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f76fac04-7bd7-4869-82c4-7d1903ac138b | Ans. is 'a' i.e., 6 months Immediately after bih, the newborn has high level of IgG antibodies in blood stream. But these antibodies are passively transferred to the baby from mother (i.e., maternal antibodies). During next few months, the maternal IgG antibodies steadily decrease. When healthy baby is about 2-3 months old, the immune system stas producing its own IgG antibodies. Once healthy babies reach six months of age, their IgG productin reaches at normal level. Note IgM antibodies production stas before bih only (3-6 months before), but at very lowlevel. | Microbiology | null | Capacity of producing IgG stas at what age
A. 6 months
B. 1 year
C. 2 years
D. 3 years
| 6 months |
d45de657-1ddd-434a-9b5b-7635694b0671 | Ans is 'a' i.e., Fetal placental steroid sulfatase deficiency o Placental steroid sufatase deficiency is an X-linked disorder (affects only males) that does not lead to ambiguous genitalia in a female child. o 'Placental steroid sullatase deficiency is a rare X-linked disorder and all affected fetuses are males' William's 22'd/8I o Congenital adrenal hyperplasia is the most common cause of ambiguous genitalia in female child. o Fetal placental aromatase deficiency and WNT-4 gene mutation cause ambiguous genitalia in female child. | Pediatrics | null | Which of the following is the least common cause of ambiguous genitalia in a female child-
A. Fetal placental steroid sulfatase deficiency
B. Fetal placental aromatase deficiency
C. Congenital adrenal hyperplasia
D. WNT-4 gene mutation
| Fetal placental steroid sulfatase deficiency |
9dbba7d3-334e-44ff-843b-b62c6a0021c6 | Fluphenazine is an anti depressant that is also available as a depot preparation. REF KD TRIPATHI 8TH ED. | Pharmacology | Central Nervous system | which of the following antipsychotic drugs is available as a depot injection?
A. Fluphenazine
B. Ziprasidone
C. Trifluperazine
D. Aripiprazone
| Fluphenazine |
915d509c-6303-4c30-9ef2-8287f795e5ba | ANSWER: (A) 3 weeksREF: Primer of radiobiology by Elizabeth Latorre Travis page 196The first trimester, particularly the first 6 weeks of development, appears to be the most radiosensitive in terms of both lethality and induction of congenital abnormalities in humansHence the answer is 3 weeks | Radiology | Radiotherapy | Fetus is most radio sensitive at which week?
A. 3 weeks
B. 8 weeks
C. 12 weeks
D. 15 weeks
| 3 weeks |
e527a977-2fa4-4c90-a46a-85b55c07bcc4 | (Histone) (225 - RS 7th)DNA is a polymer of deoxyribonucleotides and is found in chromosomes, mitochondria, and chloroplasts. The nuclear DNA is bound to basic proteins called HistonesHistones - These are basic proteins rich in Arginine & Histidine | Biochemistry | Molecular Genetics | The proteins presents in Deoxyribonucleic acid is
A. Protamines
B. Histone
C. Albumins
D. Globulins
| Histone |
34861471-59d7-4fa6-b422-9c19a27bb7f7 | Acute Intoxication After a brief period of excitation, there is a generalised central nervous system depression with alcohol use. With increasing intoxication, there is increased reaction time, slowed thinking, distractibility and poor motor control. Later, dysahria, ataxia and incoordination can occur. There is a progressive loss of self-control with frank disinhibited behaviour. The duration of intoxication depends on the amount and the rapidity of ingestion of alcohol. With blood alcohol levels of 300-450 mg%, increasing drowsiness followed by coma and respiratory depression develop. Death occurs with blood alcohol levels between 400 to 800 mg%. Occasionally a small dose of alcohol may produce acute intoxication in some persons. This is known as pathological intoxication. Another feature, sometimes seen in acute intoxication, is the development of amnesia or blackouts. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 37 | Psychiatry | Substance abuse | In an alcoholic man, Blackout is seen in
A. Alcohol abstinence
B. Hepatic encephalopathy
C. Alcohol intoxication
D. Alcohol withdrawal
| Alcohol intoxication |
8f2e2b0a-1918-4ff2-b788-b99de6e3cf5f | Ans. C. Watch for progress of labora. Multigravida, in active labor, preterm baby and mentoanterior position, can be observed for progress of labor where with progressing uterine contraction and continued flexion of the head the face might revert to vertex position or anterior rotation of the mentum can occur in which case vaginal delivery can be accomplished.b. Performing amniotomy is an unnecessary intervention in preterm labor, which will augment labor and interfere with the normal progress. It is not done unless indicated.c. Steroids are not given in this case for fetal lung maturation even though the fetus is < 34week, as the woman is much advanced in labor and will deliver before the steroid can take effect. The beneficial effect of steroid begins 24 hours after the first dose and lasts till 7 days. | Gynaecology & Obstetrics | Miscellaneous (Obs) | A G4, P3, L3 woman has come in labor at 30-week gestation. On pervaginal examination she is 7cm dilated, fully effaced, membranes intact with face presentation and mentum directed anteriorly. How is she managed?
A. Take her up for immediate Caesarean section
B. Give her steroids and watch for progress of labor
C. Watch for progress of labor
D. Perform amniotomy
| Watch for progress of labor |
28286b81-310e-495f-97fc-fe9450753bfe | Ciliated columnar epithelium is seen in trachea and bronchus Inderbir Singh&;s textbook of human Histology Seventh edition Pg no 45 | Anatomy | General anatomy | Trachea is lined by
A. Simple columnar
B. Pseudostratified columnar
C. Simple cuboidal
D. Stratified squamous, non-keratinized
| Pseudostratified columnar |
85c6dc6c-76ce-49c0-8354-561e012be7c7 | ANSWER: (C) Ewing's sarcomaREF: Apley's system of orthopaedics 8'h edition page 190, Tureks orthopaedics 6th edition page 307Repeat from June 2008EWING'S SARCOMA:Highly malignant, undifferentiated peripheral primitive neuro ectodermal tumor (PEN)Most common site is diaphysis of femurCommon in 10-20 year old maleHistopathology shows round cells containing glycogen and reticulin; PAS positive and diastase digestable80-95% tumors possess translocation; t(ll; 22)X Ray reveals laminated periosteal new bone formation also known as "Onion peel appearance" | Orthopaedics | Bone Tumour | The bone tumor seen in children with characteristic "onion-peel" periosteal reaction is?
A. Osteosarcoma
B. Giant cell tumor
C. Ewings sarcoma
D. Osteoid osteoma
| Ewings sarcoma |
a068c382-82f1-4b21-9a62-2597cf684e52 | Remember all ACE inhibitors other than Captopril and lisinopril are prodrugs. | Pharmacology | null | Which is not a prodrug:
A. Quinapril
B. Fosinopril
C. Benzopril
D. Lisinopril
| Lisinopril |
be148fee-7931-4c3e-a8b2-ca4300630819 | Ans. is 'a' i.e., HMP shunt HMP shunt is paicularly impoant for two purposes :-Synthesis of ribose for nucleotide and nucleic acid formation.Formation ofNADPH which plays impoant role in several other biological processes, e.g. synthesis of fatty acids, cholesterol, steroid hormones and neurotransmitters. | Biochemistry | null | Source of ribose is ?
A. HMP shunt
B. Glycolytic pathway
C. Uronic acid pathway
D. Beta oxidation
| HMP shunt |
fc2ca07f-e3f5-4911-b280-7f85f4ed95ac | Ref: Text book of Obstetrics by D.C.Dutta. 7th ed. Pg. 297.Explanation:Treatment of choice for toxoplasmosis during pregnancy:Spiramycin 3 g/dayPyrimethamine 25mg + sulphadiazine 1 gQlD for 4-6 weeksPyrimethamine is not given in 1' trimesterMode of infection : Eating raw, Uncooked meat/ through cat feces/ Through placentaEffects on baby:HydrocephalusChorioretinitisCerebral calcificationsMicrocephalyMental retardation | Gynaecology & Obstetrics | Infectious Diseases | Drug of choice for maternal toxoplasmosis
A. Spiramycin
B. Pyrimethamine
C. Doxy + sulfadiazine
D. Trimethorpim sulphamethoxazole
| Spiramycin |
3ddb1ef9-9514-4225-8895-e1f53f6a0cba | ANSWER: (D) EnterocytozoonREF: http://en.wikipedia.org/wiki/Coccidia, http:vVen.wikipedia.org/wiki/EucoccidioridaCoccidia are a subclass of microscopic, spore-forming, single-celled obligate parasites belonging to the apicomplexan class Conoidasida. Coccidian parasites infect the intestinal tracts of animals, and are the largest group of apicomplexan protozoa.CoccidianEucoccidianAdelecoccidianHaemogregarina, Hepatozoon, KaryolysusEimericoccidianCryptosporidiidae (Cryptosporidium) Eimeriidae (Isospora, Cyclospora, Eimeria) Sarcocystidae (Toxoplasma, Sarcocystis, Besnoitia, Neospora)AgamococcidianRhytidocystidae (Rhytidocystis) | Microbiology | Mycology | Which of the following is not a coccidian?
A. Isospora
B. Cyclospora
C. Cryptosporidia
D. Enterocytozoon
| Enterocytozoon |
269601bc-d847-40eb-949f-3dee0cbc073c | Impetigo contagiosa is caused most often by staph aureus and in some cases by group 'A' streptococci. | Dental | null | Impetigo contageosa most commonly due to –
A. Group B streptococcus
B. Staphylococci
C. Moniliasis
D. Streptococcus viridans
| Staphylococci |
78bf77e0-8342-4ba0-93dc-0c48f459d12d | Surveillance after marketing, i.e. after the drug is out in the market is a pa of Phase IV of clinical trials. It includes follow-up of patients taking the drug and adverse drug reaction (ADR) repoing as well as looking for newer treatment indications Ref: Park 24th edition | Social & Preventive Medicine | All India exam | Post marketing surveillance included in which phase of drug clinical trial?
A. i
B. ii
C. iii
D. iv
| iv |
30de73aa-efab-4f88-aa6b-5c015bef1fd3 | Periampullary Carcinoma
1. Adenocarcinoma of head of the pancreas (40-60%)
2. Adenocarcinoma of ampulla of vater (10-20%)
3. Distal bile duct adenocarcinoma (10%)
4. Duodenal adenocarcinoma (5-10%)
Patients with pancreas adenocarcinoma involving the body or tail of the gland are more likely to have weight loss and abdominal pain as their initial complaints.
These lesions can grow to a larger size before producing symptoms and are often diagnosed at a later stage with a poorer prognosis.
Most body and tail cancers have already metastasized to distant sites or extended locally to involve nodes, nerves, or major vessels by the time of diagnosis.
Best prognosis: Duodenal adenocarcinoma >Ampullary carcinoma >Distal Bile duct adenocarcinoma >Head of pancreas >Body and tail of Pancreas (DAD Head Body and Tail). | Surgery | null | Best prognosis for carcinoma of pancreas is in the region of -
A. Head
B. Tail
C. Body
D. Periampullary
| Periampullary |
c9474af0-a29b-49df-968b-ee4f3ac7e369 | Increased incidence of salmonella (may spread from gallbladder infection) is seen in sickle cell anemia, but staph aureus is still the most common. Staph aureus is the most common cause of osteomyelits in all children, including those with sickle cell disease. Salmonella osteomyelitis occurs most commonly in children with sickle cell disease, but is still less common than Staph aureus in these patients. Osteomyelitis most often affects diaphysis. | Surgery | null | Salmonella osteomyelitis is common in which of the following?
A. Sickle cell disease
B. HIV
C. IV drug abusers
D. Pregnancy
| Sickle cell disease |
74003a10-1eb1-4c22-8f4a-6dc3fecb13ac | *Medial meniscus is more frequently injured than lateral meniscus because: 1) The medial meniscus is securely attached around the entire periphery of the joint capsule, which makes it less mobile. 2) Where as the lateral meniscus is more mobile and has no weak point between a movable and relatively fixed point. 3) Popliteus muscle sends few fibers into the posterior margin of lateral meniscus. Thus muscle contraction withdraw & protects the lateral meniscus by drawing it posterilaterally during flexion of the knee and medial rotation of the tibia. Function of the Meniscus * Distributes stress across the joint surface by providing a lar * Deepens the stabilization * Acts as a sho forces result&; movement * Provide lubr synol cavi er area of contact tibial plateau for greater of the knee * The lateral meniscus is loosely attached anteriorly and posteriorly to the joint capsule * Due to the great lateral meniscu injury * Lateral menisca than medial medial meniscus * The medial meniscus is firmly attached to anteriorly and posteriorly to the joint capsule * Medial meniscal tears are more common than lateral meniscal injuries -- Occur 2-5 times more often Ref: Campbell's operative ohopaedics 13th/e p.2143 | Orthopaedics | Thigh, Knee,Leg,Foot & Ankle injuries | Medial meniscus of knee joint is injured more often than the lateral meniscus because the medial meniscus is relatively -
A. More mobile
B. Less mobile
C. Thinner
D. Attached lightly to femur
| Less mobile |
81ee94e7-c4d2-400d-88ca-d6e75a04bbd8 | Metal dermatitis is most frequently caused by nickel, chromates and mercury. Nickel is naturally present in food (green leafy vegetables) and also present in jewellery, household equipment, wearing apparel and industry. | Dental | Eczema and related disorders | Commonest metal causing skin hypersensitivity?
A. Brass
B. Copper
C. Iron
D. Nickel
| Nickel |
e6e46047-28b8-41c6-be4f-d89ac160a7d7 | Emerging patterns for language behaviour from 1-5years of age 15months Jargon Follows simple commands May name a familiar object (e.g., ball) Responds to his/her name 18months 10 words (average) Names pictures Identifies 1 or more pas of the body 24months Puts 3 words together (subject, verb, object) 30months Refers to self by the pronoun "I" Knows full name 36months Knows age and sex Counts 3 objects correctly Repeats 3 numbers or a sentence of 6 syllables Most of the speech intelligible to strangers 48months Counts 4 pennies accurately Tells story 60months Names 4 colours Repeats sentence of 10 syllables Counts 10 pennies correctly Ref: Nelson paediatrics; Table 11-1 | Pediatrics | Growth and development | A Child ,Tells a story by the age of ______
A. 24 months
B. 36 months
C. 48 months
D. 60 months
| 48 months |
ca6afe6e-0649-4857-8156-42c12325b5d4 | (A) Cyclo oxygenase pathway # ASPIRIN prduces its antithrombotic effect by irreversibly acetylating and inhibiting platelet cyclo-oxygenase (COX)-1, a critical enzyme in the biosynthesis of thromboxane A2. At high doses, aspirin also inhibits COX-2, an inducible COX isoform found in endothelial cells and inflammatory cells.> Analgesic action of aspirin is mainly due to obstructing of peripheral pain receptors and prevention of prostaglandin mediated sensitization of nerve endings.> Aspirin & some NSAIDs blocked PG generation by inhibiting cyclooxygenase (COX) enzyme.> Aspirin, even in small doses, irreversibly inhibit TXA2 synthesis> Aspirin resets the hypothalamic thermostat & rapidly reduces fever by promoting heat loss but does not decrease heat production | Pharmacology | C.N.S | Aspirin acts by
A. Cyclo oxygenase pathway
B. Lipo oxygenase pathway
C. Membrane phospholipases
D. Cyclic AMP
| Cyclo oxygenase pathway |
d6da48cd-bce5-417b-a26f-fd3e870b4e14 | ANSWER: (B) Contrast CTScanREF: Dhingra 5th Ed Pg 261"Contrast enhanced CT scan is the investigation of choice for both Nasopharyngeal angiofibroma and Neuroangiofibroma"NASOPHARYNGEAL FIBROMA (JUVENILE NASOPHARYNGEAL ANGIOFIBROMASIt is a rare tumour, though it is the commonest of all benign tumours of nasopharynx.Aetiology: The exact cause is unknown. As the tumour is predominantlyseen in adolescent males in the second decade of life, it is thought to be testosterone dependent.Site of Origin and Growth: The site of origin of the tumour is still a matter of dispute. Earlier it was thought to arise from the roof of nasopharynx or the anterior wall of sphenoid bone but now it is believed to arise from the posterior part of nasal cavity close to the superior margin of sphenopalatine foramen. From here the tumour grows into the nasal cavity, nasopharynx and into the pterygopalatine fossa, running behind the posterior ivall of maxillary sinus which is pushed forward as the tumour grows. Laterally.it extends into ptery go maxillary fossa and thence to infratemporal fossa and cheek.Pathology: Angiofibroma, as the name implies, is made up of vascular and fibrous tissues: the ratio of the two components may vary. Mostly, the vessels are just endothelium-lined spaces with no muscle coat. This accounts for the severe bleeding as the vessels lose the ability to contract, and also the bleeding cannot be controlled by application of adrenaline.Extensions of Nasopharyngeal Fibroma: Nasopharyngeal fibroma is a benign tumour but locally invasive and destroys the adjoining structures. It may extend into:Nasal cavity causing nasal obstruction, epistaxis and nasal dischargeParanasal sinuses: Maxillary, sphenoid and ethmoid sinuses can all be invaded.Pterygomaxillary fossa, infratemporal fossa and cheek.Orbits giving rise to proptosis and "frog-face deformity". It enters through the inferior orbital fissure and also destroys apex of the orbit. It can also enter the orbit through superior orbital fissure.Cranial cavity. Anterior cranial fossa (through ethmoid roof or cribriform plate). Middle cranial fossa is the most common. There are two routes of entry:By erosion of floor of middle cranial fossa, anterior to foramen lacerum. The tumour lies lateral to carotid artery and cavernous sinus.Through sphenoid sinus, in to the sella. Tumour lies medial to carotid artery.Clinical FeaturesAge and sex. Tumour is seen almost exclusively in males in the age group of 10-20 years.Profuse and recurrent epistaxis. This is the most common presentationProgressive nasal obstruction and denasal speech due to mass in the postnasal space.Conductive hearing loss and serous otitis media due to obstruction of eustachian tube.Mass in the nasopharynx. Tumour is sessile , lobulated or smooth and obstructs one or both choanae . It is pink or purplish in colour. Consistency is firm but digital palpation should never be done until at the time of operation.Others: Broad nasal bridge, proptosis, swelling of cheek, infratemporal fossa or involvement of 2nd. 3rd. 4th. 6th cranial nerves will depend on the extent of tumourInvestigationsSoft tissue lateral film of nasopharynx shows soft tissue mass in the nasopharynxX-rays of paranasal sinuses and base of skull may show1 displacement of nasal septum,opacification of sinuses, anterior bowing of posterior -wall of maxillary sinus, destruction of medial antral wall, erosion of greater wing of sphenoid or pterygoid plates, widening of lower lateral margin of superior orbital fissure.CT scan of the head with contrast enhancement is now the investigation of choice. It has replaced conventional radiographs. It shows the extent of tumour, bony destruction or displacements. Anterior bo\ving of the posterior wall of maxillary sinus (often called the Holman Miller or Antral sign) is pathognomicof angiofibroma. Magnetic resonance imaging (MRI) is complementary to CT scans, when soft tissue extensions are present intracranially, in the infratemporal fossa or into the orbit.Carotid angiography shows extension of tumour, its vascularity and feeding vessels. It is done whenembolisation is planned before operation.Biopsy of the tumour is attended with profuse bleeding and is therefore avoidedTreatmentSurgery: Surgical excision is now the treatment of choice. Various approaches to angiofibroma,depending on origin and extensions, are listed below.Transpalatine: For tumours confined to nasopharynxTranspalatine + Sublabial (Sardana'sapproach)Extended lateral rhinotomy (Via facial incision or Via degloving approach)Extended Denker s approachIntracranial-extracranialIntratemporal tossaEndoscopicContrast CT of Nasopharyngeal angiofibromaWhen the mass imvoives the plerygopalatine fossa, it leads to bowing of the posterior wall of the madillary antrum (Holiman Millerorintral sign; red amoars).Radiotherapy has been used as a primary mode of treatment. A dose of 3000 to 3500 cGy in 15-18 fractions is delivered in 3 -3.5 weeks.Chemotherapy. Recurrent and residual lesions have been treated by chemotherapy,doxorubicin, vincristine and dacarbazine in combination | ENT | Tumors of Nose and PNS | Investigation of choice for angiofibroma is?
A. X ray PNS
B. Contrast CT Scan
C. MRI
D. Carotid angiography
| Contrast CT Scan |
1e681439-2dff-4324-80e2-145ad6a29b23 | Ans. (b) Arterioles(Ref: Robbins 9th/pg 74; 8th/pg 47)Vasodilation first involves the arterioles and then leads to opening of new capillary beds in the area.The result is increased blood flow, which is the cause of heat and redness (erythema) at the site of inflammation. | Pathology | Inflammation & Repair | Vasodilation in acute inflammation is first shown by
A. Venules
B. Arterioles
C. Capillaries
D. Vein
| Arterioles |
eae94154-fe5e-4206-bbd5-f15f8c93a580 | Although b-thalassemia minor and iron deficiency anemia are both characterized by hypochromic and microcytic RBCs, there is no increase in hemoglobin A2 in iron deficiency states. A normal serum ferritin level also excludes iron deficiency. In contrast to b-thalassemia major, there is usually mild anemia without major organ dysfunction with b-thalassemia minor. Diseases that produce hemolysis and increase erythropoiesis (e.g., autoimmune hemolytic anemia, malaria) do not alter the composition of b-globin chain production. Anemia of chronic disease may mimic iron deficiency and thalassemia minor with respect to hypochromia and microcytosis; however, anemia of chronic disease is associated with an increase in the serum concentration of ferritin. | Pathology | Blood | A 25-year-old woman has a 3-year history of arthralgias. Physical examination shows no joint deformity, but she appears pale. Laboratory studies show a total RBC count of 4.7 million/ mm3, hemoglobin of 12.5 g/dL, hematocrit of 37.1%, platelet count of 217,000/ mm3, and WBC count of 5890/ mm3. The peripheral blood smear shows hypochromic and microcytic RBCs. Total serum iron and ferritin levels are normal. Hemoglobin electrophoresis shows 93% hemoglobin A1 with elevated hemoglobin A2 level of 5.8% and hemoglobin F level of 1.2%. What is the most likely diagnosis?
A. Anemia of chronic disease
B. Autoimmune hemolytic anemia
C. b-Thalassemia minor
D. Infection with Plasmodium vivax
| b-Thalassemia minor |
f33c3092-84ec-43c2-84b0-5ab3205fa4a0 | Nodular sclerosis is most common type of Hodgkin's Lymphoma. | Surgery | null | Which is most common type of Hodgkin's Lymphoma
A. Mixed cellularity
B. Nodular sclerosis
C. Lymphocytic predominant
D. Lymphocytic depletion
| Nodular sclerosis |
c8bc2ab8-5eda-4173-83b5-a9e178a884bf | C3 convease splits split C3 into two fragments : C3a which is an anaphylatoxin and C3b which remains cell bound along with C4b2a to form a trimolecular complex C4b2a3b which has enzymatic activity and is called C5 convease. Reference : Anathanarayan & paniker's 9th edition, pg no: 122 <\p> | Microbiology | Immunology | C3 convease acts on -
A. C4b2b
B. C4b2B3a
C. C4b
D. C3
| C3 |
00967b92-5605-4adb-9b41-bed2afa2507f | Any disease that is transmitted from animals to humans is called Anthropozoonoses. | Dental | null | When a disease spreads from vertebrate animals to man it is said to be:
A. Zooanthroposes
B. Anthropozoonoses
C. Amphixenoses
D. Epizootic
| Anthropozoonoses |
eaccb845-8898-4b13-a02d-1215e09c7253 | Respiratory effo is used instead respiratory rate in APGAR scoring system for resuscitation in neonates. Apgar scoring system: Apgar scores are a numerical expression of a newborn infant's physical condition. Usually determined 1 min after bih and again at 5 min, the score is the sum of points gained on assessment of color, hea rate, reflex irritability, muscle tone, and respirations. The total score, based on the sum of the five components. Signs 0 1 2 Heabeats per minute Absent Slow (<100) >100 Respiratory effo Absent Slow, irregular Good, crying Muscle tone Limp Some flexion of extremities Active motion Reflex irritability No response Grimace Cry or cough Color Blue or pale Body pink, extremities blue Completely pink If the score is Ref: Raab E.L., Kelly L.K. (2013). Chapter 9. Normal Newborn Assessment & Care. In A.H. DeCherney, L. Nathan, N. Laufer, A.S. Roman (Eds), CURRENT Diagnosis & Treatment: Obstetrics & Gynecology, 11e. | Pediatrics | null | Which of the following is NOT used in a preterm infant to assess need for resuscitation?
A. Color
B. Hea rate
C. Rate of respiration
D. Muscle tone
| Rate of respiration |
9bd3e43d-688e-4fd3-9d05-d087e997aeaf | Bone marrow involvement is seen in 72% of B cell chronic lymphocytic lymphoma. Ref: Harrisons principles of internal medicine, 18th edition, Page: 926 | Medicine | null | Bone marrow involvement is maximum in which type of lymphoma?
A. B cell chronic lymphocytic lymphoma
B. Follicular lymphoma
C. Diffuse large B cell lymphoma
D. Burkitt's lymphoma
| B cell chronic lymphocytic lymphoma |
da25135b-36fc-47e7-8e64-7b78be836830 | Restriction endonuclease Cleaves double stranded DNA at palindromic sites/ restriction sites 5' --AAGCTT-- 3'3' --TTCGAA-- 5' A palindromic sequence is a sequence which reads the same backwards as forwards. Found in bacteria Can create sticky ends or blunt ends Restriction endonuclease Sticky ends Blunt ends single-stranded overhangs no overhangs Example - EcoRI Example -SmaI | Biochemistry | Basics of DNA | Restriction endonuclease cleaves
A. Double stranded DNA
B. Single stranded DNA
C. Single stranded RNA
D. Polypeptide
| Double stranded DNA |
a023a415-cbae-4d8f-8565-95380be50f16 | * The alpha helix is disrupted by introduction of following amino acids. 1. Proline - Most common 2. Charged amino acids like H - Histidine A - Aspaic acid A - arginine G - Glutamic acid Ly-Iysine 3. Amino acids with bulky side chains if present in large number eg - (a) Tryptophan (b) Valine (c) Isoleucine | Surgery | null | An alpha helix of a protein is most likely to be disrupted if a missense mutation introduces the following amino acid within the alpha helical structure:
A. Alanine
B. Tyrosine.
C. Aspaic acid
D. Glycine
| Tyrosine. |
253a78cb-1d73-4f87-92c2-a1252dfefb03 | In cardiac action potential Phase O - Rapid upstroke - due to fast sodium channels- Influx of Na+Phase I - Initial repolarization - fast Na channels - closePhase II - Plateau - due to calcium influx Phase III - Rapid repolarization - Calcium channels close & slow potassium channels open Phase IV - Resting membrane potential - - 90 mv | Physiology | JIPMER 2019 | Phase of cardiac action potential, where calcium channels close & slow potassium channels open :
A. Phase I
B. Phase II
C. Phase III
D. Phase IV
| Phase III |
494c0398-1325-481a-a42b-aac8ce916632 | (D) Bumetanide # Furosemide, Bumetanide are loop diuretics which inhibit Na+/K+ 20 symport from thick ascending limb of loop.> Indapamide is thiazide diuretic inhibits Na+ Cl' symport in distal convoluted tubule.> Triamterene, Spironolactone are potassium sparing diuretics, inhibits Na+ flux in the tubule.> High efficacy (Loop) diuretics are: Sulphonyl derivatives - Furosemide, Bumetanide Phenoxyacetic acid derivative - Ethacrynic acid Organomercurials - Mersary | Pharmacology | Miscellaneous (Pharmacology) | Which is a Loop diuretic?
A. Acetazolamide
B. Indapamide
C. Triamterene
D. Bumetanide
| Bumetanide |
0f39aded-e153-4f6f-a287-d638ac64ad21 | Site I: This involves the transfer of electrons from NADH-CoQ. Obviously, this step is omitted by succinic dehydrogenase whose FADH2 prosthetic group transfers its electrons directly to CoQ bypassing NADH. This step is blocked by piericidin, rotenone, amobarbital, ceain drugs like chlorpromazine, guanethidine. among barbital is a barbiturate derivativeRef: MN Chatterjea Textbook of Medical Biochemistry, 8th Edition, Page no: 143 | Biochemistry | Respiratory chain | Cytochrome oxidase is inhibited by
A. Cyanide
B. Aluminum phosphide
C. Phenobarbitone
D. Carbonmonoxide
| Phenobarbitone |
39887d0b-54b0-4d01-b149-291bd5f3b4fd | The ligamentum flavum connects the lamina of two adjacent vertebrae and forms the posterior wall of the vertebral canal. It is the only answer choice that is in direct contact with the vertebral foramen. Therefore, hypertrophy of only the ligamentum flavum would present as spinal stenosis. The supraspinous and interspinous ligaments connect spinous processes. The anterior longitudinal ligament connects the anterior portion of the vertebral bodies and intervertebral disks. Finally, the nuchal ligament is a thickened extension of the supraspinous ligament above the level of C7. | Anatomy | Upper Extremity | A 45-year-old man is admitted to the hospital because of severe pain in the back and lower limb. Radiographic examination reveals spinal stenosis syndrome. Which of the following conditions is most likely to be confirmed by MRI examination?
A. Hypertrophy of supraspinous ligament
B. Hypertrophy of interspinous ligament
C. Hypertrophy of ligamentum flavum
D. Hypertrophy of anterior longitudinal ligament
| Hypertrophy of ligamentum flavum |
85875a02-ba59-4001-b91a-cb3330e3d71b | Ref: KDT 6/e p610,611 Antiplatelet drugs are used for the prophylaxis of aerial thrombotic conditions like stroke and MI. Atrial fibrillation increase the risk of thromboembolism and can result in stroke. | Anatomy | Other topics and Adverse effects | A patient Amit Kumar is suffering from atherosclerosis. Which of the following lowing is the most beneficial drug for prevention of stroke in this patient?
A. Aspirin
B. Warfarin
C. Low dose subcutaneous herparin
D. Digoxin
| Aspirin |
77f2de26-ea38-42db-a774-11189668357f | Ref Robbins 9/e p428 Gray is a unit that expresses the energy absorbed by the target tissue per unit mass Radiation UNITS Roentgen: Is the measurement of energy produced by Gamma or X-Ray radiation in a cubic centimeter of air. It is abbreted with the capital "R". One milliroentgen, abbreted "mR" is one-thousandth of a roentgen. One microroentgen, abbreted "uR" is one-millionth of a roentgen. RAD: Radiation Absorbed Dose. Original measuring unit for expressing the absorption of all types of ionizing radiation (alpha, beta, gamma, neutrons, etc) into any medium. One rad is equivalent to the absorption of 100 ergs of energy per gram of absorbing tissue. System International (SI) Units The System International (S.I. unit) units for radiation measurements are "gray" (Gy) and "sive" (Sv) for absorbed dose and equivalent dose respectively. The conversion from one system to another is simple: 1 Sv = 100 rem 1 rem = .01 Sv 1 mSv = 100 mR (mrem) 1 mR = .01 mSv 1 Gy = 100 rad 1 rad = .01 Gy 1mGy = 100 mrad 1 mrad = .01 mGy | Anatomy | General anatomy | The SI unit of radiation absorbed dose is
A. Rad
B. Becquerel
C. Gray
D. Sieve
| Gray |
52c66d05-cd5d-40ea-b45c-f276bf2437e9 | Mitochondria serve as the powerhouses of the cell. In addition to having the respiratory chain and serving as the site for oxidative phosphorylation, mitochondria also contain the enzymes of the citric acid cycle and for b oxidation of fatty acids. | Surgery | null | The respiratory chain is found in which sub cellular compament?
A. Cytosol
B. Endoplasmic reticulum
C. Golgi
D. Mitochondria
| Mitochondria |
4ebc3c69-6c06-4b5e-83a0-a83cd5b8b897 | Levo-dopa may cause mydriasis, so it is contraindicated in angle closure glaucoma. Vitamin complexes containing pyridoxine decrease the effectiveness of levo-dopa (pyridoxine is a cofactor of dopa decarboxylase and increases the formation of dopamine in the periphery. This results in decrease in l-dopa's central penetration). Abrupt withdrawal of levodopa may precipitate neuroleptic malignant syndrome. Levo-dopa should be given carefully in patients with active peptic ulcer (increased risk of bleeding) and malignant melanoma (levo-dopa is a precursor of melanin). | Pharmacology | Sedative-Hypnotics and Parkinsonism | Levodopa is contraindicated in:-
A. Alzheimer's disease
B. Multiple sclerosis
C. Glaucoma
D. Parkinsonism
| Glaucoma |
5d07259a-e038-4ff8-b1ae-de4af2c685f8 | Ans. A: Hypokalemic hyponatremic alkalosis | Surgery | null | Metabolic disturbance seen with pyloric stenosis: March 2007, March 2013 (a, b, d, e)
A. Hypokalemic hyponatremic alkalosis
B. Hyperkalemia
C. Hyperchloremic acidosis
D. Hypernatremia
| Hypokalemic hyponatremic alkalosis |
fc93a2a4-6340-4b1f-800e-87fcfd819a13 | Refer Robbins page no 789-790 Cd117 is the most impoant diagnostic marker is detectable in 95 percnt of the patients | Anatomy | G.I.T | Most appropriate marker of GIST
A. CD 117
B. CD 34
C. CD 23
D. S-100
| CD 117 |
fec61f85-4664-4069-a860-bbb407ddb3cb | Ans. is 'a' i.e., Klebsiella ozaena Atrophic rhinitis (Qzaena)o Atrophic rhinitis is a chronic inflammation of nose characterized by atrophy of nasal mucosa, including the glands, turbinate bones and the nerve elements. Atrophic rhinitis may be primary or secondary : 1) Primary atrophic rhinitis# The primary pathology' is inflammation and atrophy of the nose. Generally, atrophic rhinitis refers to primary atrophic rhinitis. Causes are : -HereditaryEndocrinal pathology - Starts at puberty. Stops after menopauseiii) Racial factors - Seen more in Whites and Yellow racesiv) Nutritional deficiency - Deficiency of vitamin A, D, E and iron may be responsible for it.v) Infective - Klebsiella ozanae, Diphtheriods, P. vulgaris, E.coli, Staphylococci, Streptococci.v) Autoimmune process - Causing destruction of nasal, neurovascular and glandular elements may be the cause.2) Secondary atrophic rhinitis# Specific infections, such as syphilis, lupus, leprosy, and rhinoscleroma, may cause destruction of the nasal structures leading to atrophic changes. Can also results from long standing purulent sinusitis , radiotherapy of nose, excessive surgical removal of the turbinate and as complication of DNS on the root side of nose.Clinical features of atrophic rhinitiso The disease is mostly seen in females and tends to appear during puberitv.o The disease is always bilateral except in case of DNS where it is seen on the wider side.o There is foul smell from the nose making the patient a social outcast though patient himself is unaware of the smell due to marked anosmia (merciful anosmia).o Patient complains of nasal obstruction inspite of unduly wide nasal chambers. This is due to large crusts filling the nose.o Epistaxis may occur when the crusts are removed,o Crusting may occur in the larynx and cause hoarseness,o Apart from nose, other sites may also be involved.Pharynx - Atrophic phary ngitis may be seenlarynx - Atrophic laryngitis may be seen which can lead to cough and hoarseness of voice.Ear - Obstruction of eustachian tube can cause serous otitis mediaPNS - Small/under developed and have thick walls. They appear opaque on X-ray. | ENT | Nose and PNS | Which of the follow ing organisms is know n to cause Atrophic rhinitis -
A. Klebsiella ozaena
B. Klebsiella pneumonia
C. Streptococcus pneumonia
D. Streptococcus foetidis
| Klebsiella ozaena |
93880c0a-210d-4eb8-867e-3bb68f79eb47 | TOT approach was introduced with the intention to reduce vascular and lower urinary tract injury risks that can be associated with traversing retropubic space. | Gynaecology & Obstetrics | null | Transobturator tape approach in treatment of urinary incontinence is known to
A. Increased long term efficacy than TVT.
B. Reduce vascular and lower urinary tract injury risks.
C. Overlie over proximal tendon of adductor magnus.
D. Traverse retropubic space, causing neurovascular injury.
| Reduce vascular and lower urinary tract injury risks. |
ac1610af-f580-4ef6-a9aa-855086fd9617 | Lamotrigine is a mood stabilizer which works best in BIPOLAR DEPRESSION Lithium is a mood stabilizer which works best in BIPOLAR MANIA valproate is a mood stabilizer which works best in RAPID CYCLING Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, 935 | Anatomy | Pharmacotherapy in psychiatry | mood stabilizer used in the management of depression
A. lamotrigine
B. valproate
C. carbamezepine
D. lithium
| lamotrigine |
86988ada-6de4-4eec-ae88-d585465e6ee8 | Ref Robbins 8/e p 327; 7/e P339,9/e p869_870 AFP is Glycoprotein synthesized in fetal life by yolk sac,fetal liver,fetal GIT.It is a marker of hepatocellular carcinoma,non seminomatous germ cell tumor Of testis Elevated level of AFP Is found less regularly in carcinoma of lung,colon, pancreas IImpoant points about hepatoblastoma arising from hepatic parenchymal cells The most common tumor in Child hood A characteristic features of hepatoblastoma is frequent activation of WTN/catenin signalling pathway,by stabilizing mutation of beta catenin,contributes to the process of carcinogenesis | Anatomy | General anatomy | Alpha fetoprotein is a marker of
A. Hepatoblastoma
B. Seminoma
C. Renal cell carcinoma
D. Choriocarcinoma
| Hepatoblastoma |
b6990fd0-73df-4f81-aaa4-8d6b52b2a6e4 | Rifampicin is an antimycobacterial drug which exes both intracellular and extracellular bactericidal activity by binding to and inhibiting mycobacterial DNA-dependent RNA polymerase blocking RNA synthesis. Ethambutol is a bacteriostatic against M tuberculosis. It acts by inhibiting arabinosyl transferases involved in cell wall synthesis, which probably inhibits the formation of arabinogalactan and lipoarabinomannan. Colchicine has antimitotic effects, arrests cell division in G1 by interfering with microtubule and spindle formation. Ref: Harrison's principles of internal medicine 18e chapter 168. | Pharmacology | null | DNA dependent RNA synthesis is inhibited by which of the following drug?
A. Rifampicin
B. Ethambutol
C. Colchicine
D. Chloromycetin
| Rifampicin |
29ae4d68-15bf-4a5a-9c26-4b84d6048bb7 | Ans. is 'b' i.e. low validity and low reliability Validity (Accuracy) o The validity of a test is the extent to which it accurately measures which it purpos to measure. In other words its the ability to show which individuals have the disease in question and which do not. o Validity has two components - sensitivity & specificity. To be truly valid, a test should be highly sensitive, specific and unbiased. In this question the test results are not accurate (accurate value is 10.2) Test has low validity. Reliability (or Repeatability, reproducibility or precision) Reliability or precision or repeatability is the level of agreement between repeated measurements of the same variable i.e. a highly reliable test must give consistent results when repeated more than once on the same individual or material, under the same conditions. In this question test is not showing consistent results --> Test has low reliability. | Social & Preventive Medicine | null | Using a new technique, Hb was estimated in a blood sample. The test was repeated for 10 times. The repos were : 9.5, 9.2, 9.4, 9.6, 9.7, 9.9, 10.2, 10.3, 10.5, 12.1. Accurate value of Hb was estimated by standard tests to be 10.2. The new technique has ?
A. High validity and high reliability
B. Low validity and low reliability
C. High validity and low reliability
D. Low validity and high reliability
| Low validity and low reliability |
45e59530-0ce3-491a-b049-16e0021bada3 | Carnitine transfers fatty acids from cytosolic fatty acyl CoA to form mitochondrial fatty acyl CoA. The conversion of acetyl CoA to malonyl CoA occurs in the cytosol. Coenzyme A cannot pass through the inner mitochondrial membrane. Acetoacetyl CoA has to be conveed to HMG CoA before it is conveed to acetoacetate. Ref: Botham K.M., Mayes P.A. (2011). Chapter 23. Biosynthesis of Fatty Acids & Eicosanoids. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e. | Biochemistry | null | Acetyl CoA is generated primarily in mitochondria. However, fatty acid synthesis from acetyl CoA occurs extramitochondrial (in the cytosol). By which one of the following mechanisms does acetyl CoA leave the mitochondrion and enter the cytosol?
A. The acetyl group is transferred to carnitine to form acetyl carnitine, which is transpoed across the inner mitochondrial membrane to the cytosol where it reacts with CoA to regenerate acetyl CoA
B. Acetyl CoA condenses with oxaloacetate to form citrate, which is transpoed into the cytosol where it is cleaved to generate acetyl CoA and oxaloacetate in an ATP-dependent reaction
C. Acetyl CoA reacts with carbon dioxide to form malonyl CoA, which is transpoed across the mitochondrial membrane
D. The mitochondrial membrane permits permeation of acetyl CoA by active transpo
| Acetyl CoA condenses with oxaloacetate to form citrate, which is transpoed into the cytosol where it is cleaved to generate acetyl CoA and oxaloacetate in an ATP-dependent reaction |
0395f9f9-7f9c-442b-82a4-ffc33eb9bdf8 | Ans. is 'b' i.e., Vitamin B6 Isoniazid induced peripheral neuritis/ neuropathy* Peripheral neuritis is a well documented adverse effect of INH, which is also the most important dose dependant toxic effect.* Peripheral neuropathy is observed in 10 to 20% of patients given dosages greater than 5 mg/kg/d, but it is infrequently seen with the standard 300-mg adult dose.* Peripheral neuropathy is more likely to occur in slow acetylators and patients with predisposing conditions such as malnutrition, alcoholism, diabetes, AIDS, and uremia.* Neuropathy is due to a relative pyridoxine deficiency. It is due to interference with production of active co - enzyme PLP (Pyridoxal phosphate) from pyridoxine.* It is readily reversed by administration of pyridoxine in a dosage as low as 10 mg/d. | Pharmacology | Anti Microbial | Peripheral neuritis induced by isoniazid is prevented by giving which vitamin along with it?
A. Vitamin B1
B. Vitamin B6
C. Vitamin B3
D. Vitamin B12
| Vitamin B6 |
2f10aca9-8d4d-4f07-8bb3-f14d534aba20 | The tip of the appendix can have a variable position within the abdominal cavity : retro-caecal (65-70%) pelvic (25-30%) pre- or post-ileal (5%) Ref - BDC 6e vol2 pg269 | Anatomy | Abdomen and pelvis | Most common position of appendix is
A. Pre ilial
B. Post ilial
C. Pelvic
D. Retro caecal
| Retro caecal |
4396b973-fa23-4c9b-bf13-219fd62a2a16 | Idiotypes are antigenic determinants that appear only on the Fab fragments of antibodies and appear to be localized at the ligand-binding site; thus, anti-idiotype antisera may block reactions with the appropriate hapten. The carbohydrate side chains of immunoglobulins are relatively nonimmunogenic. New determinants may be exposed after papain cleavage of immunoglobulins, but these determinants are not included in the classification of the native molecule. Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition | Microbiology | Immunology | An idiotype is characterized by
A. Determinant exposed after papain cleavage to an F(ab')2 fragment
B. Determinant from one clone of cells and probably located close to the antigenbinding site of the immunoglobulin
C. Determinant inherited in a Mendelian fashion and recognized by crossimmunization of individuals in a species
D. Heavy-chain determinant recognized by heterologous antisera
| Determinant from one clone of cells and probably located close to the antigenbinding site of the immunoglobulin |
2fec363f-d106-4ed1-a725-df5f8cc5176e | Pauci-immune type crescentic GN is defined by the lack of anti-GBM antibodies or significant immune complex deposition. Anti-neutrophil cytoplasmic antibodies (ANCA) typically are found in the serum, which, have a pathogenic role in some vasculitides. In some instances, therefore, crescentic GN is a component of systemic vasculitis such as microscopic polyangiitis or granulomatosis with polyangiitis. Ref: ROBBINS BASIC PATHOLOGY 10th ed Pg no: 563 | Pathology | Urinary tract | Pauci immune glomerulonephritis is seen in-
A. After transplant in Alpos
B. Microscopic polyangitis
C. Henoch-schonlein nephritis
D. Lupus
| Microscopic polyangitis |
f89b26fe-ce4b-45a8-b6ad-8db91902e7e5 | Ans. is 'd' i.e., Platelet concentrateoWhole blood contains 350 ml of donor blood plus anticoagulants. Once blood is removed from the donor, it starts a sequences of in vitro changes that change its physiological properties. Ensuring the blood and its products transfusion safe, their storage is a must. The main aim is to minimize damage to store blood. The recommend temperature for storage of blood is 2-6degCroAt present the most widely used protocol for the storage of red blood cells (packed RBCs. washed, leukodepleted, irradiated, apheresis, deglycocerolized, rejuvinated) (for up to 42 days) is the collection of blood into anticoagulant solutions (typically citrate-dextrose-phosphate); red cell concentrates are prepared by the removal of plasma and, in some cases, also leukoreduction. The product is stored at 4+-2degC in a slightly hypertonic additive solution, generally SAGM (sodium, adenine, glucose, mannitol, 376mOsm/L)oPlatelets are stored in temperature-controlled incubators (20-24degC) with constant agitation (refrigerated platelets are rapidly removed from the circulation). The recent introduction of automated bacterial screening has allowed some Blood Services to extend the shelf life from 5 to 7 days after donation.oFresh frozen plasma is stored in approved freezers at less than 30degC. It is thawed just before use (a process which takes up to 30 minutes) and once thawed, must be infused within 24 hours if kept at 4degC (or 4 hours if kept at room temperature).Blood componentStorage temperatureShelf lifeWhole blood2-6deg C35 daysRed cells2-6deg C42 daysPediatric red cells2-6deg C35 daysWashed red ceils2-6deg C28 daysLeukodepleted red cells2-6degC35 daysPlatelets20-24degC5 daysFresh frozen plasma, crvodepleted plasma.Below - 25degC12 -36 monthsCryoprecipitate Buffy coat (granulocytes)20-240degCTo midnight on the day of collection | Pathology | Blood | Which of the following is not stored at cold temperature?
A. Whole blood
B. Packed RBCs
C. Leucoreduced RBCs
D. Platelet concentrate
| Platelet concentrate |
8cd9a33b-76a7-437c-a1e0-cc686ce5ed1b | Osteopetrosis or Albers-Schonberg Disease or Marble Bone Disease is an inherited disease of the skeleton which is accompanied by an increase in calcified bone tissue - namely osteosclerosis. The bone marrow cavity is almost completely filled with compact bone tissue and coex is thickened by periosteal bone deposition. Radiologically the bones are accordingly seen as complete shadows which give the name marble bone disease. The pathogenesis is insufficiency of osteoclasts. Hence the bone resorption is inadequate. The primary spongiosa is not transformed into a secondary spongiosa. X-ray of lumbar spine shows 'sandwich veebra'. Ref: Bone diseases: macroscopic, histological, and radiological diagnosis By Claus-Peter Adler, 2000, Page 54 | Surgery | null | Marble bone disease is an inherited disease of the skeleton which is accompanied by an increase in calcified bone tissue. It is also known as:
A. Osteoporosis
B. Osteochondritis
C. Osteopetrosis
D. Osteogenesis imperfecta
| Osteopetrosis |
89ce721c-26eb-45b7-b67b-657a9fa7a7f2 | ANTROCHOANAL POLYP most commonly seen in children.
They are unilateral, usually arises from the mucosa of maxillary antrum near its accessory ostium comes out of it & grows in the channel & nasal cavity.
Maxillary sinus opens into the middle meatus. | ENT | null | Antrochoanal polyp opens In which meant
A. Middle meatus
B. Superior meatus
C. Inferior meatus
D. Sphenoethmoidal recess
| Middle meatus |
3197f1a0-fead-43f8-a73f-083b0023769d | Ans. is 'a' i.e., Phenylpropanolamine o Many repos associating phenylpropanolamine use for weight loss with haemorrhagic stroke among women, appeared in U.S.A. | Pharmacology | null | Which one of the following agents has been associated with hemorrhagic stroke -
A. Phenylpropanolamine
B. Terfenadine
C. Quinidine
D. Fenfluramine
| Phenylpropanolamine |
5861306d-eb22-41c1-bdf2-6e4df46082b5 | Vit k Act as coenzyme in Carboxylation of clotting factor 2,7,9,10 Only fat-soluble vitamin with coenzyme function. 3 forms k1-phyloquinone k2-menaquinone k3-manadione (water soluble)-synthetic form Deficiency lead to hemorrhagic disease of new born Prophylactic administration of Vit k for all new born advised | Biochemistry | FMGE 2018 | Vitamin K is required for:
A. Hydroxylation
B. Chelation
C. Transamination
D. Carboxylation
| Carboxylation |
b406116f-199a-405d-b630-e51af8e6ba1f | Durhams rule or product rule was too broad that it was repealed later | Anatomy | All India exam | The most liberal rule regarding criminal responsibility of an insane person is ______
A. Mc naughten's rule
B. Durham's rule
C. Curren's rule
D. Federal rule
| Durham's rule |
e8fb054c-3690-427b-b0f4-60a2e007ab01 | Answer is A (Dermatitis Herpetiformis) Celiac disease is associated with Dermatitis Herpetiformis Dermatitis Herpetiformis is regarded as cutaneous variant of celiac disease. Almost all patients with dermatitis N as Herpetiformis have evidence of celiac disease on intestinal biopsy' - CMD Associations of Celiac Disease (CMDT & Harrisons) Dermatitis Herpetiformis Other autoimmune disease including: (CMDT) - Addison's disease - Grave's disease Diabetes mellitus- Type I (Harrisons) - Myaesthenia Gravis - Slogren syndrome - Atrophic Gastritis - Pancreatic insufficiency IgA deficiency (Harrisons) Lymphomas (Harrisons) Note Celiac disease is associated with an increased risk of cancer including Lymphomas (NHL, Intestinal T cell Lymphoma) The possibility of Lymphoma must be considered whenever a patient with celiac sprue previously doing well on a gluten free diet is no longer responsive to gluten free diet' - Harrisons | Medicine | null | Proved association of celiac sprue is with:
A. Dermatitis herpetiformis
B. Scleroderma
C. Pemphigus
D. Pemphoid
| Dermatitis herpetiformis |
4b4c0ba8-2b0d-425f-acb2-194588977266 | Mesangial deposits of monoclonal kappa/lambda light chains suggest the diagnosis of Amyloidosis. Renal amyloidosis is the most common cause of death due to amyloidosis Amyloid deposition begins from mesangium and involves other pa later Clinical features - proteinuria , urinary cast present , kidney size increases. In primary Amyloidosis AL protein is deposited in the organs, which is made of light chains (usually lambda type) of immunoglobulins. | Pathology | Kidney disorders | Mesangial deposits of monoclonal kappa/Lambda light chains in indicative of:
A. Mesangioproliferative glomerulonephritis
B. Focal and segmental glomerulosclerosis
C. Kimmelstiel-Wilson lesions
D. Amyloidosis
| Amyloidosis |
3d7e7e16-25c6-410f-aba6-8abac9b032f9 | Cyclooxygenase can switch off the synthesis of prostaglandins by undergoing self-catalysed destruction. That is why this enzyme is known as suicidal enzyme. (Do not confuse this with suicidal inhibition). Cyclooxygenase aka prostaglandin H synthase Bifunctional enzyme with two activities - cyclooxygenase and peroxidase. There are two isoenzymes of cyclooxygenase, COX-1 (Constitutive) and COX-2 (Inducible). | Biochemistry | Miscellaneous | Which of the following enzymes is known as 'suicide enzyme'?
A. Cyclooxygenase
B. Lipoxygenase
C. Phospholipase C
D. Xanthine oxidase
| Cyclooxygenase |
314c77fa-e4b0-41e3-8eba-1620d0642a70 | Ans. is 'c' i.e., Tympanomastoidectomy Middle ear pappilomas The middle ear papillomas are rare presentations and medical literature is mainly limited to case repos or case series. These include aggressive pappilary tumors, schneiderian type of pappilomas and inveed pappilomas. They are associated with hearing difficulty and veigo and may be associated with Von Hippel Lindau syndrome. They tend to be slowly growing, locally aggressive non metastasizing neoplasms The approach for treatment of such pathology is usually radical and tympanomastoidectomy is considered the treatment of choice. This gives the best chance of cure. | ENT | null | Treatment of middle ear papilloma is ?
A. Myringotomy and simple excision
B. Myringectomy and simple excision
C. Tympanomastoidectomy
D. Local infiltration with podophyllin
| Tympanomastoidectomy |
6f9ea15e-0231-415d-bd9c-66c9dd222820 | Transamination, a chemical reaction that transfers an amino group to a ketoacid to form new amino acids. This pathway is responsible for the deamination of most amino acids. | Biochemistry | null | Transamination of pyruvate with glutamate leads to:
A. Oxaloacetate and aspartate
B. Alanine and aspartate
C. Oxaloacetate and alpha ketoglutarate
D. Alanine and alpha ketoglutarate
| Alanine and alpha ketoglutarate |
ce94d329-4a8d-4d0c-b649-0d5708ec9c91 | Explanation: Fimbriae Certain (Gram-negative bacilli carry very fine, hair-like surface appendages called fimbriae or pili.
They are shorter and thinner than flagella Fimbriae can be seen only under the electron microscope.
Fimbriae function as organs of adhesion, helping the cells to adhere firmly to particles of various kinds Fimbriated bacteria form surface pellicles in liquid media.
Many fimbriated cells (for example Escherichia, Klebsiella) agglutinate red blood cells. Hemagglutination provides a simple method of detecting the presence of such fimbriae.
The hemagglutination is specifically inhibited by D- mannose (mannose sensitive) A special type of fimbria is the sex pili.
They are found on ‘male’ bacteria and help in the attachment of those cells to ‘female’ bacteria.
They do not mediate attachment to epithelium Flagella Flagella are the organs of locomotion.
Flagellum consists of three distinct parts the filament, the hook and the basal Flagella are made up of a protein (flagellin) Flagella are less than 0.02 Jim in thickness and hence beyond the limit of resolution of the light microscope.
They may, in some instances, be seen under dark ground illumination.
They can be visualised by special staining techniques in which their thickness is increased by mordanting, or by electron microscopy Mesosoxnes Mesosomes (chondroid) are vesicular,
convoluted or niultilaniinated structures formed as invaginations of the plasma membrane into the cytoplasm.
They are more prominent in Gram-positive bacteria. They are the principal sites of respiratory enzymes in bacteria and are analogous to the mitochondria of eukaryotes.
Mesosomes are often seen in relation to the nuclear body and the site of synthesis of crosswall septa,
suggesting that they coordinate nuclear and cytoplasmic division during binary fission | Microbiology | null | Bacterial adherence to epithelium is mediated through
A. Sex pili
B. Fimbriae
C. Flagella
D. Mesosomes
| Fimbriae |
4b211276-a663-4681-9376-b72b4dcb5c71 | Ans. is 'c' i.e., Cisplatin Platinum compound These are alkylating agents and act by similar mechanism. Drugs are - First generation -9 - Cisplatin Second generation - Carboplatin Third generation - Oxaliplatin Side effects of Cisplatin Vomiting Ototoxicity Hyperuricemia Nephrotoxicity Neuropathy Note ? Cisplatin is most nephrotoxic where as carboplatin is more hematotoxic (bone marrow suppression). Carboplatin has less nephrotoxic, neurotoxic and ototoxic effects. Dose limiting toxicity of oxaliplatin is neurotoxicity (Peripheral neuropathy). Drugs causing nephrotoxicity: Chemotherapy and Immunosuppressants drugs causing nephrotoxicity: - Cisplatin - Methotrexate - Mitomycin - Cyclosporine - Ifosphamide (Causes Fanconi's Syndrome) Antibiotics: - Aminoglycoside - Sulfonamides Amphotericin B - Foscarnet Quinolones (e.g. Ciprofloxacin, Levofloxacin) - Rifampin - Tetracycline - Acyclovir (only nephrotoxic in intravenous form) - Pentamidine - Vancomycin Heavy Metals: Mercury Poisoning - Lead Poisoning - Arsenic Poisoning Bismuth - Lithium related kidney disorders AntiHyperlipidemics: - Statin Drugs (Rhabdomyolysis) Gemfibrozil-Associated with Acute Renal Failure due to Rhabdomyolysis Miscellaneous Drugs: - Chronic Stimulant Laxative use-Resulting in chronic volume depletion and Hypokalemia causes nephropathy - Radiographic contrast - ACE Inhibitor- NSA ID - Aspirin - Mesalamine | Pharmacology | null | Anti cancer drug causing nephrotoxicity ?
A. Cyclophosphamide
B. Busulfan
C. Cisplatin
D. Procarbazine
| Cisplatin |
a19c40fd-9cdf-45de-83a9-de58e1430622 | The polysaccharide of glucose (glucosan or glucan):- starch, glycogen, cellulose, dextrin, dextran, chitin
The polysaccharide of fructose (fructosan) :- Inulin | Biochemistry | null | Which is a fructosan
A. Pectin
B. Chitin
C. Inulin
D. Glycogen
| Inulin |
ce16c6a4-60bd-4569-bf0f-80ebcf944d5b | Extraintestinal Manifestations of Ulcerative Colitis Ahritis Ankylosing spondylitis Erythema nodosum Pyoderma gengrenosum Primary sclerosing cholangitis (PSC) Colectomy has no effect on the course of PSC in UC. Pyoderma gangrenosum is more common in UC. MC cutaneous manifestation of IBD: Erythema nodosum Erythema nodosum is the most responsive to treatment of the bowel and persistence of the lesion indicates inadequate control of IBD. | Surgery | Inflammatory bowel disease | In ulcerative colitis, after colectomy least likely to resolve is:
A. Ankylosing spondylitis
B. PSC
C. Pyoderma gangrenosum
D. Erythema nodosum
| PSC |
35a60859-f958-40df-a0f0-ead81e4a786a | Developmental milestones:- GROSS MOTOR DEVELOPMENT: 2 months: Holds head in plane of rest of the body when held in ventral suspension. In prone position in bed, the chin lifts momentarily. 3 months:lift head above the plane of the body. Head control stas by 3 months and fully developed by 5 months. 4 months:Remain on forearm suppo if put in prone position, lifting the upper pa of the body off the bed. 5 months: Rolls over. 6 months:sit in tripod fashion. 8 months: sits without suppo., crawling 9 months: Takes a few steps with one hand held. Pulls to standing and cruises holding on to furniture by 10 months. 10 months: creeps 12 months:creeps well, walk but falls, stand without suppo. 15 months: walks well, walks backward/ sideways pulling a toy. May crawl upstairs. 18 months: Runs, walks upstair with one hand held. Explores drawers 2 years: walk up and downstairs, jumps. 3 years : rides tricycle, alternate feet going upstairs. 4 years: hops on one foot, alternate feet going downstairs. 5 years:skips FINE MOTOR DEVELOPMENT:- 2 months- eyes follow objects to 180 deg. 3 months-Grasp reflex disappears and hand is open most of the time. 4 months- Bidextrous approach( reaching out for objects with both hands). 6 months- Unidextrous approach( Reach for an object with one hand). 8 months- radial grasp sta to develop. Turns to sound above the level of ear. 9 months- immature pincer grasp, probes with forefinger. 12 months-Unassisted pincer grasp. Releases object on request.Uses objects predominantly for playing, not for mouthing. Holds block on each hand and bang them together. 15 months- imitate scribbling , tower of two blocks 18 months- scribbles, tower of 3 blocks.turn pages of a book, 2-3 at a time. 2 years- tower of 6 blocks, veical and circular stroke. 3 years-Tower of 9 blocks, dressing and undressing with some help, can do buttoning. 4 years- copies cross, bridge with blocks 5 years- copies triangle, gate with blocks. SOCIAL AND ADAPTIVE MILESTONES: 2 months: social smile(smile after being talked to).watches mother when spoken to and may smile. 3 months:Recognizes mother, anticipates feeds. 4 months: Holds rattle when placed in hand and regards it . Laughs aloud. Excited at the sight of food. 6 months:recognizes strangers, stranger anxiety . Enjoy watching own image in mirror, shows displeasure when toy pulled off. 9 months:waves bye bye 12 months:comes when called, plays simple ball game.kisses the parent on request. Makes postural adjustments for dressing. 15 months:jargon, stas imitating mother. 18 months: copies parents in tasking, dry by day, calls mother when he wants potty, points to three pas of body on request. 2 years: ask for food, drink, toilet, pulls people to show toys. 3 years:shares toys, know fullname and gender, dry by night. 4 years:Plays cooperatively in a group, goes to toilet alone, washes face, brushes teeth. Role play . 5 years:helps in household task , dresses and undresses. LANGUAGE MILESTONES: 1 month: Ales to sound. 2 month:respond to sound by stale or quitening to a smooth voice. 3 months: babbles when spoken to. Makes sounds (ahh,coos, ) laughs. 4 months: laughs aloud. 6 months: monosyllables 9 months: understands spoken words, bisyllables. 12 months: 1-2 words with meaning. 18 months: vocabulary of 10 words. Can name one pa of body. 2 years: 3 word simple sentences 3 years:asks questions, knows full name and gender. 4 years: says songs or poem, tells story, knows three colours. 5 years: ask meaning of words. Reference: GHAI Essential pediatrics, 8th edition | Pediatrics | Growth and development | A child can Sit in Tripod position at which month?
A. 5 months
B. 6 months
C. 8 months
D. 9 months
| 6 months |
926fb54a-de7a-4e5b-8518-34d9c385b5bd | (a) To see patellofemoral articulationExplanationStandard portals in knee arthroscopy1. Anterolateral portal- Almost all the structures within the knee joint can be seen except the posterior cruciate ligament, the anterior portion of the lateral meniscus, and the periphery of the posterior horn of the medial meniscus in tight knees.- Located 1cm above the joint line, 1cm lateral to the margin of the patellar tendon.2. Anteromedial portal- Used for additional viewing of lateral compartment and insertion of probe for palpation of medial and lateral compartment structures.- Placed 1cm above the medial joint line, 1cm inferior to the tip of patella, and 1cm medial to the edge of the patella.3. Posteromedial portal- Located on the soft triangular soft spot formed by the posteromedial edge of the femoral condyle and the posteromedial edge of tibia.- Used for viewing the posteromedial structures and for repair or removal of the displaced posterior horn of meniscal tears and for posteromedial loose body removal.4. Superolateral portal.- Used for diagnostically viewing the dynamics of patella-femoral joint, excision of medial plica.- Located just lateral to the quadriceps tendon and about 2.5cm superior to the superolateral corner of patella. | Orthopaedics | Knee Ligament Injuries | Anterolateral arthroscopy of knee is for:
A. To see patellofemoral articulation
B. To see the posterior cruciate ligament
C. To see the anterior portion of lateral meniscus
D. To see the periphery of the posterior horn of medial meniscus
| To see patellofemoral articulation |
ba233049-e69a-470a-bdce-fcfbfb82a765 | Refer KDT 6/e p743 PAS Ethionamide They can lead to hypothyroidiam | Pharmacology | Chemotherapy | Hypothyroidiam is caused by which of the following antitubercular drug
A. Streptomycin
B. Ethionamide
C. Thioacetazone
D. Ethambutol
| Ethionamide |
77131f1e-73e7-4af4-a32a-f14392f8172d | Ans. is 'a' i.e., CYP 3A4 Subtypes of cytochrome P-450 Depending upon the extent of amino acid sequence homology, the cytochrome P-450 (CYP) isoenzymes are grouped into families designated by capital letters (A, B, C ....). Individual isoenzymes are again alloted numerals (1, 2, 3 ....). Examples are CYP1A2, 2A6, 2B6, 2C8, 3A4/3A5. In human beings, only a few members of three isoenzyme families carry out metabolism of most of the drugs. Cyp 3 A 4/5 carryout biotransformation of largest number (nearly 50%) of drugs. Impoant inducers of CYP 3A4/3A5 Barbiturates Glucocoicoids Rifampin Macrolide antibiotics Carbamazepine Phenytoin Pioglitazone | Pharmacology | null | Most common mitochondrial enzyme for metabolism detoxification reaction is ?
A. CYP 3A4
B. CYP 1A2
C. CYP 2A6
D. CYP 2B6
| CYP 3A4 |
ed2bde65-9fab-42b5-95c9-58e47a03c0bd | Ans. B: AmyloidosisSpleen is more frequently the seat of amyloidos is than any other organ, and that it appears in a majority of cases to be the organ primarily affected.There are two forms of amyloid disease, called respectively the Sago form and the diffuse form or waxy spleen, to which a third or combined form may be added.In the first the Malpighian bodies are mainly engaged; in the second the pulp.On section of the spleen of sago type, instead of the normal small Malpighian bodies, transparent glancing areas which have been very aptly compared to grains of boiled sago. These are dotted over the surface in great profusion. On applying a solution of iodine the affected areas stand out as brown spots, which become of a deeper colour on adding dilute sulphuric acid.The diffuse amyloid spleen presents much greater enlargement than the sago form. It is in the highest degree hard, heavy, and the edges rounded.On section The tissue seems homogeneous and inelastic, and of a dark translucent appearance, which has been compared to that of wax or bacon, hence the names Waxy and Lardaceous spleen."Kidney is the MC involved organ in amyloidosis". | Pathology | null | Lardaceous spleen is a feature of: March 2010
A. Thalassemia
B. Amyloidosis
C. Sickle cell anemia
D. Malaria
| Amyloidosis |
add3e058-883f-4bb7-839a-8603df0d4496 | Ans. B REM sleepRef: Ganong, 25th ed. pg. 274* In REM sleep, the high amplitude slow waves in EEG during sleep are periodically replaced by rapid low voltage EEG activity which is identical to awake aroused state.* Now the point is that the person is sleeping while EEG record is like that of an awake patient. Hence REM sleep is called as paradoxical sleep. | Physiology | Nervous System | Paradoxical sleep is?
A. Seen in obstructive sleep apnea
B. REM sleep
C. NRM sleep
D. Narcolepsy
| REM sleep |
1a4bfdc1-aa72-46ed-9fcb-5377d12a6c89 | Prolonged seizures - seizures lasting more than 180 seconds * Prolonged seizures can be terminated either with additional doses of the barbiturate anesthetic agent or with IV diazepam * Methohexital can also be used to abo prolonged seizures in ECT or to limit postictal agitation. Extra edge: Tardive Seizures Additional seizures appearing some time after the ECT treatment This may occur in patients with preexisting seizure disorders | Psychiatry | DNB 2018 | The definition of prolonged seizures following ECT is:
A. >90 seconds
B. >150 seconds
C. >120 seconds
D. >180 seconds
| >180 seconds |
8314546b-6674-47bb-a18c-b583fefe7511 | Indications of simple / cortical mastoidectomy (Schwartz operation)
Acute coalescent mastoiditis.
Incompletely resolved acute otitis media with reservoir sign.
Masked mastoiditis.
As a initial step to perform:
Endolymphatic sac surgery
Decompression of facial nerve
Translabyrinthine or retrolabyrinthine procedures for acoustic neuroma. | ENT | null | Schwartz operation is done in -
A. CSOM
B. Serous otitis media
C. Otosclerosis
D. Acute mastoiditis
| Acute mastoiditis |
88cb6ce3-ddf9-404b-aaf0-0feb7b813d06 | Ans. c. Glucose 6-phosphatase (Ref: Harrison 19/e p433e-1, 433e-2t, 433e-5f, 436e-5, 18/e p3200, 3201; Harper's 27/e p166)Diagnosis of a child with hypoglycemia is not able to utilize glucose from glycogenolvsis or gluconeogenesis is Von Gierk's disease. Von Gierk's disease is due to the deficiency of glucose-6 phosphatase.Von Gierk's disease (AR)Inherited as autosomal recessiveQCaused by glucose-6-phosphatase deficiency in liver, kidney, and intestinal mucosa.Skeletal muscle is deficient in glucose-6 phosphatase, so muscles are not affectedQ.Structure of glycogen is normalQ but not available metabolically.Two subtypes of GSD IType IaType Ib* Defective enzyme: Glucose-6- phosphatase* Defective enzyme: TranslocaseThe defects in both subtypes lead to inadequate conversion in the liver of glucose-6-phosphate to glucose and thus make affected individuals susceptible to fasting hypoglycemia.Clinical Features:Clinical features are hypoglycemia, lactic academia, ketosis, hyperlipidemia, increased uric acid and hepato- splenomegalyQ.Liver cells and renal tubule cells loaded with glycogenQ.Organs affected are liver, intestine and kidneyQLong-Term ComplicationsGout, polycystic ovaries, hepatic adenomasIncreased risk of pancreatitis, cardiovascular disease.Frequent fractures (osteopenia/osteoporosis)Renal disease (proteinuria, hypertension, kidney stones, nephrocalcinosis, and altered creatinine clearance)Pulmonary hypertension (rare)Diagnosis:Clinical presentation and abnormal plasma lactate and lipid values suggest that a patient may have GSD IGene-based mutation analysis provides a noninvasive means of reaching a definitive diagnosis for most patients of GSD IDefinitive diagnosis required a liver biopsy to demonstrate a deficiency.Treatment of Type I GSD:Maintenance of normal blood glucose levels through continuous infusion of glucose via feeding tube or oral administration of uncooked cornstarch (slow-release form of glucose)Fructose and galactose cannot be converted to free glucose, their dietary intake should be restricted.Dietary supplements of multivitamins, calcium and Vitamin DAllopurinolUse of medium chain triglycerides, fish oil and lipid-lowering drugs such as statins and fibric acids.ACE inhibitors, Citrate supplementationOrthotropic liver transplantation: Reserved for GSD I patients with liver malignancy, multiple liver adenomas, metabolic derangements refractory to medical management, and/or liver failure.A child was brought to the hospital was found to have hypoglycemia, hepatomegaly and accumulation of highly branched glycogen called limit dextrins. He is likely to be suffering from Cori's disease.Type IIIa Glycogen Storage Disease or Cori's Disease or Forbes Disease:Caused by a deficiency of glycogen debranching enzyme.Childhood: Hepatomegaly, growth retardation, muscle weakness, fasting hypoglycemia,Accumulation of characteristic branched polysaccharide (limit dextrins)Type IlIa Glycogen Storage Disease or Cori's Disease or Forbes DiseaseCaused by a deficiency of glycogen debranching enzymeQ.Debranching & phosphorytase enzyme are responsible for complete degradation of glycogen.When the debranching enzyme is defective, glycogen breakdown is incompleteQ.Abnormal glycogen accumulates with short outer chains and resembles dextrin.Clinical and Laboratory Findings:Deficiency of glycogen debranching enzyme causes hepatomegaly, hypoglycemia, short stature, variable skeletal myopathy, and cardiomyopathy. The disorder usually involves both liver and muscle and is termed type IlIa glycogen storage diseaseHypoglycemia, hyperlipidemia, and elevated liver transaminases occur in childrenQ.Diagnosis:Deficient debranching enzyme activity can be demonstrated in fiver, skeletal muscle, and heart * DNA-based analyses now provide a noninvasive way of subtyping these disorders in most patients.Treatment:Frequent high-carbohydrate meals with cornstarch supplements or nocturnal gastric drip feedings are usually effective in treating hypoglycemiaQA high-protein diet is recommended as gluconeogenesis is intact, providing a source for glucose.Fig. 8: Metabolic pathways related to glycogen storage diseases and galactose and fructose disorders (GSa, active glycogen synthase: GSb, inactive glycogen synthase: Pa. active phosphorylase; Pb, inactive phosphorylase; PaP. phosphorylase a phosphatase; PbKa, active phosphorylase b kinase; PbKb: inactive phosphorylase b kinase; G, glycogenin. the primer prolein for glycogen synthesis)Features of Glycogen Storage Diseases (Disorders with hepatomegaly and hypoglycemia)Type/ Common NameBasic DefectClinical FeaturesCommentsla/ von GierkeGlucose-6-phosphataseGrowth retardation, enlarged liver and kidney, hypoglycemia, elevated blood lactate, cholesterol, triglycerides, and uric acidQCommon, severe hypoglycemia Complications in adulthood include hepatic adenomas, hepatic carcinoma, renal failureQIbGlucose-6-phosphate trans- locaseAs for la. with additional findings of neutropenia and neutrophil dysfunction10% of type IIIIa/ Cori's or Forbes DiseaseLiver & muscle debranching enzymeChildhood: Hepatomegaly, growth retardation, muscle weakness, fasting hypoglycemia, accumulation of characteristic branched polysaccharide (limit dex- trins), elevated liver transaminases; liver symptoms improve with ageQ Adulthood: muscle atrophy and weakness; onset: third to fourth decades; variable cardiomyopathyCommon, intermediateseverity of hypoglycemia; hepatic adenomas, liver cirrhosis, and hepatic carcinoma can occurQIIIbLiver debranching enzyme(normal muscle debrancher activity)Liver symptoms same as in type Illa; no muscle symptoms15% of type IIIVI/ HersLiver phosphorylaseHepatomegaly, variable hypoglycemia, hyperlipidemia and ketosis; symptoms may improve with ageRare, often a "benign"- glycogenosis. severe cases being recognizedIX/ phosphorylase kinase deficiencyLiver phosphorylase kinase a subunitAs for VICommon, X-linked, typically less severe than autosomal forms; clinical variability within and between subtypes; severe cases being recognized0/ glycogen synthase deficiencyGlycogen synthaseFasting hypoglycemia and ketosis, elevated lactic acid & hyperglycemia after glucose loadDecreased glycogen storesXI/ Fanconi-BickelGlucose transporter-2 Failure to thrive, rickets, hepatomegaly, proximal renal tubular dysfunction,impaired glucose & galactose utilizationRare, consanguinity in 70% | Pediatrics | Inborn Errors of Metabolism | A child with hypoglycemia is not able to utilize glucose from glycogenolysis or gluconeogenesis. Which of the following enzyme is deficient in the child?
A. Fructokinase
B. Glucokinase
C. Glucose 6-phosphatase
D. Transketolase
| Glucose 6-phosphatase |
32db9e4c-e9cb-4903-a89f-1c2fe62c267a | Ref: R Alagappan - Manual of Practical Medicine 4th Edition.pg no:146 Jones Criteria for Diagnosis ofRheumatic FeverMajor CriteriaCarditisPancarditis, seen in 50-60% of patients, develops withinthe first 2 weeks of rheumatic fever. Pericarditis isevidenced by presence of a pericardial rub, myocarditisby tachycardia, soft S1, presence of S3 and CCF andendocarditis by the presence of Carey-Coombs' murmur(mitral diastolic murmur).Ahritis (60-75%)Flitting and fleeting type of polyahritis involving largejoints with no residual deformity is seen in 60-75% ofpatients and occurs early in rheumatic fever.Jaccod's ahritis: Ulnar detion of 4th and 5th fingerwith flexion at metacarpophalangeal joints is the only residualdeformity seen in rheumatic polyahritis.Subcutaneous NodulesNon-tender nodules are seen over bony prominenceslike elbows, shin, occiput, spine in 3-5% of patients andoccur 3-6 weeks after onset of rheumatic fever. Patientswho have subcutaneous nodules almost always havecarditis.Erythema Marginatum (< 5% and evanescent)Macular lesions with an erythematous rim and centralclearing in a bathing suit distribution are seen in < 5%of patients and occur early in rheumatic fever.Chorea (Sydenham's Chorea) (2-30%)A neurological disorder with rapid, involuntary andpurposeless non-repetitive movements with a self limitingcourse of 2-6 weeks is more common in females andis a late manifestation of rheumatic fever. | Medicine | C.V.S | Which one of the following is not Included in Jone's Major criteria -
A. Pan carditis
B. Syndenhams chorea
C. Subcutaneous nodule
D. High ESR
| High ESR |
e3e87402-137f-435f-94be-a94a2ab8b4e1 | The danger of needle stick injury is present in medical and paramedical personnel,though the chance of infection are much less than with hepatitis B infection. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO-583 | Microbiology | Virology | Risk of HIV trasnmission is not seen with -
A. Whole blood
B. Platelets
C. Plasma derived hepatitis B vaccine
D. Leucytes vaccines
| Plasma derived hepatitis B vaccine |
036d289b-bf37-43d4-ad5a-8702233dd929 | The clearance rate of Propofol exceeds hepatic blood flow, suggesting that an extrahepatic route of elimination also contribution its clearance. since propofol has extrahepatic and extrarenal route of metabolism its metabolism is never delayed in hepatic and renal failure. | Anaesthesia | Intravenous Anesthetic Agents | Which of the following intravenous anaesthetic agent has extrahepatic additional route of metabolism -
A. Thiopentone
B. Propofol
C. Etomidate
D. Ketamine
| Propofol |
e7d8d775-573d-473b-a643-60c5b8d8baa1 | Ans. is 'a' i.e., Dysthanasia In medicine, dysthanasia means "bad death" and is considered a common fault of modern medicine: Dysthanasia occurs when a person who is dying has their biological life extended through technological means without regard to the person's quality of life. | Forensic Medicine | null | Prolonging a person's life through technological means is known as :?
A. Dysthanasia
B. Novus actus interveniens
C. Euthanasia
D. Ohotanasia
| Dysthanasia |
2672f81f-6579-42ba-8f30-e02dfb5fc990 | Calcium gluconate (Also see AIIMS May 2010) . Calcium gluconate is the fastest acting agent used in t/t of hyperkalemia. . In acts within nzinutes but an impoant point to note is that it does not cause transcellular movement of potassium, instead it acts on cell membrane. - It stabilizes the cardiac cell membrane and reduces chances of cardiac arryhthmia. - Thus it has no use when there are no E.C.G. features. NaHCO3 NaHCO3 has been routinely used in the treatment of hyperkalemia. It was believed that NaHCO3 caused movement of potassium inside the cells by causing alkalosis. But studies do not suppo this - They claim that NaHCO3 do not cause movement of potassium inside the cells in acute cases of hyperkalemia. - It only decreases potassium when there is coexisting acidosis. - NaHCO3 can decrease potassium level in chronic hyperkalemia. It increases potassium delivery to the kidney. But the use of NaHCO3 still continues in most hospitals and institutes across the world. - It is now hypothesized that NaHCO3 does not cause IC* entry inside the cell by mechanism earlier believed to be, but by another mechanism. The question does not say anything about acidosis. Don't think that acidosis occurs only in severe hyperkalemia. Most patients with C.R. F. present with acidosis and mild moderate hyperkalemia. In hyperkalemia with no E.C.G. feature, calcium prophylaxis is not indicated - Calcium gluconate is administered to stabilize the cardiac membrane - Instability of the cardiac membrane is indicated by E.C.G. changes - Absence of E.C.G. changes suggest that the cardiac membrane is stable. In these cases there is no use of calcium administration. Prophylactic calcium gluconate is of no use. | Surgery | null | Hyperkalemia with no ECG finding. The drug that should not be used isaEUR'
A. Sodium bicarbonate
B. Calcium gluconate
C. Glucose with insulin
D. Resins
| Calcium gluconate |
36a5a2fe-86e2-4e52-ac0e-1f6d084344ef | Ans. A. Greater Petrosal NerveThe lacrimal nerve, derived from the ophthalmic nerve, supplies the sensory component of the lacrimal gland. The greater petrosal nerve, derived from the facial nerve, supplies the parasympathetic autonomic component of the lacrimal gland. The greater petrosal nerve traverses alongside branches of the V1 and V2 divisions of the trigeminal nerve.The parasympathetic nerve supply originates from the lacrimatory nucleus of the facial nerve in the pons. From the pons nucleus preganglionic parasympathetic fibres run in the nervus intermedius (small sensory root of facial nerve) to the geniculate ganglion but they do not synapse there. Then, from the geniculate ganglion, the preganglionic fibres run in the greater petrosal nerve (a branch of the facial nerve) which carries the parasympathetic secretomotor fibers through the foramen lacerum, where it joins the deep petrosal nerve (which contains postganglionic sympathetic fibers from the superior cervical ganglion) to form the nerve of the pterygoid canal (vidian nerve) which then traverses through the pterygoid canal to the pterygopalatine ganglion. Here, the fibers synapse and postganglionic fibers join the fibers of the maxillary nerve. In the pterygopalatine fossa itself, the parasympathetic secretomotor fibers branch off with the zygomatic nerve and then branch off again, joining with the lacrimal branch of the ophthalmic division of CN V, which supplies sensory innervation to the lacrimal gland along with the eyelid and conjunctiva. | Anatomy | Orbit | Nerve supply of Lacrimal Gland is:
A. Greater Petrosal Nerve
B. Lesser Petrosal Nerve
C. External Petrosal Nerve
D. Deep Petrosal Nerve
| Greater Petrosal Nerve |
c1234650-463b-458c-843e-2c5b0835a0bf | Weight reflects only the present health status of the child, the height indicate the events in the past also. So reduced weight for height denotes acute malnutrition. REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION. PAGE NO - 501 | Social & Preventive Medicine | obstetrics,pediatrics and geriatrics | Deficit in weight for height in a 3 year old child indicates -
A. Acute malnutrition
B. Chronic malnutrition
C. Concomittant acute and chronic
D. Under weight
| Acute malnutrition |
daed976a-c973-4eb9-ac46-730b23ea0732 | Ans. is 'b' i.e., 4th to 8th week * The development of a new individual in the uterus involves three phasesi) Pre-embro phase or germinal phase (day 0-3 weeks).ii) Embro phase or embryonic period (weeks 4-8).iii) Fetal phase (weeks 8-38). | Anatomy | Embryology | Embryonic phase of development is from -
A. 1-3 weeks
B. 4th to 8th week
C. 0-4thweek
D. 6th to 9th week
| 4th to 8th week |
9a5cc08f-cb0c-4163-9c0a-4d1a0578f71c | Ans. is 'a' i.e., Clofazamine Clofazimine Clofazimine is a leprostatic drug. It acts by interfering the template function of DNA. Adverse effects of clofazimine | Pharmacology | null | Pigmentation and icthyosis are side effects of ?
A. Clofazamine
B. Rifampicin
C. Dapsone
D. Ethionamide
| Clofazamine |
cb73233c-78e2-40be-9e1b-054703fb97f7 | Sorafenib is a Tyrosine Kinase inhibitor which is the drug of choice for Hepatocellular carcinoma. | Pharmacology | null | Which of the following is used in the treatment of Hepatocellular carcinoma ?
A. Vandetanib
B. Pazopanib
C. Sorafenib
D. Bevacizumab
| Sorafenib |
9799f49f-6b2c-407e-8fbb-08885b99d33f | a. Lung maturity(Ref: Nelson's 20/e p 2088-2093, Ghai 8/e p 379-381)By 35 wk of gestation, the lecithin: sphingomyelin (L:S) ratio averages about 2:1, indicative of lung maturity. | Pediatrics | Respiratory System | Lecithin-Sphingomyelin ratio is used for:
A. Lung maturity
B. Age of infant
C. Kidney maturity
D. Brain maturity
| Lung maturity |
c4937955-d1c4-4b30-89ff-31ee44082cf4 | Acne causes polymorphous cutaneous lesions such as comedones, papules, pustules, pseudocysts and abscesses which may leave scarring.comedones are the characteristic of acne vulgaris. Reference Harrison20th edition pg 1204 | Dental | Anatomy of skin | Comedones are seen in-
A. Acne vulgaris
B. Lichen Planus
C. Adenoma sebaceum
D. Pityriasis
| Acne vulgaris |
c6ddb41e-d03f-4c69-bee7-a8e96e7123b8 | Types of Proteinuria The following five types of proteinuria are distinguished by milligrams (mg) of protein measured during a 24-hour urine collection: Microalbuminuria (30-150 mg) Mild (150-500 mg) Moderate (500-1000 mg) Heavy (1000-3000 mg) Nephrotic range (more than 3500 mg) As kidney disease progresses, more protein enters the urine. People with nephrotic-range proteinuria typically have extensive glomeruli damage and usually, develop nephrotic syndrome. www.healthcommunities.com | Pathology | Urinary tract | Microalbuminuria is defined as protein levels of-
A. 100-150 mg/L
B. 151-200 mg/L
C. 201-300 mg/L
D. 301-600 mg/L
| 100-150 mg/L |
c481d7a7-2d18-4f96-aea5-0a790c605547 | ANSWER: (A) Cu 380 AREF: Park 20th edition page 427The T-Cu-38GA has been approved for use for 10 yearT-Cu 200 - 4 yrsNova T - 5 yrsProgestsert - 1 yrs | Social & Preventive Medicine | Family Planning | Cu T with 10 years life is?
A. Cu 380 A
B. Progestasert
C. Cu T 200
D. Nova T
| Cu 380 A |
4cd70d67-1b3a-4c8c-8c5b-d360a57f5fca | D i.e. Syphilis Recurrence of the chancre in its original place due to relapse (not re-infection) in early syphilisQ is called chancre redux. - Vesico - Bullous lesion are charcterstically seen in early congenital syphilisQ & not found in other stages of syphilis. Interstitial keratitis, along with 8th nerve deafness & hutchinson's teeth (pegged central upper incisors)Q -form Hutchinson's triad; which is seen in late congential syphilis. Sabre tibiaQ, saddle nose, mulberry molars, bull dog jaws, frontal bossing of parrot and rhagades are other features of late congenital syphilis. | Skin | null | Sabre Tibia
A. Scury
B. Rickets
C. Leprosy
D. Syphilis
| Syphilis |
3262c222-cde5-4594-a385-fcdb57669e0b | all neurological disorders affecting the frontal coex can present with psychiatric presentations pathology in orbitofrontal coex presents with disinhibition, social inappropriateness pathology in dorsolateral pReferencerontal coex presents with disturbance in planning , programming and execution pathology in medial pReferencerontal coex presents with akinetic mutism Reference: Kaplon and sadock, 11 th edition, synopsis of psychiatry, 11 th edition, pg no. 236 | Psychiatry | All India exam | Disease in which of the following lobes of the brain can manifest as psychiatry illness?
A. Frontal
B. Parietal
C. Temporal
D. Occipital
| Frontal |
d1a93947-7af7-43d0-9e8d-4f54375d6f41 | Ans. is 'a' i.e., Hypeensiono More than 90% of dissections occur in men between the age of 40 and 60 with antecedent hypeension. Other causes of dissection.o Marfan syndrome causing cystic medial necrosis (second most common).o Ehlers - Danlos syndrome.o Inflammatory aoitis --> Takayasu's disease, Giant cell aeritis.o Coarctation of aoa.o Normal woman during third trimester of pregnancy.o Congenital bicuspid aoic valve. | Pathology | null | Most common cause of Aoic dissection ?
A. Hypeension
B. DM
C. Trauma
D. Mafan syndrome
| Hypeension |
b6526d00-6df5-4681-b098-dea54bb18404 | Ans. C i.e. lc antagonist Naltrexone is an opioid receptor antagonist used primarily in the management of alcohol dependence and opioid dependence. | Pharmacology | null | Naltrexone is: March 2013
A. (mu) agonist
B. 6 (delta) agonist
C. lc (kappa) antagonist
D. NOP receptor antagonist
| lc (kappa) antagonist |
e5fd8bb4-9f5f-4608-a03d-e38b03a2d387 | Farmer's lung is caused by Hay or grain dust. | Social & Preventive Medicine | null | Cause of Farmer's lung –
A. Cotton dust
B. Grain dust
C. Sugarcane dust
D. Iron
| Grain dust |
0178a353-91a7-4192-b4fd-4c82d719612d | Rakosi- Jarabak analysis
The sum of posterior angles i.e. the cranial base (N–S–Ar), articular (S–Ar–Go), and gonial angles (Ar–Go–Me)> 396 degrees indicates clockwise direction of growth i.e. vertical growth.
The sum of posterior angles i.e. the cranial base (N–S–Ar), articular (S–Ar–Go), and gonial angles (Ar–Go–Me)< 396 degrees indicates anticlockwise direction of growth i.e. horizontal growth. | Dental | null | More than normal posterior angle indicate:
A. Horizontal growth
B. Vertical growth
C. Sagittal growth
D. No significance
| Vertical growth |
bf825040-a265-4a34-8cbc-a02a0550e9bf | Mechanism of inspiratory softening of the pulmonary ejection click. Left-sided ejection clicks occur in the presence of a dilated aoa or aoic valve abnormalities. Ejection clicks occur with flexibly stenotic aoic valves and with nonstenotic bicuspid aoic valves.gap reduces in severe pul monary stenosis Ref Davidson 23rd edition pg 453 | Medicine | C.V.S | S, ejection click & severe pulmonary stenosis relation is-
A. In severe pulmonary stenosis gap increases
B. In severe pulmonary stenosis gap reduces
C. In severe pulmonary stenosis no change
D. In severe pulmonary stenosis ejection cttek comes_before
| In severe pulmonary stenosis gap reduces |
d10d973a-56c9-40b4-b692-b61a29296e09 | Nuts and oilseeds Included in this group are groundnut (Peanut), cashewnut, coconut, walnut, almonds, pistachio, mustard seeds, sesame seeds, cotton seeds, sunflower seeds, maize germ and many others from which cooking oils are extracted. Nuts and oilseeds contain good amount of fat and good quality protein in a relatively small bulk. Regarding the fat content, walnuts contain 64.5 per cent, almonds 58. 7 per cent, cashewnuts 46.9 per cent and groundnut 40 per cent. Peanut (groundnut) butter is a very valued aicle of the diet. Regarding protein content, groundnut tops the list with 26.7 per cent. Being of vegetable origin, their protein is not equal to that of meat or eggs in quality. Nuts are good sources of vitamins of the B-group. They contribute minerals such as calcium, phosphorus, and iron. Among the commonly used nuts, cashewnuts and almonds are good sources of iron, but pistachio is the richest containing 14 mg of iron per 100 g Ref :Park 25th edition Pgno : 649 | Social & Preventive Medicine | Nutrition and health | Which nut has highest protein content -
A. Walnut
B. Groundut
C. Almond
D. Coconut
| Groundut |
2288e019-e43c-4150-95a3-deff7b1f9849 | Down syndrome is associated with incrased risk of leukemia. _____ Harrison | Pathology | null | Which of the following is not associated with malignancy -
A. Fragile X syndrome
B. Fanconi's syndrome
C. Down's syndrome
D. Bloom syndrome
| Fragile X syndrome |
21d7fe9c-2f14-4779-96d0-801daadbf543 | Answer is D (Phosphate Binders) The initial treatment of secondary hyperparathyroidism in renal osteodystrophy is management of high phosphate levels by dietary restriction and the use of Phosphate binders The objectives of management are to maintain blood levels of calcium and phosphorous to as close to normal as possible, to prevent or treat established hyperparathyroidism early and to prevent parathyroid hyperplasia. Phosphate retention begins early in the course of CKD, perhaps as early as in stage 2 and paicipates in the development of secondary hyperparathyroidism. Central to the management of high-turnover bone disease is controlling the serum phosphate levels. This may be achieved by dietary phosphate restriction or by the use of phosphate binders. Phosphate-binder therapy is recommended when serum phosphate concentrations are elevated despite patient compliance with dietary phosphate restriction. Calcium-based phosphate binders are often recommended as the initial binder therapy. High Bone Turnover Disease Bone turnover (the formation and removal of bone) is increased due to a process called secondary hyperparathyroidism (SHPT). Secondary hyperparathyroidism represents a common disorder in patients with CKD. It develops as a result of hyperphosphatemia, hypocalcemia and impaired renal vitamin D synthesis with reduction in serum calcitriol levels | Medicine | null | The initial treatment of choice for secondary hyperparathyroidism in renal osteodystrophy is:
A. Cinacalcet
B. Bisphosphonates
C. Calcium restriction
D. Phosphate binders
| Phosphate binders |
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