id
stringlengths
36
36
question
stringlengths
1
1.57k
opa
stringlengths
1
287
opb
stringlengths
1
287
opc
stringlengths
1
286
opd
stringlengths
1
301
cop
class label
4 classes
choice_type
stringclasses
2 values
exp
stringlengths
1
22.5k
subject_name
stringclasses
21 values
topic_name
stringlengths
3
135
5ef243be-ae7a-4771-b3f9-d0fdf12e3f22
Percentage of tetracaine used in eye surgery
0.50%
1%
2%
4%
0a
single
Cataract surgery can be performed using topical anaesthesia alone. Tetracaine 0.5% and Lidocaine 4% can be used. Advantages of this method are that it avoids the potential complications with retrobulbar and peribulbar injections. Disadvantages include the potential for eye movement during surgery, increased patient anx...
Anaesthesia
All India exam
324858c7-31bb-4a35-9ac7-000553573cac
Lateral Pterygoid muscle is attached to-
Articular disc of temporomandibular joint
Angle of mandible
Floor of temporal fossa
Maxillary tuberosity
0a
single
Ans. is 'a' i.e., Articular disc of temporomandibular joint Muscles of masticationMusclesOriginInsertionNerve supplyActionSpecial remarksMasseterLower border of zygomatic arch & its deep surface.Lateral surface of ramus and angle of mandible.Anterior division of mandibularnerve.Elevates the mandible, clenches teeth. Pr...
Anatomy
Head & Neck
deb80b68-e1b1-4dec-9190-ede644db87eb
According to WHO, blindness is defined as: September 2009, 2010
Visual acuity of less than 1/60
Visual acuity of less than 3/60
Visual acuity of less than 6/60
Visual acuity of less than 6/18
1b
single
Ans. B: Visual acuity of less than 3/60 As per WHO, blindness is defined as Visual acuity of less than 3/60 in the better eye with befit possible correction.
Ophthalmology
null
c6ee0b2a-b491-433a-b872-ec1ad37abc19
A 48-year-old man with AIDS is admitted to the hospital with a fever of 38.7degC (103degF). The patient has a 2-week history of persistent cough and diarrhea. Laboratory studies show that the CD4+ cell count is less than 500/mL. A sputum culture reveals acid-fast organisms, which are fuher identified as Mycobacterium a...
CD4+ helper T cells
Eosinophils
Macrophages
Neutrophils
2c
single
This pneumonia is characterized by an extensive infiltrate of macrophages. The proliferation of MAI and the recruitment of macrophages produce expanding lesions, ranging from epithelioid granulomas containing few organisms to loose aggregates of foamy macrophages. The other inflammatory cells listed are not characteris...
Pathology
Infectious Lung Disease: Pneumonia
138a65e0-9626-4787-ac5a-01e8115c6ee7
Armoured endotracheal tube is used in?
Cardiovascular surgery
Neurosurgery
Thoracic surgery
Pediatric surgery
1b
single
Neurosurgery REF: Miller 6th ed 1628, Current Diagnosis & Treatment in Otolaryngology--Head & Neck Surgery 2e "In neurosurgical operations armoured endotracheal tube is used" Three of the more commonly used endotracheal tubes are RAE endotracheal tubes, armoured endotracheal tubes, and laser-resistant endotracheal tube...
Anaesthesia
null
9265103e-29ae-4025-b8bc-efe64cac9e89
Nitrites are used for all of the following conditions except?
Congetive hea failure
Cyanide Poisoning
Esophangeal spasm
Renal colic
3d
multi
Nitrates are used in angina, congestive cardiac failure, biliary colic, cyanide poisoning. Not in renal colic. used only in biliary colic due to the sphincter spasm They cause smooth muscle relaxation including endothelium of veins-venous dilation. so used in all above-mentioned conditions. REF.Essentials of Pharmacolo...
Pharmacology
Cardiovascular system
92cfd5d4-4078-41b5-8355-75a5f83c0383
Which of the following is the nodal ministry for Integrated Child Development Services (ICDS)?
Ministry for Human Resource Development
Ministry of Rural Development
Ministry for Health and Family Welfare
Ministry of Women and Child Development
3d
single
Ministries to combat malnutrition: Programme Ministry Vitamin A prophylaxis programme Ministry of Health and Family Welfare Prophylaxis against nutritional anemia Ministry of Health and Family Welfare Iodine deficiency disorders control programs Ministry of Health and Family Welfare Special nutrition programme Ministry...
Social & Preventive Medicine
Other NHPs
838b8183-df8c-4a54-be47-176915444f58
All are risk factors for the development of surgery associated chronic kidney disease, EXCEPT:
Older age
CCF
Emergency procedures
Spinal anaesthesia
3d
multi
Common risk factors for postoperative AKI include 1. Underlying chronic kidney disease, 2. Older age, 3. Diabetes mellitus, 4. Congestive hea failure 5. Emergency procedures. Cardiopulmonary bypass is a hemodynamic state characterized by nonpulsatile flow and exposure of the circulation to extracorporeal circuits. Long...
Medicine
null
fb487a85-681a-4bb3-9299-f426f0f001f5
Structure which lies outside the femoral sheath
Femoral aery
Femoral nerve
Femoral vein
Genitofemoral nerve
1b
single
Femoral nerve Femoral sheath Femoral sheath is a funnel shaped fascial prolongation around proximal pa of femoral vessels, situated in the femoral triangle, below the inguinal ligament. It is 3-4 cm long. It is formed by fascia iliaca. Femoral sheath is divided into 3 separate fascial compaements by septa :? i) Lateral...
Anatomy
null
313aacbb-cfc9-4072-aa85-0da5c7e491ab
Dark ground microscopy is used for ?
TPI
FTA - ABS
Kahn's test
VDRL
0a
single
Darkfield / Dark ground microscope in which reflected light is used instead of transmitted light used in the ordinary microscope. The essential pa of the dark field microscope is the dark field condenser with central circular stop, which illuminates the object with a cone of light without letting any ray of light fall ...
Microbiology
general microbiology
ccd27dbe-25d3-4acd-89c5-a731b41d6765
Pure word blindness occurs due to lesion in
Anterior cerebral aery
Posterior cerebral aery
Middle cerebral aery
Spinal aery
1b
single
Answer- B. Posterior cerebral aeryPure alexia almost always involves an infarct to the left posterior cerebral aery which perfuses the splenium of the corpus callosum and left visual coex, among other things)
Medicine
null
4b46ec77-58de-42a0-a2d1-b292affe5b76
Which of the following hormone is not secreted by kidney:
1,25 dihydroxycholecalciferol
Angiotensin I
Renin
Erythropoietin
1b
single
Ans. B. Angiotensin IThe kidney produces three hormones:a. 1,25 dihydroxycholecalciferolb. Reninc. erythropoietinAngiotensinogen is found in the D2 globulin fraction of the plasma. It is synthesized in the liver and is converted to angiotensin I by renin which is further converted to angiotensin II by the action of ACE...
Physiology
Kidneys and Body Fluids
6691f3df-df23-491d-99d1-bfbf2e7df6bd
Non - noxious stimuli perceived as pain is termed as:
Allodynia
Hyperalgesia
Hyperesthesia
Hyperpathia
0a
multi
Terminology Sensory disturbance Allodynia Situation in which a non - painful stimulus, once perceived, in experienced as painful, even excruciating. An example is elicitation of a painful sensation by application of a vibrating tuning fork. Hyperalgesia Severe pain in response to a mildly noxious stimulus Hyperpathia T...
Physiology
Physiology of Pain
f77a0317-1e88-4160-943d-de2eba6d4b66
A boy with undescended testis, your concern to ask for operation is due to –a) Cosmetic reasonsb) Infertilityc) Risk of malignancyd) Impotence
a
c
ac
bc
3d
single
Let's see both options one by one. 1. Infertility Infertility is a complication of undescended testis. After treatment for a unilateral undescended testis, 85% of patients are fertile. Following bilateral aorchidopexy 50-65% of patients are fertile. 2. Malignancy Risk of developing germ cell tumors in an undescended...
Pediatrics
null
22d179dc-bd0c-4d9c-9bc3-dbb2f1eb874a
Maximum contribution to the refractive power of the eye is by:
Anterior surface of cornea
Anterior surface of lens
Posterior surface of cornea
Posterior surface of lens
0a
single
Ans. (a) Anterior surface of corneaRef: Cornea by Mannis p. 145On average anterior cornea has refractive power of +48D of convergence and posterior cornea -5D of divergence.
Ophthalmology
Elementary Optics
040b2ed8-9b17-4749-8191-2fcc6ead4f73
Stoppage of which of the following drugs can result in anxiety and insomnia causing discontinuation syndrome?
Venlafaxine
ImiPramine
Valproate
OlanzaPine
0a
single
Ans: A. VenlafaxineRef: Katzung, I3'h ed., pg. 524-525 and Goodman & Gilman, l3'h ed-, pg. 27372.Sudden withdrawal of Shoer acting antidepressants paicularly SSRIs (paroxetine and seraline) and SNRI (venlafaxine) can lead to discontinuation syndrome and troublesome side effects.These symptoms may include dizziness, hea...
Pharmacology
null
8accc6f0-4fe6-4873-b85a-73e253e250b8
Anticoagulant effect of warfarin is increased by all of the following drugs, EXCEPT:
Cimetidine
Phytonadione
Amiodarone
Phenylbutazone
1b
multi
Phytonadione is a vitamin K preparation and is used to control bleeding caused by warfarin. The anticoagulant effects of warfarin is increased by drugs that inhibits its metabolic clearance either through stereoselective or non selective pathways. Examples of such drugs are amiodarone, phenylbutazone, sulfinpyrazone, d...
Pharmacology
null
6514e9ff-19fb-4ae6-add5-e2049dc74f9f
Which organism is considered as normal flora conjunctiva?
B.Proteus
Pseudomonas
E coli
Corynebacterium xerosix
3d
single
Answer- D. Corynebacterium xerosix
Ophthalmology
null
b98dee40-285d-4c5d-bc23-7c6575de45df
Which of the following test is the test of Integrity of PDL:
Percussion test.
Thermal test.
Mobility depressibilty testing.
EPT.
0a
single
PERCUSSION test → is the test of INTEGRITY of Pdl
Dental
null
c8d4bc2f-e7c6-4d34-90d9-f7a2ed8733ff
Which is best for diagnosis of small intestinal mucosal disease?
Small bowel Series using barium contrast
Urinary D- xylose test
Small intestinal mucosal biopsy
Breath hydrogen test
2c
multi
Mucosal disease of small intestine : Infection (esp. Giardia, Whipple's disease, tropical sprue), inflammatory diseases (esp. Crohn's disease), radiation enteritis, eosinophilic enteritis, ulcerative jejunitis, mastocytosis, tropical sprue, infiltrative disorders (amyloidosis, scleroderma, lymphoma, collagenous sprue, ...
Medicine
Malabsorbtion Syndrome
6b1c5fd2-6849-4417-ac0c-bbd8ed9f7042
Which of the following is NOT an advantage of low molecular weight herparin over unfractionated heparin?
Higher efficiency in aerial thrombosis
Less frequent dosing
Higher and more consistent subcutaneous bioavailability
Laboratory monitoring of response not required
0a
single
Ref: KDT 6/e p603
Anatomy
Other topics and Adverse effects
bfbf7532-acf5-4746-a327-103ec294667a
anorexia nervosa is common in
adolescents
middle age
males
old age
0a
single
Anorexia nervosa Anorexia nervosa is a eating disorder where the patient has decreased weight and altered body image and persistent desire to maintain thinness * Gender==== more common in females * Age=======adolescence * Comorbidity=== depression and social phobia * Duration====3 months * Criteria= * Intense fear of b...
Anatomy
Sleep disorders and eating disorders
7e25b17f-f521-4fb2-b83b-6e229106621b
A patient has been diagnosed with Marfan syndrome. Which of the following is the most common cause of death in these patients?
Liver disease
Myocardial infarction
Recurrent infection
Aoic disease
3d
single
Marfan syndrome Autosomal dominant Defect in an extracellular glycoprotein called fibrillin-1. Loss of fibrillin- Clinical manifestations of Marfan syndrome. Loss of structural suppo in microfibril rich connective tissue and excessive activation of TGF-b signaling. Skeletal abnormalities Unusually tall Exceptionally lo...
Pathology
Single Gene Disorders
5c685fd5-4806-4ae2-9f54-79863ab9fe9c
A 1.5 year old female is brought to the clinic with complaints of excessive enlargement of head, intolerance to feeds and severe malnourishment. MRI imaging was suggestive of a medulloblastoma causing obstructive hydrocephalus. Which of the following is an example of irrational management of the patient?
Craniotomy and sub-total excision of the tumour. Surgeon leaves the layer of the tumour adherent with colliculus
First ventriculoperitoneal shunt was done
CCNU and vincristine were given as chemotherapy
Radiotherapy 35-40 Gy was given to the whole craniospinal axis
3d
single
Ans. d. Radiotherapy 35-40 Gy was given to the whole craniospinal axis (Ref: Harrison 19/e p602, 18/e p3388; Sabiston 19/e p1888; Schwartz 9/e p1540: healthprofessionals/page5)In this child of age 1.5 years suffering from medulloblastoma, efforts should be made to omit or delay the radiation, given the profound impact ...
Pediatrics
Central Nervous System
fc93312f-5c58-48a0-8dff-975f028c8a9c
A 26 year-old man presents with mild gastroenteritis gives the history of consumption of raw fish few days back. There is no blood or pus in the stool. Culture grown in Wagatsuma agar. Which causative agent is most likely to have caused this illness?
Vibrio cholerae
Salmonella typhi
Shigella sonnei
Vibrio parahaemolyticus
3d
single
Vibrio cholerae causes classic cholera, which is not generally mild or self- limited. Vibrio parahaemolyticus causes a relatively mild gastroenteritis. It is also found in raw fish. Selective medium is Wagatsuma agar. S. typhi is the causative agent of typhoid. Shigella infections are always invasive and generally will...
Microbiology
Systemic Bacteriology (Gram Positive Bacilli, Gram Negative Bacilli)
0f8963de-fb8d-40b7-9419-53c70164fe0f
A 55-year-old man, who has been on bed rest for the past 10 days, complains of breathlessness and chest pain. The chest X-ray is normal. The next step in investigation should he:
I.ung ventilation - perfusion scan
Pulmonary aeriography
Pulmonary venous wedge angiography
Echocardiography
0a
multi
Ans. I.ung ventilation - perfusion scan
Radiology
null
270c9ebc-964e-4fc6-8f08-506c2335f44e
A substance is present in concentration of 2 mgdeg/o in the afferent aeriole and zero mg% in the efferent. True about the substance is:
It is free filtered in glomerulus
Secreted in coical nephron
Absorbed in PCT
Impermeable in loop of Henk
0a
multi
A i.e. It is freely filtered in glomerulus If the substance is 0 mg% in efferent aeriole, it means that all of it has freely filtered in glomerulus.
Physiology
null
8e92e460-98d9-4709-82eb-dc613ac32980
Which is the initial Imaging modality of choice for Insulinoma?
USG
CT abdomen
Somatostatin Receptor Scan (SRS)
E.U.S
3d
single
For PETs in the pancreas, EUS is highly sensitive, localizing 77-100% of insulinomas, which occur almost exclusively within the pancreas. Tests for location of pNET: Somatostatin Receptor Scintigraphy is the initial imaging modality but is less available. Helical CT scan has a sensitivity of 82-94%. Gadolinium based MR...
Medicine
Disorders of Adrenal Gland
ead18fa3-9aa2-4842-9495-4be64186b25d
Kuppuswami's classification of socio economic status is based on all of the following indices, EXCEPT:
Income
Occupation
Education
House type
3d
multi
Kuppuswamy's classification is an index for estimation of socio-economic status. The 3 variables used in this classification to assess socio economic status are education, occupation and income. House type is not considered in this classification. Ref: Parks Textbook of Preventive and Social Medicine 20th edition page ...
Social & Preventive Medicine
null
75c55a63-007d-4ad2-b62a-0c52461c0fb7
A 62-year-old man undergoes excision of a cylindroma of the submandibular gland. He is most likely to have an injury to which of the following?
Maxillary branch of the trigeminal nerve
Lingual nerve
Vagus nerve
Floor of the maxilla
1b
single
The lingual nerve swings forward deep to the mylohyoid muscle and crosses twice over the submandibular (Wharton's) duct. The mandibular branch of the facial nerve (not listed in the answer choices) may accidentally be injured below the angle of the mandible. Injury to this branch causes serious facial deformity.Branchi...
Surgery
Salivary Gland
c2f0d312-7bfb-4ff6-bb64-fe4ff7dba0fa
On USG finding of cystic hygroma in fetus is suggestive of :
Down's syndrome
Marfan's syndrome
Turner's syndrome
Klinfelter's syndrome
2c
single
Turner's syndrome (XO) may have - Cystic hygroma, Widely spaced nipples, Webbed neck, Infertility, Normal I.Q.
Radiology
null
ede0ee85-f176-4a72-a850-1f1325de42b8
Route of administration of BCG for bladder cancer is :
Oral
Subcutaneous
Intravenous
None of the above
3d
multi
The intravesical route is used for BCG in the treatment of bladder carcinoma.
Pharmacology
null
a5e733e4-156c-4888-802e-3926cbcbc52a
A Patient is made to walk early after Surgery. This is for: March 2005
Treating the patient
Reducing disability
Specific protection
Rehabilitation
3d
single
Ans. D: Rehabilitation Medical rehabilitation is done for restoration of functions which aims at training and retraining the individual to the highest possible level of functional ability.
Social & Preventive Medicine
null
26033713-9137-4fe1-8322-b4c2436c0652
True about vibrio parahemolyticus ?
Polar flagella
Non halophilic vibrio
Non-capsulated
Requires NaCI
3d
multi
Ans. is 'd' i.e., Requires NaCI
Microbiology
null
04fdda71-03fe-4220-a3c1-849ba4e2fd66
Increased plasma concentration of calcium is associated with: March 2009
Rickets
Osteomalacia
Primary hyperparathyroidism
Pseudohypoparathyroidism
2c
single
Ans. C: Primary hyperparathyroidism The most common cause of high calcium levels (hypercalcemia) is an overproduction of parathyroid hormone, or hyperparathyroidism. Hyperparathyroidism tends to be more common in women, and occurs in 25 out of every 100,000 individuals. Hyperparathyroidism can be the result of all four...
Medicine
null
6a74d121-ec3b-46ad-a112-58640a5e3938
False statement about Mirena is
Progestrone containing lUCD
Contain desogestrol
Used in hormone replacement therapy
Decreases menstural blood flow
1b
multi
It is a levanorgestrel releasing device which contains about 52 mg of levanorgestrel released at a rate approximately 20 microgram perday.
Gynaecology & Obstetrics
null
09a25352-1655-422e-954b-b5fa0e6497a0
Pulse pressure in severe aoic regurgitation is equal to-
30-45mmHg
45-60mmHg
60-75 mmHg
75-90 mm Hg
3d
single
Therefore, a defining characteristic of aoic regurgitation is an increase in aoic pulse pressure (systolic minus diastolic pressure). ... Early in the course of regurgitant aoic valve disease, there is a large increase in left ventricular end-diastolic pressure and left atrial pressure.pulse pressure usually between 75...
Medicine
C.V.S
3288e411-780e-454d-b2c0-79088a094645
Which of the following statements regarding Glasgow coma scale are true?
Ranges from 3 - 15
Less than 7 is classified as coma
More than 9 excludes coma
All the above
3d
multi
Glasgow coma scale includes aspects of eye opening, verbal and motor response.
Medicine
null
7f3c4eb8-36d9-4b1b-aedb-469d7a485961
Apple jelly nodules are seen in:
Ichthyosis vulgaris
Lichen planus
Lupus vulgaris
Lupus erythematous
2c
single
Ans: C (Lupus vulgaris) Ref: Principles of Diagnosis in Dermatology. In: Thappa DM. editor. Essentials in Dermatology, 2ndedn., New Delhi: Jaypee Brothers Medical Publishers (P) Ltd 2009:16-30 Mycobacterial Diseases. In: James WD, Berger TG Elston DM, editors. Andrew 's Diseases of the Skin: Clinical Dermatology. 11th ...
Skin
C. Mycobacteria
330674dc-a276-46d2-a98e-a45099c45cdd
HMP shunt is of great impoance in cellular metabolism because it produces -
ATP
ADP
Acetyl CoA
NADPH
3d
single
D i.e. NADPH
Biochemistry
null
86954524-0e14-4345-9a4a-aa25d291ac9e
All of the following statements about amiloride are true EXCEPT:
It antagonises the action of aldosterone
It is the drug of choice for the treatment of lithium induced diabetes insipidus
It decreases calcium loss in the urine
It is more potent than triamterene
0a
multi
Amiloride acts by blocking epithelial Na+ channels. It has no effect on aldosterone receptors. It is more potent than triamterene. It decreases Ca2+ loss in the urine It is the drug of choice for lithium induced DIas it blocks entry of Li ions through ENac channels.
Pharmacology
Kidney
5bbcdadb-b639-403e-a342-41a287cb8c5d
In central serous retinopathy -
Often shows focal leakage on fluorescein fundus photography
A macular hole is a common end result
The image perceived by the patient on the affected side in unilateral cases is bigger than on the normal side
A dense central scotoma is the most common presentation
0a
single
Fundus fluorescein angiography helps in confirming the diagnosis. Two patterns are seen: Ink-blot pattern. It consists of small hyperfluorescent spot which gradually increases in size Smoke-stack pattern. It consists of a small hyperfluorescent spot which ascends veically like a smoke-stack and gradually spreads latera...
Ophthalmology
Vitreous and retina
1aa02126-6638-47fc-86c7-90e4334b63a9
Harakiri is death by:
Stab in neck
Stab in thorax
Stab in abdomen
Stab in wrist and neck
2c
single
Ans. c. Stab in abdomen (Ref: Parikh's 6/e p4.21; style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif">; Reddy 33/e p204) Harakiri is death by stab in abdomen.'Hara-kiri is an unusual form of suicide where the abdomen is baldly punctured by a short sword in a sitting position resulting in o...
Forensic Medicine
Death and Investigations
9435f813-c92e-4cd4-b416-d3207a9ced9c
Testementary capacity refers to -
Ability to make a valid will
Criminal liability
Right to vote
Ability to give evidence
0a
single
Testamentary capacity is defined as the capacity of a person to make a valid will.
Forensic Medicine
null
edd374fe-c3f5-44f0-814b-dfdb6c0ab8a3
A 60 years' man had undergone cardiac bypass surgery 2 days back. Now he started forgetting things and was not able to recall names and phone number of his relatives. What is the probable diagnosis?
Depression
Post- traumatic psychosis
Cognitive dysfunction
Alzheimer's disease
2c
multi
Ans. C. Cognitive dysfunction* The history of cardiac surgery 2 days prior followed by behavioral changes is suggestive of delirium. The questions here is stressing on "disturbances of memory'' which can be seen in delirium, however, are usually restricted to short term memory loss.* The other important features such a...
Psychiatry
Miscellaneous
92e8a7a3-04cc-451e-8a26-b6c545d24360
The normal axial length of the eye -
18mm
20 mm
28 mm
24mm
3d
single
The length of the eyeball is approximately 24 mm, So the distances from the cornea / crystalline lens to the retina and the focal length of optical rays focused by the camera/crystalline lens propagating in the vitreous humor and imaging on the retina, are also about 24 mm
Ophthalmology
null
1d1b01ba-06a9-42aa-8e96-a9537f014ac1
A thinner mix of a gypsum-bonded investment will:
Produce a smoother casting
Decrease setting expansion
Increase setting expansion
Increase thermal expansion
1b
single
GYPSUM-BONDED INVESTMENTS The α-hemihydrate form of gypsum is generally the binder for investments used in casting gold-containing alloys with melting ranges below 1000 °C. When this material is heated at temperatures sufficiently high to completely dehydrate the investment and to ensure complete castings, it shrinks c...
Dental
null
3e4492a6-8953-45cb-a5f1-9e4c15495adc
What is to done of congenital cataract involving visual axis?
Wait and watch
Operated when the baby reaches an appropriate age
Mydriatic s are given
Immediately operate
3d
single
ANSWER: (D) Immediately operateREF: parsons 20th ed p, 257Timing of surgery in congenital cataract:BilateralUnilateralDenseEarly surgery to prevent stimulus deprivation ambylopiaPartialMonitor lens opacities and visual function and intervene if vision deterioratesDenseIf the u/1 cataract is dense and involves the visua...
Ophthalmology
Congenital Cataract
0c512e55-c21c-4959-bb2e-ee3990a760d1
What differences can be seen in skulls of male and female before puberty?
Difference in weight
Difference in size
Difference in capacity
None of the above
3d
multi
There are no sex differences until puberty. The differences can be seen post puberty.
Anatomy
null
62d58b82-0c09-409c-ba89-727cbbb4b330
Sphenoid sinus drains into?
Sphenoethmoidal recess
Middle Meatus
Superior meatus
Inferior meatus
0a
single
Ans. A. Sphenoethmoidal recessThe lateral wall of nasal cavity presents three medial projections called conchae, which overlies meatuses. The sphenoethmoidal recess, above and posterior to the superior concha, receives the opening of the sphenoidal sinus. The superior meatus, under cover of the superior concha, receive...
Anatomy
Head & Neck
a80e7e21-a3c4-46cd-a987-c0d5be2859b3
Which among the following doesn't enter human body via skin?
Ancyclostoma
Strongyloides
Trichinella
Necator
2c
single
ANSWER: (C) TrichinellaREF: Jawetz, Melnick, & Adelbergs Medical Microbiology, 24TH edition chapter 46 Table 46-4Indirect repeat in December 2011, See APPENDIX-74 below for "DISEASES DUE TO HELMINTHS""Trichinella-infected by ingestion of undercooked pork which contains encysted larvae in the striated muscle"Skin penetr...
Unknown
null
53835c87-44a6-4637-a491-cee6e4ffeb84
Safe and effective method of sterilization of surgical eye instruments is
Acetone
Formalin
Autoclaving
Boiling
2c
single
Autoclaving is the safest methods of sterilization Ref khurana 6/e
Anatomy
General anatomy
f0e8be4b-427f-4eca-9727-be9a73f0f3d0
The most impoant cause of Nonunion of fracture of - humeral shaft is
Comminuted fracture
Compound (Open) fracture
Overriding of fracture ends
Distraction at fracture site
3d
single
D i.e. Distraction at fracture site Fracture shaft humerus is the easiest of major long bone fractures to be treated by conservative methods. And the most common cause of delayed union or nonunion is distraction at fracture siteQ due to gravity and weight of plaster.
Surgery
null
d5fd5a26-4d40-41f7-9b85-e25275807ef9
All of the following provisions are included in the primary health care according to the Alma Ata declaration except
Adequate supply of safe drinking water
Provision of food supply
Provision of free medicines
Basic sanitation
2c
multi
Ans. c. Provision of free medicines Primary Health Care The Alma Ata Conference has defined primary health care as -- an essential health care made universally accessible to individuals and acceptable to them, through their full paicipation and at a cost the community and country can The Alma -- Ata Declaration has out...
Social & Preventive Medicine
null
cb47c2bc-ac0d-4406-9493-4d9c7c88e070
The nucleus ambiguus is shared by all of the following cranial nerves except
IX
X
XI
XII
3d
multi
Cranial pa of nucleus ambiguus gives fibers to IX, X and the cranial root of XI nerve. The caudal pa of this nucleus gives fibers to the spinal root of XI nerveRef: Chaurasia; Volume 3; 6th edition; Page no: 342
Anatomy
Brain
57a17cad-047d-4acc-9f9a-4dab708ed297
mood stablizer used in the management of drug induced neutropenia
lithium
valproate
carbamezepine
lamotrigine
0a
single
- Lithium has a narrow therapeutic index - GIT == diarrhea, vomiting - NEUROLOGICAL=== tremor, co ordination - Therapeutic level is 0.8-1.2meq/l - HEMODIALYSIS is the TOC for lithium toxicity - OTHER USES - Anti- suicidal propey, used to prevent suicide. - Correct drug induced neutropenia. ref, kaplon and sadock, synop...
Anatomy
Pharmacotherapy in psychiatry
082dd8c4-4f49-411f-8cc2-f8689d16dc4e
Gentamicin is not given orally because:-
It has adverse effects on gastric mucosa
It interferes with absorption of other drugs
It is rapidly destroyed by gastric acid
It has poor absorption
3d
multi
AMINOGLYCOSIDES These include streptomycin, gentamicin, kanamycin, tobramycin, amikacin, sisomicin, netilmicin, neomycin and framycetin. These are not absorbed orally and do not cross blood brain barrier. These are excreted primarily by glomerular filtration and the dose should be decreased in renal insufficiency. Thes...
Pharmacology
Protein Synthesis Inhibitors
5789d435-dd57-4bec-9fee-469291534791
Dose reduction should be done for which of the following anticancer drug, if Allopurinol is used
Methotrexate
Mitoxantrone
6-Mercaptopurine
Mitomycin-C
2c
multi
Allopurinol inhibits the metabolism of 6-mercaptopurine and result in toxicity. Therefore if Allopurinol is used, dose of 6-mercaptopurine should be decreased by 75%.
Pharmacology
null
5d744376-044b-44ae-bef1-f6de6589950b
Shoest acting mydriatic and cycloplegic drug is
Hyoscine
Homatropine
Tropicamide
Cyclopentolate
2c
single
Tropicamide is the shoest acting mydriatic ANTICHOLINERGIC DRUGS FOR EYE Atropine, homatropine, cyclopentolate and tropicamide are used as mydriatic and cycloplegic agents. Mydriatic action is useful in fundus examination whereas cycloplegic action allows correct assessment of refractive error Pain in iridocyclitis occ...
Pharmacology
Parasympathetic System & Glaucoma
7274cbe2-fe6d-4de1-b267-4517bf8a662b
Which of these embryonic structures is the earliest seen USG indicator of pregnancy :
Fetal pole
Fetal hea activity
Gestation sac
Fetal skeleton
2c
single
Gestational sac cardiac activity Trans vaginal scan (TVS) 4+ weeks 5+ weeks Trans abdominal scan (TAS) 5 + weeks 6 + weeks
Gynaecology & Obstetrics
Diagnosis of Pregnancy
2c05800f-ee05-41c8-9389-49f4f3aeda20
Onion skin appearance is seen in:
Chronic osteomyelitis
Chronic osteomyelitis with proliferative periostitis
Garre’s chronic non-suppurative sclerosing osteitis
Both 2 and 3
3d
multi
Radiographic picture—Classical onion skin appearance due to cortical layer duplication is seen in both chronic osteomyelitis with proliferative periostitis and Garre’s chronic non suppurative sclerosing osteitis.
Pathology
null
49d94986-c502-4c57-aa8e-5602085c54d0
Which one of the following device provides fixed performance oxygen therapy:
Nasal Cannula
Venturi mask
O2 by T-piece
SO2
1b
single
B i.e. Ventimask Ventimask or venturimasks are high flow or fixed performance (performance not affected by changes in patient's tidal volume and respiratory rate) oxygen delivery devicesQ delivering accurate oxygen concentration
Anaesthesia
null
2d462d1a-db2e-4ab0-b683-a37f1568378f
DASH stands for -
Dietary approach to stop hypertension
Dietary approach to stop heamarrhage
Direct approach to surgery of hernia
Dietary approach to stop hemolysis
0a
single
Ans. is 'a' i.e., Dietary approach to stop hypertension * DASH stands for dietary approaches to stop hypertension.* DASH eating plan recommends to consume a diet rich in fruits, vegetables and law-fat dairy products with a reduced content of saturated and total fat.
Social & Preventive Medicine
Non-Communicable Diseases
e40cf5e6-3c83-4322-97f0-af9a7cd4d741
Most common organ affected in underwater blast ?
Intestine
Liver
Spleen
Hea
0a
single
Ans. is 'a' i.e., Intestine The most common organ affected in underwater blast injury is intestine. Explosion injury An explosion is a phenomenon resulting from sudden release of energy which is then dissipated by a blast wave, by translocation of objects, or by the generation of heat. Injuries in explosion occur due t...
Forensic Medicine
null
3b1486cb-c161-4716-b7aa-1de90addc350
Most common site for Ca. Large bowel is
Sigmoid
Rectum
Ascending colon
Descending colon
1b
single
Rectum is most common location. (if option is not given then retco - sigmoid region).
Surgery
null
6719690e-9033-4cbd-95a5-6af53d03962a
Eutectic lignocaine-prilocaine has the following unique property
It causes motor blockade without sensory block
By surface application, it can anaesthetize unbroken skin
It is not absorbed after surface application
It has strong vasoconstrictor action
1b
single
Lignocaine or prilocaine cannot anaesthetize intact skin. Eutectic mixture is the combination of equal proportions of lignocaine and prilocaine at 25° C. This mixture has a lower melting point than any of the two ingredients. It helps to make the preparation oily that can be applied on the intact skin. Eutectic mixture...
Unknown
null
fd1ee63c-dabb-4cad-81d1-1c10d31642a7
Use of tamoxifen for breast cancer can cause all of the following adverse effects, except:
Thromboembolism
Endometrial carcinoma
Carcinoma in contralateral breast
Cataract
2c
multi
Ans. c. Carcinoma in contralateral breast Tamoxifen is associated with reduced risk of cancer in the contralateral breast."Tamoxifen is approved for primary prophylaxis of breast cancer in high risk women. If reduces the recurrence rate of breast cancer in ipsilateral as well contralateral breastTamoxifen is associated...
Pharmacology
Anti-Neoplastic Agents
2b3aa846-08da-434d-87ca-b94a9ba4424b
Nail pitting is seen with ?
Paronychia
Ectodermal dysplasia
Alopecia areate
All the above
3d
multi
Ans. is'd' i.e., All the above
Skin
null
8cbac4ad-bcf4-496a-848d-326013401a7f
Widal Test is:
Flocculation test
Agglutination test
Both
None
1b
multi
Agglutination test
Microbiology
null
87b2fa8d-ac69-47fa-a294-99abffaa0a14
A 30 year old male presents with recurrent attacks of sweating and dizziness. Fuher workup reveals low blood glucose levels with inappropriatlely elevated insulin and C-peptide levels. Imaging shows a lesion in the pancreas. He is diagnosed with insulinoma and given diazoxide. Which of the following is the mechanism of...
Opening of the sensitive K+ channels
Closing of the ATP sensitive K+ channels
Increase in number of GLUT-4 receptors
Opening of the volatage sensitive Ca+2 channels
0a
single
Diazoxide acts by opening ATP sensitive K+ channels and causing a decrease in insulin secretion. Glucose enters beta cells of the pancreas GLUT-2 receptors. Once inside, it is phosphorylated by glucokinase (rate-limiting step) to glucose-6-phosphate which is oxidized to form adenosine triphosphate(ATP). This leads to o...
Physiology
Endocrinology
1dc6c06c-3cd6-41af-a368-d3a415df45f2
Troponin-T is preferable to CPK-MB in the diagnosis of acute myocardial infarction (MI) in all of the following situations except:
Bedside diagnosis of MI
Postoperatively (after CABG)
Reinfarction after 4 days
Small infarcts
2c
multi
Answer is C (Reinfarction after four days) Because cardiac troponins are elevated for prolonged periods (> I week) an episode of recurrent ischaemia after four days would be more readily diagnosed with a marker that remains elevated in blood more briefly such as cKMB .4,41, returns to normal levels by 72 hours. Limitat...
Medicine
null
c9b0b8b9-be1e-4b4a-a10d-90bea2471604
Equivalent to macrophages are -
Keratinocytes
Histiocytes
Mast cells
Microphages
1b
single
Ans. is 'b' i.e., Histiocytes Monocyte/Macrophageso Mononuclear phagocytes (MP) also known as macrophages or histiocytes are distributed throughout virtual all tissues. The macrophage is the dominant cellular player in chronic inflammation. MP arise from monoblast in the marrowy and they are released into the circulati...
Physiology
General
c62a6fd2-33de-483f-9bb3-b506460af945
Characterstic X Ray finding in ASD is:
Enlarged left ventricle
Enlarged left atria
Pulmonary pletheora
PAH
2c
single
C i.e. Pulmonary plethora
Radiology
null
7a3c1409-8288-4da3-a407-b332ae46e862
Amnesia, fugue, and multiple personality are all classified as which behaviour disorder?
Personality disorders
Dissociative disorders
Psychotic disorders
Organic mental disorders
1b
multi
In dissosiation when the patient faces a stress the psychological pain is conveed to sudden change in ones identity which can be a change in the form of memory, motor behaviour or one's identity Dissociative Amnesia u Most common type u adolescents / younger adults u Female>male u Abrupt onset, abrupt termination, few ...
Psychiatry
All India exam
deed20e5-f47a-4ab0-836c-003232c65802
Branches of coeliac axis are all except:
Splenic aery
Left gastric aery
Hepatic aery
Inferior phrenic aery
3d
multi
D. i.e. Inferior Phrenic aery
Anatomy
null
c1f606b2-60d4-43f7-82c2-6fc4cd96f0bb
The following is true about endotracheal cuff. It has-
high volume, low pressure
Low volume, low pressure
High volume, high pressure
Equal volume and pressure
0a
multi
cuff pressue * Low volume high pressure: # Require inflation to a high pressure to effect a seal with trachea. #The pressure within a low volume cuff does not relate to the pressure exeed by the cuff on the trachea. # However, a high pressure may be exeed on the mucosa if the cuff is overinflated. This may occur inadve...
Anaesthesia
Anaesthetic equipments
fc04de77-507a-4a63-aa3d-cd08b9437c66
Aromatase enzyme converts -
Estrogen to androgen
Androgen to estrogen
Progesterone to estrogen
Androgen to progesterone
1b
single
Ans. is 'b' i.e., Androgen to estrogen o Aromatase conversts androgens into estrogen in peripheral tissues.
Physiology
Sex Hormones
a7fe280b-34b8-4a85-9a19-dde598ba89a2
MHC restriction is a pa of all except aEUR'
Antiviral cytotoxic T cell
Antibacterial helper T cell/cytotoxic cells
Allograft rejection
Autoimmune disorder
3d
multi
Autoimmune disorder Major histocompatibility complex : Major histocompatibility complex, also called the human leucocyte antigen (HLA) complex is a 4 megahase region on chromosome 6. This region is densely packed with genes. These genes encodes two major proteins or antigens i.e., MHC I & MHC II. These proteins play an...
Pathology
null
d895d8e7-e6b5-41f4-b02c-a06eac08e10a
During the uterine contraction of labour, the uterine blood flow :
Decreases
Increases
does not change
Temporarily cases
0a
single
Decreases
Gynaecology & Obstetrics
null
17e283be-6891-4805-966a-eb41fcd84c7a
A 72-year-old man is prescribed hydrochlorothiazide for hypertension. Which of the following is the most likely symptomatic side effect?
increased serum potassium
metabolic acidosis
sexual impotence
respiratory alkalosis
2c
single
The most common symptomatic side effect in men is impotence, and it should be specifically looked for. The most serious complications relate to fluid and electrolyte imbalance and include hyponatremia, hypokalemia, and volume contraction.
Medicine
Endocrinology
aa9f52a1-7058-413a-b7e3-1424327b31df
FALSE about Open Angle Glaucoma is
Mild to moderate increase in IOP
Shallow Anterior chamber
Progressive peripheral visual field loss
Cupping of optic disc
1b
multi
(B) Shallow Anterior chamber # OPEN-ANGLE GLAUCOMA:> is an optic neuropathy characterized by progressive peripheral visual field loss followed by central field loss, in a characteristic pattern.> Usually but not always in the presence of elevated intraocular pressure (IOP), perhaps in part related to increased aqi eous...
Ophthalmology
Miscellaneous
71c196df-0a1c-4c79-a2be-2197b1b7c2ea
Steroid involved in water balance:
Oestrogen
Testosterone
Aldosterone
Vit D
2c
single
Ans: c (Aldosterone)Ref: Ganong, 23rd ed Pg. 357Aldosterone is the steroid that is mainly involved in water balance.AldosteroneIt increases the reabsorption of Na and excretion of K .It acts on the kidney - primarily the Principal cells of the collecting duct. Stimuli for secretion -Rennin angiotensin systemIncreased K...
Physiology
Endocrinology and Reproduction
e2567ee3-172e-4253-89d8-1a5e1a38ec72
Left ventricular failure is said to be present if pulmonary capillary wedge pressure exceeds:September 2009
5 mm Hg
10 mm Hg
15 mm Hg
20 mm Hg
3d
single
Ans. D: 20 mm HgAcute pulmonary edema is defined as the sudden increase in pulmonary capillary pressure (usually more than 20 mm Hg) as a result of acute and fulminant left ventricular failure.Patient appears extremely ill, poorly perfused, restless, sweaty, with an increased work of breathing and using respiratory acc...
Physiology
null
de803c1d-d6b5-49b1-ba45-ed4abe3ec0ef
Following renal disorder is associated with worst pregnancy outcome:
Systemic lupus erythromatosus
IgA nephropathy
Autosomal dominant polycystic kidney disease
Scleroderma
3d
single
Prognostic indicators in renal disease and pregnancy: Most reliable prognostic indicator of the outcome of pregnancy is the presence of hypertension. The fetal prognosis for women with chronic renal disease is favorable as long as they do not develop superimposed preeclampsia. Second to hypertension, the most valuable...
Gynaecology & Obstetrics
null
d59494a0-9a40-4a5f-856b-568a24f4716c
Cytogenetics for synovial cell sarcoma is -
t (X : 18)
t (17, 9)
t (9, 22)
t (11,14)
0a
single
Synovial cell Sarcoma (SCS)  Synovial cell sarcoma forms about 10% of all soft tissue sarcomas. Although the name suggests an origin from the synovial linings, less than 10% of them are intra-articular. Most synovial sarcomas show a characteristic chromosomal translocation t (X: 18) producing SYT-SS X1 or - SS X2 fusi...
Pathology
null
4e27c57c-40a7-4841-827b-f0560e36c9c3
pANCA positive vasculitis is
Wegener's granulomatosis
Churg - Strauss syndrome
Polyaeritis nodosa
All of the above
1b
multi
Answer- b. Churg - Strauss syndromePANCATypically found in:MicroscopicpolyangiitisChurg-StrausssyndromeIdiopathiccrescenticglomerulonephritisGoodpasteur'ssyndrome.pANCA's are also associated with ceain non-vasculitic entities such as ceain rheumatic and nonrheumatic autoimmune diseases, Inflammatory bowel diseases, cea...
Medicine
null
7550be07-7af8-42e2-8187-1d7f680c6bcf
Pagets disease increases the risk of
Osteoma
Osteosarcoma
Fivrosarcoma
All
1b
multi
Osteosarcoma Osteosarcomas are bulky tumors that are gritty, gray-white, and often contain areas of hemorrhage and cystic degeneration (Fig. 26-24). The tumors frequently destroy the surrounding coices and produce soft tissue masses. They spread exten- sively in the medullary canal, infiltrating and replacing hemato- p...
Anatomy
Musculoskeletal system
d4af32dd-386b-4c10-b484-f109b2b4a7ad
Drug of choice of hypeension in pregnancy is ?
Methyldopa
Thiazide
Nifedipine
Labetalol
0a
single
Ans. is 'a' i.e., Methylopa o Methyldopa is DOC for hypeension in pregnancy. o Nifedipine is 2nd choice. o Hydralazine is DOC for hypeensive emergencies in pregnancy.
Pharmacology
null
82903521-5b80-4eb0-8bbe-0061efe36856
Best diagnostic test for Best's disease is:
Dark adaptation
ERG
EOG
Gonioscopy
2c
single
Ans. EOG
Ophthalmology
null
b8c1d5cc-04bf-47d1-8d2c-4142b6ab0ac6
Which teratogen causes deafness Imatinib is used in the treatment of ?
Chronic myelomonocytic leukemia
MDS
ALL
GIST
0a
multi
Isotretinoin Isotretinoin can cause nzicrotia or anotia. These defects are frequency associated with agenesis or stenosis of the external ear canal and may lead to deafness. According to international journal of pediatrics otorhinolaryttgology "Despite extensive precautions for its use, isotretinoin remains a cause of ...
Pharmacology
null
3099ddd1-42bf-48a7-a4be-9852cd99840f
Identity the true statement about Pulmonary embolism:
S1 Q3 T3 is the most common ECG finding seen
There will be Left axis deviation
D-dimer is the gold standard investigation
Sinus tachycardia is most common finding on ECG
3d
multi
S1 Q3 T3 is highly predictive sign but not the most common ECG finding. And there will be right axis deviation. D-Dimer is best for screening not gold standard investigation.
Surgery
null
2b404aab-837f-4d8b-8123-b17d9b5cf79b
Mutation leading to sickle cell anemia?
Crossover mutation
Frame shift
Deletion
Point mutation
3d
single
Ans. is D i.e., Point mutation. Sickle cell anemia is a hereditary hemoglobinopathy, i.e., the type of disease characterized by production of defective hemoglobin. Sickle cell anemia results from mutation in b-globin gene. It is caused by a point mutation (Base substitution mutation) at the sixth position of the b-glob...
Pediatrics
null
4b29261a-e222-4bf5-bffd-77e6b7d14246
Which is true of malaria -
Rods forms are seen in P. malariae
RBC size is more in P. vivax
Relapse seen in P. falciparum
Male and female mosquito transmit disease
1b
multi
RBCs shape and size malaria: P. vivex - Enlarged, Round and Bizarre form P. falciparum - Normal in size P. malariae - Normal in size P. ovale - Enlarged, Oval and Fimbriated margin Relapse: Seen in P. vivax and P. ovale Recrudescence: Seen in P. falciparum and P. malariae infections Definitive host: Female Anopheles mo...
Microbiology
Parasitology Pa 1 (Protozoology)
f8ad01ff-a0a6-4a0c-a575-4b4994b5c3f2
Air under central tendon of diaphragm is
Air under diaphragm sign
Cupola sign
Doges cap sign
Falciform ligament sign
1b
single
The 'Cupola sign' is seen on a supine chest/abdominal radiograph in the presence of pneumoperitoneum. It refers to non-dependent gas that rises within the abdominal cavity of the supine patient to accumulate underneath the central tendon of the diaphragm in the midline.
Radiology
Gastrointestinal Radiology
1ea18537-26ca-425e-a211-fe1cc09cb12b
The most impoant prognostic factor of Wilms tumor-
Histopathology
Ploidy of cells
Age < 1 y
Mutation of c 1p gene
0a
single
Robbins basic pathology 10th edition page no 290. Wilms tumor or nephroblastoma is the most common primary tumor of the kidney in children. On microscopic examination, Wilms tumors are characterized by recognizable attempts to recapitulate different stages of nephrogenesis. The pattern of anaplastic cells within the pr...
Pathology
Pediatrics, environment and nutrition
6c2bcad9-25f9-4ae7-bfae-eb0735da8d1a
Urgent reversal of warfarin induced bleeding can be done by the administration of
Cryoprecipitate
Platelet concentrates
Fresh frozen plasma
Packed red blood cells
2c
single
Fresh frozen plasma contains clotting factors . Hence given immediately in warfarin induced bleeding. From essential of medical pharmacology K D Tripati 7th edition Page no 620
Pharmacology
Hematology
87874e64-753d-4528-8d2e-6c3514a52c68
Which of these are true of Gilbe's syndrome ?
Increased liver transaminases
Unconjugated hyperbilirubinemia
Bleeding tendency
Presence of auto-antibodies
1b
multi
Ans. is 'b' i.e., Unconjugated hyperbilirubinemia
Pediatrics
null
27d104d7-9c07-4a04-8980-bf7da5694f06
A 43-year-old woman develops acute renal failure following an emergency resection of a leaking abdominal aortic aneurysm.Three days after surgery, the following laboratory values are obtained:* Serum electrolytes (mEq/L): Na+:127;K+:5.9;Cl-:92;HCO3-:15* Blood urea nitrogen: 82 mg/dL* Serum creatinine: 6.7 mg/dLThe pati...
10% calcium gluconate, 10 mL
Digoxin, 0.25 mg every 3 h for three doses
Oral Kayexalate
Lidocaine, 100 mg
0a
single
The electrocardiogram exhibited in the question demonstrates changes that are essentially diagnostic of severe hyperkalemia. Correct treatment for the affected patient includes administration of a source of calcium ions (which will immediately oppose the neuromuscular effect of potassium) and administration of sodium i...
Surgery
Wounds, Tissue Repair & Scars
9c62cbba-3833-4bd7-a72f-ae4f92a03664
Which muscarinic receptor causes dilatation of vessels-
M1
M2
m3
m4
2c
single
Ans. is 'c' i.e., M3 o M3 receptors are found in vessels (endothelium). Activation of these recepters causes vasodilatation by release of EDRF (NO).o M3 receptors are unique muscarinic receptors in that their activation does not cause release of acetylcholine, rather causes relcease of EDRF (NO).
Physiology
Chemical Messengers: Receptors
c33164c3-6451-43b9-b35f-7036ca63e47e
Injection DMPA is given once in ?
3 days
3 week
3 months
3 years
2c
single
Ans. is 'c' i.e., 3 months Depot formulations (Injectable hormones) They are given i.m. as oily solution 1. Long acting progestin alone Depot medroxy progesterone acetate (DMPA) 150 mg at 3 month intervals. or Norethindrone (norethisterone) enanthate (NEE) 200 mg at 2 months intervals. The most impoant undesirable prop...
Social & Preventive Medicine
null