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Aortic dissection. This describes a patient with Marfan syndrome, who are typically at risk for aortic dissection. With dissection you may preserve right radial pulse but lose femoral pulses.
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Ans. (b) Vancomycin
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Ans: D (Carry..) Inferior constrictor receives an additional supply from the external & recurrent laryngeai nerve"- BDC 4th/Vol. III 223"'The Inferior phary-ngeai constrictor, the thickest of the three constrictors, arises from the sides of the cricoid and thyroid cartilage. Similarly to the superior and middle pharyng...
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The patient becomes tachypneic, hypoxic, and febrile. The leukocyte count may rise, and the chest x-ray may evolve from normal to a complete bilateral "whiteout" within 8-24 h. Sputum pro-duction is minimal. The pulmonary signs and symptoms can resolve quickly with symptom-based therapy or can culminate in respiratory ...
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Bone Shaped Keratopathy Degeneration disease occuring due to calcium deposition in Bowman's membrane. Etiology - Hypercalcemia Still's disease Sarcoidosis Treatment : Chelation with EDTA
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Oxaloacetate may be formed from pyruvate during gluconeogenesis. Degradation of tyrosine and phenylalanine may produce fumarate. Citrate is transpoed out of mitochondria to be used as a source of cytoplasmic acetyl CoA. Isocitrate is formed and removed in TCA cycle. Ref: Textbook of Biochemistry for Medical Students by...
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(Ref: KDT 6/e p547) It is a vasodilator and can result in reflex tachycardia. All other drugs listed in the question (clonidine, propanolol, reserpine) decrease the activity of sympathetic system and can result in bradycardia.
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Alkaptonuria is caused by defect of the enzyme homogentisate 1,2-dioxygenase(homogentisic acid oxidase).The disorder comes to attention due to change in colour of urine to brownish black/ staining of diapers.The urine becomes dark on standing,especially if the pH of urine is alkaline,due to the presence of homogentisic...
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In the thalassemias, overactivity of the marrow as a result of ineffective erythropoiesis and hemolysis leads to widening of the medullary cavity and thinning of coical bone. The skull radiograph shows widening of the diploic space, giving the typical "hair-on-end" appearance. Overgrowth of the maxillary and temporal b...
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Addisons disease- lack of steroids glucocoicoids helps to treat addisons disease- horome replacement therapy - hydrocoisone, prenisolone etc The disease is characterized by weight loss, muscle weakness, fatigue, low blood pressure, and sometimes darkening of the skin in both exposed and non-exposed pas of the body. Add...
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Many extracellular ligands act by increasing the intracellular concentrations of second messengers such as cyclic adenosine-3',5'-monophosphate (cAMP), calcium ion, or the phosphoinositides. Calcium is an impoant messenger in all cells and can regulate diverse responses including gene expression, contraction, secretion...
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A closed or insufficient vertical dimension of occlusion is thought to be one predisposing condition for angular cheilitis, which usually is associated with Candida albicans. Improperly balanced occlusion or poor contour of the denture base are not predisposing conditions for angular cheilitis.
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Ans. is 'd' i.e., Pramlinitide
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"Ollendroff sign" is seen in secondary syphilis, pressure over palm and sole lesions elicit severe pain- Deep dermal tenderness. Option c) is the correct answer. Option a) - Auspitz sign seen in Psoriasis Option b)  - Wimberger's sign seen in early congenital syphilis Option c) - Periostitis seen in late congenital syp...
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Ans. D. Intraarteriala. Intraarterial drug administration is used to expose a particular organ to drug supplied by the artery and hence it is a local route.b. This decreases risk of systemic toxicity.c. Anticancer drugs for hepatocellular carcinoma and head and neck cancer are given by intraarterial route.
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Ans. (D) All(Ref: KDT 18th/e p818-819)All first line antitubercular drugs can cross placenta. Streptomycin is contraindicated in preganancy whereas other drugs are found to be safe.
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ANTROCHOANAL POLYP Antrochoanal polyp is non-cancerous growth arising from the mucous membrane of the maxillary sinus and reaches the opening of the sinus in the nasal cavity through the opening of maxillary sinus in the middle meatus. It is single and unilateral, i.e. it occurs in one of the maxillary sinus. It arises...
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Ref - semantischolar.org
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Relapsed myeloma can be treated with novel agents including lenalidomide and/or boezomib. Thalidomide, if not used as initial therapy, can achieve responses in refractory cases. High-dose melphalan and stem cell transplant, if not used earlier, also have activity in patients with refractory disease. Ref: Harrison's pri...
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The presence of osmotic fragility is the main diagnostic test for hereditary spherocytosis. Ref: Harrisons principles of internal medicine, 18th edition, Page 875.
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Autopsy Findings in hypothermia: Postmoem lividity is pinkish - due to persistent oxyhemoglobin in the capillaries. Due to cold, there is low metabolic activity and cold tissues fail to take up the delivered oxygen. Rarely skin is pale (white) and thus hypothermic deaths are also called as "white deaths". Skin may show...
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Ans. is 'a' i.e., Hemangioma [Ref: Clinical hepatology: principles and practice of hepatology, volume 1 by* Hemangiomas are the most common benign liver tumors and occur two to six times more commonly in women.* Most of the hemangiomas of liver are found incidentally in asymptomatic individuals.
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B i.e. Herpes simplex Dendritic & geographical corneal ulcers Q are seen in herpes simplex ocular disease. Dendritic ulcers (branching ulcer with knobbed ends), resembles no other condition, and is pathognomic of herpes simplex ocular infectionQ. The use of steroids in dendritic ulcer hastens the formation of geographi...
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Park's textbook of preventive and social medicine 23rd edition *The active immunity in case of diseases like chickenpox,rubella and measles is acquired following clinical infection
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Ans. is 'B' i.e., Lithium Bipolar mood disorders o Bipolar mood disorder or manic-depressive illness is a psychiatric illness characterized by shifts in mood from mania on one extreme to depression on the other hand. o When 4 or more episodes occur in one year, it is referred as rapid cycling. Treatment of bipolar diso...
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Ans. A: Metastasis Pregnant women with fibroids are at increased risk for: Pain Breech presentation Malposition Higher incidence of cesarean delivery Preterm bih Premature rupture of the membranes Postpaum hemorrhage Placental abruption Submucosal, fibroids located beneath the placenta, and fibroids 7 to 8 cm in diamet...
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To look out for the reasons behind the changing trends of Cardiovascular disease worldwide , WHO staed project named MONICA ( Monitoring of trends and determinants in Cardiovasculardisease). Population centres need to be large and numerous; to reliably establish 10-year trends in event rates. Foy-one MONICA Collaborati...
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ACE Inhibitors are contraindicated in B/L renal aery stenosisThey can be used if benefits are more in U/L stenosisThey are used in hypeensive emergencies eg: EnalaprilatRef: KD Tripathi 6th ed, Pg 484
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Propanolol is a b-blocker. Verapamil should not be given with b blockers because additive sinus depression, conduction defects or asystole may occur.
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d. 14-15 years(Ref: Nelson's 20/e p 84-89, Ghai 8/e p 13-14)Height velocity curves for males (solid line) and females (dashed line) showing maximum growth velocity in:Boys at 14-15 yrsGirls at 11-13 yrs
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ACOG - does not recommend this test in women with low risk pregnancies or multi fetal gestation.
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Above features suggests Alzheimers disease. In Alzheimer's disease, as neurons are injured and die throughout the brain, connections between networks of neurons may break down, and many brain regions begin to shrink. By the final stages of Alzheimer's, this process--called brain atrophy--is widespread, causing signific...
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(Hypothermia): Ref: 303-Sabiston 17th (49-A. yadav- anesthesia 3rd) (135-37-HI7th)* Hypothermia can result from a preoperatively, intraoperatively or postoperately* A trauma patient involved with injuries in a cold environment can suffer significant hypothermia, similarly paralysis leads to hypothermia because of a los...
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The posterior relations of the head of the pancreas include the common bile duct, inferior vena cava and the right and left renal veins terminating into it. The first pa of the duodenum is an anterior relation of the head of the pancreas.Ref: Clinical Anatomy, By Richard S. Snell, 6th edition, Page 230; Clinical Anatom...
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(B) Postural hypotension # Laboratory findings of Primary Aldosteronism depend on both the duration and the severity of potassium depletion.> An overnight concentration test often reveals impaired ability to concentrate the urine, probably secondary to the hypokalemia> Urine pH is neutral to alkaline because of excessi...
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Upper temporal region is most common site for retinal break The mechanism most commonly involves a break in the retina that then allows the fluid in the eye to get behind the retina. A break in the retina can occur from a posterior vitreous detachment, injury to the eye, or inflammation of the eye. Other risk factors i...
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Ans: d (Oestrogen)EXPLANATION:A majority of cells observed in a normal vaginal smear are, not surprisingly, vaginal epithelial cells. In addition, varying numbers of leukocytes, erythrocytes and bacteria are usually evident, and small numbers of other contaminating cells and microorganisms are sometimes observed.Analyz...
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Esophagus is a long tube with approximately 25cm in length, have 3 pas - cervical, thoracic and abdominal pa. PA OF ESOPHAGUS AERY SUPPLY CERVICAL Inferior thyroid aery THORACIC Descending thoracic aoa ABDOMINAL Left gastric and inferior phrenic aery
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Ans. is 'c' i.e., Crack pot sign "Cracked pot or macewan sign indicates raised intracranial pressure after sutures and fontanels have closed" o Fontanelle is wide and bulging (not depressed) Signs of Increased intracranial tension in infants Separation of cranial sutures --> Earliest sign Wide bulging anterior fontanel...
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Trimethoprim, Methotrexate and pyrimethamine inhibits dihydrofolate reductase enzyme and prevents formation of Tetrahydrofolic acid and from Dihydrofolic acid.
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Ans. Smaller than the normal pupil
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Infection of Trichinella is initiated by ingestion of ble larvae in raw or undercooked meat. Digestive action liberates the larvae. The liberated larvae develop into adults in the duodenum and jejunum, where they mate and bear offspring. The adult worms are expelled in the stool. The newborn larvae penetrate the intest...
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Ans. is 'c' i.e., Suxamethonium * Least potent skeletal muscle relaxant - Succinylcholine (Gallamine was least potent but it is not used now).* Least potent nondepolarising muscle relaxant - Rocuronium
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Weight gain + Oligomenorrhea --->Cushing syndrome. Coisol inhibits gonadotropin release that explains the amenorrhea. Hypeension in these patients is secondary to increased coisol that has some mineralocoicoid activity also. Excess glucocoicoids also interfere with central regulatory systems, leading to suppression of ...
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Acetoacetate is a ketone body.During ketolysis,it is activated to acetoacetyl CoA which gives acetyl CoA.Acetyl CoA can not be reconveed back to pyruvate so acetoacetate can not be utilized for gluconeogenesis. Ref: Janson L.W., Tischler M.E. (2012). Chapter 2. Carbohydrates. In L.W. Janson, M.E. Tischler (Eds), The Bi...
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Ans. Ground mustard
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.In secondaries neck with occult primary - * FNAC of node/open biopsy to confirm * Proper clinical methods to identify the location of primary * CECT is the investigation of choice to look for primary.also aids in the initial evaluation of a atient presenting with injury to anterior abdomen. ref:SRB&;s manual of surger...
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.
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Accessory canals may occur either due to loss of root sheath cells or due to inclusion of blood vessels during root development.
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Ans. is 'None' Treatment of AML o The most commonly used chemotherapy regimen is combination of cytarabine (cytosine arabinoside) and anthrocycline (Doxorubian or daunorubicin). 3-4 cycles are given. o Patients who fails to attain complete remission after two induction courses, Should immediately proceed to an allogeni...
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Drugs associated with ototoxicity as well as nephrotoxicity Vancomycin Aminoglycosides Cisplatin
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Ans. D. AgoraphobiaAgoraphobia fear or avoidance of places like crowds, public places, being outside alone, public transpoation, from which escape would be difficult in the event of panic symptoms.Treatment includes:Pharmacotherapy -Benzodiazepines, SSRIs, TCAsPsychotherapy -Suppoive, Insight-oriented, Behavior, Cognit...
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The gross appearance of the skin is consistent with the invasion of dermal lymphatics by carcinoma - the so-called inflammatory carcinoma, which is not a histologic type of breast cancer, but a descriptive phrase based upon the gross appearance (peaud'orange) resembling an inflammatory process. Nipple retraction and no...
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TodaniModification of Alonso-Lej classification Type I - Dilation of extrahepatic biliary tree Type Ia- cystic dilation Type Ib - focal segmental dilation Type Ic- fusiform dilation Type II - Diveicular dilation of extrahepatic biliary tree Type III - Cystic dilation of intra duodenal poion of common bile ducts (choled...
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Ans. is 'c' i.e., Glossopharyngeal nerve Tympanic plexus o Tympanic plexus is formed by i) Tympanic branch of glossopharyngeal nerve. ii) Superior and inferior caroticotympanic nerves which are branches of sympathetic plexus around internal carotid artery. o Tympanic plexus contains preganglionic secretomotor fibers wh...
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Characteristic Caput succedaenum Cephal hematoma Incidence →  More common Edema in layers of scalp Superficial, diffuse swelling May cross suture line Less common Subperiosteal hemorrhage Deep, locatised swelling Do not cross suture line Content →  Fluid  Blood Time of presentation →  Maximum size at ...
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Good sources of vitamin D include fatty fish,fish liver oils, egg yolk etc. Milk is not a good source of  vitamin D. Reference: Satyanarayana- Biochemistry, 3rd edition, pg-128
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Answer is D (Mycoplasma Pneumonia) Mycoplasma pneumoniae infections are associated with a cold antibody haemolytic anemia Autoimmune hemolytic anemias are characterized by formation of autoantibodies against patient's own red cells. Depending upon reactivity of autoantibodies these are fuher divided into two types. War...
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Ans. Baring of the blind spot
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.
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Infection (like pneumonia) is one of the cause of delirium. Altered sensorium, disorientation to place (Patient thinks he is in jail) and person (not recognizing the doctor and staff), and hallucinations (scorpions attacking him) suggest the diagnosis of delirium.
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Ans. C i.e. Microangiopathy Cells and conditions Bite cells are seen in: G6PD deficiency Helmet cells are seen in: Hemolytic uremic syndrome Coombs positive Schistocytes are seen in: Acquired spherocytosis/microangiopathy Ring sideroblasts (iron granules in mitochondria around the nucleus) are seen in: Sideroblastic an...
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Ans: (B) b-HCG levelRef : D.C. Dutta 8th ed. 1227Hydatiform moles are abnormal pregnancies characterized histologically by aberrant changes within the placenta. Specifically, the chorionic villi in these placentas show varying degrees of trophoblastic proliferation and edema of the villous stroma.They areof two types: ...
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Posterior urethral value
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The insulinoma might be localized by noninvasive means, using ultrasound, CT scan, or MRI techniques. An indium-111 pentetreotide scan is more sensitive than ultrasound, CT, or MRI for detection of somatostatin receptor positive tumors, but not a good diagnostic tool for insulinomas. An endoscopic ultrasound has a sens...
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Answer is D (Strongly Positive Rheumatoid factor): Type I Cryoglobulinemia (simple cryoglobulinemia) is typically associated with Monoclonal IgM paraprotenemia producing a Hyperviscosity type syndrome. Type I Cryoglobulins rarely have Rheumatoid Factor Activity and do not activate complement in vitro (hence complement ...
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A i.e. Borderline personality disorderCharacteristic feature of Borderline P.D. is series of suicidal threats or acts or self harmQAlways remember h/o multiple suicidal attempts may be present in histrionic P.D. but it is for becoming centre of attraction and for receiving sympathyQIn Borderline P.D. there is:Instabili...
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ANSWER: (A) N-Acetyl cysteineREF: See APPENDIX-42 for list of "ANTIDOTES" APPENDIX - 42AntidotesAntidotePoison/drug/toxinN-AcetylcysteineAcetaminophenCarbon tetrachlorideOther hepatotoxinsAmyl nitrite, sodium nitrite and sodium thiosulfate (Cyanide antidote kit)NitrilesBromatesChloratesCyanide (e.g., HCN, KCX and NaCN)...
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B i.e. Wife above 20
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Ans: D i.e. Curvature of cornea Instruments & their uses Corneal sensitivity may be tested by touching it in various places with a wisp of cotton wool twisted to a fine point & comparing the effect with that on the other, normal cornea The corneal endothelium can be examined cursorily by the specular examination techni...
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If a father or mother of a child below the age of 12 years, or anyone having the care of such a child, leaves such a child in any place with the intention of abandoning the child shall be punishable with 7 years imprisonment as per section 317 IPC. IPC 318 deals with concealment of bih and is punishable with 3 years im...
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[Cl (Ochsner: sherren regimen) (1216-LB) (1215-B &L 25th)Management of a appendix mass* If an appendix mass is present and the condition of the patients is satisfactory, the standard treatment is the conservative Ochsner-Sherren regimen* It is advisable to remove the appendix after an interval of 6-8 weeksAppendicitis ...
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Maturity-onset diabetes of the young (MODY) is characterized by autosomal dominant inheritance, early onset of hyperglycemia (usually <25 years; sometimes in neonatal period), and impaired insulin secretion. It is non insulin requiring diabetes and can be managed by diet and sulfonylurea (paicularly HNF-1a and HNF-4a f...
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Cervial plexus supplies Skin over the angle of the jaw and over the parotid gland. Lower margin of the lower jaw
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Acute ITP is a self limiting disorder seen mor frequently in children following recovery from a viral illness or an upper respiratory illness.The clinical manifestations develop abruptly with petechial hemorrhages,easy bruising ,menorrhagia,nasal bleeding ,bledding from gums,melaena & hematuria.In ITP, platelet count i...
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D i.e. Distended pulmonary veins in the lower lobes
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Ans. is 'd' i.e., Optic chaisma
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Removal of placenta must be done by controlled cord traction (Brandt and Andrews method) or waiting for spontaneous placental separation. Excessive cord traction may inadveently cause uterine inversion. Credes method is obsolete because of high risk of retention of placental bits.
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Major duodenal papilla → Hepatopancreatic ampulla (opening of the biliary-pancreatic duct). Minor duodenal papilla → Accessory pancreatic duct opening.
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Ans : B (Inhibition of Na+-K+-2 Cl-cotransport) [Ref: K.D.T. 6th/561-573)Mechanism of Action of DiureticsHigh Efficacy or High Ceiling or Loop DiureticsThere act by inhibition of Na+-K+-2 Cl- cotransport# Major site of action is the thick ascending loop of henie (ASCLH) i.e. site II.# Recently distinct absorptive or se...
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Discharges from the nipple Discharge can occur from one or more lactiferous ducts. Management depends on the presence of blood in the discharge or discharge from a single duct. Treatment Treatment must firstly be to exclude a carcinoma by occult blood test and cytology. Simple reassurance may then be sufficient but, if...
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Nissen&;s Fundoplication left crus approach to a 360-degree wrap (Nissen Fundoplication) which is the procedure of choice for GERD Left crus approach: Direct and early view of the sho gastric vessels and spleen. Rosetti and Hell modification of Nissen&;s modification Include only anterior stomach wall in the wrap The i...
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Hyaline casts - These are the most common type of casts and they can be found in normal urine samples. They consist almost entirely of Tamm Horsfall protein. Zero-to Two hyaline casts per low power field is considered normal. Increased numbers of Hyaline casts can occur with exercise, heat exposure, dehydration, fever...
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Ans. (c) Saliva dribbling to the opposite side of the knotRef: Textbook of Forensic Medicine And Toxicology: Principles And Practice by Vij/162Difference between Hanging and Strangulation by ligatureTraitHangingStrangulation by ligatureManner of deathMostly suicidalHomicidalFacePale, No petechiaeRed congested, marked p...
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.glioblastoma multiforma. It is very aggressive malignant tumour.and also highly vascular in nature. ref:SRB&;s manual of surgery,ed 3,pg no 1050
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Use of alkaline detergent for washing clothes is a non deliberate cultural practice with anti mosquito effect. Mosquito larva cannot survive in alkaline water. MOSQUITO CONTROL Gambusia affinis - larvicidal fish Anti larval - Source reduction (elimination of mosquito breeding grounds), use of larvicides (surface films ...
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Weil- Felix reaction for the diagnosis of typhus fever. - The Agglutination reaction is when a paiculate antigen is mixed with its antibody in the presence of electrolytes at a suitable temperature and pH, the paicles are clumped or agglutinated. Reference : Anathanarayan & paniker's 9th edition, pg no: 108,109 <\p>
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Ans. (d) These cancers take up Radio iodineRef: Bailey and Love 27th Edition Page 820* Medullary thyroid cancers are not hormone dependent (Not TSH dependent)* They don't take up RAI* Differentiated thyroid Cancers - Papillary and follicular take up Radio active iodine and used in cases of treatment of high risk cases.
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Answer is A (Serum creatinine) Presence of blood glucose of 750mg/d1 in a comatose patient suggests a possible diagnosis of non ketotic "hyperglycemic coma or diabetic ketoacidosis. Amongst the options provided estimation of blood pH will help establish a diagnosis of diabetic ketoacidosis while estimation of serum cre...
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Ans. Normal sleep wake cycle
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All kidney transplants should receive maintenance immunosupressive therapies except identical twins The most frequently used combination is triple therapy- prednisolone Calcineurin inhibitors (Cyclosporine ) or tacrolimus previously called FK506. antimetabolite(Azathioprine or mycophenolate mofetil) TOR inhibitors can ...
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Ans. (c) Neurofibromatosis Type IIRef: Surgery Sixer 3rd Edition Page 957Associated with* ADPKD* Ehler Danlos Syndrome* Marfan's Syndrome* Fibromuscular dysplasia* NF-1
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ANSWER: (B) Superficial second degree burnREF: With text"Clinically, first-degree burns are painful but do not blister' REF: Schwartzs Principles of Surgery 9th edition Chapter 8. Bums'"Second-degree burns are divided into two types: superficial and deep- All second-degree bums have some degree of dermal damage, and th...
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The first pharyngeal arch, which is often associated with the mandible, is responsible for development of Meckel's cartilage, malleus, incus, and mandible. Additionally, it is innervated by the trigeminal nerve, specifically the mandibular division that innervates the muscles of mastication. This patient presents with ...
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Ricochet bullet Bullet changes it's direction by striking on some surface or object. Ricochet occurs when it strikes on some intermediate objects before entering the body. Due to ricochet the bullet may be deformed and more superficially placed in the body. The external wound of entry will be larger, triangular or cruc...
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Diabetes mellitus
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medical adrenelectomy or pharmacological adrenelectomy means- using medications or drugs to suppress the production of hormones from the adrenal gland Mitotane is highly effective in the long-term management of Cushing's syndrome but has a slow onset of action. Mitotane combined with fast-acting steroidogenesis inhibit...
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Ans. is 'c' i.e., Sta imipenem therapy in place of ceftriaxone Carbapenems like imipenem are the only beta lactams reliably efficacious against ESBL producing bacteria. Drugs used for ESBL producing bacteria are: A) beta-lactamase inhibitor combination o Clavulinic acid +Amoxcillin Clavulanic acid + Ticarcillin o Sulba...
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Ans. is 'a' i.e., RA with HIV Amongst the given options, none is the contraindication for the use of anti-TNFoc therapy.
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Ans. A: Space of disseKidney-Histologically, the mesangium and capillary basement membrane of glomeruli are the most frequent renal sites of amyloid deposition, followed by involvement of aeriolar and aerial walls and peritubular interstitial tissues. As the extent of the amyloid deposition increases, the glomerular ca...
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