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A patient presents with cervical lymphadenopathy. Biopsy demonstrates a nodular lymphoma with follicle formation. This lesion would most likely be associated with which of the following?
Nodular lymphomas of all types are derived from the B-cell line. The translocation t(14, 18), with bcl-2 activation, is associated with these lymphomas. Must know: An abl-bcr hybrid and t(9, 22) translocation are associated with chronic myeloid leukemia (CML). c-myc activation and t(8, 14) are associated with Burkitt's lymphoma. Ref: Robbins Basic Pathology, 8th Ed, page 20-21;198-199
2
bcr-abl hybrid
bcl-2 activation
c-myc activation
t(8, 14)
Pathology
null
0e7a0c23-2b0e-4137-a985-bcd54b43f464
single
Regarding anaplastic carcinoma, which of the following statement is true?
ATC is the most aggressive form of thyroid carcinoma with a disease-specific moality approaching 100%. A typical manifestation is an older patient with dysphagia, cervical tenderness, and a painful, rapidly enlarging neck mass. Patients frequently have a history of prior or coexistent DTC, and up to 50% have a history of goitre. Findings may also include superior vena cava syndrome. The clinical situation deteriorates rapidly into the tracheal obstruction and rapid local invasion of surrounding structures.p53 mutations are found in 15% of tumoursIt is 100% fatal if initially, it is operable thyroidectomy done. Postoperative external-beam irradiation or adjunctive chemotherapy adds little to the overall prognosis but should be consideredRef: Sabiston 20e, page no: 933
2
Common in young
Associated with p53 mutation
Surrounding neck tissue is usually free
Radiotherapy cures
Surgery
Endocrinology and breast
2133621d-fc12-4f00-90d4-66c9c6323c8c
multi
ESI act was made in -
- the ESI act passed in 1948 is an impoant measure of social security and health insurance in the country. - it provides for ceain cash and medical benefits to industrial employees in case of sickness, maternity and employment injury. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no: 815 <\p>
2
1946
1948
1952
1954
Social & Preventive Medicine
Hospital waste and disaster management, Occupational health
4145bc69-f09b-44b0-a586-939f44d620a3
single
Munchausen's syndrome by proxy involves-
Munchausen's syndrome by proxy is a form of child abuse in which a patent, usually the mother, or a caretaker repeatedly fabricates or actually inflicts injury or illness in a child for whom medical intervention is then sought, often in an emergency setting.
3
Drug abuse
Toxin-mediated neuropsychiatric
Illness caused by care giver
All of the above
Psychiatry
null
a76e61bf-90b3-4278-a3b4-88ae80648880
multi
All of the following are features of phaeochromocytoma except :
Answer is D (Wheezing): Wheezing has not been mentioned as a symptom of Pheochromocytoma. The most common symptoms in order of frequency during paroxysm are: - Headache - Palpitation - Vomiting - Sweating - Dyspnea - Weakness - Pallor The most common manifestation is hypeension. e It most commonly occurs in paroxysms i.e. Paroxysmal Hypeension The most common symptom is headache Ohothostatic Hypotension 2 :is seen as a consequence of diminished plasma volume & blunted sympathetic reflexes.
4
Hypeensive paroxysm
Headache
Ohostatic hypotension
Wheezing
Medicine
null
b36c4dfb-3fab-40a1-b341-81ff1c1167a3
multi
MC malignancy in children is:
b. Leukemia(Ref: Nelson 20/e p 2416)Most frequent childhood cancers are: (in order of decreasing frequency)Leukemia (Most common is ALL)Brain TumorsNeuroblastomaWilms tumor
2
Retinoblastoma
Leukemia
Wilms tumor
Neuroblastoma
Pediatrics
C.V.S.
4f0d57d3-1ead-4648-b574-1a52247a4b25
single
In a 10-year-old child the lower canines are trying to erupt in 2mm insufficient space. The primary molars are large and firmly fixed. The 1st premolars are also erupting. The treatment of choice is:
null
4
Remove primary 2nd molars
Place a removable bite-opener
Remove 1st premolars
Mesial stripping of primary 2nd molars
Dental
null
49407639-b13e-4b60-b70e-4f26aa3ceeb1
single
Isthmus of thyroid gland lies at which level -
Ans. is 'd' i.e., C7 Scheme to show the location arsd subdivisions of the thyroid gland including the false capsule
4
C2
C4
C5
C7
Anatomy
Thyroid Gland
5cb29ecf-479a-4d05-a96d-7ab9b09e3e44
single
Which of the following side effects are seen with etomidate-
Etomidate a intravenous anaesthetic agent is Milky white in colour , imidazolone derivative, causes pain on iv injection. Major advantages over other intravenous agents is cardiovascular stability thus use cardiac compromised patients Routinely not in clinical use since it is adrenal suppressant. Other side effects myoclonus and increased nausea and vomiting.
2
Myoclonus, Adrenal suppression, Haemodynomic imbalance(HI)
Myoclonus, adrenal suppression, pain on IV injection
Pain on IV injection, Adrenal suppression, HI
Pain on IV injection, HI ,Myoclonus.
Anaesthesia
Intravenous Anesthetic Agents
12019185-33e2-4f7d-a34a-840a28c49628
single
Which of the following nerves lies closest to the Wharton' s duct -
null
2
Hypoglossal
Lingual
Chorda tympani
Facial
Surgery
null
3aeea2d0-4027-46a6-8e90-0c3da0d3b67a
single
Which carrier pump is transpoing solutes in thick ascending limb of Henle loop?
Carrier pump Na-K-2Cl transpoer. REABSORPTION IN THICK ASCENDING LIMB: Sodium, Potassium & Chloride reabsorption: By "Secondary active transpo" - Through Na2+-K+-2Cl-- carrier transpoer. Transpos one Na2+, one K+, & two Cl-. Active sodium absorption occurs. 30% filtered Na2+ reabsorbed. Ref: Guyton 12th Ed.
1
Carrier pump Na-K-2Cl transpoer.
NaCl- cotranspoer
Na2+-H+ exchanger
Na2+-K+ exchanger
Physiology
All India exam
46477482-c4d2-4f7f-84a5-951bdb858606
single
Function of incretin is -
Ans. is 'b' i.e., Increased insulin secretion o Incretins are GI hormones which are secreted by enteroendocrine cells in response to meals.o The most important action of incretins is to stimulate insulin secretion after a meal.o Two important GI incretins are.i) Glucagon-like peptide 1 (GLP-1).ii) Glucose-dependent insulinotropic polypeptide (GIP).o GLP-1 is more insulinotropic hormone.
2
Increased heart rate
Increased insulin secretion
Increased respiratory rate
Stimulate erythropoiesis
Physiology
Pancreas
29d06fef-7501-4acc-97fb-319d93785589
single
Cribriform, Honey comb (or) swiss cheese histology pattern is seen in
null
1
Adenoid cystic carcinoma
Pleomorphic adenoma
Acinic cell carcinoma
Clear cell carcinoma
Pathology
null
c2b16fd2-fc07-4a6f-9efc-07386c851f78
single
Which of the following malignancy is associated with underlying progression and spreads characteristically in a stepwise fashion and hence staging the disease is an impoant prognostic factor? -
Hodgkin&;s disease primary arises within the lymph nodes and involves the extranodal sites secondarily Based on the extent of involvement of the disease ,Staging is studied in order to select proper treatment and assess the prognosis. Reference textbook of Pathology 6th edition author: Harsha Mohan page number 369-373
1
Hodgkin's lymphoma
Multiple myeloma
Mature T cell NHL
Mature B cell NHL
Pathology
Haematology
85ade234-0532-415b-8520-0a21a377d771
multi
A patient presented with defective adduction of the hip joint with pain in the knee and hip joint, the nerve involved is?
Obturator nerve is the largest nerve formed from the anterior divisions of lumbar plexus (L2,L3,L4).The roots unite within the posterior pa of psoas, and then descends through psoas and runs downward over sacral ala into lesser pelvis, lying lateral to ureter and internal iliac vessels. They enter the upper pa of the obturator foramen and then subsequently divides into anterior and posterior branches. Anterior Division:Muscular branches: To the following muscles;GracilisAdductor brevisAdductor longusPectineus (variable)Aicular branches: To hip jointSensory branches: To medial aspect of thigh Posterior Division:Muscular branches: To the following muscles;Obturator externusAdductor pa of adductor magnusAdductor brevis (variable)Aicular branch: To knee joint Must know:Adductor magnus has double nerve supply. Its adductor pa is supplied by the obturator nerve, while its hamstring pa is supplied by the tibial pa of the sciatic nerve. The pectineus also has a double innervation; its anterior fibres are supplied by the femoral nerve and the posterior fibres by the obturator nerve.
1
Obturator nerve
Tibial nerve
Femoral nerve
Saphenous nerve
Anatomy
null
0744f560-f170-40b8-a9fb-4931ed0f1371
single
In paogram, first time of the initial markings are made in:
Paograph In paogram, first time of the initial markings are marked on the ale line. The subsequent plotting is done from this point. Till the graph stays on the left if the ale line, the progress can be considered satisfactory. If the graph moves towards the right of the ale line, caution is required and when the graph crosses to the right of action line, it warrants intervention. NOTE: There are new recommendations regarding the dilatation at which sta of active labour should be plotted on the paograph, which is now said to be 6 cm. However due to lack of consensus, it is still in consideration and till any confirmed guideline on this is available to us we shall go by the old norm of 4 cm. till
3
Left side of the action line
On the action line
On the ale line
Right side of the ale line
Gynaecology & Obstetrics
Obstetrics
f3284c27-b880-49a7-8e57-b9867e7e64be
single
Corpulence index is a measure of:
Corpulence index= actual weight/ desirable weight A value above 1.2 indicates obesity Ref: Park 21st edition, page 178.
3
Copper level in the serum
Iron loss in faeces
Obesity
Income inequality
Social & Preventive Medicine
null
63350a10-8aa9-42c8-a742-5366dce5eaa9
single
The type of enzyme inhibition in which succinate dehydrogenase reaction is inhibited by malonate is an example of:
Inhibition of the enzyme succinate dehydrogenase by malonate illustrates competitive inhibition by a substrate analog. Succinate dehydrogenase catalyzes the removal of one hydrogen atom from each of the two-methylene carbons of succinate. Both succinate and its structural analog malonate can bind to the active site of succinate dehydrogenase. However, since malonate contains only one methylene carbon, it cannot undergo dehydrogenation. Ref: Kennelly P.J., Rodwell V.W. (2011). Chapter 8. Enzymes: Kinetics. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e.
3
Noncompetitive
Uncompetitive
Competitive
Allosteric
Biochemistry
null
d32b71db-d463-4c6c-9bc0-4ed5744ee0a5
multi
Which of the following drugs does not cross placenta ?
null
1
Heparin
Warfarin
Dicoumarol
Nicoumalone
Pharmacology
null
9c66db2c-dde1-405c-8647-23466a0018a6
single
Which of the following drug will cause hemolysis in G6PD patients:
Ref: KDT 6th ed. pg. 64 * G6PD is an enzyme present on RBC membrane provides strength to RBC which can counteract free radicals and oxidizing stress of drugs.* In absence of G6PD enzyme, these cells cant bear the stress and results in Hemolysis.* Drugs causing Hemolysis in G6PD deficiency patients are:# Anti malarials (Primaquine, chloroquine)# Antibiotic (Nitrofurantoin)# Anti emetic (Furazolidone)# Sulfonamide (dapsone)# Fava beans* Ciprofloxacin is one of the quinolones, effective against G+ and G- including pseudomonas.* It is contraindicated in pregnancy and children below 18 years of age because it effects growing bone and tendons.* Ciprofloxacin is considered as oral DOC for enteric fever.* DOC for enteric fever: Ceftriaxone
3
Cephalosporins
Ampicillin
Chloroquine
Erythromycin
Pharmacology
Hematology
a07e013c-6183-4ba5-ab13-a88afb035e73
single
Target sign on USG is seen in
Target sign - hypoechoic ring and hypertrophied pyloric muscle around echogenic mucosa Centrally on transverse Scan - Seen in CHPS.
1
Congenital hypertrophic pyloric Stenosis
Gastric ulcers
Achalasia
All the above
Radiology
null
19839ee4-e08d-4af4-a067-7f25e22537f6
multi
Patient is able to recognize voice but not face
Memory and language problems after temporal lobectomy. Temporary double vision after temporal lobectomy. Increased number of seizures after corpus callosotomy, but the seizures should be less severe. Reduced visual field after a hemispherectomy. Ref: guyton and hall textbook of medical physiology 12 edition page number:835,836,837
1
Temporal lobe
Occipital
Frontal lobe
Parietal lobe
Physiology
Nervous system
4db5c0a7-5cdf-429c-9683-1afb70f3e99b
single
Tiger eye sign on MRI is seen in -
Ans. is 'a' i.e., Halloverden spatz diseaseo Tiger eye is an abnormal T2 signal in the globus pallidus seen in Pantothenate kinase-2 (PANK-2) mutation of Holloverden spat disease.
1
Halloverden spatz disease
CHPS
Achalasia Cardia
null
Radiology
Brain Imaging: Inflammatory, Infectious, and Vascular Diseases
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multi
Pyogenic infection and brain infarction associated with -
Ans. is 'b' i.e., Liquefactive necrosis
2
Coagulative necrosis
Liquefaction necrosis
Caseous necrosis
Fat necrosis
Pathology
null
173726a0-3629-40e2-8d51-70abfebd4466
single
In gingival bleeding index given by Ainamo and Bay, positive score is taken at what time after appearance of bleeding on probing?
null
1
10 Sec.
20 Sec.
30 Sec.
40 Sec
Dental
null
35a640bb-f370-47ab-8d41-be236bb9f5a7
single
20 yr old boy is brough to the emergency following an A with respiratory distress and hypotension He has subcutaneous emphysema and no air entry on the right side What is the next best step in the management
Hlistory of clinical examination is suggestive of tension pneumothorax according to trauma updates needle decompression in adults should be done in 5th Ics at mid axillary line * in children needle in 2nd ICS at MCL ref : baile and love 27th ed
2
sta IV fluids after inseion of wide bore iv line
Needle decompression in the 5th Ics
Shift to Icu and intubate
Positive pressure ventilation
Surgery
All India exam
a6c73a3e-97d1-4e2d-a7f0-654966afc99d
multi
A 25-year-old man presents to the outpatient clinic complaining of feeling sleepy all the time, even during the daytime. The symptoms have persisted for years and are now brought to medical attention after falling asleep at work on multiple occasions. He is concerned that he might lose his job. He has no past medical history and is not taking any sedative medications. On physical examination, he is slender and the heart and lung exams are normal. Neurologic assessment reveals normal orientation, memory, concentration, and no focal deficits. Which of the following symptoms might he also complain about?
The early age of onset and otherwise good health suggest a diagnosis of narcolepsy, which is usually accompanied by other symptomatology. Hypnagogic hallucinations are almost always visual. They occur most frequently at the onset of sleep, either during the day or at night. They are generally very vivid. Cataplexy is a brief loss of muscle power without loss of consciousness. The patient is fully aware of what is going on. The paralysis may be complete or partial. Automatic behavior with amnesia is a common manifestation of the narcolepsy cataplexy syndromes, occurring in 50% of cases. Automatic behavior can be confused with complex partial seizures. Paresthesia are not part of narcolepsy syndrome. Snoring, restless sleep, and morning headache suggest sleep apnea.
2
excessive snoring (wife's report)
automatic behavior (wife's report)
restless sleep (wife's report)
paresthesia
Medicine
C.N.S.
69495835-836b-4fd7-ad1b-f7ababe71493
multi
Analgesic used for pain associated with STEMI
Morphine is a very effective analgesic for the pain associated with STEMI.However, it may reduce sympathetically mediated aeriolar and venous constriction, and the resulting venous pooling may reduce cardiac output and aerial pressure. These hemodynamic disturbances usually respond promptly to elevation of the legs, but in some patients, volume expansion with intravenous saline is required. These side effects usually respond to atropine (0.5 mg intravenously). Morphine is routinely administered by repetitive (every 5 min) intravenous injection of small doses (2-4 mg), rather than by the subcutaneous administration of a larger quantity, because absorption may be unpredictable by the latter route.Ref: Harrison 19e pg: 1603
1
Morphine
Diclofenac
Paracetamol
Dicyclomine
Medicine
C.V.S
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single
Otitis and osteomyelitis is seen in?
Ans. (b) BCGRef : OP Ghai 8th ed./191BCG* Although BCG vaccination often causes local reactions, serious or long-term complications are rare. Reactions that can be expected after vaccination include moderate axillary or cervical lymphadenopathy and induration and subsequent pustule formation at the injection site; these reactions can persist for as long as 3 months after vaccination.* Most serious complication of BCG vaccination is disseminated BCG infection.* The most frequent disseminated infection is BCG osteomyelitis
2
Hepatitis B vaccine
BCG
Measles vaccine
IPV
Pediatrics
Immunization
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single
Reversible cause of dementia -a) Hypothyroidismb) Alzheimer's diseasec) Vitamin B12 deficiencyd) Vitamin A deficiency
null
1
ac
bc
ad
b
Psychiatry
null
362e31d4-f386-4b53-8193-c70246dddd86
single
In Bater's Syndrome, which of the following is not seen-
Bater's syndrome - There is loss of transpo function of Thick ascending loop of henle(TALH) Segment of nephron which results in hypokalemic metabolic alkalosis classic BS- typically suffer from polyuria and polydypsia due to reduction in renal concentrating ability . Increase in urinary calcium excretion 20% are hypomagnesemic. Marked activation of RAAS. Antenatal BS- They suffer from severe systemic disorder characterized by marked electrolyte wasting, polyhydramnios ,hypercalciuria with nephrocalcinosis . Ref:Harrison 20 th edition pg no 306.
4
Metabolic Alkalosis
Hypokalemia
Hypomagnesemia
Decrease in urinary calcium
Medicine
Kidney
2c547be7-5c76-4a7a-8772-e73cb206fa8c
single
Which of the following steroids is not used topically:
Prednisonlone
4
Hydrocoisone
Fluticasone
Triamcinolone
Prednisonlone
Pharmacology
null
282ae6e6-3a5d-4742-84e3-10f110f0409c
multi
The procedure shown below is
This is LLETZ: Diathermy wire loop is used to remove a portion of Cervix that includes transformation zone with area of CIN.
3
Radical trachelectomy
Partial hysterectomy
Large loop excision of transformation zone
Dilatation and curettage
Gynaecology & Obstetrics
null
fdc80bf1-2905-446b-afc2-af0d0f7aaac2
single
Hemorrhagic conjunctivitis occurs with
C i.e. Enterovirus Acute Haemorrhagic Conjunctivitis or Apollo Conjunctivitis or Jai Bangla Conjunctivitis or Epidemic haemorrhagic conjunctivitis is caused by picorna virus family (usually enterovirus 70)Q. But occasionally Coxsackie virus A-24 or adenovirus //Q also leads to this.
3
Herpes zoster
Herpes simplex
Enterovirus
All
Ophthalmology
null
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multi
MDR tuberculosis is defined when M. tuberculosis shows resistance to -
Ans. is 'a' i.e., Isoniazid + Rifampicin * Multidrug-resistant TB (MDR-TB) are by definition infected with strains of Mycobacterium tuberculosis resistant to isoniazid and rifampin.* Extremely drug resistant TB (XDR-TB) due to MDR strains that are resistant to all fluoroquinolones and to at least one of three second-line injectable agents (amikacin, kanamycin, and capreomycin).* Following are definitions of drug resistant tuberculosis :Definitions of drug-resistant tuberculosis51* Drug-resistant tuberculosis: tuberculosis caused by an isolate of mycobacterium tuberculosis that is resistant to least 1 of the first-line antituberculosis drugs: isoniazid, rifampin, ethambutol, pyrazinamide, or streptomycin* Monoresistance: resistance to 1 antituberculosis medication.* Multidrug-resistant tuberculosis: tuberculosis caused by an isolate of M tuberculosis that is resistant to the 2 most effective first-line drugs-isoniazid and rifampin-and possibly other antituberculosis drugs.* Extensively drug- resistant tuberculosis: multidrug-resistant tuberculosis that is also resistant to the most effective second-line drugs, fluoro-quinolones, and at least 1 of the 3 injectable second-line drugs used to treat tuberculosis (amikacin, kanamycin, or capreomycin) and, possibly, to other antituberculosis drugs.
1
Isoniazid + Rifampicin
Isoniazid + Pyrazinamide
Rifampicin + Pyrazinamide
Rifampicin + Ethambutol
Medicine
Infection
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single
Frost bite is treated by -
Ans. is 'b' i.e., Slow rewarming
2
Rapid rewarming
Slow rewarming
IV pentoxyphiline
Amputation
Surgery
null
4a01fb41-5522-4fee-95a3-a46c18133625
single
Triad of biotin deficiency is
(Dermatitis, glossitis, Alopecia) (407-H) (314-Basic pathology 8th)(Biotin deficiency) - clinical features -Adult = Mental changes (depression, hallucination), paresthesia, anorexia, nausea, A scaling, seborrheic and erythematous rash may occur around the eye, nose, mouth, as well as extremities (407-H)Infant = hypotonia, lethargy, apathy, alopecia and a characteristic rash that includes the ears.Symptoms of biotin deficiency includes - Anaemia, loss of apepite dermatitis, glossitis (150- U. Satyanarayan) Symptoms of biotin deficiency - Dermatitis "spectacle eyed" appearance due to circumocular alopecia, pallor of skin & membrane, depression, Lassitude, somnolence, anemia and hypercholesterolaemia - (173-Rana Shinde 6th)
2
Dermatitis, glossitis, Steatorrhea
Dermatitis, glossitis, Alopecia (314-Basic 8th)
Mental changes, diarrhoea, Alopecia
Dermatitis, dementia, diarrhoea
Pathology
Environment & Nutritional Pathology
96aecd5f-d167-481f-9b42-b884051f969d
single
True of the following:
Ans. (c) Parathormone (PTH) promotes absorption of Ca++ from intestine(Ref: Ganong, 25th ed/p.379)Parathormone (PTH) promotes absorption of Ca++ from intestineThis is an indirect action of PTH by increasing vitamin D levels
3
Calcium reabsorbed in DCT
90% calcium excreted by glomerulus
Parathormone (PTH) promotes absorption of Ca++ from intestine
PTH promote action of calcitonin
Physiology
Endocrinology and Reproduction
9d91a11e-5a94-4e47-9456-2f420212fcfc
multi
Rabies vaccine schedule is:
8, 0, 4, 0, 1, 1
2
0,3,7,14,28
8,0,4,0,1,1
8,0,0,4,1,1
8,0,4,0,0,1
Social & Preventive Medicine
null
540abb01-b894-46b6-be4f-e508ae5da26f
single
Enzymes not used in glycogen metabolism
The liver phosphorylase-b is the inactive form. It becomes active on phosphorylation. The active form is phosphorylase-a.Glycogen synthase exists in two distinct forms that can be interconveed by the action of specific enzymes; active dephosphorylated glycogen synthase(glucose-6-p-independent) and less active, phosphorylated glycogen synthase D(glucose-6-p-dependent.Ref: DM Vasudevan, page no: 127
3
Glycogen phosphorylase B
Glycogen synthase I
Glycogen synthase C
Glycogen synthase D
Biochemistry
Metabolism of carbohydrate
65f0ae92-f497-4d74-aa29-7ebba65bf209
single
A community suffering from dry mouth condition is likely to have
null
1
Increased incidence of dental caries
Decreased incidence of dental caries
Increased incidence of crack tooth syndrome
Decreased incidence of crack tooth syndrome
Dental
null
ade865ca-91ac-4738-9529-081697898bb6
single
Urinary catheterisation indicated in case of acute retention of urine in following conditions
The most frequent causes of acute retention Male * Bladder outlet obstruction (the most common cause) * Urethral stricture * Acute urethritis or prostatitis * Phimosis Female * Retroveed gravid uterus * Bladder neck obstruction (rare) Both (Male and female) * Blood clot * Urethral calculus * Rupture of the urethra * Neurogenic (injury or disease of the spinal cord) * Smooth muscle cell dysfunction associated with ageing * Faecal impaction * Anal pain (haemorrhoidectomy) * Intensive postoperative analgesic treatment * Some drugs * Spinal anaesthesia Ref: Bailey and love 27th edition Pgno : 1426
3
Stricture
Rupture
Postoperative
Carcinoma prostate
Surgery
Urology
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single
17 years old girl with ovarian tumor, USG showed predominant solid component, CA-125-ve, AFP- ve, ALP raised -
Ans. is 'a' i.e., DysgerminomaOvarian mass in 25 year old female suggests the diagnosis.Although dysgerminomas are relatively uncommon among all ovarian neoplasms (only accounting for only about 2%) they account for about 32.8% of malignant ovarian germ cell neoplasms.Majority of cases arise in adolescent and young adults in whom they account for one third of all ovarian neoplasm.The growth of dysgerminomas is usually rapid as a result patients often presents with abdominal enlargement and pain due to rupture with hemoperitoneum or torsion.Tumour markers associated with dysgerminoma.Dysgerminomas can contain syncytiotrophoblastic giant cells that produce placental alkaline phosphatase and lactate dehydrogenase.Alpha fetoproteinIn general dysgerminomas do not produce alpha fetoprotein (AFP) although borderline elevation are described. hCGhCG is associated with only 3.5% of dysgerminomas.Endodermal sinus (Yolk sac Tumour)Endodermal sinus tumour also called yolk sac tumour makes upi4-20% of all malignant ovarian germ cell neoplasms.These neoplasms usually occur in young girl and women.The median age of presentation is 23 years and one third of patients are premenarchal.Histologically they are associated with schiller duval bodies.Patients with endodermal sinus tumour often presents with abdominal pain and pelvic mass, similar to dysgerminomas - Turnover growth can be very rapid and aggressive.Serum AFP levels are elevated in a significant number of patients.Malignant teratomaImmature teratoma are also called malignant teratomas.They comprise less than l% of ovarian teratomas and are most common in first two decades of life.These neoplasms are typically composed of tissue from three germ layers i.e., ectoderm, mesoderm, endoderm arranged in haphazard manner.The clinical presentation is similar to that of other ovarian germ cell neoplasms (incidentally discovered adrenal mass abdominal enlargement of pain).AFP or LDH are elevated in some cases.Serous mucinous cystadenomaSerous and mucinous cystadenomas are among the most common benign ovarian neoplasm.Cystadenomas will not present as solid mass on ultrasound. It would be a cystic mass.They are thin walled, uni-or multiocular and range in size from 5 to over 20 cm.Ovarian epithelial tumours usually present with elevation in CA-125.Markers secreted by germ cell and sex cord-stromal tumors of the ovary AFPhCGLDHE2InhibinTestostAndroDHEAGerm cell tumors Dysgerminoma-+-++-----Embryonal+-++-+-----Immature teratoma+--+-+----+-Choriocarcinoma-++------Endodermal sinus+-+--- -Gonadoblastoma---+-+-+-+-+-Polyembryoma+-+------Mixed germ cell+-+-+------Sex cord-stromal tumors Thecoma-fibroma--------Granulosa cell---+-++- -Sertoli-Leydig+---+-+-+-+-+-AFP: alpha-fetoprotein hCG: human chorionic gonadotrophinLDH: lactate dehydrogenaseE2: estradiolTestost: testosteroneAndro: androstenedioneDHEA: dihydroepiandrostenedione
1
Dysgerminoma
Endodermal sinus tumor
Malignant teratoma
Mucinous cystadenoma
Gynaecology & Obstetrics
Ovary
65fa4e00-4b90-4d7c-83d9-43261e62c761
single
A 23-year-old woman who receives a deep cut to her ring finger by a kitchen knife is unable to move the metacarpophalangeal joint. Which of the following pairs of nerves was damaged?
Metacarpophalangeal joint of the ring finger is flexed by the lumbrical, palmar, and dorsal interosseous muscles, which are innervated by the ulnar nerve. Extensor digitorum, innervated by the radial nerve, extends this joint. Musculocutaneous and axillary nerves do not supply muscles of the hand. Median nerve supplies the lateral two lumbricals, which can flex metacarpophalangeal joints of the index and middle fingers.
4
Median and ulnar
Radial and median
Musculocutaneous and ulnar
Ulnar and radial
Anatomy
Nerve supply, Nerve Lesions
f7c281c5-13ba-4c7a-a2f6-bd0d959f1637
single
A child was given Ringer's lactate due to severe blood loss by a road accident. What is the potassium content of Ringers' lactate in mEq/L?
Composition in 1 Litre of Ringer's lactate: Sodium 130 mEq/L Potassium 4 mEq/L Calcium 3.5 mEq/L Chloride 110 mEq/L Lactate 27 mEq/L Ref: Oski's Pediatrics: Principles And Practice By Julia A. McMillan, Ralph David Feigin, 4th edition, Page 64.
3
1
2
4
6
Pediatrics
null
45d3545d-603a-4883-827c-cde9b36a4615
single
The left suprarenal vein drains into:
Ans: b (Lt. renal vein)Venous drainage of the suprarenals:Left suprarenal vein drains into the Lt. renal veinRt. suprarenal vein drains into the inferior vena cavaArterial supply.Each gland is supplied by:1) Superior suprarenal artery- Br. of inferior phrenic artery2) Middle suprarenal artery- Br. of abdominal aorta3) Inferior suprarenal artery- Br, of renal artery
2
Inferior vena cava
Lt. renal vein
Rt. renal vein
Portal vein
Anatomy
Blood Vessels of Abdomen and Pelvis
19c4c3a4-027b-412f-acd7-67d21a702b07
single
Organophosphate insecticides are all except – a) Dieldrinb) Fenthion c) Diazinond) Propoxure) Lindane
Organo-phosphorus Insecticides: – Malathion – Parathion – Fenthion – Diazinon – Fenitrothion – Chlorpyrifos – Dioxathion – Chlorthion Organo-chlorine Insecticides: – DDT – BHC (HCH) – Lindane – Dieldrin Carbamate Insecticides: – Carbaryl – Propoxur
3
acd
bde
ade
ad
Social & Preventive Medicine
null
f7cb9aa2-9199-4a88-bc15-b15f4ff81783
multi
Among the drugs given below, which is LEAST likely to be implicated in drug induced hepatitis?
null
2
Isoniazid
Streptomycin
Rifampicin
Pyrazinamide
Pharmacology
null
392b8b4f-22b8-4e6c-8817-f4837d044028
single
Ferning ol cervical mucu3 depends on :
Eslrogen
1
Eslrogen
Progesterone
LH
FSH
Gynaecology & Obstetrics
null
0cc12a07-286f-495f-8275-76ea2700d318
single
Which of the following can be given as a single dose antimalarial for P.vivax malaria
null
4
Atovaquone + Proguanil
Artemisinin
Quinine + Tetracycline
Pyrimethamine + Sulfadoxime
Pharmacology
null
6661727e-96ff-4b42-af9f-239946e02966
single
Hippocampal formation includes all Except
The hippocampal formation in the medial temporal lobe of the brain includes the dentate gyrus, the hippocampus proper and the subiculum
3
Dentate gyrus
Sibiculum
Amygdaloid
Entorhinal coex
Medicine
C.N.S
78f4c2f3-24bf-44e5-a2bb-fc48579cd092
multi
Reactive arthritis is usually caused by -
Ans. is 'a' i.e.. Shigella Flexneri o Organisms that have been associated with Reiter Arthritis include the follow ing:C trachomatis (L2b serotype)Ureaplasma urealyticumNeisseria gonorrhoeaeShigella flexneriSalmonella enterica serovars TyphimuriumMycoplasma pneumoniaeMycobacterium tuberculosisYersinia enterocolitica and pseudotuberculosisCampylobacter jejuniClostridium difficileBeta-hemolytic (example, group A) and viridans streptococci
1
Shigella flexneri
Shigella boydii
Shigela shiga
Shigela dysentriae
Medicine
Bacteriology
086f3a1d-a3bf-4ba1-a7f6-83f335509950
multi
Most common congenital tumour of conjunctiva is
Commonest congenital tumour of the conjunctiva - Epibulbar dermoid
3
Papilloma
Squamous cell carcinoma
Epibulbar dermoid
Melanoma
Ophthalmology
null
19ffc703-91e8-4d6e-a401-53dd62c1f112
single
All are true about spinal tuberculosis except ?
Ans. is 'c' i.e., Exaggerated lumbar lordosis Tuberculosis of spine (Pott's spine) The spine is the commonest site of bone and joint tuberculosis. The most common site is Dorsolumbar region. Lower dorsal (thoracic) region is the most common segment involved followed by lumbar segment. The tuberculosis of spine is also called pott's disease or tubercular spondylytis. Spinal tuberculosis is always secondary, the primary foci being either in the lungs, lymph nodes or gastrointestinal tract. Clinical features of TB of spine The disease is commonest in young adults. The presenting complains are : - Back pain : Commonest and earliest symptom. Initially pain occurs on sudden movement of spine. Stiffness of back : Is also an early symptom and occur along with pain. Visible deformity Gibbus or Kyphosis Localized swelling : Due to cold abscess Paraplagia : In neglected cases Constitutional symptoms : Evening fever, loss of appetite, night sweat, loss of weight. on examination, following findings may be seen : ? Decreased range of motion. Local tenderness : Over the spinous process of affected veebra. Deformity : - Cervical spine : - Straight neck with loss of cervical lordosis. Thoracic : - Gibbus/kyphosis Lumbar : - Loss of lumbar lordosis iv) Para-veebral swelling : - Cold abscess
3
Back pain earliest symptom
Dorsolumbar spine commonest site
Exaggerated lumbar lordosis
Secondary to lung infection
Surgery
null
b3b67b3b-c146-4a08-a6e5-4e8db5ae05b4
multi
Maximum oral bioavailability among statins is of which drug -
Ans. is 'a' i.e., Fluvastatino All statins can be absorbed orally (maximum fluvastatin). Food increases absorption of all drugs except pravastatin. Lovastatin and simvastatin undergo extensive first pass metabolism and are administered as prodrugs.Remembero Statins are the most effective and best tolerated hypolipidemic drugs,o All Statins, except rosuvastatin and pravastatin are metabolized.o Food increases absorption of all statins except pravastatin.o Lovastatin and simvastatin are prodrugs, while pravastatin, fluvastatin, ator\>astatin and rosuvastatin are administered in active form.o Rosuvastatin is the longest acting and most potent statin,o Rosuvastatin causes greater rise in HDL - cholesterol than other statins,o Pravastatin decreases plasma fibrinogen level,o Atorvastatin has additional antioxidant property.o Because HMG-CoA reductase activity is maximum at midnight, all statins are administered at bed time to obtain maximum effectiveness. However, this is not necessary? for atorvastatin and rosuvastatin, which have long plasma t 1/2 .o Statins also have pleotropic effects (antioxidant, antiinflammatory and antiproliferative properties) which are responsible for lowering the risk of athrosclerosis.o Statins are the first choice drugs for primary hyperlipidemias with raised LDL and total CH (Type IIa, lIb, V) as well as for secondary hypercholesterolaemia.
1
Fluvastatin
Atorvastatin
Pravastatin
Simvastatin
Pharmacology
Hypolipidemic
77dd4439-041f-469b-9561-36b182b31a03
single
A 22 year old boy was all alright 2 days back. But since then he claims that people are abusing him and he c/o hearing of voices when no one is around, aggressive behavior since 2 days. He has fever since only 2 days. No past history. Which is the most likely diagnosis?
Ans. B. Acute Psychosis* Hearing of voices, Aggressive Behaviors, muttering to self is a sign of psychosis as it less than 1 month it is Acute Psychosis.* It is not fever induced or Delirium because in these conditions the orientation is usually impaired but is not impaired in this question.* In delusional disorder - there is a single non - Bizarre (physically impossible, logically - impossible) and other than that everything is usually normal. In this condition there is hearing of voices, Aggressive and muttering to self, which usually is not there in Delusional disorder.
2
Dementia
Acute psychosis
Delirium
Delusion
Psychiatry
Miscellaneous
de6e23eb-8209-474b-8159-a56fe9f24069
multi
Breast fed babies as compared to aificially fed babies have all the follwing benefits except -
Ans. is None
4
Lower incidence of diarrhoea episodes
Lower incidence of respiratory infection
Lower incidence of late onset tetany
null
Pediatrics
null
e5fb985e-d115-4d06-8936-eb8b61599c7d
multi
Withdrawal of which of the following causes piloerecton?
Ans. A. MorphineManifestations of morphine withdrawalLacrimationAnxiety & fearSweatingRestlessness rYawningGooseflash (Piloerection).
1
Morphine
Cannabis
Smoking
Alcohol
Psychiatry
null
c7f07a0d-fb59-4cf3-b859-552f020ce5d4
single
Commonest site for fibroid is :
Intramural
2
Submucous
Intramural
Subserous
Cervical
Gynaecology & Obstetrics
null
bf4baa4b-ba58-444a-ba64-dd342aae17d2
single
Semi-circular canals are associated with
Each semicircular canals has an enlargement at one of its ends called the ampulla, and the ducts and ampulla are filled with a fluid called endolymph. Flow of the fluid through one of the ducts and through its ampulla excites the sensory organs of the ampulla. In each ampulla a small crest called crista ampullaris is present. On top of crista is cupula. Into the cupula are projected hundreds of cilia from hair cells where bending of cupula in one direction causes repolarization of the hair cells, whereas bending it in the opposite direction hyperpolarises the hair cells. Then from the hair cells, appropriate signals are sent by way from the vestibular nerve to apprise the central nervous system of a change in rotation of head and rate of change in each of the three planes of space. REF: TEXTBOOK OF MEDICAL PHYSIOLOGY GUYTON AND HALL, 12e Page no 790, 791.
2
Linear acceleration
Angular acceleration
Static equlibirium
Hearing
Physiology
Nervous system
a2c1e82b-6615-42b5-8c9a-da5c952a5f3e
single
Abnormalities in synthetic function of liver results in: (PGI Dec 2006)
Ans: A (|PT); B {Hyperbilirubinemia} & C (| Acute phase reactants) 411]Liver Function Test - Harrison 17th/ 1918"The most commonly used liver ''function" testsQ are measurements of serum bilirubin, albumin, and prothrombin timeQ. The serum bilirubin level is a measure of hepatic conjugation and excretion, and the serum albumin level and prothrombin time are measures of protein synthesis. Abnormalities of bilirubin, albumin, and prothrombin time are typical of hepatic dysfunctionQ"The aminotransferases (transaminases) are sensitive indicators of liver cell injury and are most helpful in recognizing acute hepatocellular diseases such as hepatitis. They include the aspartate aminotransferase (AST) and the alanine aminotransferase (ALT)-.Serum prothrombin time, collectively measures factors II, V, VII, and XQKupffer cells usually lie within the sinusoidal vascular space and represent the largest group of fixed macrophages'3 in the bodLiver abnormalities are diagnosed by assessing prothrombin time (PT *), direct & total serum bilirubin (hyperbilirubinemia), albumin, and levels of acute phase reactants (serum alanine & aspartate aminotransferase = ALT & AST)(r)Principal Function of Liver Ganona 22nd / 501Formation and secretion of bileQNutrient and vitamin metabolismQGlucose and other sugarsQAmino acidsLipids: Fatty acids, cholesterol, LipoproteinsFat soluble vitaminsWater soluble vitaminsInactivitation of various substancesToxinsQSteroidsOther hormonsesSynthesis of plasma proteins:Acute phase reactantsQAlbuminQClotting factors (e.g. II, VII, IX, X)QImmunity : Kupffer cells(r)
1
|PT
Hyperbilirubinemia
|Acute phase reactant
Disturbance in Kupffer cells
Physiology
Liver and Gall Bladder
195d05d4-c95f-42af-952c-8336ec85fc1f
single
Active method of transport is-
Ans. is 'd' i.e., Against concentration gradient* Transport across a cell membrane is divided into passive or active, based on whether it is along the concentration gradient or against the concentration gradient.1) Passive transport# It is in the direction of concentration gradient i.e., "Downhill movement"# Does not require energy expenditure# Example are : -i) Without carriers : - Simple diffusion, osmosisii) Through carrier: - Facilitated diffusion2) Active transport# It is against the direction of concentration gradient, i.e., "Uphill movement".# Energy (e.g., ATP) is required# Carrier protein is required# Examples are primary active transport and secondary active transport.
4
Simple diffusion
Facilitated diffusion
Along concentration gradient
Against concentration gradient
Physiology
General
93d4dd2f-3598-4c55-9d21-0cd40429e833
single
Chaperones are:
CHAPERONES-FOLDING /SHAPE /ASSEMBLY OF PROTEIN POST-TRANSITIONAL CHANGE They facilitate and our the interactions on the polypeptide surfaces to finally give the specific conformation of a protein. Type 1. Hsp70 system- This mainly consists of Hsp70 (70-kDa heat shock protein) and Hsp40 (40-kDa Hsp). These proteins can bind individually to the substrate (protein) and help in the correct formation of protein folding 2. Chaperonin system: This is a large oligomeric assembly which forms a structure into which the folded proteins are inseed. The chaperonin system mainly has Hsp60 and Hspl0.
3
Purine metabolism mediators
Antigen presenting cells
Mediators of post-transitional assembly of protein complexes
None of the above
Biochemistry
FMGE 2018
87bebfdc-ecba-45e8-a77e-6251ad4c8970
multi
Structures preserved in functional radical dissection of the neck -a) Int. jugular veinb) Sternomastoidc) Lymph nodesd) Accessory nerve
Functional dissection is modified radical neck dissection (MRND Type III ) Modified radical neck dissection is done only selected cases where tumor is very well differentiated and less aggressive like in papillary carcinoma of thyroid with lymph node secondaries . Structures preserved here are sternomastoid muscle , internal jugular vein and spinal accessory nerve . Ref - Srb's manual of surgery 5/e p450
3
abc
bcd
abd
acd
Anatomy
Head and neck
845fd308-5ff8-4d4b-a61e-b6b081a9756d
single
Humectant in tooth paste serves to
null
2
as an abrasive
retains moisture
flavoring agent
foaming agent
Dental
null
f6a709b0-617b-43a5-a328-323bcd053e32
single
Route of administration of nitrous oxide is:
null
1
Inhalation.
Oral.
Intramuscular.
Intravenous.
Dental
null
f333a657-b4c7-4fbe-965e-a5863050326d
single
Which of the following has no Tm value ?
D i.e. Urea
4
Albumin, arginine
Betahydroxybutyrate, glucose
Glucose haemoglobin, phosphate
Urea
Physiology
null
88322e14-17ce-4c36-b51c-e18c3c8703f3
single
All are seen in primary extraglandular Sjogren syndrome except -
Ans. is 'a' i.e., Rheumatoid ahritiso Primary Sjogren syndrome is not associated with other autoimmune disorders, e.g. Rheumatoid ahritis. o Sjogren syndrome occurs in elderly (50-60 yrs)female.
1
Rheumatoid ahritis
Raynaud's phenomena
Lymphoma
Splenomegaly
Pathology
null
4904b604-4789-4b53-b0a9-9f2de9e7f564
multi
Adenovirus causes all except -
Infectious mononucleosis is caused by EBV
4
Hemorrhagic cystitis
Diarrhea
Respiratory tract infection
IMN
Microbiology
null
812eb042-8d22-4d73-90cc-3abb12602b99
multi
Traction epiphysis is are
Traction epiphysis are usually present at the end if bones and develop due to traction by the attached muscle (and are therefore extracapsular), eg Greater (and lesser) tubercle in humerus and greater ( and lesser) trochanter in femur Ref: Gray's39e/p185-210
2
Head of humerus
Lesser tubercle
Deltoid tuberosity
Ciracoid process
Anatomy
General anatomy
94c3e97b-c88c-4c4b-8941-e0cf47d25ea2
single
Total body water is
In the average young adult male, 18% of the body weight is protein and related substances, 7% is mineral, and 15% is fat. The remaining 60% is water.(REF: GANONG'S REVIEW OF MEDICAL PHYSIOLOGY 23rd EDITION page no.2)
4
40% of body weight
20% of body weight
10% of body weight
60% of body weight
Physiology
General physiology
aa1e5ee8-1bbd-40ba-8f78-d30088285f20
single
Best parameter for monitoring HIV disease progression is -
Ans. is 'c' i.e., Peripheral blood CD4 + Tcell counts with Plasma levels of HIV RNA Laboratory monitoring in HIV infection* The epidemic of HIV infection and AIDS has provided the clinician with new challenges for integrating clinical and laboratory data to effect optimal patient management.* The close relationship between clinical manifestations of HIV infection and CD4+ T cell count has made measurement of CD4+ T cell numbers a routine part of the evaluation of HIV-infected individuals.* The discovery of HIV as the cause of AIDS led to the development of sensitive tests that allow one to monitor the levels of HIV in the blood.* Determinations of peripheral blood CD4+ T cell counts and measurements of the plasma levels of HIV RNA plasma provide a powerful set of tools for determining prognosis and monitoring response to therapy.
3
Peripheral blood CD4 + Tcell counts
Plasma levels of HIV RNA
Peripheral blood CD4 + Tcell counts with Plasma levels of HIV RNA
Peripheral blood CD4 + T cell counts or Plasma levels of HIV RNA
Medicine
Infection
28f48704-8184-4283-bcf2-a0f8bc58f411
single
Which of the following drugs has maximum chances of absorption from gastric mucosa ?
- Among the given options, only diclofenac sodium is acidic and remains unionized in the acidic medium of the stomach. Other drugs are basic in nature. So diclofenac has higher chances of getting absorbed from gastric mucosa.
2
Morphine sulfate
Diclofenac sodium
Hyoscine hydrobromide
Quinine dihydrochloride
Pharmacology
null
45d22f08-bc46-4f15-b85a-34147cf674bd
single
A pregnant mother is treated with oral anticoagulant.The likely congenital malformation that may result in the fetus is:
Warfarin is an anticoagulant drug. Action : Interferes with the synthesis of the vitamin K dependent factors like II, VII, IX and X. Side effects: Hemorrhage It leads to: – Contradi’s syndrome : skeletal and facial anomalies in the fetus – Chondrodysplasia punctata in the fetus. Miscarriage, IUGR and stillbirths accentuates neonatal hypothrombinemia.
4
Long bones limb defect
Cranial malformation
Cardiovascular malformation
Chondrodysplasia Punctata
Gynaecology & Obstetrics
null
d9137c27-502e-4c77-bbe7-05b59358d32d
single
The most common side effect of IUCD which requires its removal
Pain is the second major side effect leading to IUCD removal WHO estimates that 15-40 percent of the IUCD removal appears to be for pain only Pain may be experienced during the inseion and for a few days thereafter and during menstruation Reference: Park&;s textbook of preventive and social medicine, Page no: 498
2
Bleeding
Pain
Pelvic infection
Ectopic pregnancy
Social & Preventive Medicine
Demography and family planning
c4281d72-8bbd-485d-af93-08602ecfa4f1
single
Trombiculid mite can transmit
null
4
Indian tick typhus
Q. fever
Relapsing fever
Scrub typhus
Social & Preventive Medicine
null
0c144fbe-d5b5-4b10-81a9-881841e4c414
single
Which of these organelles functions as the digestive system of the cell?
Lysosomes are spherical vesicles enveloped by a single membrane.  Lysosomes are regarded as the digestive tract of the cell, since they are actively involved in digestion of cellular substances-namely proteins, lipids, carbohydrates and nucleic acids.  Lysosomal enzymes are categorized as hydrolases. The lysosomal enzymes are responsible for maintaining the cellular compounds in a dynamic state, by their degradation and recycling.  The degraded products leave the lysosomes usually by diffusion, for reutilization by the cell. Sometimes, however, certain residual products, rich in lipids and proteins, collectively known as Iipofuscin accumulate in the cell.  Lipofuscin is the age pigment or wear and tear pigment which has been implicated in aging process. Key Concept: Lysosomes are regarded as the digestive tract of the cell, since they are actively involved in digestion of cellular substances-namely proteins, lipids, carbohydrates and nucleic acids.  Ref: Textbook of Biochemistry, Satyanarayana
4
Mitochondria
Rough endoplasmic reticulum
Golgi apparatus
Lysosomes
Biochemistry
null
3ab7240a-cab6-4113-882f-2c10e1c4d79c
single
Adenocarcinoma of ethmoid sinus occurs commonly in?
Workers of the furniture industry( woodworkers) develop a demo carcinoma of the ethmoids and the nasal cavity, while those engaged in nickel refining get squamous cell anaplastic carcinoma. (Ref: Textbook of diseases of ENT, PL Dhingra, 7th edition, pg no. 231)
4
Fire workers
Chimney workers
Watch markers
Wood workers
ENT
Nose and paranasal sinuses
bf51daea-1ea4-4089-8ff3-249806e9a60b
single
In nonexposed persons, the level of coproporphyrin in urine is :
A i.e. < 150 mg/litres
1
Less than 150 microgram/litre
Less than 1000 microgram/litre
More than 500 microgram/litre
None of the above
Forensic Medicine
null
3879567e-a763-4224-b454-d6b78c471efc
multi
About RCT all are true except
null
2
Baseline characteristics are comparable
Dropouts are excluded from the study
Sample size depends on type of study
Bias eliminated by double blinding
Social & Preventive Medicine
null
78948081-c616-40a2-82af-d8926aeabdcb
multi
Urinary incontinence results from all except:
Rectovesical fistula doesn&;t cause urinary incontinence, as the level of fistula is above the sphincter mechanism. Causes of Incontinence: Problems of social control Uninhibited detrusor hyperreflexia and impaired social perception in dementia Storage problems Small bladder capacity owing to fibrosis (tuberculosis, radiotherapy or interstitial cystitis) Small functional capacity owing to severe detrusor instability, neurogenic dysfunction or infection Impairement of emptying Chronic retention or neurogenic bladder dysfunction have small functional bladder capacities with detrusor ovveractivity causing incontinence despite having large residual volumes of urine. Weak Sphincter This leads to genuine stress incontinence Fistulae Leakage from fistulae (Vesicovaginal) or upper tract duplication with an ectopic ureter Ref: Bailey 27th edition Pgno: 1430
4
Neurogenic bladder
Vesico vaginal fistula
Ectopic ureter
Rectovesical fistula
Surgery
Urology
05d432f6-f3a1-4adb-9f96-906d22796c78
multi
True about PPV is
The predictive value of a positive test indicates the probability that a patient with a positive test result does indeed have the disease in question. The more prevalent a disease, the more accurate will be the predictive value of a positive screening test. Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 153
1
Increases with prevalence
Decreases with prevalence
No relation with prevalence
Accuracy
Social & Preventive Medicine
Epidemiology
16558b78-87a6-471c-986b-25d566e018ba
multi
Which of the following antiretroviral drugs is a non-nucleoside reverse transcriptase inhibitor -
null
2
Zidovudine
Efavirenz
Saquinavir
Stavudine
Medicine
null
efe8c262-9474-4fd5-bb39-46798829e4ea
single
Which of the following is most characteristics of granuloma
ref Robbins 9/e p97-78 a granuloma is an organized collection of macrophages. In medical practice, doctors occasionally use the term "granuloma" in its more literal meaning: "a small nodule". Since a small nodule can represent anything from a harmless nevus to a malignant tumor, this usage of the term is not very specific. Examples of this use of the term granuloma are the lesions known as vocal cord granuloma (known as contact granuloma), pyogenic granuloma and intubation granuloma, all of which are examples of granulation tissue, not granulomas. "Pulmonary hyalinizing granuloma" is a lesion characterized by keloid-like fibrosis in the lung, and is not granulomatous. Similarly, radiologists often use the term granuloma when they see a calcified nodule on X-ray or CT scan of the chest. They make this assumption since granulomas usually contain calcium, although the cells that form a granuloma are too tiny to be seen by a radiologist. The most accurate use of the term "granuloma" requires a pathologist to examine surgically removed and specially colored (stained) tissue under a microscope. Histiocytes (specifically macrophages) are the cells that define a granuloma. They often, but not invariably, fuse to form multinucleated giant cells (Langhans giant cell). The macrophages in granulomas are often referred to as "epithelioid". This term refers to the vague resemblance of these macrophages to epithelial cells. Epithelioid macrophages differ from ordinary macrophages in that they have elongated nuclei that often resemble the sole of a slipper or shoe. They also have larger nuclei than ordinary macrophages and their cytoplasm is typically more pink when stained with eosin. These changes are thought to be a consequence of "activation" of the macrophage by the offending antigen.
1
Epitheliod cell
Giant cells
Fibroblast
Endothelial cells
Anatomy
General anatomy
0fbcc627-0d7e-4768-a266-99e0f337062f
single
Milk teeth - Total no. in human being __________
Deciduous teeth, commonly known as milk teeth, baby teeth, temporary teeth, and primary teeth, are the first set of teeth in the growth development of humans and other diphyodont mammals. They develop during the embryonic stage of development and erupt--that is, they become visible in the mouth--during infancy. they are 20 in number . Babies&; teeth begin to develop before they are born, but in most cases don&;t come through until they&;re between 6 and 12 months old. Most children have a full set of 20 milk or baby teethby the time they&;re 3 years old. When they reach 5 or 6, these teeth will sta to fall out, making way for adult teeth. Reference: GHAI Essential pediatrics, 8th
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20
28
32
24
Pediatrics
Growth and development
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Specific type of cells found in infectious mononucleosis:
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Downey cells.
Raquet cells.
Arbiskov cells.
None of the above.
Pathology
null
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All of the following cause myocardial depression except:
B i.e. Etomidate - Etomidate causes adreno - coical suppressionQ by inhibiting enzymes 11/3 hydroxylase (mainly) & 17 a hydroxylase involved in coisol and aldosterone (mineralocoicoid) productionQ. Vit C supplimentation restores coisol level. - Etomidate and midazolam provide cardiovascular stabilityQ. But etomidate is most cardiostable agentQ that causes the least hemodynamic disturbance of any of the intravenous anesthetic agents. So it is intravenous anesthetic agent of choice for patients with cardiac disease and aneurysm surgeryQ. - Direct myocardial depression is caused by halothane (severe), nitrous oxide (moderate), iso/sevo/des-flurane (mild), thiopental (marked), propofol (dose dependent) and ketamineQ (but this is masked by cardiotonic sympathetic stimulatory action). Etomidate > midazolem are most cardiostable agentsQ.
2
Halothane
Etomidate
Thiopentone
Ketamine
Anaesthesia
null
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Organism commonly causing diarrhoea in young children is:
Ans: a (Rota vims) Ref: Nelson, 18th ed, p. 1399; 17th ed, p. 1081; OP Ghai, 6th ed, p. 270In early childhood, the single most important cause of severe dehydrating diarrhoea is rota virus infection.Important pathogens of human viral gastroenteritis* Rota vims\* Adenovirus* Astro vims* Calci vims such as Norwalk agentSerotyping of rota virus depends on the outer capsid glycoproteins VP7 and VP4Most important adverse event of rota virus vaccine is intussusception among the recipients of the vaccine usually occurring during the 1st week after immunization and usually after lst dose, due to this the use of this vaccine is banned. (PGI 2007 december)
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Rotavirus
Calci virus
E. coli
Staphylococcus
Pediatrics
Infection
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All the following are hormonal agents used against breast cancer EXCEPT :
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3
Letrozole
Exemestane
Taxol
Tamoxifen
Pharmacology
null
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The North Kerelia project evaluate risk factors of
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Diabetes
Cancers
Coronary heart disease
Obesity
Social & Preventive Medicine
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Lateral border of the cubital fossa is -
Ans. is 'a' i.e., Brachiradialis Cubital fossaLateral boundryBrachioradialisMedial boundryPronater teresBaseLine joining the two epicondyles of humerusApexPoint joining lateral and medial boundriesFloorBrachialis, supinatorRoofSkin, superficial fascia (containing medial cubital vein, lateral and medial cutaneous nerve of forearm), deep facia, bicipital aponeourosisCONTENTS* Median nerve* Brachial artery termination and begining of radial and ulnar arteries.* Biceps tendon* Radial nerve and* Radial collateral artery
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Brachiradialis
Pronator teres
Flexor Carpi Radialis
Triceps
Anatomy
Upper Extremity
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A 50-year-old man with muscle pain and fever for a month now notes darker colored urine for the past 2 weeks. On physical examination, he has palpable purpuric lesions of his skin. Urinalysis shows hematuria and proteinuria. Serum laboratory findings include mixed cryoglobulinemia with a polyclonal increase in IgG, as well as a high titer of anti-neutrophil cytoplasmic autoantibodies, mainly antimyeloperoxidase (MPO-ANCA, or P-ANCA. A skin biopsy is performed. What pathologic finding is most likely to be observed in this biopsy?
Microscopic polyangiitis involves small vessels, typically capillaries. Kidneys and lungs are commonly involved, but many organs can be affected. There may be an underlying immune disease, chronic infection, or drug reaction. Giant cell arteritis typically involves arterial branches of the external carotid, most often the temporal artery. Micro abscesses may be present with an infectious process, or with thromboangiitis obliterans (Buerger disease), which typically involves lower extremities. Mycotic aneurysms occur when a focus of infection, often from a septic embolus, weakens an arterial wall so that it bulges out. Perivascular eosinophilic infiltrates may be seen with Churg-Strauss syndrome, which typically involves the lungs.
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Giant cells and macrophages
Medial fibrinoid necrosis
Micro abscesses
Mycotic aneurysms
Pathology
Blood Vessels
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MHC class I represented on -
Ans. is 'b' i.e., All nucleated cells o MHC class I is found on the surface of all nucleated cells and platelets.
2
All cells
All nucleated cells
RBCs
null
Pathology
null
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Iodine uptake is seen in the following organs
Ans. B Thyroida. Iodine Trapping (Iodine pump)b. Iodide uptake is a critical first step in the thyroid hormone synthesis by the thyroid.c. Iodide uptake from circulation, is mediated by Na+/I- symporter (NIS), which is expressed at the basolateral membrane of the thyroid follicular cells. It is an example of secondary active transport.d. The rate of iodide trapping by the thyroid is influenced by several factors, the most important being the cone of TSH (i.e. TSH stimuliltes iodide uptake)e. Low Level of NIS are also present in the salivary glands, lactating breast and placenta.f. "The salivary glands, the gastric mucosa, the placenta, the ciliary body of the eye, the choroid plexus. And the mammary glands also transport iodide against a concentration gradient but their uptake is notg. affected by TSH. Diiodotyrosine is formed in mammary tissues but T4 and T3 are not".h. Low Iodine levels increase the amount of NSI and stimulate uptake, whereas high iodine levels suppress NIS expression and uptake.i. Excess iodide transiently inhibits thyroid iodide organification, a phenomenon known as theWOLFF-CHAIKOFF-EFFECT.Another iodide transporter, PENDRIN, is located on the apical surface of thyroid cells and mediates iodine EFFLUX into the lumen. Mutation of the PENDRIN gene causes Pendred syndrome , a disorder C/B a. defective organification of iodide b. goiter, and c. SN deafness.
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Ovary
Thyroid
Parathyroid
Adrenal gland
Physiology
Thyroid
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An acute apical abscess is usually a result of:
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Periodontal pocket
Occlusal interference
Necrotic pulp
Chronic gingivitis
Pathology
null
a2fffbd4-2551-44de-94e9-018362d1b6bb
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Anti leprosy drug causing ichthyoses is -
Ans. is 'b' i.e., Clofazimine Acquired ichthyosis (Ichthyosis acouista)o Acquired ichthyosis is seen in : -Deficiency:- Protein, Vitamin A, Kwashiorkor, Marasmus.Infection:- Leprosy, AIDSSenile ichthyosis: -ElderlySystemic diseases: -SLE, DM, hypothyroidism, Sarcoidosis, liver & kidney diseases.Malignancy, especially: -Hodgkin's lymphoma.Drugs Clofazimine, :-Statins, triparanol.
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Dapsone
Clofazimine
Rifampicin
Clarithromycin
Unknown
null
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False about Wolman disease is -
Wolmans disease is due to deficiency of the enzyme lysozomal acid lipase . Major accumulating metabolites being cholestrol esters and triglycerides. It is a lysosomal storage disease, also shows autosomal ressesive inheritance. so answer is option 4. Robbins basic pathology. 7th edition . Chapter Genetic disorders. Pge no. 161. ref img
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It is a lysosomal storage disorder
It is characterized by deficient acid lysosomal lipase
It shows autosomal AR inheritance pattern
It is characterized by adrenal calcification and corneal clouding
Pathology
Endocrinology
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Sign of pubey in boys ?
Ans. is 'b' i.e., Enlargement of testes In girls, the first visible sign of pubey is the appearance of breast buds (Thelarche), between 8-12 years of age. In boys the first visible sign of pubey is testicular enlargement, beginning as early as 91/2 yr.
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Enlargement of penis
Enlargement of testes
Appearance of pubic hair
Appearance of axillary hair
Pediatrics
null
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In rickets all are seen EXCEPT:
ANSWER: (B) Increased acid phosphataseREF: Nelson Textbook of Paediatrics 17th edition page 186-187"Alkaline phosphatase not acid phosphatase is increased in rickets"RICKETS is a softening of bones in children due to deficiency or impaired metabolism of vitamin D, magnesium, phosphorus or calcium, potentially leading to fractures and deformity.TypesNutritional RicketsVitamin D Resistant RicketsVitamin D Dependent Rickets (Type I 8c Type II)Congenital Rickets Signs and symptoms:Bone pain or tendernessDental problemsMuscle weakness (rickety myopathy or "floppy baby syndrome" or "slinky baby" (such that the baby is floppy or slinky-like)Increased tendency for fractures (easily broken bones), especially greenstick fracturesSkeletal deformityToddlers: Bowed legs (genu varum)Older children: Knock-knees (genu valgum) or "windswept knees"Cranial, pelvic, and spinal deformities (such as lumbar lordosis)Growth disturbanceHypocalcaemia (lowT level of calcium in the blood)Tetany (uncontrolled muscle spasms all over the body)Craniotabes (soft skull)Costochondral swelling (aka "rickety rosary" or "rachitic rosary")Harrison's grooveDouble malleoli sign due to metaphyseal hyperplasiaWidening of wrist raises early suspicion, it is due to metaphyseal cartilage hyperplasia.Diagnosis:Blood tests:Serum calcium may show low levels of calcium, serum phosphorus may be low, and serum alkaline phosphatase may be high.Arterial blood gases may reveal metabolic acidosisAn X-ray or radiograph of an advanced sufferer from rickets tends to present in a classic way:bow legs (outward curve of long bone of the legs) and a deformed chest. Changes in the skull also occur causing a distinctive 'square headed" appearance. These deformities persist into adult life if not treated. Long-term consequences include permanent bends or disfiguration of the long bones, and a curved back.
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Craniotabes
Increased acid phosphatase
Bow legs
Increase alkaline phosphatase
Pediatrics
Vitamin D
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All of the following decrease bone resorption in osteoporosis except:
Ans. (D) Teriparatide(Ref: CMDT 2010/1041; KDT 8/e p365)Teriparatide acts by stimulating the formation of bone whereas bisphosphonates act by inhibiting the resorption of bone. Strontium ranelate has both of these properties.
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Alendronate
Etidronate
Strontium
Teriparatide
Pharmacology
Endocrinology
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