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Ans: A. Krukenberg tumor(Ref Robbins 9/e p1034: 8/e p1050)Krukenberg tumor:Classic metastatic gastrointestinal carcinoma involving ovaries.Features:Characterized by bilateral metastases composed of mucin-producing, signet-ring cancer cells, most often of gastric origin.
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Leukotrienes are a family of eicosanoid inflammatory mediators produced in leukocytes by the oxidation of arachidonic acid and the essential fatty acid eicosapentanoic acid by the enzyme arachidonate 5-lipoxygenase. As their name implies, leukotrienes were first discovered in leukocytes, but have since been found in ot...
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Coccidian-like bodies have been identified in stools of some patients with diarrhea. These organisms appear to be similar to blue-green algae and were referred to as Cyanobacterium-like until they were recently reclassified as Cyclospora. They are larger than the microsporidia and resemble neither Giardia nor Protothec...
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Vitamin K has an impoant role in the blood clotting process. It brings about the posttranslational modification of ceain blood clotting factors clotting factor II (prothrombin), factor VII (SPCA) factor IX (Christmas factor) factor X (Stua prower factor) they are synthesized as inactive precursors (zymogens) in the liv...
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Conjugated hyperbilirubinemia: Dubin Johnson Rotors Unconjugated hyperbilirubinemia Gilbe's Crigler- Najar Reference: Davidson, 23rd edition, page 860
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Case-control studies is basically a comparison study. Cases and control must be comparable with respect to known "confounding factors "such as age, sex occupation, social status etc. The questions asked relate to personal characteristics and antecedent exposures which may be responsible for the condition studied. Ref: ...
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Operate without formal consent is necessary in this case, delay will lead to death of the patient. Ref: Parikh's Textbook of Medical Jurisprudence Forensic Medicine and Toxicology, 5th Edition, Page 569 and 6th Edition, Page 1.37
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Ans. Ca Ovary
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Oxidoreductases: Enzymes involved in oxidation-reduction reactions. Transferases: Enzymes that catalyse the transfer of functional groups. Hydrolases: Enzymes that bring about hydrolysis of various compounds. Lyases: Enzymes specialized in the addition or removal of water, ammonia, CO2 etc. Isomerases: Enzymes involved...
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Refer katzung 11e p 241 Amiodarone-induced pulmonarytoxicity (APT) is one of the most serious side effects of use. Incidence is approximately 5% when doses of 400 mg or more are used daily. ... Amiodarone pulmonarytoxicity can present in various ways: pneumonia interstitial disease, respiratory distress or solitary pul...
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Wpw syndrome : sho PR interval , QRS more than 120 msec , delta wave When an individual is in normal sinus rhythm, the ECG characteristics of WPW are a sho PR interval (less than 120 milliseconds in duration), widened QRS complex (greater than 120 milliseconds in duration) with slurred upstroke of the QRS complex, and ...
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Ans. is 'd' i.e., Dracunculiasis
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MC cause of Cushing's syndrome is iatrogenic exogenous administration of steroids MC endogenous cause of Cushing's syndrome is bilateral adrenal hyperplasia secondary to hypersecretion of ACTH from pituitary or from an ectopic non-pituitary source. Cause of Cushing's Syndrome Endogenous Exogenous ADRENAL HYPERPLASIA Pi...
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Incomplete or mixed rotation, which is more common, results in the small bowel occupying mainly the right side of the abdomen, with the cecum generally residing in the right upper quadrant. With mixed rotation, the volvulus may occur in the first few days of life.Also know: Complete failure of rotation, or non-rotation...
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Ref Harrison 19 th ed pg 1627 The renal resistive index has predictive value regarding the bility of the kidney. It remains operator- and institution-dependent, however. Captopril-enhanced renography has a strong negative predictive value when entirely nor- mal. Magnetic resonance angiography (MRA) is now less often us...
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Pain during injection is an important and common feature of Rocuronium Injection.
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Ans. is 'd' i.e., Filariasis o G-CSF (Granulocyte Colony-stimulating factor) is used in the treatment various type of neutropenia.Uses of G-CSF (Granulocyte Colony-stimulating factor)1) Primary Prophylaxis: reducing and preventing chemotherapy-associated neutropenia in at-risk patients.2) Secondary prophylaxis: reducin...
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Ans. is 'b' i.e., Type-II o Type II hypersensitivity may involve three different antibody -dependent mechanisms.Opsonization - Complement and Fc receptor mediated phagocytosis.Transfusion reactionsAutoimmune hemolytic anemia'agranuloeytosis/ thrombocytopenia.Erythroblastosis fetalis.Complement and Fc - receptor mediate...
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Respiratory syncytial virus (RSV) is the most impoant cause of pneumonia and bronchiolitis in infants. The classic disease is bronchiolitis, characterized by diffuse wheezing, variable fever, cough, tachypnea, difficulty feeding, and, in severe cases, cyanosis. In severe cases, children must be hospitalized and given h...
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Ans. is 'd' i.e., All the above o CTEV is the commonest and most important congenital deformity of the foot,o CTEV is more common males in than in females (males to female ratio 2-5 : 1).o In half of the cases CTEV is bilateral,o Right and left foot are affected equally,o The deformity consists of following elementsEqu...
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TNF-alfa (alpha) inhibitors (TNF-alpha) are a group of medicines that suppress the body's natural response to tumor necrosis factor (TNF), a protein produced by white blood cells that is involved in early inflammatory events. TNF-alfa inhibitors treat a wide range of inflammatory conditions such as RA , juvenile ahriti...
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Once the zygote has reached the two-cell stage, it undergoes a series of mitotic divisions, increasing the numbers of cells. These cells, which become smaller with each cleavage division, are known as blastomere. After the third cleavage, however, blastomeres maximize their contact with each other, forming a compact ba...
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Preclinical or incubatory carrier -The incubatory carriers are potent carriers (1-5 days)Convalescent carrier - Patient who has recovered from an attack of cholera may continue to excrete vibrios, during his convalescence for 2 -3 weeksContact or healthy carrier - Subclinical infection contracted through association wi...
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Aprepitant is a highly selective NK1 receptor antagonist orally active and enter the brain. It is used in treating and preventing chemotherapy induced emesis. It is metabolized by CYP3A4 enzymes and can also inhibit the metabolism of drugs metabolized by this enzyme e.g.warfarin.(Katzung 11/e p 1086,Goodman and Gilman ...
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Refer KDT 6/e p 286 Glaucoma occurs after the use of prolonged topical therapy in susceptible individuals
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Biopsy of the kidney may be performed both to establish the diagnosis or to assess the severity of already suspected kidney disease. The main findings on kidney biopsy are increased cells and IgA deposition in the mesangium (pa of the glomerulus, where blood is filtered), white blood cells, and the development of cresc...
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Ans. is 'a' i.e., Phenylalanine hydroxylase Phenylketonuria o It is an inborn metabolism of phenylalanine, in which there is inability of oxidation of phenylalanine into tyrosine. There is defective function of phenylalanine hydroxylase, which may be due to Classical phenylketonuria (hyperphenylalanemia type I) - Defic...
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Primary amenorrhea refers to the failure of the onset of menstruation beyond the age of 16 years regardless of the development of secondary sexual characters Ref: Shaw Gynecology 17 e pg 141.
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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 p...
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Most vitamins are absorbed in the upper small intestine, but vitamin B 12 is absorbed in the ileum.This vitamin binds to IF and this complex is absorbed across the ileal mucosa.Vitamin B12 and folate absorption are Na independent.(Ref: Ganong&;s Review of medical physiology, 23 rd edition, page 458)
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As Explained in the previous question– Patient presenting with bleeding, at 37 weeks of gestation with central placenta previa, management should be immediate emergency cesarean section.
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It is based on the fact that a loud sound of 70-100 dB above the threshold of hearing of paicular ear, causes bilateral contraction of the stapedial muscle which can be detected by tympanometry.This can be seen both in the stimulating ear (ipsilateral ear) and in the non stimulating ear (contralateral ear).
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V.I.P. is a inhibitory neurotransmitter found in nerves in the gastrointestinal tract and thus is not itself a hormone.
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Pencillin
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Ans. (a) Hashiinoto's thyroiditisRef: Harrison 18th edition Page 1922* Thyroiditis will predominantly produce hypothyroidism.* De quervains is the only thyroiditis which will have early hyperthyroidism
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Characterised by presence of Sterile vegetation on the valves of patient with SLE. THE lesion probably develops as a consequence of immune complex deposition and thus exhibit associated inflammation often with fibrinoid necrosis of the valve substance adjacent to the vegetation Robbins 9 th edition page no. 395
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The cause is typically a bacterial infection and less commonly a fungal infection. Risk factors include valvular hea disease including rheumatic disease, congenital hea disease, aificial valves, hemodialysis, intravenous drug use, and electronic pacemakers. The bacteria most commonly involved are streptococci or staphy...
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The accountant has galactorrhea (inappropriate production of milk) caused by a prolactinoma (a tumor of the anterior pituitary that secretes PRL). Dopamine, the major regulator of PRL secretion, inhibits PRL production and release by the anterior pituitary. Bromocriptine is a drug that acts like dopamine to inhibit PRL...
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It is currently accepted that malaria-parasitized red blood cells (pRBC) are eliminated, like senescent erythrocytes, phagocytically by macrophages in the red pulp of the spleen. REFERENCE.nih.gov
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Ref: Harrison's 18th editionExplanation:Emphysematous CholecystitisIt is thought to begin with acute cholecystitis (calculous or acalculous) followed by ischemia or gangrene of the gallbladder wall and infection by gas-producing organisms.Bacteria most frequently cultured in this setting includeAnaerobes, such as C. we...
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Intracranial hemorrhage
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A i.e. White matter
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Levetiracetam acts on SV2A
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There is disturbance of immediate and recent memory which are responsible for registration, retention and recall of new memories. On recovery there is amnesia for the period of delirium, but remote memory is intact. That means there is no memory loss and patient remembers everything before the episode of delirium, ther...
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Chemicals used for peeling (chemical peeling) are :- Trichloroacetic acid  Hydroxy acid (Glycolic acid)    Salicylic acid (β-hydroxy)               Carbolic acid (Phenol)       β-hydroxy acid (citric acid, lactic acid, glycolic acid, malic acid)          Resorcinol Kojic acid Jessner solution Baker's solution Pyruvic...
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In 14th century, quarantine was introduced in Europe to protect against transmission of plague. Ships, crews, travellers were detained for a 40 day period. Also remember, list of Quarantinable diseases are: Diphtheria Infectious tuberculosis Plague Small pox Yellow fever SARS Viral hemorrhagic fever Cholera Flu
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Energy released by creatinine phosphate is -10.5kcalRef: DM Vasudevan Textbook of Medical Biochemistry, 6th edition, page no: 226
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CHLAMYDIAL CONJUNCTIVITIS: In established trachoma, there may be superior epithelial keratitis, sub epithelial keratitis, pannus, or superior limbal follicles, and ultimately the pathognomonic cicatricial remains of these follicles, known as Herbe's pits--small depressions covered by epithelium at the limbo corneal jun...
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Seen in ascending cholangitis, stone in the CBD due to impaction causes obstruction and stasis. obstruction causes jaundice and pain, stasis leads to infection, bacteremia and fever Reference SRB edition: 5 page:651
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Ans. is 'a' i.e., Plain X-ray Volvulus neonatorum o The fetal alimentary canal returns from the extraembryonic coelom into the abdomen at 8-10 weeks, and the bowel undergoes rotation and fixation at ceain points by the attachment of its mesentery to the posterior abdominal wall. o When the process is incomplete or dete...
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The transverse fascia is a thin aponeurotic membrane which lies between the inner surface of the transverse abdominal muscle and the parietal peritoneum.It forms pa of the general layer of fascia lining the abdominal parietes, and is directly continuous with the iliac fassia, internal spermatic and pelvic fascia.In the...
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Penicillin G due to it's rapid tubular secretion, it is very sho acting. It's duration of action is increased with probenecid which compete with penicillin at tubular pump. Procaine penicillin G and benzathine penicillin G are administered IM and serve as depot forms. They are slowly absorbed into the circulation and p...
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Erythromycin
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Ans is 'a' i.e. Intraepidermal Important vesiculobullous disordersIntraepidermalo Pemphigus (vulgaris, P. foliaceous. erythematosus )o Staphylococcal scalded skin syndromeo Bullous impetigoo Friction blisterso Hailey Hailey disease (familial benign pemphigus)o Subcorneal pustular dermatosiso Eczematous dermatitiso Darr...
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Ans. is 'b' i.e., Termination of corneal descemets membrane * Schwalbe's line is the anatomical line found on the interior surface of the eye's cornea, and delineates the outer limit of the corneal endothelium layer. Specifically, it represents the termination of Descemet's membrane.In many cases it can be seen via gon...
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Greater Sac Repeat .from Nov 08 "Being developed in the dorsal mesogastrium, the spleen projects into the greater sac surrounded by peritoneum of the original leaf leaf of the dorsal mesogastrium."- Last's Anatomy
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Triangle of auscultation is a small triangular interval on the back of thorax bounded by: medially - lateral border of trapezoid laterally -medial border of scapula inferiorly - upper border of latissimus dorsi. The floor- 6th & 7th rib, 6th intercoastal space , rhomboid major. B D Chaurasia 7th edition Page no : 67 Fi...
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b. Adrenal medulla(Ref: Nelson's 20/e p 2227-2729, Ghai 8/e p 525)Pheochromocytoma is a neoplasms of chromaffin cells in medulla that release catecholamines.
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CRUCIATE LIGAMENTS: Very thick and strong fibrous bands.Direct bonds of union between tibia and fibula.Maintain anteroposterior stability of knee joint. Anterior cruciate ligament:- Begins from anterior pa of intercondylar area of tibia, runs upward, backward and laterally and is attached to the posterior pa of medial ...
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Premature thelarche is the term we use for girls who develop small breasts (often an inch or less across), typically before the age of 3 years. Girls with premature thelarche do not have other signs of pubey. Ref : Nelso
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Ans. is 'c' i.e., TSH o Since the neonates are asymptomatic at birth all newborns are screened for neonatal hypothyroidism. TSH is estimated either in cord blood at the time of birth (preferred) or blood obtained from heel prick after 2 days of birth.
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If injured tooth requires more current than that for a normal tooth to give response indicates pulp death. If less current is needed to elicit a response from a traumatize tooth indicates pulpal inflammation.
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Lactoferrin is present in secondary/specific granules. Neutrophils have two main types of granules:- The smaller specific (or secondary) granules contain:- The larger azurophil (or primary) granules contain:- Lysozyme Collagenase Lactoferrin Plasminogen activator Histaminase Alkaline phosphatase Myeloperoxidase Bacteri...
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Cholesterol is a precursor for synthesis of : Vitamin D, Steroid hormones Bile acids Lipocoin/ Annexin, inhibitor of phospholipase A2 enzyme. Increased expression of the gene coding for annexin-1 is one of the mechanisms by which glucocoicoids (such as coisol) inhibit inflammation.
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Autoimmune hemolytic anemia is a feature of CLL Features of CML: - - Increased Basophil count: i. Leading to release of histamine ii. Leading to itching, pruritis, flushing episodes, peptic ulcers, secretory diarrhea - Immature cell in P. Smear (Shift to left) - Infection: Neutrophil Alkaline phosphatase (NAP) score is...
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The symptoms of Raynaud's phenomenon, ahralgia, and dysphagia point toward the diagnosis of scleroderma. Scleroderma- systemic vasculopathy of small and medium-sized vessels, excessive collagen deposition in tissues, and an abnormal immune system. Affect women more than men. There are two variants of scleroderma-- CRES...
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Features of Cystic fibrosis Delayed passage of Meconium Recurrent pneumonia Steatorrhea Late onset Diabetes Azoospermia
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Ans) c (Hypercalcaemia) Ref Bailey 25th ed pg 790Following thyroidectomy hypocalcaemia occurs due to parathyroid insufficiency and not hypercalcaemia.Complications of thyroidectomyHaemorrhage - Reactionary haemorrhage from one of the thyroid arteries.Respiratory obstruction - Most cases are due to laryngeal oedema. (Mo...
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Hypergammaglobulinemia results from an overproduction of immunoglobulins by plasma cells, either monoclonal and reflective of a plasma cell or lymphoproliferative disorder, or polyclonal and accompanying other disease states. IgG replacement therapy and theradiotheraphy aretreatment of choice for most primary immunodef...
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Most abundant amino acids found in collagen is Glycine Collagen is the most abundant of all human proteins. Around 28 types of collagen are known. Type 1 is most abundant The fold in collagen is because of presence of Glycine. ADDITIONAL READING ON STRUCTURE OF COLLAGEN: Collagen is made up of 3 alpha- chains (not alph...
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Ans. (a) R0Ref: Sabiston 20th Edition, Page 1218* R 0,1,2 are used to show the completeness after resection of a cancer* R0--Microscopic margin is negative in specimen* R1--Microscopic margin is positive in specimen* R2--Macroscopic margin is positive in specimen
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The median apeure ("Foramen of Magendie") drains CSF from the fouh ventricle into the cisterna magna. Cisterna magna occupies the interval between inferior surface of cerebellum and posterior aspect of medulla oblongata. The two lateral apeures (foramina of Luschka), one on the left and one on the right, are the primar...
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Ans. a (2 weeks). (Ref. PARK PSM 22nd/ pg. 395-396)REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME (RNTPC)# TB is leading killer of adults globally.# India accounts for nearly l/3rd of global burden.# Although exact and current information on TB incidence and prevalence is not available, studies show an incidence rate ...
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(C) Endomycelial antibodies # Pathological features of Crohn's disease: Starts in terminal ileum as ulcerations of intestines in 60% cases inflammatory edema with mucosal ulcers& fibrotic thickening results in hose pipe rigidity Mesenteric nodes are enlarged & calcified Intense infiltration of mononuclear Skip areas Ca...
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The diagnostic evaluation of an infertile couple should be thorough and completed as rapidly as possible. The primary diagnostic steps in the workup of the infertile couple include (1) documentation of ovulation by measurement of basal body temperature (BBT) or mid-luteal phase serum progesterone; (2) semen analysis; (...
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Recurrent hypoglycemic attack with hepatomegaly is seen in Type I glycogen storage disease (Von Gierke disease). Glycogen storage diseases Glycogen storage diseases result from a hereditary deficiency of one of the enzymes involved in the synthesis or sequential degradation of glycogen. Clinical features depend on th...
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ANSWER: (B) BupivacaineREF: Miller 5th ed p.586, Local Anesthesia in dentistry By Paul D. Robinson, Fraser McDonald, Thomas R. Pitt Ford, T. R. Pitt For page 75Combined spinal-epidural (CSE) techniques may be used for analgesia in labour. An epidural needle is sited in the epidural space and a longer small-gauge spinal...
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Enteroclysis: Contrast study of small bowel by infusing contrast agent through Nolan intestinal tube Contrast agent- High density microbar solution with methyl cellulose or water soluble iodine dye Indications: Small bowel tumors Stricture small bowel Congenital anomalies Crohns disease, intestinal tuberculosis Advanta...
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Ans. is 'a' i.e., Lateral wall of nose Inverted Papilloma (Transitional cell papilloma/Schneiderion papilloma)o Inverted papilloma is a benign neoplasm occurs mostly between 40-70years with male preponderance (5 : 1).o It arises from the lateral wall of nose and is always unilateral. Rarely, it may arise from nasal sep...
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Answer is C (Renal involvement): Renal involvement is rare in Drug induced Lupus Drug induced lupus is associated with Antihistone antibodies, rare anti ds DNA and serositis. Drug induced Lupus: Features Syndrome of Positive ANA with symptoms such as fever, malaise, ahritis, intense ahralgia/myalgia, serositis and / or...
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The scanning Electron microscopy is a recent development which provides a higher resolution and 3 dimensional image of the object . Although the substantial increses in resolution power of Electron microscopy has led to significant discoveries a major disadvantage is the inability to examine living cells A method invol...
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Risperidone * Impoance * Most commonly used Side effects * Behaves as FGA at large doses * EPS * TD Sexual dysfunction REf. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no 935
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Grading of VUR based on radiocontrast MCO : Grade Description I Reflux into non - dilated distal ureter II Reflux into upper collecting system in non dilated ureter III Reflux into dilated ureter IV Reflux into grossly dilated ureter V massive Reflux with ureteral dilation , tortuous effaced calyces
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CLINICAL APPLICATIONS * Brachytherapy can be used in combination with other therapies such as surgery, EB or chemotherapy, paicularly when the tumor is too large or is not easily accessible. * Brachytherapy has been most widely applied in the treatment of: Cervical Prostate Breast and skin cancers Brachytherapy can als...
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Stage 111 is extraocular extension.(that is tumor has spread to the orbit) and is thus treated by exenteration(all the orbital contents along with the periosteum of the bone is removed. Refer khurana 6/e
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IL-8 is a C-X-C chemokine. Hematopoietins:IL-2, IL-3, IL-4, IL-5, IL-6, IL-7, IL-9, IL-11, IL-12, IL-15, IL-16, IL-17, IL-21, IL-23, EPO, LIF, GM-CSF, G-CSF, OSM, CNTF, GH, and TPO. IL-1 family : IL-1alfa, IL-1beta, IL-1ra, IL-18, bFGF, aFGF, and ECG.F C-X-C chemokines: IL-8, NAP-2, ENA78, GCP-2, PF4, CTAP-3, MIG, and ...
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This pt. is suspected to have Ca Prostate as Prostatic Ca is the most common malignant tumor in men over 65 yrs. of age. Symptoms of Bladder outlet obstruction and back pains (due to bony metastasis in the pelvis & lumbar vertebra) indicate towards prostate Ca. Serum acid phosphates is a tumor marker of prostate Ca. Bu...
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Ans. D: Index case The index case or primary case is the initial patient in the population of an epidemiological investigation. The index case may indicate the source of the disease, the possible spread, and what reservoir holds the disease in between outbreaks. The index case is the first patient that indicates the ex...
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Eosinophils have a granule that contains major basic protein (MBP) Proteoglycan 2, (natural killer cell activator, eosinophil granule major basic protein), also known as PRG2, is a protein which in humans is encoded by the PRG2 gene. It is a potent enzyme against helminths. The eosinophil major basic protein also cause...
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Pleomorphic adenomas arise most commonly in the parotid gland. These form majority (~80-90%) of tumors of the parotid gland. Pleomorphic adenomas are less common in the submandibular glands & sublingual glands; relatively rare in the minor glands. Pleomorphic adenomas are benign tumors derived from a mixture of ductal ...
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Ans. A. SerotonineThe three main neurotransmitters involved in depression are dopamine, norepinephrine and serotonin (s-HT).When brain Ievels of one or more neurotransmitter are low or unbalanced, depression can result. Generally, antidepressant drugs work by increasing production or decreasing the breakdown of one or ...
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Enteric fever can be presented as cholecystitis, more frequently chronic, and the patient is a typhoid carrier excretes Salmonella typhimurium in the bile.Acalculous cholecystitis is a rare presentation of leptospirosis progressing to Weil&;s disease.Acute acalculous cholecystitis can develop secondary to dengue hemorr...
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The accepted safe level of fluoride in drinking water is 0.5 - 0.8 ppm. Deficiency of fluorine in drinking water is associated with dental caries and excess with dental and skeletal fluorosis.
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Ref-KDT 6/e p40 Drugs acting and ionotropic receptor are fast acting where as those acting through nuclear receptors are slowest in action
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Abetalipoproteinemia is characterized by a normal mucosal appearance except for the presence of mucosal absorptive cellsthat contain lipid postprandially and disappear after a prolonged period of either fat-free intake or fasting.Ref: Harrison; 19th edition; Page no: 1939
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Ans. is b, i.e. Blood transfusionRef. Dutta Obs. 6/e, p 259; Fernando Arias 3/e, p 342, fig. 13.2Unstable vitals (BP =80/60) belong most probably to moderate category bleeding.In Mild cases - Vitals remain stable.Severe cases - Patient is in shock with very low or unrecordable B.P.The gestational age of patient is 32 w...
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C i.e. Senile immature cataract
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Oesophagus
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Ans. All of the above
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Ans. C: Hypocalcemia Nephrogenic diabetes insipidus is characterized by a decrease in the ability to concentrate urine due to a resistance to ADH action in the kidney. The 24 hour urine volume is more than 50 mL/kg body weight and the osmolarity is less than 300 mosmol/ L. Nephrogenic diabetes insipidus can be observed...
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