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1d05977f-576f-45e6-8022-3b5f062ef67d | Ans. is 'a' i.e., Distal to dilated segment "The major feature of Hirschsprung ds is an absence of ganglion cells in the neural plexus of the intestinal wall, together with hypertrophy of nerve trunks. The absence of ganglion cells gives rise to a contracted non-peristaltic segment with a dilated hypertrophied segment of normal colon above it ___ Bailey 24/e | Surgery | Colon, Rectum, and Anus - Diagnostic Evaluation | Aganglionic segment is encountered in which part of colon in case of Hirchsprung's disease -
A. Distal to dilated segment
B. In whole colon
C. Proximal to dilated segment
D. In dilated segment
| Distal to dilated segment |
6c7f7183-0070-4e46-a26c-9c57cb7d6623 | The recommended illumination (IES Code)in watch manufacturing company is 2000-3000 lux Rule of thumb is that the illumination must be 30 times higher the level at which ask can be just done. Parks textbook of preventive and social medicine.K Park. Edition 23.page no:741.table2. | Social & Preventive Medicine | Environment and health | Light requirement in watch manufacturing company is -
A. 2000-3000 Lux
B. 5000-10000 Lux
C. 10000-20000 Lux
D. 50000 Lux
| 2000-3000 Lux |
e56cb61a-fff4-4f59-a5b9-3c3580aa7a44 | ANSWER: (D) OxprenololREF: KDT 6 th edition page 140Membrane stabilizing activity (in propanolol, oxprenolol, acebutolol). This activity is claimed to contribute to the antiarrhythmic action, but appears to be significant only at high doses | Pharmacology | Anti Adrenergic System | Drug with membrane stabilizing activity is?
A. Nadolol
B. Atenolol
C. Carvedilol
D. Oxprenolol
| Oxprenolol |
3fe063ec-fd78-48d6-8d8f-8709cbd7eb41 | Cocaine use produces a mild physical, but a strong psychic dependence. A triphasic withdrawal syndrome follows an abrupt discontinuation of chronic cocaine use. Signs and symptoms : In the early phase (crash phase, 9 h to 4 days), there is anorexia, depression, agitation, excessive craving, hypersomnia, fatigue and exhaustion which is followed by normal mood, anxiety and anhedonia (next 4-7 days). In third phase (extinction phase, after 7-10 days), there are no withdrawal symptoms, but increased vulnerability to relapse. Treatment : Bromocriptine and amantadine are useful in reducing cocaine craving. Gabapentin is being used in adult addicts. | Forensic Medicine | Drug Abuse | A triphasic withdrawal syndrome follows an abrupt discontinuation of ______ use.
A. Alcohol
B. LSD
C. Heroin
D. Cocaine
| Cocaine |
67fce0c1-0aa2-43f1-8ca8-e7ce08bc1de6 | Lamivudine belongs to the set of antiviral agents effective against hepatitis B virus infection. Given case repos on liver injuries after ceain antiviral agent treatments, this study examined the effects of lamivudine on alanine aminotransferase (ALT) and total bilirubin (TB) using a medical system database Ref Harrison20th edition pg 2675 Lamivudine has been used for treatment of chronic hepatitis B at a lower dose than for treatment of HIV/AIDS. It improves the seroconversion of e-antigen positive hepatitis B and also improves histology staging of the liver. Long-term use of lamivudine leads to emergence of a resistant hepatitis B virus (YMDD) mutant. Despite this, lamivudine is still used widely as it is well tolerated Lamivudine, commonly called 3TC, is an antiretroviral medication used to prevent and treat HIV/AIDS. It is also used to treat chronic hepatitis B when other options are not possible.It is effective against both HIV-1 and HIV-2.It is typically used in combination with other antiretrovirals such as zidovudine and abacavir. Lamivudine may be included as pa of post-exposure prevention in those who have been potentially exposed to HIV. Lamivudine is taken by mouth as a liquid or tablet HIV, high level resistance is associated with the M184V/I mutation in the reverse transcriptase gene as repoed by Raymond Schinazi's group at Emory University. GlaxoSmithKline claimed that the M184V mutation reduces "viral fitness", because of the finding that continued lamivudine treatment causes the HIV viral load to rebound but at a much lower level, and that withdrawal of lamivudine results in a higher viral load rebound with rapid loss of the M184V mutation; GSK therefore argued that there may be benefit in continuing lamivudine treatment even in the presence of high level resistance, because the resistant virus is "less fit". The COLATE study has suggested that there is no benefit to continuing lamivudine treatment in patients with lamivudine resistance. A better explanation of the data is that lamivudine continues to have a paial anti-viral effect even in the presence of the M184V mutation. In hepatitis B, lamivudine resistance was first described in the YMDD (tyrosine-methionine-aspaate-aspaate) locus of the HBV reverse transcriptase gene. The HBV reverse transcriptase gene is 344 amino acids long and occupies codons 349 to 692 on the viral genome. The most commonly encountered resistance mutations are M204V/I/S. The change in amino acid sequence from YMDD to YIDD results in a 3.2 fold reduction in the error rate of the reverse transcriptase, which correlates with a significant growth disadvantage of the virus. Other resistance mutations are L80V/I, V173L and L180M Ref Davidson 23rd edition pg 768 | Medicine | C.N.S | Lamivudine is given when?
A. HBeAg positive
B. HBeAg negative
C. ALT >_ 2 ULN
D. Viral DNA> 10(square) copies
| ALT >_ 2 ULN |
2db106ce-b897-42ee-9a27-426ad09ebd9b | Ans. (b) Rabies Vaccine that grows in embryonated eggs: Influenza Yellow fever (17 D strain) Rabies (Flury strain) Mumps Varicella vaccine growns in chick embryo fibroblast culture. Rubella - RA 27/3 vaccine produced in human diploid fibroblast. No eggs culture vaccine of measles are produced. All are tissue culture vaccine, either chick embryo or human diploid cell line. | Microbiology | null | Vaccines prepared by embryonated hen's egg are:
A. Measles
B. Rabies
C. Rubella
D. Varicella
| Rabies |
c8c28ce0-6826-4d8f-ab49-9831ff2d4cd5 | Ans. is 'c' i.e., Neuroblastoma The commonest intra-abdominal tumor in first two years of life Neuroblastoma The commonest intra-abdominal tumor between 2"d to 5th year of life - Wihn's tumor The commonest intra-abdominal tumor in children (no age specification) Neuroblastoma (Wilm's tumor is the second most common abdominal tumor in children) Remember: The commonest cause of abdominal mass in Newborn is : Multiple dysplastic kidneys (if neoplasm or tumor has not been mentioned when asking for the commonest intra-abdominal mass, the answer will be multiple dysplastic kidneys) | Pediatrics | null | Which is the commonest abdominal mass in neonate -
A. Wilm's tumor
B. Polycystic kidney
C. Neuroblastoma
D. Rhabdomyosarcoma
| Neuroblastoma |
80727211-e047-437d-99f1-69d8221d13e4 | Remember that a buffer is most effective when its pKa is within the pH range of the surrounding medium. Histidine is the only amino acid with good buffering capacity at physiologic pH. The imidazole side chain of histidine has a pKa around 6.0 and can reversibly donate and accept protons at physiologic pH. Arginine and lysine are basic amino acids with pKa's of 12.5 and 10.5, respectively; at physiologic pH both will behave as bases and accept protons. Aspaic acid and glutamic acid are acidic amino acids with pKa's of approximately 4; at physiologic pH they will behave as acids and donate protons. Ref: Rodwell V.W. (2011). Chapter 30. Conversion of Amino Acids to Specialized Products. 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 | Which of the following amino acids is most responsible for the buffering capacity of hemoglobin and other proteins?
A. Arginine
B. Aspaic acid
C. Glutamic acid
D. Histidine
| Histidine |
ccc6c882-5c84-44df-af69-a50d0a6d14f2 | Ans. (c) CholecystitisCholecystitis is inflammation of gall bladder wall.Radiological evaluation does not show elevation of right hemidiaphragm in these cases.AMOEBIC LIVER ABSCESS* Chest radiographs are abnormal in the majority of patients with amebic hepatic abscesses. Findings include elevation of the right hemi-diaphragm, right pleural effusion, atelectasis in the region of the base of the right lung, and a right pleural effusion.PYOGENIC LIVER ABSCESS* Chest radiographs are abnormal in half of patients with pyogenic liver abscesses, reflecting an underlying inflammatory process. The most frequent findings include a right pleural effusion, elevation of the right hemi-diaphragm, and atelectasisIn case of subdiaphragmatic abscess also, there is elevation of right hemi-diaphragm. | Surgery | Miscellaneous | Which of the following is NOT associated with elevation Right hemi-diaphragm:
A. Amebic abscess
B. Pyogenic abscess
C. Cholecystitis
D. Sub diaphragmatic abscess
| Cholecystitis |
4d79e291-8a7b-4f4e-aba6-4e1123ba0d21 | D i.e. Atropine Pinpoint pupils are seen in - 'Car Chlor Or Mor' i.e. Carbolic acid, Chloral hydrate, Organophosphorus, Morphine (opiate)Q and 'New Horn' i.e. neurosyphilis/tabes dorsalis (spinal miosis or small, irregular Argyll Robeson pupil) and Horner's syndrome. Atropine and cocaine cause mydriasisQ Barbiturate poisoning 1/t constricted & reacting pupils which dilate during terminal asphyxiaQ | Forensic Medicine | null | Mydriasis is/are caused by:
A. Homer syndrome
B. Neurosyphilis
C. Organophosphorus poisoning
D. Atropine
| Atropine |
b8404abb-8c0c-464e-9720-0393fd0e4963 | Ans. is 'a' i.e., Ultrasonography o Ultrasonography is based on piezoelectric effect.o MRI is based on gyeromagneticproperty of proton (H+).Ultrasonography (USG) / Ultrasoundo USG is performed with the pulse-echo technique. By the virtue of piezoelectric effect in the ultrasound probe (or transducer), electric energy is converted to sound energy that is transmitted into patient's tissues. The US transducer (probe) then becomes a receiver, detecting echo of sound energy reflected from tissue.o The US transducer (probe) then becomes a receiver, detecting echo of sound energy reflected from tissue.o The ultrasound transducer uses the principle or property of piezoelectricity.o Quartz is a naturally occuring peizoelectric material.o Currently, Lead Zirconate titanate (PZT) is the most widely used material in the ultrasound tranducer/probes | Radiology | Ultrasonography, CT, and MRI | Which of the following techniques use piezoelectric crystals -
A. Ultrasonography
B. X-ray diffraction
C. NMR imaging
D. Xeroradiography
| Ultrasonography |
23637300-9b66-4e37-bfac-6dcd82e06399 | Ans. A: Sodium Nitroprusside Antihypeensive therapy in acute aoic dissection aims specifically to lessen pulsatile load or aoic stress, in order to retard the propagation of the dissection and prevent aoic rupture. The goals of treatment are to prevent myocardial ischemia, decrease left ventricular afterload, decrease myocardial oxygen consumption, and prevent rupture and bleeding from suture lines Nitroprusside is a potent direct aerial and venous dilator, acting through release of nitric oxide. It has a rapid onset of action, and a shoer half-life and thus is given in the form of continuous infusion. The hypotensive effects of nitroprusside can be unpredictable because it simultaneously causes potent venodilatation and peripheral aerial vasodilatation. This is especially the case for patients with severe left ventricular hyperophy and preload-dependent diastolic dysfunction. It has been shown to cause coronary steal; it can cause a significant reflex tachycardia, and it can decrease oxygen circulation. It is photosensitive, so it requires special handling. Its most serious adverse effect is in the form of cyanide toxicity, which occurs due to accumulation of its metabolites thiocyanate/ cyanide and its clinical presentation may vary leading to difficulty in diagnosis. Thus, it is recommended that this drug be used only when other intravenous antihypeensive agents are not available | Pharmacology | null | A patient with hypeension is also having aoic dissection. Anti-hypeensive agent of choice is: September 2008
A. Sodium nitroprusside
B. Reserpine
C. Pindolol
D. Nifedipine
| Sodium nitroprusside |
1d798a72-cfe5-4375-8458-29c156bcadab | Ans. D. Supraclavicular nervesThe phrenic nerve consists of contributions from spinal nerve levels C3 to 5.Therefore, when sensory information comes from the parietal peritoneum on the inferior diaphragmatic surface, it may refer through spinal nerves at the same levels.a. Supraclavicular nerve shares levels with the C3 and C4 levels.b. The greater and lesser occipital nerves both originate at the C2 level.c. Great auricular nerve root value is C2, C3 | Anatomy | Abdomen & Pelvis | The parietal peritoneum covering the inferior surface of the diaphragm transits its sensory information via the phrenic nerve. In the case of peritonitis in the parietal peritoneum on the inferior surface of the diaphragm, pain may be referred through which of the following nerves?
A. A
B. B
C. C
D. D
| D |
3f4b03b8-c4fb-4192-9861-ec70b6ade393 | Operations for GORD are based on the creation of an intra-abdominal segment of oesophagus, crural repair and some form of wrap of the upper stomach (fundoplication) around the intra-abdominal oesophagus.Nissen fundoplication is one of the commoner procedures done.Ref: Bailey and Love 27e pg: 1078 | Surgery | G.I.T | Operation of choice in GERD is
A. Highly selective vagotomy
B. Fundoplication
C. Hellers myotomy
D. Gastrectomy
| Fundoplication |
f4873d26-d753-4048-bbe1-64d8649eb261 | Non immunized contacts should receive prophylactic penicillin or erythromycin. They should also be given 1000 to 2000 units of antitoxin and actively immunized against diphtheria. Ref: Park 21st edition, page 151. | Social & Preventive Medicine | null | Non immunized susceptible diphtheria contacts should receive:
A. Erythromycin
B. Penicillin and diphtheria antitoxin
C. Penicillin, diphtheria antitoxin and DPT vaccine
D. No treatment is required
| Penicillin, diphtheria antitoxin and DPT vaccine |
65934f28-68d3-447f-b328-b5c56b393fae | Fibrin degradation product (FDP) is the best test to diagnose bleeding in DIC. D-Dimer assay is for screening | PT & | aPTT seen in a lot of conditions - so not best. | Medicine | Platelet & Coagulation disorders | Which of the following is the best test to diagnose bleeding in DIC?
A. Increased PT
B. Increased aPTT
C. Decreased fibrinogen
D. Increased fibrin degradation products
| Increased fibrin degradation products |
4e6f7dc8-11e3-485c-ab6e-e41e1a3f7827 | ANSWER: (C) 7thREF: Gray's Anatomy 40th Ed Ch: 49Indirect repeat Anatomy 2012 Session II, 2013 Session 1The inferior angle overlies the seventh rib or intercostal space and T7 | Anatomy | Back, Deltoid, and Scapular Region | Inferior border of scapula lies at the level of which rib?
A. 5th
B. 6th
C. 7th
D. 8th
| 7th |
17df7825-4359-4de9-a6e6-ed584940a378 | Ans. B. Carbonic Anhydrase IIIn osteoporosis, also called as marble bone disease there is increased bone density. It is due to mutation in gene encodingcarbonic anhydrase II enzyme. The deficiency of this enzyme in osteoclasts leads to inability of bone resorption. | Biochemistry | Enzymes | Marble bone disease, characterized by increase in bone density is due to mutation in the gene encoding:
A. Carbonic Anhydrase I
B. Carbonic Anhydrase II
C. Carbonic Anhydrase III
D. Carbonic Anhydrase IV
| Carbonic Anhydrase II |
33e7cae5-5277-43b0-8a2b-1f9ef1355d87 | Presence of acidic stools with reducing substance positive, suggests a diagnosis of lactose intolerance. | Pediatrics | Disorders of Gastrointestinal System Including Diarrhea | A two-year-old child presents with persistent diarrhea, acidic stools and presence of one percent of reducing substance in the fresh stools. What is the most probable diagnosis?
A. Cystic fibrosis
B. Lactose intolerance
C. Rotavirus induced diarrhea
D. Intestinal tuberculosis
| Lactose intolerance |
d07da705-f903-4f1a-8828-f88fae64228a | Treatment options for acute M.pneumoniae infection include macrolides (e.g., oral azithromycin, 500 mg on day 1, then 250 mg/d on days 2-5), tetracyclines (e.g., oral doxycycline, 100 mg twice daily for 10-14 days), and respira-tory fluoroquinolones Ref Davidson edition23rd pg 585 | Anatomy | Respiratory system | Drug of choice for mycoplasma pneumonia is
A. Penicillin
B. Tetracycline
C. Cefuroxime
D. Erythromycin
| Erythromycin |
c222240e-3b33-4f5d-a035-e3c708f87453 | Specific protection comes under Primary prevention. It prevents risk factor from progressing to disease. Ref : Park&;s Textbook of Preventive and Social Medicine; 23rd edition; Page 42 | Social & Preventive Medicine | Concept of health and disease | Desks provided with table top to prevent neck problems in an example of
A. Primordial prevention
B. Secondary prevention
C. Specific protection
D. Disability limitation
| Specific protection |
128af4d6-c3e4-48e0-a0cc-5c082fe78995 | Ans. is 4b' i.e., Ligase /Ref Essential of biochemsitry p. 186]o All synthases are ligases.o All digestive enzymes are hydrolases.o Lyases are:DecarboxylasesAldolasesHydratasesEnolaseFumaraseArginosucinaseEnzyme classImportant enzymesOxidoreductaseOxidases, Dehydrogenases, Hydroperoxidases, (catalase, peroxidase), oxygenases.TransferaseAmino transferase or transaminase, e.g., SGOT (AST) and SGPT (ALT), kinases (HexokinaseQ glucokinase, pyruvate kinase etc), Transketolases, transaldolases, transcarboxylases.HydrolasesAll digestive enzymes (Pepsin, trypsin, lipases, esterases), lysosomal enzymes, urease, and phosphataseLyasesDecarboxylasesQ, aldolases, hydratases, enolase, fumaraseQ, ArginosuccinaseIsomerasesRacemases, epimerases. cis- trans- isomerases, mutasesLigasesSynthatasesQ, Carboxylases, DMA ligase | Biochemistry | Amino Acid Metabolism | Glutamine synthetase is a -
A. Isomerase
B. Ligase
C. Lyase
D. Transferase
| Ligase |
45bf6850-35e9-466a-aeaa-b85c3423b7c2 | Ans. is 'b' i.e., Odd/even day hospital admission Methods of Randomization o Randomization is accomplished in a number of classic ways 1. Lottery method Suppose 10 patients are to be put in a control group or the trial group out of 100 available. The serial numbers of patients are noted on 100 cards and then shuffled well. The cards are drawn one by one and thus patients are allocated into trial and control groups. 2. Table of Random Numbers Published tables of Random numbers are used. This is considered to be the best method of randomization. A computer program is used for randomization o Randomization methods , which may at first seem reasonable (odd-even day randomization or daytime-nighttime convenience randomization), may actually suppo bias, paicularly if the study is open-label or the operator or subject are not blinded as to the nature of the intervention. For example, if the study involves a procedure such as wound irrigation and the patients are randomized to have wounds irrigated with sterile saline on even days and tap water on odd days, a patient may present on an even day and the treating clinical investigator may elect not to enroll the patient in the study or to break the randomization, because they "just think that this paicular wound needs saline irrigation." This is a very common error in otherwise well-designed clinical studies. | Social & Preventive Medicine | null | Which of the following is not an accepted method of randomization-
A. Computer drawn randomization
B. Odd/even day hospital admission
C. Lottery
D. Random number table
| Odd/even day hospital admission |
de8e87a0-bd91-47b5-85a2-54c7de8ec2c5 | The Von willebrand factor is synthesized in the endothelial cells ,megakaryocytes and platelets While the principal site of synthesis of factor VIII is the liver Reference :textbook of Pathology ,7th edition ,Author: Harsha Mohan, page number 314. | Pathology | Haematology | Von Willebrand&;s factor is synthesized in which one of the following -
A. Vascular endothelium
B. Macrophages
C. Liver
D. Eosinophils
| Vascular endothelium |
5004bc72-a76c-481a-a5ea-b5d2609651b5 | "In a normal infant, the Moro's reflex begins to fade at three months of age and gradually disappears at 4-6 months.
When it persists beyond 6 months it indicates a delay in CNS development." ---------- Tachdjian
"Moro's reflex disappears by six months in a normal infant." ------------ Ghai | Pediatrics | null | Persistence of Moro's reflex is abnormal beyond the age of –
A. 3rd month
B. 4th month
C. 5th month
D. 6th month
| 6th month |
3b86072f-bafb-44ab-b878-e6f08a4cd7c9 | Otitis externa is an inflammatory and infectious process of the external auditory canal. Pseudomonas aeruginosa and Staphylococcus aureus are the most commonly isolated organisms. Less commonly isolated organisms include Proteus species, Staphylococcus epidermidis, diphtheroids, and Escherichia coli. | ENT | null | The most common causative organism for external otitis in adults is:
A. Streptococcus viridans
B. Staphylococcus epidermidis
C. Pseudomonas aeruginosa
D. E. coli
| Pseudomonas aeruginosa |
9b010130-0fa2-4f72-be34-28fc5a00335f | D i.e. C - PeptideInsulin has two interchain (A7 - B7, & A20 - B19) and one intrachain (A6 - All) disulfide bridges with in AB hetrodimeric structureQ.Insulin is synthesized as pre-pro-hormone (MW 11, 500), which makes it difficult to synthesize insulin in laboratory even after synthesizing A, B chains. This pre prohormone is directed by hydrophobic 23 aminoacid pre or leader sequence into cisternae of endoplasmic retinaculum, which is then removed to form 9000 MW proinsulin.Staing from amino terminal, the chain sequenc of proinsulin is. | Physiology | null | Insulin is secreted along with the following molecule in a 1: 1 ratio:
A. Pancreatic polypeptide
B. Glucagon
C. GLP-1
D. C- peptide
| C- peptide |
1dbdf7c2-95d8-41a0-9d5d-641e2666be8e | Acute psychosis ??? [Ref: Kaplan and Saddock synopsis of Psychiatry 10/e p 516-5171We are unable to reach a conclusive diagnosis with the information provided in the question.Acute onset, presence of fever, no history of psychiatric illness suggests delirium.But, the diagnosis of delirium cannot be made definitively in the absence of disorientation.In the question there is no definite comment on orientation of the patient.May be, that suggests, the patient is not disoriented.Acute onset, presence of perceptual disturbances (hallucination and other symptoms point towards acute psychosis.But acute psychosis seems unlikely because:-- Absence of cognitive dysfunction or thought disorders.- Absence of H/o psychiatric illness or substance abuse disorders.Psychotic disorders cannot be diagnosed only in the presence of perceptual disturbances. Some disorder in cognitive dysfunction or thought disorders is also required.May be this is a case of acute transient psychosis- These disorders do not give the classical manifestations of psychotic disorders.- They are characterized by the predominance of perceptual disturbances, and they do not fulfil the criteria of psychotic disorders.Acute and Transient Psychotic disordersA large number of psychiatrists especially from the developing countries like India, repoed that many patients developed an acute psychotic disorder that neither followed the course of schizophrenia nor resembled mood disorders in the clinical picture and usually had a better prognosis than schizophrenia.Acute and transient psychosis as a descriptive entity was recognized only with the advent of 1CD-10 in 1992. Where it is included under psychotic disorder.- The key features that characterize the disorder are an -- acute within (2 weeks) onset in all the cases presence of typical syndrome which are described as rapidly changing variables, polymorphic states and typical schizophrenic symptoms evidence ,for associated acute stress in a substantial number of cases and complete recovery in most cases within 2-3 months.A pa from these criteria ICD-10 also provides diagnostic guide- lines which include- Not meeting the criteria for manic or depressive episodes although the affective symptoms may be prominent - Absence of organic causation although perplexity confusion and inattention may he present. - Absence of obvious intoxication by drugs or alcohol.It is evident that ICD 10 intends to "clearly differentiate" the concept of acute transient psychosis .from those of affective psychosis, organic psychosis and drug induced psychosis.This is the point which is creating doubt in our minds.The ICD wants to clearly differentiate it from organic psychosis.- The boy presents with "fever" therefore the organic cause for the psychosis cannot be ruled out. - May be the psychosis is due to fever (some C.N.S. infection)- If fever had not been mentioned the diagnosis would have been clear. But the presence of fever prevents us from diagnosing this as acute transient psychosis.- The correct option would have been "organic psychosis" or "psychosis due to general medical condition". - Acute psychosis cannot be diagnosed without addressing the organic basis of the disease.Four subtypes of acute transient psychosis are described in ICD 10 -Acute polymorphic psychotic disorder without symptoms of schizo- phrenia - Acute polymorphic psychotic disorders with symptoms (?f schizo- phrenia - Acute schizophrenia like psychotic disorder- Acute predominantly delusional psychotic disorderOverall, duration of total episode should not exceed 3 months and that .for schizophrenic symptoms should not exceed 1 month. There is provision for change of diagnosis to schizophrenia. | Psychiatry | null | A 20 year old boy c/o hearing of voices, aggressive behavior since 2 days. He has fever since 2 days. When asked to his family, they says that he has been muttering to self and gesticulating. There is no h/o of psychiatric illness. Likely diagnosis is
A. Dementia
B. Acute psychosis
C. Delirium
D. Delusional disorder
| Acute psychosis |
9954aebd-4d12-4239-b332-29e6ca333eef | Stage I and II has got better prognosis. Spread to axillary nodes is the most impoant prognostic indicator. Age: Younger the age worser the prognosis. Sex: Carcinoma male breast has got worser prognosis compared to female breast. Because of early spread in carcinoma male breast. Atrophic scirrhous has got best prognosis. Medullary carcinoma has got better prognosis than scirrhous carcinoma because of lymphocytic infi ltration. Invasive carcinoma has got worser prognosis. Inflammatory carcinoma breast has worst prognosis. Ref; (page no;559 ) 5th edition of SRB&;S manual of Surgery | Surgery | Endocrinology and breast | The most impoant prognostic factor in breast carcinoma is
A. Histological grade of the tumor
B. Stage of the tumor at the time of diagnosis
C. Status of estrogen and progesterone receptors
D. Over expression of p-53 tumour suppressor gene
| Stage of the tumor at the time of diagnosis |
9d2b0404-9a26-4240-9d2c-08067145d4ff | Omphalocele is a midline abdominal wall defect. The abdominal viscera (commonly liver and bowel) are contained within a sac composed of peritoneum and amnion from which the umbilical cord arises at the apex and center. When the defect is less than 4 cm, it is termed a hernia of the umbilical cord; when greater than 10 cm, it is termed a giant omphalocele. Associated abnormalities occur in 30-70% of infants and include, in descending order of frequency, Chromosomal abnormalities (trisomy 13, 18, 21) Congenital hea disease (tetralogy of Fallot, atrial septal defect) Beckwith-Wiedemann syndrome (large-for-gestational-age baby; hyperinsulinism; visceromegaly of kidneys, adrenal glands, and pancreas; macroglossia; hepatorenal tumors; cloacal extrophy) Pentalogy of Cantrell Prune belly syndrome (absent abdominal wall muscles, genitourinary abnormalities, cryptorchidism) Ref: Albanese C.T., Sylvester K.G. (2010). Chapter 43. Pediatric Surgery. In G.M. Dohey (Ed), CURRENT Diagnosis & Treatment: Surgery, 13e. | Pathology | null | Which of the following is associated with > 20% risk of chromosomal anomalies?
A. Omphalocele
B. Gastroschisis
C. Cleft lip
D. Spina bifida
| Omphalocele |
e51b039a-7a08-4747-b23b-eba9f6545ce8 | Ans. is 'a' i.e., Bone marrow Multiple mveiomao Multiple myeloma is a plasma cell neoplasm characterized by involvement of the skeleton at multiple sites,o Plasma cells proliferate abnormally and the proliferated plasma cells infiltrate various organs, particularly bone marrow, but can also spread to lymph nodes and extranodal sites like skin,o The proliferation and survival of myeloma cells are dependent on several cytokines, IL-h Is particularly important.o The neoplastic plasma cells secrete abnormally large amounts of immunoglobulin.o The immunoglobulin secreted by neoplastic plasma cells are quiet different form the immunoglobulin normally present in the blood.o The normal immunoglobulin consists of two heavy and two lights chains molecules and the production of both chain is tightly balanced.o The immunoglobulin secreted in this condition may be : -Isolated light chain or heasy chain.May be an intact antibody molecule of any heavy chain subclass.May be an altered antibody or fragment. | Pathology | Multiple Myeloma | Multiple myeloma most common part involved is-
A. Bone marrow
B. Cortex of bone
C. Metaphyses
D. Epiphyses
| Bone marrow |
8341990b-1d42-4707-bb74-b154e0cde6d9 | COPPER Poisonous Compounds: (1) Copper sulphate (blue vitriol) occurs in large, blue crystals. (2) Copper subacetate (verdigris), occurs in bluish-green masses or powder. Signs and Symptoms: Increased salivation, burning pain in the stomach with colicky abdominal pain, thirst, nausea, eructations and repeated vomiting. The vomited matter is blue or green. There is diarrhoea with much straining; motions are liquid and brown but not bloody. Oliguria, haematuria, albuminuria, acidosis and uraemia may occur. In severe cases haemolysis,haemoglobinuria, methaemoglobinaemia, jaundice, pancreatitis and cramps of legs or spasms and convulsions occur. The breathing is difficult, cold perspiration and severe headache occur. In some cases, paralysis of limbs is followed by drowsiness, insensibility, coma and death due to shock. Later deaths occur due to hepatic or renal failure or both. Ref:- k s narayan reddy; pg num:-547 | Forensic Medicine | Poisoning | Copper sulfate poisoning manifests with
A. High anion gap acidosis
B. Rhabdomyolysis
C. Acute hemolysis
D. Peripheral neuropathy
| Acute hemolysis |
41c5ee5c-1991-4635-9440-79789fec69c6 | Aromatase enzyme: In a normal ovary, LH acts on the theca interstitial stromal cells, whereas FSH acts on granulosa cells. In response to LH the thecal cells secretes androgen, and the produced androsendione is conveed in the granulosa cells to estrogen by the action of aromatase enzyme. Ref: Physiology By James N. Pasley 2nd Edition, Page 145 ; Androgens in health and disease By William J. Bremne Page 84 ; Pade approximation and its applications: Diagnosis and management of PCOS, Issue 765, By Luc Wuytack, Page 107 | Physiology | null | Which of the following enzyme is associated with the conversion of androgen to oestrogen in a growing ovarian follicle is:
A. Aromatase
B. 5 alpha reductase
C. Desmolase
D. Isomerase
| Aromatase |
952e0805-cb2b-4be6-b884-76f7ce6d779d | Ans. is 'c' Petit mal epilepsy "Absence seizures or (Petit mal epilepsy is characterized by sudden, brief lapses of unconsciousness without loss of postural control line seizures typically lasts for only seconds, consciousness return as suddenly it was lost, and there is no postictal confusion.Absence seizures are usually accompanied by subtle, bilateral signs such as rapid blinking of eyelids, chewing movements or small amplitude clonic movements of the hand" | Medicine | Seizures and Epilepsy | Absence seizures are seen in:
A. Grand mal epilepsy
B. Myoclonic epilepsy
C. Petitmal epilepsy
D. Hyperkinetic child
| Petitmal epilepsy |
6c6287a7-09db-40a2-a97f-1b0b0becd01e | Manganese: Cofactor for enzymes, e.g., arginase, pyruvate carboxylase.
Enzymes that require a metal ion cofactor are termed metal-activated enzymes to distinguish them from the metalloenzymes for which bound metal ions serve as prosthetic groups.
Reference-Satyanarayana Pg- 405 | Biochemistry | null | Which of the following enzymes contain manganese as its cofactor?
A. LDH
B. Arginase
C. Hexokinase
D. DNA polymerase
| Arginase |
5d0a032c-1b73-405b-af2f-4a612432f97f | The oesophagus is a muscular tube 25 cm (10 in) long, which connects the pharynx to the stomach. It begins in the neck, level with the lower border of the cricoid cailage and the sixth cervical veebra. It descends largely anterior to the veebral column through the superior and posterior mediastina, passes through the diaphragm, level with the tenth thoracic veebra, and ends at the gastric cardiac orifice level with the eleventh thoracic veebra. | Anatomy | null | The esophagus crosses the diaphragm at the level of:
A. T8
B. T9
C. T10
D. T11
| T10 |
dd28e798-60e9-40a6-83d8-d418b9ab909e | The kidney is innervated primarily by the sympathetic nervous system, and as such, regulates the contraction of the smooth muscle surrounding the afferent and efferent aerioles of the glomerulus. Sympathetic stimulation to the efferent glomerular aerioles causes their constriction and increases the filtration rate, leading to an increase in urinary output. Similarly, with the loss of sympathetic innervation, such as due to sympathectomy of the kidney, relaxation of tone of the afferent aeriole occurs and the filtration rate increases, which results in an increased urine output. Decreased urine output may result from the constriction of the afferent aerioles, leading to a decrease in glomerular filtration rate. Also Know: Factors affecting the GFR: Changes in renal blood flow Changes in glomerular capillary hydrostatic pressure Changes in systemic blood pressure Afferent or efferent aeriolar constriction Changes in hydrostatic pressure in Bowman's capsule Ureteral obstruction Edema of kidney inside tight renal capsule Changes in concentration of plasma proteins: dehydration, hypoproteinemia, etc (minor factors) Changes in Kf Changes in glomerular capillary permeability Changes in effective filtration surface area Ref: Barrett K.E., Barman S.M., Boitano S., Brooks H.L. (2012). Chapter 37. Renal Function & Micturition. In K.E. Barrett, S.M. Barman, S. Boitano, H.L. Brooks (Eds), Ganong's Review of Medical Physiology, 24e. | Physiology | null | Constriction of the afferent aeriole to the kidney glomerulus results in:
A. Reduction of glomerular filtration rate and decreased urinary output
B. Increased urine output
C. Increased glomerular filtration rate and no change in urine output.
D. Decreased urine output
| Reduction of glomerular filtration rate and decreased urinary output |
f31d9293-31b1-4fc3-9af1-70735f827e4c | Ans. D 90 secondsRef: Datta, 8th ed. pg. 673The image shows LSCS being performed, with the head being delivered by hooking fingers carefully between the lower uterine flap. The head is delivered by elevation and flexion using the palm as fulcrum and the optimum time between the uterine incision and delivery should be less than 90 seconds. | Physiology | Heart, Circulation, and Blood | During the following procedure, optimum interval between uterine incision and delivery should be less than ______ seconds.
A. 30 seconds
B. 45 seconds
C. 60 seconds
D. 90 seconds
| 90 seconds |
bbb33bf0-110f-43b9-9743-c92725c9d9bb | Groove sign of Greenblatt' is pathognomonic of LGV → when inguinal lymph nodes are enlarged, they are separated by Poupart's ligment, producing a groove. | Dental | null | Groove sign is seen in –
A. Donovanosis
B. LGV
C. Chancroid
D. Genital herpes
| LGV |
c6cb65bc-f7d8-4e5b-a19e-837f0510b746 | Ans. C: Valproate Sodium valproate is effective in absence/petit-mal seizures, combined grand mal and petit mal, myoclonic epilepsy, paial epilepsy, maniac depressive psychosis and as a prophylactic in febrile convulsion Absence seizures/Petit mal seizures (from the French for "little illness", a term dating from the late 18th century). Absences seizures are brief (usually less than 20 seconds), generalized epileptic seizures of sudden onset and termination. They have 2 essential components: - Clinically the impairment of consciousness (absence) - EEG generalized spike-and-slow wave discharges Absence seizures are broadly divided in typical and atypical absence seizures. Typical absence seizures usually occur in the context of idiopathic generalised epilepsies and EEG shows fast >2.5 Hz generalised spike-wave discharges. Atypical absence seizures: - Occur only in the context of mainly severe symptomatic or cryptogenic epilepsies of children with learning difficulties who also suffer from frequent seizures of other types such as atonic, tonic and myoclonic - Onset and termination is not so abrupt and changes in tone are more pronounced - Ictal EEG is of slow less than 2.5 Hz spike and slow wave. - The discharge is heterogeneous, often asymmetrical and may include irregular spike and slow wave complexes, fast and other paroxysmal activity. - Background interictal EEG is usually abnormal. Treatment of patients with absence seizures only is mainly with sodium valproate or ethosuximide, which are of equal efficacy controlling absences in around 75% of patients. Sodium valproate as a single drug is the DOC if tonic clonic seizures are also present or emerge during the therapy with ethosuximide Lamotrigine monotherapy is less effective with nearly half of the patients becoming seizure free. | Pharmacology | null | Drug of choice for absence seizures: March 2011
A. Carbamazepine
B. Lamotrigine
C. Valproate
D. Phenytoin
| Valproate |
c8ed0948-f3e7-40fc-a4f3-eeec566f2a1f | b. Sarcoidosis(Ref: Nelson's 20/e p 2269-2271, Ghai 8/e p 433-443)Important causes of pericarditis/pericardial effusion in children:Infectious* Viral (Coxsackie virus B, EBV, Influenza, Adenovirus); Fungal (Histoplasmosis, Actinomycosis)* Bacterial (TB, Streptococcus, Pneumococcus, Staphylococcus, Meningococcus, Mycoplasma, Tularemia, Listeria, Leptospirosis)* Immune complex (Meningococcus, Hemophilus influenzae)* Parasitic (Toxoplasmosis, Echinococcosis) Connective tissue diseasesMetabolic-endocrineRheumatoid arthritisRheumatic feverSystemic lupus erythematosusSystemic sclerosisSarcoidosisWegener granulomatosisUremiaHypothyroidismChylopericardiumOut of the causes given in the options, Sarcoidosis is the least common. | Pediatrics | C.V.S. | Least common cause of pericarditis/pericardial effusion in children:
A. Rheumatic fever
B. Sarcoidosis
C. Rheumatoid arthritis
D. SLE
| Sarcoidosis |
9437b7e8-5a39-4cae-976f-317b698241ae | Disability defined as lack of ability of an individual to do his routine activity Disease defined as a condition in which body health is impaired, a depaure from a state of health, an alteration of human body interupting the performance of vital functions Impairment is defined as any loss or abnormality of psychological, physiological,or anatomical structure or function Handicap defined as a disadvantage for a given individual,resulting from an impairment or disability , that limits or prevents the fulfilement of a role that is normal for that individual ref ;(page no;44) 23rd edition of PARK&;s textbook of Preventive and Social medicine | Social & Preventive Medicine | Social science, Mental health & Genetics | The lack of ability of an individual to do his routine activity is -
A. Disease
B. Impairement
C. Disability
D. Handicap
| Disability |
73117041-6b7c-4c28-9d9f-3b35d889b24e | Ans. is 'c'Rarely neurocysticercosis happens and most common site is Parenchymal and associate with Ingestion of infected eggs of Taenia solium with food and water. | Microbiology | Misc. | Most common affected tissue in cysticercosis is:
A. Brain
B. Eye
C. Muscles
D. Liver
| Muscles |
4ea5a407-292b-400c-ae64-70e10f2611dc | Ans. is 'c' i.e., Intestinal epitheliumCells with good regenerative capacityi) Surface epithelium (stratified squamous) of skin, oral cavity, vagina and cervix.ii) Lining mucosa of all excretory ducts of glands (Salivary gland, pancreas, biliary duct).iii) Columinar epithelium of GIT (Intestinal mucosa) and uterus.iv) Transitional epithelium of the urinary tract.v) Bone marrow cells and hematopoietic cells.vi) Basal cells of epithelia.Cells with limited regenerative capacity i) Parenchymal cells of liver, kidney and pancreas.ii) Mesenchymal cells, e.g., fibroblast and smooth muscles.iii) Vascular endotheliumiv) Osteoblast, chondroblastv) Resting lymphocytes and other leukocytes.Cells with no regenerative capacity i) Neuronsii) Cardiac muscleiii) Skeletal muscle. | Physiology | null | Maximum regenerative capacity is of ?
A. Liver cells
B. Kidney cells
C. Intestinal epithelium
D. Neurons
| Intestinal epithelium |
01c76cc9-44a5-47c4-934f-31b672b30f79 | Ans. (d) Squamous cell carcinomaRef: Devita 9th edition, page 729* Most common site oral Cancer: Carcinoma Tongue > Carcinoma Lip* Most common histological type: Squamous Cell Cancer* Most common site of oral Cancer in India: Cancer of Buccal Mucosa* Max Risk of L.N. Metastasis: Carcinoma Tongue* Min Risk of L.N Metastasis: Carcinoma lip > hard palate* Most common age: 50-60 years | Surgery | Oral Cavity | The commonest cancer of oral cavity is
A. Adenocarcinoma
B. Melanoma
C. Sarcoma
D. Squaous cell carcinoma
| Squaous cell carcinoma |
4fb53146-fc2a-4223-bcb5-3a6bf4fe17b1 | Ans. is 'd' i.e., Number of total cases at a given point of time * Prevalence refers specifically to all current cases (old and new) existing at a given point in time or over a period of time in a given population.* Prevalence is of two types: (i) Point prevalence, and (ii) Period prevalencei) Point prevalence# Point prevalence is defined as the number of all current cases (old and new) of a disease at one point of time, in relation to a defined population.Point prevalence =No. of all current cases (old & new) of a specified disease existing at a given in time------------------------------------Estimated population at same point in timex 100# When the term prevalence rate is used, without any further qualification it is taken to mean "point prevalence"ii) Period prevalence# It measures the frequency of all current cases (old 8c new) existing during a defined period of time (e.g. annual prevalence) expressed in relation to a defined population.# It includes cases arising before but extending into or through to the year as well as those cases arising during the year.Period prevalence =No. of existing cases (old 8c new) of a specified disease during a given period oftime interval------------------------------------------Estimated - mid - interval population at riskx 100* Prevalence is a proportion.* Prevalence is determined by cross sectional study. | Social & Preventive Medicine | Epidemiology | Point Prevalence is defined as-
A. Number of new cases at a given point of time
B. Number of new cases in a given year
C. Number of total cases in a given year
D. Number of total cases at a given point of time
| Number of total cases at a given point of time |
78af5124-72b0-4a14-87e8-cb8990aec9fb | Answer- A. CystinosisTwo disorders are caused by a proven defect in carrier-mediated transpo of metabolites: cystinosis end the group of sialic acid storage disorders (SASD). | Pathology | null | Lysosomal transpo defect is seen in
A. Cystinosis
B. Goucher's disease
C. Metachromatic leukosytrophy
D. Tay Sach's disease
| Cystinosis |
6e3e4a71-b1d7-408f-9832-a137d1bbf2c2 | - Recent studies indicate that erythropoietin promotes survival of early erythroid progenitor cells through inhibition of default apoptosis pathway. - Thus, this hormone rescues stem cells that are otherwise fated to undergo programmed cell death. - None of the other choices are known to control the expansion of hematopoietic stem cell colonies in bone marrow. | Pathology | Hematopoeisis: Basic concepts | An 18-year-old man moves from sea level to an elevation of 2,400 m to train as a skier. The increased requirement for oxygen delivery to tissues at the higher elevation stimulates the synthesis of a renal hormone (erythropoietin), which targets hematopoietic stem cells in the bone marrow. Erythropoietin promotes the survival of early erythroid progenitor cells primarily through which of the following mechanisms?
A. Altered cell-matrix adhesion
B. Downregulation of p53
C. Enhanced glucose uptake
D. Inhibition of apoptosis
| Inhibition of apoptosis |
f53f9aa1-e451-4370-92d4-9ed8158c8d9e | Chalcosis is copper alloy in the eye Refer: Khurana 6th edition page number 194 | Ophthalmology | Lens | Sunflower cataract is caused by
A. Siderosis
B. Chalcosis
C. Lead intoxication
D. Silicosis
| Chalcosis |
4f166711-487a-4f8b-a42a-c903cb4975f0 | Ans. is 'a' i.e., Epiblast cells o Notochord is a bud like structure formed by epiblast cells extending from cranial end of primitive streak to caudal end of prochordal plate, in between the ectoderm and endoderm.o Siginificances of notochord includes followingi) It defines the axis of embryoii) It functions as the primary inductor, inducing the overlying ectoderm to develop into neural plate (the primordium of CNS).iii) It serves as the basis for development of axial skeleton. The notochord is an intricate structure around which vertebral column is formed and indicates future site of vertebral bodies. However, the notochord does not give rise to vertebral column, after development of vertebral bodies, the notochord degenerates and disappears, but parts of it persist as the nucleus pulposus of intervertebral disc. | Anatomy | Nervous System | Notochord develops from -
A. Epiblast cells
B. Hypoblast cells
C. Syncytiotrophoblasts
D. Cytotrophoblasts
| Epiblast cells |
7ba37a39-49dd-412d-a945-49fa3d17ceaf | Palatoglossus-palatopharyngeus form the boundary of the tonsillar fossaReference: Chaurasia; 6th edition | Anatomy | Head and neck | Muscle forming anterior and posterior faucial folds of tonsillar fossa, respectively
A. Levator veli palatine-tensor veli palatine
B. Palatoglossus-palatopharyngeus
C. Palatopharyngeus-salpingopharyngeus
D. Styloglossus-stylopharyngeus
| Palatoglossus-palatopharyngeus |
ea554870-34ff-4fde-b59d-f05a9e1ddaf3 | Answer- A. Baters syndromeBater syndrome is an autosomal recessive disorder caused by mutation in gene coding for basolateral chloride channel (ClC-kb). There is loss of sodium, chloride, potassium and calcium in urine.The major clinical findings are hyponatremia, hypokalemia, polyurea, polydipsia, metabolic alkalosis, normal to lowBP, hypomagnesemia (only in some patients), hypochloremia, hypercalciuria (causing nephrocalcinosis), and growth | Medicine | null | Patient came with complaints of Polydipsia, hypercalciurea, nephrolithiasis, metabolic alkalosis. Possible cause is
A. Baters syndrome
B. Gittlemans syndrome
C. Addisons disease
D. Chronic diuretic use
| Baters syndrome |
aeb677ed-4e3d-42a2-bc16-d26a4fc90b34 | Echocardiographic features of mitral stenosis:-Thickened and calcified mitral leaflets and subvalvular apparatus -Decreased E-F slope (M-mode)-Hockey stick appearance of the anterior mitral leaflet in diastole(long axis view)-Immobility of the posterior mitral leaflet (a similar appearance can be seen in hypereosinophilia or ergot use)-Fish mouth orifice in the sho axis view-Increased LA size, with the potential for thrombus formationDynamic CT: the Restricted opening of the thickened valve from commissural fusion (especially with rheumatic valve disease), valve calcification, or both results in a "fish-mouth" appearance on sho-axis images. Bowing of a thickened and fibrotic anterior leaflet during diastole may result in a "hockey-stick" appearance which is best seen on two- or four-chamber images(Ref: The echo manual by Jae K Oh; J B Seward; A Jamil Tajik, page no 202) | Radiology | All India exam | Hockey stick appearance on echo is a feature of
A. Mitral stenosis
B. Mitral incompetence
C. Aoic stenosis
D. Aoic regurgitation
| Mitral stenosis |
7e1895a0-cb9d-47e4-9a10-d535a79d30db | Amaurosis fugax, one type of TIA, is a manifestation of carotid bifurcation atherosclerotic disease. It is manifested by unilateral blindness, being described by the patient as a window shade across the eye, lasting for minutes or hours. It is caused by micro emboli from a carotid lesion lodging in the retinal artery, the first intracerebral branch of the internal carotid artery. | Surgery | Arterial Disorders | An elderly patient complains of recurrent episodes of amaurosis fugax. This is attributable to microembolization of which of the following?
A. Facial artery
B. Retinal artery
C. Occipital artery
D. Posterior auricular artery
| Retinal artery |
b1cb63ab-b1e5-4db7-ac2c-775faf9682de | Ans. is 'd' ie Acute Pancreatitis * The signs and symptoms exhibited by the pt. correlate with that of acute pancreatitis, most characterstic of which is - Radiation of pain to back and party in previous night (ie. h/o alcohol)Other imp. diagnostic clue (not given in question) is- Relief from pain on sitting in upright posture.*Some imp, points about Acute PancreatitisEtiology - Gall stones (50 - 70% i.e. MC cause)*Alcohol (25%) OthersGrey Turner sign or Cullens sign* :Bleeding into the fascial planes in acute pancreatitis can cause 1 discolouration of - flanks* in Grey Turner sign*Mnemonic : Cullen's -Umbilicusumbilicus* in Cullens sign* Plain abdominal x-ray findings -include a sentinel loop*a colon cut off sign*a renal 'halo ' sign * | Surgery | Pathophysiology - Acute Pancreatitis | A 21yrs. old pt. attended a party the previous night and gives the following symptoms pain in abdomen radiating to back, pulse 100/ min, BP 100/76temp 39deg C and vomiting before coming Most probable dx is :
A. Acute appendicitis
B. Acute cholecystitis
C. Acute diverticulitis
D. Acute pancreatitis
| Acute pancreatitis |
85018719-e9c4-45b4-a540-2460d651efd8 | Sho QT syndrome (SQTS) is an inherited cardiac channelopathy characterised by an abnormally sho QT interval and increased risk for atrial and ventricular arrhythmias. Diagnosis is based on the evaluation of symptoms (syncope or cardiac arrest), family history and electrocardiogram (ECG) findings multiple myeloma shows sho QT interval Ref Harrison 20th edition pg 1534 | Medicine | C.V.S | Which of the following disease can be associated with sho QT interval on ECG ?
A. Chronic myeloid leukemia
B. Multiple myeloma
C. Chronic lymphocytic leukemia
D. Hodgkin's disease
| Multiple myeloma |
62c4a958-74be-414f-9638-183e78e60976 | Ans) b (It measures the thing.. ) Ref park 20th ed p 226The term validity refers to what extent the test accurately measures which it purports/ intended to measure.Validity expresses the ability of a test to separate or distinguish those who have the disease from those who do not have.Validity has two components - Sensitivity and specificitySensitivity and specificity together with "predictive accuracy" are inherent properties of a screening test. | Social & Preventive Medicine | Biostatistics | An indicator is said to valid if
A. It also measures the thing it didn't suppose to measure
B. It measures the thing it expected to measure
C. Over value when measured by different method
D. Under value when measured by different method
| It measures the thing it expected to measure |
db94e6e6-1973-4f84-82ef-e9ec29ac1697 | Reed-Sternberg cells (also known as lacunar histiocytes for ceain types) are distinctive, giant cells found with light microscopy in biopsies from individuals with Hodgkin's lymphoma (a.k.a. Hodgkin's disease, a type of lymphoma). They are usually derived from ,B lymphocytes classically considered crippled germinal center B cells, meaning they have not undergone hypermutation to express their antibody. Seen against a sea of B cells, they give the tissue a moth-eaten appearance. Reed-Sternberg cells are large (30-50 microns) and are either multinucleated or have a bilobed nucleus with prominent eosinophilic inclusion-like nucleoli (thus resembling an "owl's eye" appearance) | Surgery | Vascular surgery | Malignant cell in Hodgkin's lymphoma is
A. Reed stenberg cell
B. Lymphocytes
C. Histocytes
D. Reticulum cells
| Reed stenberg cell |
72171a96-33f2-452e-a6d5-3096a2e7b820 | Normal ECG waves and Intervals: ECG wave/Interval Characteristics 1. P Wave Reflects Atrial Depolarization (activation) 2. QRS complex Depolarization of ventricles 3. T Wave Repolarization of ventricles 4. PR Interval Atrial depolarization and conduction through AV node 5. QT Interval Total duration of Ventricular depolarization and repolarization 6. ST segment Plateau phase of ventricular action potential | Anatomy | FMGE 2019 | PR interval in ECG shows?
A. Ventricular depolarization
B. Ventricular Repolarization
C. Conduction through AV node.
D. Atrial Repolarization
| Conduction through AV node. |
4669e0a7-a634-4ffd-8c63-db50d725b420 | Ans: a (Uric acid) Ref: Bailey and Love, 24th ed, p. 1317Pure uric acid stones are radiolucent and appear in an excretory urogram as filling defects.Uric acid stones if contain calcium, will cast a faint radiological shadow.Examples for radiolucent stones* Uric acid* Dihydroxy adenine* Orotic acid* Xanthine* Allopurinol* Triamterine and Indinavir induced stones. | Radiology | Genito Urinary System | Which of the following is a radiolucent stone?
A. Uric acid
B. Oxalate
C. Cysteine
D. Triple phosphate
| Uric acid |
bac8823b-af87-4b48-a1b4-f799da696f57 | Ans. A: OxytocinHormonal control of Breast development and secretion and ejection of milkProgesterone -- influences the growth in size of alveoli and lobes.Oestrogen -- stimulates the milk duct system to grow and become specific.Follicle stimulating hormoneLuteinizing hormoneProlactin -- contributes to the increased growth of the alveoli during pregnancy and formation of milkOxytocin -- oxytocin contracts the smooth muscle layer of band-like cells surrounding the alveoli to squeeze the newly-produced milk into the duct system. Oxytocin is necessary for the milk ejection reflex, or let-down to occur.Human placental lactogen (HPL) --This hormone appears to be associated with breast, nipple, and areola growth before bih.Colostrum contains higher amounts of white blood cells and antibodies than mature milk, and is especially high in immunoglobulin A (IgA), which coats the lining of the baby's immature intestines, and helps to prevent germs from invading the baby's system. | Physiology | null | Milk ejection is facilitated by:March 2007, March 2013
A. Oxytocin
B. Growth hormone
C. FSH
D. LH
| Oxytocin |
df2c9db2-b2d9-4f10-be2b-07493135d300 | Ans. B. Increased sexual drive in male* Nymphomaniac: excessive sexual desire in females.* Satyriasis: excessive sexual desire in males | Psychiatry | Sexual Disorders | Which of the following describes Satyriasis?
A. Decreased sexual drive in male
B. Increased sexual drive in male
C. Decreased sexual drive in female
D. Increased sexual drive in female
| Increased sexual drive in male |
e074a5c9-3f07-4549-a9f3-ca09d8d160c5 | Management guidelines for rabies apa from vaccination Anti Rabies Serum Horse Rabies serum: 40 IU/Kg on Day 0 (50% in wound, 50% I'M) Human Rabies Immunoglobulin : 20 IU/Kg (Maximum in wound, rest IM gluteal) (Concentration 150 IU/ml) Serum sickness with Horse serum : 15-45% Person under Antirabic Treatment should avoid Alcohol (during and 1 month after treatment) Undue physical and mental strain and late nights Coicosteroids and other immunosuppressive agents Intramuscular injections of cell culture and purified Duck Embryo Vaccines : Deltoid (Not in Buttocks) Rabies Vaccine dosages Intramusculae dose of Rabies Vaccine for post exposure prophylaxis: 1ml Intradermal dose of Rabies Vaccine for Post-exposure prophylaxis : 0.1 ml Intramuscular dose of Rabies Vaccine for Pre-Exposure prophylaxis : 1 ml Intradermal dose of Rabies Vaccine for Pre-Exposure prophylaxis : 0.1 ml Rabies Immunoglobulin Dosages Dose of Human Rabies Immunoglobulin (HRIg): 20 IU/Kg body wt Dose of Equine Rabies Immunoglobulin (ERIg) : 40 IU/Kg body wt Ref: Park 25th edition Pgno : 297-298 | Social & Preventive Medicine | Communicable diseases | Dose of Human anti-rabies immunoglobulin is
A. 10 IU/kg
B. 20 IU/kg
C. 30 IU/kg
D. 40 IU/kg
| 20 IU/kg |
1aac741e-cf86-47b1-a2b7-b16d1ec1c2d5 | Baroreceptor stimulation results in
Inhibition of sympathetic activity
Excitation of parasympathetic activity
Decrease in heart rate
Decrease in blood pressure | Physiology | null | Baroreceptors stimulation would result in
A. Inhibition of para sympathetic activity
B. Excitation of sympathetic activity
C. Increase in heart rate
D. Decrease in blood pressure
| Decrease in blood pressure |
3e9677d6-d332-4a57-9c25-10be6cdf24b9 | EBV REF: Textbook of Microbiology & Immunology by Parija 2009 Page 504 Heterophil antibodies, which is an antibody against EBV cross reacts with red blood cells of different animal species. This can be used as a rapid screening test for mononucleosis (Monospot test and Paul Bunnell tests) The Paul-Bunnell test uses sheep erythrocytes; the Monospot test, horse red cells.blood cells. In infectious mononucleosis, IgM heterophil antibodies are usually detectable for the first 3 months of infection. | Microbiology | null | Paul Bunnel test is done for?
A. HBV
B. EBV
C. CMV
D. HIV
| EBV |
be5e5c9f-3c38-4cb3-b1ca-702113709d63 | large or giant intestinal fluke Largest trematode infecting humans Pig serves as reservoir of infection (refer pgno:127 baveja 3 rd edition) | Microbiology | parasitology | The largest trematode infecting masn is -
A. F. Hepatica
B. F. Buski
C. E. Granulosus
D. Clonorchis sinensis
| F. Buski |
01c13267-d2e8-4648-8a1e-8ac7af4f7d62 | Ans. C: 5 ppm Park's PSM, 21st ed., p- 723 states: Chlorine destroys cyclops and larvae of the guineaworm in a strength of 5 ppm Cyclops may be controlled by the use of the physical, chemical or biological methods: Physical methods - Straining - Boiling at 60 degree Celsius Chemical methods - Chlorine in a strength of 5 ppm - Lime - Abate Biological - Barbel fish and gambusia fish The most satisfactory and permanent method of controlling Cyclops in drinking water is to provide piped water supply or tube wells. Abolition of step wells and provision of sanitary wells should receive attention in rural areas. | Social & Preventive Medicine | null | Amount of chlorine needed to kill cyclops in drinking water is: September 2007
A. 3 ppm
B. 4 ppm
C. 5 ppm
D. 6 ppm
| 5 ppm |
38477486-f22f-41e9-9921-5084b525abda | Segmental mandibulectomy recommended for alveolar lesions, tumors adherent to the mandible, or for radiographic evidence of bone involvement. Ref: Craniomaxillofacial Reconstructive and Corrective Bone Surgery: Principles of Internal Fixation By Alex M. Greenberg, Joachim Prein, 2002, page 411. | Surgery | null | A 80 year old patient presents with a midline tumor of the lower jaw, involving the alveolar margin. He is edentulous. Rx of choice is:
A. Hemi mandibulectomy
B. Commando operation
C. Segmental mandiblectomy
D. Marginal mandibulectomy
| Segmental mandiblectomy |
5236c1f1-48f6-4447-bcc8-c35a8134e5c5 | Melatonin and serotonin are derivatives of Tryptophan. | Biochemistry | null | Which of the following is not a derivative of amino acid tyrosine
A. Thyroxine
B. Melatonin
C. Melanin
D. Epinephrine
| Melatonin |
f318db83-43d6-4977-ab14-e29a91b15583 | Answer: b) Vaginal fluid pH > 4.5, presence of clue cells on the smear and fishy odor on KOH mountVAGINAL INFECTIONSDiagnosticCriteria Differential Diagnosis of Vaginal infectionsNormalBacterialvaginosisCandidiasisTrichomoniasisBacterial (strep, staph, E.coli)Vaginal pH3.8-4.2>4.5<4.5>4.5>4.5DischargeClear,FlocculentThin, gray or white, adherent HomogenousWhite, curdy, Cottage- Cheese likeYellow to green Frothy adherentPurulentAmine odor (KOH,"whiff" test)AbsentPresent(Fishy)AbsentAbsentAbsentMicroscopicLactobacilliClue cells, coccoid Bacteria, No WBCMycelia,buddingYeast,pseudohyphaeTrichomonads WBC> 10/hpfMany WBCsMain patient ComplaintsNoneDischarge, bad odour- possibly worse after intercourseltching\burningdischargeFrothy discharge, bad odour, vulval pruritis, dysuria & multiple small punctuate strawberry spots on the vaginal vault and portio vaginalis of the cervix (strawberry vagina)Thin, watery discharge,pruritus | Gynaecology & Obstetrics | Miscellaneous (Gynae) | A 28 Years old white female presents with a 15-day history of malodorous vaginal discharge and pruritus. She reports that the smell is worse after intercourse and is accompanied by a white discharge. No significant medical or gynecological history. She is in a stable monogamous relationship and has never been pregnant. Which of the following diagnostic features is consistent with Bacterial vaginosis?
A. Vaginal fluid pH > 6, scanty secretions with increased para basal cells
B. Vaginal fluid pH > 4.5, presence of clue cells on the smear and fishy odor on KOH mount
C. Vaginal fluid pH > 4, presence of hyphae on KOH mount
D. Vaginal fluid pH > 5, motile trichomonads on microscopy
| Vaginal fluid pH > 4.5, presence of clue cells on the smear and fishy odor on KOH mount |
49860c53-f494-45ba-ae72-f62ac3234dd0 | The valvulae conniventes, also known as Kerckring folds or plicae circulares, are the mucosal folds of the small intestine, staing from the second pa of the duodenum, they are large and thick at the jejunum and considerably decrease in size distally in the ileum to disappear entirely in the distal ileal bowel loops. p Ref - radiopedia.org | Anatomy | Abdomen and pelvis | Valvulae conniventes are seen in
A. Jejunum
B. Ileum
C. Stomach
D. Colon
| Jejunum |
979aaf88-2be5-4485-b647-ca09d41d00e5 | The risk factors for SBP are 1.Ascitic fluid protein < 1 g/dl 2.Variceal hemorrhage 3.Prior episode of SBP Acute variceal bleeding patients need prophylaxis against SBP & Drugs used for prophylaxis are: 1.Inj.Ceftriaxone 1 g/day 2. Oral. Ofloxacin 400 mg/day or Norfloxacin 400 OD Primary prophylaxis is indicated in patients with features of : Ascitic fluid protein < 1.5 g/dl With at least one of the following 1. Serum creatinine > 1.2 mg/dl 2. BUN > 25 mg/dl 3. Serum Na < 130 mEq/L 4. CTP > 9 points with bilirubin > 3 mg/dl 5. DRug is Norfloxacin 400 mg OD for long time. Ref: AASLD practice guidelines:Hepatology, Vol.49 ,No.6 ,2009. | Medicine | null | Prophylaxis against spontaneous bacterial peritonitis ( SBP) in case of cirrhosis with ascites is indicated in:
A. Patients with high protein ascites
B. Prior history of SBP
C. Serum creatinine 1 mg/dl
D. Child pugh < 8
| Prior history of SBP |
dc66ca91-10dd-4a3b-837e-6604434bd306 | Radiation-induced thyroid cancer Authors: Section Editors: Deputy Editor: INTRODUCTION Radiation exposure of the thyroid during childhood is the most clearly defined environmental factor associated with benign and malignant thyroid tumors. The risk of thyroid cancer following irradiation is related to radiation dose and age (greater for children exposed early in life), and the risk persists throughout life. Radiation exposure during childhood also increases the risk of benign thyroid nodules and hypothyroidism. The purpose of this topic is to review the evaluation of a patient with a history of childhood radiation exposure and how such a history affects treatment of patients with thyroid tumors. Radiation injury to other organs is reviewed separately. (See and .) RADIATION EXPOSURE Type of exposure -- Radiation exposure may be external or internal. *External - The predominant types of external radiation are diagnostic radiographs, therapeutic radiation for the treatment of cancer, and historical use of external radiation to treat a wide variety of nonmalignant conditions. External radiation also includes brachytherapy, whereby a sealed radiation source is placed adjacent to a treatment area. *Internal - Internal radiation exposure includes ingestion of foods or liquids contaminated with radioactivity or by inhalation of radioactive gases or paicles. Internal radiation occurs after exposure to nuclear fallout (from testing and accidents at operating nuclear power plants or above ground nuclear explosive testing) or after ingestion of radioiodine for diagnostic tests and for therapy of hypehyroidism. | Pathology | Endocrinology | Radiation induced thyroid cancer is -
A. Papillary
B. Follicular
C. Anaplastic
D. Medullary
| Papillary |
35fa0e73-f3a4-4a45-92c3-2addf6870f04 | Ans. is 'd' i.e., 0.05 P is the probability that the difference seen between 2 samples occurs due to chance". If p . .05 it is considered statistically significant. It means that There is 5% probability that the result could have been obtained by chance. or The investigator can be 95% sure that the result was not obtained by chance. | Social & Preventive Medicine | null | Significant value of `p' is ?
A. 0.01
B. 0.02
C. 0.04
D. 0.05
| 0.05 |
f0649bfc-cd60-422b-91ee-ff7258af3fc1 | Ref: Cloherty's Manual of Newborn Care. 6th edition, Page 323Explanation:THE LECITHIN -SPHINGOMYELIN (L/S) RATIOAssessment of fetal lung maturity (FLM) prenatally by testing amniotic fluid obtained by amniocentesis.It is performed by thin-layer chromatography.The risk of RDS is very low if the L/S ratio is >2.Exceptions to L/S ratio >2 are:o Infants of diabetic mothers (IDMs)o Intrapartum asphyxiao Erythroblastosis fetalis.Other possible exceptions are intrauterine growth restriction (IUGR), abruptio placentae, preeclampsia and hydrops fetalis.Blood and meconium tend to elevate an immature L/S ratio and depress a mature L/S ratio.OTHER METHODSThe TDx-FLM 11 measures the surfactant- albumin ratio.Measured using fluorescent polarization technology.A value of >45 mg/g indicates maturity.Lamellar body counts in the amniotic fluid.Lamellar bodies are '"packages" of phospholipids produced by type II alveolar cells.A count of >50,000 lamellar bodies/microliter predicted lung maturity. | Pediatrics | Disorders of the Respiratory Tract | Lecithin/Sphingomyelin ratio is done to assess the maturity of:
A. Lung
B. Fetal circulation
C. Brain
D. Gonad
| Lung |
410bd82b-db45-48b6-a283-ced1a065c031 | Intensity
Whisper - 30 dB
Normal conversation - 60 dB
Shout - 90 dB
Discomfort of ear - 120 dB
Pain in ear -130 dB
Ref. Dhingra, 6/e, p 19 | ENT | null | At which level sound is painful -
A. 100-120dB
B. 80-85dB
C. 60-65dB
D. 20-25dB
| 100-120dB |
a1a73572-997e-4e72-94df-85b924188e63 | Aspergillosis is caused by the inhalation of Aspergillus conidia or mycelial fragments which are present in the decaying matter, soil or air, resulting in aspergillus asthma, bronchopulmonary aspergillosis and aspergilloma. Ref: Textbook of Microbiology, Ananthanarayan and Paniker; 9th edition | Microbiology | mycology | What is the most probable poal of entry for Aspergillus
A. Puncture wound
B. Blood
C. Lungs
D. Gastrointestinal tract
| Lungs |
2523d6a1-2ee2-4d9e-bb95-979aad656d7a | Ans. is 'a' i.e., Colles fracture DeformityAssociated fracture / conditionGarden Spade DeformitySmiths FractureGun stock deformityCubitus varus commonly due supracondylar humerus fractureDinner fork deformityColles FractureGenu VarumBlounts disease | Orthopaedics | Injuries of the Forearm | Dinner fork deformity is seen in -
A. Colies fracture
B. Supracondylar fracture of Humerus
C. Smith's fracture
D. Volar Barton Fracture
| Colies fracture |
f2473863-cd83-4434-83cc-e108d3b0d95c | ESI act is an impoant measure of social security and health insurance in India. Administration: The Union Ministry of Labour is the Chairman of ESI corporation. Secretary to Govt. of India Ministry of Labour is Vice-Chairman of ESI. | Social & Preventive Medicine | Occupational Health | Ministry covering ESI:
A. Ministry of health
B. Ministry of Home
C. Ministry of Human Resource Development
D. Ministry of Labour
| Ministry of Labour |
8ac6f3df-cb8c-4c9c-af4a-f52f6d67ae68 | Extrahepatic complications of chronic hepatitis B Extrahepatic complications of chronic hepatitis B, is associated with deposition of circulating hepatitis B antigen-antibody immune complexes. They are; Ahralgias and ahritis - common, Purpuric cutaneous lesions (leukocytoclastic vasculitis) - Rare Immune-complex glomerulonephritis Generalized vasculitis (polyaeritis nodosa) Ref: Harrison, Edition-18, Page-2568. | Medicine | null | Leukocytoclastic vasculitis as an extrahepatic manifestation is noticed in:
A. Chronic hepatitis B
B. Chronic Hepatitis C
C. Autoimmune hepatitis
D. Wilson's disease
| Chronic hepatitis B |
89a362ca-fe4b-47ad-a781-e5de47f5a2f4 | - Drug of choice for treatment of flukes (except liver fluke) and tapeworms (except dog tapeworm) is praziquantal. - Drug of choice for treatment of liver fluke is triclabendazole. - Drug of choice for dog tapeworm (Echinococcus) is albendazole - Drug of choice for all nematodes (see exceptions below) is albendazole - Drug of choice for treatment of filariasis is diethylcarbamezine. - Drug of choice for treatment of onchocerca and strongyloides is ivermectin. | Pharmacology | Anti-Parasitic Drugs | An antihelmenthic drug that is effective against blood fluke, liver fluke, lung fluke and cysticercus is:
A. Albendazole
B. Praziquantal
C. Ivermectin
D. Thiabendazole
| Praziquantal |
91539529-af93-464a-adf7-f0a80d95f610 | Hormones That Use the Adenylyl Cyclase-cAMP as Second Messenger System Adrenocoicotropic hormone (ACTH) Angiotensin II (epithelial cells) Calcitonin Catecholamines (b receptors) Coicotropin releasing hormone (CRH) Follicle-stimulating hormone (FSH) Glucagon Growth hormone releasing hormone (GHRH) Human chorionic gonadotropin (hCG) Luteinizing hormone (LH) Parathyroid hormone (PTH) Secretin Somatostatin Thyroid-stimulating hormone (TSH) Vasopressin (V2 receptor, epithelial cells) Insulin acts on tyrosine kinase receptor pathway. | Physiology | Endocrine System | Which of the following hormone doesn't use the adenylyl cyclase-cAMP as a second messenger ?
A. TSH
B. Epinephrine
C. Insulin
D. Glucagon
| Insulin |
de7ac38e-d08f-4323-9d1c-cf8b00fddab7 | PERITONSILLAR ABSCESS(QUINSY) Collection of pus between the fibrous capsule of the tonsil, and the superior constrictor muscle of the pharynx. Condition is generally unilateral. Tonsil is swollen, red, hot & congested. Uvula and soft palate are pushed to opposite side. Uvula Points towards Normal side as shown in the image. Organism involved are Streptococcus, Staph aureus, anaerobic organism, more often mixed growth is seen. Parapharyngeal abscess (abscess of lateral pharyngeal space, pterygomaxillary, space, pharyngomaxillary space: Swelling is on lateral wall of Pharynx pushing tonsils towards midline. Patient may also have a swelling in neck, posterior to SCM muscle. Patient may also present with Trismus. Ludwig's angina is cellulitis of submandibular space. | ENT | NEET Jan 2020 | A 3 years old boy presented with fever with pain in the throat and difficulty in deglutition. On examination following findings are seen. What is the most likely diagnosis?
A. Peritonsillar abscess
B. Parapharyngeal abscess
C. Ludwig's angina
D. Retropharyngeal abscess
| Peritonsillar abscess |
4e613b22-82b7-4997-a481-4eb9f1dc0b16 | Ans is 'd' i.e. Highly specific reversible and noncompetitive carbonic anhydrase inhibitor o Carbonic anhydrase inhibitors act by a non-competitive, reversible inhibition of the enzyme carbonic anhydrase. o Brinzolamide is a highly .specific inhibitor of carbonic anhydrase II (CA II), which is the main carbonic anhydrase isoenzyme involved in the secretion of aqueous humour. o Inhibition caused by brinzolamide is reversible and non-competitive. | Pharmacology | null | Brinzolamide is a
A. Highly specific irreversible and noncompetitive carbonic anhydrase inhibitor
B. Highly specific irreversible and competitive carbonic anhydrase inhibitor.
C. Highly specific reversible and competitive carbonic anhydrose inhibitor
D. Highly specific reversible and non-competitive carbonic anhydrase inhibitor.
| Highly specific reversible and non-competitive carbonic anhydrase inhibitor. |
0c5e8330-2a50-4d94-9591-ac49809ca88a | (a) Atticoantral CSOM(Ref. Scott Brown, 8th ed. Vol 2; 989)Tympanosclerosis is hyalinisation and calcification of the fibrous layer of tympanic membrane. It is not associated with cholesteatoma. Foreign body in ear does not lead to cholesteatoma formation.Keratosis obturans is the collection of desquamated keratin debris in the external auditory canal. This keratin debris comes from the external auditory canal stratified squamous epithelium. | ENT | Ear | Cholesteatoma commonly associated with:
A. Atticoantral CSOM
B. Tubotympanic CSOM
C. Tympanosclerosis
D. Foreign body in ear
| Atticoantral CSOM |
cdc0584b-8fd6-451b-85f7-3cb56770b070 | alopecia areata develops as single or multiple oval or round patches of hair loss on the scalp, beard area,eyebrows, eyelashes and other hairy areas of the body. Telogen effluvium- generalized and diffuse hair loss over scalp and body Cradle cap - infantile seborrhoeic dermatitis characterized by yellowish, patchy, greasy, scaly and crusty skin rash that occurs on the scalp of recently born babies. Tinea capitis-a dermatophytosis caused by trichophyton and microsporum fungi , can be either an ectothrix or endothrix type of infection. Ectothrix involves both inside and outside of hair shaft. Endothrix involves only inside of hair shaft. Page no.241,242,55,169 ref Harrison20th edition | Dental | Anatomy of skin | A child presenting with localized patches of complete hair loss with normal appearance of scalp. Diagnosis is -
A. Tinea capitis
B. Cradle cap
C. Alopecia areata
D. Telogen effluvium
| Alopecia areata |
bd20d1fa-9e46-42cf-96ad-bc776eec6540 | (c) Source: (Hay et al, pp 1163-1166. Kliegman et al, pp 925-928. McMillan et al, pp 482-483, 501-506. Rudolph et al, pp 1097-1099.) The radiograph shows diffuse that infiltrates bilaterally; this can be seen with neonatal pneumonia or primary surfactant deficiency. The rapid onset of the symptoms, the low WBC count with left shift, and the depicted chest x-ray findings, however, are typical of a patient with group B streptococcus (GBS) pneumonia. Appropriate management would include rapid recognition of symptoms, cardiorespiratory support, and prompt institution of antibiotics. Despite these measures, mortality from this infection is not uncommon. The other infectious causes listed do not present so early, and the noninfectious causes listed do not cause elevations in the band count. GBS disease in the infant is decreasing in incidence with better prevention strategies in the perinatal period; early screening in pregnancy and treatment with antibiotics just prior to delivery to eliminate GBS colonization markedly decreases the risk to the infant. Congenital syphilis can cause pneumonia, but it is diagnosed at birth along with other features including hepatosplenomegaly, jaundice, rashes, hemolytic anemia, and others. Diaphragmatic hernia presents with early respiratory distress, but the diagnosis is confirmed clinically with bowel sounds heard in the chest and a radiograph that has loops of bowel located above the normal placement of the diaphragm. Transient tachypnea of the newborn (TTN) causes an increase in respiratory rate and occasionally a low oxygen requirement; the history is often positive for a cesarean delivery, and the radiograph shows retained fluid in the fissures. TTN does not cause temperature instability nor an abnormal CBC. Chlamydial pneumonia is not a condition that occurs in an 8-hour-old infant; it is generally a mild pneumonia that can develop in an exposed infant at several weeks of life. | Pediatrics | Growth, Development, and Behavior | An 8-hour-old term infant develops increased respiratory distress, hypothermia, and hypotension. A complete blood count (CBC) demonstrates a white blood cell (WBC) count of 2500/mL with 80% bands. The chest radiograph is shown below. Which of the following is the most likely diagnosis?
A. Congenital syphilis
B. Diaphragmatic hernia
C. Group B streptococcal pneumonia
D. Transient tachypnea of the newborn
| Group B streptococcal pneumonia |
bad555df-d202-4de6-957f-c976fa530600 | Ans. is 'b' i.e., Pleuroperitoneal canal Bochdalek herniao Most Bochdalek hernia are on the left side (~80%) and may rarely be bilateral.o Compression of the lung results in pulmonary hypoplasia, involving both the lungs (ipsilateral > contralateral)o Pulmonary vasculature is also abnormal leading to pulmonary hypertension.o Thus the two main factors that affect morbidity and mortality are pulmonary hypoplasia and pulmonary hypertension.o The most frequent clinical presentation of CDH is respiratory distress due to severe hypoxemia,o The anteroposterior diameter of the chest may be large along with a scaphoid abdomen,o The diagnosis of CDH can be made prenatally by ultrasound.o The postnatal diagnosis is relatively straightforward because a plain chest radiograph demonstrates the gastric air bubbles or loops of bowel within the chest. There may also be a mediastinal shift away from the side of the hernia.o Historically, the surgical repair of a CDH was considered to be a surgical emergency' because it was believed that the abdominal viscera within the chest prevented the ability to ventilate. More recently with the recognition of the role of pulmnary hypertension and pulmonary hypoplasia and the adverse effects of early operative repair on the pulmonary function has caused a policy of delayed repair.o Thus most pediatric surgeons wait for a variable period (24 to 72 hrs) to allow for stabilization of the infant before doing surgical repair.Congenital diaphragmatic herniao It is the herniation of abdominal contents into the thoracic cavity through the diaphragmatic defecto The defect may be:Posterolateral (Bochdalek hernia)Retrosternal (Morgagni hernia)At the esophageal hiatus (hiatal hernia)Adjacent to the hiatus (paresophageal hernia)o Although all these defects are congenital, the term congenital diaphragmatic hernia is generally used for Bochdalek hernia. | Surgery | Unusual Hernias | Bochdalek hernia is related to -
A. Inguinal canal
B. Pleuroperitoneal canal
C. Femoral canal
D. Obturator foramen
| Pleuroperitoneal canal |
c3e5f7f1-b752-4ff4-929b-0cb46463c7bb | Prominance of Thyroid cailage (because of sharp angle) in males is called Adam's apple. Thyroid cailage with right and left lamina both meet at midline and form an angle of 90deg in males, 120deg in females. At rest it lies at level of C3 | ENT | FMGE 2018 | Adam's apple seen in boys is because of:
A. Hyoid bone
B. Tracheal rings
C. Thyroid cailage
D. Cricoid cailage
| Thyroid cailage |
2b3ce6e8-b033-45af-8317-05a736e4cd26 | Tension-free vaginal tape A knitted 11 mm x 40 cm polypropylene mesh tape is inseed transvaginally at the level of the midurethra Complications: Sho term Voiding difficulties , Bladder perforation, de novo Urgency and Bleeding Ref: SHAW&;S TEXTBOOK OF GYNAECOLOGY; 15th edition; Pg no:194 | Gynaecology & Obstetrics | Urogynecology | Site of placement of tension free vaginal tapes in stress urinary incontinence
A. Ureterovaginal junction
B. Urethrovaginal junction
C. Upper pa of urethra
D. Middle pa of urethra
| Middle pa of urethra |
c43ce7d9-b54b-4d22-9c53-5409e3d99a25 | The route by which most of the carbon dioxide is carried in the bloodstream. Once dissolved in the blood plasma, carbon dioxide combines with water to form carbonic acid, which immediately ionizes into hydrogen and bicarbonate ions. The bicarbonate ions serve as pa of the alkaline reserve.Ref: Ganong&;s Review of Medical Physiology; 24th edition; page no: 644 | Physiology | Respiratory system | Most impoant from of carbon-dioxide transpo in the blood
A. It is mostly transpoed as carboxy hemoglobin
B. As dissolved CO2
C. As bicarbonates
D. Due to CO2 molecules attached to hemoglobin
| As bicarbonates |
13c6d74a-cbb1-4455-a2d8-c23314b84072 | Presence of uniocular diplopia together with the finding of the golden crescent on oblique illumination (edge of subluxated lens) or black crecent line on coaxial illumination (edge of subluxated lens) suggests a diagnosis of `subluxation' of the crystalline lens. Ectopic lens refers to the displacement of shows lens from its normal position (subluxation, dislocation). | Ophthalmology | null | A patient presents to the emergency department with uniocular diplopia. Examination with oblique illumination shows golden crescent while examination with coaxial illumination show a dark crescent line. Which of the following is the most likely diagnosis –
A. Lenticonus
B. Coloboma
C. Microspherophakia
D. Ectopia lentis
| Ectopia lentis |
47f97467-47f7-4033-b48d-b8ff6271d262 | The duodenojejunal flexure is suppoed by a fibromuscular band called the suspensory ligament of the duodenum (ligament of Treitz), which is attached to the right crus of the diaphragm. C. - The pancreas is an endocrine and exocrine gland; is retroperitoneal in position and receives blood from the splenic, gastroduodenal, and superior mesenteric aeries. E - The spleen lies in the left hypochondriac region, is hematopoietic in early life, and later functions in worn-out red blood cell destruction. It filters blood, stores red blood cells, and produces lymphocytes and antibodies. D - The splenic aery is a branch of the celiac trunk, follows a touous course along the superior border of the pancreas, and divides into several branches that run through the lienorenal ligament. A -. The common hepatic aery is divided into the proper hepatic and gastroduodenal aeries. | Anatomy | Small and Large intestine | CT scan abdomen at the level of the twelfth thoracic veebra in a pt., Which structure provides an attachment of the suspensory muscle of the duodenum (ligament of Treitz)?
A. A
B. B
C. C
D. D
| B |
35dcda2f-95cc-4bd2-93f1-159fc4a31477 | Best method to treat ulnar nerve abscess is incision and drainage. folowed by treatment with coicosteroids and mbmdt iadvl textbook of dermatology page 2091 | Dental | Bacterial infections | Best method of treatment of ulner never abscess in case of leprosy is -
A. High does of steroid
B. incision and drainage
C. Thalidomide
D. High does of clofazamine
| incision and drainage |
30d8cb7a-6892-4b27-bfb4-7b5e76492206 | Ans. A: Constitutional The causes of sho stature can be divided into 3 broad categories: Chronic disease (including undernutrition genetic disorders) Familial sho stature Constitutional delay of growth and development (commoner) Endocrine diseases are rare causes of sho stature. The hallmark of endocrine disease is linear growth failure that occurs to a greater degree than weight loss. | Pediatrics | null | Most common cause of sho stature is:
A. Constitutional
B. Hypothyroidism
C. Growth hormone deficiency
D. Systemic illness
| Constitutional |
d171cb55-85eb-4cba-bae5-a9ac255cc2c4 | Clinical causes of osmotic diarrhea that causes an osmolar gap greater than 50 includes lactase deficiency, sorbitol foods, saline cathaics and antacids. Osmotic diarrhea occur when water soluble molecules are poorly absorbed, remain in the intestinal lumen and retain water in the intestine. It usually follows ingestion of osmotically active substances. In this, Stool volume is less than 1 litre /day Diarrhea stops with fasting Stool has an osmolar gap (normal stool osmolar gap is less than 50) Ref: Mayo Clinic Internal Medicine Review, Eighth Edition edited by M. Habermann Thomas, page 262. | Medicine | null | Which of the following condition is associated with Osmotic diarrhoea?
A. Lactase deficiency
B. Ulcerative sprue
C. Surreptitious ingestion of laxatives
D. Endocrine tumors
| Lactase deficiency |
ed2a9e8e-66a7-4090-84f1-21d823db1ade | Ans. is 'b' i.e., Rifampin with doxycyclinelRef : Harrison 18n/e p. 1299,1672 & I4/e p. 1268).The gold standard for the treatment of brucellosis in adults is IM streptomycin (0.75-1 g daily for 14-21 days) together with doxycycline (100 mg twice daily for 6 weeks).In both clinical trials and observational studies, relapse follows such treatment in 5-10 % of cases.The usual alternative regimen (and the current World Health Organization recommendation) k rifampin (600-9{n mg/it) plus doxycycline (100 mg twice daily) for 6 weeks. | Pharmacology | null | WHO recommended regime for the treatment of Brucella infection is ?
A. Streptomycin with doxycycline
B. Rifampicin with doxycycline
C. Rifampicin with ciprofloxacin
D. Streptomycin with erythromycin
| Rifampicin with doxycycline |
f1cd79fa-584d-4331-86e0-6c09038db2a3 | Ans. c (Trauma) (Ref: Parson's Disease of Eye 19th/pg. 283; Basak Ophthalmology 2nd/pg. 82, 305).CATARACTContusion cataractContusion of the eyeball will produce a rosette-shaped subcapsular opacity on the anterior surface of the lens. It will normally remain unchanged but will migrate into the deeper cortex over time due to the apposition of new fibers.Lamellar (Zonular) cataractIt is the most common developmental cataract.Opacities are located in one layer of lens fibers, often as "riders" only in the equatorial region.Nuclear cataractIn the fourth decade of life, the pressure of peripheral lens fiber production causes hardening of the entire lens, especially the nucleus. The nucleus takes on a yellowish brown color (brunescent nuclear cataract). This may range from reddish brown to nearly black discoloration of the entire lens (black cataract). Nuclear cataracts develop very slowly. Due to the lenticular myopia, near vision (even without eyeglasses) remains good for a long time.Cortical cataractNuclear cataracts are often associated with changes in the lens cortex. It is interesting to note that patients with cortical cataracts tend to have acquired hyperopia in contrast to patients with nuclear cataracts, who tend to be myopic.# Berlin's edema (commotio retinae) is a condition caused by blunt injury to the eye. Berlin's edema is an acute traumatic maculopathy characterized by retinal opacification. Histopathologic studies have shown that it is characterized by disruption of photoreceptor outer segments and retinal pigment epithelial damage. OCT an effective tool for management of patients with posterior segment trauma. OCT is more comfortable for the traumatized patient than other imaging techniques because it is a non-contact method utilizing infrared illumination. OCT is also highly sensitive in identifying subtle anatomic changes.Educational points: CataractFeatureAfter-cataract (Post cap opacity)Elschnig pearl & Rings of SoemerringsBrown/Cataract brunescensNuclear/hard cataractBlack cataract/Cataract nigransNuclear/hard cataractBlue dot cataract (Punctate)Most common congenital cataractComplicated cataract'Bread crumb' appearanceConcussion cataract'Rossete-shaped' cataractCoronary cataractDevelopmental cataract at pubertyChalcosisSunflower cataractDiabetic cataract'Snow flake/storm' appearanceHypermature senile cataractMorgagnian cataractLamellar/ZonularRidersMyotonic dystrophyCataract with polychromatic dots ("Christmas-tree") | Ophthalmology | Lens | 'Rosette cataract' is caused by:
A. Diabetes
B. After cataract
C. Trauma
D. Gaucher's disease
| Trauma |
68ccfc5f-7932-44f2-8402-98c4013f9b41 | The common clinical presentations include meconium ileus in neonatal period,recurrent bronchiolitis in infancy and early childhod,recurrent respiratory tract infections ,chronic lung disease , bronchiectasis, steatorrhoea,with incresing age pancreatitis and azoospermia. Ref : Essential pediatrics,O.P.Ghai,7 th edition ,pg no:36 | Pediatrics | Respiratory system | Infant with cystic fibrosis (CF) are likely to develop
A. Meconium ileus
B. Loose motions
C. Vomiting
D. Constpation
| Meconium ileus |
7d29458d-a231-40cc-9f06-1938dcb2d001 | P. malariae which attacks mainly senescent (old) RBC’s: Agent of Quartan malaria
P. ovale and P. vivax: attack younger RBCs and reticulocytes: Agent of benign tertian malaria
P. falciparum: attacks RBC of all ages: Agent of malignant tertian malaria. | Microbiology | null | Senescent RBC's are mainly attacked in-
A. Vivax malaria
B. Ovale malaria
C. Falciparum malaria
D. Quartan malaria
| Quartan malaria |
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