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af0f70fc-37d3-4d1e-8919-5155306a962e | Ref: Guyton, 12th edition, Page 995 and Essentials of Medical Physiology By Khurana, Page 509Explanation:PHASES OF ENDOMETRIAL CYCLEThe endometrial cycle of 28 days can be divided into three phases:o Menstrual Phase (1-5 days)o Proliferative Phase (6-14 days)o Secretory Phase (15-28 days).(See table on the next page) | Physiology | Sex Hormones | Secretory phase of endometrium is due to which hormone?
A. Estrogen
B. Progesterone
C. Prolactin
D. Pregnenediol
| Progesterone |
bd797b69-3241-4141-8b82-722869bc01b3 | This patient needs medical treatment to relieve him of symptoms of prostatism (now better k/a LUTS i.e. lower urinary tract symptoms) Two classes of drugs are commonly used for BPH a Adrenergic blockers - eg. Prazosin, Terazosin (a1 blockers) & Tamsulosin, Alfuzosin (a1a blockers) 5a reductase inhibitors - eg. Finasteride, Dutasteride, Triptorelin pamoate a-Adrenergic blockers Since activation of al receptors in the bladder neck, prostate and prostatic urethra increases their smooth muscle tone, their blockade relaxes these structures, reducing the dynamic obstruction and increasing the urinary flow rate. 5a reductase inhibitor These drugs prevent the conversion of testosterone into more active dihydrotestosterone responsible for androgen action in many tissues including prostate. Their use results in a reduction in the size of the gland and improvement in symptom. But six months of therapy is required to see the maximum effect on the prostate size and symptomatic improvement and symptomatic improvement is seen only in men with enlarged prostate (> 40 cm3) Since the patient in the question needs to relieve him of his symptoms till he gets fit to be operated, a blocker (Terazocin) would be used. a lockers afford faster and greater symptomatic relief than finasteride. The bad point about a blocker is that their effect lasts only till drug is given and even with continued therapy, benefits may decline after several years due to disease progression. About Combination therapy Combination of both these class of drugs is used by surgeons to derive combined benefit from both; its use is not justified in this patient as he needs to allete his symptoms till he gets operated - the definitive & most effective t/t. Ref : Bailey & Love 25/e p13.50 | Anatomy | Urology | A 60-year diabetic & hypeensive male with second-grade prostatism admitted for prostatectomy developed myocardial infarction. Treatment now would be -
A. Finasteride
B. Terazocin
C. Finasteride and terazocin
D. Diethyl stilbestrol
| Terazocin |
7dd95586-573e-4c8d-bb5d-c59648a15efb | (d) The ascending aorta takes its origin from the left ventricle and ends at the level of the sternal angle by becoming the arch of the aorta. | Anatomy | Thorax | Choose the appropriate lettered site or structure in this CT scan of the thorax. Takes its origin from the left ventricle and ends at the sternal angle?
A. A
B. B
C. C
D. D
| D |
ad0c0234-5f2d-492b-ab44-6f43ca5710f7 | ANS. BClassification of diarrhea based on severity in children and management.SignsClassify asIdentify treatment(Urgent pre-referral treatment are in bold print)Two of the following signs:* Lethargic or unconscious* Sunken eyes* Not able to drink or drinking poorly* Skin pinch goes back very slowlySevere dehydration* If child has no other severe classificationGive fluid of severe dehydration (Plan C)ORIf child also has another severe classificationRefer urgently to hospital with mother giving frequent sips of ORS on the way. Advise the mother to continue breastfeeding* If child is 2 years or older, and there is cholera in your area, give antibiotic for cholera.Two of the following signs:* Restless, irritable* Sunken eyes* Drinks eagerly, thirsty* Skin pinch goes back slowly.Some dehydration* Give fluid, zinc supplements and food for some dehydration (Plan B)* If child also has a severe classification:Refer urgently to hospital with mother giving frequent sips of ORS on the way. Advise the mother to continue breastfeeding* Advise mother when to return immediately* Follow-up in 5 days if not improving* If confirmed/symptomatic HIV, follow-up in 2 days if not improving* Not enough signs to classify as some or severe dehydrationNo dehydration* Give fluid, zinc supplements and food to treat diarrhea at home (Plan A)* Advise mother when to return immediately* Follow-up in 5 days if not improving* If confirmed/symptomatic HIV, follow-up in 2 days if not improving | Medicine | Fluid & Electrolyte | You and your friend goes for a picnic to a hilly area. He has 5 to 6 episodes of loose stools. There is no fever, tachycardia or no other signs of dehydration. What should you do next?
A. Start a course of oral ofloxacin and onidazole
B. Give ORS solution with water
C. Take him to a nearby hospital
D. Start intravenous (IV) fluids
| Give ORS solution with water |
9a71db9d-4834-4549-95a2-8841b3ed10f0 | Hemophila A:-
Hemophilia A is due to deficiency of factor VIII
Hemophilia A is inherited as an X-linked recessive trait.
Factor VIII is an intrinsic pathway component required for activation of factor X.
Clinical manifestations are due to defect in coagulation system : -
Large post traumatic ecchymoses or hematoma. Prolonged bleeding after a laceration or any form of surgical procedure.
Bleeding into weight bearing joints.
Petechiae are characteristically absent (in contrast to platelet dysfunction where bleeding occur from small vessels of skin and mucous membrane, e,g.: petechiae).
Laboratory findings :-
□ ↑ PTT □ Normal BT □ Normal PT
Normal platelet counts Remember
Hemophilia B (christmas disease) is due to deficiency of factor IX.
Hemophilia B has clinical features and laboratory findings similar to hemophilia A | Pathology | null | Hemophilia A due to deficiency of
A. Factor VIII
B. Factor IX
C. Factor X
D. Factr XI
| Factor VIII |
d492381e-1188-4cd2-bfaf-ccee1c032831 | OPTIC NEURITIS Signs: 1. Visual acuity is usually reduced markedly. 2. Colour vision is often severely impaired. 3. Pupil shows ill-sustained constriction to light. Marcus Gunn pupil which indicates relative afferent pupillary defect (RAPD) is a diagnostic sign. It is detected by the swinging flash light test. Swinging flash light test: It is performed when relative afferent pathway defect is suspected in one eye (unilateral optic nerve lesion with good vision). To perform this test, a bright flash light is shone on to one pupil and constriction is noted. Then the flash light is quickly moved to the contralateral pupil and response noted. This swinging to-and-fro of flash light is repeated several times while observing the pupillary response. Normally, both pupils constrict equally and the pupil to which light is transferred remains tightly constricted. In the presence of relative afferent pathway defect in one eye, the affected pupil will dilate when the flash light is moved from the normal eye to the abnormal eye. This response is called 'Marcus Gunn pupil' or a relative afferent pupillary defect (RAPD). It is the earliest indication of optic nerve disease even in the presence of normal visual acuity. Ref:- A K KHURANA; pg num:-294,474,475 | Ophthalmology | Neuro-ophthalmology | Marcus Gunn pupil is a feature of
A. Ciliary ganglion lesion
B. Lesion of Edinger-Westphal nucleus
C. Optic neuritis
D. Papilloedema
| Optic neuritis |
87dab8c0-d2a4-4c96-9ab2-6e09a3065017 | Ans. is 'a' i.e., Keratinocytes Desmosomeso Desmosomes are the major adhesion complex in epidermis, anchoring keratin intermediate filaments (IFs) to the cell membrane and bridging adjacent keratinocytes, and allowing cells to withstand trauma.o The main components of desmosomes consist of the products of three gene superfamilies : -Desmosomal cadherins They are calcium ion dependent cell adhesion molecules that show homophillic homophi llic adhesions (i.e. a cadherin molecule of one cell binds to same molecule on another cell.)They includeo Desmogleins l-4(Dsgl-Dsg4)o Desmocollins 1-3 (Dscl-Dsc3)Armadillo proteinso Plakoglobins (Pgs)o Plakophillin (Pkps 1-3)Plakinso Desmoplakins (Dps),o Plectino Envoplakino PeriplakinAntigen defectDiseaseDsg 1Pemphigus foliaceusDsg 3Pemphigus vulgarisDsc lSubcorneal pustular dermatosisDpk 1&2Erythema multiformeEnvoplakin & PeriplakinPerineoplastic pemphigus | Skin | Anatomy of Skin | Desmosomes are helpful in connecting -
A. Keratinocytes
B. Melanocytes
C. Dermis and epidermis
D. Langerhanscells
| Keratinocytes |
77975bf0-196a-4fbb-ad20-b3373a3c9c20 | The given picture shows 'mature pincer grasp' which develops at 12 month. 6 months Unidextrous or palmar grasp 7 months Transfer objects from 1 hand to another 9 months immature/ assisted pincer grasp 12 months mature/unassisted pincer grasp- 'CASTING' | Pediatrics | Impoant Motor Milestones | When does a child attain this impoant fine motor milestone?
A. 3 months
B. 6 months
C. 9 months
D. 12 months
| 12 months |
f4d65b94-2bef-4c72-9c3a-eded41ba71aa | Optokinetic nystagmus (OKN), elicited with a rotating striped optokinetic drum, useful in localizing cause of an isolated homonymous hemianopia. Physiological OKN involves smooth pursuit of a target, followed momentarily by a saccade in the opposite direction to fixate on the next target. If a homonymous hemianopia is due to a lesion in the parietal lobe, smooth pursuit pathways towards the side of the lesion are likely to be affected, making this component of OKN defective. OKN will therefore be asymmetrical: erratic when the drum is rotated towards the side of the lesion, but regular when the drum is rotated away from the side of the lesion. If the lesion is in the occipital lobe, smooth pursuit pathways are intact and OKN will be symmetrical - this is the Cogan dictum, which also states that the parietal lobe lesion is more likely to be a tumour and the occipital lesion an infarction. optokinetic drum | Ophthalmology | Neuro Ophthalmology | A patient with homonymous hemianopia is found to have asymmetric optokinetic nystagmus. The location of the lesion is
A. Parietal lobe
B. Occipital lobe
C. Temporal lobe
D. Lateral geniculate body
| Parietal lobe |
c9a0f4db-06da-4c30-9cce-1d4a843f81b2 | Most of the metabolic disorder have autosomal recessive inheritance expect Her-Her's disease Left-Lesch My hand syndrome Eye-ouclar albinism Has-hunter syndrome Five -fabrys disease Pimples -porphyria Refer robins 7th/152,9/e p141 | Anatomy | General anatomy | Which of the following is an autosomal dominant metabolic disorder
A. Cystic fibrosis
B. Phenylketonuria
C. Alpha 1antitrypsin deficiency
D. Familial hypercholesterolemia
| Familial hypercholesterolemia |
dab15a07-54c8-4700-a0ac-6ac99c09fefb | Ref. The Short Textbook of Pediatrics. Pg 600
Triple and Quadruple test
The triple screening measures the amounts of three substances in a pregnant woman's blood: alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), and estriol (uE3)
The quad screen test is a maternal blood screening test that looks for four specific substances: AFP , hCG , Estriol, and Inhibin-A
Indications
Have a family history of birth defects
Are 35 years or older
Used possible harmful medications or drugs during pregnancy
Have diabetes and use insulin
Had a viral infection during pregnancy
Have been exposed to high levels of radiation
Timing
The triple screen test is performed between the 15th and 18th week of pregnancy | Unknown | null | Ideal time for doing Quadruple test?
A. 15-18 weeks
B. 12-14 weeks
C. 10-12 weeks
D. 8-10 weeks
| 15-18 weeks |
41bec971-11b9-4ba3-a802-f3fb414bb4b3 | Ans. is 'a' i.e., 6 months *Weight of an infant doubles by 5 months and quadruples by 2 years of age.AgeWeightBirth3kg5 months6kg (2 x birth weight)1 years9kg (3 x birth weight)2 years12kg (4 x birth weight)3 years15kg (5 x birth weight)5 years18kg (6 x birth weight)7 years21kg (7 x birth weight)10 years30kg (10 x birth weight) | Pediatrics | Growth, Development, and Behavior | Weight of an infant doubles by what age?
A. 6 months
B. 1 year
C. 2 years
D. 3 years
| 6 months |
0acce54c-8f70-4b01-a613-f83b77841857 | Ans. (a) Apo A1Ref Harper's Biochemistry 28/e, chapter 25 | Biochemistry | Cholesterol and Lipoproteins | LCAT activates?
A. ApoA1
B. ApoB100
C. Apo C-2
D. Apo C-3
| ApoA1 |
1bf5f547-f495-4203-ba78-2294fa5d84b7 | D i.e. Thymol Toluene is the best preservative of urine for chemical analysis & Thymol for general purposeQ. | Forensic Medicine | null | Urine is stored in:
A. Urine is stored in:
B. Normal saline
C. Hydrochloric acid
D. Thymol
| Thymol |
e9ce5781-1710-4969-ac43-58ad054d33e0 | The crossed extensor reflex or crossed extensor response or crossed extension reflex is a reflex in which the contralateral limb compensates for loss of suppo when the ipsilateral limb withdraws from painful stimulus in a withdrawal reflex Ref: guyton and hall textbook of medical physiology 12 edition page number: 775,776,777 | Physiology | Nervous system | Postural reflex with integrating center in spine
A. Righting reflex
B. Tonic labyrinthine reflex
C. Righting reflex
D. Crossed extensor reflex
| Crossed extensor reflex |
bebefba6-6417-4c22-bd37-b79061eba353 | Type Name Enzyme Deficiency Clinical Features IIIa Limit dextrinosis, Forbe or Cori disease Liver and muscle debranching enzyme Fasting hypoglycemia Hepatomegaly in infancy Accumulation of characteristic branched polysaccharide (limit dextrin) Muscle weakness Reference: Harper; 30th edition; Table: 18-2; Page no: 179 | Biochemistry | Metabolism of carbohydrate | Enzyme deficiency in Cori disease is
A. Liver phosphorylase
B. Branching enzyme
C. Liver and muscle debranching enzyme
D. Muscle phosphorylase
| Liver and muscle debranching enzyme |
35f54eac-1235-45ba-b271-61c788bc93aa | The dreaded complication of Rituximab is progressive multifocal leukoencephalopathy Ref: Harrison's principles of internal medicine, 18th edition ; Page 882. | Medicine | null | The dreaded complication of Rituximab is:
A. Progressive multifocal leukoencephalopathy
B. AIDP
C. Bone marrow suppresion
D. Cardiac toxicity
| Progressive multifocal leukoencephalopathy |
faf76837-a83d-4939-88ca-3cabf345b2ba | Stimulation of ovary in early follicular phase is by FSH, as the growth and differentiation of primordial follicles are under the control of FSH. Presence of FSH prevents follicles from undergoing Atresia. Stimuation of ovary in later follicular phase is predominantly by FSH but also LH is required in later follicular stage for the final maturity of the follicle before rupture. | Gynaecology & Obstetrics | Normal Menstruation, Abnormal Menstruation, Menopausal Physiology and forsight of conception | Stimulation of ovary in the early follicular phase is by:
A. Oestrogen
B. Progesterone
C. FSH
D. LH
| FSH |
ad395086-de9f-4fbb-b7b4-c298a035bcfb | Endometrial cancer stage III: Stage IIIA: Involvement of uterine serosa and/ or adnexa Stage IIIB: Involvement of vagina and/or parametrium Stage IIIC: IIIC1: Positive Pelvic nodes IIIC2: Positive Paraaoic nodes with or without positive pelvic nodes Positive peritoneal cytology doesn&;t alter the stage Ref: FIGO SURGICAL STAGING 2014 | Gynaecology & Obstetrics | Gynaecological oncology | A lady presented with carcinoma endometrium involving >50% of myometrium extending to vagina and positive peritoneal cytology but no involvement of para aoic and preaoic nodes. What is the stage of disease ?
A. Ill A
B. Ill B
C. Ill C1
D. Ill C2
| Ill B |
6b64255f-bea4-4caa-9a7e-8d06e924bdc4 | On DSA- The classic angiographic appearance of a meningioma is a radial "sunburst" of vessels extending from the base of the tumor toward its periphery. Dural vessels supply the core or center of the lesion, radiating outward from the vascular pedicle of the tumor. DSA image showing characteristic SUNBURST PATTERN of meningioma. Mother in law sign- Lesions that enhance early during the aerial phase and remain opacified well after the venous phase and is seen in meningioma. Other Features of Meningioma Dural tail sign Hyperdense on CT Isointense/Hypointense on T2 Calcification Skeletal Hyperostosis Pneumosinus dilatans | Radiology | Neuroradiology | Sunray/ spoke wheel vasculature is a feature of
A. Craniopharyngioma
B. Glioblastoma multiforme
C. Oligodendroglioma
D. Meningioma
| Meningioma |
c60f0bae-6257-46f5-a051-82daf6fc9540 | Point mutation of BRAF seen in 60% of malignant melanoma and 80% of benign nevi.Category of oncogenes:1)Growth factors *Overexpression of HGF - Thyroid cancer2)Growth factor receptors *EGFR -Squamous cell carcinoma of lung and glioblastoma*Her2/neu- Breast cancer *FLT3 - Breast cancer, ovarian cancers, and myeloid leukemia*KIT- GIST3)Proteins involved in signal transduction*KRAS-Colon, lung and pancreatic cancers*HRAS- Bladder cancers, kidney tumors*NRAS - Melanoma*ABL -Chronic myelogenous leukemia*BRAF- Melanoma*Beta-catenin- Hepatoblastoma and Hepatocellular carcinoma4)Nuclear regulatory proteins *C-MYC- Burkitt lymphoma*N-MYC- Neuroblastoma, Small cell carcinoma of the lung*L-MYC - Small cell carcinoma of the lung5)Cell cycle regulators*Cyclin D - Mantle cell lymphoma(Ref: Robbins 8/e p281, 283) | Pathology | General pathology | BRAF mutation is seen in 60% of cancers of
A. Malignant melanoma
B. Basal cell carcinoma
C. Squamous cell carcinoma
D. Teratoma
| Malignant melanoma |
0c81fe12-7aff-4a4c-a367-7ae82631a156 | The axillary nerve from the posterior cord supplies teres minor and deltoid muscle. Coracobrachialis is supplied by a musculocutaneous nerve from the lateral cord. Pectoralis minor is supplied by medial pectoral nerve arising from the medial cord and lateral pectoral nerves arising from lateral cord. The long head of biceps brachii is supplied by a musculocutaneous nerve from the lateral cord. BD Chaurasia 7th edition Page no: 57 | Anatomy | Upper limb | Posterior cord supplies
A. Teres minor
B. Pectoralis minor
C. Coracobrachialis
D. Long head of biceps
| Teres minor |
7720b5d3-74d2-473e-af51-66c9d47589e7 | Mannitol Mannitol is widely used to reduce ICP Commonly used preparation : 20% solution, 0.25-1 gm/kg is given IV as bolus Serum osmolality should not be allowed to go >320 mOsm/L, to avoid systemic acidosis and renal failure. Uses of mannitol To reduce increased ICT or intra ocular tension To maintain GFR and urine flow in impending renal failure Forced diuresis in hypnotic or other poisoning To counteract low osmolality of plasma/ECF due to rapid hemolysis or peritoneal dialysis Contraindications of Mannitol Acute Tubular Necrosis Anuria Pulmonary edema Acute left ventricular failure CHF Cerebral hemorrhage Ref :Harrison's 19th edition Pgno :1779-1780 | Surgery | Trauma | In patient of head injuries with rapidly increasing intracranial tension without hematoma, the drug of choice for initial management would be
A. Lasix
B. Steroids
C. 20% Mannitol
D. Glycine
| 20% Mannitol |
f81ae5b3-f8f2-4593-92c3-ba49d2cb1269 | ANS. APentazocine: Partial agonist and antagonist at mu receptor, and agonist at kappaBuprenorphine: Partial agonist at mu and antagonist at kappaTramadol: Affinity for mu is low, while that for kappa and delta is very low. (Tramadol also has an additional mechanism of inhibiting reuptake of NA and 5-HT, and thus activating monoaminergic spinal inhibition of pain. Its analgesic action is only partially reversed by opioid antagonist naloxone.Fentanyl: Congener of pethidine, 80-100 times more potent than morphine. It is chemically unrelated to morphine, but interacts with opioid receptors and its actions are blocked by naloxone. | Pharmacology | C.N.S | A patient presented with right lower quadrant pain. He was already treated for right renal stone disease. Which of the following opioid is partial agonist at MU and full agonist at Kappa?
A. Pentazocin
B. Buprenorphine
C. Tramadol
D. Fentanyl
| Pentazocin |
6023e7d9-19ba-4e59-a7c5-3d58ad2dee58 | Hypokalemia, defined as a plasma K+ concentration of <3.5 mM, Hyperkalemia is defined as a plasma potassium level of 5.5 mM Ref: Harrison 19e pg: 305 | Medicine | Fluid and electrolytes | Hypokalemia is defined as a plasma potassium concentration of
A. < 3.5 mmol/L
B. < 3.6 mmol/L
C. < 3.7 mmol/L
D. < 3.8 mmol/L
| < 3.5 mmol/L |
52e9c7b0-7e8f-48e6-a149-c5d918d52c66 | Basic drugs like morphine, d-TC and amphotericin B etc act as histamine liberators and can cause acute reaction leading to itching and hypotension. | Pharmacology | null | Which of the following drugs can cause hypotension by the release of histamine from mast cells?
A. Aspirin
B. Procaine
C. Morphine
D. Sulfadiazine
| Morphine |
694184ca-0054-49b2-994e-49271341c57b | Diagnostic is always Tissue Diagnosis -Tumors and infection can mimic each other (clinically and radiologically), e.g. Osteosarcoma and Ewings sarcoma are two tumors that mimic osteomyelitis. (Both have accompanying fever and increased local temperature). -Tumors and bone infections are usually metaphyseal and both need tissue diagnosis for differentiation. Thus, Culture is gold standard for infection -Histopathology is gold standard for tumors So rule is Culture all biopsies, biopsy all cultures. | Orthopaedics | Imaging and basics in Ohopedics | A 5year-old child complains of pain and swelling of the right tibia. On laboratory evaluation he has elevated ESR and leucocytosis X-ray shows a tibial lesion. Which of the following is the best investigation which can help us clinch the diagnosis:
A. Blood C/S
B. Pus C/S
C. MRI
D. Biopsy
| Biopsy |
6437e449-2df3-418b-8604-7805a9b70435 | .10% of first degree relatives; 50% of monozygotic twins develop Crohn's disease. Genes NOD2 / CARD15 in chromosome 16q12 has got strong association with Crohn's disease. CARD15 is expressed in Paneth cells of the ileum. * Smoking is related to Crohn's disease as aetiology, as for relapse and for exacerbations. There is increased mucus membrane permeability - antigen induced cell mediated inflammatory response - release of cytokines like TNF, interleukin 2 -m defect in suppressor T cell - granuloma and other pathology. ref:SRB&;s manual of surgery ,ed 3,pg no 801 | Surgery | G.I.T | Crohn&;s disease is associated with
A. NOD2\/CARD15 gene
B. P53 supressor gene
C. Philadelpha chromosomes
D. BRACI gene
| NOD2\/CARD15 gene |
ef451697-5362-4b91-9049-9906360180f0 | Pseudounipolar neuron a unipolar neuron, almost always a primary sensory neuron, that was originally bipolar but whose two processes fused during development to form a single process that bifurcates at a distance from the cell body. One branch is structurally an axon with a myelin sheath but functions as a dendrite, with afferent conduction originating in a nerve ending.Ref: Ganong&;s review of medical physiology 23rd edition Page no: 81 | Physiology | General physiology | Dorsal root ganglia have
A. Unipolar
B. Multipolar
C. Bipolar
D. Psudounipolar
| Psudounipolar |
b17f0c94-208d-451e-bca4-c904e8c6e375 | Ans. (A) Renal vasodilatory effect(Ref: Katzung 11/e p137)Dopamine acts on D1 , b1 and a1 receptors. Stimulation of D1 receptors cause renal vasodilation, which is useful clinically to improve renal perfusion in shock with oligouria. | Pharmacology | Adrenergic System | Dopamine is preferred in treatment of shock because of:
A. Renal vasodilatory effect
B. Increased cardiac output
C. Peripheral vasoconstriction
D. Prolonged action
| Renal vasodilatory effect |
8e0ab827-7c14-4b00-b993-b9848c8513f2 | Jaeger's cha is used for measuring Near Vision The Jaeger cha is an eye cha used in testing near vision acuity. It is a card on which paragraphs of text are printed, with the text sizes increasing from 0.37mm to 2.5mm. This card is to be held by a patient at a fixed distance from the eye dependent on the J size being read. The smallest print that the patient can read determines their visual acuity | Ophthalmology | Optics and Errors of Refraction | Jaegers cha is used to measure
A. Distant vision
B. Near vision
C. Color vision
D. Contrast sensitivity
| Near vision |
3f21f255-42e5-44fe-8e15-1fa684276ce3 | (Braunwald, 15/e, pp 823, 893.) Erysipelas, the cellulitis described, is typical of infection caused by S.Pyogenes - Group A b- hemolytic Streptococci (GAS). There is often a preceding event such as a cut in the skin, dermatitis, or superficial fungal infection that precedes this rapidly spreading cellulitis. Anaerobic cellulitis is more often associated with underlying diabetes. S. epidermidis does not cause rapidly progressive cellulitis. Staphylococcus aureus can cause cellulitis that is difficult to distin guish from erysipelas, but it is usually more focal and likely to produce furuncles, or abscesses. | Surgery | null | A 19-year-old male has a history of athlete's foot but is otherwise healthy when he develops the sudden onset of fever and pain in the right foot and leg. On physical exam, the foot and leg are fiery red with a well-defined indurated margin that appears to be rapidly advancing. There is tender inguinal lymphadenopathy. The most likely organism to cause this infection is
A. Staphylococcus epidermidis
B. Tinea pedis
C. Streptococcus pyogenes
D. Mixed anaerobic infection
| Streptococcus pyogenes |
bec8848f-1a03-4743-80c0-85b9de3203ef | The history of a recurrent PID and a sudden deterioration points towards a ruptured T/O mass . Alone PID, will have pain and fever with Increased TLC, but not present with the above mentioned acute onset. Acute onset goes in the our of a ruptured abscess. Appendicitis and diveiculitis may have similar onset but the systemic symtoms of toxicity are more profound and both of these are not associated with Vaginal discharge This case can be managed with a exploratory laparotomy & lavage, antibiotics and then follow up of the cultures taken at surgery. | Gynaecology & Obstetrics | Genital Tract Infections (Too hot to handle!) | 35 years old woman with H/O recurrent PID presents in emergency with sudden onset of abdominal pain with fever. She had her regular period 5 days back. Physical examination reveals abdominal tenderness with guarding and rigidity. Per speculum finding shows diy vaginal discharge. Per vaginal examination shows adnexal tenderness. Lab investigation shows increased TLC & increased ESR, Most probable diagnosis is -
A. Ruptured ectopic
B. Ruptured tubo ovarian mass
C. Diveiculitis
D. Appendicitis
| Ruptured tubo ovarian mass |
0fd44817-865a-4bc2-9ccb-7454e868b583 | Total hysterectomy with bilateral salpingo -oophorectomy | Gynaecology & Obstetrics | null | Treatment of malignant ovarian tumours is :
A. Total hysterectomy
B. Total salpingo - oophorectomy
C. Total hysterectomy with unilateral salpingo - oophrectomy
D. Total hysterectomy with bilateral salpingo -oophorectomy
| Total hysterectomy with bilateral salpingo -oophorectomy |
5dcd4ce2-a268-4f75-ae13-de3f66b3aa36 | Ans. C. Medial nasal processFrontonasal process is divided into:-i) Lateral nasal processes:From alae of nose.ii) Medial nasal processes:These merge with each other to form intermaxillary segment which gives rise to : philtrum (middle pa of upper lip),premaxillary plate. | ENT | null | Philthrum is derived from-
A. Maxillary process
B. Mandibular process
C. Medial nasal process
D. Lateral nasal process
| Medial nasal process |
134add0f-aa4e-4f02-83a2-3db34e7538eb | Venous Drainage - The veins form a plexus along the lateral border of the uterus. The plexus drains through the uterine, ovarian and vaginal veins into the internal iliac veins. Ref : B D Chaurasia's Human Anatomy , seventh edition ,volume 2 , pg. no., 422. | Anatomy | Abdomen and pelvis | The venous plexus of uterus is related to which of the following border/ surface of uterus ?
A. anterior surface of uterus
B. posterior surface of uterus
C. lateral border of uterus
D. anterior surface of cervix
| lateral border of uterus |
0a723bc2-c3dd-430a-814d-85fffead627e | Ans) b (Misoprosotol) Kef: KDT 6th ed p. 629Misoprostol is the prostaglandin analogue used in the treatment of peptic ulcer.DRUGS USED IN PEPTIC ULCER1) H2 antagonists-ranitidine, cimetidine, famotidine roxatidine and nizatidine.Nizatidine has little first-pass metabolism and a bioavailability of al-most 100%. Famotidine is the most potent among them.2) Proton pump inhibitors (PPIs)- omeprazole, lansoprazole, rabeprazole, pantoprazole, and esomeprazole. They are the most effective drugs in GERD.3) Mucosal protective agents-sucralfate, colloidal bismuth compounds4) Prostaglandin analogs-misoprostol5) Antacids6) Anticholinergics-Pirenzipine, propantheline7) Anti-H.pylori drugs -Amoxicillin, clarothromycin, metronidazole, tinidazole, tetracycline. | Pharmacology | Prostaglandins | Prostaglandin used in the treatment of peptic ulcer is
A. Carboprost
B. Misoprostol
C. Dinoprost
D. Latanoprost
| Misoprostol |
f1835a2d-43f5-43fe-90b7-e8e7438eee75 | The Moro reflex is present in normal infants. A sudden stimulus (eg, a loud noise) causes abduction and extension of all extremities, with extension and fanning of digits except for flexion of the index finger and thumb. This is followed by flexion and adduction of the extremities. Moro's reflex disappear at three month of age and persistence of this reflex beyond three months is abnormal. Ref: Essential paediatrics by OP Ghai, 6th edition, Page 146. | Pediatrics | null | Moro's reflex stas during intrauterine life. Persistence of Moro's reflex is abnormal beyond the age of:
A. 3rd month
B. 4th month
C. 5th month
D. 6th month
| 3rd month |
3d8157fb-83cc-401c-b7e0-d1e84b0d3b4c | Undeaker's fracture is basically a postmoem fracture, and occurs due to careless handling of the dead body by undeakers; in fact this fracture can be produced by anyone who has to do anything with the dead body. * Pathologists are known to extend the head to make the removal of the neck structures easier. To do this, they usually inse a block about 10-15 cm high under the neck may fall forcibly backwards, producing this fracture. * It involves subluxation of the lower cervical spine due to tearing of the interveebral disc at about C6-C7. X RAY OF HANGMANS FRACTURE REF : MAHESWARI 9TH ED | Orthopaedics | Management in Orthopedics | Undeaker's fracture is -
A. C23
B. C34
C. C56
D. C67
| C67 |
57ea4675-2567-437b-8b37-498a9b02369c | Sporotrichosis is a chronic infection involving cutaneous, subcutaneous and lymphatic tissue. It is caused by Sporothrix schenckii. Pathogenesis: 1. Lesions on the exposed pas of the skin follow minor trauma. Nodules are first formed, followed by ulceration and necrosis of nodules. 2. From the lesions in skin and subcutaneous tissue, the infection can spread by lymphatic channels to lymph node and lymphatics are hardened and cord-like. Ref: Textbook of Microbiology, Ananthanarayan and Paniker; 9th edition | Microbiology | mycology | A former from the sub-Himalayan region presents with multiple leg ulcers. The most likely causative agent is
A. Trichophyton rubrum
B. Cladosporium species
C. Sporothrix Schenckii
D. Aspergillus
| Sporothrix Schenckii |
940a50fc-9e94-42b3-b05b-eb8bb1083213 | Ans. (b) Circular stapler cuttingRef: Sabiston's Textbook of surgery, 20th edition, Pages 1402-03* Longo procedure is the stapled hemorrhoidopexy procedure.* The other name is minimally invasive procedure for hemorrhoids (MIPH).* Circular stapler is used in this procedure | Surgery | Rectum | Which of the following stapler is used for MIPH?
A. Linear cutting stapler
B. Circular cutting stapler
C. Linear stapler
D. Circular stapler
| Circular cutting stapler |
fbedc4f8-5f19-48d4-a725-f0604f9277d4 | Ans. is 'b' i.e., IFN-y A granuloma is a focus of chronic inflammation consisting of a microscopic aggregation of macrophages that are transformed into epithelium like cells (epithelioid cells) surrounded by a Collor of mononuclear leukocytes, principally lymphocytes and occasionally plasma cells. Frequently, these epitheloid cells fuse to form giant cells in the periphery or some times in the center of granuloma. Pathogenesis of granuloma Immune granuloma (most common type of granuloma) is a type IV hypersensitivity that involved CD-4 helper T cell. On-exposure to paiculate antigen macrophages process and present this antigen to Helper T cells and also secretes IL-2. T-cells are activated on contact with this antigen and by IL-2. Activated T-cells (helper) produce IFN-y, the major cytokine of granulomatous inflammation. IFN-y has the following effects It is the most impoant activator of macrophages. It induce granuloma formation by conversion of activated macrophages into epitheliod cells and formation of giant cell. Augment the differentiation of T-cells. Finally there is formation of granuloma induced by IFN-y. Remember Foreign body (Nonimmune) granuloma consist almost entirely of epitheloid cells and multinucleated giant cells but no lymphocytes. Granulomas induced by parasites contain a large component of eosinophils. In lymphogranuloma venerum and Cat scratch disease granulomas have a characteristic central neutrophilic abscess surrounded by macrophages and other mononuclear cells. | Pathology | null | Macrophages are conveed to epitheloid cells by which cytokine ?
A. IL-2
B. IFN-y
C. TNF-a
D. TGF-(3
| IFN-y |
db86d07b-e135-4aab-98b1-4375025bc778 | (Pellegra): (535 - Harper 29th edition & Tryptophan)* Pellegra - caused by Niacin deficiency* Com is low in both niacin and tryptophan, com based diets can cause pellegra(i) Symptoms 3Ds - dermatitis, diarrhea, dementia(ii) Pellegra is frequently observed in Hartnup's disease(iii) Megadoses of niacin are useful in the treatment of hyperlipidemia* Retinoic acid has a role in the regulation of gene expression and tissue differentiation* Vitamin A deficiency is a major public health problem world wide* Vitamin E is the major lipid soluble antioxidant in cell membranes and plasma lipoproteins* Vitamin K is the coenzyme for carboylation of glutamate in post synthetic modification of calcium-binding proteins* Thiamine nutritional status can be assessed by erythrocyte transketolase activation* *** Viatamin B6 status is assessed by Assaying erythrocyte transaminases* Methyl malonyl CoA mutase, Leucine aminomutase and methionine synthase are three vitamin B12 dependant enzymes* Vitamin B12 deficiency causes functional folate deficiency - the "Folate Trap"* Folic acid supplements reduce the risk of Neural tube defects and hyperhomeocysteinemia & may reduce the incidence of cardiovascular disease & some cancers* Beta carotene, Vitamin E, Ascorbic acid and Lipoic acids serve as antioxidants and reduce the risk of heart attacks and cancers* Vitamin B6 is required for glycogen degradation by glycogen phosphorylase. A deficiency would result in fasting hypoglycemia, Additionally a deficiency of biotin (required by pyruvate carboxylase of gluconeogenesis) would also result in fasting hypoglycemia. (394- Lippincotts 6th) | Biochemistry | Vitamins and Minerals | Which of the following is vitamin B-complex disease
A. Scurvy
B. Pellegra
C. Night blindness
D. Rickets
| Pellegra |
98de5a4a-f995-4180-8d90-00aa2bbafb89 | (a) Plummer-Vinson syndrome(Ref. Sleisenger Gastrointestinal & Liver Disease, 8th ed.,; 851)Triad of postcricoid dysphagia, oesophageal webs, and iron deficiency anemia constitutes Plummer Vinson syndrome. Due to iron deficiency there occurs atrophy of the gastric mucosa leading to achlorhydria.Intrinsic factor (IF) is needed for the absorption of dietary cobalamin, i.e. vitamin B12 . This binding of IF with B12 prevents the proteolytic digestion of B12 . Intrinsic factor is secreted by the parietal cells of the cardiac and fundic mucosa of the stomach, which also secrete hydrochloric acid (HCl). The IF-cobalamin complex then reaches terminal ileum where cobalamin gets absorbed.In PV syndrome due to atrophy of gastric mucosa therefore there is no IF available leading to poor absorption of vitamin B12 .Eagle syndrome is pain in the tonsillar fossa area due to enlarged calcified styloid process.Job's syndrome is hyperimmunoglobulin E syndrome.Treacher Collin syndrome is 1st arch hypoplasia causing maxillo-mandibular hypoplasia. | ENT | Miscellaneous (E.N.T.) | Women with vitamin B12 deficiency presents with dysphagia and anemia. What is the syndrome mentioned in the presentation?
A. Plummer-Vinson syndrome
B. Eagle syndrome
C. Job's syndrome
D. Treacher Collin syndrome
| Plummer-Vinson syndrome |
59ffc77f-3f4b-41ff-be1e-172d29ea1020 | CAGE Questionnaire The CAGE questionnaire basically consists of four questions: i. Have you ever had to Cut down on alcohol (amount)? ii. Have you ever been Annoyed by people's criticism of alcoholism? iii. Have you ever felt Guilty about drinking? iv. Have you ever needed an Eye-opener drink (early morning drink)? A score of 2 or more identifies problem drinkers. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 39 | Psychiatry | Substance abuse | CAGE test is used for diagnosis of
A. Opioid abuse
B. Schizophrenia
C. Alcoholism
D. Paranoid Psychosis
| Alcoholism |
1ee6b03a-979a-43ec-a992-28e7236d04cf | Catalse neutralizes residual H2O2 that interfers with composite bonding and polymerization. | Dental | null | After intracoronal bleaching immediate facial composite veneer is required, what should be done
A. Rinse with 3 % hydrogen peroxide and ultrasonics
B. Treat with catalase for 3 mins
C. Cannot be done at least for 7 days
D. Rinse with triple distilled water
| Treat with catalase for 3 mins |
b398d5d8-24d0-4853-b9f0-d6995ba2ff20 | Ans. (a) <500(Ref: Robbins 9th/pg 582)Neutropenia is denoted as ANC (absolute neutrophil count)ANC=100(%neutrophils+%bands)x(WBC) Mild neutropenia (1000>=ANC<1500): minimal risk of infectionModerate neutropenia (500>=ANC<1000): moderate risk of infectionSevere neutropenia (ANC<500): severe risk of infection.Agranulocytosis refers to a virtual absence of neutrophils in peripheral blood. It is usually applied to cases in which the ANC is lower than 100/mL | Pathology | Inflammation & Repair | Severe infection will increase if absolute neutrophil count will become?
A. <500
B. Less than 800
C. Less than 1000
D. Less than 2000
| <500 |
dc8f39b7-bda1-41c4-a014-0c434b810491 | In hemochromatosis, hypogonadism is caused by impairment of hypothalamic pituitary function and not due to deposition of Iron in the Testis.
Hemochromatosis
Hemochromatosis is characterized by the excessive accumulation of body iron, most of which is deposited in parenchymal organs such as liver and pancreas.
The total body content of the iron is tightly regulated, as the daily losses are matched by gastrointestinal absorption. In hereditary hemochromatosis, regulation of intestinal absorption of dietary iron is lost, leading to net iron accumulation of 0.5 to 1.0 gm/year.
It may be recalled that the total body iron pool ranges from 2-6 gm in normal adults; about 0.5 gm is stored in the liver 98% of which are hepatocytes. In hemochromatosis, the iron accumulation may exceed 50 gm, over one-third of which accumulates in the liver.
The iron accumulation is lifelong, the rate of net iron accumulation is 0.5 to 1.0 gm/year. The disease manifests itself typically after 20 gm of storage iron have accumulated. The disease first manifests itself in the fifth to sixth decades of life.
Excessive iron is directly toxic to host tissues
The clinical features of hemochromatosis are characterized principally by deposition of excess iron in the following organs in decreasing order of severity. | Pathology | null | Raised iron content is NOT found in which organ in Hemochromatosis -
A. Heart
B. Skin
C. Testis
D. Pituitary
| Testis |
5bd70ed5-327d-4a6d-b8a6-531b17312fb6 | Ans. is 'c* i.e., Ace inhibitorsSafe antihypertensive in pregnancyAntibypertensive avoided in pregnancyo Hydralazineo Methyldopao Labetalolo Dihvdropyridine calcium channel blockerso Cardioselective b-blockero Prazosino Clonidineo Diureticso ACE inhibitorso Nonselective b-blockerso Sodium nitroprussideo Reserpine | Pharmacology | Pregnancy | In pregnancy which of the following antihypertensive drug is contraindicated?
A. Hydralazine
B. Labetotlol
C. Ace inhibitors
D. Alpha methyldopa
| Ace inhibitors |
463f6db8-cdc5-48bd-8653-5b52562c2561 | (B) Dug well # Advantages of Dug well type of latrine are:> It is easy to construct and no special equipment such as an auger is needed to dig the pit> The pit has a longer life than the bore hole because of greater cubic capacity. A pit 75 cm (30 in.) diameter and 3 to 3.5 m (10-12 ft.) deep will last for about 5 years for a family of 4 to 5 persons.> When the pit is filled up, a new pit is constructed.> The action of the dug well latrine is the same as in the bore hole latrine, i.e., anaerobic digestion. | Social & Preventive Medicine | Miscellaneous | Best latrine for rural community is
A. Bore hole
B. Dug well
C. Water seal
D. septic tank
| Dug well |
0c9ad3bf-43f2-460d-9acb-7b824adf199f | (c) The right renal artery arises from the aorta, is longer than the left renal artery, and runs behind the IVC and the right renal vein. | Anatomy | Abdomen & Pelvis | Choose the appropriate lettered structure in this CT scan of the abdomen at the level of the upper lumbar vertebra. Which structure runs behind the IVC?
A. A
B. B
C. C
D. D
| C |
8e70d5a0-ca90-49bd-8da3-a22d115a56e2 | Answer D. Herpes gestationisThe presence of multiple yellow plaques on erythematous bases sparing the orbital regions is consistent with a diagnosis of herpes gestationis, a rare autoimmune disorder of pregnancy that affects newborns in only 5 to 10 percent of cases. The more common dermatitis of pregnancy -- pruritic urticarial papules and plaques of pregnancy -- does not involve the face. This presentation would not be consistent with the other listed choices. | Medicine | Infection | This 6-day-old infant's mother had developed intensely pruritic lesions at 33 weeks of gestation. What is the diagnosis?
A. Congenital syphilis
B. Epidermolysis bullosa acquisita
C. Neonatal gonorrhea
D. Herpes gestationis
| Herpes gestationis |
4ceea402-29d7-4c6a-9617-95d01dd219a5 | ANSWER: (C) Vitamin KREF: Harrison's 18th ed chapter 302Vitamin K deficiency in adults may be seen in patients with chronic small-intestinal disease (e.g., celiac disease, Crohn's disease), in those with obstructed biliary tracts, or after small-bowTel resection.Patients with liver disease may have an elevated prothrombin time because of liver cell destruction as wrell as vitamin K deficiency. If an elevated prothrombin time does not improve on vitamin K therapy, it can be deduced that it is not the result of vitamin K deficiency. | Surgery | Gall Bladder & Bile Ducts | Patient with hepatic insufficiency is being planned for surgery. Which vitamin deficiency has to be treated first?
A. Vitamin A
B. Vitamin D
C. Vitamin K
D. Vitamin E
| Vitamin K |
fa3cb46f-1e2a-4f44-a3ab-a18afa2defd8 | Antipsychotic drugs have Extrapyramidal symptoms- dur to D2 blockade in limbic system Extrapyramidal symptoms Clinical features Special DOC Malignant neuroleptic syndrome Fluctuating level of consciousness Hypehermia Muscles rigidity Increase level of CPK Increase level of liver enzyme Confusion Diaphoresis Most common cause of death in this syndrome is acute renal failure Most serious side effect Dantrolene | Psychiatry | Mood Disorders | A 31 - year - old male, with mood disorder, on 30 mg of haloperidol and 100 mg of lithium, is brought to the hospital emergency room with history of acute onset of fever, excessive sweating, confusion, rigidity of limbs and decreased communication for a day. Examination reveals tachycardia and labile blood pressure and investigations reveal increased CPK enzyme levels and leukocytosis. He is likely to have developed:
A. Lithium toxicity
B. Tardive dyskinesia
C. Neuroleptic malignant syndrome
D. Hypeensive encephalopathy
| Neuroleptic malignant syndrome |
43870e3b-c8d0-4868-955c-2cd632ab2f55 | Nontreponemal test (VDRL) detects mainly IgG, So cannot differentiate from passive maternal transfer Method to diagnose congenital syphilis is: A reactive IgM test specific for syphilis
19s IgM FTA-ABS, Captia syphilis M test (IgM ELISA) and Western blot | Microbiology | null | Congenital syphilis can be best diagnosed by -
A. IgM FTA- ABS
B. IgG FTA-ABS
C. VDRL
D. TPI
| IgM FTA- ABS |
f55d8147-93ab-4a09-95f4-f8fc5fcaf63f | Clinical Features Earliest symptom is urinary frequency. Tuberculosis of genital tract should be considered in the presence of following situations Chronic cystitis that refuses to respond to adequate treatment Sterile pyuria, gross or microscopic hematuria. Non- tender enlarged epididymis with beaded or thickened vas. Chronic draining scrotal sinus. Induration or nodulation of prostate and thickening of one or both seminal vesicle. | Surgery | Kidney and ureter | Earliest and often the only presentation of TB kidney is:
A. Increased frequency
B. Pain
C. Hematuria
D. Renal calculi
| Increased frequency |
eabfb292-e2d8-4f1b-926c-484a70a904aa | Paroxysmal nocturnal hemoglobinuria (PNH) is a disease that results from acquired mutations in the phosphatidylinositol glycan complementation group A gene (PIGA), an enzyme that is essential for the synthesis of ceain membrane-associated complement regulatory proteins.PNH blood cells are deficient in three GPI-linked proteins that regulate complement activity: (1) decay accelerating factor, or CD55; (2) membrane inhibitor of reactive lysis, or CD59; and (3) C8 binding protein.Of these factors, the most impoant is CD59, a potent inhibitor of C3 convease that prevents the spontaneous activation of the alternative complement pathway.Red cells deficient in these GPI-linked factors are abnormally susceptible to lysis or injury by complement and manifests as intravascular hemolysisRobbins pathology 9e pg: 642 | Pathology | General pathology | Paroxysmal nocturnal hemoglobinuria results from acquired mutations in
A. PML-RARA
B. BCL-2
C. NOTCH1
D. PIGA
| PIGA |
3ca03601-2ed7-459f-a7e9-b9b26bc7fdab | Ans. is 'b' i.e., Posteroinferior Myringotomyo Myringotomy is also known as myringocentesis, tympanostomy or tympanotomy. Myringotomy is a surgical procedure in which a small incision is made in the eardrum (tympanic membrane). Myringotomy is done to drain suppurative or nonsuppurative fluid (effusion) of middile ear or to provide aeration in case of nonfunctional eustachian tube.IndicationsAcute suppurative otitis mediaSevere earache with bulging tympanic membraneIncomplete resolution with opaque drum and persistent conductive deafnessComplications of acute otitis media, e.g. facial paralysis, labyrinthitis or meningitis with bulging tympanic membraneSerous otitis mediaAero-otitis media (to drain fluid and ""'unlock" the eustachian tube)Atelectatic ear (grommet is often inserted for long-term aeration)Incision sites for myringotomyo Two common incision sites are usedAnterior-inferior quadrantAlso known as anterior myringotomyUsed in cases of serous otitis media when grommet is to be insertedPostero-inferior q uad rantAlso known as posterior myringotomyUsed in cases of ASOMThis area is preferred because this is the most accessible area, relative less vascular and there are less chances of damage to ossicular chain. | ENT | Ear | ASOM to drain middle ear, incision is -
A. Anteroinferior
B. Posteroinferior
C. Anterosuperior
D. Posterosuperior
| Posteroinferior |
d811341d-3a9c-42e4-91a0-b40a89a3b3d2 | (B) Ziprasidone # Risperidone, a benzisoxazole derivative, is more potent at 5HT2 than D2 receptor sites, like clozapine, but it also exerts significant a2 antagonism, a property that may contribute to its perceived ability to improve mood and increase motor activity.> Risperidone is not as effective as clozapine in treatment resistant cases but does not carry a risk of blood dyscrasias.> Olanzapine is similar neurochemically to clozapine but has a significant risk of inducing weight gain.> Quetiapine is distinct in having a weak D2 effect but potent a1 and histamine blockade.> Ziprasidone causes minimal weight gain and is unlikely to increase prolactin, but may increase QT prolongation.> Aripiprazole also has little risk of weight gain or prolactin increase but may increase anxiety, nausea, and insomnia as a result of its partial agonist properties.ANTIPSYCHOTIC AGENTSNameUsualPOSide Effects Daily Dose, mgSedationCommentsClozapine(Clozaril)2 0 0 - 600Agranulocytosis (1%); weight gain; seizures; drooling; hyperthermia+ +Requires weekly WBCRisperidone (Risperdal) observed with doses >6 mg qd2-6Orthostasis+Requires slow titration; EPSEsOlanzapine(Zyprexa)10-20Weight gain+ +Mild prolactin elevationQuetiapine(Seroquel)3 5 0 - 700Sedation; weight gain; anxiety+ + +Bid dosingZiprasidone(Geodon)40-60Orthostatic hypotension+/+ +Minimal weight gain; increases QT intervalAripiprazole (Ability)10-30Nausea, anxiety, insomnia0/+Mixed agonist /antagonist | Medicine | Miscellaneous | One of the following drug causes least gain in weight
A. Quetiapine
B. Ziprasidone
C. Olanzapine
D. Risperidone
| Ziprasidone |
08526563-51a2-4f49-b28f-9197ad990af5 | 3 pathogens predominate in Acute Otitis Media: Strepto pneumoniae, H. influenzae & Moraxella catarrhalis. | Pediatrics | Impoant Bacterial Diseases in Children | Most common cause of acute otitis media in children is:
A. Strep pneumoniae
B. Strep pyogenes
C. Staph aureus
D. Pseudomonas
| Strep pneumoniae |
aa3db60d-f1ee-499f-aeab-09ec50a572db | Ans. a. Muscarinic receptors (Ref: KDT 7/e p459, 6/e p442)Tricyclic anti-depressants produce side-effects like dry mouth, urinary retention due to action on Muscarinic receptors.'Tricyclic antidepressants have anticholinergic side-effects, acts on muscarininc receptors, manifested as dry mouth, bad taste, constipation, epigastric distress, urinary retention (specially in males with enlarged prostate), blurred vision, palpitation.Side Effects of Tricyclic anti-depressants1. Anticholinergic:- Acts on muscarininc receptors, manifested as dry mouth, bad taste, constipation, epigastric distress, urinary retention (specially in males with enlarged prostate), blurred vision, palpitation.2. Sedation, mental confusion and weakness especially with amytryptiline and more sedative congeners.3. Increased appetite and weight gain is noted with most TCAs and trazadone. but not with SSRIs and bupropion.4. Some patients receiving any antidepressants may abruptly switch over to a dysphoric-agitated state or to mania.5. Sweating and fine tremors are relatively common.6. Seizure threshold is lowered-fits maybe precipitated, especially in children.7. Postural hypotension, especially in older patients8. Cardiac arrhythmias, especially in patients with ischemic heart disease- maybe responsible for sudden death in these patients.9. Rashes and jaundice due to hypersensitivity are rare. | Pharmacology | C.N.S | Tricyclic anti-depressants produce side-effects like dry mouth, urinary retention due to action on:
A. Muscarinic receptors
B. Nicotinic receptors
C. Adrenergic receptors
D. Serotonergic receptors
| Muscarinic receptors |
d3c2333b-eaea-402d-89ff-edbb9b0e97b3 | (Ref: KDT 6/e p282) Patient should be given both mineralocoicoids as will as glucocoicoid. Max.mineralocoimid activity - Aldosterone Max. glucocoicoid activity - Dexamethasone | Anatomy | Other topics and Adverse effects | A 50 year old man with advanced tuberculosis has developed signs/of severe acute adrenal insufficiency. The patient should be treated immediately with a combination of:
A. Aldosterone and fludrocoisone
B. Triamcinolone and dexamethasone
C. Coisol and fludrocoisone
D. Dexamethasone and metyrapone
| Coisol and fludrocoisone |
3c515a3e-e28c-4b34-8101-9ddabb2c5eba | Ans. is 'c' i.e., Inse a nasogastric tube Management of congenital diaphragmatic hernia o Earlier congenital diaphragmatic hernia was considered to be a surgical emergency. It was believed that the mass effect of herniated viscera is the major factor in cardiorespiratory compromise. o Now it is recognized that major cause of cardiorespiratory compromise is pulmonary hypeension and pulmonary hypoplasia. o So now the patient is initially resuscitated before surgery is performed. This resuscitation consists of a) Stabilization by mechanical ventilation with 100% 0, b) Nasograstric suction o Ventilation prevents the development of pulmonary hypeension and provide adequate oxygen delivery. Now days infants are ventilated by high frequency oscillation. o Nasogastric tube is used for suction to aspirate swallowed air and to prevent distension of the herniated bowel which would fuher compress the lung. o So both option 'c' & 'd' are preoperative procedures in congenital diaphragmatic hernia. The question is which should be performed fist. Remember that nasogastric suction is performed first in a case of CDH unless the patient presents with following symptoms ----> a) Cyanosis, b) Apnea, c) Respiratory disease o Here in the question the patient does not complain of any of the above symptoms so nasogastric suction should be the first priority. | Pediatrics | null | A new born baby has been referred to the casualty as a case of congenital diaphragmatic hernia. The first clinical intervention is to -
A. Inse a central venous pressure line.
B. Bag and mask ventilation
C. Inse a nasogastric tube
D. Ventilate with high frequency ventilator
| Inse a nasogastric tube |
b0d59e79-14c0-427a-bc3f-caa4b2753e69 | Ans. is 'a' i.e., Lateral border o MC site is middle of lateral border or the ventral aspect. | Surgery | Oral Cavity | Carcinoma tongue is most common at -
A. Lateral border
B. Dorsum
C. Posterior 1/3rd
D. Tip of tongue
| Lateral border |
4a5e8e14-9e1f-4478-ba13-925d01089067 | The unique characteristic of gastric secretion is its high concentration of hydrochloric acid, a product of the parietal cells. As the concentration of H+ rises during secretion, that of Na+ drops in a reciprocal fashion. K+ remains relatively constant at 5-10 meq/L. Chloride concentration remains near 150 meq/L, and gastric juice maintains its isotonicity at varying secretory rates. Acid secretion at the apical membrane is accomplished by a membrane-bound H+/K+-ATPase (the proton pump); H+ is secreted into the lumen in exchange for K+. Ref: Dohey G.M., Way L.W. (2010). Chapter 23. Stomach & Duodenum. In G.M. Dohey (Ed), CURRENT Diagnosis & Treatment: Surgery, 13e. | Physiology | null | Which of the following ion is exchanged in the stomach for H+ secretion?
A. Na+
B. K+
C. Ca+
D. Cl-
| K+ |
d904d359-0e3a-494f-9765-164445f01100 | Resins show response within → 1-2 hr
Insulin + Glucose shows response within → 15-30 minutes
Ca gluconate shows response within → minutes (less than 5 minutes)
B2 adrenergic shows response within → 30 minutes
NaHCO3 shows response within → 30 minutes
Hemodialysis is the most effective and rapid nlav of lowerine plasma potassiumQ | Medicine | null | Treatment of Acute Hyperkalemia -a) Ca gluconate givenb) Insulin & Glucose reduces hyperkaJemia within 4 hrsc) Dialysis not usefuld) Resin shows the response within minutese) IV NaHCO3 given
A. a
B. b
C. ae
D. ad
| ae |
0f63a5cd-059a-45fd-8ac5-1dd041796bac | psoriasis:-chronic Inflammatory skin disease.Genetic predisposition. Psoriasis susceptibility 1 (PSORS1) is the most impoant susceptibility locus. Clinical features:-1. Classic lesion-Well defined erythematous plaque with a silvery white scales.2. Size varies from pin point papules to plaques.3. The scales are loosely adhered,and on renoval of scales,coherent scaling can be seen as if one scratches a wax candle ( signe de la tache de bougie).4. On complete removal of scales,a red moist membrane ,Bulkeley membrane, seen.5. On fuher scraping,punctate bleeding points are seen.-Auspitz's sign.This occurs due to suprapapillary thinning and capillary dilatation.6. A surrounding ring of hypopigmentation seen ,Woronoff's ring, seen associated with the treatment and implies a good response to treatment impoant features of psoriasis- 1.erythematous scaly plaques covered with loosely adherent silvery scales. 2.auspitz sign 3.koebners phenomenon IADVL textbook of dermatology,page 1032 | Dental | Papulosquamous disorders | The impoant feature of psoriasis is -
A. Crusting
B. Scaling
C. Oozing
D. Erythema
| Scaling |
642a3ac2-1084-4afd-85cd-5c22c42da7f2 | Presence of uniocular diplopia together with finding of golden crescent on oblique illumination (edge of subluxated lens) or black crecent line on coaxial illumination (edge of subluxated lens) suggests a diagnosis of 'subluxation' of the crystalline lens. Ectopic lentis refers to displacement of lens from its normal position (subluxation, dislocation). (Ref: Ophthalmology by khurana 7th/e p.222 & (2005)/e p.24; Clinical Examination in by Mukherjee 2006/e p.166; Neema 6th/e p.285, 286) | Ophthalmology | Lens | A patient presents to the emergency depament with uniocular diplopia. Examination iwth oblique illunination shows golden crescent while examination with co-axial illumination show a dark crescent line. Which of the following is the most likely diagnosis -
A. Lenticonus
B. Coloboma
C. Microspherophakia
D. Ectopia lentis
| Ectopia lentis |
6f480190-a7db-4529-be2d-3fa71fa9a27e | Human anatomical wastes such as human tissues, organs, and body pas are classified as Waste Category No. 1. They are disposed in plastic bags with a yellow color code and treated by Incineration or deep burial. Ref: Park's Textbook Of Preventive And Social Medicine By K. Park, 19th Edition, Page 649; Park's Textbook Of Preventive And Social Medicine By K. Park, 18th Edition, Page 599 | Social & Preventive Medicine | null | What is the color-coding of bag in hospitals to dispose off human anatomical wastes such as body pas :
A. Yellow
B. Black
C. Red
D. Blue
| Yellow |
06152a61-2aa0-40ec-9ce6-cdc1aa928f3b | Ehlers danlos syndrome *A genetic defect in the synthesis of fibrillar collagen*Of all the types, type IV (vascular type) is the most severe form as it involves internal organs*Common type - Type VI (kyphoscoliosis type) caused due to a defect in lysyl hydroxylase*Type VII - defect in type 1 collagen*Type IV - Defect in type 3 collagen*Type I and II - Defect in type 5 collagen ( Ref: Robbins 8/e p146) | Pathology | General pathology | The most severe form of Ehler Danlos syndrome is
A. Type 1
B. Type 8
C. Type 4
D. Type 2
| Type 4 |
a530f011-89fd-4a5d-8c9a-620cf9de6eae | Double probe pH monitoring - Pharyngo-esophageal reflux. Esophageal PH monitoring - GERD Barium esophagogram - Frequently performed to diagnose problems related to esophageal and pharynx that present with symptoms like dysphasia. Radionuclide scintigraphy - Radiotracer injected into vein that travels to specific organ and emits gamma rays as it decays which is then recorded using Gamma camera. Used to detect normal functionality of the organ. | Surgery | DNB 2018 | Pharyngo-esophageal reflux is monitored by:
A. Esophageal pH monitoring
B. Double probe pH monitoring
C. Barium esophagogram
D. Radionuclide scintigraphy
| Double probe pH monitoring |
9b8feba2-ac12-48b5-bf81-0d341e4d35a4 | Ewing's sarcoma is typically characterized by a translocation t (11; 22) (q 24; q12) in up to 90% of patients. | Pathology | null | Which of the following is the most common mutation in Ewing's sarcoma -
A. Translocation X : 18
B. Translocation 11; 22
C. Activative mutation of G5alpha surface protein
D. Missense mutation in EXTI
| Translocation 11; 22 |
f7c494e0-1725-444c-b985-9e93b5d5fe9d | Delayed speech, difficulty in communication and concentration in a 3 year old child suggests the diagnosis of autism.
Autism
Autism is a neurologic disroder characterized by -
Qualitative impairment in social interaction
Qualitative impairment in communication.
Restricted repetitive and streotyped patterns of behaviour, interests, and activities. | Pediatrics | null | A 3 year old boy with normal developmental milestones with delayed speech and difficulty in communication and concentration. He is not making friends. Most probable diagnosis is –
A. Autism
B. ADHD
C. Mental retardation
D. Specific learning disability
| Autism |
35973051-096b-4b0f-8b09-cd7ea208aaa0 | Gout
Gout is the common endpoint of a group of disorders that produce hyperuricemia.
It is marked by transient attacks of acute arthritis initiated by crystallization of monosodium urate into the joints, leading eventually to chronic gouty arthritis and deposition of masses of urates in joints and other sites, creating top
Most common joint involved in gout is a big toe, i.e. metatarsophalangeal joint of the great toe. | Pathology | null | Tophus is the pathognomic lesion of which of the following condition -
A. Multiple myeloma
B. Cystinosis
C. Gout
D. Eale's disease
| Gout |
037bead8-d504-4608-a6de-f05c37256d98 | Ans. is 'a' i.e., INH Adverse effects of INH Peripheral neuritis (most common), hepatitis, optic neuritis & atrophy, seizure, ataxia, muscle twitching, toxic encephalopathy, psychoses, rashes, fever, ahralgia, acne, lupus like syndrome, hemolytic anemia in G6PD deficiency. Note: Most common antitubercular drug which is implicated in causing peripheral neuropathy is INH. | Pharmacology | null | Neuropsychiatry symptoms are seen with which anti TB drug ?
A. INH
B. Rifampicin
C. Pyrazinamide
D. Streptomycin
| INH |
bee8a237-6047-40f4-bacd-b0c0f97bd8ac | About Pre-op shaving Bailey writes - "Pre-op shaving should be avoided except for aesthetic reasons or prevent adherence of dressing. If it is to be done, it should be undertaken immediately before surgery as there is a higher infection rate when it is performed the night before, because minor skin injury enhances superficial bacterial colonisation."
Farquharson op. surgery also supports the above view and writes that pre op shaving can be done to get a clear view but it does not reduce infection.
Steps for Reducinj Wound infection
1) Prophylactic antibiotics
is based on the concept that bacterial contamination occurs during surgery, and that the administration of the antibiotic used for prevention must be timed for optimal blood levels during the operations.
antibiotics are administered by intravenous route at the time of induction of anaesthesia
Monofilament sutures are used over polyfilament sutures to prevent infection.
Proper apposition of the wound and prevention of any dead space and hematomas.
Proper washing of hands with a detergent solution containing added chlorhexidine or an iodine based antiseptic.
Bowel preparation for intraabdominal surgeries
Skin preparation with an antiseptic solution
Elimination of any foreign body or dead tissue from the wound. | Surgery | null | Prevention of wound infection is done by :a) Pre op shavingb) Pre op antibiotic therapyc) Monofilament sutured) Wound apposition
A. abc
B. acd
C. ac
D. bcd
| bcd |
6d2c4b8c-577f-4b92-afe0-2202c21830ea | FUNCTIONAL RESIDUAL CAPACITY = ERV + RV The volume of air that remains in lungs at the end of normal expiration = 2300 ml | Physiology | DNB 2018 | What is FRC?
A. Volume present in lungs after normal expiration
B. Volume present in lungs after forceful expiration
C. Volume present in lungs after deep inspiration
D. Volume present in lungs after normal inspiration
| Volume present in lungs after normal expiration |
e96d9400-9093-46c8-91ef-0fb6c3496401 | Ans. is 'b' i.e., Encodes proteins of respiratory chain o Human mitochondria contain two to ten copies of a small circular double-stranded DNA molecule that makes up approximately 1% of total cellular DNA. The majority of the peptides in mitochondria (about 54 out of 67) are coded by nuclear genes. The rest are coded by genes found in mitochondrial (mt) DNA.This mtDNA codes for mt ribosomal and transfer RNAs and for 13 proteins that play key roles in the respiratory chain.Some Major Features of the Structure and Function of Human Mitochonrial DNAo Is circular, double-stranded, and composed of heavy (H) and light (L) chains or strands,o Contains 16,569 bp.o Encodes 13 protein subunits of the respiratory chain (of a total of about 67) -y Seven subunits of NADH dehydrogenase (complex I)y Cytochrome b of complex IIIy Three subunits of cytochrome oxidase (complex IV)y Two subunits of ATP synthaseo Encodes large (16S) and small (12S) mt ribosomal RNAso Encodes 22 mt tRNA moleculeso Genetic code differs slightly from the standard code -y VGA (standard stop codon) is read as Trp.y AGP and AGG (standard codons for Arg) are read as stop codons,o Contains very few untranslated sequences,o High mutation rate (5 to 10 times that of nuclear DNA).o Comparisons of mtDNA sequences provide evidence about evolutionary origins of primates and other species. | Biochemistry | Structure of DNA | Function of mitochondrial DNA -
A. Encodes proteins of cell membrane
B. Encodes proteins of respiratory chain
C. Helps in cell replication
D. Formation of rRNA
| Encodes proteins of respiratory chain |
7eeca842-7150-4dc0-9173-ab4fa1afa79a | Prilocaine and benzocaine can cause methemoglobinemia. | Anaesthesia | null | Local anaesthesia causing methemoglobinemia –
A. Procaine
B. Prilocaine
C. Etodicaine
D. Ropivacaine
| Prilocaine |
59badf12-c5d9-4790-9116-54c8c0237718 | Ans. is 'c' Cochlear implant Any person who fails to benefit from hearing aids in given , cochlear implant. Here the child does not benefit from hearing aid so he should be given cochlear implant.Note : Make sure that the patient is not prelingually deaf because Cochlear implants are not useful in prelingually deaf patient. | ENT | Hearing Loss | A child aged 3 yrs, presented with severe sensorineural deafness was prescribed hearing aids, but showed no improvement. What is the next line of management:
A. Fenestration surgery
B. Stapes mobilisation
C. Choclear implant
D. Conservative
| Choclear implant |
10285f15-d722-4df7-bf62-39d8e05e7426 | Retinopathy of Prematurity (ROP) Screening is done in
Preterm babies < 32 weeks of gestation
Babies with birth weight < 1.5 kg
Preterm babies of 32 - 34 weeks of gestation
Babies with birth weight 1.5 - 2 kg
Preterm babies of 32-34 weeks and babies with birth weight 1.5-2kg should have had bad neonatal course like:
a) Ventilatory support
b) O2 supply for > 24 hours
c) Ionotrope support for condition like shock
d) Blood transfusion
e) Culture positive sepris. | Pediatrics | null | Retinopathy of Prematurity (ROP) screening is done in the following babies
A. Preterm < 34 weeks of gestation
B. Preterm of 33 weeks of gestation who required mechanical ventilation
C. Babies with birth weight < 1.8 kg
D. Babies with birth weight < 2 kg
| Preterm of 33 weeks of gestation who required mechanical ventilation |
d0eb33a7-526e-4852-bfc3-b706c70febb7 | C. albicans is a major cause of vulvovaginitis. Patient presents with " cottage - cheese like" vaginal discharge. C. granulomatis causes granuloma inguinale. Chancroid results in painful genital ulcers and is caused by the organism H. ducreyi. HSV type 2 can cause genital vesicular lesions. N. meningitidis can cause meningitis. | Pathology | Female genital Tract | A 56-year-old diabetic woman has recently been treated with a 2-week course of antibiotics for a skin infection. She returns to the clinic for follow-up with a new complaint of a "cottage cheese-like" vaginal discharge with significant vaginal itching. The most likely cause of these symptoms is
A. C. granulomatis.
B. C. albicans.
C. Chancroid.
D. Neisseria meningitidis.
| C. albicans. |
05833e5b-1666-4af6-8fc7-3d8ce6ff239c | Ans. B: Osteogenic sarcoma Of the primary bone malignancies, multiple myeloma is the commonest Osteosarcoma is the second most common, and a highly malignant primary bone tumour Osteosarcoma: Metaphyseal MC site: Lower end of femur Sunburst appearance Codman's triangle Pa:ient may present with metastasis to lungs Treefment: Chemotherapy + limb salvage surgery | Surgery | null | Most common primary bone tumour in adult bone is: March 2011
A. Chondrosarcoma
B. Osteogenic sarcoma
C. Adamantinoma
D. Ewings sarcoma
| Osteogenic sarcoma |
33734b3f-2817-4407-8888-8014d50e97c4 | Refer Maheshwari 6th/e 94 Most of the closed fractures can be treated by hanging cast from shoulder to wrist with the elbow flexed to 90 degree Other methods of conservative Treatment areU-slab,chest arm bandage and functional castbrace | Anatomy | General anatomy | Hanging cast is used in
A. Femur
B. Radius
C. Tibia
D. Humerus
| Humerus |
f23e7490-e8ef-4cc2-b3ac-287a992a969a | A i.e. Hea beat USG of umbilical aery is done to know about hea beatQ. | Radiology | null | Ultrasonogrsphy of umbilical aery is done to know about
A. Hea beat
B. Gastational age
C. Fetalweight
D. Fetal maturity
| Hea beat |
a2b22c0d-5cae-4472-8dd8-9c8aff85f9c7 | Oligospermia The Semen Analysis of the patient shows : Sperm count is 15 million/ml. PH = 7.5 Volume = 2 ml Morphology = 60% normal Normal should be at least 20 million/ml i.e. this patient is oligospermic (N = > 7.2) N = at least 2 ml N = 50% Normal Morphology So, all criteria are normal except sperm count (to be specific sperm concentration) which is less than normal and therefore most likely diagnosis is oligospermia. | Gynaecology & Obstetrics | null | A 25 year old infeile male underwent semen analysis. Results show : sperm count - 15 million/ml ; pH - 7.5 ; volume - 2 ml ; no agglutination is seen. Morphology shows 60% normal and 60% motile sperms. Most likely diagnosis is :
A. Normospermia
B. Oligospermia
C. Azoospermia
D. Aspermia
| Oligospermia |
3a7ac283-6691-49cd-ae89-90cbea9a58b3 | Convergence [Ref: Divergence and convergence are two evolutionary processes by which organisms become adapted to their Convergence has been defined as the acquisition of morphologically similar traits between distinctly unrelated environments. organisms. Convergence occurs at every level of biological organization. Functional Convergence Mechanisticechanistic convergence convergence occurs when the sequence and structure of molecules are very different but the M This refers to molecules that serve the same function but have no sequence or structural similarity and carry out their function by entirely different mechanisms. mechanisms by which they act are similar. Structural Convergence This refers to molecules with very different amino acid sequences that can assume similar structural motifs, which may carry out similar functions. Sequence Convergence In sequence convergence, one or more critical amino acids or an amino acid sequence of two proteins come to resemble each other due to natural selection. (In protein evolution, sequence divergence, rather than sequence | Biochemistry | null | Different sequence of amino acids having similarstructure of proteins is an example of
A. Divergence
B. Convergence
C. Oppounistic
D. Incidental
| Convergence |
9bec300e-5b51-49cd-ba97-502b09b13497 | A thymoma is a tumor originating from the epithelial cells of the thymus that may be benign or malignant. Thymomas are frequently associated with the neuromuscular disorder myasthenia gravis;thymoma is found in 20% of patients with myasthenia gravis. Once diagnosed, thymomas may be removed surgically | Pathology | Haematology | A patient presents with mediastinal mass with sheets of epithelial cells giving arborizing pattern of reactivity alongwith interspersed lympoid cells. The apt diagnosis would be -
A. Thymoma
B. Thymic carcinoid
C. Primary mediastinal lymphoma
D. Non-Hodgkin lymphoma
| Thymoma |
f27ff32b-b945-4fb6-b735-8a888a4760a0 | Ans. is 'a' i.e., Depressed pacemaker activity o Local anaesthetics block cardiac sodium channels and thus depress abnormal cardiac pacemaker activity, excitability, and conduction. At extremely high concentrations, local anaesthetics can also block calcium channels. | Pharmacology | null | Cardiotoxicity of bupivacaine -
A. Depressed pacemaker activity
B. Toxic compound damaging myocardial cells
C. Depressed neural control on hea
D. Vascular thrombosis and Myocardial ischemia
| Depressed pacemaker activity |
f0341f6f-74c7-4633-9567-a6ca17f925ac | Ans. is 'c' i.e., Sigmoid sinus thrombosiso Contrast-enhanced CT scan can show sinus thrombosis by typical delta-sign. It is a triangular area with rim enhancement, and central low density area is seen in posterior cranial fossa on axial cuts.o Delta-sign may also be seen on contrast enhanced MRI.Lateral sinus thrombosis (sigmoid sinus thrombosis)o Lateral or sigmoid sinus thrombophlebitis arises from inflammation in the adjacent mastoid. It may occur as a complication of: -Acute coalescent mastoiditisCSOM and cholesteatomaClinical featureso Hectic Picket-Fence type of fever with rigor.o Headache, Progressive anemia and emaciation.o Griesinger's sign :- odema over the posterior part of mastoid due to thrombosis of mastoid emissary veins. o Papilloedemao Tobey-Ayer test:- Compression of vein on the thrombosed side produces no effect while compression of vein on healthy side produces rapid rise in CSF pressure which will be equal to bilateral compression of jugular veins.o Crowe-Beck test:- Pressure on jugular vein of healthy side produces engorgement of retinal veins. Pressure on affected side does not produce such change.o Tenderness along jugular veinImaging studieso Contrast-enhanced CT scan can show sinus thrombosis by typical delta-sign. It is a triangular area with rim enhancement, and central low density area is seen in posterior cranial fossa on axial cuts.o Delta-sign may also be seen on contrast enhanced MRI. | ENT | CSOM and its Complications | Delta-sign is seen in -
A. Petrositis
B. Acute mastoiditis
C. Sigmoid sinus thrombosis
D. Glomus tumor
| Sigmoid sinus thrombosis |
ff06e0a5-414a-4cc2-af05-4b82803d7686 | Answer is B (Esophagus varices) 'Massive haematemesis in the background of splenomegaly suggests variceal bleed due to poal hypeension.' | Medicine | null | A young patient presenting with massive hematemesis was found to have splenomegaly. In this case the most likely source of bleeding is:
A. Duodenal ulcer
B. Esophageal varices
C. Erosive mucosal disease
D. Gastric ulcer
| Esophageal varices |
0e4eda90-3a5c-4f11-a5ac-49c99eb9190c | B i.e. CalcitoninCalcitonin, a hormone secreted by parafollicular cells or C cellQ of thyroid gland, lowers the serum calcium levelQ. Effect of Hormone on Calcium & Phosphate LevelHormoneSerum CalciumSerum phosphateVit DIncreasesQIncreaseQPTHIncreasesQDecreaseQCalcitoninDecreasesQDecreaseQ | Physiology | null | Which of these can cause hypocalcemia:
A. Thyroxine
B. Calcitonin
C. Calcitonin
D. Choloecalciferol
| Calcitonin |
37327128-74b8-4f7c-827b-fa6536e7721b | All of the above drugs belong to ester group of local anesthetics. All ester are metabolized in plasma except cocaine which is metabolized in liver. | Pharmacology | null | Which of the following local anesthetic is metabolized by liver
A. Procaine
B. Cocaine
C. Benzocaine
D. Chlorprocaine
| Cocaine |
977913c9-1c7d-453d-9aa3-cf414cecdc0b | The middle cardiac vein commences at the apex of the hea; ascends in the posterior longitudinal sulcus, and ends in the coronary sinus near its right extremity. | Anatomy | null | The middle cardiac vein is located in the?
A. Anterior interventricular sulcus.
B. Posterior interventricular sulcus.
C. Posterior AV groove.
D. Anterior AV groove.
| Posterior interventricular sulcus. |
c0feba02-b74c-4149-b3cf-7956fc5f4635 | Ans. is d, i.e. Perform an ultrasound scan for fetal abnormalities and screen for aneuploidy Before answering the question lets discuss a few details on cervical cerclage surgery.Nomenclature for cerclage applicationOld (1999)New (2007)Prophylactic, electiveHistory indicatedTherapeutic, salvageUltrasound indicatedRescue, emergency urgentPhysical examination indicatedRecommendations for history indicated cerclageShould be offered to women with 3 or more previous preterm births and/or second trimester lossesShould not be routinely offered to women with two or fewer previous preterm birth and/or second trimester losses (Level B evidence)Recommendations for USG indicated cerclageWomen with history of 1 or more spontaneous preterm births or/mid trimester losses with Y, V or U detected on USG or cervical length <25mm before 24 weeks-Not recommended for women without a history of spontaneous preterm delivery or second trimester losses with incidentally detected cervical length <=25mm-Not recommended for funneling of cervix in the absence of cervical shortening to <=25mm A cervical cerclage should be carried out in her as she has H/O 3 previous preterm deliveries.An ultrasound scan for fetal abnormalities and screening for aneuploidy should be carried out, before insertion of a history- indicated suture, to ensure both viability and the absence of lethal/major fetal abnormalities. Assessment of cervical length is not indicated before applying a history indicated cerclage. It is not essential to perform a white cell count or C-reactive protein levels before performing a cervical cerclage. | Gynaecology & Obstetrics | Normal Labour | Which of the following investigations are essential before cervical cerclage is performed?
A. Estimate C-reactive protein levels
B. Perform a white cell count
C. Perform a transvaginal ultrasound scan to assess the cervical length and exclude funnelling
D. Perform an ultrasound scan for fetal abnormalities and screen for aneuploidy
| Perform an ultrasound scan for fetal abnormalities and screen for aneuploidy |
de02a458-354e-49ee-9ba0-3a93dc731ee1 | Pilocarpin is a miotic by acting on iris sphincter muscle. Pilocarpine is a parasympathomimetic drug. It is a non-selective muscarinic receptor agonist in the parasympathetic nervous system, which acts at the muscarinic acetyl choline receptor M3. It also acts on ciliary muscles to open up trabecular meshwork, hence increase the drainage of aqueous humor, thus decreasing the intraocular pressure. So it is useful in glaucoma also. Atropine, homatropine, tropicamide are mydriatics. | Ophthalmology | null | Which one of the following is not a mydriatic?
A. Pilocarpin
B. Atropine
C. Homatropine
D. Tropicamide
| Pilocarpin |
5b263ae8-5a6e-4255-9784-730db66aa6a4 | 38 weeks Historically obstetric cholestasis was thought to be benign disease. Biochemical abnormalities and pruritus in obstetric cholestasis persists until delivery following which resolution occurs. - Pruritus usually improves within 1 week liver function tests returns to normal in 3-7 days in the majority and 4-6 weeks postnatally in the remainder. Adverse obstetric outcomes with cholestatic pregnancy was .first quantified by Fisk who repoed an overall perinatal moality of 70 per 100 live bih and intrauterine deaths of 30 per 1000 pregnancies. - There is an increased risk of intrauterine death, classically. .from 37 weeks gestation, an increased risl of ineconium passage and increased risk of preterm labour. - The mechanism of intrauterine death is unceain but is likely to be related to a toxic effect on the fetus. This resulted in a policy of active management for obstetric cholestasis. - "With active management and elective delivery at 37 to 38 weeks, the perinatal moality reduced to zero". | Gynaecology & Obstetrics | null | At what gestational age should a pregnancy with cholestasis of pregnancy be terminated
A. 34 weeks
B. 36 weeks
C. 38 weeks
D. 40 weeks
| 38 weeks |
5e3e1f1e-9e1b-40b5-a4c6-24cbf0afb14b | Acid-fast staining
After staining with aniline dye, acid-fast organisms resist decolourisation with acids.
The method most commonly used is modified Ziehl Neelsen. | Microbiology | null | The method used for acid-fast staining -
A. Robertson’s method
B. Ziehl Neelsen
C. Silver impregnation method
D. Dark ground illumination
| Ziehl Neelsen |
efd80ac7-89dc-4dfd-ac10-68a9cd63d6bd | Ans. is 'd' Avascular Necrosis Avascular necrosis of the talar body, resulting from interruption of the precarious vascular supply to the talus, is the most dreaded late complication after talar neck fractures. The risk of developing avascular necrosis in a Hawkins type I fracture is only 0% to 15%, since only the blood supply entering through the neck is disrupted. Hawkins type II fractures have a 20% to 50% risk of avascular necrosis, with the artery of the tarsal canal and the dorsal blood supply from the neck being disrupted. Type III and IV fractures have a 69% to 100% risk of avascular necrosis, with all 3 main sources of blood supply damaged. Greater displacement, comminution, and open fractures could increase the likelihood of developing avascular necrosis. Avascular necrosis of the body weakens the talar trochlea, subjecting it to collapse if full weight bearing is allowed in the presence of avascular necrosis. Whether collapse of the talar dome is partial or full, the subsequent degenerative changes lead to pain and disability in both the ankle and subtalar joints, along with shortening of the affected leg. Malunion and Nonunion Talar neck fractures frequently develop malunion and nonunion, leading to decreased range of motion. The incidence of malunion has been reported to be approximately 30%, and the incidence of nonunion is approximately 2.5%. Typical findings of malunion are varus malalignment of the talar neck and deformity of the medial column. Sangeorzan et al stressed that malalignment of only 2 mm results in significant changes in the subtalar contact characteristics that could lead to the progressive development of posttraumatic arthritis. Posttraumatic Arthritis Long-term follow-up studies have shown high rates of posttraumatic arthritis after talar neck fractures. Causes of posttraumatic arthritis may be multifactorial, and may include damage to articular cartilage at the time of injury, progressive cartilage degeneration from fracture malunion, nonunion causing malalignment and incongruence, or osteonecrosis. The incidence of posttraumatic arthritis after talar neck fractures ranges from 50% to 100%, and is a more common finding than osteonecrosis. The arthritis primarily involves the subtalar joint, but may also affect the ankle and talonavicular joints. The subtalar joint is prone to arthritis because the calcaneus slides past the talus during dislocation, causing compressive and shearing forces that may result in injury to the cartilage.Not all cases of posttraumatic arthritis become symptomatic. The development of severe arthrosis causing chronic pain and stiffness may necessitate arthrodesis if conservative treatment is ineffective. | Orthopaedics | Injuries of the Foot | Most common complication, of talus fracture is
A. Avascular necrosis
B. Non union
C. Osteoarthritis of ankle joint.
D. Osteoarthritis of subtalar joint.
| Osteoarthritis of subtalar joint. |
d426810d-4800-40ca-9b90-39da41bf5993 | Macrocytic anemia - In it RBC's are larger in size than their normal size Causes:- -Vitamin B12 deficiency -Folic acid deficiency -Alcoholism WITH REGARD TO OTHER OPTIONS: Normocytic anemia (option a):Causes of normocytic anemia include acute blood loss, apoplastic anemia (bone marrow failure), haemolytic anemia (abnormal breakdown of RBC's). Microcytic anemia(option c):Majority of microcytic anemia are result of insufficiency in haemoglobin synthesis or failure in haemoglobin synthesis or both. For e.g. iron deficiency. Dimorphic anemia (option d): In Dimorphic Anemia, two distinct forms of red cell populations exist. It can occur when iron deficiency anemia responds to iron therapy, after the transfusion of normal blood to a patient with Hypochromic Anemia and in Sideroblastic Anemia. | Biochemistry | Vitamins and Minerals | What type of anemia is seen in B12 deficiency:
A. Normocytic
B. Macrocytic
C. Microcytic
D. Dimorphic
| Macrocytic |
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