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27b53fcd-e646-4d9e-8aab-b61894f7a753 | Ans. is 'a' i.e., Hyponatremia TUR syndrome and water intoxication syndrome are same. They are caused due to dilutional hyponatremia. | Surgery | null | T.U.R. (transurethral resection) syndrome is due to ?
A. Hyponatremia
B. Hypokalemia
C. Hypovolaemia
D. Hypoxia
| Hyponatremia |
70a0c6a3-9662-4397-9ce4-561fb1be21e3 | Bleomycin: This is a mixture of closely related glycopeptide antibiotics having potent antitumour activity. It chelates copper or iron, produces superoxide ions and intercalates between DNA strands-causes chain scission and inhibits repair . It is highly effective in testicular tumour and squamous cell carcinoma of skin, oral cavity, head and neck, genitourinary tract and esophagus; also useful in Hodgkin&;s lymphoma. Mucocutaneous toxicity and pulmonary fibrosis, but little myelosuppression are the special features. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:826,827 | Pharmacology | Chemotherapy | Pulmonary fibrosis is seen with:
A. Bleomycin
B. Cisplatin
C. Methotrexate
D. Actinomycin D
| Bleomycin |
cf0abac0-e2a6-40ab-9635-d6742ddfe74e | Atlanto - occipital (between the skull and C1) joint permit nodding of the head (as when indicating approval or yes) and Atlanto-axial joint permits the head to be turned from side to side i.e. rotation (as indicating disapproval, the no movement). | Anatomy | null | The movement at the following joint permits a person to look towards the right or left -
A. Atlanto - occipital joint
B. Atlanto - Axial joint
C. C2-C3 joint
D. C3-C4 joint
| Atlanto - Axial joint |
2c8e8a0f-0b5f-45c7-8b63-242fb584f612 | Lipoprotein lipase deficiency (Type I hyperlipoproteinemia): is a rare, autosomal recessive disorder caused by a deficiency of lipoprotein lipase.Resulting in fasting chylomicronemia and hyperiglycerolemia.There is slow clearance of chylomicrons and VLDL. Low levels of LDL and HDL. There is no increased risk of coronary disease. Lipoprotein lipase (LPL): is a glycoprotein anchored to proteoglycans that decorate the capillary endothelial surfaces of adipose tissue, hea and skeletal muscle. The triglycerides of chylomicrons are hydrolyzed by LPL, and free fatty acids are released. ApoC-II, which is transferred to circulating chylomicrons from HDL, acts as a cofactor for LPL in this reaction. LPL deficiency has autosomal recessive inheritance. Both LPL and apoC-II deficiency usually present in childhood with recurrent episodes of severe abdominal pain due to acute pancreatitis. Deficiency leads to Increase TG & Increase Chylomicrons Chylomicrons are grossly increased and there is slow clearing of chylomicrons VLDL is also increased (but chylomicrons dominate). Decrease in LDL and Hdl DL Hyperlipoproteinemias Disease Inheritance Defect Elevated Lipoproteins and lipids Familial lipoprotein lipase deficiency (type I) AR Deficiency of LPL, abnormal LPL, or apo C-II deficiency causing inactive LPL. Increased TG and chylomicrons Slow clearance of chylomicrons and VLDL. Low levels of LDL and HDL. No increased risk of coronary disease. Familial hypercholesterolemia (type IIa) AD Defective LDL receptors or mutation in ligand region of apo B-100. Increased cholesterol Elevated LDL Results in atherosclerosis and coronary disease. Familial combined hyperlipidemia (type IIb) Unknown Excessive VLDL secretion from increased ApoB100 and LDL (decreased LDL receptor) Increased LDL and VLDL. Familial type III hyperlipoproteinemia (broad beta disease, remnant removal disease, familial dysbetalipoproteinemia Deficiency in remnant clearance by the liver is due to abnormality in apo E. Patients lack isoforms E3 and E4 and have only E2, which does not react with the E receptor. Increase in chylomicron and VLDL remnants of density < 1.019 (VLDL). G and cholesterol Causes hypercholesterolemia, xanthomas, and atherosclerosis. Familial hyperiacylglyceridemia (type IV) AD Overproduction of VLDL often associated with glucose intolerance and hyperinsulinemia. Cholesterol levels rise with the VLDL concentration. LDL and HDL tend to be subnormal. This type of pattern is commonly associated with coronary hea disease, type II diabetes mellitus, obesity, alcoholism, and administration of progestational hormones. Endogenous hyperiglyceridemia (Type V) Chylomicrons and VLDL Glucose intolerance and hyperuricemia Ref: Chatterjee Shide. 4th Editon, p374 | Biochemistry | null | Which of the following is increased in lipoprotein lipase deficiency?
A. VLDL
B. LDL
C. HDL
D. Chylomicrons
| Chylomicrons |
4645d219-6726-4669-8dbe-1df25763f0aa | Hepatitis B is more severe&protracted&high chance of moality REF:<\p> MICROBIOLOGY ANANTHA NARAYANAN NINTH EDITION PAGE.542 | Microbiology | Virology | Which of the following hepatitis has a poor prognosis -
A. Hepatitis A
B. Hepatitis B
C. Non-A Non-B type
D. Hepatitis C
| Hepatitis B |
f3599e9f-66d1-4d1b-9501-b22fef1915e6 | Ans. is 'a' i.e., Inflammation of anal gland | Surgery | null | Most common cause of anorectal abscess is ?
A. Inflammation of anal gland
B. Folliculitis
C. Inflammation of rectal mucosa
D. Rectum
| Inflammation of anal gland |
c6417cf2-291a-4eb1-ae5a-daf3b7c7d7c6 | MC site of brain metastases (85%) CEREBRUM2nd MC site of brain metastases- CEREBELLUM LUNG, BREAST, MELANOMA (SKIN CANCER), COLON AND KIDNEY cancers commonly spread to the brain.(Refer: Nelson's Textbook of Pediatrics, SAE, 1st edition, pg no. 2460) | Pediatrics | All India exam | The most common site of brain metastasis is
A. Cerebrum
B. Cerebellum
C. Medulla oblongata
D. Pons
| Cerebrum |
9a889b7c-dfd1-4bfa-88ac-91f96ef3f542 | STREPTOCOCCAL INFECTIONS * Gram-positive bacteria arranged in chains or pairs . * Not pa of normal cutaneous flora (but resident of aerodigestive tract and vagina). * Classification two methods: a) Ability to induce hemolysis (a, b, g) and/or b) Lancefield groups (A-D, G) based on characteristic polysaccharide cell wall * Of note, group A b-hemolytic streptococci (S. pyogenes, GAS) most pathogenic. Erysipelas (St. Anthony's Fire):- * Superficial type of cellulitis with significant dermal lymphatic involve-ment; typically due to GAS. * Presents as a well-defined, bright red indurated plaque with sharp, raised borders commonly on the face or legs, +- constitutional symptoms. Treatment of choice:- Penicillin (PCN) (if PCN allergic can use macrolide). Ref:- Sima Jain; pg num:-206 | Dental | Bacterial infections | Erysipelas is a skin infection often caused by
A. Erysipelothrix rhusiopathiae
B. Streptococcus pyogenes
C. Pseudomonas aeruginosa
D. Trichophyton rubrum
| Streptococcus pyogenes |
fdbb8246-63db-47ea-b5e9-30b791e517c4 | -30 to +90 REF: Harrison's Internal Medicine 17th edition chapter 221 The hea's electrical axis refers to the general direction of the hea's depolarization wavefront (or mean electrical vector) in the frontal plane. With a healthy conducting system the cardiac axis is related to where the major muscle bulk of the hea lies. Normally this is the left ventricle with some contribution from the right ventricle. It is usually oriented in a right shoulder to left leg direction, which corresponds to the left inferior quadrant of the hexaxial reference system, although -30deg to +90deg is considered to be normal | Surgery | null | Normal axis of hea is?
A. -30 to +90
B. +90 to 120
C. +120 to -30
D. 60 to - 60
| -30 to +90 |
3bcf953e-670c-4c34-98c0-b5fff374823b | To control alkalosis, kidney secretes excess bicarbonate. Due to hyponatremia, body conserves sodium and so bicarbonate is secreted along with the hydrogen in. Urine becomes acidic and called as paradoxical aciduria Reference: SRB edition: 5th page no:830 | Surgery | G.I.T | Metabolic abnormality seen in congenital hyperophic pyloric stenosis is
A. Hypochloremic hypokalemic metabolic alkalosis
B. Hyperchlonemic hypokalemic metabolic alkalosis
C. Hypochloremic hypokalemic metabolic acidosis
D. Hyperchoremic hypokalemic metabolic acidosis
| Hypochloremic hypokalemic metabolic alkalosis |
030a4e7d-1f9b-41de-9371-ca8bec7a442d | Ans. is 'a' i. e., Atrio ventricular nodal reentrant tachycardia Wolf - Parkinson - White Syndrome* The diagnosis of Wolf - Parkinson - White Syndrome is reserved for patients who have both preexcitation and tachydysrhythmia.* Ventricular pre excitation causes an earlier than normal deflection of the QRS complex called a delta wave.* Atrio ventricular nodal reentrant tachycardia (AVNRT) is the most common tachydysarhythmia in WPW syndrome patients. It accounts for 95% of the dysrhythmias seen with these patients. Orthodromic AVNRT is much more common than antidromic. | Medicine | C.V.S. | The most common reentrant tachycardia associated with WPW syndrome is -
A. Atrio ventricular nodal reentrant tachycardia
B. Atrial fibrillation
C. Atrial flutter
D. Atrio ventricular reciprocating tachycardia.
| Atrio ventricular nodal reentrant tachycardia |
e001167b-9b67-4e19-a60b-366e8a86592a | Congenital cataract is cause due to defects in CRY GS3 gene. During embryonic development, the PAX6 protein is thought to turn on (activate) genes involved in the formation of the eyes. Aniridia is caused by mutations in the PAX6gene. SIX 5-Mutations in this gene are a cause of branchiootorenal syndrome type 2. PITX 3-This gene encodes a member of homeodomain proteins.Mutations of this gene have been associated with anterior segment mesenchymal dysgenesis and congenital cataracts. | Ophthalmology | Cataract | Congenital cataract occurs due to abnormalities in protein formation in which of the following genes?
A. PAX 6
B. SIX 5
C. CRY GS 3
D. PITX 3
| CRY GS 3 |
96b69e9d-3df3-4abe-8637-22c95ac81c89 | Binding of transcription regulatory proteins to DNA is regulated by several motifs :
Helix turn helix
Leucine zipper
Zinc finger
Binding motif for steroid receptor family & thyroid (nuclear) receptor family is a zinc finger.
In proteins with zinc - finger motif, the binding site is repeated 2-9 times.
Proteins with helix-turn-helix and leucine zipper motifs form symmetrical palindromes and their DNA binding sites are symmetrical palindromes.
In leucine - zipper motif, there is a periodic repeat of a leucine residue at every 7th position | Biochemistry | null | Steroids act via nuclear receptors which interact with DNA through
A. Helix turn helix
B. Zinc finger motif
C. Histidine
D. Leucine zipper
| Zinc finger motif |
e82e8d17-d041-40b8-bc53-2ac18b328397 | Ans. (b) Postductal coarctation. POSTDUCTAL/ADULT type: 1. Lesion at the level distal to ductus arteriosus 2. It is more common 3. Short segment 4. Proximal (prestenotic) & distal (poststenotic) aortic dilatation 5. Collateral circulation 6. Left ventricular overloading: PROMINENT FEATURE PREDUCTAL/INFANTILE type: 1. Lesion at the level proximal to ductus arteriosus 2. Long segment 3. Left ventricular overloading with PULMONARY HYPERTENSION PROMINENT FEATURE - right-sided overload Remember: * Rib notching is due to intercostal vessel dilatation * Scapular notching is due to internal mammary artery Ref - Rib notching refers to deformation of the superior or inferior surface of the rib. It can affect a single rib (from trauma or solitary masses e.g. schwannoma) or can affect multiple ribs. Differential diagnosis The differentials differ according to whether it is the superior or inferior surface that is notched. Superior rib notching abnormal osteoblastic activity osteogenesis imperfecta connective tissue diseases rheumatoid arthritis systemic lupus erythematosus (SLE) Marfan syndrome Sjogren's syndrome local pressure abnormal osteoclastic activity hyperparathyroidism miscellaneous neurofibromatosis type 1 restrictive lung disease poliomyelitis progeria abnormal muscle pull Inferior rib notching (Roesler sign) enlarged collateral vessels coarctation of the aorta interrupted aortic arch subclavian artery obstruction Takayasu disease Blalock-Taussig shunt: involves only upper two rib spaces arteriovenous malformation (AVM) of the chest wall superior vena cava obstruction with enlarged venous collaterals pulmonary AVM neurogenic tumours schwannoma (usually single) neurofibromatosis type 1 (rarely can be superior if neurofibroma is very large) Superior and inferior rib notching hyperparathyroidism neurofibromatosis type 1 | Unknown | null | A 30-year-old hypertension patient presents with daily headaches. The CXR done shows the following?
A. Preductal coarctation
B. Postductal coarctation
C. Aortic dissection
D. Takayasu arteritis
| Postductal coarctation |
f8f3892a-3f06-458e-bd40-53e57b253c93 | Dipalmytol lecithin in is the major surfactant Ref: guyton and hall textbook of medical physiology 12 edition page number:311,312,313 | Physiology | Respiratory system | Major surfactant is
A. Dipalmytoil lecithine
B. Dipalmytoil cephalin
C. Dipalmytoil serine
D. Dipalmytoil inositol
| Dipalmytoil lecithine |
d0f2d1bb-54e8-4e3f-a624-aa7f76ac7d71 | Ans. (b) SanguinarineRef: K. Park 23sted. /658* EPIDEMIC DROPSY is caused by contamination of mustard oil with Argemone oil (seeds of argemone Mexicana seeds closely resembles to that of mustard oil)* Toxin which is contained in argemone oil is Sanguinarine* This sanguinarine interferes with oxidation of Pyruvic acid, which leads to accumulation of pyruvic acid in blood.* This may cause non-inflammatory edema of lower limbs, diarrhea, dyspnea and even cardiac failure and death.Also KnowFood Adulteration diseases and their toxinsDiseaseToxinAdulterantLathyrismBOAAKhesari DalEpidemic dropsySanguinarineArgemone oilEndemic ascitesPyrrolizidine alkaloidsCrotolaria seedsErgotismErgot/clavinet alkaloidsClaviceps fusiformisAflatoxicosisAflatoxinsAspergillus flavus | Social & Preventive Medicine | Nutrition and Health | Toxin of Epidemic dropsy is:
A. BOAA
B. Sanguinarine
C. Alkaloid
D. Ergot
| Sanguinarine |
0a69a009-1f4a-458b-9e6e-f475622ed2bd | Acetoacetate is the primary ketone body while beta-hydroxybutyrate and acetone are secondary ketone bodies. They are synthesised exclusively by the liver mitochondria.Ref : DM Vasudevan - Textbook of Biochemistry 6th Edition pg no: 143 | Biochemistry | Metabolism of lipid | Ketone bodies are formed in the
A. Liver
B. Pancrease
C. Kidneys
D. Lungs
| Liver |
9f8d8531-cb22-47ea-87c4-f97def5bb075 | (Mesoderm) (8-9-Khurana 4th) (5-Parson 20th)Structures derived from the Embryonic layers1. Surface ectoderm2. Neural ectoderm(a) The crystalline lens(b) Epithelium of the cornea(c) Epithelium of the conjunctiva(d) Lacrimal glands(e) Epithelium of eyelids and its derivatives, viz.: cilia, tarsal glands, and conjunctival glands.(f) Epithelium lining the lacrimal apparatus (Lacrimal glands, Tarsal glands)(a) Retina with its pigment epithelium(b) Epithelial layers of ciliary body(c) Epithelial layers of iris(d) * Sphincter and dilator papillae muscles(e) Optic nerve (neuroglia and nervous elements only)(f) Melanocytes - Retinal pigment epithelium(g) Secondary vitreous(h) Ciliary zonules3. Associated paraxial mesoderm(a) ** Blood vessels of choroid, iris, ciliary vessels, central retinal artery, other vessels (Vascular endothelium of eye and orbit)(b) Primary vitreous(c) Substantia propria, Descemet's membrane, and endothelium of cornea(d) The sclera(e) Stroma of iris(f) Ciliary muscle(g) Sheaths of optic nerve(h) Extraocular muscle(i) Fat, ligaments and other connective tissue structures of the orbit(j) Upper and medial walls of the orbit(k) Connective tissue of the upper eyelid4. Visceral mesoderm of maxillary process below the eye(a) Lower and lateral walls of orbit(b) Connective tissue of the lower eyelid. | Ophthalmology | Anatomy | The embryonic vascular layer of the eye is derived from
A. Neural crest
B. Mesoderm
C. Ectoderm
D. Surface ectoderm
| Mesoderm |
853e41dc-17a9-42f4-974b-88e5ba10f65b | i.e. (Costodiaphragmatic recess: (1658-66 - H17th) (306-8-CMDT-l1)* Most dependent recess of the pleura is the posterior costophrenic angle**. So in pleural effusion this recess would be filled earliest. But at least 100-200 ml of fluid. Would be required to fill this recess before it can be defected on a PA view* The lung is less dense than water and floates on pleural fluid that accumulates in dependent regions* Sub pulmonary fluid may appear as lateral displacement of the apex of the diaphragm with an abrupt slop to the costophrenic sulcus or a greater than 2 cm seperation between the gastric air bubble and the lung.* On a standard upright chest radiograph approximately 75-100 ml of pleural fluid must accumulate in the posterior costophrenic sulcus to the visible on the lateral view and 175-200 ml must be present in the lateral costophrenic sulcus to be visible on he frontal view (307-CMDT-l 1)* Best method to defect minimal pleural effusion decubitus view with a horizontal beam*** Most common cause of pleural effusion is LVF* Most common cause of an exudative pleural effusion developing countries TuberculosisCriteria of Exudative pleural effusion1. Pleural fluid protein / serum protein > 0.52. Pleural fluid LDH / serum LDH >0.63. Pleural fluid more than two thirds normal upper limit for serumCauses of Transudative Pleural Effusion 1. CHF (>90% of cases)2. Cirrhosis with ascitis3. Pulmonary embolization4. Nephrotic syndrome5. Peritoneal dialysis6. SVC obstruction7. Myxedema8. Urinothorax9. Constrictive pericarditis10. Atelectasis (Acute)Chest CT scan may identify as little as 10 ml of fluid | Medicine | Respiratory | Pleural effusion, in standing position gravitates n the region of
A. Oblique fissure
B. Costomediastinum recess
C. Costodiaphragmatic recess
D. Cardiac knoch
| Costodiaphragmatic recess |
68f32b7f-5ec8-46d8-9592-7f8ecf8223c5 | Ans. B Purkinje cellsRef. Gray's, 4Vted.pg. 335-336* The cerebellar cortex contains five types of neurons: Purkinje, Granule, Basket, Stellate and Golgi Cells. | Anatomy | Neuroanatomy | Cerebellar cortex contains:
A. Pyramidal cells
B. Purkinje cells
C. Stromal cells
D. Kupffer cells
| Purkinje cells |
2a1b1659-e71c-4b9b-86b6-2cf73285d98b | Gout: Disturbed purine metabolism leading to ecxessive accumulation of uric acid in the blood -an inherited disorder ;or impaired excretion of uric acid by kidneys.result is accumulation of sodium bicarbonte crystals in soft tissues.Tisues of predliction are cailages,tendon ,bursa. Patient ,beyond 40 years of age, presents as 1.ahritis-MP joint of big toe is ourite site,acute severe pain 2.bursitis-commonly of olecranon bursa 3.tophi formation deposit of uric acid salt in soft tissue. Treatment: NSAIDS,uricosuric drugs,uric acid inhibitors. REF:Essential Ohopaedics.Maheswari &Mhaskar.Edition 9.Pg no:293 | Orthopaedics | Joint disorders | Most common joint involved in Gout y ahritis is ?
A. Knee joint
B. Hip joint
C. MP joint of the big toe
D. MP joint of thumb
| MP joint of the big toe |
f77392de-9f6e-48be-aab5-04c9c2961708 | Ans. D. One, decreasesThe Hemoglobin tetramer binds to one mol of 2,3 BPG in the central cavity formed by four subunits.2,3 BPG forms salt bridges with terminal amino group of both b globin chain via, Valine, Lysine and Histidine.Considering these two sentences, If central cavity is taken into account 2,3 BPG binds to one site.But actually 2,3 BPG is forming salt bridges with two beta subunit, so correctly it is binding to two b sites.So two is a better answer than four, for the number of binding site. As it is not there in the option, better answer is one.Binding of 2,3 BPG decreases the affinity of Oxygen towards HbHb F has low affinity towards 2, 3 BPG. | Biochemistry | Vitamins and Minerals | 2,3 DPG binds to sites in hemoglobin and causes in its oxygen affinity:
A. Four, increases
B. Four, decreases
C. One, increases
D. One, decreases
| One, decreases |
faf4f448-4ccb-4552-822d-eac7587bd0f4 | Ans.: A (3 mEq/L) Potassium level in serum of Child 3.4-4.7 mEq/LPotassium in CSF of child : 70% of plasma 1evel i,e 2.38-3.29TestsConventional UnitsSI UnitsPorphyrins, urineCoproporphyrinUroporphyrin34-230 meg/24 h 27-52 mcg/24 h52-351 nmol/24h 32-63 nmol/24hPotassium, plasma (Hep)MalesFemales3.5-4.5 mEq/L3.4-6.0 mEq/L3.5-4.5 mmol/L3.4-4.4 mmol/LPotassiumSerumPremature Cord5.0.-10.2 mEq/L5.0-10.2 mmol/L48 h3.0-6.0 mEq/L3.0-6.0 mmol/LNewborn, cord5.6-12.0 mEq/L5.6-12.0 mmol/LNewborn3.7-5.9 mEq/L3.7-S.9 mmol/LInfant4.1-5.3 mEq/L4.1-5.3 mmol/LChild3.4-4.7 mEq/L3.4-4.7 mmol/LAdult3.5-5.1 mEq/L3.5-5.1 mmol/LUrine, 24 h25-125 mEq/d, varies with diet25-125 mmol/d; varies with dietCSF70% of plasma level or 2.5-2.3 mEq/L: rises with plasma hyperosmolality0.70 pf plasma level or 2.5-3.2 mmol/L: rises with plasma hyperosmolility | Physiology | Miscellaneous Nervous System | Concentration of Potassium in children's CSF is:
A. 3 mEq/L
B. 5 mEq/L
C. 10 mEq/L
D. 15 mEq/L
| 3 mEq/L |
1a4e2d7f-c595-44bd-952b-c74e6bdbfd32 | Xylocaine or lidocaine administered intravenously is specifically indicated in the acute management of ventricular arrhythmias such as those occurring in relation to acute myocardial infarction, or during cardiac manipulation, such as cardiac surgery. it belongs to class 1b agents other best drugs to prevent arrhythmias post-MI-lidocaine Ref: | Pharmacology | Cardiovascular system | Drug of choice for ventricular arrhythmias due to mycardial infarction (MI) is:
A. Quinidine
B. Amiodarone
C. Xylocaine
D. Diphenylhydantoin
| Xylocaine |
ce5c7221-dd20-49c8-b883-f7ffd812b030 | Head circumference at birth = 35cm
↑ in HC in 1st 3 months = 2cm/month = 6cm
↑ in HC in 4-6 months = 1cm/month = 3cm
↑ in HC in 7-6 months = 0.5cm/month = 3cm
By 1st year, HC = 35+6+3+3 = 47cm
↑ in HC = 47 - 35cm = 12cm
% of ↑ in HC in 1st year of life = 12/35 × 100 = 33% | Pediatrics | null | The increase in head circumference in 1st year of life is what percentage of head circumference at birth
A. 15%
B. 66%
C. 33%
D. 90%
| 33% |
ea2ae6e2-25ba-4a22-9036-b09667a1db55 | Ans: D (Levonorgestrel IUCD) Ref: Shaw's Textbook of Gynaecology 15th Edition Pg: 230Explanation:Levonorgestrel IUCD is progesterone impregnated IUCD and is recommended to control bleeding in menorrhagia.Other non contraceptive benefits of LNG IUCD:DUBEndometrial hyperplasiaIntrauterine contraceptive devices (IUCD)Biologically inert devices : Lippe's loopCopper containing devices : CopperT Hormonal IUCDS : Progestasert, Levonova, MIRENAHormonal IUCDs Progesterone38mg of ProgesteroneReleases 65 micrograms/dayEffective for 1 year40% reduction in Menorrhagia40% reduction in DysmenorrheaLevonova60 mg of LevonorgestrelReleases 20 micrograms/dayIncreased chances of ectopic pregnancySafe during lactationEffective for 5 yearsMIRENA52 mg of levonorgestrelReleases 25 micrograms/dayDoes not suppress ovulationActs on endometrium and cervical mucusUsed in DUB, Endometrial hyperplasia, HRTEffective for 5 years | Gynaecology & Obstetrics | Non-Hormonal - Intrauterine Devices | IUD of choice in menorrhagia: (Repeat)
A. Lippe loop
B. Cu-T 375
C. Cu-T 200
D. Levonorgestrel IUCD
| Levonorgestrel IUCD |
fafb802d-fa37-4bca-8e23-ee8a87e87df4 | Muscles producing movements of ankle - A. Dorsiflexion : Tibialis anterior is the principal muscle,(Extensor digitorum anterior longus, Extensor hallucis longus,Peroneus teius are the accessory muscles) B. Plantar flexion : Gastrocnemius and Soleus are the principal muscles ( plantaris, Tibialis posterior, Flexor hallucis longus, Flexor digitorum longus are the accessory muscles) Ref : B D Chaurasia's Human Anatomy , seventh edition , volume 2 , pg. no. 161 ( table 12.3 ) | Anatomy | Lower limb | Dorsiflexion of ankle joint is by
A. Tibialis anterior
B. Peroneus longus
C. Tibialis posterior
D. Soleus
| Tibialis anterior |
09c464d4-70b4-4183-82ed-6f9ede16244e | a. TGA(Ref: Nelson's 20/e p 2211-2217, Ghai 8/e p 420-423)The given clinical picture suggests a diagnosis of TGA (Transposition of great arteries)In TOF and Pulmonary atresia, pulmonary vascularity is decreasedIn TAPVC, S2 is not single, rather there is a wide fixed split of the 2nd heart sound. | Pediatrics | C.V.S. | A 2 weeks baby with central cyanosis has grade II systolic murmur, normal S1, single S2, plethoric lung. What is the diagnosis?
A. TGA
B. TAPVC
C. TOF
D. Pulmonary atresia
| TGA |
106eb9c4-0454-4609-9384-2b4e94a53660 | Impoant Events Following Feilization 0' hour Feilization (day-15 from LMP) 30 hours 2 cell stage (blastomeres) 40-50 hours 4 cell stage 72 hours 12 cell stage 96 hours 16 cell stage. Morula enters the uterine cavity 5th day Blastocyst 4-5th day Zona pellucida disappears 5-6th day Blastocyst attachment to endometrial surface 6-7th day Differentiation of cyto and syncytiotrophoblast layers 10th day Synthesis of hCG by syncytiotrophoblast 9-10th day Lacunar network forms 10-11th day * Trophoblasts invade endometrial sinusoids establishing uteroplacental circulation * Interstitial implantation completed with entire decidual coverage REF : DUTTA BOOK OF OBESTETRICS | Gynaecology & Obstetrics | All India exam | Establishment of fetoplacental circulation seen at-
A. 11 to 13 days
B. 20 to 22 days
C. 7 days
D. 25 to 26 days
| 20 to 22 days |
3d3269bb-99a9-4e70-8558-030d41829b9c | Functions of vitamin B12 a. Vitamin B12 contains cobalt in a corrin ring that resembles a porphyrin.(1). Vitamin B12 is the cofactor for methylmalonyl-CoA mutase, which catalyzes the rearrangement of methylmalonyl-CoA to succinyl-CoA (see Fig below).(a). This reaction is involved in the production of succinyl-CoA from valine, isoleucine, threonine, methionine, and the propionyl-CoA formed by the oxidation of fatty acids with an odd number of carbons.(2). Vitamin B12 is involved in the transfer of methyl groups from FH4 to homocysteine to form methionine (see Figure below).A vitamin B12 deficiency results in a megaloblastic anemia plus demyelination of nerves, because of reduced levels of SAM in the nervous system. These cells are large because the vitamin deficiency interferes with DNA synthesis, and the cells double in size without being able to replicate their DNA. Once the anemia begins, the large blast cells are released by the marrow in an attempt to control the anemia. A hypochromic, microcytic anemia can result from the lack of iron, or lack of pyridoxal phosphate. Both conditions lead to a reduction in the synthesis of heme, so the red cells cannot carry as much oxygen (which gives them the pale color). The cells are small in order to maximize the concentration of hemoglobin present in the cells. Hemolytic anemia occurs when the red cell membrane fragments, which can occur with pyruvate kinase deficiencies or a lack of glucose-6-phosphate dehydrogenase activity (which results in reduced NADPH levels). Sickle cell anemia is caused by a point mutation in the b-globin gene, substituting a valine for a glutamic acid.The transfer of a 1-carbon unit from serine to deoxyuridine monophosphate (dUMP) to form deoxythymidine monophosphate (dTMP). FH4 is oxidized to FH2 in this reaction. FH2 is reduced to FH4 by dihydrofolate reductase. The rectangles indicate the steps at which the antimetabolites methotrexate and 5-fluorouracil act. FH2 , dihydrofolate; FH4 , tetrahydrofolate; NADP, nicotinamide adenine dinucleotide phosphate; NADPH, reduced NADP. | Biochemistry | Vitamins and Minerals | A deficiency of substance B12 can result in an anemia. Choose the type of anemia that would occur if the substance were deficient.
A. Megaloblastic anemia
B. Hypochromic, microcytic anemia
C. Hemolytic anemia
D. Sickle cell anemia
| Megaloblastic anemia |
04f84f3a-b13a-4ee0-960e-0df774653d3d | Ans: B i.e. Pilocarpine Iridocyclitis is included under anterior uveitis Iritis is most frequently mistaken either for conjunctivitis or acute glaucoma. The error of mistaking iritis for acute glaucoma is very serious, paicularly because the treatment of the 2 conditions is diametrically opposite. Dilatation of the pupil, which is urgently necessary in iritis, is the worst possible treatment in acute angle closure glaucoma Drug in uveitis Aspirin is very useful in relieving pain. Pilocarpine is contraindicated in uveitis In anterior uveitis, dilatation of the pupil & relaxation of the ciliary muscle with cycloplegics such as atropine 1% drops or ointment twice or thrice daily, warm compresses, and the control of the acute phases of inflammation with steroids, are the essentials of local treatment | Ophthalmology | null | Drug contraindicated in iridocyclitis: March 2012, March 2013 (a, d, h)
A. Aspirin
B. Pilocarpine
C. Atropine
D. Steroids
| Pilocarpine |
0fe82906-164c-4e56-b30d-1a4d44812e15 | Ans. is 'b' i.e., David morley Growth cha Also known as "road-to-health" cha. It was first designed by David morley. It is a visible display of the child's physical growth and development. It is designed primarily for the longitudinal follow-up (growth monitoring) of child. Mostly weight for age is taken into consideration (height is not taken into consideration). This is because weight is the most sensitive measure of growth and any detion from normal can be detected easily by comparison with reference curves. A child can lose weight but not height. The growth cha offers a simple and inexpensive way of monitoring weight gain and infact child health oveime. | Social & Preventive Medicine | null | Road - to health cha was given by?
A. John Snow
B. David Morley
C. Koch
D. Henrey Ducant
| David Morley |
b2568c9d-2281-4184-bed6-613eb61e5624 | Ans. is 'd' i.e., Imipenem + Amikacin Extended spectrum b lactamases are now responsible for majority of multidrug resistance in Gram negative bacteria.Outbreaks due to strains possessing ESBL have been associated with extensive institutional use of 3rd generation cephalosporins.Extended spectrum b lactamases are resistant to :Third generation cephalosporinsAztreonamAminoglycosidesTetracyclinesTrimethoprim - sulphamethoxazoleFluoroquinolonesDrug effective against expended spectrum b lactamase inhibitors.* CarbapenemAlso knowCarbapenems of ESBL resistance occurs via transferrable plasmids. | Unknown | null | The blood culture from a patient of febrile neutropenia has grown Pseudomonas aeruginosa, It was found to be a producer of extended-spectrum beta-lactamase enzyme. The best choice of antimicrobial therapy should be -
A. Ceftazidine + amikacin
B. Aztreonam + Amikacin
C. Cefpirome + amikacin
D. Imipenem + Amikacin
| Imipenem + Amikacin |
2fc16ed5-9269-4a8b-9a84-533b51a2d92b | Ans. is 'b' i.e., Rubrospinal tract o Pyramidal (corticospinal) tract and extrapyramidal tracts concerned with the muscles of the trunk and proximal portion of limbs (Le., the muscle mainly concerned with the postural control) occupy anterior white column of spinal cord and terminate in the medial ventral horn on the medial group of intemeurons. These tracts are collectively called medial pathways. Medial pathways include ventral (anterior) corticospinal tract, vestibulospinal tracts, reticulospinal tract and rubrospinal tract.o On the other hand, descending tracts concerned with distal muscles of the limb (i.e., those muscles which mediate fine skilled movements(A1 13)) occupy lateral white column and are called lateral pathways. Lateral pathways include lateral corticospinal tract and rubrospinal tracts. | Physiology | Neural Tracts | Descending motor tract responsible for rapid skilled movements.
A. Anterior corticospinal tract
B. Rubrospinal tract
C. Vestibulospinal tract
D. Reticulospinal tract
| Rubrospinal tract |
9e28c9ce-144d-4ef8-b797-938f0efd1857 | Turner's syndrome is associated with coarctation of aoa. Reference: Ghai essential pediatrics, 9 th edition, page 638 | Medicine | Genetics | Turner syndrome is associated with
A. Aotic regurgitation
B. Aoic dissection
C. Pulmonary stenosis
D. Coarctation of aoa
| Coarctation of aoa |
4b2f3b05-abbd-4aca-9618-96cacfba38f1 | The human leukocyte antigen (HLA) system or complex is a gene complex encoding the major histocompatibility complex (MHC) proteins in humans. These cell-surface proteins are responsible for the regulation of the immune system in humans. The HLA gene complex resides on a 3 Mbp stretch within chromosome 6p21. HLA genes are highly polymorphic, which means that they have many different alleles, allowing them to fine-tune the adaptive immune system. The proteins encoded by ceain genes are also known as antigens, as a result of their historic discovery as factors in organ transplants. Different classes have different functions:HLA-DR4 (DR4) is an HLA-DR serotype that recognizes the DRB1*04 gene products. The DR4 serogroup is large and has a number of moderate frequency alleles spread over large regions of the world. | Pathology | General pathology | HLA associated with rheumatoid ahritis -
A. DR1
B. DR2
C. DR3
D. DR4
| DR4 |
8b390d8d-1806-4b22-8930-af9af30b75db | Tumor staging is one of the most impoant criteria in the therapeutic and prognostic consideration of WT. The International Society of Pediatric Oncology (SIOP) staging system is based on preoperative chemotherapy but is applied after resection. The presence of metastases is evaluated at presentation, relying on imaging studies, and chemotherapy is instituted before operative intervention. The National Wilms Tumor Study Group (NWTSG) has also developed a staging system that incorporates the clinical,surgical, and pathologic information that was obtained at the time of resection but stratifies patients before the initiation of chemotherapy. The advantage of this system is that it ors stage-based therapy, thereby avoiding unnecessary chemotherapy in patients who might not otherwise benefit from it. ref : Sabiston 20th ed , chapter 66 , pg no 1889 | Surgery | Urology | Which of the following is the Post-Chemotherapy based staging system in Wilm's tumor
A. National Wilm's tumor staging system
B. International society of Pediatric oncology
C. AJCC TNM
D. Chadwick
| International society of Pediatric oncology |
d5e95b90-d2d8-45ad-bc84-c79d29df57e1 | Ans. A: 2 hours after sleepGH is synthesized and secreted from the anterior pituitary gland in a pulsatile manner throughout the day; surges of secretion occur at 3- to 5-hour intervals. The largest and most predictable of these GH peaks occurs about 2 hours of deep sleep, otherwise there is wide variation between days and individuals. | Physiology | null | At what time of the day GH levels are highest:September 2007
A. 2 hours after sleep
B. 2 hours before sleep
C. Evening
D. Early morning
| 2 hours after sleep |
624e62b0-95e0-4265-8aa2-9ae53784b4b3 | C i.e. Alkaptonuria Features Disease Fish Mouth Veebrae - Sickel Cell AnemiaQ HomocystinuriaQ Cod Fish Veebra (Biconcave veebra) - Osteomalacia, Osteoporosis, Hyperparathyroid Rugger jersey spine (sclerosis of upper & lower spine borders) - CRF induced osteomalaciaQ - Osteopterosis (marbel bone disease) Calcification of Interveebral disc - Alkaptonuria (m.c.) Picture Frame veebrae - Paget's disease Veebrae plana - Eosinophilic granulomaQ | Radiology | null | Calcification of Interveebral Disc is seen in
A. Gout
B. Rheumatoid
C. Alkaptonuria
D. Psoriasis
| Alkaptonuria |
87f606b2-8e1c-423e-9a9c-8c887c4c4323 | 1st image shows the classical Pembeon sign. 2nd image shows a mass in the right mediastinum-s/o CA lung causing compression of SVC. The SVC receives venous drainage from the head, neck, upper limb, and thorax. Located in the upper mediastinum, this thin-walled vessel is susceptible to pressure from external sources. The most common cause of such external compression is malignancy, usually from a right-side bronchogenic carcinoma. Presents with dyspnea, hoarseness and Horner syndrome. The development of SVC syndrome is often an emergency because the trachea may be obstructed, leading to respiratory compromise. | Unknown | Integrated QBank | A 50-year-old man complains of swelling of the neck and shoness of breath for 7 days. He has noticed some nasal stuffiness with hoarseness of his voice for about 4 weeks and had attributed these symptoms to an upper respiratory infection. He denies the use of alcohol but has smoked two packs of cigarettes per day for 35 years. Lately, he feels as though something is pushing against his throat. On physical examination, the patient's face appears ruddy and swollen. The jugular veins are distended. Following sign is observed in the patient. Chest x ray was done with the following findings. What is the most likely diagnosis?
A. Retrosternal goiter
B. Thymoma
C. SVC syndrome
D. Congestive cardiac failure
| SVC syndrome |
ff284320-b991-4707-8a1c-c5fbe64f6930 | Ans. is a, i.e. ChancreRef: Harrison 17th/edf pl040; William's Gynae lst/ed, p58-9, Current diagnosis and treatment of STD's p21KEY POINTSPainless well-defined ulcers with firm base should raise the suspicion of chancre.(The lesion in the question is thought to be painless as the lady in the question is not coming because of ulcer, but for contraceptive advice. Presence of ulcer is an incidental finding).Chancre is the primary lesion of primary syphilis.* It is most commonly found on the labium majus, labium minus, fourchette, clitoris, urethral orifice or cervix but can be found anywhere on the lower genital tract.* In 10% cases more than one primary lesion is present.* The first manifestation is a small papule which breaks to form an ulcer.* Ulcer is firm, painless with raised edges and granulomatous base.* In fact any sort of discrete relatively painless ulceration on the vulva may be primary syphilitic lesion.* Inguinal glands enlarge when the primary is on the vulva or lower vagina.* Lymph nodes are hard, shotty, painless, and do not suppurate. | Gynaecology & Obstetrics | Sexually Transmitted Disease in the Female | A lady approaches a physician for contraceptive advice. On examination, there were two symmetrical ulcers on vulva, which were well-defined with firm base. Which of the following is the most likely cause?
A. Chancre
B. Herpes
C. Syphilis
D. Malignancy
| Chancre |
1c63e07f-92c9-455f-848e-ece2c48b81de | Pancreatic adenocarcinoma and cholangio carcinoma produce demsoplastic response | Pathology | null | Desmoplastic response is commonly seen in?
A. Ovarian cancer
B. Hodgkins Lymphoma
C. Renal cell carcinoma
D. Pancreatic carcinoma
| Pancreatic carcinoma |
b1ceabc0-b3f5-4874-960b-5511e3147ee0 | Ans. (b) Suppresses hypothalamic--pituitary axis(Ref: Ganong, 25th ed/p.327)Continuous (nonpulsatile) administration of GnRH inhibits the release of FSH and LH by the pituitary in both women and men | Physiology | Endocrinology and Reproduction | Continuous administration of GnRH-
A. Stimulates hypothalamic--pituitary axis
B. Suppresses hypothalamic--pituitary axis
C. May suppresses or stimulate hypothalamic--pituitary axis
D. Has so no effect on hypothalamic--pituitary axis
| Suppresses hypothalamic--pituitary axis |
5c230271-f1c6-4a71-9ccf-2955c8d5456c | Ans. d (Subarachnoid space). (Ref. Harrisons, Medicine, 18th/735)SPINAL ANESTHESIA# The term "spinal anesthesia" was coined in 1885 by Leonard Corning.Technique of spinal anesthesia:# In spinal anaesthesia the spinal needle is pierced upto subarachnoid space where the anaesthetic agent is injected to produce the anaesthesia.# The selected level should be below LI in an adult and L3 in a child to avoid needle trauma to the spinal cord. As an anatomic landmark, the L3-L4 interspace is located at the line intersecting the top of the iliac crests. Either a midline or paramedian approach can be used.# The anatomic layers passed through include skin, subcutaneous structures, supraspinous ligament, interspinous ligament, ligamentum flavum, dura mater, and arachnoid membrane.# Once the needle tip is believed to be in the subarachnoid space, the stylet is removed to see if CSF appears at the needle hub. With small diameter needles (26 to 29 gauge) this generally requires 5 to 10 seconds, but may require >1 minute in some patients. Gentle aspiration may speed the appearance of CSF. If CSF does not appear, the needle orifice may be obstructed by a nerve root and rotating the needle 90 degrees may result in CSF flow. Alternatively, the needle orifice may not be completely in the subarachnoid space and advancing an additional 1 to 2 mm may result in brisk CSF flow. This is particularly true of pencil-point needles, which have their orifice on the side of the needle shaft proximal to the needle tip.# Finally, failure to obtain CSF suggests that the needle orifice is not in the subarachnoid space and the needle should be reinserted.# Common complications include hypotension, bradycardia, increased sensitivity to sedative medications, nausea and vomiting (possibly secondary to hypotension), postdural puncture headache, nerve injury, total spinal, and hematoma/abscess formation at the site of puncture.# Total spinal anesthesia results from local anesthetic depression of the cervical spinal cord and brain stem. Signs and symptoms include dysphonia, dyspnea, upper extremity weakness, loss of consciousness, pupillary dilation, hypotension, bradycardia, and cardiopulmonary arrest. Eaily recognition is the key to management. Treatment includes securing the airway, mechanical ventilation, volume infusion, and pressor support.# Absolute contraindications include local infection at the puncture site, bacteremia, severe hypovolemia, coagulopathy, severe stenotic valvular disease, infection at the site of the procedure, and intracranial hypertension. Relative contraindications include progressive degenerative (demyelinating) neurologic disease (multiple sclerosis), low back pain, and sepsis.# Intrathecal opioids:- Opioids produce intense visceral analgesia and may prolong sensory blockade without affecting motor or sympathetic function.- Fentanyl and sufentanil have a rapid onset of action and an effective duration greater than 6 hours.- Morphine lasts 6-24 hours.- Side effects include respiratory depression (which may occur late with hydrophilic agents), nausea, vomiting, pruritus, and urinary retention. | Anaesthesia | Local and Regional Anesthesia | In spinal anaesthesia the needle pierced upto
A. Subdural space
B. Extradural space
C. Epidural space
D. Subrachnoid space
| Subrachnoid space |
321c5671-dcd5-4ead-bafa-77517de37126 | Acetaminophen toxicity leads to hepatic necrosis, indicated by rising ALT and AST levels. If death is not immediate, hyperbilirubinemia also can be seen. N-Acetylcysteine augments glutathione by contributing a sulfhydryl group for binding to toxic metabolites. Elevated serum amylase is seen in pancreatitis. Elevated serum creatine kinase is seen with injury to skeletal and cardiac muscle. Ketonuria is a feature of absolute insulin deficiency in diabetes mellitus; it also is a feature of starvation. Hypokalemia can be a feature of renal diseases and glucocorticoid deficiency. | Pathology | Environment & Nutritional Pathology | A 26-year-old woman with a 6-month history of depression accompanied by active suicidal ideation ingests 35 g of acetaminophen. She quickly experiences nausea and vomiting. Within 1 day, she becomes progressively obtunded. On physical examination, her temperature is 36.9deg C, pulse is 75/min, respirations are 15/min, and blood pressure is 100/65 mm Hg. She is treated with N-acetylcysteine. Depletion of which of the following is most likely to accentuate her organ damage?
A. Glutathione (GSH)
B. Amylase
C. Creatine kinase
D. Ketone bodies
| Glutathione (GSH) |
1286dc37-e52c-4f82-8730-e385c312bf99 | ANSWER: (A) S. aureusREF: Harrison's 18th Ed Ch. 334The hematogenous route of infection is the most common route in all age groups, and nearly every bacterial pathogen is capable of causing septic arthritis.In infants, group B streptococci, gram-negative enteric bacilli, and S. aureus are the most common pathogens.Since the advent of the Haemophilus influenzae vaccine, the predominant causes among children < 5 years of age have been S. aureus, Streptococcus pyogenes (group A Streptococcus), and (in some centers) Kingella kingae.Among young adults and adolescents, N. gonorrhoeae is the most commonly implicated organism. S. aureus accounts for most nongonococcal isolates in adults of all ages; gramnegative bacilli, pneumococci, and B-hemolyticstreptococci'particularly groups A and B but also groups C, G, and F are involved in up to one-third of cases in older adults, especially those with underlying comorbid illnesses. | Microbiology | Staphylococci | Most common cause of non gonococcal arthritis?
A. S. Aureus
B. Ureoplasma ureolyticum
C. E. coli
D. Bacteroids
| S. Aureus |
4cd335c9-fe0d-4f55-b959-5dd398b2c624 | Anastomosis around scapula maintains the blood supply when there is an obstruction at 2nd part of axillary artery.
Anastomosis around body of scapula :
This is formed by
Suprascapular branch of subclavian artery.
Deep branch of transverse cervical artery which is a branch of thyrocervical trunk from subclavian artery and
Circumflex scapular branch of subscapular artery from 3rd part of axillary artery.
Anastomosis on the acromion process :
This is formed by
Acromial branch of thoracoacromial artery from 2nd part of axillary artery.
Ascending branch of posterior circumflex humeral artery from 3rd part of axillary artery and
Acromial branch of Suprascapular artery from subclavian artery. | Anatomy | null | Occlusion occurs at the 2nd part of axillary artery, blood flow is maintained by anastamosis between :
A. Anterior and posterior circumflex humeral artery
B. Circumflex scapular and posterior circumflex humeral artery
C. Deep branch of the transverse cervical artery and subscapular artery
D. Anterior circumflex artery and subscapular artery
| Deep branch of the transverse cervical artery and subscapular artery |
b68bdb54-231f-4afc-945c-3ac58489800e | CPK -creatine phosphokinase is an enzyme which is increased in myocardial infarction. Amylase is produced by the pancreas and salivary glands. Increased in acute pancreatitis SGOT- elevated in myocardial infarction ALT elevated in liver diseasesRef: DM Vasudevan, 7th edition, box no; 23.4, page no: 308 | Biochemistry | Endocrinology | Enzyme marker for pancreas
A. CPK
B. Amylase
C. SGOT
D. ALT
| Amylase |
aae67ca1-0bed-42ea-89a4-fbe7f8f8251c | Fetal lung maturation in diabetic pregnancy. The increased incidence of the idiopathic respiratory distress syndrome (IRDS) in infants of diabetic mothers may be explained by preterm delivery and asphyxia but the metabolic derangement per se may also be responsible for the inadequate production of surfactant Reference: GHAI Essential pediatrics, 8th edition | Pediatrics | New born infants | Surfactant deficiency occurs in
A. Infant of diabetic mother
B. Meconeum aspiration syndrome
C. Transient tachypnea of newborn
D. Bronchopulmonary dysplasia
| Infant of diabetic mother |
6148d3cc-d8d7-4a47-97d2-7313a0d61da1 | Nerve injured in the fracture of neck of humerus is axillary nerve. | Orthopaedics | null | A boy fell down from a tree and has fracture of neck of humerus. He cannot raise his arm because of the involvement of-
A. Axillary nerve
B. Supraspinatus nerve
C. Musculocutaneous nerve
D. Radial nerve
| Axillary nerve |
5a2d5850-7d9e-4e97-9e1b-171f2fa2ab89 | LINES OF BLASCHKO The lines of Blaschko represent a pattern assumed by many different nevoid and acquired skin diseases on the human skin and mucosae. These lines do not correspond to any known nervous, vascular or lymphatic structures but represent the developmental growth pattern of the skin. Ref:- Oxford Blackwell Science; pg num 360-1 | Dental | Anatomy of skin | What does lines of Blaschko represent
A. Lines along Lymphatics
B. Lines along Blood vessels
C. Lines along Nerves
D. Lines of Development
| Lines of Development |
15d9ba4d-8137-437b-a091-89c609edaae7 | B. Failure of fusion of the tricuspid leaflets with the annulus fibrosus results in Ebstein's anomaly PTA and TOF is a defect of aoopulmonary septum. | Anatomy | CVS Embryology | A failure of the tricuspid leaflets to attach to the annulus fibrosus will result in which of the following?
A. Persistent truncus aeriosus (PTA)
B. Ebstein's anomaly
C. Transposition of the great aeries
D. Common ventricle
| Ebstein's anomaly |
0c70dcce-988f-49ab-aee2-3326f1b2ece9 | Components of Young's syndrome:
Bronchiectasis
Sinusitis
Obstructive azoospermia. | Pediatrics | null | Which of the following is not a component of young's syndrome
A. Bronchiectasis
B. Sinusitis
C. Situs inversus
D. Obstructive azoospermia
| Situs inversus |
99e26cb0-2827-4386-9a71-b821a6b240b3 | Bacteroides species are gram negative bacilli, and are anaerobes. They are a large group of bile-resistant, non-spore-forming, slender rods that may appear as coccobacilli. Bacteria of the genus Streptococcus are Gram-positive cocci typically arranged in chains. Actinomyces are Gram-positive rods characterized by filamentous, tree-like branching growth. Clostridium perfringens is a large, Gram-positive, nonmotile rod with square ends. It grows overnight under anaerobic conditions, producing hemolytic colonies on blood agar. Ref: Brooks G.F. (2013). Chapter 21. Infections Caused by Anaerobic Bacteria. In G.F. Brooks (Ed), Jawetz, Melnick, & Adelberg's Medical Microbiology, 26e. | Microbiology | null | Which among the following microorganism is a gram negative anaerobe?
A. Streptococci
B. Bacteroides
C. Actinomyces
D. Clostridium welchii
| Bacteroides |
f576aaf8-2d60-45e4-afa0-fb356b99e7f1 | Ans. is 'a' loss of sensorium Loss of sensorium is a typical feature of Delirium. It is not seen in dementia.Dementia has following features -Generalized loss of neurons is seen in brain matter.Impairment of intellectual functions, impairment of memory* (predominantly of recent memory)Deterioration of personalityImpairment of Judgement & impulse controlImpairment of abstract thinkingImpairment of all functions occuring globally. | Psychiatry | Dementia Due to Metabolic Causes | Not a feature of dementia is -
A. Loss of sensorium
B. Wearing of dirty clothes
C. Forgetfulness
D. Loss of neurons in brain matter
| Loss of sensorium |
5c93a291-a995-4c63-acb7-7f29f3e5b54b | Glycine is one among the commonest amino acids found in protein structure. Being small and non-polar, glycine is mostly present in the interior structure of protein.
Satyanarayana, Ed 3, Pg 302 | Biochemistry | null | Flexibility of protein depends on
A. Glycine
B. Tryptophan
C. Phenylalanine
D. Histidine
| Glycine |
d22389e5-8187-420b-9529-06dcb122a7fb | Ans. is 'a' i.e., Thymine o Adenine is always paired with thymine by formation of two hydrogen bonds. Guanine is always paired with cytosine by formation of three hydrogen bonds. | Biochemistry | Structure of DNA | Adenine in DNA binds with -
A. Thymine
B. Guanine
C. Cytosine
D. Uracil
| Thymine |
3452e671-d5b8-4fa0-91a7-eb70623638b7 | The development of new-onset diabetes insipidus in the third trimester is usually due to increased vasopressinase activity either due to increased placental production or decreased hepatic vasopressinase metabolism due to liver damage from various causes including preeclampsia, acute fatty liver of pregnancy, or HELLP, syndrome. This phenomenon is called transient vasopressin-resistant diabetes insipidus (DI) of pregnancy. Ref: Mehta N.D., Chen K.K., Monzon C., Rosene-Montella K. (2012). Chapter 223. Common Medical Problems in Pregnancy. In G.V. Lawry, J. Matloff, D.D. Dressler, D.J. Brotman, J.S. Ginsberg (Eds), Principles and Practice of Hospital Medicine. | Gynaecology & Obstetrics | null | A 34 weeks pregnant female with increased urinary frequency diagnosed of having transient-diabetes insipidus. This patient may have the following associated pathology:
A. Severe pre-eclampsia
B. Hydramnios
C. Multiple pregnancy
D. IUGR
| Severe pre-eclampsia |
1d8d81b2-b52d-44dc-8fa3-9082e8745330 | Ans. is 'b' i.e., Acetylcholine receptor Myasthenia gravis* It is a muscle disease caused by immune-mediated loss of acetylcholine receptors at neuromuscular (myoneural) junction, i.e. Nm type of nicotinic receptors.* The antibodies in myasthenia gravis attack the nicotinic acetylcholine receptor, or a related protein called MusK a muscle-specific kinase.* When arising before age 40 years, it is most commonly seen in women, but there is equal occurrence between the sexes in older patients. Thymic hyperplasia is found in 65% and thymoma in 15% of patients.* Analysis of neuromuscular transmission in myasthenia gravis shows a decrease in the number of muscle acetylcholine receptors (AChRs), and circulating antibodies to the AChR are present in nearly all patients with myasthenia gravis.* Patients show improvement in strength in response to administration of anticholinesterase agents. This remains a most useful test on clinical examination. | Pathology | Immunity | In myasthenia gravis, the antibodies are formed against?
A. Muscarinic receptor proteins
B. Acetylcholine receptors
C. Actin
D. Myosin
| Acetylcholine receptors |
101a4c93-e47f-4e5a-8f8a-17645212d0fe | The structural gene for b-galactosidase (lacZ) is clustered with the genes responsible for the permeation of lactose into the cell (lacY) and for thiogalactoside transacetylase (lacA). The structural genes for these three enzymes, along with the lac promoter and lac operator (a regulatory region), are physically associated to constitute the lac operonRef: Harper 27e, page: 430 | Biochemistry | Metabolism of nucleic acids | Number of structural genes in Lac operon is
A. 3
B. 4
C. 5
D. 6
| 3 |
02068b30-0938-4aff-b0e6-c49ad9818c8b | i.e. (Posterior cricoarytenoids): (243-BDC-3-5th ed)Muscles acting on the Larynx|| |Movements Muscles1. Elevation of larynx Thyrohyoid, mylohyoid2. Depression of larynx Sternothyroid, sternohyoid3. Opening of larynx Thyroepiglotticus4. Closing inlet of larynx Aryepiglotticus5. Abductor of vocal cords Posterior cricoaryteroids only6. Adductor of vocal cords Lateral cricoarytenoids, transverse oblique arytenoids7. Tensor of vocal cords Cricothyroids8. Relaxor of vocal cords Thyroarytenoids(i) Cricothyroid is supplied by external laryngeal nerve(ii) Rest of the intrinsic muscle - recurrent laryngeal nerve | Anatomy | Head & Neck | Abductors of vocal cord is
A. Lateral cricoarytenoids
B. Posterior cricoarytenoids
C. Thyro arytenoids
D. Cricothyroids
| Posterior cricoarytenoids |
71453fe5-854a-4456-9012-04208d5132c2 | The recommended definition is fetal (neonatal) weight exceeding two standard deviations or above 90th centile for the appropriate normal population.
According to ACOG: birth weight of > 4500 gm is called as macrosomia.
In Indian context birth weight of > 4000 gm is called as macrosomia. | Gynaecology & Obstetrics | null | Macrosomia is/are associated with:a) Gestational diabetes mellitusb) Maternal obesityc) Hypothyroidism d) Hyperbilirubinemia e) Fetal goitre
A. ac
B. a
C. ad
D. ab
| ab |
4acd79c7-cca0-466f-870e-44e082ca031e | Rhinitis medicamentosa is due to the prolonged use of topical nasal decongestants like oxymetazoline and xylometazolineTreatment- Stoppage of the decongestants, topical and systemic steroids.Ref: Hazarika; 3rd ed; Pg 298 | ENT | Nose and paranasal sinuses | Rhinitis medicamentosa is due to
A. Nasal decongestants
B. Steroids
C. Surgery
D. Antihistaminics
| Nasal decongestants |
9731c17d-0637-4273-b03d-7f7f37344764 | Formalin cannot be used for preservation because it hardens and fixes the tissues and poison cannot be extracted. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 404 | Forensic Medicine | Special topics | Never used in chemical analysis
A. Saturated NaCl solution
B. Formalin
C. Rectified spirit
D. Sodium fluoride
| Formalin |
ca1345d0-1dc2-49f5-92ff-a225ee256914 | Ans. is d, i.e. Salpingitis isthmica nodosaRef Novak 14/e, p 608Arias Stella reactionArias Stella reaction is characterized by adenomatous change of the endometrial glands.There is intraluminal budding.Cells loose their polarity, have hyperchromatic nucleus, vacuolated cytoplasm and occasional mitosis.The reaction is seen in ectopic pregnancy (in 10-15% cases) and indicates blightening of conceptus either intra or extra uterine.Arias Stella Reaction is not specific for ectopic pregnancy but for blightening of conceptus either intra uterine or extrauterine.In the options given:OvarianpregnancyInterstitialpregnancy }Are examples of ectopic pregnancy and therefore Arias Stella reaction will be seen in them.Molar pregnancy will lead to blightening of ovum and therefore, Arias Stella reaction may be seen.Salpingitis isthmica nodosa: Salpingitis Isthmica Nodosa (SIN) is a noninflammatory pathologic condition of the tube in which tubal epithelium extends into the myosalpinx and forms a true diverticulum. This condition is found more often in the tubes of women with an ectopic pregnancy than in nonpregnant women. Whether tubal pregnancy is caused by SIN or whether the association is coincidental is unknown.So by itself in SIN, Arias Stella Reaction is not seen. Only when SIN will lead to Ectopic pregnancy then Arias Stella Reaction will be seen. | Gynaecology & Obstetrics | Ecotopic Pregnancy | Arias Stella reaction is not seen in:
A. Ovarian pregnancy
B. Molar pregnancy
C. Interstitial pregnancy
D. Salpingitis isthmica nodosa
| Salpingitis isthmica nodosa |
0d4dbc53-a874-473a-9248-32c3663840df | When the patient extends both arms upright in the supinated position and holds them at shoulder height for at least 10 seconds (Patients should be asked to keep eyes open initially and later test again with eyes closed):Normal response:Palm will remain flat, elbows straight and the limbs horizontal ORSymmetrical detion from this position (i.e. on both the sides - dominant hand may pronate slightly more than the non-dominant hand)Positive pronator drift: Components of pronator drift as mentioned above is seen in the weaker side (asymmetric response) which indicates a lesion in contralateralPseduodrift:Slight pronation, without downward drift of the dominant armNot necessarily abnormal - must be interpreted in clinical context InterpretationPositive with eyes open: Motor deficitPositive with eyes closed: Sensory deficit (Posterior column)Outward and upward drift: Cerebellar drift"Updrift" (involved arm rising overhead without patient awareness): Parietal lobe lesions (loss of position sense)Drift without pronation: Functional upper limb paresis (Conversion disorder)Ref: Ganong&;s review of medical physiology, 23rd edition, Page no:242 | Physiology | Nervous system | Pronator drift test is done for lesion of
A. Pyramidal tract
B. Oliva rubral tract
C. Tractus cuneatus
D. Antero lateral tract
| Pyramidal tract |
a410a20e-74f7-461d-88cc-59fc125b1c84 | Ans. is 'c' i.e., Phospholipase A2 Anti-inflammatory action of corticosteroids:* Irrespective of the type of injury or insult, the attending inflammatory response is suppressed by glucocorticoids.* This is the basis of most of their clinical uses.* The action is nonspecific and covers all components and stages of inflammation. This includes reduction of increased capillary permeability, local exudation, cellular infiltration, phagocytic activity and late responses like capillary proliferation, collagen deposition, fibroblastic activity, and ultimately scar formation.* The action is direct and local-topical use is possible.* The cardinal signs of inflammation-redness, heat, swelling, pain are suppressed.* Glucocorticoids interfere at several steps in the inflammatory response but the most important overall mechanism appears to be limitation of recruitment of inflammatory cells at the local site and production of proinflammatory mediators like PCs, LTs, PAF through inhibition of phospholipase A2.* Corticoids are only palliative, do not remove the cause of inflammation; the underlying disease continues to progress while manifestations are dampened.* They favour spread of infections because capacity of defensive cells to kill microorganisms is impaired.* They also interfere with healing and scar formation: peptic ulcer may perforate asymptomatically.* Indiscriminate use of corticoids is hazardous. | Pharmacology | Asthma | Antiinflammatory action of steroid is due to inhibition of-
A. Cyclooygenase
B. Lipooxygenase
C. Phospholipase A2
D. Myeloperoxidase
| Phospholipase A2 |
3db3fd74-d1e7-4b60-b71c-1c752a81622d | Vasopressin is a hormone secreted by cells of the hypothalamic nuclei and stored in the posterior pituitary for release as necessary; its stimulates contraction of the muscular tissues of the capillaries and aerioles, raising the blood pressure, and increases peristalsis, exe some influence on the uterus, and resorption of water by the kidney tubules, resulting in concentration of urine. Its rate of secretion is regulated chiefly by the osmolarity of the plasma.Ref: Ganong&;s review of medical physiology; 24th edition; page no:-303 | Physiology | Endocrinology | Where does ADH not act?
A. PCT
B. Collecting duct.
C. Collecting tubules
D. DCT
| PCT |
299de6a6-a2be-42a5-a573-c3641f22e9c8 | D i.e. Gastroduodenal- Rt gasgtroepiploic a. is branch of gastroduodenal a.Q & left gastroepiploic a. is a branch of splenic a.Q (left sided structure).- Superior pancreatico-duodenal a. is a br. of gastroduodenal a. & inferior pancreatico-duodenal a. is a br. of superior mesentric a.Q - Rt. gastric a. is a br. of hepatic a.Q & lt gastric a. is a br. of celiac trunk.Q | Anatomy | null | The it gastroepiploic aery is a branch of the:
A. Left gastric
B. Splenic
C. Celiac trunk
D. Gastroduodenal
| Gastroduodenal |
6ee47cd2-837a-4a23-a511-e2141b38cc99 | Answer is A (hs CRP) hs CRP which is a serum marker of systemic inflammation has emerged as a major risk factor marker fir future cardiovascular events CRP and Future risk of cardiovascular events CRP when measured by high sensitivity assays (hs CRP) strongly and independently predicts risk of Myocardial Infarction, Stroke, Peripheral Aerial disease and Sudden Cardiac Death among healthy individuals hs CRP adds prognostic information at all levels of LDL cholesterol and at all levels of risk as determined by the Framingham risk score hs CRP is a better predictor of cardiovascular risk than lipoprotein 'a', homocysteine or interleukin 6 and an elevated hs CRP carries a significantly higher relative risk offitture cardiovascular events than any of the other individual factors Infact hs CRP may be a better predictor of cardiovascular risk than elevated LDL cholesterol levels `Absolute vascular risk is higher in individuals with elevated hs CRP levels and low levels of LDL cholesterol than in those with elevated levels of LDL cholesterol but low levels of hs CRP' | Medicine | null | Best predictor for future risk of cardiovascular events, amongst the following is:
A. hs CRP
B. Lipoprotein 'a'
C. Homocysteine
D. Interleukin 6
| hs CRP |
70d1a0d1-c63d-488d-8711-5483c269aff2 | Livedo reticularis consists of a mottled reticular vascular pattern and appears like lace like purplish discoloration of the skin. It is a manifestation of venous thrombosis. Ref: Harrisons, Edition - 18 , Page - 2736 | Medicine | null | Dermatological manifestation of antiphospholipid antibody syndrome among the following is:
A. Cutaneous eruptions
B. Acneiform eruptions
C. Livedo reticularis
D. Telangiectasia
| Livedo reticularis |
7766dec4-c70a-4f41-a454-b932968a9acf | Total fertility rate determines the average number of children a woman would have if she were to pass through her reproductive years bearing children at the same rates as the women now in each age group does.
It is computed by summing the age specific fertility rates for all ages. This gives the approximate magnitude of the completed family size. - Park | Social & Preventive Medicine | null | The completed family size may be estimated by -
A. Birth rate
B. Death rate
C. Total fertility rate
D. Age specific fertility rate
| Total fertility rate |
1b697af6-c7a0-4eee-92a8-2ab8d74c78ef | Ans. C. OPC poisoningAll the symptoms listed in the questions are symptoms associated with cholinergic effects which is OPC poisoning.it should not be confused with atropine poisoning where effects are anticholinergic. | Pharmacology | A.N.S. | A28-year-old farmer is convulsing, with 100bpm heart rate, BP180/100, diarrhea, vomiting and urination. Pupil are pin point. Drug poisoning suspected is:
A. Aspirin poisoning
B. Amphetamine
C. OPC poisoning
D. Atropine poisoning
| OPC poisoning |
d127a044-5c98-4ddc-a065-a4b41d8e5ddd | Ans: c (100 Rad) Ref: Practical Radiotherapy- Physics and equipment 2nd ed/p.25, 2521 Gray = 100 RadGray is defined as: ' The absorbed dose (D) is the quotient of de by dm, where de is the mean energy imparted by the ionising radiation to matter of mass dm. D = de dmThe S.I unit of absorbed dose is gray. 1 Gray = 1 joule per kg = 100 RadIntensity is defined as the X - ray energy passing through unit area per unit time and is measured in roentgens.Rem is the Rontgen equivalent man, where absorbed dose of rads is multiplied by the quality factor of the type of radiation. The biological effect of radiation is expressed in Rem. | Radiology | Fundamentals In Radiology | 1 Gray is equal to
A. 1 Rontgen
B. 1 Rad
C. 100 Rad
D. 1 Rem
| 100 Rad |
9ad9a2cc-f595-4ac7-aec5-b829b3543057 | Papillary thyroid cancer is the most common cancer. Occurs in 70-80% of patients diagnosed with thyroid cancer. Common in females and younger age group. According to Woolner's Classification there are 3 types. 1)Occult primary(less than 1.5cm) 2) Intrathyroidal 3) Extrathyroidal Reference: SRB's Manual of Surgery, 6th Edition, page no = 468. | Surgery | Endocrinology and breast | Most common histological type of the thyroid carcinoma is
A. Medullary type
B. Follicular type
C. Papillary type
D. Anaplastic type
| Papillary type |
d91f8d8d-86ba-407d-b644-4935b90be04d | (A) Nigrostriate pathviay> The long dopamine systems are the nigrostriatal system, which projects from the substantia nigra to the striatum and is involved in Motor control. | Physiology | Nervous System | Major dopaminergic pathway is
A. Nigrostriate pathway
B. Mamillothalamic tract
C. Thalamo cortical relays
D. Cerebral association fibres
| Nigrostriate pathway |
f5588d2f-4b7f-48ac-81f3-4adc072945ad | Ans. is 'a' i.e., Thomas test Tests for Hip JointTESTINDICATIONTHOMASFixed flexion DeformityTrendelenburg TestFailure of the Abductor MechanismBryants TriangleSupratrochanteric ShorteningSquaring of pelvisAdduction/Abduction DeformityTelescoping TestPositive in DDH, transcervical neck femur fractureNelatons LineSupratrochanteric ShorteningChienes testSupratrochanteric ShorteningShoemakers LineSupratrochanteric Shortening | Orthopaedics | Arthritis | Test for fixed flexion deformity of the Hip?
A. Thomas test
B. Trendelenburgs test
C. Nelatons test
D. Telescoping test
| Thomas test |
b6d59fe5-c3f3-4016-9272-7dd7933986db | Lead poisoning is mainly manifested by neurologic disorders, particularly in children. Lead absorption is enhanced by zinc deficiency; zinc is a trace metal. Lead inhibits heme incorporation into hemoglobin, leading to increased amounts of zinc protoporphyrin with anemia. Cadmium is a heavy metal associated with toxicity to the gastrointestinal tract, kidneys, and lungs. Copper is a trace metal that is unlikely to cause toxicity from environmental sources, although copper accumulation can occur with Wilson disease. Acute iron poisoning is associated with gastrointestinal, renal, and CNS toxicities. Nickel jewelry may cause skin rash; inhaled nickel produces respiratory problems. | Pathology | Blood | Children 6 to 10 years old in the same community are observed by the local physician to be doing poorly in school, which has been attributed to behavioral problems. Their parents state that these children have poor appetites, complain of nausea, and have frequent headaches. On physical examination, they have decreased sensation to touch over the lower extremities. They exhibit loss of fine motor control of movement and have a slightly ataxic gait. A representative CBC shows hemoglobin of 11.8 g/dL, hematocrit of 35.2%, MCV of 82 mm3, platelet count of 282,300/ mm3, and WBC count of 4745/ mm3. Examination of the peripheral blood smear shows basophilic stippling of the RBCs. Excessive chronic ingestion of which of the following substances is most likely to explain these findings?
A. Cadmium
B. Copper
C. Iron
D. Lead
| Lead |
4bf68693-d0a6-40bc-a23a-9c81060a6c3f | Trapezius Iatrogenic injury of the spinal accessory nerve (usually accidental damage during minor neck surgery) is the most common cause of accessory nerve palsy. Although rare, this kind of damage can cause extensive morbidity, including numbness, paralysis, pain, and winging of the scapula. In jugular foramen syndrome, caused by pathologies including nasopharyngeal carcinoma or a glomus tumor, lesions of the glossopharyngeal, vagus and accessory nerves coexist. | Anatomy | null | Winging of scapula is due to damage to the nerve supply of?
A. Serratus anterior
B. Latissimus dorsi
C. Trapezius
D. Deltoid
| Trapezius |
9df78a9b-44fb-42cf-a895-36d43549995c | Answer is C (Mesangial deposits of IgA): Presence of non blanching rash (Purpura), swelling of knee (Ahralgia) along with haematuria (glomerulonephritis) suggests the diagnosis of Henoch- Schonlein purpura. H.S purpura is characterized by deposition of IgA in the mesangial region (Robbins) | Medicine | null | A 8 year old male had non blanching rashes over the shin and swelling of knee joint with haematuria +++ and protein +. Microscopic analysis of his renal biopsy specimen is most likely to show?
A. Tubular necrosis
B. Visceral podocyte fusion
C. Mesangial deposits of IgA
D. Basement membrane thickening
| Mesangial deposits of IgA |
5c85d988-8669-4baa-89f7-85bf6531c620 | Simple proteins are those that are made up of only amino acids. Conjugated proteins are combinations of protein with a non-protein pa, called prosthetic group Albumin is a simple protein. It may transpo metal ions. But there is no prosthetic group -> option a is excluded. Gluten, a protein composite of:- Prolamin (in wheat named gliadin) Glutelin(in wheat named glutenin) This is again a simple protein -> option b is excluded. Myoglobin contains heme prosthetic group. So, it is obviously a conjugated protein -> option c is the answer. | Biochemistry | Proteins bonds and structure | Which of the following is an example of conjugated protein?
A. Albumin
B. Glutelin
C. Myoglobin
D. Globulin
| Myoglobin |
280c3867-cd2b-4e05-91e7-bac05b9b7e67 | Ans. is 'b' i.e, Sin of Gomorrah Buccal coitus (coitus per os/sin of gomorrah) In this, the male organ is introduced into mouth, usually of a young child. Fellatio is oral stimulation of penis by male or female. Cunnilingus is oral stimulation of female genitals. | Forensic Medicine | null | What is another name for buccal coitus ?
A. Buggery
B. Sin of Gomorrah
C. Cunnilingus
D. Fetishism
| Sin of Gomorrah |
af368e40-942b-479f-9f97-61327c0f94f4 | Most commonly, TR is secondary to marked dilation of the tricuspid annulus from RV enlargement due to PA hypeension. Functional TR may complicate RV enlargement of any cause, including an inferior MI that involves the RV. It is commonly seen in the late stages of hea failure due to rheumatic or congenital hea disease with severe PA hypeension (pulmonary aery systolic pressure >55 mmHg), as well as in ischemic and idiopathic dilated cardiomyopathies. It is reversible in pa if PA hypeension can be relieved. Rheumatic fever may produce organic (primary) TR, often associated with TS. Infarction of RV papillary muscles, tricuspid valve prolapse, carcinoid hea disease, endomyocardial fibrosis, radiation, infective endocarditis, and trauma all may produce TR. As is the case for TS, the clinical features of TR result primarily from systemic venous congestion and reduction of CO. With the onset of TR in patients with PA hypeension, symptoms of pulmonary congestion diminish, but the clinical manifestations of right-sided hea failure become intensified. The neck veins are distended with prominent v waves and rapid y descents, marked hepatomegaly, ascites, pleural effusions, edema, systolic pulsations of the liver, and a positive hepatojugular reflex. ref : Harrison&;s principle of internal medicine,20 th edition,pg no.1948 | Medicine | C.V.S | Enlarged pulsatile liver is seen in-
A. Tricuspid regurgitation
B. Aoic regurgitation
C. Mitral regurgitation
D. Pulmonary regurgitation
| Tricuspid regurgitation |
eaa2da68-a0d7-4f65-b0bb-5683a53ac249 | Ans. c (Cri du chat) (Ref. Harrison's Internal medicine 17th edition, p. 412; Robbin's pathology 7th edition, p. 177)Cri-du-chat syndrome: Congenital microdeletion of short arm of chromosome 5 (46, XX or XY, 5p-). Findings: microcephaly, moderate to severe intellectual disability, high-pitched crying/mewing, epicanthal folds, cardiac abnormalities (VSD).Location of diseases on chromosomesDiseasesDeletionWolf-hirschorn syndrome4p-Cridu chat5p-DiGeorge syndrome22q-Cat-cry syndrome22p-Miller-Dieker17p-a-thalassemia16p -Angelman Syndrome15q - (angel ... maternal Mama)Prader-Willi Syndrome15q - (paternal .... P .... Papa)Retinoblastoma13q 14 -Beckwith-Wiedemann syndrome11 pl5 -WAGAR11 pl3 -Down's syndromeTrisomy 21PatauTrisomy 13Edwards syndromeTrisomy 18Educational Points:22q 11 deletion associated with high incidence of schizophrenia (Harrison's 17th edition, p. 2075; Robbins, 178)TrisomyCardinal featuresTrisomy 13 (Patau syndrome)# Auricular deformities# Microcephaly# Arrhinencephaly# Inner ear anomalies# Ocular anomalies# Hypertelorism# Cleft lip and palate# VSD# Simian creaseTrisomy 18 (Edward syndrome)# Auricular deformities# Inner ear anomalies# Ptosis of eyelids# Micrognathia# Flexion deformities# Mental retardationTrisomy 21 (Down's syndrome)# Auricular deformities# Hypertelorism# Epicanthal fold# Protruding tongue# High arched palate# Inner ear anomalies# Cardiovascular defects# Mental retardation | Medicine | Genetics | Deletion of short arm of 5th chromosome is___ syndrome
A. Edward
B. Patau
C. Cri-Du-Chat
D. Down's
| Cri-Du-Chat |
e5a24220-c97f-411b-9084-d01db1735792 | Clinical features of Rhinosporodiosis : Leafly, polypoidal mass, pink to purple in colour, attached to nasal septum or lateral wall mass is very vascular, bleeds on touch and studded with white dots (Strawberry-Like appearance). | ENT | null | Nasal polyps with subcutaneous nodules are seen in-
A. Zygomycosis
B. Rhinosporidiosis
C. Sporotrichosis
D. Aspergillosis
| Rhinosporidiosis |
e73b7bff-701c-4648-9bde-bbe63d8e4aac | Ans. is c, i.e. VestibuleRef: COGDT 11th/ed, p26Vestibule is the triangular area bounded anteriorly by the clitoris, posteriorly by Fourchette and on either side by labia minora. | Gynaecology & Obstetrics | Gynaecological Anatomy | The triangular area bounded by clitoris, fourchette and labia minora is:
A. Fossa navicularis
B. Ventricle
C. Vestibule
D. Vulva
| Vestibule |
a375cfda-35e6-470e-a218-17fb4ae8285f | C i.e. Vaso vagal attack Total spinal anesthesia - Ocurs if the large volume of LA used for epidural -anesthesia is injected into subarachnoid space i.e. it occurs following epidural/caudal anesthesia, if there is inadveent intrathecal injection of large volume of drugs. - It occurs after (not during injection) Vasovagal attack or emotional fainting (Syncope) Likely to occur paicularly in an anxious patient with a rapidly ascending spinal block. It may occur instantaneously even during the procedure (e.g. spinal)Q. Pallor, nausea and (neurocardiogenic) bradycardia or asystole are a/w hypotension and fainting. Rapid resolution results from placing the patient in head down position and administration of iv ephedrine or atropine. Systemic toxicity - If large amount of LA reach the tissues of hea and brain they exe the same membrane stabilizing effect as on nerve resulting in progressive depression of function. The earliest feature is numbness or tingling of tongue and circumoral area; b/o rich blood supply to these tissue depositing enough drug to have an effect on nerve endings. The patient may beome light headed, anxious, drowsy and or complain of tinnitus. Convulsions, loss of consciousness, coma and apnoea may develop subsequently. Cardiovascular collapse may result from direct myocardial depression and vasodilation or hypoxemia d/t apnoea. - The most ommon cause is accidental intravascular injectionQ but it may also result from absolute overdose during blocks. System absorption of LA is greatest after intercostal nerve block and caudal anesthesia; intermediate after epidural anesthesia > brachial plexus > sciatic & femoral nerve block; and least after infiltration anesthesia. | Anaesthesia | null | An anesthesia resident was givnig spinal anesthesia when the patient had sudden aphonia and loss of consciousness. What could have happened?
A. Total spinal
B. Paial spinal
C. Vaso vagal attack
D. Intra vascular injection
| Vaso vagal attack |
7b8685ec-a4c9-4203-a832-3b642ce437cd | Mayapple (May Apple) Toxic Principle : Podophyllin (purified form: podophyllotoxin) Clinical Features : Exposure of eyes causes irritation with conjunctivitis, keratitis, corneal ulceration, and iritis. Ingestion results in nausea, abdominal pain, vomiting,and diarrhoea. fever, tachypnoea, tachycardia, hypotension, ataxia, dizziness, lethargy, confusion, and altered sensorium. Treatment : No specific antidote is known. Emesis may be useful during the initial phases of toxicity. Hemodialysis is ineffective, but charcoal hemoperfusion has reversed acute symptoms within hours. Topically administered resin should be removed with petroleum jelly. If eye contact occurs, flush with copious amounts of warm water and consult a physician or poison center immediately. | Forensic Medicine | Toxicology - 3 | The toxic principle of this plant is:-
A. Tetrahydro canabinol
B. Thevetin
C. Oduvin
D. Podophyllin
| Podophyllin |
a38b4098-25a6-4b3e-aedb-12d1aacead9c | Abandoning of a child Father or mother of a child who is under 12 years or anyone who is having care of such child, leaves such a child in any place with the intention of abandoning the child shall be punished with imprisonment upto 7 years. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 354 | Forensic Medicine | Sexual offences and infanticide | Abandoning a child will be punished for
A. 2 years
B. 4 years
C. 5 years
D. 7 years
| 7 years |
dab02540-b737-424b-aeac-4d7502be3b55 | Ans. is 'b' i.e., B Positive in Lead I and Negative in Lead II The normal QRS axis lies between -30deg and + 90". Left axis detion is conventionally diagnosed when QRS axis lies more leftward negative than -30". A quick way to assess QRS axis is to look at leads I and II. If the QRS axis is positive in leads 1 and II then the axis is normal. If the QRS complex positive in lead I and negative in lead II left axis detion. If the QRS complex is negative in lead I and positive in lead II right axis detion. Negative QRS complexes in both leads I and II most commonly indicates -4 incorrect positioning of the limb electrodes. | Medicine | null | Left Axis Detion is seen are
A. A Positive in Lead I and Positive in Lead 11
B. B Positive in Lead I and Negative in Lead II
C. C Negative in Lead I and Negative in Lead II
D. D Negative in Lead I and Positive in Lead II
| B Positive in Lead I and Negative in Lead II |
44a5c30c-49ee-4884-81ae-7209629cbd29 | Ans. is 'a' i.e., Vasoconstriction o All the given options are caused by angiotensin II. But vasoconstriction is the most prominent action.Actions of angiotensin 11 (A-II)o The most prominent action of A-II is vasoconstriction.o Angiotensin II is one of the most potent vasoconstrictors known, being four to eight times as active as epinephrine.o Vasoconstriction involves arterioles and venules and occurs in all vascular beds. However, it is less marked in cerebral, skeletal muscle, pulmonary and coronary vessels.o A-II increases the force of myocardial contraction by promoting Ca+2 influx.o A-II and A-II I are tropic to zona glomerulosa of adrenal cortex -| aldosterone secretion - Na+ & water retention.o A-II also has a direct action on kidney - promotes Na+, C1- and HCO2- reabsorption.o In brain, A II induces drinking behavior and ADH release. It also increases central sympathetic outflow.o A-II enhances sympethetic activity by peripheral action as well - It releases Adr from adrenal medulla, stimulates autonomic ganglia and increases the output of NA from adrenergic nerve endings. | Physiology | Glomerular Filtration, Renal Blood Flow, and Their Control | Most prominent action of angiotensin II-
A. Vasoconstriction
B. Induction of thirst
C. Increased secretion of aldosterone
D. Increased Na+ reabsorption
| Vasoconstriction |
c8676dc3-d6f2-47f6-9a20-35b082f1405b | Following disease are caused by EBV (Epstein Barr virus): * Infectious mononucleosis * Nasopharyngeal carcinoma * Burkitt's lymphoma * Hodgkin's disease * B-cell lymphoma * Hairy (oral) leukoplakia Ref: Ananthanarayana textbook of Microbiology 9th edition Pgno : 474 | Microbiology | Virology | Which of the following is not related to Epstein- Barr virus infection?
A. Infectious mononucleosis
B. Epidermodysplasia verruciformis
C. Nasopharyngeal carcinoma
D. Oral hairy leukoplakia
| Epidermodysplasia verruciformis |
55988eda-6aec-4eae-874b-3750206c88e0 | Catecholamines are derivatives of phenylalanine/tyrosine. "Nor" in noradrenaline (norepinephrine) indicates the absence of methyl group. The methyl group of adrenaline (epinephrine) is derived from S-Adenosyl methionine (AdoMet) | Biochemistry | Phenylalanine and Tyrosine metabolism Detail | Which of the following chemical reaction is involved in the conversion of noradrenaline to adrenaline?
A. Hydroxylation
B. Carboxylation
C. Methylation
D. Dehydrogenation
| Methylation |
d24bffd2-26b7-45ce-8432-5d3e1ed56b19 | Ans. is. 'a' i. e., Inseion of viral nucleic acid into bacteria by bacteriophage | Microbiology | null | Prophage is defined as:
A. Inseion of viral nucleic acid into bacteria by bacteriophage
B. First cycle of division of bacterial nucleic acid
C. Last cycle of division of bacterial nucleic acid
D. Integrated temperate bacteriophage genome into bacterial chromosome
| Inseion of viral nucleic acid into bacteria by bacteriophage |
89683850-05c0-4130-85a6-2e80392ec14a | Ans. is b, i.e., MethionineFood itemlimiting amino acidLegumesMethionine (also leucine & threonine)CerealsThreonine (also lysine)PulsesMethionine (also cysteine)MaizeTryptophan (also lysine) | Biochemistry | null | Limiting amino acid in legumes ?
A. Lysine
B. Methionine
C. Alanine
D. Tryptophan
| Methionine |
c1b8e003-e1e5-4bf5-abd3-7a2c9ce1cd4d | Ans. is c i.e. Levonorgestrel tablets Centchroman tablets are not used as emergency contraception. Cu-T cannot be used in nulliparous patients. LNG tablet is the answer of choice as it has : - Less failure rate No side effects Single dose therapy 0.75mg LNG is to be taken within 72 hours of unprotected intercourse and another 12 hours later. Levonorgestrel is the DOC for emergency contraception. Ethinyl estradiol tablets has high failure rate (3.2%). | Gynaecology & Obstetrics | null | A 20 years old girl was raped around 13th day of her cycle. The best possible emergency contraception to be offered would be :
A. Centchroman tablets
B. Cu-T inseion
C. Levonorgestrel tablets
D. Ethinylestradiol tablets
| Levonorgestrel tablets |
f15c5211-1687-4a64-a7c4-a58131c4aa41 | Ans. is 'd' i.e., Syphilis Laboratory diagnosis of syphiliso Lab. diagnosis of syphilis consists of: -A) Demonstration of spirochetes under microscopy# Microscopy is applicable only in primary & secondary stage as spirochetes are abundant during primary, and secondary stage (maximum number of spirochetes and infectivity). Microscopy used are Dark field microscopy, and immunofluorescence microscopy (Direct fluerecent antibody test - DFA-TP).B) Serological tests# These tests form the mainstay of laboratory diagnosis. Serological tests are: -1) Non-specific tests (reagin antibody or standard tests):- Kahn test, VDRL, Rapid plasma reagin (RPR), automated VDRL-ELISA, Washermann test. These test measure IgG & IgM against cardiolipin.2) Group specific test: - CFT3) Species specific tests: - Treponema pallidum particle agglutination (TPPA) test, Treponema pallidum immobilization (TP1), Triponema pallidum hemagglutination assay (TPHA), ELISA.o Specific treponemal tests (FTA-ABS, TPHA, TPI) are of little value as indicators of clinical cure, as they tend to remain positive inspite of Treatment. Non treponemal tests (eg VDRL) will become nonreactive or will be reactive at lower titers after therapy, so can be used for monitoring patient's response to treatment These tests usually become negative 6-18 months after effective treatment of syphiliso A four fold or greater decrease in antibody titre indicates response to therapy | Microbiology | Bacteria | VDRL test is used for -
A. Chanchroid
B. LGV
C. Granuloma inguinale
D. Syphilis
| Syphilis |
43878189-a732-4f01-b090-4f7b413390cf | IgM is a heavy molecule. - IgM molecules are polymers of five four-peptide subunits. the earliest immunoglobulin synthesized by the fetus. - the isohemagglutinins ( anti- A, anti - B ) and many other natural antibodies to microorganisms are usually IgM. ReReference:nathanarayan & paniker's 9th edition, pg no: 98 <\p> | Microbiology | Immunology | Hemagglutinin (Anti A and Anti B) are which type of antibodies -
A. Ig G
B. Ig M
C. Ig A
D. IgE
| Ig M |
e1fd6d5a-c46d-42a8-88d8-b53ad1c5dfa9 | (Ref: KDT 6/e p270) It is an alpha-glucosidase inhibitor. It inhibits the breakdown of complex carbohydrates to simple carbohyrates and thus decreases their absorption. | Anatomy | Other topics and Adverse effects | Which of the following drugs promotes the release of endogenous insulin?
A. Acarbose
B. Glipizide
C. Nateglinide
D. Pioglitazone
| Acarbose |
1a5fe7bb-580e-4784-a09a-f1081dddc4e9 | The epiblast is capable of forming all three germ layers (ectoderm, mesoderm, and endoderm) during gastrulation week 3 of development . | Anatomy | Development period- week 1,2,3,4 | The epiblast is capable of forming which of the following germ layers?
A. Ectoderm only
B. Ectoderm and mesoderm only
C. Ectoderm and endoderm only
D. Ectoderm, mesoderm, endoderm
| Ectoderm, mesoderm, endoderm |
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