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Scar endometriosis can occur following : | Ans. is d i.e. All of the above Endometriosis sometimes occurs in abdominal wall scars following operations on uterus or tubes and is known as Scar endometriosis. Operations most likely to be followed by scar endometriosis Hysterotomydeg * Classical cesarean sectiondeg Myomectomydeg * Ventrofixationdeg Following operations for section of Fallopian tubedeg * Following operations for removal of pelvic Episiotomydeg endometriosisdeg | 4 | Classical Cesarean Section | Hysterotomy | Episiotomy | All of the above | Gynaecology & Obstetrics | null | 583121fc-95c1-4e8a-bd7d-f80f1d223566 | multi |
Which of the following is the most common predisposing factor for placenta accreta? | Placenta accreta is the attachment of placenta directly to the myometrium without any intervening decidua basalis Impoant risk factor : * Placenta pre ( most common ) * Prior cesarean section | 4 | Myomectomy | Recent curettage | Previous cesarean section | Placenta pre | Gynaecology & Obstetrics | Placenta - Types and their complications | 846be67d-4d7b-4eea-b950-c81d2fd17e08 | single |
What is the best characterizes of the sinusoids | sinusoids - In some tissues the 'exchange' network is made up of vessels that are somewhat different from capillaries, and are called sinusoids. Sinusoids are found typically in organs that are made up of cords or plates of cells. These include the liver, the adrenal coex, the hypophysis cerebri, and the parathyroid glands. Sinusoids are also present in the spleen, in the bone marrow, and in the carotid body. The wall of a sinusoid consists only of endothelium suppoed by a thin layer of connective tissue. The wall may be incomplete at places, so that blood may come into direct contact with tissue cells. Deficiency in the wall may be in the form of fenestrations (fenestrated sinusoids) or in the form of long slits (discontinuous sinusoids, as in the spleen). At some places the wall of the sinusoid consists of phagocytic cells instead of endothelial cells. Sinusoids have a broader lumen (about 20 um) than capillaries. The lumen may be irregular, Because of this fact blood flow through them is relatively sluggish. REF: Inderbir Singh's Textbook of Human Histology, seventh edition, pg.no.,218. | 2 | Have smaller diameter than lymph capillaries | Are not found in skeletal muscle | Have a continuous endothelial lining | Have a continuous basement membrane | Anatomy | General anatomy | c57f9567-484b-45ce-b570-a2e35abbdbe9 | multi |
The chest CXR of patient shows? | CXR shows the presence of reticular nodular shadows in both lung fields. Choice A is ruled out since emphysema shows hyperinflation with flattening of the diaphragm. Choice C and D are associated with increased CT ratio and cardiac borders can be ruled out. Hence answer by exclusion is choice B | 2 | Emphysema | Reticular shadows | Batwing edema | Kerley B lines | Medicine | Interstitial Lung Disease | de51cebe-a745-4538-ab7c-e066f4c0b07f | single |
Elschnig&;s pearls are a sign of | After cataract It is also known as 'secondary cataract'. It is the opacity which persists or develops after extracapsular lens extraction. Causes: (i) Residual opaque lens matter may persist as after cataract when it is imprisoned between the remains of the anterior and posterior capsule, surrounded by fibrin (following iritis) or blood (following hyphaema). (ii) Proliferative type of after cataract may develop from the left-out anterior epithelial cells. The proliferative hyaline bands may sweep across the whole posterior capsule. Clinical types: After cataract may present as thickened posterior capsule, or dense membranous after cataract. Soemmering's ring: which refers to a thick ring of after cataract formed behind the iris, enclosed between the two layers of capsule. pearls: in which the vacuolated subcapsular epithelial cells are clustered like soap bubbles along the posterior capsule. Ref:- A K Khurana; pg num:-201 | 1 | Secondary cataract | Cystoid macular oedema | Chronic uveitis | All of the above | Ophthalmology | Lens | c8dd1209-766f-4901-8ec0-6a83d54510d9 | multi |
Regarding urinary bladder stone one is Not true ? | Answer is 'b' i.e. Uric acid stones are dropped from above It is the oxalate stones that are usually dropped from above (i.e. formed in the kidney and dropped in the bladder through ureter). Uric acid stones are mostly formed within the bladder. In general most of the bladder calculi are formed within the bladder itself. Only some stones are formed in the kidney and pass into the bladder, where they grow by additional deposition of crystals. Etiology for Bladder calculi Bladder outlet obstruction is the most common cause of vesical calculi in adults. Other causes are - neurogenic bladder leading to urinary stasis - a foreign body eg. Foley catheter and forgotten DJ stent, which serve as nidi for stones. - bladder diveicula Bladder stones are commonly seen in older men (>50 yrs.) usually because of bladder outlet obstruction In the Western world bladder stones are rare in pediatric population but bladder stones are endemic in children in underdeveloped nations (in Noh Africa, Thailand, Burma, Indonesia i.e. found near the tropics). This is because of low-protein, high carbohydrate diet and chronic dehdyration. These are usually ammonium urate stones. Common vesical stones are Uric acid stones & Struvite stones Other less common stone types are Oxalate stones Cystein stones Struvite stones are also known as 'Jack stones' because of their rough surface as against the smooth surface of uric acid stones. Struvite stones are composed of ammonium, magnesium and calcium phosphates and occurs in urine infected with urea-splitting organisms, eg. proteus. Bladder stones are usually solitary but may also be multiple. | 2 | Common in Paediatric pt in tropics than that of non tropical areas | Uric acid stones are dropped from above | Jack stone is due to urea splitting bacteria | Commonly distal passage obstruction cause stone | Surgery | null | 5954e5fb-b9c6-4e0b-836f-5dd56503a6cb | multi |
A 13 year old boy has bilateral gynecomastia. i is height is 148 cm, weight 58 kg; the sexual maturity rating is stage 2. The gynecomastia is most likely due to – | null | 3 | Prolactinoma | Testicular tumour | Pubertal gynecomastia | Chronic liver disease | Pediatrics | null | 7b660d57-98de-454d-aa47-292b265f3ec2 | single |
Following is used to stain fungi | null | 1 | PAS | Fontana stain | Ferrous trichrome | Pearls prussian blue | Pathology | null | edda2042-4ce7-49bf-8b78-c128ba93381d | single |
Fluoresciene stain is used in the eye to stain ? | Ans. is 'a' i.e., Cornea Impoant corneal examinations Keratometry, Corneal topography Specular microscopy Slit lamp Pachymeter Placido's disc Fluorescein, Alacian blue & Bengal rose stain Window reflex, slit lamp biomicroscopy, Placidos' disc Used for Curvature of cornea Corneal endothelial density Corneal opacity Thickness of cornea Corneal sheen Corneal staining Corneal surface | 1 | Cornea | Retina | Choroid | Iris | Ophthalmology | null | 2fb7dc3b-1c9c-4523-81e5-f638a6d60476 | single |
Hea failure cells are - | Ans. is `b' i.e., Pigmented alveolar macrophageso Hea failure cells (siderophages) are hemosiderin containing macrophages in alveoli that are seen in left ventricular failure and denote previous episodes of pulmonary edema.Left sided hea failure o The major morphological and clinical effects of LVF are due increased back pressure in pulmonary circulation and the consequences of diminished peripheral blood pressure and flow.o The extracardiac organs involved commonly are ?1. Lung (most common)2. Kidney3. BrainLungo Pressure in the pulmonary veins increases and transmitted retrogradely to capillaries and aeries. o This results in pulmonary congestion and pulmonary-edema --> Wet lung.o There is perivascular and interstitial transdate, paicularly in the interlobular septa --> responsible for kerley's `B' lines on X-rays.o Edematous fluid accumulates in alveoli.o Iron containing proteins and hemoglobin leak out from the capillaries, and are phagocytosed by macrophages and conveed to hemosiderin.o Hemosiderin - containing macrophages in the alveoli (called siderophages, or hea failure cells) denote previous episodes of pulmonary edema.o The clinical manifestations of LVF are primarily due to these changes in lungs Dysnea, ohopnea, paroxysomal nocturnal dysnea.Kidneyo Decreased cardiac output causes a reduction in renal perfusion.o If it is severe enough to impaire the excretion of nitrogenous product (BUN, Creatinine), Prerenal ARF (Prerenal azotemia) may be precipitated.Braino Reduced perfusion to brain may cause hypoxic / ischemic encephalopathy. | 2 | Lipofuscin granules in cardiac cells | Pigmented alveolar macrophages | Pigmented pancreatic acinar cells | Pigment cells seen in liver | Pathology | null | 0b024109-b675-4d63-aa96-6594b245f35f | single |
Submental lymph nodes drains from - | Ans. is 'a' i.e., Centre of lower lips Submental lymph nodeso These lymph nodes lie on the mylohyoid in the submental triangle. The receive afferents from superficial tissue below chin, central part of lower lip, adjoining gums, anterior part of the floor of the mouth and tip of the tongue. These nodes, themselves, drain into (efferent) into submandibular nodes. | 1 | Centre of lower lips | Posterior 1 /3 of tongue | Anterior 2/3 of tongue | Angle of mouth | Anatomy | Oral Cavity & Tongue | c333ea69-4004-464a-8b28-8ad492afc746 | single |
Amoebic liver abscess most commonly affects - | Ans. is 'a' i.e., Right lobe of liver Amoebic Liver abscesso Caused by Entamoeba histolytica whose cysts are acquired through the feco-oral route and their trophozoites reach the liver through portal venous systemo Like pyogenic abscess they are also common in rt. lobe of livero Clinical Picture# the typical clinical picture is of a patient 20-40 yrs of age who has travelled to an endemic area, presents with fever, chills, anorexia, rt. upper quadrant pain.# although liver abscess results from an obligatory colonic infection, a recent history of diarrhoea is uncommon.# jaundice is rare. (c.f. in pyogenic abscess jaundice is seen in -25% of pts.)o Liver function tests may show mild abnormalities, hyperbilirubinemia is uncommono CT > U/S are the mainstay of investigation.o Diagnosis is confirmed by serological tests (enzyme immuno assay) for antiamoebic antibodieso Cultures of amoebic abscess are usually negativeo Treatment# Metronidazole is the mainstay of t/t and is curative in over 90% of patients.(other nitroimidazoles i.e. secnidazole, tinidazole, are also effective)#Therapeutic needle aspiration is avoided. Done only wheno pt. fails to respond to metronidazoleo high risk of ruptureo abscess secondarily infected with pyogenic organismo Complications may occur uncommonly; these are# rupture into the peritoneum, pleural cavity or pericardium. | 1 | Right lobe of liver | Left lobe of liver | Portal vein | Right pleural cavity | Surgery | Hepatic Tumors, Cysts, and Abscesses | a65c561a-3316-49be-bd2d-1a624d03bf8c | single |
Apple-jelly nodules is/are seen in: | Ans: A (Lupus vulgaris) Apple jelly nodules:characterized by yellow-brown nodules with tiny darker granules. On probing, the noduies are soft jelly-like"- Neena Khanna 3rd/217Lupus Vulgaris Neena Khanna 3rd/217MorphologySingle (or few) lesions.Well demarcated, annular or arcuate plaques which slowly extend centrifugally. Periphery' shows erythematous to brownish, deep seated nodules which on diascopy9 may stand out as apple jelly nodules..Over period of time, the center becomes atrophic (paper thin), depigmented and scarred. Characteristically, new nodules may appear within area of scarringFeatures of Psoriasis are: Isomorphic phenomenon for Koebner's phenomenon), ring of Woronoff, (a hypopigmented halo surrounding plaque), silvery scales, positive grattage test, Auspitz sign, Munro's micro-abscesses etc- Neena Khanna 3rd/40-41Psoriasis Neena Khanna 3rd/38It is a chronic dermatosis characterized by an unpredictable course of remissions and relapses and presence at typical sites of papules and plaques which are:Well definedErythematous.Surmounted with large, silvery, loose scales.DLE Neena Khanna 3rd/ 186Characteristic lesion is a well demarcated coin shaped (discoid), annular, erythematous plaque with adherent scalesWhen the scale is removed, its undersurface show's keratotic spikes which have occupied the dilated pilosebaceous canals (carpet tack sign)Features of Licken planus are: Isomorphic phenomenon (or Koebner's phenomenon), Wickham's striae (surface has white streaks when viewed under a magnifying lens)- Neena Khanna 3rd/ 52 | 1 | Lupus vulgaris | DLE | Lichen planus | Psoriasis | Skin | C. Mycobacteria | 4d94fb8f-f3be-4392-a555-2256015f61d4 | single |
Both PT and APTT are prolonged in - | Ans. is 'a' i.e., Factor II deficiencyo Prolongation of both PT and A PPT is typically seen in deficiency of involoved in the common pathway, namely factor //, factor V and factor X (and fibrinogen).o Heparin in clinical concentrations is typically associated with isolated prolongation of APTT while PT is normal be cause heparin acts on the intrinsic pathway. (However Heparin at very high concentrations within the sample may cause prolongation of both PT & APTT). | 1 | Factor II deficiency | Thrombocytopenia | Factor VII deficiency | Heparin therapy | Medicine | Bleeding and Thrombotic Disorders | 72f2d5c0-9419-4fc5-a396-b8316e5d68ee | multi |
Fejereskov and Thylstrup index is used for | null | 2 | Caries Index in primary teeth | Index to measure Fluorosis | Gingival Bleeding Index | Periodontal Index | Dental | null | b205e045-f3af-4dc9-9049-d348a22b1c87 | single |
At which level the somites initially form- | The first pair of somites develop a short distance posterior to the cranial end of the notochord, and the rest of the somites from caudally. | 2 | Thoracic level | Cervical level | Lumbar level | Sacral level | Anatomy | null | a875ff74-4138-4641-816c-c1037cecf34d | multi |
An infant has papulovesicular lesions on palms, soles, face and trunk. The diagnosis would he | Ans. a. Scabies Scabies: Primary lesions are of three types:Q Burrow: Serpentine (S-shaped) path traversed by parasite in stratum corneumQ. It is pathognomic of lesion. Papules and papulovesicles: Due to hypersensitivityto the mite Fine pin head size follicular papules Scalp, face, palms and soles are characteristically spared in adultsQ. In infants, scalp, face, palms and soles are typically involvedQ. Atopic dermatitis: In order to qualify as a case of atopic dermatitis with the UK refinement of Hanifin and Rajka's diagnostic criteria for atopic dermatitis, the child must have An itchy skin condition (or parental repo of scratching or rubbing in a child)plus Three or more of the following: Onset below age 2 years (not used if child is under 4 years) History of skin crease involvement (including cheeks in children under 10 years) History of a generally dry skin Personal history of other atopic disease (or history of any atopic disease in a first degree relative in children under 4 years) Visible flexural dermatitis (or dermatitis of cheeks/forehead and outer limbs in children under 4 years) Uicaria: Present with wheals, angioedema or both. Wheals is the descriptive term for transient, well-demarcated, superficial erythematous or pale swellings of the dermis, which are usually very itchy and are associated with a surrounding red flare initially. Angioedema swellings affect the deeper dermal, subcutaneous and submucosal tissues. They are usually painful rather than itchy, poorly defined, and pale or normal in colour Seborrhoeic Dermatitis: Occurs on hairy sites, flexures or on central trunk Characterized by itching or burning, severe dandruff, greasy yellow scales (stuck on appearance) | 1 | Scabies | Atopic dermatitis | Uicaria | Seborrhoic dermatitis | Skin | null | 3c621a20-423a-48e1-ba8f-bf4d4759fce5 | single |
Blood supply of femoral head is: | B i.e. Obturator aery | 2 | Femoral aery | Obturator aery | Internal pudendal aery | All | Anatomy | null | 167efc54-fa4d-4d2c-904b-b36cf7040875 | multi |
Hyperpolarization is due to | In hyperpolarization the membrane becomes more negative It is due to continued potassium efflux or chloride ion influx. Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:67,68,69 | 1 | Influx of chlorine | Influx of potassium | Influx of sodium | All | Anatomy | General anatomy | 2bf471cf-6bce-4665-bffa-7e06e131c2e6 | multi |
Which of the following cancer makes up the majority in reproductive tract neoplasms during pregnancy? | Cancer in the reproductive tract may also complicate pregnancy and of these cervical neoplasia makes up the majority.Cervical > Ovary > Uterus, Vulva or Vagina(Ref: William's Obstetrics; 25th edition) | 2 | Vaginal | Cervical | Uterine | Ovarian | Gynaecology & Obstetrics | All India exam | fd61091f-97e0-4d50-9ea4-9f325c7f662b | single |
Resistance to acyclovir is most commonly due to mutation in a viral gene that encodes a protein that: | (Ref: KDT 6/e p768) Nucleoside/tide analogues (like acyclovir) act by conveing to NTPs. First phosphorylation step occurs inside the virs and resistance occurs if there is mutation in this gene. | 2 | Conves viral RNA into DNA | Phosphorylates acyclovir | transpos acyclovir into the cell | Transpos acyclovir out of the cell | Pharmacology | Other topics and Adverse effects | 5d9a0623-6ec1-4dc5-bf90-8b6e0b42049f | single |
Which of the following stages of gypsum expansion shows initial crystal growth? | Imagine that the initial mix is represented in the figure (stage I) by the three round particles of hemihydrate surrounded by water.
Under normal setting conditions, the crystals of the dihydrate begin to form on the nuclei. The water around the particles is reduced by hydration and these particles are drawn more closely together because surface tension of the water keeps the water surface area at a minimum (stage II).
As the crystals of dihydrate grow, they contact each other and the water around the particles again decreases (stage III).
Further dihydrate growth consumes more water and should draw the crystals together as before, but the outward thrust of the growing crystals opposes this contraction (stage IV).
Eventually, the crystals become intermeshed and entangled (stage V).
Key Concept | 2 | I | II | III | IV | Dental | null | f74bef4a-c236-4fa2-8e13-13faa3e3b47f | single |
In neonates, spinal cord ends at:March 2010 and 2012, March 2013 | Ans. C: L3 | 3 | L1 | L2 | L3 | L4 | Anatomy | null | 923fbe25-caa5-4388-9465-63b9133a416c | single |
Which of the following is the most important interaction in the formation of cell membrane lipid bilayer and in lipid-protein interaction? | Interactions in the cell membrane.
- Hydrophobic (most important)–
Between lipids- Information of lipid bilayer
Transmembrane proteins and lipids
- Van der walls interaction
Between lipids- Information of lipid bilayer
Transmembrane proteins and lipids
- Electrostatic bonds
Between transmembrane and peripheral proteins
- Hydrogen bonds
Between transmembrane and peripheral proteins
- Covalent bond (least important)
Peripheral protein with the hydrophilic end of phospholipid | 1 | Hydrophobic interactions | Both hydrophobic and convalent interactions | Covalent bonds | Hydrogen bonds | Physiology | null | f2a070f5-c219-4479-b9df-acf2ca2123e3 | multi |
Spot the diagnosis in the following IVU | Note the ectopic kidney seen in the pelvis on left side above the urinary bladder. This patient had solitary right kidney, which was normal in position. Ectopic kidneys are found in one in 1000 people, usually on the left near the pelvic brim. The other kidney is generally normal. A diseased ectopic kidney may present diagnostic problems and may be mistakenly excised as an unexplained pelvic mass. | 4 | Horse shoe kidney | Bladder diveiculum | Pelvic mass | Ectopic kidney | Radiology | Genitourinary radiology | 19383a25-6995-4415-a34b-7e5ae4da4563 | single |
Which of the following is true regarding the principle of use of MRCP | MRI cholangiography and MRI cholangiopancreaticography (MRCP) are imaging techniques used to evaluate the biliary system. Heavily T2- weighted images are used to provide an overview of the biliary system and pancreatic duct Excellent diagnostic - quality images are obtainable, with high sensitivity and specificity for evaluation of biliary duct dilation, strictures and intra ductal abnormalities Ref: Blumga surgery of liver, biliary tract and pancreas 5th edition Pgno : 315 | 3 | Intra liminal dye is used to create the three dimension view of the structures | Dye is instilled percutaneously first then MRI is used | Use of heavily T2-weighted image without contrast to create the three dimensional image of the biliary tree using MIP algorithm | Use of systemic Gadolinium as a contrast agent to create the three dimensional image of the biliary tree | Anatomy | G.I.T | c6d037fd-bbc7-43b4-a3ef-bf05ce9c4eab | multi |
A 5 years old boy presents with hepatomegaly, hypoglycaemia, ketosis. The diagnosis is: | Ans. B. Glycogen Storage Disorder(Ref: Nelson 20e Chapter 715 Defects in metabolism of Carbohydrates)Patients with type IGSD may present in the neonatal period with hypoglycemia and lactic acidosisThese children often have doll-like faces with fat cheeks, relatively thin extremities, short stature, and a protuberant abdomen that is due to massive hepatomegaly; the kidneys are also enlarged, whereas the spleen and heart are normal.The biochemical hallmarks of the Type Ia GSD (Von Gierke's) disease are hypoglycemia, lactic acidosis, hyperuricemia, and hyperlipidemia | 2 | Mucopolysaccharidosis | Glycogen storage disorder | Lipopolysaccharidosis | Diabetes mellitus | Biochemistry | Carbohydrates | 9a05da9b-02ba-4a30-a5e2-2d5cb2298df4 | single |
Early fusion of coronal suture along with other skull sutures is seen in: | Premature closure of the coronal suture results in a ahigh, tower-like cranium, called oxycephaly or turricephaly. It is more common in females. | 2 | Brachycephaly | Oxycephaly | Trigonocephaly | Scapocephaly | Anatomy | null | dce8de49-8525-4e50-a17c-4e770c840a87 | single |
In Hanup's disease, the following amino acids are excreted into the urine | Hanup disease reflects impaired intestinal and renal transpo of tryptophan and other neutral amino acids.The defect limits tryptophan availability for niacin biosynthesis and accounts for the pellagra-like signs and symptomsHarper 30th edition Pg: 308 | 3 | Basic amino acids | Acidic amino acids | Neutral amino acids | Hydrophilic aminoacids | Biochemistry | Metabolism of protein and amino acid | 855cf896-4f81-4f71-94ba-c5076d3ba405 | single |
The contribution of operation of sodium potassium electrogenic pump for the development of net -90 millivolt on resting membrane potential is | null | 1 | -4 millivolt | -80 millivolt | -70 millivolt | +4 millivolt | Surgery | null | 985953c7-eb82-4a46-9205-5d5e86a2c3f3 | single |
Malleus and Incus are derived from? | A i.e. First arch | 1 | First arch | Second arch | Third arch | Fouh arch | Anatomy | null | 86e0203a-807c-46ee-aa01-8769ac31c285 | multi |
Which of the following is known to cause Pedal Botryomycosis - | null | 3 | Actinomyces somaliensis | Nocardia asteroides | Staphylococcus aureus | All of the above | Microbiology | null | db773618-4e3a-4c1a-b2d2-8da77cb74621 | multi |
A farmer is found convulsing in the farm. Diarrhea, sweating and urination are apparent. Pupils are pin point. Drug poisoning is suspected. Most probable cause is: | Ans. C. Organophosphate poisoningThese are characteristic features of anti-cholinesterase (organophosphate and carbamate) poisoning.A. Symptom due to muscarinic actions: (DUMBELS)* Diarrhoea, Diaphoresis* Urination* Miosis* Bronchoconstriction* Excitation CNS* Lacrimation,* SalivationB. Symptom due to nicotinic action:Skeletal muscle fasciculations, weakness leading to (diaphragmatic) paralysis and deathTwo kinds of poisonings result in pin point pupil i.e. Opioids Poisoning and Organophosphate Poisoning | 3 | Acetaminophen overdose | Amphetamine toxicity | Organophosphate poisoning | Atropine poisoning | Pharmacology | Anaesthesia | 1a75f21b-fae8-4c17-b4a1-732899826a80 | single |
In post-ductal coarctation of aoa, collaterals may be formed by which of the following: | Suprascapular aery, Subscapular aery, Posterior intercostal aery and Veebral Aery may all form channels for collateral ciculation in coarctation of aoa. The veebral aery is probably the least prominent pathway for collateral circulation amongst the options provided and hence may be accepted as the single best answer by exclusion. Ref: Moss and Adams' hea disease, 7th Edition, Page 990; Gray's Anatomy, 36th Edition, Page 710, 40th Edition, Page 984, 985; Radiology of Peripheral Vascular Diseases By Zeitler, Ammann, 2000, Page 324; Aoic Diseases : Clinical Diagnostic Imaging Atlas By Hutchison (Elsevier), 2008, Page 273. | 4 | Veebral aery | Suprascapular aery | Subscapular aery | None | Anatomy | null | bcd2bd64-68a5-437f-a0e4-1990576cf211 | multi |
Which enzymatic mutation is responsible for immortaity of cancer cells | Prevention of telomere shortening with every cell division, due to activity of telomerase is the cause of immortality in cancer cells, germ cells, and stem cells as it protects from cellular aging and apoptosis. | 3 | DNA reverse transcipatase | RNA polymerase | Telomerase | DNA polymerase | Biochemistry | null | b0fa4358-b1d3-4405-8b29-2c0dab66816c | single |
Because of an inflammatory bowel disease (Crohn's disease) and a small bowel obstruction leading to bowel ischemia, an elderly woman requires bypass of her ileum and jejunum and is scheduled for a gastrocolostomy. The surgeon will ligate all aeries that send branches to the stomach. Which of the following aeries may be spared? | The inferior pancreaticoduodenal aery does not supply the stomach. All the other aeries supply the stomach. | 3 | Splenic aery | Gastroduodenal aery | Inferior pancreaticoduodenal aery | Left gastroepiploic aery | Anatomy | Stomach and aerial supply of abdomen | eaa79ce5-2cda-4404-9c7e-4aa7176a8cb6 | multi |
Multiple drug resistance is transferred through - | Ans. is 'c' i.e., Conjugation Resistance to multiple drugs is transmitted by R factor (plasmid) o R factor is transferred from one bacterium to other by conjugation. o Transduction and mutation usually cause resistance to one drug. o Transformation is not involved significantly in drug resistance. | 3 | Transduction | Transformation | Conjugation | Mutation | Pharmacology | null | 18817371-aae2-4e83-9db8-732b06531d7a | single |
Which line of death ceificate represent major antecedent cause of death - | Ans. is 'c' i.e., Ic International death ceificate The basis of moality data is death ceificate. For ensuring national and international comparability, it is necessary to have a uniform and standardized system of recording and classifying deaths. For this purpose WHO has recommended international death ceificate. Consist of four lines: Line Ia: Disease or condition directly leading to death Line Ib: Antecedent/ underlying cause Line Ic: Main antecedent / underlying cause Line II: Other significant conditions contributing to death but not related to disease/ condition causing it Example of a death ceificate: Line Ia: Renal failure Line Ib: Diabetic nephropathy Line Ic: Diabetes mellitus Line II: Hypeension Concept of underlying cause, Line Ic is the most impoant line in death ceificate, thus also known as `Essence of Death Ceificate'. | 3 | Ia | Ib | Ic | II | Social & Preventive Medicine | null | fa2e5107-26ee-487d-97a7-7a957e4a5eca | single |
Which of the following is not associated with mucous secretion? | Panthet cells are not associated with mucous secretion, it secretes lysozyme and also has some phagocytic functions. Goblet cells are specialized mucus secreting cells present throughout the intestine. Brunners glands are found in the submucosa of small intestine, they produce viscid, mucoid, alkaline secretion which neutralize acid chyme. Crypts of Lieberkuhn secretes mucus, electrolytes and water. | 1 | Paneth cell | Goblet cell | Brunner's glands | Crypts of Lieberkuhn | Physiology | null | 52854007-73d3-45e5-9b38-ef30cda2723a | single |
Which of the following cranial nerves do not carry parasympathetic outflow | Parasympathetic cranial nerves are 3-occulomotor 7-facial 9-glossopharyngeal 10-vagus Refer kDT 7/e p78 | 2 | Occulomotor | Trochlear | Facial | Glossopharyngeal | Pharmacology | Autonomic nervous system | dcc3c697-23eb-4dca-bfdc-4d3c3f35115f | single |
Which is not given in anaphylactic reaction? | null | 3 | Epinephrine | Anti-histamine | Blood transfusion | Beta-adrenergic agonists | Pharmacology | null | 697a4432-84aa-49fc-9be9-52f7f71abfc4 | single |
A hospitalized patient has an ejection fraction of 0.4, a hea rate of 95 beats/min, and a cardiac output of 3.5 L/min. What is the patient's end-diastolic volume? | First, calculate stroke volume from the cardiac output and hea rate: Cardiac output = stroke volume x hea rate; thus, stroke volume = cardiac output/ hea rate = 3500 mL/95 beats/min = 36.8 mL. Then, calculate end-diastolic volume from stroke volume and ejection fraction: Ejection fraction = stroke volume/end-diastolic volume; thus end-diastolic volume = stroke volume/ejection fraction = 36.8 mL/0.4 = 92 mL. | 4 | 14 mL | 37 mL | 55 mL | 92 mL | Physiology | Cardiac Output | da2e7620-e32d-4298-b5bd-eb6f5b5e1908 | single |
Phantom limb is an example of disorder of: | Perception is defined as any information which is perceived through sensory organs In phantom limb, the patient feels sensations in the amputated limb which in reality is not present. Hence, it's a disorder of perception. | 2 | Thought | Perception | Cognition | None of the above | Psychiatry | Basics of Psychiatry | 9e758ccb-3bcc-461d-a31b-0feb910ee961 | multi |
The most common prescription medication for sialorrhea | Traditional medications for the treatment of drooling target the reduction of saliva production using anticholin- ergic mechanisms. While they will reduce salivary output, they do not treat the underlying neuromuscular problems, so some patients may find the anticholinergic side effects out - weigh the benefit of the drug. Additionally, the drying effect these medications have can lead to xerostomia, especially if the patient has a constant open mouth. Glycopyrrolate is the most common prescription medication for sialorrhea and drooling , with atropine sulfate, scopolamine, amitriptyline, and benztropine also being reported in the literature. OnabotulinumtoxinA (Botox ) injections into salivary glands with ultrasonic guidance have shown to be of some benefit in patients who have failed or are intolerant to anticholinergics | 1 | Glycopyrrolate | Atropine sulphate | Scopolamine | Amitriptyline | Pathology | null | 9011e96e-d8d9-481d-9847-19b48c8f7466 | single |
True about Measles rash appearance: | RASH IN MEASLES Stas 12-24 hours after appearance of Koplik spots. Retro -auricular origin spreads to other pas of body (fades in opposite direction). Takes 1 - 2 days to cover body * Fever is highest and patient is sickest on day of rash. | 3 | Along with Koplik spots | 1-2 days before Koplik spots | 1-2 days after Koplik spots | Post measles stage | Social & Preventive Medicine | Respiratory Infections | 6091e027-b401-4a86-9fd3-164e480ca485 | multi |
Grading disease severity as mild, moderate, severe is an example of which scale? | There are characteristics that should be measured in terms of quantities but nonavailability of a good instrument compels measure in terms of what is called an ordinal scale. Example is disease severity measured as mild, moderate or severe. Ref: Medical biostatistics, 1st edition pg: 99 | 2 | Nominal | Ordinal | Interval | Ratio | Social & Preventive Medicine | null | 2a07a02a-45c3-4d00-87b9-09165148e4ad | single |
Which of the following antitubercular drugs is not hepatotoxic | Refer KDT 6/e p743 Streptomycin and Ethambutol are not hepatotoxic Read carefully option (c) is Ethionamide AMD not Ethambutol | 4 | Isoniazid | Rifampicin | Ethionamide | Streptomycin | Pharmacology | Chemotherapy | 1040818c-4093-449d-b4ad-a2445c4e7a2d | single |
Landau-Kleffner syndrome is characterized by all of following except | Ans. C. Normal EEG during sleep Ref : Nelson Textbook of Pediatrics 20th/ed p2837ExplanationLandau-Kleffner syndrome is a condition of unknown cause characterized by:# Loss of language skills attributed to auditory agnosia in a previously normal child# Seizures (focal, generalized tonic-clonic, atypical absence, partial complex, and, occasionally, myoclonic seizures).# High-amplitude spike-and-wave discharges ON EEG which are always more apparent during non-rapid eye movement sleep; thus, a child in whom Landau-Kleffner syndrome is suspected should have an EEG during sleep, particularly if the awake record is normal.# CT and MRI studies typically yield normal results. | 3 | Seizure | Loss of language skill | Normal EEG during sleep | Normal brain CT scan | Pediatrics | Central Nervous System | 32b366a1-fb34-4016-a2c1-3d52381cb5e7 | multi |
Nicotinic acid ? | Ans. is 'a' i.e., Increases HDL Nicotinic acid (Niacin) There arc three main type of lipases related to metabolism of lipoproteins ? Lipoprotein lipase - Present in blood vessels and causes hydrolysis of tryglyceride content of VLDL and chylomicrones. Hepatic lipase - Conves IDL to LDL by hydrolysing the triglyceride content of IDL. Hormone sensitive lipase - Present intracellularly in peripheral tissue and causes intracellular lipolysis by hydrolysing triglycerides. Niacin (Nicotinic acid) inhibits intracellular lipolysis by inhibiting hormone sensitive lipase - intracellular FFA to liver - 4 .1, triglyceride synthesis. Niacin also increases the activity of lipoprotein lipase - T hydrolysis of VLDL triglyceride. Nicotinic acid also reduces the production of VLDL in liver by inhibiting TG-synthesis - indirectly the VLDL degradation products IDL and LDL are also reduced. Nicotinic acid is the most effective drug to raise HDL-CH. Increased HDL is due to interference of direct pathway of HDL cholesterol to liver which involves apo-Ai - Niacin decreases apo- A, mediated hepatic clearance. Nicotinic acid is used in type I, III, IV & V hyperlipoproteinemias. | 1 | Increases HDL | Increased triglyceride synthesis | Type II hyperlipoproteinemia | Decreased hydrolysis of VLDL | Pharmacology | null | 8a6cd863-7239-4364-922a-4a22f0f71904 | single |
Circulus aeriosus iridis major is formed by the anastomosis of | Anterior ciliary aeries: These are derived from the muscular branches of ophthalmic aery. These aeries pass anteriorly in the episclera, give branches to sclera, limbus and conjunctiva; and ultimately pierce the sclera near the limbus to enter the ciliary muscle; where they anastomose with the two long posterior ciliary aeries to form the circulus aeriosus major, near the root of iris. Reference :- A K KHURANA; pg num:-136 | 3 | Long posterior ciliary aeries with sho posterior ciliary aeries | Long posterior ciliary aeries with anterior conjunctival aeries | Long posterior ciliary aeries with anterior ciliary aeries | Anterior ciliary aeries with sho posterior ciliary aeries | Ophthalmology | Anatomy, Development and clinical examination | d779bcc8-f9ab-4bf5-a78c-84693308e74a | single |
A 20 year old patient presents with syncope. His current ECG is shown below. His elder brother had died suddenly while watching television. The patient was given Cardioversion and subsequent cardiac MRI revealed fibro-fatty changes in RV myocardium. What is the diagnosis of this patient? | Arythmogenic RV dysplasia(ARVD) ECG shows HR of 300/min with broad complex tachycardia. Variation in amplitude of QRS complexes which indicates a diagnosis of polymorphic Ventricular Tachycardia. In acute setting DC shock 200 J Biphasic should be given. The Cardiac MRI repo showing fibro-fatty changes in RV myocardium explains that the substrate for initiation of Polymorphic VT is originating from RV. This confirms the diagnosis as Arythmogenic RV dysplasia(ARVD) ECG - Presence of Epsilon wave. | 2 | Hyperophic obstructive Cardiomyopathy | Arythmogenic RV dysplasia | Brugada syndrome | Tako- Tsubo Cardiomyopathy | Medicine | ECG and Arrhythmias 1 | d5210d12-6dda-4a4c-b9c2-cd2d934a4118 | single |
Most common phase I biotransformation reaction is? | Ans. is 'a' i.e., Oxidation Oxidation is the most impoant metabolizing reaction. | 1 | Oxidation | Hydrolysis | Cyclisation | Reduction | Pharmacology | null | 22285557-454d-4537-8d8b-096ccaad4c38 | single |
Sulfasalazine is used in - | Ans. is 'a' i.e., Ulcerative colitis Inflammatory bowel disease (crohn's disease & ulcerative colitis)o 5-aminosalicylic acid (5-ASA) is the main anti-inflammatory compound that acts locally in colon. It is the first line of treatment in mild to moderate UC and CD. When given alone 5-ASA is absorbed > 80% in proximal intestine and very little reaches upto colon. To decrease the absorption it may be associated with some innert compound.o Sulfasalazine (5-AS A + sulfapyridine), olsalazine (ASA+ASA) and balsalazide (5-AS A + aminobenzoylalanine) are effective in ulcerative colitis.o Different formulations of 5-ASA have been developed to deliver it to colon, called mesalamine.o Other drugs used in IBD are :-1. Glucocorticoids - They are used only for remission of U.C. and have no role in maintenance therapy.2. Purine analogues (Azathioprine, 6-MP) - Can be used for the induction and maintenance of remission of U.C. and C.D.3. Methotrexate - Can be used in CD, but has no use in U.C.4. Anti TNF-a (Infliximab, adalimumab, certolizumab, etanercept) - Can be used in CD.5. Cyclosporine - Used in severe U.C., which is refractory to glucocorticoids.6. Anti-Integrin therapy (Natalizumab) is recently approved for moderate to severe Crohn's disease not responding to other therapies. It is targeted against a4 subunit of integrins. The patient on natalizumab therapy should not be given other immunosuppressants due to risk of progressive multifocal leukoencephalopathy. | 1 | Ulcerative colitis | Osteoarthritis | Gouty arthritis | Irritable bowel syndrome | Pharmacology | G.I.T | 00d2ec9a-b4a0-4e1f-8806-b30803ad4bd3 | single |
Kaposi sarcoma is caused by: March 2013 | Ans. C i.e. HHV 8 Kaposi sarcoma (KS) It is a tumor caused by Human herpesvirus 8 (HHV8), also known as Kaposi sarcoma-associated herpesvirus (KSHV). It was originally described by Moritz Kaposi , a Hungarian dermatologist practicing at the University of Vienna in 1872. It became more widely known as one of the AIDS-defining illnesses in the 1980s. Kaposi's sarcoma (KS) is a systemic disease that can present with cutaneous lesions with or without internal involvement. Four subtypes have been described: - Classic KS, affecting middle aged men of Mediterranean descent; - African endemic KS; KS in iatrogenically immunosuppressed patients; and - AIDS-related KS. Classic KS tends to be indolent, presenting with erythematous or violaceous patches on the lower extremities. African endemic KS and AIDS-related KS tend to be more aggressive. The AIDS-related KS lesions often rapidly progress to plaques and nodules affecting the upper trunk, face, and oral mucosa. The diagnosis can be made with a tissue biopsy and, if clinically indicated, internal imaging should be done. | 3 | HHV 6 | HHV 7 | HHV 8 | All of the above | Microbiology | null | 5e6eadec-afaf-47d1-b8c6-259852f3d548 | multi |
All of the following are examples of microdeletion syndromes, EXCEPT: | The term contiguous gene syndrome refers to genetic disorders that mimic a combination of single-gene disorders. They result from the deletion of a small number of tightly clustered genes. Because some are too small to be detected cytogenetically, they are termed microdeletions. The application of molecular techniques has led to the identification of at least 18 of these microdeletion syndromes. Some of the more common ones include the Wilms' tumor-aniridia complex (WAGR), Miller Dieker syndrome (MDS), and velocardiofacial (VCF) syndrome. WAGR is characterized by mental retardation and involvement of multiple organs, including kidney (Wilm's tumor), eye (aniridia), and the genitourinary system. Ref: Harrison's principle of internal medicine 17th edition, chapter 64. | 4 | Wilms' tumor-aniridia complex | Miller Dieker syndrome | Velocardiofacial syndrome | None of the above | Medicine | null | c0b26902-473a-4579-9674-20a9aef5ab3d | multi |
All are true for PTSD except | D i.e. Anxiolytic is treatment of choice | 4 | Hippocampus & amygdala | Anhedonia | Depression and quilt | Anxiolytic is treatment of choice | Psychiatry | null | a9d6a4df-029e-4955-bf03-388dc4580f0b | multi |
Which of the following is true regarding Pneumothorax? | Spontaneous pneumothorax in most patients occurs from the rupture of blebs and bullae. Primary spontaneous pneumothorax (PSP) is typically observed in tall, young people without parenchymal lung disease and is thought to be related to increased shear forces in the apex. Secondary spontaneous pneumothoraces (SSP) occur in the presence of lung disease, primarily in the presence of COPD. Other diseases that may be present when SSPs occur include tuberculosis, sarcoidosis, cystic fibrosis, malignancy, and idiopathic pulmonary fibrosis. Chest tube drainage is the treatment of choice. | 4 | May occur in asthma patient | Pleuritic chest pain may be present | Decreased breath sounds | All the above | Medicine | null | 114a81b1-9922-4108-84e7-9fcac92978f2 | multi |
'Herald patch' is seen in: | Ans. A. Pityriasis rosea. (Ref. Harrison's 18lh/pg. 367)In Pityriasis rosea, initially, there is a single 2- to 6-cm annular salmon-colored patch (herald patch) with a peripheral rim of scale, followed in days to weeks by a generalized eruption involving the trunk and proximal extremities.Pityriasis rosea:# It is an acute, self-limiting skin condition. A primary plaque ('herald patch') is followed by a distinctive, generalized itchy rash 1-2 weeks later. The rash lasts for approximately 2-6 weeks. Lesions are typically oval, dull pink or tawny and appear in a 'Christmas tree' distribution, usually on the trunk and the upper arms and legs.# It is thought that human herpes viruses 6 and 7 may play a role in etiopathogenesis. Some drugs, eg bismuth, barbiturates, captopril, gold, metronidazole, D-penicillamine and isotretinoin occasionally cause a drug-induced pityriasis rosea.# Pityriasis rosea is a self-limiting disease, and treatment is supportive.# Exposure to sunlight is helpful.# Topical zinc oxide and calamine lotion are useful for pruritus.# Pruritus can also be treated with topical corticosteroids, oral antihistamines or antipruritic lotions.# Oral erythromycin may be effective in treating the rash and decreasing the itch.- Pityriasis alba is an uncommon feature of atopic dermatitis that presentsin children and adolescents. Light- coloured skin spots also occur in pityriasis alba (slightly scaly, on skin exposed to the light), Gibert's pityriasis rosea, pityriasis versicolor (Gr. "pityron" = bran; refers to the light skin scaliness). Pityriasis versicolor is a very common skin infection with a fungus: Pityrosporum ovale (yeast stage) or Malassezia furfur (mycelium stage). This lipophilic fungus forms the tyrosinase inhibitor azelaic acid from sebaceous fats, a substance which inhibits melanin synthesis. This explains the white appearance of the skin spots. Account must be taken of the fact that depigmented skin spots can also be caused by damage to the melanocytes (pigment cells) after an ordinary infection, wound or bum (post-inflammatory hypopigmentation), due to vitiligo (the texture of the skin with this condition is otherwise normal), as a residual lesion in endemic treponematosis and syphilis (the differential diagnosis is often difficult here). It is important to know that people with leprosy often have a false positive VDRL (screening for syphilis). TPHA permits differentiation.Pityriasis rubra pilaris (also known as "Devergie's disease,"or "Lichen ruber acuminatus," and "Lichen ruber pilaris"refers to a group of chronic disorders characterized by reddish orange, scaling plaques and keratotic follicular papules. Symptoms may include reddish-orange patches (Latin: rubra) on the skin, severe flaking (Latin: pityriasis), uncomfortable itching, thickening of the skin on the feet and hands, and thickened bumps around hair follicles. | 1 | Pityriasis rosea | Pityriasis rubra pilaris | Pityriasis lichenoides et varioliformis acuta | Pityriasis alba | Skin | Papulosquamous Disorders | 66b83499-305c-4995-9dda-1d73d559451d | single |
Common fungus causing corneal ulcer -a) Aspergillusb) Mucorc) Fusariumd) Sprothrix | null | 4 | a | bc | ad | ac | Microbiology | null | af398a68-b91e-4911-a7c2-fe1228b53042 | single |
A 34-year-old man is brought to the emergency room by his family because of extreme lethargy. After further questioning, he admits to taking a large number of phenobarbital tablets. Which of the following is the most appropriate next step in management? | Activated charcoal absorbs barbiturates very effectively and is useful in decontamination of the GI tract. Renal elimination of phenobarbital is enhanced by alkalinization of the urine to a pH of 8 with sodium bicarbonate and fluids. Hemodialysis and hemoperfusion are reserved for extreme cases with refracting hypotension. Short-acting barbiturates are metabolized in the liver, so fluid administration and alkalinization are not helpful. | 2 | acidification of urine to pH 3.0 | repetitive administration of activated charcoal | ipecac to induce vomiting | hemoperfusion | Medicine | Miscellaneous | abd22ebe-9179-43ca-b09c-8fdb4d8bf4f6 | multi |
Degree of freedom for 2/2 contingency table is? | Ref: Parks 23rd edition Degree of freedom = (r-1)(c-1) =(2-1)(2-1)= 1 | 1 | 1 | Zero | 2 | 4 | Social & Preventive Medicine | Biostatistics | 1eec3dab-7c27-4682-b67a-622efaa6eac9 | single |
Most common cause of lobar hemorrhage in the elderly | Answer- C. Amyloid angiopathyLobar intracerebral hemorrhage is bleeding in the largest pa of the brain called the cerebrum.Intracerebral hemorrhage are attributed to hypeensive vasculopathy in small penetrating brain aeries and subcoical vessels in patients with amyloid angiopathy.Amyloid angiopathn a chronic deposition of congophilic rnaterial in brain vessels, is the most common cause of lobar hemorrhage in older patients. | 3 | Coagulopathy | Aneurysm | Amyloid angiopathy | Trauma | Medicine | null | 051b8b6f-020c-426b-8a19-623e0ba582a2 | single |
Which of the following is not true about spasmodic dysphonia | SPASMODIC DYSPHONIA Spasmodic dysphonia is also called as laryngeal dysphonia. The condition is characterised by spasm of phonatory muscles. It is a neurological disorder and is of following types: (A) Adductor spasm (M/C):- Adductor muscles go into spasm lead ing to strained and strangled voice (scratchy creaky voice). Management :- Botulinum toxin injection in thyroarytenoid muscle. (B) Abductor spasm:- Abductor muscles go into spasm. Vocal cords are unable to abduct leading to leakage of air during speech. The voice is breathy or whispery. Management :- Botulinum toxin injection in posterior cricoarytenoid muscle. Ref:- Dhingra; pg num:-314 | 1 | Local laryngeal disorder | May be associated with other focal dysphonia | Patient with the abductor type have strained and strangled voice | Botulinum toxin is the standard treatment for it | ENT | Larynx | c072acce-9fbe-4bde-bfc5-0f4b8da4cb72 | multi |
Which of the following organism is biggest ? | Ans. is 'a' i.e., Balantidium coli | 1 | Balantidium coli | Entamoeba coli | Escherichia coli | Entamoeba histolytica | Microbiology | null | 35c720cf-9c40-43a8-b936-e9b0f17f5878 | single |
Drug producing haematological side effect is: | Ans: A (Nitrous oxide) Ref: Ajax Yadav, Short Textbook of Anesthesia, 1st edition, pg 59.Explanation:Nitrous oxide produces Aplastic anemia and Megaloblastic anemiaNITROUS OXIDE (LAUGHING GAS)Stored as liquid in blue color cylinderE5 times more heavier than air35 times more soluble than nitrogenAnesthetic propertiesIt is not a complete anesthetic.It is used as a carrier gas to other anestheticsMAC is 104% (It is not possible to deliver, so not a complete anesthetic).Maximum concentration which can be given is 66%.A minimum of 33% of Oxygen has to be given (Otherwise can cause severe hypoxia)It is usually given as N20 66% and 02 33% mixtureBlood gas coefficient is 0.47 making it agent w ith faster induction and recoveryGood analgesicNot a muscle relaxantWhen given with other inhalational agent, it increases the concentration of that agent (Second gas effect) and also its own concentration (Concentration effect)Sudden stoppage can lead to Diffusion Hypoxia (Should always be tapered slowly by giving 100% oxygen)MetabolismIt is not metabolized in human body.It is excreted unchanged in lungsSmall amount is excreted via skin (Percutaneous excretion)Impurities in N20 cylinder can cause severe laryngospasm, methhemoglobinemia and Pulmonary edemaSystemic ActionsCVS: It does not depress the myocardium in vivo, so it can be safely used in patients with cardiac disease and shockCNS: It increases cerebral metabolic rate and raises intra cranial tensionRS: It causes tachypnea and decrease tidal volume, maintaining minute volumeVentilatory response to hypoxia is bluntedNo significant effect on Liver and KidneysSide EffectsHematological: It inactivates vitamin B12 (If used for >6 hours) - defective folate metabolism - Bone marrow depression - Aplastic anemia and Megaloblastic anemiaCNS: Vitamin B 12 deficiency can cause Demyelination of spinal cord (Subacute degeneration of spinal cord) especially involving posterior columns and lateral spinothalamic tractsClosed Gas Spaces: Compliant spaces like gut. penumoperitoneum, pneumothorax and non- compliant spaces like middle ear cavity, pneumoencephalum can develop very high pressure following nitrous oxide inhalation.This happens because for I mole of nitrogen removed. 35 moles of nitrous oxide enter (35 times more soluble than nitrogen.Therefore, Nitrous oxide is contraindicated inPneumothoraxPneumoperitoneumPneumoencephalumMiddle ear surgeryPosterior fossa surgeryLaproscopic surgeryAcute intestinal obstruction and volvulus of gutEye surgeriesUses in AnesthesiaAs a supplement to anesthesia (not a complete anesthetic)As a carrier gas for inhalational agentsAs analgesic in obstetrics, dental pain, burn dressing and acute trauma | 1 | Nitrous oxide | Halothane | Ketamine | Sevoflurane | Anaesthesia | Miscellaneous General Anesthesia | 81009b09-9466-4ba6-9bf4-87d0d79bd920 | single |
A patient presents with endocrinopathy. fibrous dysplasia of bone and hyperpigmentation. What should be the possible diagnosis? | Mc Cune Albright syndrome is a triad of Precocious puberty (endocrinopathies) fibrous dysplasia, cafe-au-lait spots. | 3 | Ollier's syndrome | Mazabraud syndrome | Mc Cune-Albright syndrome | Maffucci's syndrome | Pathology | null | 2139c14b-367c-41dc-85bb-8bd6ab36da77 | single |
Paneth cells characterized by | Paneth cells are zinc-containing cells widely distributed in Lieberkuhn's crypts of small intestine in many species, but their function has remained obscure. Our previous study showed that a single intravenous injection of diphenylthiocarbazone (dithizone), a zinc chelator, forms zinc-dithizonate complexes in the cytoplasm of Paneth cells to ensure rapid and selective killing of the cells. REFERENCELE nih.gov | 2 | More number of lysosomal enzyme | High concentration of zinc | More concentration of EFR | Foamy cells | Pathology | G.I.T | 2374249c-f96b-4f33-a825-a614587d5f71 | single |
The following drug has significant drug interaction with the digoxin except | Cholistyramine inhibits intestinal absorption of digoxin Thiazides result in hypokalemia and thus me precipitate digitalis toxicity by pharmacodynamic interaction Quinidine and verapamil reduces the excretion of digoxin and Thus may precipitate the toxicity(pharmakokinetic interaction) Refer kDT 6/e p499 | 4 | Cholestyramine | Thiazide diuretics | Quinidine | Amlodipine | Pharmacology | Cardiovascular system | 184f084d-e54b-4886-bcf2-166829061f30 | multi |
Acute cholinesterase inhibitors intoxication include all of the following except | Cholinesterase inhibitors have cholinomimetic actions. The major source of such intoxications is pesticide use in agriculture.The dominant initial signs are those of muscarinic excess: miosis, salivation, sweating, bronchial constriction, vomiting, and diarrhea. Central nervous system involvement (cognitive disturbances, convulsions, and coma) usually follows rapidly, accompanied by peripheral nicotinic effects, especially depolarizing neuromuscular blockade.Katzung 13e pg:118 | 2 | Salivation, sweating | Mydriasis | Bronchial constriction | Vomiting and diarrhea | Pharmacology | Autonomic nervous system | 70e42988-5271-46b9-9bd7-d1b7669c0694 | multi |
Calcium is absorbed from: | All the divalent cations, except Mg++ , are absorbed from duodenum. Mg++ is absorbed from ileum. Calcium is absorbed mainly in duodenum and upper jejunum, not whole of jejunum. | 1 | Duodenum | Jejunum | Ileum | Colon | Physiology | Gastrointestinal System | 4fabc0a1-0b39-44bc-bd47-df23f119fd29 | single |
A 62-year-old childless woman noticed a blood-tinged vaginal discharge twice during the past month. Her last menstrual period was 10 years ago. Bimanual pelvic examination shows that the uterus is normal in size, with no palpable adnexal masses. There are no cervical erosions or masses. Her body mass index is 33. Her medical history indicates that for the past 30 years she has had hypertension and type 2 diabetes mellitus. An endometrial biopsy specimen is most likely to show which of the following? | Postmenopausal vaginal bleeding is a red flag for endometrial carcinoma. Such carcinomas often arise in the setting of endometrial hyperplasia. Increased estrogenic stimulation is thought to drive this process, and risk factors include obesity, type 2 diabetes mellitus, hypertension, and infertility. Choriocarcinomas are gestational in origin. A submucosal leiomyosarcoma could produce vaginal bleeding, but the uterus would be enlarged because leiomyosarcomas tend to be large masses. Malignant mullerian mixed tumors are much less common than endometrial carcinomas, but they could produce similar findings. Malignant mullerian mixed tumors are typically uterine neoplasms that have glandular and stromal elements; the malignant stromal component can be heterologous and may resemble mesenchymal cells that are not ordinarily found in the myometrium, such as cartilage. Squamous carcinomas of the endometrium are rare, and more likely to arise in the cervix. | 1 | Adenocarcinoma | Choriocarcinoma | Leiomyosarcoma | Malignant mullerian mixed tumor | Pathology | Female Genital Tract | d8245966-fb0e-4aab-8c10-d60c6aa586e0 | single |
Aquaporin deficiency cause? | 1. Nephrogenic diabetes insipidus: Aquaporin 2" gene mutation impede the normal functionality of the kidney water channel, which results in the kidney being unable to absorb water. Autosomal recessivemanner. 2. Liddle syndrome: Gain of function of epithelial Na channel (ENaC) 3. Bater syndrome:- Defect in "Na-K-2Cl cotranspoer, Cl channel & ROMK" in loop of Henle. 4. Gitelman syndrome: Defect in "Na+-Cl- cotranspoer and TRPM6 transpoer" in DCT. | 1 | Nephrogenic diabetes insipidus | Liddle syndrome | Baer syndrome | Gitelman syndrome | Medicine | NEET Jan 2020 | 9d861117-6c17-4302-8648-af97b7d78acd | single |
Sonographic criteria for diagnosing PCOD includes all except | Presence of 12 or more cysts on ultrasound is diagnostic of PCOD. | 2 | Enlarged ovaries > 10mL | Presence of > 20 cysts in ovary | Cyst size 2 → 9 mm | Cysts in either one or both ovaries | Gynaecology & Obstetrics | null | 6596667c-daff-4ad9-838f-1d7e370bf7d1 | multi |
Letrozole belongs to which group? | Ans. is 'd' i.e., Aromatase inhibitors Aromatase inhibitorso Aromatase inhibitors are drugs which inhibit the enzyme Aromatase.o Aromatase is an enzyme responsible for the conversion of testosterone (androgens) to estrogens.o This conversion of androgens to estrogens occur in several tissues including ovary, adrenal cortex, peripheral tissues.o Inhibition of Aromatase leads to decrease in estrogen level.o Aromatase inhibitors prevent the conversion of androgens to estrogens only in postmenopausal women, not in premenopausal women.o In premenopausal women, as the level of estrogens decrease it activates the pituitary hypothalamic axis. Activation of pituitary hypothalamic axis leads to increased secretion of pituitary gonadotropins. The pituitary gonadotropins inturn increase the secretion of estrogens. Thus the estrogen level returns back to their normal level.o On the other hand aromatase inhibitors effectively decrease the secretion of estrogen in postmenopausal women.o In postmenopausal women, the production of estrogen from androgens occurs, only in extraovarian sites such as peripheral tissues where the conversion of androgens to estrogens is blocked by aromatase inhibitors.Use of aromatase inhibitorso Aromatase inhibitors are used in the t/t of Hormone receptor positive breast carcinomas in postmenopausal women. They are not effective in premenopausal women.How are Aromatase inhibitors useful in Breast carcinomas ?o In breast carcinomas, estrogen delivers growth signals to the hormone receptors. The hormone receptors upon receiving the growth signals, cause the proliferation of tumor cells,o After the inhibition by aromatase inhibitors, estrogen level decreases, this leads to lesser delivery of growth signals and in turn lesser proliferation of tumor cells.Aromatase inhibitors are of two types :o Type I (steroidal) aromatase inhibitor - They cause irreversible inhibition of aromatase, e.g. Exmestane. formestane.o Type II (non-steroidal) aromatase inhibitor - They cause reversible inhibition of aromatase e.g. Anastrazole, Letrozole, vorozale.o Above classification is based on chemical structure (steroidal or non-steroidal ) and type of inhibition (reversible or irreversible). Based on the evolution the aromatase inibitors are:First generation - AminoglotethimideSecond generation - Steroidal type I(Example, formestane), non-steroidal type II (Anastrazole, Letrozole, Vorozole, fadrozole)o Side effects - Hot flushes, nausea, diarrhoea, dyspepsia, thinning of hair and Joint Pain (Arthralgia) and increased risk of fracture.o There is no endometrial proliferation (no risk of endometrial carcinoma), no risk of venous thromboembolism and no deterioration of lipid profile.Remembero Anastrozole and letrozole are nonsteroidol compound, while exemestane is steroidol.o Exemestane also has weak androgenic activity',o Anastrozole is more potent than letrozole.o First generation aromatase inhibitors - Aminoglutethimide.o Second generation aromatase inhibitors - Letrozole, anastrozole, fadrozole and exemestone. | 4 | SERM | SERD | LHRH analogues | Aromatse inhibitors | Pharmacology | Sex-Hormone | 83fb5ffb-3d0c-4f8c-a55f-f5e819d2f37b | single |
CAD predisposing factors-a) Homocysteinemiab) ↓ Lipoprotein Bc) ↑ Fibrinogend) ↑ HDLe) ↑ plasminogen activator inhibitors 1 | Homocysteine and Prothrombotic (↑ fibrinogen and ↑ plasminogen activator inhibitors) factors are emerging risk factors for atherosclerosis and coronary heart disease. | 4 | acd | bde | cde | ace | Pathology | null | 93f32b42-91e6-4a96-874d-79f0ebae9491 | single |
Drug of choice for prophylaxis of acute mountain sickness is? | DOC for acute mountain sickness are Carbonic anhydrase inhibitors like Acetazolamide. BEST treatment is to descent down because it occurs due to decreased pO2 at high altitudes. DOC for motion sickness is Hyoscine. | 4 | Diltiazem | Digoxin | Dexamethasone | Acetazolamide | Pharmacology | Kidney | 61db1f3c-f8de-400b-9885-15e292e6f33d | single |
In modern day obstetrics, most common cause of rupture uterus is - | Ans. is 'b' i.e., Previous LSCS scar rupture * Disruption in the continuity of all uterine layers: endometrium, myometrium and serosa anytime beyond 28 weeks of pregnancy is called rupture of uterus.Incidence* 1 in 2000 to 1 in 200 deliveries. Rupture uterus from obstructed labor is becoming less because of improved obstetric care, but prevalence of scar rupture is increased because of increase in LSCS rates.Etiology* Rupture of previous LSCS scar during VBAC is one of the commonest cause of rupture uterus today.* Spontaneous (intact or unscarred uterus)* Scar rupture* Iatrogenic.* LSCS scar generally ruptures in labor (mainly in second stage or towards end of first stage) and unlikely to rupture during pregnancy.* Iatrogenic rupture is mainly due to injudicious use of oxytocin or prostaglandins (for induction or augmentation of labor) and very very rarely due to Internal Podalic Version and destructive operations as they are not performed in modern day obstetrics. | 2 | Prolonged labour | Previous LSCS scar rupture | Forceps delivery | Internal podalic version | Gynaecology & Obstetrics | Miscellaneous (Gynae) | 2f831bc8-b2c6-47da-a76a-9ada20456324 | single |
Which one of the following serum levels would help in distinguishing an acute liver disease from chronic liver disease - | null | 4 | minotransaminase | Alkaline phosphatase | Bilirubin | Albumin | Medicine | null | 24c0ce75-6e0e-47e2-aa9d-0c035ee63291 | single |
Which of the following features are of naso alveolar cyst | null | 2 | An ovoid shaped radiolucency above the lateral incisor and canine teeth | Erosion of base above lateral incisor and canine teeth | An inverted funnel shaped radiolucent lesion above the roots of lateral incisor and canine teeth | A pear shaped radiolucent Lesion between roots of lateral incisor and canine teeth | Pathology | null | fce84819-33a1-4d96-acc6-2a3124f92b68 | multi |
A child develops non blanching macules and papules on lower extremities, mild abdominal pain and skin biopsy showed IgA deposition. Most appropriate diagnosis is - | Henoch-Schonlein purpura (HSP), also known as IgA vasculitis, is a disease of the skin, mucous membranes, and sometimes other organs that most commonly affects children. In the skin, the disease causes palpable purpura (small, raised areas of bleeding underneath the skin), often with joint pain and abdominal pain. With kidney involvement, there may be a loss of small amounts of blood and protein in the urine (hematuria and proteinuria), but this usually goes unnoticed; in a small propoion of cases, the kidney involvement proceeds to chronic kidney disease. HSP is often preceded by an infection, such as a throat infection HSP is a systemic vasculitis (inflammation of blood vessels) and is characterized by deposition of immune complexes containing the antibody immunoglobulin A (IgA); the exact cause for this phenomenon is unknown. In children, it usually resolves within several weeks and requires no treatment apa from symptom control but may relapse in a third of cases and cause irreversible kidney damage in about one in a hundred cases. In adults, the prognosis is different from in children. The average duration of cutaneous lesions is 27.9 months.For many, it tends to be relapsing-remitting over a long period of time, rather than self-limiting and there tend to be more complications sogns and symptoms: Purpura, ahritis, and abdominal pain are known as the "classic triad" of Henoch-Schonlein purpura. Purpura occur in all cases, joint pains and ahritis in 80%, and abdominal pain in 62%. Some include gastrointestinal hemorrhage as a fouh criterion; this occurs in 33% of cases, sometimes, but not necessarily always, due to intussusception. The purpura typically appear on the legs and buttocks, but may also be seen on the arms, face and trunk. The abdominal pain is colicky in character, and may be accompanied by nausea, vomiting, constipation or diarrhea. There may be blood or mucus in the stools.The joints involved tend to be the ankles, knees, and elbows, but ahritis in the hands and feet is possible; the ahritis is nonerosive and hence causes no permanent deformity.Foy percent have evidence of kidney involvement, mainly in the form of hematuria (blood in the urine), but only a quaer will have this in sufficient quantities to be noticeable without laboratory tests. Problems in other organs, such as the central nervous system (brain and spinal cord) and lungs may occur, but is much less common than in the skin, bowel and kidneys. Of the 40% of patients who develop kidney involvement, almost all have evidence (visible or on urinalysis) of blood in the urine. More than half also have proteinuria (protein in the urine), which in one eighth is severe enough to cause nephrotic syndrome (generalised swelling due to low protein content of the blood). While abnormalities on urinalysis may continue for a long time, only 1% of all HSP patients develop chronic kidney disease. Hypeension (high blood pressure) may occur. Protein loss and high blood pressure, as well as the features on biopsy of the kidney if performed, may predict progression to advanced kidney disease. Adults are more likely than children to develop advanced kidney disease ref Harrison20th edition pg 2134 | 2 | Drug induced vasculitis | HSP | Wegener's granuloniatosis | Kawasaki disease | Dental | Autoimmune skin disorders | 0050d8a4-a761-469b-b2cc-eb74efee146d | single |
Not true about iodophores ? | Ans. is 'a' i.e., Inorganic compounds Iodine Iodine is more sporicidal than chlorine. Iodine is often used in aqueous and alcoholic solution as skin disinfectant. Aqueous and alcohol based povidone iodine preparations (Betadine) are best and safe skin disinfectants (antiseptics). Iodophores are organic compounds that slow the release of iodine. The iodophores additionally serve as surfactants, thus increasing penetration while simultaneous steadily supplying iodine over long periods. So, iodophores are more active. | 1 | Inorganic compounds | Release iodine | Surfactants | Disifectant | Social & Preventive Medicine | null | fbabcda6-88f3-4f70-90b3-84f966b8e17c | multi |
Giant cells seen in Measles are called? | Lymphoid organs typically have marked follicular hyperplasia, large germinal centers and randomly distributed multinucleated giant cells called Wahin-Finkeldey cells, which have eosinophilic nuclear and cytoplasmic inclusion bodies.Found in the paracoical region of hyperplastic lymph nodes in some patients of measles and AIDS. It consists of fused lymphocytes and can be seen in a lymph node biopsy after a measles vaccination.Ref: Robbins Pathology, 7th Ed, page 363 | 4 | Hp bodies | Inclusion containing polykaryon | Koplik cells | Wahin-Finkeldey cells | Pathology | null | 8d3fbb93-7987-4e7a-bdee-1ef5fbb1124b | multi |
The term anisometropia indicates | Ans. Refractive error | 1 | Refractive error | Long vision | Sho vision | Ageing process | Ophthalmology | null | ab1932af-ff2f-458a-8b15-dd3bb48be8e7 | single |
A 40-year-old man presents to casualty with history of regular and heavy use of alcohol for 10 years and morning drinking for one year. The last alcohol intake was three days back. There is no history of head injury or seizures. On examination, there is no icterus, sign of hepatic encephalopathy or focal neurological sign. The patient had coarse tremors, visual hallucinations and had disorientation to time. Which of the following is the best medicine to be prescribed for such a patient: March 2013 (e) | Ans. A i.e. Diazepam | 1 | Diazepam | Haloperidol | Imipramine | Naltrexone | Psychiatry | null | 69a32c84-1fbd-43c1-a7ba-78ab7c542a11 | multi |
The features of uterine contraction in spastic lower segment are all except | Fundal dominance ,which indicates that the intensity is strongest ath the fundus,(not at the lower segment) with a gradual decrease downwards. Refer page no 109 of Text book of obstetrics ,sheila balakrishnan,2 nd edition. | 1 | Presence of fundal dominance | There may be reversed polarity | Inadequate relaxation in between contractions | Basal tonus is usually raised above the critical level of 20 mm Hg | Gynaecology & Obstetrics | Abnormal labor | 1b9ba6cb-4b24-4864-983f-132f6078274d | multi |
10 year old child with posterior fossa mass. On biopsy following features were seen. What are these dense eosinophilic fibers marked with arrow? | Ans. (a) Rosenthal fibers*Rosenthal fibers are eosinophilic, corkscrew fibers found in pilocytic astrocytoma, the most common primary brain tumor in children. They contain two heat-shock proteins (aB-crystallin and hsp27) as well as ubiquitin.*They are seen in Alexander disease and, pilocytic astrocytoma. | 1 | Rosenthal fibers | The Alzheimer type II astrocyte | Corpora amylacea | None | Pathology | Central Nervous System | ccbc242a-370c-45db-86c6-6ffe25cbeee3 | multi |
A large baby is born with which complication in pregnancy | Ans. is a i.e. Gestational diabetes | 1 | Gestational diabetes | Gestational hypeension | Cardiac disease | Anaemia | Gynaecology & Obstetrics | null | cc3b0128-9207-43ca-97bb-4b414a579a4e | single |
A woman was involved in an accident in which her left leg was crushed and immediate amputation had to be done but you couldn't get a prior consent as the victim was unconscious and the relatives were not available. Later her husband sues you you for doing an amputation without a valid consent. Which of the following sections will provide you protection in this scenario? | Any harm caused to a person in good faith, even without consent is not an offence if the circumstances are such that it is impossible for the person to signify consent and has no guardian from whom it is possible to obtain a consent in time for the thing to be done in benefit as per section 92 IPC. Also know: As per section 90 IPC the consent given by an intoxicated/insane person is invalid. Ref: Textbook of Forensic Medicine and Toxicology by Narayan Reddy, Edition 21, Page - 42, 43 | 1 | Section 92 IPC | Section 52 IPC | Section 88 IPC | Section 90 IPC | Forensic Medicine | null | abf304fc-1d14-47cc-bace-facd6622a965 | single |
The Rorschach Inkblot test consists of a set of .......... standardized inkblots. These vary in colour, shading, form, and complexity. | Rorschach Inkblot test- Evaluation of Personality, it contains 10 cards having ambiguous inkblot patterns and the subject has to interpret what he is seeing in the card from preselected options Extra Edge Thematic Apperception Test- Test is built on the assumption that people's stories reveal impoant aspects of their needs and self-perceptions as well as their views about significant others' in their life. In rhis 20 stimulus cards depicting a number of scenes of varying ambiguity will be shown. | 4 | 5 | 7 | 9 | 10 | Psychiatry | Miscellaneous | 81fe9a94-47ed-413f-9a6a-ddc676c95fdc | single |
Following are acute porphyrias except | The acute porphyrias are acute intermittent porphyria (AIP), variegate porphyria (VP), aminolevulinic acid dehydratase deficiency porphyria(ALAD) and hereditary coproporphyria (HCP). The non-acute porphyrias are X-linked dominant protoporphyria (XLDPP), congenital erythropoietic porphyria (CEP), porphyria cutanea tarda (PCT), and erythropoietic protoporphyria (EPP). The non-acute porphyrias along with two acute porphyrias, VP and HCP, that may also involve skin manifestations--are sometimes called cutaneous porphyrias. ref : Harrisons 20th ed pg 2523 | 4 | ACUTE INTERMITTENT PORPHYRIA | Variegate porphyria | Heriditary corpoporphyria | Porphyria cutanea tarda | Medicine | Genetics | 6cf9c68b-6920-49e1-9617-0464ebc41bff | multi |
Which of the following glycolytic enzymes is used in gluconeogenesis? | Aldolase is the enzyme which catalyses reversible reaction of glycolysis. So this enzyme is utilised in gluconeogenesis. Glucokinase, pyruvate kinase and phosphofructokinase are enzymes which catalyse the reversible reaction of glycolysis. | 2 | Glucokinase | Aldolase | Pyruvate kinase | Phosphofructokinase | Biochemistry | null | 17e554cf-7198-4d1e-9af7-27b871e1e49d | single |
An organism with sterols in their cell wall is | “Mycoplasma lacks a rigid cell wall and they are bounded by a triple-layered unit membrane that contains sterols.
” Mycoplasma PPLO - by Nocard & Roux • Smallest free-living organism • Gram-negative.highly pleomorphic organism,
stained by Giemsa • Found in the form of elementary bodies & filaments of various size • Facultative anaerobe, require a source of cholesterol for growth
• Media = hayflick media, Eaton's media • Colonies = biphasic with a fried egg appearance • C/F: Primary atypical pneumonia. Bullous myringitis.
Otitis • Lab diagnosis: 1. Isolation of organism - from throat swab, respiratory secretion 2. serological diagnosis -1.
Specific - HI, IF. metabolic inhibition 2. Nonspecific- streptococcus MG 3.
Cold agglutination Treatment: DOC- Erythromycin (Presence of 70 S ribosome makes it susceptible to antibiotics that inhibit protein synthesis;
but due to the lack of cell wall they are resistant to penicillin) Remember
• Ureaplasma ureolyticum belongs to the family mycoplasmatacea; which can hydrolyse urea & is a cause for nongonococcal urethritis •
L forms of bacteria - are due to the loss of bacteria but they retain the biochemical & antigenic properties of present bacteria. | 1 | Mycoplasma | Bacillus | Streptococcus | Spirillum | Microbiology | null | fb8542e4-9450-477c-b516-27143d0ad578 | multi |
Gas' in the tissue should be differenciated with - | null | 3 | Pseudomyxoma peritonei | Pseudomonas infection | Clostridium nouyi | Non clostridial infection | Surgery | null | 60841234-fd08-40a3-a44e-95a16ab29bab | single |
Chest X-ray of an industrial worker exposed to asbestos for 20 yrs shows diffuse appearance of lower lobe with 'comet tail' infarct on PA view. The most likely diagnosis is: | This is a case of mesothelioma secondary to asbestos exposure. The diffuse appearance of lower lobe with 'comet tail' infarct is typical of mesothelioma. Ref: Aicle: The Comet Tail Sign1; 1999 | 1 | Mesothelioma | Lobular collapse | Bronchogenic carcinoma | Round atelectasis | Radiology | null | 901a16f5-37e9-4567-8e7c-e722b1655b62 | single |
Most common presentation of Renal cell carcinoma is | null | 2 | Abdominal mass | Hematuria | Flank pain | Nocturia | Medicine | null | c6560a39-e305-4557-a9d1-291239b7d197 | single |
In starvation, earliest to become depleted - | Ans. is 'a' i.e., CarbohydratesMetabolic alteration during fasting-starvationo he metabolic changes observed in fasting are generally opposite to those described for absorptive (fed) state. In the absence of food, plasma levels of glucose, amino acids, and TGs fall, triggering a decline in insulin secretion and an increase in glucagon release. This results in decreased insulin: glucagon ratio. Which is responsible for most of the metabolic changes.o The primary role of altered metabolism during fasting is to maintain blood glucose through the synthesis (gluconeogenesis) and utilization of alternate substrates. Fasting-starvation is divided in three broad categories:-Initial stage :- Lasts upto 2-3 daysIntermediate stage Lasts upto 24 daysAdvanced stage:- begins after 24 days.Initial stage (first stage):- Liver glycogen is the first main provider of energy. But due to limited storage it can not last longe (16-18 hrs.). Further glucose is provided by gluconeogenesis by non- carbohydrate sources (muscle protein breakdown is increased which provides amino acids alanine and glutamine for gluconeogenesis). Utilization of alternate substrates (other than glucose) starts increasing interminal period of this stage. Free fatty acids and ketone bodies start rising in this stage. Glycogenis completely depleted by the end of this stage. Blood glucose is slightly decreased.Intermediate stage (Second stage):- Free fatty acids are the major substrates for energy production. They are derived from hydrolysis of fat (triglycerides) in adipose tissue. Ketone bodies serve as additional source of energy. As glycogen source is already depleted, the only source of glucose is increased gluconeogenesis. After sometimes muscle breakdown decreases due to decreased need of glucose as a fuel for brain which has began using ketone bodies as a source of energy.Advanced stage (Third stage):- When fat stores are almost exhaused, energy requirment is obtained from breakdown of tissue proteins and protein stores once again enter in stage of rapid depletion. | 1 | Carbohydrates | Proteins | Fats | None | Physiology | Pancreas | 97ab74ed-0abb-4268-9641-649cc4776c70 | multi |
Endocrinologic factors associated with recurrent aboion include all of the following except- | Endocrinologic factors associated with recurrent aboion include - Luteal phase insufficiency Diabetes mellitus Hypersecretion of luteinizing hormone (LH) Thyroid disease Insulin resistance Polycystic ovarian syndrome, Hyperprolactinemia Decreased ovarian reserve. | 4 | Thyroid disease | Hyperprolactinemia | Luteal phase insufficiency | Reduced secretion of luteinizing hormone (LH) | Gynaecology & Obstetrics | Aboions, Spontaneous & Induced Emergency Contraception (Hey,whats the hurry !) | f1c7fa40-82f8-4a6c-8a8e-b00c1c5eb2f0 | multi |
Primitive streak remanants give rise to ? | Sacrococcygeal teratoma (SCT) is a type of tumor known as a teratoma that develops at the base of the coccyx (tailbone) and is thought to be derived from the primitive streak. Sacrococcygeal teratomas are benign 75% of the time, malignant 12% of the time, and the remainder are considered "immature teratomas" that share benign and malignant features. Benign sacrococcygeal teratomas are more likely to develop in younger children who are less than 5 months old, and older children are more likely to develop malignant sacrococcygeal teratomas. The Currarino triad (OMIM 176450), due to an autosomal dominant mutation in the MNX1 gene, consists of a presacral mass (usually a mature teratoma or anterior meningocele), anorectal malformation and sacral dysgenesis. Ref: https://en.m.wikipedia.org/wiki/Sacrococcygeal_teratoma | 3 | Neuroblastomas | Wilm's tumour | Sacrococcygeal teratoma | Hepatoblastoma | Surgery | Urology | ac9978e4-fe06-4656-82e9-14d693aeab6f | single |
Which is safest to be used in asthmatic patients: | C i.e. Chloral hydrate | 3 | Nitrazepam | Phenobarbitone | Chloral hydrate | All hypnotics are safe | Anaesthesia | null | 1f5ebaf0-ca14-4175-9319-e2ffb82cc9f5 | multi |
True statements about the twin-to-twin transfusion syndrome include which of the following? | In the twin-to-twin transfusion syndrome, the donor twin is always anemic, owing not to a hemolytic process but to the direct transfer of blood to the recipient twin, who becomes polycythemic. The recipient may suffer thromboses secondary to hyper-transfusion and subsequent hemoconcentration. Although the donor placenta is usually pale and somewhat atrophied, that of the recipient is congested and enlarged. Hydramnios can develop in either twin but is more frequent in the recipient because of circulatory overload. When hydramnios occurs in the donor, it is due to congestive heart failure caused by severe anemia. | 2 | The donor twin develops hydramnios more often than does the recipient twin | Gross differences may be observed between donor and recipient placentas | The donor twin usually suffers from a hemolytic anemia | The donor twin is more likely to develop widespread thromboses | Gynaecology & Obstetrics | Obstructed Labour | fbcd3309-51db-4fac-9419-a2c87550d542 | multi |
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