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761d031c-0374-4bf3-a46f-d4e076f8055e | "Arterial blood gas analysis reveals hypoxemia and hypocapnia, with subsequent metabolic acidosis in severe pulmonary embolism. During anaesthesia, end tidal CO2 concentration may fall dramatically because of increased dead space and reduced cardiac output". _________ Anesthesia & Intensive care
Note : Fat embolism can present as pulmonary embolism when an extensive fat embolism of lung is present. | Orthopaedics | null | A 64 year old hypertensive obsese female was undergoing surgery for fracture femur under general anaesthesia. Intra-operatively her end-tidal carbon dioxide decreased to 20 from 40 mm of Hg, followed by hypotension and oxygen saturation of 85%. What could be the most probable cause?
A. Fat embolism
B. Hypovolemia
C. Bronchospasm
D. Myocardial infarction
| Fat embolism |
f5bda2fd-4fea-4d2f-a8dd-d82652a8a70c | Acarbose is alpha glucosidase inhibitor. It inhibits the breakdown of complex carbohydrates to simple carbohydrates and thus they decrease the absorption. Glipizide is second generation sulphonylurea which helps in secretion of insulin. Metformin is biguanide which decrease the synthesis of glucose. Exenatide is GLP-1 analogue which delay in gastric emptying, decrease appetite and augment glucose secretion. | Pharmacology | Pancreas | Which of the following drugs is taken during the first pa of the meal for the purpose of delaying absorption of dietary carbohydrates?
A. Acarbose
B. Glipizide
C. Metformin
D. Exenatide
| Acarbose |
ccaf0db5-f94b-484c-a030-dcba9337654b | OBER&;S TEST:Used in physical examination to identify tightness of iliotibial band. During the test ,the patient lies on his side with the unaffected leg on the bottom with their shoulder and pelvis in line. The knee may extended or flexed to 90 or 30 degrees.The hip is maintained in slight extension.The test leg is abducted,then allowed to lower toward the table with the pelvis stabilized NORMAL: able to abduct parallel to the examining surface Inability to adduct to parallel indicates tightness of iliotibial band REF : MAHESWARI 9TH ED | Orthopaedics | Bony dysplasia and soft tissue affection | Test for tight iliotibial band is
A. Ober's test
B. Osber's test
C. Simmond's test
D. Charnley's test
| Ober's test |
6413275e-0cae-4aac-ab68-ac3c51233325 | Lamotrigine is the most effective drug among the given options. Ref: Harrisons principles of internal medicine, 18 th edition ; Page : 3263, Table : 369/9. | Medicine | null | The antiepileptic drug effective in Lennox-Gastaut syndrome is:
A. Lamotrigine
B. Gabapentin
C. Tiagabine
D. Primidone
| Lamotrigine |
fb22bfc1-6edc-4099-9d59-5ab1aec761e2 | Factors that predispose to fistula formation and may prevent closure include foreign body, radiation, inflammation, epithelialization of the tract, neoplasm, distal obstruction, and steroids.Factors that result in unhealthy or abnormal tissue surrounding the enterocutaneous fistula decrease the likelihood of spontaneous resolution. For example, radiation therapy, such as used for treatment of pelvic gynecologic and rectal malignancies, can result in chronic injury to the small intestine characterized by fibrosis and poor wound healing. High-output fistulas, defined as those with more than 500 cc per day output, are usually proximal and unlikely to close. Treatment consists of source control, nutritional supplementation, wound care, and delayed surgical intervention if the fistula fails to close. | Anaesthesia | Preoperative assessment and monitoring in anaesthesia | Ten days after an exploratory laparotomy and lysis of adhesions, a patient, who previously underwent a low anterior resection for rectal cancer followed by postoperative chemoradiation, is noted to have succus draining from the wound. She appears to have adequate source control--she is afebrile with a normal white blood count. The output from the fistula is approximately 150 cc per day. Which of the following factors is most likely to prevent closure of the enterocutaneous fistula?
A. Previous radiation
B. Previous chemotherapy
C. Recent surgery
D. History of malignancy
| Previous radiation |
273dda97-7fed-4d82-b195-833c128a1a63 | Ans. (a) Malformation(Ref: Robbins 9th/pg 452)Malformation refers to primary structural defect of an organ due to intrinsically abnormal developmental process (multifactorial); Eg Anencephaly, Congenital heart defects | Pathology | Disease of Infancy & Childhood | Primary structural defect of an organ is termed -
A. Malformation
B. Disruption
C. Deformation
D. Association
| Malformation |
e606ba31-702f-4b9e-b881-573e88acc7eb | The first investigation for abnormal uterine bleeding is Urine Beta HCG to rule ouut pregnancy. Abnormal Uterine Bleeding(AUB): is a common and debilitating condition. Chronic AUB was defined as &;bleeding from the uterine corpus that is abnormal in volume, regularity and/or timing that has been present for the majority of the last 6 months. AUB may affect females of all ages. Factors that influence incidence most greatly are age and reproductive status. A structured approach for establishing the cause using the FIGO PALM COEIN classification system will facilitate accurate diagnosis and inform treatment options. In the reproductive age group , the hypothalamic-pituitary-ovarian (HPO) axis matures, and anovulatory uterine bleeding is encountered less often. The diagnostic goal is exclusion of pregnancy and identification of the underlying pathology to allow optimal treatment. Miscarriage, ectopic pregnancies, and hydatidiform moles may cause life-threatening hemorrhage. Pregnancy complications are quickly excluded with determination of urine and serum Beta-human chorionic gonadotrophin (hCG levels). This is typically obtained on all reproductive-aged women. Other options: Pap smear evaluation is usually done for cervical and endometrial cancers which are commonly seen in peri and post menopausal women. Transvaginal sonography (TVS) typically offers greater patient comfo and suitable detection of postmenopausal endometrial hyperplasia and cancer compared to transabdominal ultrasonography. Ref: Shaw&;s textbook of Gynaecology 17th edition Pgno: 139 | Gynaecology & Obstetrics | Disorders of menstruation | First investigation done for abnormal uterine bleeding in reproductive age group is _______
A. Ultrasonography transabdominal
B. Pap smear
C. Urine Beta HCG
D. Ultrasonography transvaginal
| Urine Beta HCG |
acf4efba-a38c-4bf9-a87c-22861c5a7619 | In most cases the disease tends to remain low grade and chronic producing only minor symptoms of abdominal distress,intermittent diarrhea and liver pain or tenderness.C.sinensis has been linked to bile duct carcinoma.It is mostly observed in areas where chlonorchiasis is endemic (refer pgno:126 baveja 3 rd edition) | Microbiology | parasitology | Causes of biliary tract carcinoma after ingesting infected fish -
A. Grathostoma
B. Angiostrongylus cantonens
C. Clonorchis sinensis
D. H. Dimunata
| Clonorchis sinensis |
35300445-fc06-4e52-bc1e-4befe09b76ae | Tarsometatarsal The 1987 Revised Criteria for the Rheumatoid ahritis 4 out of 7 criteria are required to classify a patient as having rheumatoid ahritis Patients with 2 or more clinical diagnoses are not excluded. 1.Morning stiffness: morning stiffness in and around joints lasting at least 1 hour before maximal improvement 2.Ahritis of 3 or more joint areas: soft tissue swelling (ahritis) of 3 or more joint areas observed simultaneously by a physician. The 14 possible joint areas involved are, right or left: - proximal interphalangeal metacarpophalangeal wrist elbow knee - ankle metatarsophalangeal Ahritis of hand joints: swelling (ahritis) of the proximal interphalangeal, metacarpophalangeal, or wrist joints Symmetric ahritis: simultaneous involvement of the same joint areas on both sides of the body Rheumatoid nodules: subcutaneous nodules over bony prominences, extensor surfaces, or juxtaaicular regions Serum rheumatoid factor: demonstration of abnormal amounts of serum rheumatoid factor Radiographic changes: radiographic erosions and/or periaicular osteopenia in hand and/or wrist joints Criteria 1 to 4 must be present, for at least 6 weeks. Criteria 2 to 5 must be observed by a physician. | Surgery | null | Joint not involved in Rheumatoid ahritis according to 1987 modified ARA criteria?
A. Knee
B. Ankle
C. Tarsometatarsal
D. Met at arsophalangeal
| Tarsometatarsal |
685d2f83-c9ce-40b4-90c4-0acd533bb8d5 | Ans. a (USG cranium). (Ref. Grainger, Diagnostic Radiology, 4th ed., 2469)Cranial ultrasound of Infants# USG cranium is best method to diagnose hydrocephalus through the anterior and posterior fontanalles.# Progression of hydrocephalus can be estimated by comparison with previous studies.# USG is also helpful in following ventricular decompression in patients treated for hydrocephalus.# Neonatal hydrocephalus can also be evaluated by Doppler to assess indirectly intracranial pressure and help to determine the need for shunt placement.Cranial CT# CT enable us to evaluate the brain structure and ventricular size by noninvasive highly reliable technique.# But due to the ionizing radiations hazard, CT as a screening investigation is less preferable.Qhstretk. (Fetal) Cranial ultrasound# Obstretic ultrasound study is one of the best methods for antenatal diagnosis of hydrocephalus as it is noninvasive & hazard free not only to fetus as well as to mother. However assessment prior to GA of 20 weeks may be difficult, as ventricles constitute a large portion of cranial vault.# Signs suggestive of fetal hydrocephalus on obstretic USG study are:- Atrial size > 10 mm- Dangling "Choroid plexus" sign- BPD > 95th percentile- +- PolyhydramniosEducational points:# Lemon sign:- Concave/linear frontal contour abnormality located at coronal suture strongly associated with spina bifida.# Banana sign:- Cerebellum wrapped around posterior brainstem + obliteration of cisterna magna secondary to small posterior fossa + downward traction of spinal cord in Chiari II malformation.# Key points about Obstetric color Doppler study:- Assessment of flow in MCA is important parameter to diagnose fetal anemia.- Assessment of flow in umbilical vessels is important parameter to diagnose fetoplacental insufficiency.- Reduced diastolic flow in umbilical artery is the earliest sign of fetoplacental insufficiency.- Reversal of flow in umbilical artery (as well as pulsatile flow in umbilical vein) is the most ominous sign and may indicate impending fetal death. | Radiology | Nervous System | Hydrocephalus in infant is best diagnosed by
A. USG cranium
B. CT scan head
C. Encephalogram
D. Lumbar-puncture
| USG cranium |
81df78f3-28c4-4f25-bb89-94571ead91bf | Seven of the reactions of glycolysis are reversible and are used in the synthesis of glucose by gluconeogenesis. Thus, seven enzymes are common to both glycolysis and gluconeogenesis : (i) Phosphohexose isomerase; (ii) Aldolase; (iii) Phosphotriose isomerase, (iv) Glyceraldehyde 3-phosphate dehydrogenase; (v) Phosphoglycerate kinase; (vi) Phosphoglycerate mutase; (vii) Enolase. Three reactions of glycolysis are irreversible which are circumvented in gluconeogenesis by four reactions. So, enzymes at these steps are different in glycolysis and gluconeogenesis. | Biochemistry | null | Which is not a common enzyme for glycolysis and gluconeogenesis?
A. Aldolase
B. Glucose-6-phosphatase
C. Phosphoglycerate mutase
D. Phosphoglycerate kinase
| Glucose-6-phosphatase |
31fe7b54-b8d4-4012-a442-e0a6de1a1518 | Ans. is 'a' i.e., Halothane o Halothane is the most hepatotoxic anesthetic.o Hepatotoxic anaesthetic agents are :1. Chloroform2. Halothane3. Carbon tetrachloride4. Trichloroethylene5. MethoxyfluraneRemembero Nitric oxide is least potent inhalation agent (MAC - 105%).o Halothane is most potent inhalation agent-MAC - 0.75 (Methoxyflurane was the most potent inhalation agent hut it is not used now due to its nephrotoxic action).o Desflurane is fastest acting inhalation agent.o Diethyl ether is slowest acting (Previously it was methoxyflurane).o Ether has highest muscle relaxant action.o N2O has least muscle relaxant action.o N2O is least lipid soluble.o Halothane is most lipid soluble.o Most of the Inhaled anaesthetics are eliminated from lung, though some metabolism in liver may occur - In terms of the extent of hepatic metabolism, the rank of order is methoxyflurane > Halothane > enflurane > sevoflurane > isoflurane > desflurane > nitrous oxide. | Anaesthesia | Anesthesia for Liver Disease | Hepatotoxic agent is -
A. Halothane
B. Ketamine
C. N2O
D. Ether
| Halothane |
a03a141d-c3b3-499d-9c9f-7ab5090be664 | <p>measles complications:- Most common complications are 1. Measles associated diarrhoea. 2. Pneumonia 3. Otitis media 4. Respiratory complications Pneumonia is the most life threatening complication. Pulmonary complications account for more than 90% of deaths due to measles. Neurological complications:- 1. Febrile convulsions 2. SSPE (subacute sclerosing pan encephalitis). This is a rare complication occuring after many years after measles infection. It is characterised by mental deterioration, paralysis, involuntary movements, muscle rigidity and coma. 3. Encephalitis Measles during pregnancy causes congenital anomalies in children. {Reference: park&;s textbook of preventive and social medicine, 23rd edition, pg no.148}</p> | Social & Preventive Medicine | Communicable diseases | Which of the following is the "Least common" complication of measles-
A. Diarrhoea
B. Pneumonia
C. Otitis media
D. SSPE
| SSPE |
29205d8f-9b6e-424d-862a-470f1f439941 | Locked-in Syndrome: A pseudo-coma state in which an awake patient has no means of producing speech or volitional movement Retains voluntary veical eye movements and lid elevation Pupils are normally reactive. Aphonic because of the involvement of pyramidal fibers Involvement of medulla leads to 9th, 10th, 12th nerves. Conscious, ale and awake as the tegmental Ascending Reticular Activating System (ARAS) is intact. Veical eye movements are intact as it is controlled by the interstitial nucleus of Cajal and the rostral pa of the M.L.F Horizontal movements are lost ,basalis pontis is involved- 6th cranial nerve involvement | Medicine | Stroke and TIA | Which cranial nerve(s) is/are not involved in "Locked in syndrome"?
A. 9
B. 10
C. 11
D. 12
| 11 |
37550fd7-46d1-4623-bb64-a1d925af5830 | In premature & term neonates- it lies b/w 1st & 3rd lumbar veebrae. In children between ages of (1-7yrs)- it lies between 12th thoracic and 3rd lumbar veebra. In adults, it terminates at the level of middle 3rd of body of 1st lumbar veebra which corresponds approximately to transpyloric plane. Spinal cord occupies superior 2/3rd of veebral canal It continues cranially with medulla oblongata, just below the level of foramen magnum, at the upper border of atlas and terminates caudally as conus medullaris. During development, veebral column elongates more rapidly than spinal cord, so there is increasing discrepancy b/w anatomical level of spinal cord segments & their corresponding veebrae. | Anatomy | Neuroanatomy 3 | Spinal cord in an infant terminates at
A. L1
B. L2
C. L3
D. L4
| L3 |
c4d7a407-b64a-4299-956b-43a71a09d2a5 | Ans. is 'c' i.e., Seminoma * Testicular tumors are divided into two major categories : (i) Germ cell tumors, and (ii) Sex cord tumors.A) Germ cell tumors# More than 95% of testicular tumors are germ cell tumors. They are further divided into -i) Seminoma* It is the most common germ cell tumor of testis. Female counterpart of seminoma is dysgerminoma of ovary.ii) Non-seminoma germ cell tumors (NSGCT)* These are spermatocytic seminomay embryonal carcinoma, Yolk sac tumor (also called endodermal sinus tumor or infantile embryonal carcinoma), teratoma, and choriocarcinoma.# Risk factors for germ cell tumors of testis are -i) Cryptorchidism (abdominal > inguinal, i.e. higher the undescended testis more the chances of malignancy).ii) Testicular feminization syndrome and Klinefelter syndrome.iii) Excess 12P copy number either in the term of i(12P) or increased 12P an aberranthy banded marker chromosome.B) Non-germ cell tumors (sex cord tumors)# These are ley dig cell tumor and sertoli cell tumor.# Leydig (interstitial) cell tumors are positive for Reinke crystalloids. | Pathology | Male Genital Tract | Most common type of germinal cell tumor in testis is?
A. Teratoma
B. Embryonal carcinoma
C. Seminoma
D. Endodermal sinus tumor
| Seminoma |
a18d43d0-c54e-44eb-a80a-346c206ebbcf | The treatment for hyperkalemia can be thought of in 3 distinct steps. First, antagonize the effects of hyperkalemia at the cellular level (membrane stabilization). Second, decrease serum potassium levels by promoting the influx of potassium into cells throughout the body.(insulin,beta2 agonist) Third, remove potassium from the body.(k+resins) In cells with calcium-dependent action potentials, such as SA and atrioventricular nodal cells, and in cells in which the sodium current is depressed, an increase in extracellular calcium concentration will increase the magnitude of the calcium inward current and the Vmax by increasing the electrochemical gradient across the myocyte. This would be expected to speed impulse propagation in such tissues, reversing the myocyte depression seen with severe hyperkalemia. The effects of intravenous calcium occur within 1 to 3 minutes but last for only 30 to 60 minutes. Therefore, fuher, more definitive treatment is needed to lower serum potassium levels. Calcium gluconate is the preferred preparation of intravenous calcium. The dose should be 10 mL of a 10% calcium gluconate solution infused over 2 to 3 minutes. | Medicine | ECG and Arrhythmias 1 | In hyperkalemia with bradycardia treatment is: -
A. Calcium gluconate
B. Steroid
C. Salbutamol
D. K+ resin
| Calcium gluconate |
d679cbbc-5167-4004-b2ce-e2f6f29dc960 | Cataract is not a common cause of night blindness. Other causes are more recognized causes. Causes of Night Blindness Vitamin A deficiency (first symptom is red-green differentiation anomaly) Pathological myopia Tapetoretinal degenerations{eg. Retinitis pigmentosa(RP)} Familial congenital night blindness Oguchi's disease | Ophthalmology | Neuro Ophthalmology | Not a common cause of night blindness:
A. Cataract
B. RP
C. Oguchi disease
D. Pathological myopia
| Cataract |
291d5c67-079f-4fc0-98c0-e35c3f1cf723 | Ans. is 'c' i.e., Vaccination o The reduced incidence of diphtheria in India is primarily due to the high coverage of appropriate immunization in children and to an apparent reduction in toxin-producing strains of the bacterium. | Social & Preventive Medicine | Diphtheria | In recent surveillance reports cases of diphtheria are reducing. This is due to -
A. Chemoprophylaxis
B. Improved standard of living
C. Vaccination
D. Health education
| Vaccination |
d411bf42-cc87-43c8-b545-4867293a74d3 | Ans. C. Lung compliancea. TLC is the maximum volume to which the lungs can be expanded with the greatest possible inspiratory effort.b. TLC=IRV+TV+ERV+RV=IC+RVc. Compliance (stretch ability) of lungs: D is increased in Emphysema (obstructive lungs dis) and decreased in Interstitial pulmonary fibrosis (Restrictive lung disease). Compliance of lung is change in lung volume per unit change in airways pressure.d. TLC is increased in obstructive lung disease (eg. emphysema, COPD) and decreased in the restrictive lung disease (Interstitial pulmonary fibrosis). | Physiology | Respiratory System | Total lung capacity depends on:
A. Size of airway
B. Closing tidal volume
C. Lung compliance
D. Residual volume
| Lung compliance |
eeb66d6f-fb93-4291-8af6-b0671388b458 | Cyanide is probably the most potent inhibitor of ETC (Complex IV). It binds to Fe3+ of cytochrome oxidase blocking mitochondrial respiration leading to cell death. Cyanide poisoning causes death due to tissue asphyxia (mostly of the central nervous system) In Acute cyanide poisoning Amyl nitrite is given followed by sodium thiosulphate. This is an example of Chemical antagonism i.e. one drug binding to other making it unavailable in body. | Biochemistry | FMGE 2019 | Type IV complex of ETC is inhibited by
A. Oligomycin
B. Antimycin
C. Cyanide
D. CO2
| Cyanide |
7ef8dfdf-60ce-4701-8fd5-f7a6553d8fb9 | In this case, we should suspect bladder carcinoma ( transitional cell carcinoma ) . Smokers are at a higher risk of developing TCC.Other risk factors being chemical .industry workers in western countries and schistosomiasis in endemic regions . It is more common in males -3:1. They usually presents with painless gross hematuria. Thus the best option here is urine microsopy for RBC's and malignant cells.urine cytology even though not a good screening test because of lack of sensitivity is highly specific . Mainstay of diagnosis is cystourethroscopy. investigations include imaging ( CT , MRI ,USG ,IVU ) and blood investigations for HB , electrolytes and urea . Bailey and Love 27th edition.chapter 77.pg no 1449. | Surgery | Urology | A 60 yr old smoker came with a history of painless gross hematuria for one day. Most logical investigation would be
A. Urine routine
B. Plain X ray KUB
C. USG KUB
D. Urine microscopy for malignant cytology
| Urine microscopy for malignant cytology |
b7dd95d8-e3a4-4562-aa6d-cea8f6f9daac | Oral malignancy with best prognosis is carcinoma lips. Oral cancer with worst prognosis is floor of mouth carcinoma. | ENT | null | Which Ca has best prognosis:
A. Carcinoma lip
B. Carcinoma cheek
C. Carcinoma tongue
D. Carcinoma palate
| Carcinoma lip |
8a4b25d1-a225-465a-9845-b866b911232b | Propylthiouracil is the only thioamide which is least teratogenic and hence it is the drug of choice to hyperthyroidism in pregnancy and lactation. | Pharmacology | null | Drug the choice for hyperthyroidism in first trimester of pregnancy is
A. Methimazole
B. Propylthiouraril
C. Carbimazole
D. Perchlorate
| Propylthiouraril |
36059aab-677f-4156-8ff8-0ba0327b51bf | The loose aggregation of platelets in the temporary plug is bound together and conveed into definitive clot bg fibrin. Fibrin is initially a loose mesh of interlacing strands. It is conveed by the formation of covalent cross-linkages to a dense tight aggregate. The latter reaction is catalyzed by activated factor 13 and requires calcium. Ref: Ganong&;s Review of medical physiology, 24th edition.Pg no. 566 | Physiology | Cardiovascular system | Which of the following coagulation factors causes cross-linking and stabilization of clot?
A. Factor XIII
B. Thrombin
C. Factor VIII
D. Factor IX
| Factor XIII |
c7f9fab1-4168-46a1-9291-705eb0cd0c43 | Ans. is 'a' i.e., Increase the dose of warfarin | Pharmacology | null | A patient on warfarin was given phenobarbitone, The result would have been -
A. Increase the dose of warfarin
B. Decrease the dose of warfarin
C. Increase the dose of phenobarbitone
D. Decerease the dose of phenobarbitone
| Increase the dose of warfarin |
7bf2b381-3b5d-408a-8b8d-91843953adee | Most common childhood tumor → Leukaemia
Most common childhood leukemia → ALL
Most common solid tumor of childhood → Brain tumor
Most common tumor in infancy → Neuroblastoma
Most common abdominal tumor in child → Neuroblastoma | Pediatrics | null | Most common malignancy in children is –
A. Leukemia
B. Lymphoma
C. Wilm's tumor
D. Neuroblastoma
| Leukemia |
da6c0cfc-0bc2-4ccd-b640-124cb4bc2bee | Excessive salivation, blue line on gums, tremors (i.e. Hatter's shake), disturbed personality (i.e. erethism) and loss of appetite (anorexia) suggest the diagnosis of mercury poisoning. | Forensic Medicine | null | A factory worker presents with excessive salivation, blue lines on gums, tremors, disturbed personality, insomnia, and loss of appetite. The most likely poisoning is -
A. Mercury
B. Lead
C. Arsenic
D. Phosphorus
| Mercury |
af573629-e465-47a1-9544-c520a4c44597 | Ans. is 'd' i.e.. Transfer of activated long chain FFA into mitochondria o Activated long chain fatty acid (acyl CoA) cannot penetrate inner mitochondrial membrane.o Acyl group of acyl CoA is transferred to carnitine, resulting in formation of acylcarnitine.o Acylcarnitine is then transported across the inner mitochondrial membrane into the mitochondrial matrix by translocase.o Once inside the mitochondrion, acyl group of acylcarnitine is transferred back to CoA, resulting in formation of acvl-CoA which undergoes b-oxidation. | Biochemistry | Lipid Oxidation and Synthesis | Role of carnitine in lipid metabolism -
A. Catalyzation of the cyclization sequence
B. Essential for extracellular transfer of fatty acids
C. Essential for biosynthesis of fatty acids
D. Transfer of activated long chain FFA into mitochondria
| Transfer of activated long chain FFA into mitochondria |
1a1c1412-b518-4dfe-859f-f2c7c82278e5 | Ans. b (Group B). (Ref. Textbook of microbiology by Ananthanarayan 6th ed. 187).Serological or Lancefield classification system for streptococci1Group A streptococciCatalase -,Beta-hemolysis,Bacitracin sensitive,PYR test +,Ribose not fermented.Includes Streptococcus pyogenes.2Group B streptococciCAMP + and Beta-hemolysis +.CAMP reaction (Christie, Atkins and Munch Peterson reaction) due to their ability to hydrolyze hippurate, which can be demonstrated as accentuated zone of hemolysis when streptococcus agalactiae is inoculated perpendicular to streak of staph aureus grown on blood agar.Includes only one bacterium, S. agalactiae.Currently, it has been found to be a cause of sexually transmitted urogenital infections in females.3Group C streptococciRibose and trehalose fermentation4Group D streptococciGrow in 6.5% NaCI and are optochin sensitive.Hydrolysis of bile esculin (dark brown medium)-this indicates the ability of the bacteria to tolerate bile from the liver and growth in high salt cone.Includes Enterococcus and non-Enterococcus.The Enterococci include E. faecalis, a cause of urinary tract infections, and E. faecium, a bacterium resistant to many common antibiotics. Diseases such as septicemia, endocarditis, and appendicitis have also been attributed to group D Strep. Once identified, Group D Strep can be treated with ampicillin alone or in combination with gentamicin. Viridans GroupThe Viridans Streptococci, consisting of S. mutans and S. mitis, are alpha-hemolytic bacteria.These bacteria inhabit the mouth.In fact, a large percentage of tooth decay can be attributed to S. mutans.5Group F streptococciMinute streptococci;streptococcus MG. | Microbiology | Bacteria | CAMP reaction is shown by which streptococci?
A. Group A
B. Group B
C. Group C
D. Group D
| Group B |
9b424535-eb42-4c23-a467-7a50cf60c294 | Sternocleidomastoid and trapezius develop from branchial arch mesoderm and are supplied by spinal pa of the accessory nerve. Levator scapulae are supplied by a branch from dorsal scapular nerve and branches from C3, C4. BD Chaurasia 7th edition Page no: 65 | Anatomy | Upper limb | Cranial pa of accessory nerve supplies
A. Sternocleidomastoid
B. Trapezius
C. Levator scapulae
D. Levator palatini
| Sternocleidomastoid |
79103c19-09f0-4e51-865e-ce76f2219d88 | The Relative Afferent Pupillary Defect (RAPD), or Marcus-Gunn Pupil is an extremely significant and highly objective clinical finding in the examination of the visual system. The "swinging flashlight test" is probably the best test for identifying an RAPD. In this test, a strong, steady light is used. The light is shined into one eye, and then quickly switched to the other. This is repeated back and foh, until one of four conclusions is reached (listed below). Since light in one pupil causes both pupils to constrict, quickly switching from one eye to the other will give a "relative" indication of the functioning of each eye and optic nerve. If both eyes are equally dysfunctional, no "relative" defect would be found. | Ophthalmology | Neuro-ophthalmology | Marcus Gunn pupil is due to -
A. Total afferent pupillary defect
B. Relative afferent pupillary defect
C. Efferent pathway defect
D. Cerebral lesion
| Relative afferent pupillary defect |
f0f4b676-ab5a-4469-916c-bdfd4113be62 | Side effects of clozapine
Agranulocytosis
Urinary incontinence
Unstable BP & Tachycardia
Hypersalivation (sialorrhoea)
Worsening of diabetes
Weight gain
Seizures
Sedation | Psychiatry | null | The adverse effect of clozapine -
A. Hypertension
B. Sialorrhea
C. Extrapyramidal S/E
D. Neuroleptic malignant syndrome
| Sialorrhea |
54941263-b5cb-47b5-9078-427f5c9d1817 | ANSWER: (B) SepsisREF: Forensic Medicine and Toxicology By R.N.Karmakar page 230, Textbook of Forensic Medicine and Toxicology, Krishan Vij 5th ed fig 26.2The most common complication from illegal abortion is retained product of conception; the most frequent cause of death is infection and sepsis.NATURAL VS CRIMINAL ABORTION Natural abortionCriminal abortionCauseSpontaneousInducedPrecipitating factorMaternal or fetal diseaseUnwanted pregnancyEvidence of genital violenceAbsentPresentForeign body from genitalsAbsentMay be presentToxic effect of drugAbsentMay be presentFetal injuryAbsentRarely present | Unknown | null | Most common cause of death in criminal abortion is?
A. Hemorrhage
B. Sepsis
C. Air embolism
D. Perforation
| Sepsis |
5ba3d7de-9e3f-42cf-9ba8-7330fd1c1701 | Ans. is 'c' i.e., Rosuvastatin o Two most potent statins are Pitavastatin (most potent) and rosuvastatin most potent). | Pharmacology | null | Most potent statin -
A. Simvastatin
B. Pravastatin
C. Rosuvastatin
D. Simvastatin
| Rosuvastatin |
ab67dd74-7d14-41f7-9591-9b8e7a4c4151 | MRI in Liver lesions MRI had emerged as the best imaging test for liver lesion detection and characterization MRI provides high lesion-to-liver contrast and does not use radiation Liver-specific contrast media, such as mangofodipir trisodium (taken up by hepatocytes) and ferrumoxides (taken up by kupffer cells) demonstrate selective uptake in the liver and primarily used for lesion detection These two contrast agents are also useful in characterising specific liver tumors, such as FNH, hepatic adenoma and HCC Ref: Shackelford 7th edition Pgno : 1560 | Surgery | G.I.T | Focal lesion in liver is best detected by
A. MRI
B. CT
C. USG
D. PET
| MRI |
8156512f-8a11-47f3-8c3f-edfb0de612aa | CRL is the best USG parameter to determine gestational age in first trimester Crown rump length - it is the longest straight line measurement of the embryo from the other margin of cephalic pole to rump mid-sagittal plane with fetus in neutral , non fixed position - Best seen on TVS - Overall best USG parameter to assess the fetal age - Ideal time to measures CRL is 7 - 10 weeks - can be done upto 14 weeks | Gynaecology & Obstetrics | Diagnosis of Pregnancy | A patient presents with LMP 8 weeks ago. She has history of delayed cycles in the past. Which of the following is the most accurate way of dating the pregnancy?
A. Determination of uterine size on pelvic examination
B. Quantitative serum HCG level
C. Crown-rump length on abdominal or vaginal ultrasound
D. Determination of progesterone level along with serum HCG level
| Crown-rump length on abdominal or vaginal ultrasound |
c337bf74-49d1-4b5d-9838-04319f80bd54 | (A) OCD # Obsessive-compulsive disorder (OCD) is a psychiatric anxiety disorder most commonly characterized by a subject's obsessive, distressing, intrusive thoughts and related compulsions (tasks or "rituals") which attempt to neutralize the obsessions.# Obsessions are defined by:> Recurrent and persistent thoughts, impulses, or images that are experienced at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress.> Thoughts, impulses, or images are not simply excessive worries about real-life problems.> Person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action.> Person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind, and are not based in reality.> Tendency to haggle over small details that the viewer is unable to fix or change in any way. This begins a mental pre-occupation with that which is inevitable.# Compulsions are defined by:> Repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly.> The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive. | Psychiatry | Miscellaneous | A lady used to repeatedly wash her hands due to the fear of acquiring AIDS is due to
A. OCD
B. Mania
C. Depression
D. Anxiety
| OCD |
5c30c58e-aa88-4ad7-9c3f-59e0fbae78c0 | Ans. is 'a' i.e., 0.05 meter/sec Cardiac tissueConduction velocity (meter/second)SA node0 [?] 05Inteatrial pathways1Atrial muscle0 [?] 30AV node0 [?] 05 (minimum)Bundle of His1Purkinje system4 (maximum)Ventricular muscle1 | Physiology | Heart, Circulation, and Blood | Conduction velocity in AV node 8c SA node-
A. 0.05 meter/sec
B. 0.5 meter/sec
C. 1 meter/sec
D. 5 meter/sec
| 0.05 meter/sec |
67addd49-aef4-4a17-8a92-cb1d6d4c5048 | . Cells which are not able to express MHC 1 | Pathology | null | Which of the following cells do Natural killer cells attack?
A. Cells which express MHC 1
B. Cells which are not able to express MHC 1
C. MHC cells which express MHC 2
D. Cells which are not able to express MHC
| Cells which are not able to express MHC 1 |
382bb95e-7844-47d5-8371-4cfd97a22c7d | Surveillance has been defined as the continuous scrutiny of all aspects of occurrence and the spread of diseases that are peinent to effective control. Surveillance goes beyond the passive repoing of cases Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 138 | Social & Preventive Medicine | Epidemiology | Continues scrutiny of factors that affect the occurence of a disease is -
A. Epidemiology
B. Monitoring
C. Surveillance
D. Screening
| Surveillance |
9a6a5483-3749-4f06-bdb0-8d3aadf2990a | Ans. is 'b' i.e. Kupffer's cell hyperplasia with macrophage infiltration around periportal area laden with pigments * In severe infections with plasmodium falciparum, the vital organs are packed with erythrocytes containing mature form of the parasite.* There is abundant intra and extraerythrocytic pigment and organs such as liver, spleen and placenta may be grey black in colour.Also know * Durck's granuloma are pathognomic of malignant cerebral malaria.Histopathological features in liver due to falciparum malariaReticuloendothelial cell proliferation i.e., Kupffer cell hyperplasia.Malarial pigmentation i.e., haemoglobin pigmentation.CongestionPortal infiltration of the macrophageSinusoidal infiltration and sinusoidal dilatationCholestasisNuclear vacuolationLiver cell necrosisFatty changeBallooning of hepatocytesVacuolated cytoplasm's | Pathology | Cellular Pathology | Finding on histopathological examination in liver in case of malaria is :
A. Microabscess formation
B. Kupffer's cell hyperplasia with macrophage infiltration around periportal area laden with pigments.
C. Non caseating granuloma
D. Non specific finding of neutrophilic infiltratio
| Kupffer's cell hyperplasia with macrophage infiltration around periportal area laden with pigments. |
9002d192-e641-4d19-8c77-f898455cf855 | This man has a respiratory acidosis. Overdose with drugs that suppress ventilation (e.g., heroin, morphine, barbiturates, methaqualone, and "sleeping pills") often causes hypercapnia. In patients with an intact renal response, the respiratory acidosis causes a compensatory rise in plasma HCO3-, which lessens the fall in pH. However, the renal response requires several days to develop fully. The plasma HCO3- of 26 mEq/L (normal: 22-28 mEq/L) for this man is typical of acute respiratory acidosis with little or no renal compensation. pH 7.34, PaCO2 (mm Hg) 29, HCO3- (mEq/L) 15 reflects metabolic acidosis. pH 7.40, PaCO2 (mm Hg) 40, HCO3- (mEq/L) 24 is normal. pH 7.47, PaCO2 (mm Hg) 20, HCO3- (mEq/L) 14 reflects respiratory alkalosis. | Medicine | null | A 26-year-old man is admitted through the casualty of the hospital for a heroin overdose. His hea rate is 45 beats/min, and his blood pressure is 75/40 mm Hg. Which of the following best depicts the results from an aerial blood sample?
A. pH 7.22, PaCO2 (mm Hg) 66, HCO3- (mEq/L) 26
B. pH 7.34, PaCO2 (mm Hg) 29, HCO3- (mEq/L) 15
C. pH 7.40, PaCO2 (mm Hg) 40, HCO3- (mEq/L) 24
D. pH 7.47, PaCO2 (mm Hg) 20, HCO3- (mEq/L) 14
| pH 7.22, PaCO2 (mm Hg) 66, HCO3- (mEq/L) 26 |
62654a1a-2b78-4b92-b306-35c20dfb1b73 | Ans: b (Clavicle)Ref: Maheshwari Ortho, 3rd ed, p. 73 | Orthopaedics | Injuries Around Shoulder | Most common bone fracture in body is:
A. Radius
B. Clavicle
C. Femur
D. Vertebra
| Clavicle |
78287b9c-d2ff-40bd-aa9f-afa70e8d805d | Mitomycin-C is an antineoplastic antibiotic that acts as an alkylating agent by inhibiting DNA and protein synthesis. ... Topical application of mitomycin-C (0.4 mg/mL) was used as an adjuvant treatment in the endoscopic laser management of laryngeal and tracheal stenosis Ref: Internet sources | ENT | Larynx | Drug treatment for laryngeal stenosis is
A. Adriamycin
B. Mitomycin C
C. Cyclophosphamide
D. Doxorubicin
| Mitomycin C |
dfe3c09d-5b5e-41a9-be50-cb272175c9e6 | Graduated compression stockings (GCS) help prevent the formation of blood clots in the legs by applying varying amounts of pressure to different pas of the leg. Thigh or waist-high stockings help reduce pooling of blood in the legs and help prevent lightheadedness or falling when you stand up (ohostatic hypotension). Stockings that rise to just below the knee help limit lower leg swelling due to fluid buildup Ref Davidson 23rd edition pg 450 | Medicine | C.V.S | A 40 year old presenting with dizziness on standing with systolic reduction of BP of 50mm Hg; appropriate treatment
A. Graded compression stockings
B. Salbutamol
C. Fludrocoisone
D. b-blockers
| Graded compression stockings |
6756d58a-7931-4c20-a4eb-e0d91428056c | Ans. is `c' i.e., Classify as severe pneumonia, sta antibiotics and refer urgently | Social & Preventive Medicine | null | A child aged 24 months was brought to the Primary Health Centre with complaints of cough and fever for the past 2 days. On examination, the child weighed 11kg, respiratory rate was 38 per minute, chest indrawing was present. The most appropriate line of management for this patient is ?
A. Classify as pneumonia and refer urgently to secondary level hospital
B. Classify as pneumonia, sta antibiotics and advise to repo after 2 days
C. Classify as severe pneumonia, sta antibiotics and refer urgently
D. Classify as severe pneumonia and refer urgently
| Classify as severe pneumonia, sta antibiotics and refer urgently |
8f726ce9-e9cf-40ea-a158-ff085d122e28 | Ans. (C) Breakdown of GTP to GDP(Ref: KDT 8th/e p54)Alpha subunit of G protein contains GTPase activity and thus dissociates GTP to form GDP. This result in re-uniting a subunit with b and g subunit | Pharmacology | General Pharmacology | Action of alpha subunit of G-protein is:
A. Binding of agonist
B. Conversion of GDP to GTP
C. Breakdown of GTP to GDP
D. Internalization of receptors
| Breakdown of GTP to GDP |
6825a23d-8f16-4e4c-8c06-7130affb99e0 | In the given question there was an episode of jaundice, but LFT is normal and CBD is not dilated. The best option is laparoscopic cholecystectomy only Management of CBD stones associated with GB stones * Pre-operatively detected stones:- * Unsuspected stones found at the time of cholecystectomy:- Experienced laparoscopic surgeon Experienced laparoscopic surgeon Cholecystectomy and choledochotomy in same sitting Laparoscopic CBD exploration and stone retrieval through the cystic duct * Laparoscopic choledochotomy and stone extraction Inexperienced laparoscopic surgeon Inexperienced laparoscopic surgeon Pre-op ERCP with stone removal and laparoscopic cholecystectomy later Conve to open procedure and remove CBD stone Complete the cholecystectomy and refer the patient for ERCP | Surgery | Gallbladder | A 50 year old with history of jaundice in the past has presented with right upper quadrant abdominal pain. Examination and investigations reveal chronic calculous cholecystitis. The liver functions tests are within normal limits and on ultrasound examination, the common bile ducts is not dilated. Which of the following will be the procedure of choice?
A. Laparoscopic cholecystectomy
B. Open choledocholithotomy followed by laparoscopic cholecystectomy
C. ERCP + choledocholithotomy followed by Laparoscopic cholecystectomy
D. Laparoscopic cholecystectomy followed by ERCP + choledocholithotomy
| Laparoscopic cholecystectomy |
380388e0-cdda-4430-954e-df5537a40c30 | LONG THORACIC NERVE
■ Arises from ventral rami of C5, C6, and C7.
■ Descends behind the brachial plexus on the lateral surface of the serratus anterior, to which it supplies.
■ The serratus anterior muscle can be examined by asking patient to push against a wall with both hands. Winging of scapula will be typically noted | Anatomy | null | Which muscle paralysis can cause ‘Winging of scapula’?
A. Serratus anterior
B. Supraspinatus
C. Teres minor
D. Deltoid
| Serratus anterior |
6661e270-bfeb-47fd-84db-a8335649f1c9 | A demonstration is a carefully prepared presentation to show how to perform a skill or procedure. Here a procedure is carried out step by step before an audience. Demonstration is found to have high education value in programmes like teaching a mother the use of oral rehydration therapy at home. Ref: Park 21st edition, page: 803. | Social & Preventive Medicine | null | The BEST method for teaching mothers about using ORS is:
A. Group discussion
B. Demonstration
C. Lecture
D. Flannel graph
| Demonstration |
bf0dbdb9-f0ba-4c00-960c-8f7a58d78765 | Post coital or emergency contraceptives are, Ethinyl oestradiol Conjugated estrogen Ethinyl oestradiol + Norgestrel Levonorgestrel Mifepristone Copper IUDs Ref: Textbook of Obstetrics by D.C. Dutta, 6th edition, Page 550. | Gynaecology & Obstetrics | null | A female wanted to have an emergency contraception after an unprotected intercourse. Which of these is NOT useful as an emergency contraceptive?
A. LNG IUD
B. Oral Mifepristone
C. Oral Levonorgestrel
D. Cu-containing IUD
| LNG IUD |
40475463-bff9-4d47-9def-271d7ca80d6d | Stills disease is a variant of rheumatoid commonly occurring in adults in 20's and 30's.
Patients characteristics clinical features are:
High spiking fever often up to 40°C.
Sore throat
Evanescent salmon coloured non pruritic rash, seen on chest & abdomen
Lymphadenopathy
Pericardial effusion
Wrist joint involvement
Chances are that you might confuse it with Felty's syndrome so I am giving the important features of both these conditions together | Pathology | null | A characteristic feature of Still's disease -
A. Prominent kidney involvement
B. Rashes
C. Positive Rheumatoid factor
D. Neutropenia
| Rashes |
5796ec13-1a66-4072-9648-7be79e8308e9 | Option a, b, c, d * There are three mechanisms of horizontal gene transfer in bacteria:- 1.Transformation 2. Transduction 3. Conjugation (Most common mechanism), It was discovered first by Lederberg and Tatum. * Conjugation plays an impoant role in the transfer of plasmids coding for antibacterial drug resistance and bacteriocin production . * R factor (or the resistance factor) is a plasmid which has two components. o Resistance transfer factor (F) is the plasmid responsible for conjugational transfer(similar to F factor) o Resistance determinant (r): Codes for resistance to one drug. An R factor can have several r determinants. | Microbiology | General Microbiology (Sterilization and Bacterial Genetics) | Which of the following is the most widespread method of genetic transfer among bacteria?
A. Transformation
B. Transduction
C. Lysogenic conversion
D. Conjugation
| Conjugation |
b2a15042-9ed0-417c-b113-e79f5d1c25fe | steps: (1) migration and proliferation of fibroblasts into the site of injury and (2) deposition of ECM proteins produced by these cells. The recruitment and activation of fibroblasts to syn- thesize connective tissue proteins are driven by many growth factors, including PDGF, FGF-2 (described earlier), and TGF-b. The major source of these factors is inflamma- tory cells, paicularly macrophages, which are present at sites of injury and in granulation tissue. Sites of inflamma- tion are also rich in mast cells, and in the appropriate chemotactic milieu, lymphocytes may be present as well. Each of these cell types can secrete cytokines and growth factors that contribute to fibroblast proliferation and activation. As healing progresses, the number of proliferating fibroblasts and new vessels decreases; however, the fibro- blasts progressively assume a more synthetic phenotype, so there is increased deposition of ECM. Collagen synthe- sis, in paicular, is critical to the development of strength in a healing wound site. As described later, collagen syn- thesis by fibroblasts begins early in wound healing (days 3 to 5) and continues for several weeks, depending on the size of the wound. Net collagen accumulation, however, depends not only on increased synthesis but also on diminished collagen degradation (discussed later). Ulti- mately, the granulation tissue evolves into a scar composed of largely inactive, spindle-shaped fibroblasts, dense collagen, fragments of elastic tissue, and other ECM com- ponents (Fig. 2-30, B). As the scar matures, there is proA A gressive vascular regression, which eventually transforms the highly vascularized granulation tissue into a pale, largely avascular scar. Growth Factors Involved in ECM Deposition and Scar Formation Many growth factors are involved in these processes, including TGF-b, PDGF, and FGF. Because FGF also is involved in angiogenesis, it was described earlier. Here we briefly describe the major propeies of TGF-b and PDGF. * Transforming growth factor-b (TGF-b) belongs to a family of homologous polypeptides (TGF-b1, -b2, and -b3) that includes other cytokines such as bone morphogenetic proteins. The TGF-b1 isoform is widely distributed and is usually referred to as TGF-b. The active factor binds to two cell surface receptors with serine-threonine kinase activity, triggering the phosphorylation of transcription factors called Smads. TGF-b has many and often oppo- site effects, depending on the cell type and the metabolic state of the tissue. In the context of inflammation and repair, TGF-b has two main functions: TGF-b stimulates the production of collagen, fibro- nectin, and proteoglycans, and it inhibits collagen degradation by both decreasing proteinase activity and increasing the activity of tissue inhibitors of pro- teinases known as TIMPs (discussed later on). TGF-b is involved not only in scar formation after ref Robbins 9/e p83 | Anatomy | General anatomy | Which of the following is not an inflammatory mediator
A. Tumor necrosis factor
B. Myeloperoxidase
C. Interferons
D. Interleukins
| Myeloperoxidase |
7cee84e8-c62b-47fa-ad8b-b6b8cf0560d0 | "Acute muscle dystonia caused by antiemetic-antipsychotic drugs is promptly relieved by parenteral promethazine or hydroxyzine." This is based on the central anticholinergic action of the drugs.
Promethazine is a first-generation anti-histaminic which has a maximum penetration of blood-brain barrier and maximum anticholinergic activity. | Pharmacology | null | A drug given for metoclopramide induced dystonic reaction is :
A. Pheniramine
B. Promethazine
C. Chlorpromazine
D. Prochlorperazine
| Promethazine |
8e18e69d-c81f-4039-9c95-310b07c39dda | Mother's milk has more lactose as compared to cow's milk. | Pediatrics | Breast Milk & Breast Feeding | Compared with cow's milk, mother's milk has more?
A. Lactose
B. Vitamin D
C. Proteins
D. Fat
| Lactose |
38b99eb5-0ca1-4025-a359-45dfb85913a3 | In a patient with CSOM, persistent ear discharge with or without deep seated pain in spite of an adequate coical or modified mastoidectomy points towards petrositis. Spread of infection from middle ear and mastoid to the petrous pa of temporal bone is petrositis it can also involve adjacent 5th cranial nerve and 6" cranial nerve when it produces classical triad of symptoms - 6th nerve palsy, retro orbital pain (5th nerve) and persistent discharge from the ear, known as Gradenigo's syndrome Treatment Adequate drainage is the mainstay of treatment along with specific antibiotic therapy. Modified radical or radical mastoidectomy is often required if not done already. The fistulous tract should be identified, curetted and enlarged to provide free drainage. | ENT | null | A man presented with persistent ear pain and discharge, retro-orbital pain and modified radical mastoidectomy was done to him. Patient comes back with persistent discharge, what is your diagnosis?
A. Diffuse serous labyrinthitis
B. Purulent labyrinthitis
C. Petrositis
D. Latent mastoiditis
| Petrositis |
0cecd862-910f-4395-96c2-4e6a0c3945e4 | Verrucuous epidermal nevus Linear verrucuous lesions, with characteristic histopathological feature of granular degeneration of the epidermis ours the diagnosis of verrucous epidermal nevus. Epidermal nevus Epidermal nevi are hamaomas that are characterized by hyperplasia of the epidermis and adnexal structures. These nevi may be classified into a number of distinct variants which are based on clinical morphology, extent of involvement and the predominant epidermal structure in the lesion. Variants of the epidermal nevi are ? - Verrucuous epidermal nevus - Nevus sebaceous - Nevus comedonicus - Eccrine nevus - Apocrine nevus - Becker's nevus - White sponge nevus Verrucuous epidermal nevus Verrucuous epidermal ,nevus consists of hyperplasia of the surface epidermis and typically appears as verrucuous papules that coalasce to form well demarcated, skin colored to brown, papillomatous plaque. Most lesions are present at bih and develop during infancy. They enlarge slowly during childhood and generally reach a stable size at adolescence. Lesions may be localized or diffuse. Linear configurations are common especially on the limbs and may follow skin tension lines or Blaschko's lines. The salient histological features are ? Perinuclear vacuolization of the cells in the stratum spinosum and stratum granulosum. Irregular cellular boundaries peripheral to the vacuolization and increased number of irregularly :,aped large keratohyaline granules. Compact hyperkeratosis in stratum corneum. Darner white disease Autosomal dominant disease. Males and females are equally affected. Daffier white disease is not present at bih and usually begins in the first or second decade. Characteristic sites of prediliction are the face, forehead, scalp, chest and the hack (seborrhic sites). Clinical features consists of way papules and plaques in (seborrhic sites). Histology shows suprabasal acantholysis in epidermis with dyskeratotic cells. Incontinentia pigmentii X linked disease (so only seen in females) Lesions are present along the Blaschko lines, which are initially vesicular, that later on turns into verrucuous lesions and hyperpigmented stages. Common histological features are : - Hverkeratosis - Eosinophilic spongiosis of epidermis - Basal cell degeneration - Pigment incontinenti | Skin | null | Child presents with linear verrucous plaques on the trunk with vacuolisation of keratinocytes in S.Spinosum and S.Granulosum. Diagnosis is ?
A. Incontinenta pigmenti
B. Delayed hypersensitivity reaction
C. Verrucous epidermal nevus
D. Linear darriers disease
| Verrucous epidermal nevus |
655de91c-95e0-4166-8a2a-d04c42d55729 | IEL are6 a distinctive population of T cells dispersed among the luminal epithelial cells. paicularly in the small intestine there is a predominantly of CD8+T cells | Anatomy | G.I.T | In the intraepthielial region of the mucosa of intestine the predominant cell population is that of
A. B cell
B. T cell
C. Plasma cells
D. Basopils
| T cell |
a0e1a2d9-7a9e-4457-8dd7-925d12f31a25 | scapholunate dislocation : * Most common ligamentous instability of the wrist * Patients may have high degree of pain despite apparently normal radiographs * Physicians should suspect this injury if patient has wrist effusion and pain seemingly out of propoion to the injury * If improperly diagnosed can lead to chronic pain * Located proximal axial line from 3rd metacarpal Scapholunate Dissociation-Diagnosis * Exam -- Watson&;s test -- Scaphoid shuck test -- Pain/swelling over dorsal wrist, proximal row * Imaging -- Plain films: >3mm difference on clenched fist view -- Scaphoid ring sign Scapholunate Dissociation Treatment * If discovered within 4 weeks, surgery * After 4 weeks, conservative treatment reas -- Bracing -- NSAIDS -- Consider evaluation by hand surgery to confirm no surgery needed ref : maheswari 9th ed | Orthopaedics | Forearm wrist and hand injuries | Terry Thomas sign is seen in
A. Keinbock's disease
B. Carpal dislocation
C. Calcaneal disorder
D. Hip trauma
| Carpal dislocation |
7a80dd43-865e-46ac-ada9-e531c3ba686a | After MI, there is failure of Na+-K+ pump resulting in NCX failure Thus intracellular Ca+2 increases Now when perfusion is established (nutrients are available), because of increased ICF Ca+2, cardiac fibers contract very strongly Already muscle fibers are fragile due to M.I, now this contraction results in fuher damage. This is basic reason for "reperfusion injury". | Physiology | Conducting System of Hea | The basic reason for "reperfusion injury" to the myocardium is:
A. Generation of free radicals
B. Extension of the ischemic zone
C. Increased ICF
D. Increased ECF
| Increased ICF |
a2bce9c5-44fc-444b-9a40-d2f7fc02a0db | The single most sensitive tool for evaluating the iron status is by measurement of serum ferritin. Hemoglobin concentration is relatively insensitive. REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION. PAGE NO - 623 | Social & Preventive Medicine | Nutrition and health | First indices to change in iron deficiency anemia is -
A. S. Iron
B. Total iron binding capacity
C. S. Ferritin
D. S. Haemoglobin concentration
| S. Ferritin |
a446fbdd-d3a9-4b22-bf10-aa7f2f948c78 | Child with right sided po-wine stain- seen in sturge weber syndrome. Features of sturge weber syndrome: S- Seizure T- Trigeminal distribution of po wine stain U- Unilateral weakness R- Retardation( mental retardation) G-Glaucoma E- Buphthalamos here, glaucoma is associated with surface ocular vascular malformations . | Dental | Pediatric dermatology | Which of the following is associated with the disease pathology seen in this child?
A. Leg length discrepancy
B. Airway involvement
C. Glaucoma
D. Growth hormone deficiency
| Glaucoma |
d966d76a-613c-45a1-af6f-084422083130 | Penetrating keratoplasty has to be done in cases of deep corneal scar or hydrops. SURGICAL MODALITIES FOR KERATOCONUS Keratoplasty for Keratoconus DALK (deep anterior Lamellar keratoplasty): when > 1/2 of stroma is involved. ALTK (Anterior lamellar therapeutic keratoplasty) : When less than 1/2 of stroma is involved. Penetrating Keratoplasty: When full thickness of cornea is involved as in hydrops with scar. INTRASTROMAL CORNEAL RING SEGMENTS Reduce corneal steepening Made of PMMA. Femtolaser is used to make tunnel in cornea. Used in Pellucid Marginal Degeneration, post LASIK ectasia and keratoconus. | Ophthalmology | Cornea | Patient came with hydrops and scarring of cornea. What would be the treatment modality you would opt for him:
A. Penetrating Keratoplasty
B. Endothelial lamellar Keratoplasty
C. Deep anterior lamellar keratoplasty
D. Collagen cross linking
| Penetrating Keratoplasty |
40f8775f-ba22-451b-80d6-fa93674bc7e2 | Incubation period of mumps varies from 2 to 4 weks, usually 14- 18 days Reference : Park&;s Textbook of preventive and social medicine, 24th edition.Pg no.162 | Social & Preventive Medicine | Communicable diseases | Incubation period of Mumps -
A. 4-5 days
B. 7-15 days
C. 12-24 days
D. 50 days
| 12-24 days |
24203aa2-0e3b-476c-b8a5-7dfe29c6e74d | Ans. A: Cremasteric veinVaricocelectomy, the surgical correction of a varicocele, is performed on an outpatient basis.The three most common approaches are inguinal (groin), retroperitoneal (abdominal), and infrainguinal/subinguinal (below the groin).Possible complications of this procedure include hematoma (bleeding into tissues), infection, or injury to the scrotal tissue or structures.In addition, injury to the aery that supplies the testicle may occur.An alternative to surgery is embolization, a non-invasive treatment for varicocele.Embolization is an effective treatment for post-surgical varicoceles. | Surgery | null | Drainage of venous blood from testes following division of testicular vein for treatment of varicocele is by: March 2009
A. Cremasteric vein
B. Dorsal vein of penis
C. Internal pudendal vein
D. Pampiniform plexus
| Cremasteric vein |
2f450319-b190-46b6-9de9-f5645e019e33 | Moore suggested a classification of omphalocele into types 1, 2 and 3 with the diameters of < 2.5 cm, 2.5 to 5 cm and > 5 cm respectively. | Surgery | null | In Moore's classification of omphalocole (examphalos), type I umbilical defect is less than ________ cm.
A. 0.5
B. 2.5
C. 3.5
D. 4.5
| 2.5 |
36a78af0-82a3-4d63-9dbf-b8c057217e7c | The diagnosis is secondary hyperparathyroidism as a consequence of the chronic renal disease. Calcium deposits are seen in the periarticular areas of the fourth and fifth metacarpophalangeal, third proximal interphalangeal, and fourth distal interphalangeal joints. There is slight soft tissue swelling, especially, of the fourth and fifth metacarpophalangeal joints. Calcification in scleroderma is subcutaneous in location. In gout if monosodium urate is deposited it could appear as a soft tissue mass. | Medicine | Endocrinology | A 35-year-old woman, on hemodialysis for chronic renal disease, complains of pain in the hands. On examination, the joints are normal with no inflammation or tenderness on palpation. Lab values reveal a low calcium, high phosphate, and high PTH level. What is the most likely diagnosis? (See Figure below.)
A. scleroderma
B. gout
C. secondary hyperparathyroidism
D. pseudogout
| secondary hyperparathyroidism |
a9f22898-cc6a-4ad0-af7c-729d13827f21 | Emphysema aquosum is a sign of wet drowning. Drowning fluid actually penetrates alveolar walls to enter the tissues and the blood vessels. This has been described as emphysema aquosum. Cause of death in wet drowning: Disruption of pulmonary surfactant Dry drowning: Water does not enter the lungs, but death results from: Immediate sustained laryngeal spasm Cardiac arrest due to vagal inhibition | Forensic Medicine | Drowning | Emphysema aquosum is associated with?
A. Dry drowning
B. Wet drowning
C. Immersion syndrome
D. Secondary drowning
| Wet drowning |
bb21518a-3cea-45de-b40f-c3db7315194b | The most common presentations of the lymphatic filariases are asymptomatic (or subclinical) microfilaremia, hydrocele , acute adenolymphangitis (ADL), and chronic lymphatic disease. If there is obstruction of the retroperitoneal lymphatics, increased renal lymphatic pressure leads to rupture of the renal lymphatics and the development of chyluria, which is usually intermittent and most prominent in the morning. (Harrison's Principles of internal medicine, 20th edition, page 1747) | Medicine | Infection | Chyluria is due to-
A. Carcinoma
B. Tuberculosis
C. Filaria
D. Malaria
| Filaria |
f3141bf3-7ab9-407e-ab73-6cd9800a3b8b | Ans. (a) Perforation of duodenum* This is a clear-cut case of drug induced ulcer and perforation - Duodenal ulcer perforation* Features are diffuse abdominal pain with right iliac fossa pain due to tracking of pus in right colic gutter - Valentino Syndrome* Obliteration of liver dullness* Board like rigidity | Surgery | Stomach & Duodenum | Patient is on Autocoids for 1 year now complains of severe pain Epigastrium relieved by antacid drugs. He complaints of Right Iliac fossa pain and loss of liver dullness. Diagnosis is:
A. Perforation of duodenum
B. Diverticulitis
C. Gastroenteritis
D. Enteric perforation
| Perforation of duodenum |
1b5f7a7d-4d04-45cd-93c1-655d411b2ffd | As excess of carbohydrates are conveed to fat in the body (liver) which eventually gets packed into VLDL so, VLDL represents the amount of fat production in the body, or in other words, it also represent excess dietary carbohydrate intake. While Chylomicrons represents the externally taken fats. Function Lipoproteins Lipoprotein rich in triglyceride Lipoprotein with least electrophoretic mobility Transpoer of dietary (exogenous) triglycerides & Cholesterol Chylomicrons Transpoer of endogenous triglycerides VLDL Transpos endogenous Cholesterol from Liver to Peripheral tissue. LDL Lipoprotein rich in apolipoproteins Transpos excess Cholesterol from Peripheral tissue to Liver called as reverse cholesterol transpo HDL has the highest electrophoretic mobility and least lipid content. HDL paicles are the densest. On electrophoresis, HDL moves fahest on electrophoretic plate towards the anode. HDL Lipoprotein resembling plasminogen Lp(a) | Biochemistry | Lipoproteins | A person switches from high fat diet to low fat diet with compensatory increase in carbohydrates to maintain the same calories. Which of the following fat component will be increased ?
A. Chylomicron
B. VLDL
C. IDL
D. HDL
| VLDL |
aa9d2f72-4c71-42fe-ac34-d81c256916fc | Causes of isolated splenic metastasis: Carcinoma Ovary (27%) > Colorectal carcinoma (26%) > Uterine cancer (17%) MC primary for metastasis of spleen: Malignant melanoma (30-50%) > Ca Breast (21%) > Ca lung (18%) | Surgery | Spleen | Most common cause of isolated splenic metastasis is:
A. Carcinoma pancreas
B. Carcinoma stomach
C. Carcinoma ovary
D. Carcinoma cervix
| Carcinoma ovary |
09a25352-1655-422e-954b-b5fa0e6497a0 | Therefore, a defining characteristic of aoic regurgitation is an increase in aoic pulse pressure (systolic minus diastolic pressure). ... Early in the course of regurgitant aoic valve disease, there is a large increase in left ventricular end-diastolic pressure and left atrial pressure.pulse pressure usually between 75-90 mm/hg Ref Davidson 23rd edition pg 450 | Medicine | C.V.S | Pulse pressure in severe aoic regurgitation is equal to-
A. 30-45mmHg
B. 45-60mmHg
C. 60-75 mmHg
D. 75-90 mm Hg
| 75-90 mm Hg |
d48fc7eb-671f-4f5c-bdec-6cfc614d3ffc | Placental exchanges that take place occur according to different mechanisms. Simple diffusion is the movement of molecules of gas and water from a high concentration to a low concentration. Iodine readily crosses the placental barrier. Active transpo is another method. This method transpos specific molecules across a membrane or against a concentration gradient which requires energy (ATP) (i. e. Ca++, Na +, and K+). Endocytosis is the method by which the macromolecules are captured by cell microvilli. Leakage is difficult to understand, but it has to do with the connections or like connections between fetal and maternal blood. Ref: Molina P.E. (2013). Chapter 9. Female Reproductive System. In P.E. Molina (Ed), Endocrine Physiology, 4e. | Physiology | null | Transplacental exchanges that take place are essential to the well being of the fetus. Which of those listed below is NOT a method?
A. Simple diffusion
B. Active transpo
C. Endocytosis
D. Exocytosis
| Exocytosis |
11aa7d32-e159-4432-823e-85d8ee9f8c2a | FLAGELLATED DERMATITIS: It is characterised by pruritic, erythematous, linear streaks that resemble whiplash marks, hence the name flagellated. Bleomycin is metabolized by an enzyme hydrolase. This enzyme is deficient in skin and lungs. Therefore, the major adverse effects of bleomycin is related to skin (flagellated dermatitis) and lungs (pulmonary fibrosis) OTHER CAUSES OF FLAGELLATED DERMATITIS: DRUGS: BLEOMYCIN, DOCETAXEL, BENDAMUSTINE RHEUMATOLOGICAL CAUSES: DERMATOMYOSITIS, ADULT ONSET STILL'S DISEASE TOXINS: SHIITAKE MUSHROOMS | Pharmacology | Cytotoxic Anticancer Drugs | Which of the following anticancer drug can cause flagellated dermatitis?
A. Cisplatin
B. L-asparginase
C. Doxorubicin
D. Bleomycin
| Bleomycin |
9713b812-2bf3-4513-b009-37e6e86f52f9 | As the eighth nerve schwannoma grows, it extends into the posterior fossa to occupy the angle between the cerebellum and pons (cerebellopontine angle). In this lateral position, it is so situated as to compress the seventh, fifth, and less often the ninth and tenth cranial nerves, which are implicated in various combinations. Later it displaces and compresses the pons and lateral medulla and obstructs the CSF circulation. | ENT | null | The commonest cranial nerve involved in acoustic neuroma is:
A. IX
B. VI
C. VIII
D. X
| VIII |
80e64981-fab4-4f2d-bbfe-23f5dd405386 | Answer is option 2, antibody to thyroid receptors. Thyrotropin receptor (TSHR) antibodies that stimulate the thyroid (TSAb) cause Graves' hypehyroidism and TSHR antibodies which block thyrotropin action (TBAb) are occasionally responsible for hypothyroidism. Unusual patients switch from TSAb to TBAb (or vice versa) with concomitant thyroid function changes. We have examined case repos to obtain insight into the basis for "switching." | Pathology | Endocrinology | Long thyroid stimulating agent is
A. Antibody to thyroid globulin
B. Antibody to thyroid cell receptors
C. Antibody to thyroxine
D. Antibody to thyroid cells
| Antibody to thyroid cell receptors |
44b6fdad-e127-4e7a-a931-20ff71967cb4 | Ans. a. Minimum = 3. Maximum = 15 (Ref: Harrison 19/e p1730, 18/e p3381-3382; Sabiston 19/e p1894; Schwartz 9/e p1522; Bailey 26/e p312. 25/e p301. 302)In Glasgow Coma Scale (GCS). maximum score is 15 and minimum score is 3.Glasgow Coma Scale (GCS)Eye OpeningVerbal responseBest Motor responseSpontaneous4Oriented5Obeys commands6To loud voice3Confused, disoriented4Localizes pain5To pain2Inappropriate words3Flexion (withdrawal) to pain)4No response1Incomprehensible sounds2Abnormal flexion posturing3 No response1Extension posturing2 No response1Maximum score-15Q. minimum score-3Q.Best predictor of outcome: Motor responseQPatients scoring 3 or 4 have an 85% chance of dying or remaining vegetative, while scores above 11 indicate only a 5-10% likelihood of deathQ | Surgery | Head Injury | What are the minimum and maximum possible values of Glasgow Coma Score?
A. Minimum = 3, Maximum = 15
B. Minimum = 0, Maximum = 13
C. Minimum = 0, Maximum = 15
D. Minimum = 3, Maximum = 18
| Minimum = 3, Maximum = 15 |
ae8cb5b6-b8e6-467c-8498-03f45c7cd626 | Ans: B i.e. DuodenumSite of absorptionStomach is the site of absorption of water and alcoholDuodenum is the site of absorption of iron and calciumIleum is the site of absorption of vitamin B12 and bile salt | Physiology | null | Iron is absorbed in: March 2012
A. Stomach
B. Duodenum
C. Ileum
D. Duodenum + Jejunum
| Duodenum |
9c2aada7-eb94-4d00-b2ee-06508fad8e71 | Ans. is 'b' i.e., Beating of feet * Beating may be of following types -i) Falanga (Falolka/Baatinada) : Beating of soles of feet with blunt object.ii) Telefono : Simultaneous beating of both ears with palms.iii) Quirofana : Beating on abdomen while upper half of body lying unsupported on table. | Forensic Medicine | Injuries | Falanga is -
A. Suspension by wrist
B. Beating of feet
C. Placing electric wires in vagina
D. Clamping of thighs between bamboos
| Beating of feet |
eef4bc79-54f8-44a9-97a5-47bdc62e9822 | Beck Cognitive therapy is a psychotherapy developed by American pyschiatrist Aaron T. Beck. Cognitive therapy is one of the therapeutic approaches within the larger group of cognitive behavioural therapies. Cognitive therapy seeks to help the client overcome difficulties by identifying and changing dysfunctional thinking, behaviour and emotional responses. This involves helping clients develop skills for modifying beliefs, identifying distoed thinkings, relative to others in different ways and changing behaviours. Treatment is based on collaboration between client and therapist and on testing beliefs. Therapy may consist of testing the assumptions which one makes and identifying how some of one's usually unquestioned thoughts are distoed, unrealistic and unhelpful. Once, those thoughts have been challenged, ones feelings about the subject matter of those thoughts are more easily subject to change. Beck initially focussed on depression and developed a list of errors in thought that he proposed could maintain depression, including arbitrary inference, selective abstraction, over generalization and magnification (of negatives) and minimization (of positives). According to Beck's theorey of the etiology of depression, depressed people acquire a negative view of the world in childhood and adolescence. Children and adolescent who suffer from depression acquire this negative view earlier. Depressed people acquire such view through a loss of a parent, rejection by peers, (criticism from teachers or parents, the depressive attitude and other negative events). When the person with such view encounters a situation that resembles the original conditions of the learned view in some way, even remotely, the negative views of the persons are activated. A simple example may illustrate the principle of how cognitive therapy works Having made a mistake at work, a person may believe "I am useless and can't do anything right at work". Strongly believing this then tends to worsen his mood. The problem may be worsened fuher if the individual reacts by avoiding activities and then behaviourally confirming the negative belief to himself. As a result, any adaptive response and fuher constructive consequences become unlikely, which reinforces the original belief of being useless. In therapy, the latter example could be identified as a self fulfilling prophecy or "problem cycle" and the effos of the therapist and client would be directed at working together to change it. | Psychiatry | null | Cognitive model of depression is given by ?
A. Ellis
B. Beck
C. Godfrey
D. Meicheinbanon
| Beck |
e2242b6b-7fb0-4015-a389-66c21827cdcd | MRI as the diagnostic test of choice for hepatic hemangioma at most centers. Nuclear medicine studies may be used to confirm the diagnosis when a probable hemangioma is detected on ultra-sonography. Nuclear medicine studies may also help to clarify the nature of a lesion when the diagnosis is equivocal on CT or MRI. Percutaneous biopsy of a hepatic hemangioma carries an increased risk of hemorrhage. Liver biopsy is contraindicated in most circumstances where a hemangioma is high in the differential diagnosis of a hepatic mass. Hepatic angiography: The diagnostic accuracy of noninvasive tests has obted the need for hepatic aeriography in most cases. | Radiology | Fundamentals in Radiology | A 22 years old man presents with a solitary 2 cm space occupying lesion of mixed echogenecity in the right lobe of the liver on USG. The rest of the liver is normal. Which of the following test should be done next?
A. Ultrasound guided biopsy of the lesion
B. Hepatic scintigraphy
C. Hepatic angiography
D. Contrast enhanced CT scan of the liver
| Hepatic scintigraphy |
858c4c56-8d14-48dd-bb95-5195df720725 | contrast agents used for myelography are : Iohexol Iopamidol Metrizamide Myodil | Radiology | Fundamentals in Radiology | Dye used for myelography
A. Conray 320
B. Myodil
C. Dianosil
D. Iopaoic acid
| Myodil |
e3ef3bc0-f3e5-4597-941c-364749ac436d | (C) IL-4 # Pyrogenic cytokines: Known pyrogenic cytokines include IL-1, IL-6, TNF, ciliary neurotropic factor (CNTF), and interferon (INF)a. Others probably exist; although IL-18 - a membrane of the IL-1 family - does not appear to be pyrogenic cytokine. Each cytokine is encoded by a separate gene, and each pyrogenic cytokine has been shown to cause fever in laboratory animals and in humans. When injected into humans, IL-1, IL-6 and TNF produce fever at low doses (10 to 100 ng/kg).> Fever, characterized by an elevation of body temperature, usually by 1deg to 4degC, is one of the most prominent manifestations of the acute-phase response, especially when inflammation is caused by infection. Fever is produced in response to substances called pyrogens that act by stimulating prostaglandin (PG) synthesis in the vascular and perivascular cells of the hypothalamus. Bacterial products, such as lipopolysaccharide (LPS; called exogenous pyrogens), stimulate leukocytes to release cytokines such as IL-1 & TNF (called endogenous pyrogens) that increase the levels of cyclooxygenases that convert AA into prostaglandins. In the hypothalamus the PGs, especially PGE2, stimulate the production of neurotransmitters, which function to reset the temperature set point at a higher level. IL-4 is involved in immediate hypersensitivity reactions. | Pathology | Misc. | Which is NOT pyrogenic Interleukin
A. IL-1
B. TNF-a
C. IL-4
D. IL-6
| IL-4 |
9d03e175-6ba0-4834-8ce2-1e8bd96adb2f | Ans: (a) Cognizable, non-compoundable and non-bailableRef: The First Schedule, Classification of Offences, Indian Penal CodeCognizable offencesCognizable offences are more serious crimes wherein police can arrest the suspect without any warrant.Ex. rape, murder, ragging, dowry death etc.Compoundable offencesCompoundable offences are those offences where, the complainant (one who has filed the case, i.e., the victim), enter into a compromise and agrees to have the charges dropped against the accused.Bailable offencesBailable offences are less serious crimes wherein the suspect can be released from custody by furnishing a bond on bail. | Forensic Medicine | Law & Medicine, Identification, Autopsy & Burn | Murder is.............. offence.
A. Cognizable, non-compoundable and non-bailable
B. Cognizable, compoundable and bailable
C. Non-cognizable, non-compoundable and non-bailable
D. Non-cognizable, compoundable and bailable
| Cognizable, non-compoundable and non-bailable |
fd011c29-dc35-41a9-ba97-23ffdcf9a75d | Management of Advanced stage diseaseIncludes stage III and IVDebulking surgery versus neoadjuvant chemotherapy followed by Postoperative chemotherapyPrimary cytoreduction surgery is the preferred in1. Retroperitoneal only disease preoperatively 2. Patients with stage IIIC or IV disease with good performance status who have < 5cm upper abdominal disease 3. Patients who are considered ideal for intraperitoneal chemotherapy if optimally reducedNeoadjuvant chemotherapy and interval debulking surgery is preferred in1. Patients with bulky upper abdominal peritoneal disease >5cm in diameter2. Medically unfit for surgeryPostoperative chemotherapySystemic chemotherapy with 6 cycles of carboplatin and paclitaxelPostoperative radiotherapy1. Not effective compared to chemotherapy2. Used clear cell or mucinous carcinomasMAINTENANCE THERAPY1. No role after the complete clinical response 2. Drugs used: 3month or 12month paclitaxel every 28days | Gynaecology & Obstetrics | Gynaecological oncology | In stage III ovarian cancer patient with upper abdominal disease < 5cm, management of choice is
A. Debulking surgery
B. Mantle cell irradiation
C. Abdomino-pelvic radiotherapy
D. Neo-adjuvant chemotherapy
| Debulking surgery |
99d540ec-42f0-49ad-97cb-80732db7f32d | Ectodermal dysplasia is characterized by congenital dysplasia of ectodermaL structures, manifested as hypohidrosis (partial or complete absence of sweat glands) hypotrichosis and hypodontia or partial anodontia.
Two types
Hypohidrotic (Christ-Siemens-Touraine syndrome) most common type and includes dental manifestations.
Hidrotic (Clouston syndrome)- no specific dental defects are seen. | Pathology | null | Which of the following diseases of the skin is the most
likely to be associated with partial anodontia?
A. erythema multiformae
B. hereditary ectodermal dysplasia
C. keratosis follicularits
D. lichen Onus
| hereditary ectodermal dysplasia |
9f949b71-ee37-4529-baae-71e8064b75c9 | Ans. is 'd' i.e., 1-5 m Pneumoconiosis o Pneumoconiosis is an occupational lung disease caused by the inhalation of dust. o The development of pneumoconiosis depends on - (i) The amount of dust retained in the lungs and airways. (ii) The size, shape of the paicles --> The most dangerous paicle ranges from Ito 5 m in diameter because they may reach the terminal small airway and air sacs and settle in their linings. (iii) Paicle solubility and physiochemical reactivity. (iv) Additional effects of other irritants (e.g. concomitant smoking). Impoant pneumoconiosis o Cool worker's pneumoconiosis (CWP) --> Coal dust o Silicosis (grinder's disease) --> Silica dust o Asbestosis --> Asbestos dust o Beryliosis --> Berylium dust o Siderosis --> Iron dust o Byssinosis --> Cotton dust | Pathology | null | The dangerous paicle size causing pneumoconiosis varies from ?
A. 100-150 m
B. 50-100 m
C. 10-50 m
D. 1-5 m
| 1-5 m |
b52bcdad-1153-4599-8c15-68193a4b1492 | Treatment of ovarian tumour in pregnancy depending on time of pregnancy: During pregnancy In an uncomplicated case, the best time of elective operation is b/w 14-18wks as chances of aboion are less and access to the pedicle is easy. But if the tumour is diagnosed beyond 36 weeks, tumour is removed early in puerperium. During labour If the tumour is above the presenting pa watchful expectancy is followed but if its impacted in pelvis, caesarian section should be done followed by removal of tumour in same setting. During puerperium The tumour should be removed as early in puerperium as possible because the longer is the wait for the surgery, there is more chance of having the tumor undergo a torsion | Gynaecology & Obstetrics | Obstetrics | An 6 cm simple ovarian cyst was identified in late pregnancy, what would be the best management ?:
A. Emergency laparotomy
B. Removal after after 6 weeks of puerperium
C. Removal early in the puerperium
D. Conservative as most tumors would subside
| Removal early in the puerperium |
60453595-5fc3-4ef2-870b-bfc940dc9197 | TREATMENT OF CSF RHINORRHEA Early cases of post-traumatic CSF rhinorrhoea can be managed by conservative measures such as bed rest, elevating the head of the bed, stool softeners, and avoidance of nose blowing, sneezing and straining. Prophylactic antibiotics can be used to prevent meningitis. Acetazolamide decreases CSF formation. These measures can be combined with lumbar drain if indicated. Surgical repair can be done by the following: 1. Neurosurgical intracranial approach. 2. Extradural approaches such as external ethmoidectomy for cribriform plate and ethmoid area, trans-septal sphenoidal approach for sphenoid and osteoplastic flap approach for frontal sinus leak. 3. Transnasal endoscopic approach. With the advent of endoscopic surgery for nose and sinuses, most of the leaks from the anterior cranial fossa and sphenoid sinus can be managed endoscopically with a success rate of 90% with first attempt. Principles of repair include: (a) Defining the sites of bony areas . It can be (i) Cribriform plate (ii) Lateral lamina close to anterior ethmoid aery (iii) Roof of ethmoid (iv) Frontal sinus leak (v) Sphenoid sinus (b) Preparation of graft site. (c) Underlay grafting of the fascia extradurally followed by placement of mucosa (as a free graft or pedicled flap) (d) If bony defect is larger than 2 cm, it is repaired with cailage (from nasal septum or auricular concha) followed by placement of mucosa. (e) Placement of surgicel and gelfoam fuher strengthens the area. This is followed by a high antibiotic smeared nasal pack. Sometimes fat from the thigh or abdomen is used to plug the defect in place of fascia graft. (f) Lumbar drain if CSF pressure is high. (g) Antibiotics CSF leak from frontal sinus often requires osteoplastic flap, operation and obliteration of the sinus with fat. Ref : ENT textbook by Dhingra 6th edition Pgno : 163-165 | ENT | All India exam | A person present with cribriform plate fracture with CSF rhinorrhea. What will be immediate treatment?
A. Frequent blowing of nose
B. Plugging of nose with paraffin
C. Craniotomy
D. Antibiotics with wait for 7 days
| Antibiotics with wait for 7 days |
24618e4e-33d6-4912-874c-0214a19b7447 | Evaluation for pulmonary hemosiderosis Anemia with low RBC count, microcytotosis and hypochromia point towards iron deficiency anemia. - "Bone marrow biopsy" in iron deficiency anemia demonstrates erythroid hyperplasia and micronormoblasts reaction. - Prussian blue staining of the bone marrow aspirate and smear and biopsy demonstrate absent of iron stores. The patient continue to have iron deficiency anemia despite the blood transfusions. - This suggests chronic blood loss leading to iron deficiency anemia. - Chronic blood loss can result .from GIT (melena hematemesis) pathology. - G.I. Endoscopy is done in these cases to rule out GIT pathway. Chronic blood loss may also result from hemolytic anemias. - "Hemosiderin in urine" is found in patients with intravascular hemolysis. - Most of the autoimmune hemolytic anemias cause extravascular hemolysis (urine hemosiderin is absent). - Intravascular hemolysis occurs in paroxysmal nocturnal hemoglobinuria. This leads to chronic iron deficiency anemia. - Hemosiderin is present in urine due to intravascular hemolysis. Urinary hemosiderin can differentiate b/w PNH and other autoimmune hemolytic anemias. Idiopathic pulmonary hemosiderosis - Idiopathic pulmonary hemosiderosis is a rare condition chaeracterized by repeated episodes of intraalveolar bleeding that lead to abnormal accumulation of iron as hemosiderin in alveolar macrophage and subsequent development of pulmonary fibrosis and anemia. - The clinical features are characterized by a triad of - Hemoptysis - Moderate to severe iron deficiency anemia. - Diffuse radiological abnormality Diagnosis in these cases is confirmed by - Iron stains of sputum aspiration of and biopsy. The patient in the question does not give any features that are suggestive of idiopathic pulmonary hemosiderosis. He does not require evaluation for pulmonary hemosiderosis. | Pathology | null | A 60 yr old female with I-1/0 8 blood transfusion in 2 years. Her Hb- 60g/L, TLC-5800, platelet-3.4 lakhs, MCV 60, RBC-2.1 lakhs/mm3. He is having hypochromic microcytic anemia. Which investigation is not needed aEUR'
A. Evaluation for pulmonary hemosiderosis
B. Urinary hemosiderin
C. Bone marrow examination
D. G I endoscopy
| Evaluation for pulmonary hemosiderosis |
8cbcdc81-71bc-4881-8c3b-97c543fdd8ee | Ans. is 'c' i.e., Renal colic Uses of nitrates Angina pectoris MI CHF and acute LVF --> nitroglycerine i.v. can be used Act by decreasing preload (LV filling pressure). Biliary colic and esophageal spasm (achalasia cardia) Acute coronary syndrome (unstable angina and non-ST segment elevation Ml). Cyanide poisoning | Pharmacology | null | Nitrates are not used in -
A. CCF
B. Esophageal spasm
C. Renal colic
D. Cyanide poisoning
| Renal colic |
8cc53ec0-d0d1-4eda-9c89-760ff8dc0aef | Ans. is 'a' i.e., Thermogenin o Amongst the given options, a, b and c are uncouplers. o However, only thermogenin, among these three is a natural (physiological) uncoupler. Uncouples o As the name suggests, these compounds block the coupling of oxidation with phosphorylation. These compounds allow the transfer or reducing equivalents in respirators chain but prevent the phosphorylation of ADP to ATPy by uncoupling the linkage between ETC and phosphorylation. Thus the energy instead of being trapped by phosphorylation is dissipated as heat. Uncouplers may be NaturalThermogenin, thyroxine Synthetic 2, 4-dinitrophenol (2, 4-DNP), 2, 4-dinitrocresol (2, 4-DNC), and CCCP (chlorocarbonylcyanidephenyl hydrazone). | Unknown | null | Natural uncoupler is-
A. Thermogenin
B. 2, 4-dinitrocresol
C. 2, 4 Dinitrophenol
D. Oligomycin
| Thermogenin |
5b2ac300-6988-4cd6-9c6a-b0d860cacde1 | Left shift (high affinity for O2) Right shift (low affinity for O2) Temperature decrease increase 2.3-DPG decrease increase p(CO2) decrease increase p(CO) increase decrease pH (Bohr effect) increase (alkalosis) decrease (acidosis) Type of haemoglobin Fetal haemoglobin Adult haemoglobin | Physiology | null | A decrease in which of the following parameters will shift the O2 dissociation curve to the right?
A. pH
B. Paial pressure of CO2
C. 2,3 DPG concentration
D. Temperature
| pH |
048023a8-f2c4-43b0-ba35-af0c68424222 | Rapid,deep(Kussmaul) breathing usually implies metabolic acidosis but may also occur with pontomesencephalic lesions. Ref:Harrison's medicine -18th edition,page no:2251. | Medicine | Respiratory system | Kussumauls breathing
A. Metabolic alkalosis
B. Respiratory alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
| Metabolic acidosis |
59dfe863-d05e-4c2f-8878-56b1d45c3c50 | Ans. is 'd' i.e., Diazepam Prodrug o Few drugs are inactive as such and need conversion in the body to one or more active metabolites. Such a drug is called a prodrug. Prodrug Levodopa Enalapril - Methyldopa Chloralhydrate Dipivefrine Oxcarbazepine Prednisone Bacampicillin Sulfasalazine Cyclophosphamide Mercaptopurine Fluorouracil Sulindac Azathioprine Coisone Benorilate Proguanil Zidovudin Terfenadine Prontosil | Pharmacology | null | Which of the following is not a prodrug-
A. Enalapril
B. Oxcarbazepine
C. Chloral hydrate
D. Diazepam
| Diazepam |
6e9ea73b-13c6-4306-9945-0dbfcdfa071f | Meckel&;s dieiculum may cause severe hemorrhage due to peptic ulceration. The blood is usually passed per rectum and is maroon in colour. it may cause bloody vomitus. Ref : BAILEY AND LOVE&;S SHO PRACTICE OF SURGERY,24 TH EDITION PG NO:1159 | Pediatrics | Gastrointestinal tract | Cause of "bloody" vomitus in a neonate
A. Meckel's diveiculum
B. Intussusception
C. Malrotation
D. Cholecystitis
| Meckel's diveiculum |
14faae5c-8635-443b-8d1d-a91f31afd2e4 | The sounds of Korotkoff are produced by turbulent flow in the brachial aery. When the aery is narrowed by the cuff, the velocity of flow through the constriction exceeds the critical velocity and turbulent flow results. | Physiology | Cardiovascular system | The basis of Korotkoff sound is
A. Aoic valve closure
B. Production of hea sound
C. Aerial turbulence
D. Aerial valve expansion
| Aerial turbulence |
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