Occasionally the penis is introduced, by mistake, outside the female condom, which may lead to pregnancy and STDs including HIV. 3. It is an expensive method.

2

Male condom

Female condom

IUCD

Vaginal ring

Gynaecology & Obstetrics

Contraceptives

f4b84482-f856-4ea3-b60f-8a121ff1a49d

single

Which virus given below is not a teratogenic virus ?

Ans. is 'd' i.e., Measles Many viruses can be transmitted to the fetus and cause infection and tissure damage. Five viruses are known to be teratogenic in humans: cytomegalovirus, rubella, herpes simplex, Venezuelan equine encephalitis, and varicella viruses.

4

Rubella

Cytomegalovirus

Herpes simplex

Measles

Microbiology

null

3ab18fa0-d119-46e1-a38d-7888f854b14c

single

Vector for T.cruzi is -

T.cruzi passes its life cycle I two host Definitive host- humans Intermediate host-triatomine bugs Humans become infectious when reduviid bug bites and the infected faecal matter is discharged near bite wound (refer pgno:49 baveja 3 rd edition)

1

Reduvid bug

Tsetse fly

Sand fly

Hard tick

Microbiology

parasitology

dc0cd454-82f0-4b0d-82a2-70190cc41ea1

single

Which of the following is most commonly involved in Hypersensitivity vasculitis:

Answer is C (Post-capillary venules): Post-capillary venules are most commonly involved in Hypersensitivity vasculitis Hypersensitivity vasculitis Hypersensitivity vasculitis refers to small vessel vasculitis that is restricted to the skin and not associated with any other form of primary or secondary vasculitis. Implicit in the definition is that this condition is not associated with medium or large vessel disease at other sites, nor with small vessel disease in other organs (only skin) Microscopic polyangitis affects the skin and also internal organs and hence is not considered pa of hypersensitivity vasculitis The typical histopathological feature of cutaneous vasculitis is the presence of leukocytoclastic vasculitis of small vessels. Vasculitis is charachterized by Leukocytoclasis -- Harrison's Synonyms for Hypersensitivity vasculitis include: cutaneous small vessels vasculitis, leucocytoclastic vasculitis, cutaneous leucocytoclastic angitis etc. 'Post-capillary venules are the most commonly involved vessels. Capillaries and aerioles may be involved less frequently' -- Harrison American College of Rheumatology 1990 Criteria for the Classification of Hypersensitivity Vasculitis Laboratory and Radiographic Work-up of Patients with Possible Hypersensitivity Vasculitis Age at disease onset > 16 years Medication at disease onset Palpable purpura Maculopapular rash Biopsy including aeriole and venule, showing granulocytes in a perivascular or extravascular location For purposes of classification, hypersensitivity vasculitis may be diagnosed if the patient meets at least three of these five criteria.

3

Capillaries

Aerioles

Post-capillary venules

Medium sized aeries

Medicine

null

d08aa898-c9f8-421e-96cc-cd3272a9b5b9

single

Hallmarks of the hemophilia is

(Hemarthroses): Ref: 326-G, 1657-Nelson 17th (321-Ghai 7th)Hemophilia - X-1 inked recessive, The females carries the hemophilia trait but only male offspring suffers from the disease.Clinical features - Bleeding following tooth extraction, severe trauma or following surgery muscle hematoma, and bleeding in joints.* Prolonged bleeding following circumcision may be the first symptoms* Excessive bleeding episodes from umbilical cord may be the presenting features in newborns* As the child learns to walk, there are repeated episodes of hemarthrosis* Bleeding may occur in the any area of the body, the hallmark of hemophilia is the hemarthrosis. The earliest joint hemorrhages appears most commonly in the ankle, because of the lack of stability of this joint as the toddler assumed an upright posture (1657-Nelson 17th)

2

Epistaxis

Hemarthrosis

Abdominal pain

Anaemia

Pediatrics

Blood

8865278a-5360-4e66-b4dc-4d6013826241

multi

For central venous pressure monitoring all are true except

Pulmonary capillary wedge pressure in 4-12 mmHg normally.

3

Internal jugular vein is preferred site

Indicated to administer hyperosmolar drugs

Pulmonary capillary wedge pressure normally is 10-20 mmHg

Swan- ganz catheter entering pulmonary artery shows as dicrotic notch.

Anaesthesia

null

e0b946d9-d756-4716-8c87-c558792dd281

multi

Cranial end of Wolffian duct forms:

Ans: A (Epoophoron) Ref: Grays Anatomy 40th EdExplanation:Embryology of Reproductive SystemGonadMALES (Testis)FEMALES (Ovary)Gubernacular cord Mesonephros (Wolffian body)Gubernaculum testisOvarian and round ligamentsAppendix of epididymis (?)Appendices vesiculosae (?)Efferent ductulesEooophoronLobules of epididymis ParadidymisParoophoronAberrant ductules Mesonephric duct (Wolffian duct)Duct of epididymisDuct of epoopboron (Gartner's duct)Vas deferens Ejaculatory duct Part of the bladder and prcstatic urethraPart erf bladder and urethraParamesonephricDuct (Mullerian)Appendix of testsUterine tube UterusProstatic ulricteVaginaAllantoic ductUrachusUrachusCloaca: Dorsal partRectum and upper part of anal canalRectum and upper part of anal canalVentral partMost of bladderMost of bladder and urethra Part of the prostatic urethra Urogenital sinusProstatic urethra distal to the utricle Bulbo-urethral glandsGreater vestibular glandsRest of urethra to qlansVestibuleGenital foldsVentral penisLabia minoraGenital tuberclePenisClitorisUrethra in clans Genital ridgeTestisOvaryGenital swellingScrotumLabia majora

1

Epoophoron

Paraepoophoron

Gartner cyst

Bartholin cyst

Unknown

null

30f2f606-5278-45a2-9cf9-686ce1585e72

single

A 60-year old male presents with progressive difficulty in swallowing, vomiting and occasional regurgitation for the past 3 months. Barium studied showed marked dilatation of the upper esophagus with narrowing of the lower segment. Manometry showed absent esophageal peristalsis. This patient needs to have -

The most common cause of narrowing of the esophagus, or stricture, is scarring of the esophagus from reflux of stomach acid occurring in patients with heaburn. Patients with a narrowed poion of the esophagus often have trouble swallowing; food feels like it is "stuck" in the chest region, causing discomfo or pain. Less common causes of esophageal narrowing are webs or rings (which are thin layers of excess tissue), cancer of the esophagus, scarring after radiation treatment or a disorder of the way the esophagus moves . Esophageal Dilation. During esophageal dilation (also called pneumatic dilation), an endoscopic tube is inseed through the mouth and into the esophagus. A balloon is expanded inside the esophagus to stretch muscle fibers inside the lower esophageal sphincter (LES). Ref Davidson edition23rd pg 729

1

Ballon dilatation

Endoscopic banding

Sclerotherapy

Proton pump inhibitor

Medicine

G.I.T

a41e53bd-4ce6-4877-85ef-5ab8c27af288

multi

Regarding ranula, all are true except -

A ranula is a mucous retention cyst which arises from sublingual salivary gland and presents as fluctuant swelling with a bluish translucent colour. Types of Ranula Ranula may be of two types : - 1)Simple : - Situated in the floor of mouth without any cervical prolongation. 2)Deep/plunging : - Ranula with a cervical prolongation in submandibular region.

2

Retention cyst

Arises from submandibular gland

Translucent

Plunging may be a feature

ENT

null

b585feb4-9615-481a-bef2-fce2f9d5ea98

multi

Thinnest labial plate is found in the region of:

null

2

Upper central incisors

Lower central incisors

Upper canines

Lower canines

Dental

null

46f20a2a-755e-4562-bda4-cd3fd0c6731c

single

If thiopentone is injected accidently into an aery the first symptom is

D i.e. Pain

4

Analgesia

Paralysis

Skin ulceration

Pain

Anaesthesia

null

86799b51-64da-4c55-a02f-ab32d1504ec0

single

40 years old male patient came with complaint of dry cough and dyspnoea. On lung function tests, restrictive pattern of decreases lung function is seen. Chest x-ray showed few reticular opacities in bilateral lung. HRCT of lung was performed which shows GGO in bilateral lung fields sparing sub-pleural region. Most probable diagnosis is

Interstitial Lung Disease UIP (Usual interstitial pneumonia) NSIP (Non - specific interstitial pneumonia) Reticular opacities Traction bronchiectasis Subpleural honeycombing Subpleural sparing

2

UIP

NSIP

Hypersensitivity pneumonitis

Respiratory bronchiolitis

Radiology

Radiology Q Bank

68c63050-83c0-4669-8c29-9637d4061726

single

Malignant gastric ulcers are characterized by all except

In malignant ulcers mucosal rugae stop far of the ulcers whereas in benign ulcers mucosal rugae projects outwards front the margins of the ulcer

1

ulcer extends beyond the gastric wall.

Mucosal rugae stop far of ulcers

Eccentric crater

Margins are raised

Pathology

null

59faef49-7dda-434f-89be-2d9a2e4138cd

multi

The measure of strength of association between risk factor and outcome is:

It is a measure of the strength of association between risk factor and outcome. The derivation of the Odds ratio is based on three assumptions: a) The disease being investigated must be relatively rare. In fact, the majority of chronic diseases have a low incidence in the general population. b) The cases must be representative of those with the disease. c) The controls must be representative of those without the disease. For example, the odds ratio is estimated at 8.1. This implies that the risk of oral cancer was 8.1 times greater in individuals who chewed tobacco than in those who did not chew tobacco. Soben Peter Essentials of preventive and community dentistry 4th edition

1

Odds ratio

Attributable risk

Relative risk

Poisson's ratio

Dental

null

6105a32b-f642-4b65-bf6c-4847310d065b

single

The following affect enzyme activity except

Regulation of Enzymes Can be classified as: Regulation of Enzyme Quality (Intrinsic Catalytic Efficiency) • Allosteric Regulation • Covalent modification. Covalent modification • Phosphorylation/dephosphorylation • Methylation • Adenylation • ADP ribosylation • Acetylation. Regulation of enzyme quantity Control of Enzyme Synthesis By Induction and Repression Control of Enzyme Degradation Enzymes are degraded by Ubiquitin—Proteasome pathway.

3

Methylation

Acetylation

Induction

Phosphorylation

Biochemistry

null

378ae4f9-5261-4def-9ae3-afe4caa39adf

multi

Aggrecan is:

Aggrecan is a proteoglycan, also known as cailage-specific proteoglycan core protein (CSPCP) or chondroitin sulfate proteoglycan 1. It is encoded by the ACAN gene. Aggrecan is an integral pa of the extracellular matrix (ECM) in cailagenous tissue and it withstands compression in cailage.

4

A receptor over platelets

A molecule present in osteoid tissue

Granules in leukocytes

Impoant component of cailage

Physiology

Concepts in physiology

327a02c7-48b3-476d-99a2-628840d5d751

single

Feature of diabetes mellitus in pregnancy:a) Postdatismb) Hydramniosc) Neonatal hyperglycemiad) ↑congenital defecte) PPH

As explained in the previous question maternal hyperglycaemia leads to fetal hyperglycaemia, which in turn causes polyuria and thus causes polyhydramnios. Polyhydramnios leads to preterm delivery and not post datism. Excessive uterine enlargement because of polyhydramnios and macrosomia causes increased incidence of atonic PPH. Diabetes leads to increased incidence of congenital defects in fetus. Maternal hyperglycemia → to fetal hyperglycemia → hyperinsulinemia → to neonatal hypoglycemia at birth.

1

bde

ade

ace

bce

Gynaecology & Obstetrics

null

3a17848e-5035-41d7-b828-bd717f08c03d

single

Treatment of Mycobacteria avium complex include all except :

null

4

Ciprofloxacin

Clarithromycin

Rifabutin

Pyrazinamide

Pharmacology

null

dcc29e89-1737-4b7d-b358-2ebcbec9307f

multi

Specific antibody associated with primary biliary cirrhosis is:

Ans. C: Anti-mitochondrial Primary biliary cirrhosis is strongly associated with the presence of anti-mitochondrial antibodies (AMA), which are diagnostic PBC: Associated with CREST syndrome, sicca syndrome, auto-immune thyroiditis, type I DM and IgA deficiency IgG AMA is detected in more than 90% of patients with PBC 90% of women are between 35 - 60 years Earliest symptom is pruritis Eventually hepatocellular failure and poal hypeension develops Lab findings: - Increased serum alkaline phosphatase - Increased serum 5-nucleotidase activity - Increased gamma-glutamyl transpeptidase - Serum bilirubin is usually normal - Aminotransferase levels minimally increased - Treatment: Ursodiol

3

Anti-myosin

Anti-nuclear

Anti-mitochondrial

Anti-endomysial

Medicine

null

1ed4e42b-0cd6-4aa0-8429-59a2fe0c5edf

single

Long acting insulin is?

ANSWER: (A) Insulin glargineREF: Pharmacology ReCap 2.0 for Bachelor of Dentistry Students by Dr. J. G. Buch page 304, Harrison s 18m ed chapter 344INSULINS:Highly purifiedmono-componentinsulinPorcine Actrapid- RegularShort actingPorcine Monotard- LenteIntermediate actingPorcine Insulatard- NPH Porcine Mixtard30% regular, 70% IsophaneHuman insulinHuman Actrapid- RegularShort actingHuman Monotard- LenteIntermediate actingHuman Insulatard- NPH Human Mixtard30% regular, 70% IsophaneInsulin analoguesInsulin Lispro Insulin aspart Insulin glulisineUltra short actingInsulin glargineLong acting

1

Insulin glargine

Insulin Lispro

Insulin aspart

Insulin glulisine

Pharmacology

Endocrinology

69c8235c-e810-46f2-8a9f-23d5430f8940

single

Which of the following is not an alkylating agent?

5- Fluorouracil' Repeat from AI1MS 09

3

Cyclophosphamide

Busulfan

5-Fluorouracil

Melphalan

Pharmacology

null

4f2dd91a-9b19-4160-b450-7079c4f378cd

single