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438bf93a-d441-4291-ac94-041d058823d7
|
Ans. a (Pectoralis major). (Ref. Bailey & Love Surgery, 25th ed., 842)MASTECTOMY is now only strictly indicated for large tumors, central tumor beneath or involving nipple, multifocal disease, and local recurrence or for patient preference.Simple mastectomyRadical mastectomy (Halsted)Modified radical Mastectomy (Patey's)# Only breast & Axillary tail of breast# Breast# Axillary lymph nodes# Pectoralis major# Pectoralis minor# Whole breast# Large portion of skin including nipple# Dissection of axilla# All fat, fascia & lymph nodes of axilla.# Pectoral minor either divided or retracted# Intercostal brachial nerves divided.STRUCTURES SPARED IN MRM1. Pectoralis major2. Axillary vein3. Nerve to serratus anterior & latissimus dorsiEducational points:# Conservative breast cancer surgery is QUART (Quadrantectomy Axillary Dissection & RT).# Sentinel node biopsy localized by radionuclide scan or by injection of patent blue dye.# Reconstruction materials:- Silicone gel,- Musculocutaneous Flaps {TRAM gives best cosmetic results)
|
Surgery
|
Breast Cancer - Treatments
|
Which of the following is spared in modified radical mastectomy (MRM)?
A. Pectoralis major
B. Pectoralis minor
C. Axillary lymph nodes
D. Nipple
|
Pectoralis major
|
f764ad5e-a74c-4a1c-aaeb-7f93b209d7e6
|
Ans. c (Sturge-Weber syndrome) (Ref. Harrison's medicine 17th/Chapter 379; IADVL 2nd/ pg l68)PHAKOMATOSES (NEUROCUTANEOUS SYNDROMES = NEUROECTODERMAL DYSPLASIAS)# Autosomal dominant:- Neurofibromatosis (von Recklinghausen synd)# Not autosomal dominant:- Encephalotrigeminal angiomatosis (Sturge-Weber synd)- Tuberous sclerosis (Bourneville synd)- Retinocerebellar hemangioblastoma (VHL synd)- Neurocutaneous melanosis- Ataxia-telangiectasiaSTURGE-WEBER SYNDROME (ENCEPHALOTRIGEMINAL ANGIOMATOSIS)# Classical triad:- Facial portwine stain in distribution of VI (trigeminal nerve), present at birth and unilateral; may cross midline.- Mentral retardation- Seizures# Ocular features:- Ipsilateral glaucoma,- Buphthalmos,- Strabismus and- Loss of vision,# CT SCAN:- "Tram-track" or S-shaped intracranial calcifications, seen after the age of 2 years.- Ipsilateral Choroid plexus and venous angiomas with leptomeningeal angiomatoses over the parietoccipital lobes.VON HIPPEL-LINDAU DISEASE# Mutation of the von Hippel-Lindau (VHL) gene on chromosome 3p, a tumor-suppressor gene, causes this disorder.# Associated tumors:- Hemangioblastomas (Erythropoietin producing) - cerebellum, retina, medulla, spinal cord- Renal cysts 60%; Pancreatic, epididymis, or liver cysts- Renal cell carcinoma 45%- Pheochromocytoma (NIH Type 2a or 2b)- Islet cell tumors; Endolymphatic sac tumors; Serous adenomasTUBEROUS SCLEROSIS (BOURNEVILLPS DISEASE)# Autosomal dominant# Classical clinical triad of = EPIlepsy, LOw IQ, Adenoma sebaceum (EPDLOIA).# 'Ash leaf' macule - the earliest cutaneous sign & results in poliosis (circumscribed patch of gray-white hair)# Hamartomas involving many organs# Cardiac rhabdomyomas# Angiomyolipomas of kidneys, liver, adrenals, and pancreas (Angiomyolipomas are the most common renal abnormality, occur bilaterally, are often multiple, and are usually asymptomatic)# Brain -- periventricular subependymal nodules- Cortical tubers- 15% develop subependymal giant cell astrocytoma (SEGA) - the foramen Munro tumor# Lungs - LAM (Lymphangioleomyomatosis) and pulmonary interstitial fibrosisNEUROFIBROMATOSIS TYPE 1 (VON RECKLINGHAUSEN'S DISEASE)# NF1 is characterized by cutaneous neurofibromas, pigmented lesions of the skin called cafe au lait spots, freckling in non-sun-exposed areas such as the axilla, hamartomas of the iris (Lisch nodules), and pseudoarthrosis of the tibia.# Neurofibromas present as multiple, palpable, rubbery, cutaneous tumors.# Aqueductal stenosis (hydrocephalus), scoliosis, short stature, hypertension, epilepsy, & mental retardation may occur.# Patients with NF1 are at T risk of developing nervous system neoplasms, including plexiform neurofibromas, optic pathway gliomas, ependymomas, meningiomas, astrocytomas, and pheochromocytomas.# Mutation of NF1 gene on chromosome 17 causes von Recklinghausen's disease. The NF1 gene is a tumor-suppressor gene; it encodes a protein, neurofibromin, which modulates signal transduction through the ras GTPase pathway.NEUROFIBROMATOSIS TYPE 2 (MISME Complex)# bilateral vestibular schwannomas in >90% of individuals who inherit the gene.# Predisposition for the development of Meningiomas, gliomas, and Schwannomas of cranial and spinal nerves.# In addition, a characteristic type of cataract, juvenile posterior subcapsular lenticular opacity, occurs in NF2.# Multiple cafe au lait spots and peripheral neurofibromas occur rarely.# This syndrome is caused by mutation of the NF2 gene on chromosome 22q; NF2 encodes a protein called neurofibromin 2, schwannomin, or merlin, with homology to a family of cytoskeletal proteins that includes moesin, ezrin, and radixin.
|
Medicine
|
C.N.S.
|
Port wine stain of the face, seizures, hemiparesis, intracranial calcification and glaucoma are features of?
A. Neurofibromatosis
B. Tuberous sclerosis
C. Sturge-Weber syndrome
D. VHL
|
Sturge-Weber syndrome
|
ed5b84e2-4385-4246-806c-49b3030d2ffd
|
Atracurium Cis-atracurium Mixture of cis-isomers Pure cis-isomer Histamine release No / minimal release CVS unstable CVS stable Less potent Dose - 0.5-0.6mh/kg More potent Dose - 0.1-0.2 mg/kg - Cis-atracurium and atracurium are dependent on Hoffman elimination - Cis-atracurium's duration of action is more predictable because of spontaneous breakdown. Although atracurium undergoes similar elimination, it is less potent than cis-atracurium, so its breakdown product, laudanosine, is found in higher concentrations
|
Anaesthesia
|
NEET 2019
|
Cis atracurium is better then atracurium because:-
A. Less histamine release
B. Less half life
C. Low drug dose
D. Low cost
|
Less histamine release
|
1fabd9dd-4b77-41ee-a717-c3833fc01fea
|
Ans. is 'b' i.e., Vibrio parahemolyticus Strains of vibrio parahemolyticus isolated from patients are always hymolytic on Wagatsuma agar, while strains from environmental sources are always non-hemolytic. This linkage of enteropathogenicity to ability of hemolysis on Wagatsuma agar is called Kanagawa's phenomenon.
|
Microbiology
| null |
Kanagawa's phenomenon is seen in ?
A. Pseudomonea aeuroginosa
B. Vibrio parahemolyticus
C. Shigella sonie
D. Proteus mirabilis
|
Vibrio parahemolyticus
|
70e5d83b-44a7-415b-aa00-dbcf082b562a
|
Ans. is 'd' i.e., 11/2 years o See IAP vaccination schedule.
|
Pediatrics
| null |
MMR. vaccination is given at-
A. Bih
B. 6th month
C. One year
D. 11/2 years
|
11/2 years
|
927e20d3-87f8-4b2e-89b0-95670c91f4af
|
Etomidate
It is another induction anaesthetic (0.2- 0.5 mg/kg) which has a briefer duration of action (4-8 min).
than thiopentone; produces little cardiovascular and respiratory depression, but motor restlessness and rigidity is more prominent as are pain on injection or nausea and vomiting on recovery. It is a poor analgesic and has not found much favour ,except for patients with compromised cardiovascular status.
Reference: Essentials of Medical Pharmacology Eighth Edition KD TRIPATHI page no 410
|
Pharmacology
| null |
Which of the following inducing agent produces cardiac stability?
A. Etomidate
B. Ketamine
C. Halothane
D. Thiopentone
|
Etomidate
|
e5214055-30d1-422c-880e-3baa2c2efb55
|
Ans. is 'd' i.e., 25-40 gm o The weight of adrenal gland depends on the cause of cushing syndrome : ? Due to ACTH production by pituatory microadenoma (cushing disease) or by ectopic ACTH production. o ACTH stimulates the zona reticularis and zona fasciculata which results in either diffuse hyperplasia (25-40 gm) or nodular hyperplasia (30-50 gm) of adrenal. Primary pituitary adenoma Weight is less than 30 gm. Primary pituitary carcinoma -4 Weight is 200-300 gm. Exogenous glucocoicoid administration o Exogenously administered glucocoicoids inhibit the release of ACTH from pituitary by negative feed back mechanism. o So, there is no stimulatory signal on zona fasciculata and zona reticularis --> Both these layers undergo atrophy. o As zona glomerulosa function is independent of ACTH, its thickness remains normal. o Due to atrophy the weight of the gland is less than normal, i.e., < 4 gm.
|
Pathology
| null |
Weight range of adrenal glands in most of cases of cushing's disease is -
A. 4-11gm
B. 11-13 gm
C. 14-24 gm
D. 25-40 gm
|
25-40 gm
|
b936693f-dd7d-455e-a988-47fc39298810
|
The coeliac trunk arises from the front of the abdominal aoa just below the aoic opening of the diaphragm at the level of the disc between veebrae thoracic twelve and first lumbar. The trunk is only about 1.25 cm long. It ends by dividing into its three terminal branches, namely the left gastric, hepatic and splenic aeries. Ref : B D Chaurasia's Human Anatomy ,seventh edition , volume 2 , pg. no., 302 ( fig. 21.3 to 21.5 ).
|
Anatomy
|
Abdomen and pelvis
|
Which of the following aery is not a terminal branch of coeliac trunk ?
A. common hepatic aery
B. left gastric aery
C. splenic aery
D. gastroduodenal aery
|
gastroduodenal aery
|
9d1214b6-7220-470b-85b2-402f2127fb97
|
Ans. D i.e. Angiography Pulmonary angiography has been now replaced by CT and MR angiography
|
Radiology
| null |
Most reliable method of diagnosing pulmonary embolism is: September 2004
A. Plain skiagram
B. Perfusion
C. Electrocardiography
D. Angiography
|
Angiography
|
d18aec2f-6403-4e95-ba83-eb249dee4ac8
|
Deficiency manifestations of Vitamin A:
Night blindness (nyctalopia) is one of the earliest symptoms of vitamin A deficiency.
The individuals have difficulty to see in dim light since the dark adaptation time is increased.
Prolonged deficiency irreversibly damages a number of visual cells.
Severe deficiency of vitamin A leads to xerophthalmia. This is characterized by dryness in conjunctiva and cornea, and keratinization of epithelial cells.
In certain areas of conjunctiva, white triangular plaques known as Bitot's spots are seen.
lf xerophthalmia persisits for a long time, corneal ulceration and degeneration occur.
This results in the destruction of cornea ,a condition referred to as keratomalacia, causing total blindness
Vitamin A deficiency blindness is mostly common in children of the developing countries
Key Concept:
Night blindness (nyctalopia) is one of the earliest symptoms of vitamin A deficiency.
Ref : Textbook of Biochemistry, Satyanarayana
|
Biochemistry
| null |
One of the earliest symptoms of Vit. A deficiency is:
A. Nyctalopia
B. Xerophthalmia
C. Bitot's spot
D. Keratomalacia
|
Nyctalopia
|
8dde9b32-c47d-422e-9720-57c03d99d65c
|
Ans. a (Defects in phagolysosome function) (Ref. H - 17th/pg. Table 61-4)CHRONIC GRANULOMATOUS DISEASEChronic Granulomatous Disease presents before the age of 2 and can be transmitted through X-linked or autosomal pattern of inheritance. The defect lies in the inability to generate oxidative burst to kill organisms after being phagocytosed. The neutrophils lack enzyme NADPH oxidase, which plays an important role in production of microbicidal oxygen radicles. In the lab, the diagnosis can be confirmed through Nitro blue Tetrazolium reduction dye test, which will be negative. B cell and T cell functions are normal. Recurrent infections with catalase producing organisms are common. The NBT test is a measure of the respiratory burst in neutrophils and is used to screen for CGD. Neutrophils will reduce the dye NBT, a clear yellow water-soluble compound, to formazan upon stimulation of the respiratory burst. Formazan thus forms precipitates as a dark blue granular substance, which remains trapped in the cytoplasm. Patients with CGD lack a component of the oxidase system, which produces super oxide anion and thus cannot reduce NBT to formazan. Results are interpreted as follows: Normal (positive test) - cells with an orange-red nucleus and blue cytoplasm; Abnormal (negative test) - cells with an orange-red nucleus and colorless cytoplasm.Phagocytic cell deficiency:Leukocyte adhesion deficiency syndrome (type 1): Defect in LFA-1 integrin proteins on phagocytes. Presents early with recurrent bacterial infections, absent pus formation, and delayed separation of umbilicus.Chediak-Higashi disease:Autosomal recessive. Defect in microtubular function and lysosomal emptying of phagocytic cells. Presents with recurrent pyogenic infections by staphylococci and streptococci, partial albinism, and peripheral neuropathy.Chronic granulomatous disease:Defect in phagocytosis of neutrophils owing to lack of NADPH oxidase activity or similar enzymes. Presents with marked susceptibility to opportunistic infections with bacteria, especially S. aureus, E. coli, and Aspergillus. Diagnosis confirmed with negative nitroblue tetrazolium dye reduction test. Rx:Gamma Interferon.Inherited Disorders of Phagocyte Function: Differential FeaturesClinical manifestationsCellular or molecular defectsDiagnosisChronic Granulomatous Diseases (70% X-linked, 30% Autosomal Recessive)Severe infections of skin, ears, lungs, liver, and bone with catalase-positive microorganismsSuch as S. aureus, BurkholderiaChromobacterium violaceum; often hard to culture organism; excessive inflammation with granulomas, frequent lymph node suppuration; granulomas can obstruct GI or GU tracts; gingivitis, aphthous ulcers, seborrheic dermatitisNo respiratory burst due to the lack of one of four NADPH oxidase subunits in neutrophils, monocytes, and eosinophilsNBT or DHR test; no superoxide and H2O2 production by neutrophils; immunoblot for NADPH oxidase components; genetic detectionChediak-Higashi Syndrome(Autosomal Recessive)Recurrent pyogenic infections, especially with S. aureus; many patients get lymphoma-like illness during adolescence; periodontal disease; partial oculocutaneous albinism, nystagmus, progressive peripheral neuropathy, mental retardation in some patientsReduced chemotaxis and phagolysosome fusion, increased respiratory burst activity, defective egress from marrow, abnormal skin window; defect in LYSTGiant primary granules in neutrophils and other granule-bearing cells (Wright's stain); genetic detectionSpecific Granule Deficiency(Autosomal Recessive)Recurrent infections of skin, ears, and sinopulmonary tract; delayed wound healing; decreased inflammation; bleeding diathesisAbnormal chemotaxis, impaired respiratory burst and bacterial killing, failure to upregulate chemotactic and adhesion receptors with stimulation, defect in transcription of granule proteins; defect in C/EBPLack of secondary (specific) granules in neutrophils (Wright's stain), no neutrophil- specific granule contents (i.e., lactoferrin), no defensins, platelet granule abnormality; genetic detectionMyeloperoxidase Deficiency(Autosomal Recessive)Clinically normal except in patients with underlying disease such as diabetes mellitus; then candidiasis or other fungal infectionsNo myeloperoxidase due to pre- and posttranslational defectsNo peroxidase in neutrophils; genetic detectionLeukocyte Adhesion DeficiencyType 1: Delayed separation of umbilical cord, sustained neutrophilia, recurrent infections of skin and mucosa, gingivitis, periodontal diseaseImpaired phagocyte adherence, aggregation, spreading, chemotaxis, phagocytosis of C3bi-coated particles; defective production of CD18 subunit common to leukocyte integrinsReduced phagocyte surface expression of the CD18-containing integrins with monoclonal antibodies against LFA-1 (CD18/CD11a), Mac-1 or CR3 (CD18/CD11b), pl50,95 (CD1S/ CD11c); genetic detectionType 2: Mental retardation, short stature, Bombay (hh) blood phenotype, recurrent infections, neutrophiliaImpaired phagocyte rolling along endotheliumReduced phagocyte surface expression of Sialyl-Lewisx, with monoclonal antibodies against CD15s; genetic detectionPhagocyte Activation Defects(X-linked and Autosomal Recessive)NEMO deficiency: mild hypohidrotic ectodermal dysplasia; broad based immune defectrpyogenic and encapsulated bacteria, viruses, Pneumocystis, mycobacteria; X-linkedImpaired phagocyte activation by IL-1, IL-18, TLR, CD40 TNF-leading to problem with inflammation and antibody productionPoor in vitro response to endotoxin;lack of NF-B activation; genetic detectionClinical manifestationsCellular or molecular defectsDiagnosisIRAK4 deficiency: susceptibility to pyogenic bacteria such as staphylococci, streptococci, Clostridia; resistant to mycobacteria; autosomal recessiveImpaired phagocyte activation by endotoxin through TLR and other pathway; TNF-signaling preservedPoor in vitro response to endotoxin; lack of NF-B activation by endotoxin; geneticdetectionHyper IgE-Recurrent InfectionSyndrome (Autosomal Dominant)(Job's Syndrome)Eczematoid or pruritic dermatitis, "cold" skin abscesses, recurrent pneumonias with S. aureus with bronchopleural fistulae and cyst formation, mild eosinophilia, mucocutaneous candidiasis, characteristic facies, restrictive lung disease, scoliosis, delayed primary dental deciduationReduced chemotaxis in some patients, reduced suppressor T cell activityClinical features, involving lungs, skeleton, and immune system; serum IgE > 2000 IU/mL
|
Pathology
|
Immunity
|
Chediak-Higashi syndrome is characterized by
A. Defects in phagolysosome function
B. Defects in macrophage production
C. Defects in leukocyte adhesion
D. Defects in microbicidal activity
|
Defects in phagolysosome function
|
967e2c9e-1911-4f06-b795-31d8ccfff7c3
|
There is little change in the width of the dental arch anterior to the first permanent molars after the fifth or sixth year of life.
In the mandibular dentition, mandibular intercanine width is relatively complete by 9–10 years of age in both boys and girls.
In the maxilla, intercanine width is essentially completed by 12 years of age in girls, but continues to grow until 18 years of age in boys.
Hence, the maxillary intercanine dimension serves as a ‘safety valve’ for this basal discrepancy.
|
Dental
| null |
Safety valve mechanism is:
A. The anteroposterior increment in the maxilla at 14 years
B. Increase in the mandibular intercanine width at 14 years
C. Increase in the mandibular height at 12 years
D. Increase in the maxillary intercanine width at 12 years
|
Increase in the maxillary intercanine width at 12 years
|
e9c4faca-7692-4ede-a6ab-ed2765087d95
|
Ans. (A) Hyoscine(Ref: KDT 8th/e p132)Hyoscine is used for the prophylaxis of motion sickness whereas other drugs listed in the question are used for the treatment of vomiting.
|
Pharmacology
|
A.N.S.
|
Which of the following drugs is useful in prophylaxis of motion sickness?
A. Hyoscine
B. Metoclopramide
C. Prochlorperazine
D. Ondansetron
|
Hyoscine
|
770d4817-f118-4511-8fa5-ea6cd7f84a7c
|
most common mode of transmission of HIV virus is through hetrosexual REF:ANANTHANARAYANAN TEXT BOOK OF MICROBIOLOGY 9EDITION PGNO.570
|
Microbiology
|
Virology
|
Most common mode of transmission of HIV world wide is -
A. Heterosexual
B. Homosexual
C. IV-drug abuse
D. Contaminated blood products
|
Heterosexual
|
da762a98-1ff7-4ce0-9bf9-691ffaf93df7
|
Annexin V is a calcium-dependent phospholipid binding protein that has a high affinity for the phophatidylserine (PS), a plasma membrane phospholipid. One of the earliest features of apoptosis is the translocation of PS from the inner to the outer leaflet of the plasma membrane, thereby exposing PS to the external environment. Annexin V binds to PS exposed on the cell surface and identifies cells at an earlier stage of apoptosis than assays based on DNA fragmentation. The Annexin V Assay, a classical technique for detecting apoptosis, is the most commonly used method for detecting apoptosis by flow cytometry.
|
Pathology
| null |
Annexin V is associated with which of the following?
A. Necrosis
B. Apoptosis
C. Atherosclerosis
D. Inflammation
|
Apoptosis
|
604694c4-58e1-422c-98fc-cebbf1c545fb
|
Ans. is 'c' i.e., Charcoal 15% + Potassium nitrate 75% + sulphur 10% The classical gun powder is known as black powder, consists of charcol (15%), Sulphur (10%), and potassium nitrate (75%). Depending on fineness, the black gun powder is designated as FG, FFG, FFFG. etc. (F = fineness). Pyrodex is another gun powder with same components, but with different ratios.Black gun powder produces smoke, i.e. It is smoke producing pow der. Smokeless powder, in addition to black powder, has nitrocellulose (single base), or nitrocellulose plus nitroglycerine (double base), or nitrocellulose plus nitroglycerine plus nitroguanidine (triple base). Semi smokeless pow der has 80% black pow der and 20% smokeless powder (nitrocellulose).
|
Forensic Medicine
|
Death and Investigations
|
Black gun pow der composition -
A. Charcoal 60% + Potassium nitrate 20% + sulphur 20%
B. Charcoal 25% + Potassium nitrate 70% + sulphur 05%
C. Charcoal 15% + Potassium nitrate 75% +- sulphur 10%
D. Charcoal 65% +Potassium nitrate 20% + sulphur 15%
|
Charcoal 15% + Potassium nitrate 75% +- sulphur 10%
|
f1b93b4b-760e-4a64-900f-54ae185d8ef3
|
Asymmetric intrauterine growth retardation (IUGR) is seen in chronic placental insufficiency due to inadequate substrate transfer. The fetus is affected in later months during the phase of cellular hyperophy. The placental pathology includes, Placenta prae Abruption Circumvallate Infarction Mosaicism Poor placentation Symmetric IUGR is seen in genetic disease or infection. The fetus is affected from the noxious effect very early in the phase of cellular hyperplasia. Ref: Textbook of Obstetrics by DC Dutta, 6th edition, Page 463-464.
|
Radiology
| null |
Ultrasound scanning of a fetus shows asymmetric growth retardation. It may be associated with the following pathology:
A. Anencephaly
B. Trisomy 18
C. Congenital rubella syndrome
D. Placenta pre
|
Placenta pre
|
dd11ccb3-74a2-480c-a545-9d31d361f460
|
HETEROPHILE REACTION :- Similar antigens on dissimilar organisms are called heterophile antigens Closely related antigens can occur on a wide variety of organisms. Antibodies reacting with such antigens are called heterophile antibodies. Serologic tests employing such antigens are called heterophile tests. Frie's test is used in the diagnosis of LGV. Antigen made from sterile pus aspirated from previously unruptured LGV abscesses, produces a reaction in patients with lymphogranuloma inguinale when injected intradermally.
|
Microbiology
|
Systemic Bacteriology (Haemophilus, Yersinia, Spirochaetes, Ricketssia, Chlamydia, Mycoplasma and Miscellaneous Bacteria)
|
Which of the following is not a heterophile reaction?
A. Weil Felix test
B. Paul Bunnell test
C. Frie's test
D. Cold agglutinin test
|
Frie's test
|
e28d4f9f-5e8e-4c43-aaf3-db545cb1dd00
|
Most sporadic gastrinomas are located in the first and second pa of the duodenum. The anatomical area comprising the head of the pancreas, the superior and descending poion of the duodenum and the relevant lymph nodes has been called the 'gastrinoma triangle' because it harbours the vast majority of these tumoursRef: Bailey and Love 27e pg: 851
|
Surgery
|
Endocrinology and breast
|
Tumor commonly seen in the area marked below
A. Insulinoma
B. Gastrinoma
C. Non-functional tumours
D. VIPoma
|
Gastrinoma
|
f0ce84f0-861b-4149-85e6-7e517a5cafd6
|
An incidentaloma is an adrenal mass, detected incidentally by imaging studies conducted for other reasons, not known previously to have been present or causing symptomsMore than 75% are non-functioning adenomas but Cushing's adenomas, phaeochromocytomas, metastases, adrenocoical carcinomas and Conn's tumours can all be found this wayRef: Bailey and Love 27e pg: 839
|
Surgery
|
Endocrinology and breast
|
Most of the incidentalomas are
A. Non-functioning adenoma
B. Adrenocoical carcinoma
C. Adrenal metastasis
D. Pheochromocytoma
|
Non-functioning adenoma
|
2cd59b94-c0b6-47f0-a8db-b10d73dc55cf
|
Ans. (a) CalcitoninCytology showed showed parafollicular cells along with clusters of plasmacytoid and few spindle shaped cells are suggestive of medullary ca thyroid and so should be followed up by its tumor marker calcitonin.
|
Pathology
|
Endocrine
|
A patient presented with neck swelling. Cytology showed showed parafollicular cells along with clusters of plasmacytoid and few spindle shaped cells. What investigation should be done to follow up the patient?
A. Calcitonin
B. TSH level
C. Anti TPO antibody
D. TRH
|
Calcitonin
|
f44eae11-bfc0-4d31-9083-6b6f0e3123c9
|
Ampicillin or third generation cephalosporins are effective against H. influenzae and are given by parenteral route (i.m. or i.v.) without waiting for results of throat swab and blood culture. Ref: PL Dhingra 7th edition of Ear, Nose and Throat; Pg no 328
|
ENT
|
Larynx
|
Drug of choice for treatment of epiglottitis is
A. Ceftriaxone
B. Sulphamethoxazone
C. Chloramphenicol
D. Clindamycin
|
Ceftriaxone
|
578ff365-4324-4df8-ab68-631fa3b0d743
|
APRV - Airway Pressure Release Ventilation Mode of mechanical ventilation that is less common than pressure control or volume control, APRV was described initially by Stock and Downs in 1987 as a continuous positive airway pressure (CPAP) with an intermittent release phase. APRV applies CPAP (P high) for a prolonged time (T high) to maintain adequate lung volume and alveolar recruitment, with a time-cycled release phase to a lower set of pressure (P low) for a sho period of time (T low) or (release time) where most of ventilation and CO2 removal occurs Using high-flow (demand valve) CPAP circuit, unrestricted spontaneous breathing can be integrated and can happen any time regardless of the ventilator cycle. If the patient has no spontaneous respiratory effo, APRV becomes typical to 'inverse ratio pressure'-limited, 'time cycle'-assisted mechanical ventilation (pressure-controlled ventilation).
|
Anaesthesia
|
JIPMER 2018
|
APRV stands for:
A. Adult pressure release ventilation
B. Airway pressure release ventilation
C. Air pressure reverse ventilation
D. Airway pressure reduction ventilation
|
Airway pressure release ventilation
|
0318cf9e-6caa-44bf-adc1-7ffffc839050
|
Transvaginal ultrasound Diagnosis of Ectopic pregnancy Pregnancy is definitely diagnosed by demonstrating intrauterine sac. - A normal intrauterine sac appears regular and well defined on ultrasound. So ectopic pregnancy can be diagnosed by demonstrating the absence of the intrauterine sac. In a woman in whom ectopic pregnancy is suspected because of pain, bleeding and positive pregnancy test, performance of vaginal sonography is the logical first step. If the sonography demonstrates live intrauterine fetus then ectopic pregnancy is extremely unlikely. Alternatively if the uterus is empty, an ectopic pregnancy can be diagnosed based on the visualization of an adnexal mass separate from the ovaries. 3-hCG hormones also play an impoant role in the diagnosis of pregnancy. fi HCG is a hormone secreted during pregnancy. It is positive in viually 100% of ectopic pregnancies. However, a positive test only confirms pregnancy and does not indicate whether it is intrauterine or extrauterine. In normal pregnancy pHCG should double up every 2 days but in ectopic pregnancy the rate of increase of fl hCG is slow. 13 hCG litres and ultrasound complement one another in detecting ectopic pregnancy and have led to earlier detection. By correlating fl hCG titres with ultrasound .findings an ectopic pregnancy can often be differentiated.from intrauterine pregnancy. An intrauterine sac should be visible by transvaginal ultrasound when the p hCG is approximately 1000 ml p/m1 and by transabdominal ultrasound approximately 1 week later when the fi hCG is 1800-3600 ?nip/int. Thus when an empty uterine cavity is seen with a 13 hCG litre above this threshold, the patient is likely to have an ectopic pregnancy. An empty cavity is less of a concern when a fihCG below this threshold is obtained. Serum progesterone measuremen A single measurement of serum progesterone may sometimes clarify the diagnosis when ectopic pregnancy is suspected, but Its accuracy is crude and the customary thresholds are < 5 ng/m and > 25 'tend. i.e.a value exceeding 25 ng/m1 excludes ectopic pregnancy with 97.5% sensitivity, value below 5 ng/ml occur in only .3 percent of normal regnancies. So normal pregnancies can be excluded if the progesterone level is below 5%. Surgical diagnosis of ectopic pregnancy :- Laparoscopy Direct visualization of the ,fallopian tubes and pelvis by diagnostic laparoscopy offers a reliable diagnosis in most cases of suspected ectopic pregnancy and a ready transition to definitive operative therapy. At times, identification of an early unruptured tubal pregnancy may be difficult even if the tube is .fully visualized. Inspite of the low morbidity and quick recovery time, laparoscopy usually is performed when, on the basis of noninvasive test or curettage results, the diagnosis of ectopic pregnancy is fairly ceain and medical therapy is not planned. In these cases laporoscopy is used both for therapeutic and diagnostic purpose. Laparotomy Open abdominal surgery is preferred when the woman is hemodynamically unstable or when laparoscopy is not feasible. Laparotomy should not be delayed while laparoscopy is performed in a woman with obvious abdominal hemorrhage that required immediate definitive treatment. Culdocentesis Culdocentesis is the transvaginal passage of a needle into the posterior cul-de-sac in order to determine whether free blood is present in the abdomen. This procedure is useful in the diagnosis of intraperitoneal bleeding. This procedure will reveal nonclotting blood if intra-abdominal bleeding has occurred. If culdocentesis is positive, laparoscopy or laparotomy should be performed immediately. Indeed, some argue that the main purpose of culdocentesis is, not in diagnosis but to better prioritize patients so that those with positive culdocentensis are taken immediately to the operating room. More on imaging procedures used in the diagnosis of ectopic pregnancy Vaginal sonography There has been much improvement in the early diagnosis of ectopic pregnancy using vaginal sonography. Its use results in earlier and more specific diagnosis of uterine pregnancy than abdominal sonography and it has become the imaging method of choice in early pregnancy. Abdominal sonography:- Id entification of pregnancy products in the fallopian tube.
|
Gynaecology & Obstetrics
| null |
Most sensitive diagnosis test for ectopic pregnancy
A. Transvaginal USG
B. Culdocentesis
C. MRI
D. Serial monitoring of (-HCG
|
Transvaginal USG
|
28699e4e-9ee9-4ce2-9dd9-b5a73a1c126c
|
(B) 1,00,000 live births # Maternal mortality rate (MMR) - number of maternal deaths per 1,00,000 women of reproductive age per year. In India it is about 120 as compared to 0.5 of United States.
|
Social & Preventive Medicine
|
Miscellaneous
|
Maternal mortality rate (MMR) is defined as - Number of maternal deaths per
A. 1000 live births
B. 1,00,000 live births
C. 10,000 live births
D. 100 live births
|
1,00,000 live births
|
21e05b83-126a-40d2-addd-9553f88c2868
|
Answer is D (Ureteroscopic Retrieval) : The patient in question has a small calculus (1.0 cm) in size, which is located in the distal ureter and hence is amenable to ureteroscopic removal. The presence of proximal hydroureteronephrosis indicates obstruction and forms- the indication for clone removal. Indications and mahods for removal of stone Indications for stone removal Repeated attacks of colic Stone is too large to pass Stone is enlarging Stone is not moving Stone is causing complete obstruction of the kidney Urine is infected Ureteroscopic Removal Small stone Stone in lower pa of ureter within 5-6 cm of ureteric orfice Extracorporal shock wave Lithotripsy Best for proximal stones that can be identified by the imaging system of Lithotriptor Stones in miduretor can be pushed up in the pelvis and then exposed to shock waves Not appropriate if complete obstruction is present Stones < 2.0 to 2.5 cm can be removed Percutaneous Nephrolithotripsy It is done for proximal ureteric cacluli Stones > 2.5 cm, those that are resistant to shock waves Open Surgery is done very rarely nowadays when all methods have failed, Urethrolithotomy is done for long standing calculi not accessible by instruments and ESWL.
|
Medicine
| null |
A 10-mm calculus in the right lower ureter associated with proximal hydroureteronephrosis is best treated with:
A. Extracorporeal shockwave lithotripsy
B. Antegrade percutaneous access
C. Open ureterolithotomy
D. Ureteroscopic retrieval
|
Ureteroscopic retrieval
|
1e9135cf-580c-45d7-8cf6-9e4067d02687
|
HIV may pass from infected mother to foetus through placenta or to her infant during delivery. In absence of any intervention rate of this vary from 20-25%. Reference; Park&;s Textbook of preventive and social medicine, 24th edition.Pg no. 364
|
Social & Preventive Medicine
|
Communicable diseases
|
Mother to child transmission of HIV -
A. 25%
B. 50%
C. 60%
D. 75%
|
25%
|
e052c61c-1d33-4c8a-a2db-8971d4f8dbb2
|
Ans. C. Stein-Leventhal syndromeAndrogenetic Alopecia (Male pattern; Female pattern): AssociationsIn women, features of hyperandrogenism may be present inthe form of hirsutism, acne & clitoromegaly.Always rule out polycystic ovary disease (PCOD).Stein-Leventhal syndrome, also called polycystic ovary syndrome (PCOS)Myxedema:Hair texture may become fine, and a diffuse alopecia occurs in up to 40% of patients, persisting for months after restoration of euthyroidism.
|
Skin
| null |
Androgenic alopecia in female is caused by:
A. Myxedema
B. Cushing disease
C. Stein-Leventhal syndrome
D. Addison's disease
|
Stein-Leventhal syndrome
|
54c86dae-c36b-444f-a798-c320f2c4224a
|
Ans. is b i.e. Fetal Hb Ref. Dutta Obs. 6/e, p 247-248: Williams Obs. 23/e, p 583, 584; Text book of Ohs. by Sheila Balakrishnan, p 167-168 Fetal hemoglobin can be distinguished from Adult hemoglobin by : Wright stain : On staining blood with wright stain if RBC's appear nucleateddeg the blood is of fetal origindeg. Singers alkali denaturation test : It is based on the fact that fetaldeg hemoglobin is more resistant to alkali denaturationdeg. Test -- Blood + Sodium hydroxide/ Potassium hydroxide
|
Gynaecology & Obstetrics
| null |
Singers Alkali denaturation test is done with :
A. Maternal Hb
B. Fetal Hb
C. Amniotic fluid
D. Menstrual fluid
|
Fetal Hb
|
2684e3a2-908b-4611-8d66-f83b02aefb7a
|
Left Atrial hypertrophy is never seen in ASD.
|
Pediatrics
| null |
NOT a feature of Atrial Septal defect among the
following
A. Complications include Left Atrial hypertrophy
B. Complications due to ASD are of late onset
C. Most Common Congenital heart disease presenting in Adult age
D. Wide fixed Split in 2nd heart sound
|
Complications include Left Atrial hypertrophy
|
37ab5b85-534f-4346-a1d7-efc2e842b981
|
Ans. is 'b' i.e., Tetracycline Drugs causing Pseudotumour cerebri o A miodarone o Mineralocoicoids (withdrawl) o Oral contraceptives o Glucocoicoids (withdrawl) o Hypervitaminosis A o Tetracyclines o Quinolones
|
Pharmacology
| null |
Which of the following drug causes Pseudotumour cerebri -
A. Sparfloxacin
B. Tetracycline
C. Gentamicin
D. Clofazimine
|
Tetracycline
|
c9856ac9-7380-4d33-8534-94e7b9286034
|
Ans. is 'a' i.e., Umami o Umami a savory taste s one of the five basic tastes (together with sweetness, sourness, bitterness, and saltiness)o People taste umami through receptors specific to glutamate. Glutamate is widely present in savory foods, such as meat broths and fermented products, and commonly added to some foods in the form of monosodium glutamate (MSG) Since umami has its own receptors rather than arising out of a combination of the traditionally recognized taste receptors, scientists now consider umami to be a distinct taste
|
ENT
|
Oral Cavity
|
Last taste sensation discovered is-
A. Umami
B. Sweetness
C. Bitter
D. Sour
|
Umami
|
8278cf0b-929c-4cd8-a6fd-74455817cb6b
|
Ans. C: LithiumLithium has been the drug of choice for the treatment of maniac episode (acute phase) as well as for prevention of fuher episodes in bipolar mood disorder.It has also been used in the treatment of depression with less success.Lithium needs to be closely monitored by repeated blood levels, as the difference between the therapeutic (0.8-1.2 mEq/ L) and lethal blood levels (more than 2.5-3.0 mEq/1) is not very wide (narrow therapeutic index).
|
Psychiatry
| null |
Estimation of serum levels is impoant for which of the following drug: September 2009
A. Haloperidol
B. Benzodiazepines
C. Lithium
D. Chlorpromazine
|
Lithium
|
8ccd2c54-04c1-4c2b-a183-313b9ab08442
|
Best's disease is an autosomal dominant disorder with variable penetrance and expressivity. Bassen-Kornzwig disease is an autosomal recessive inherited disorder of lipoprotein metabolism. Gyrate atrophy is an autosomal recessive dystrophy with peripheral choroidal degeneration. Laurence-Moon-Biedle syndrome is also inherited in autosomal recessive manner. Best's disease: It is caused by a mutation in the BEST1 (VMD2) gene, which encodes a transmembrane calcium-sensitive chloride channel (bestrophin) expressed in retinal pigment epithelium. Fundus examination ranges from a mild pigmentary disturbance within the fovea to the typical vitelliform or "egg yoke" lesion located in the central macula. Visual acuity is good and electro retinogram is normal. An abnormal electro-oculogram (EOG) is the hallmark of the disease. Ref: Vaughan & Asbury's General Ophthalmology, 18 Edition, Chapter 10
|
Ophthalmology
| null |
Which of the following disease shows autosomal dominant pattern of inheritance?
A. Best's disease
B. Bassen-Kornzwig disease
C. Gyrate atrophy
D. Laurence-Moon-Biedle syndrome
|
Best's disease
|
cee122fe-00ea-44b4-827a-1c853428e7c9
|
Speed of rabies virus progress in axon is 250 mm/day.
|
Microbiology
| null |
Speed of rabies virus progress in axon is
A. 100 mm/day
B. 150 mm/day
C. 200 mm/day
D. 250 mm/day
|
250 mm/day
|
44ae8dc4-a0d5-4740-8db3-acf1d4a8dfc0
|
Propofol is considered the anaesthesia of choice for day care surgery (out patient surgery) as induction is smooth & pleasant and recovery is rapid.
|
Anaesthesia
| null |
A 20 year old patient presented with early pregnancy for Medical termination of Pregnancy (MTP) in day care facility. What will be the anaesthetic induction agent of choice ?
A. Thiopentone
B. Ketamine
C. Propofol
D. Diazepam
|
Propofol
|
e1bbae1b-272d-4e0b-86a5-5cc959467cdf
|
Ans. is 'a' i.e., 8 year o precocious puberty is defined as appearence of secondary' sexual character before 8 year of age in girl and 9.5 year of age (Nelson says 9 year) in bodys.o Thelarche = Isolated breast development.o Premature, Pubarche/Adrenarche - Appearance of sexual hair before age of 8 year in girl and before 9 year is boys without other evidence maturation.o Premature menarche - Isolated uaginal bleeding in the absence of other secondary sexual charater.
|
Pediatrics
|
Gonads
|
Precocious puberty in girl age limit -
A. 8 year
B. 10 year
C. 9 year
D. 11 year
|
8 year
|
1042a01c-0d86-4e71-a39b-127cda205584
|
Ans: a (Ceftriaxone) Ref: Tripathi, 6th ed, p. 706 10th ed, p. 735- Ceftriaxone has a long duration of action with half life of 8 hrs- Ceftazidime has half life of 1.5-1.8 hrs- Cefaperazone has half life of 2 hrs- Cefotaxime has half life of 1 hrFirst-generation cephalosporinsThird- generation cephalosporinsCefadroxil (PO)Cefotaxime (IV)Cephalexin (PO) Cephradine (PO)Ceftazidime (IV)Cefazolin (IV)Ceftriaxone (IV) Ceftizoxime (IV) Cefoperazone (PO)Second-generation cephalosporinsCefixime (PO)Cefoxitin (IV)Cefpodoxime proxetil (PO)Cefotetan (IV)Cefdinir (PO)Cefuroxime (TV)Ceftamet pivoxil (PO)Cefuroxime axetil (PO) Fourth-generation cephalosporins Cefepime (IV) Cefpirome (IV)Cephalosporins are not active against enterococci and L monocytogenes.Cefazolin penetrates well into most tissues. It is a drug of choice for surgical prophylaxisCeftriaxone and cefotaxime are the most active cephalosporins against penicillin-resistant strains of pneumococci and are recommended for empirical therapy of serious infections that may be caused by these strains.Cephalosporins that contain a methylthiotetrazole group (e.g., cefamandole, cefmetazole, cefotetan, cefoperazone) frequently cause hypoprothrombinemia and bleeding disorders
|
Pharmacology
|
Anti Microbial
|
Longest acting cephalosporin:
A. Ceftriaxone
B. Ceftazidime
C. Cefoperazone
D. Cefotaxime
|
Ceftriaxone
|
449d6278-3734-4fcb-b39c-9608781cfd7c
|
Answer is A (Hemochromatosis):The association of Ahritis, hyperpigmentation of skin and hypogonadism suggests the diagnosis of hematochromatosis.
|
Pathology
| null |
A patient presents with Ahritis, hyperpigmentation of skin and hypogonadism, likely diagnosis is.
A. Hemochromatosis
B. Ectopic ACTH secreting tumour of the lung
C. Wilson's disease
D. Rheumatoid ahritis
|
Hemochromatosis
|
50541e9a-5ee0-459a-8200-ded914091ec7
|
Most common causes of transverse lie are:
Multiparity
Preterm fetus
Abnormal uterine anatomy
Hydramnios
Contracted pelvis.
|
Gynaecology & Obstetrics
| null |
Which among the following is common cause for transverse lie
A. Prolonged labor
B. Nulliparity
C. Placenta previa
D. Oligohydramnios
|
Placenta previa
|
898f5c02-ffcb-4aac-aac8-409048aa962a
|
The adult worms live in the small intestine of infected persons mostly in the jejunum,less often in the duodenum, and infrequently in the ileum Ref : panikers textbook of Medical parasitology 8th edition page 187
|
Microbiology
|
parasitology
|
Habitat of hookworm is -
A. Jejunum
B. ileum
C. Colon
D. Duodenum
|
Jejunum
|
496777c1-edc5-4c03-8944-017e8e8c180b
|
The risk is higher in patients with disseminated DLE (22%) than in DLE confined to the head and neck (1.2%). Females developing DLE before the age of 40 years,with HLA-B8 in their histocompatibility type, have an increasedrisk of 'conveing' to SLE. Neither immunological nor biochemical abnormalities appear to alter the patient's progress. Note: Carpet tack/tin tack sign is positive in DLE lesions. Ref: Rook's textbook of dermatology, Edition-8, Page 51.20.
|
Skin
| null |
What is the percentage of patients with disseminated discoid lupus erythematosus who develop SLE?
A. 2%
B. 22%
C. 52%
D. 82%
|
22%
|
a1f4617e-e66a-4bb5-b06d-d47f38f18675
|
-family is a group of biologically related individuals living together and eating from a common kitchen. - the stage of contraction of family begins when the first child leaves the home and ends when the last child leaves the home of parents. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no:683 <\p>
|
Social & Preventive Medicine
|
Social science, Mental health & Genetics
|
Stage of contraction of family stas at -
A. Marriage
B. Bih of fis child
C. Bih of last child
D. Leaving home of first child
|
Leaving home of first child
|
0eca62d8-81e5-41d3-b142-9db95b800726
|
"Fouh power law" of radius ~ Blood flow varies directly and resistance inversely with the fouh power of the radius (r 4). If the radius is changed by a factor of 3 (reduced by 1/3rd), resistance would change by (34).
|
Physiology
|
Cardiac Output
|
A 60-year old patient underwent renal aery doppler which shows narrowing and turbulence in right renal aery. If radius of the aery is reduced by 1/3rd, resistance to blood flow in right kidney would have increased by:
A. 3 times
B. 9 times
C. 16 times
D. 81 times
|
81 times
|
d57c5949-9c7d-4526-9faa-731c315ce487
|
Etiology of minimal change ds is unknown. Electron microscopy reveals the primary injury to the visceral epithelial cells, which may be caused by:- A) immunological mechanism: Lack of immune deposits in the glomerulus exclude the possibility of immune complex mechanism. But several features suggest immunological mechanisms like 1.H/o respiratory infection or routine prophylactic immunization 2.dramatic response to coicosteroids 3.asscoiated with allergies or atopic disorder 4.increased incidence in Hodgkin&;s lymphoma patient s. Immune dysfn _>increased cytokine production_these damage visceral epithelial cells _ increase glomerular permeability _proteinuria B) Non-immunological mechanism:- 1.mutations in structural proteins -nephrin(found in congenital nephrotic syndrome -Finnish type)& podocin. MCD is accompanied by loss of glomerular polyanions on GBM. Defects in charge barrier allows selective proteinuria-albumins. Ref: General and systemic pathology -Ramadas Nayak-First edition -page no: 521
|
Physiology
|
Renal physiology
|
The main cause of minimal change ds is
A. Increase in pore size
B. Loss of negative charge on membrane
C. Loss of cells
D. Decreased circulation
|
Increase in pore size
|
4cb20df6-6726-4827-921a-ce3be9fccf96
|
MTP act 1971, provides safeguards to the mother by authorizing only a Registered Medical Practitioner having experience in gynecology and obstetrics to perform aboion where the length of Pregnancy does not exceed 12 weeks Where the pregnancy exceeds 12 weeks and is not more than 20 weeks, the opinion of two Registered Medical Practitioners is necessary to terminate the pregnancy Reference : Park&;s textbook of preventive and social medicine, 23rd edition, Page no: 506
|
Social & Preventive Medicine
|
Demography and family planning
|
MTP can be done upto
A. 12 weeks
B. 16 weeks
C. 20 weeks
D. 10 weeks
|
20 weeks
|
b90f8bf7-e2a6-43c1-97ed-107aee9d4f58
|
A developmental assessment for children under age 3 is an attempt to assess various aspects of the child's functioning, including areas such as cognition, communication, behavior, social interaction, motor and sensory abilities, and adaptive skills. Assessment of the family and the child's environment also provides important contextual information.
Topics covered in this section
This section covers the basic aspects of the general developmental assessment for young children with suspected developmental problems including possible autism. This section focuses on the general approach to the developmental assessment, including some specific components of such an assessment, but does not review information on specific autism assessment instruments.
Basis for guideline recommendations about the general developmental assessment
In the previous section on the use of autism assessment instruments, the guideline recommendations are based on the panel's interpretation of an extensive and systematic review of the scientific literature. The panel did not attempt to systematically evaluate the research evidence on effectiveness of the general developmental assessment methods discussed in this section as this was considered outside the specific scope of the guideline. Therefore, guideline recommendations in this section are based on the consensus opinion of the panel, using its collective knowledge and experience in assessing children with autism. In the panel's opinion, these recommendations reflect appropriate practices for assessing children with possible autism and are generally consistent with the scientific knowledge in this field.
|
Pediatrics
| null |
What is the age limit for further developmental assessment in a child not reaching for objects
A. 3 months
B. 5 months
C. 9 months
D. 12 months
|
9 months
|
e4231175-b118-40d6-bbe8-5de9df79d407
|
Ans. is 'a' i.e., Pyrrolizidine Endemic ascites o Endemic ascites is caused by a hepatotoxin - pyrralizidine alkaloid found in weed seeds of Crotolariu (Jhunjhunia). o These weed seeds of Jhunjhunia contaminate the millet seeds Panicum ',Ware (locally k/a Gondhli) o Endemic ascites presented in Sarguja district of Madhya Pradesh during 1973 & 1976 as outbreak of rapidly developing ascites and jaundice with high moality. Preventive measures Educating the people Deweeding of Jhunjhunia plants which grow along with the staple food-millet. o Sieving to separate out the Jhunjhunia seeds from millet seeds.
|
Social & Preventive Medicine
| null |
Endemic ascites is associated with the following ?
A. Pyrrolizidine
B. Aflatoxin
C. Sanguinarine
D. Beta oxalylamino alanine (BOAA)
|
Pyrrolizidine
|
7755315d-9b53-4c50-867c-0c0bd6ef74d7
|
Ans. is 'd' i.e., Presbyacusis Tinnitus Tinnitus is ringing sound or noise in the ear. The characteristic feature is that the origin of this sound is within the patient.
|
ENT
| null |
Not a cause of objective tinnitus ?
A. Palatal myoclonus
B. Glomus tumor
C. Carotid aery aneurysm
D. Presbyacusis
|
Presbyacusis
|
0b33904a-fd44-41a6-9c59-5baa7e78bc3a
|
Hexose sugar is present in:Glucose, "blood sugar", the immediate source of energy for cellular respirationGalactose, a sugar in milk (and yogu), andFructose, a sugar found in honeyRibose is a pentose sugar
|
Biochemistry
| null |
Hexose sugar is not present in:
A. Ribose
B. Glucose
C. Fructose
D. Galactose
|
Ribose
|
5c0306f9-b903-4411-b1d9-276502aa404d
|
Ans. Central posterior subcapsular lens changes
|
Ophthalmology
| null |
The early changes in coicosteroid-induced cataract are in the form of:
A. Central posterior subcapsular lens changes
B. Anterior coical lens changes
C. Nuclear changes
D. Diffuse lens changes
|
Central posterior subcapsular lens changes
|
61a0c6fc-cb12-422b-ae4e-53a40784216a
|
Ans. is 'c' i.e., Coal dust * Anthracosis- Coal dust* Silicosis- Silica* Siderosis- Iron* Byssinosis- Cotton dust (textile industry)* Farmer's lung- Hay or grain dust (micropolyspora faeni)* Sequousis- Moldy red wood saw dust* Suberosis- Moldy cork dust* Detergent workers lung- Enzyme additives* Baggassosis- Sugarcane dust (thermoactinomyces sacchari)
|
Social & Preventive Medicine
|
Occupational Health
|
Anthracosis is caused by -
A. Silica
B. Iron
C. Coal dust
D. Cotton dust
|
Coal dust
|
b7495466-d23f-4582-a6ee-d617fc00cf42
|
Pseudocholinesterase which metabolizes succinylcholine is synthesized by liver and is present in plasma. True cholinesterase which metabolizes acetylcholine is synthesized by muscle end plate. Ref: KD Tripathi 8th ed.
|
Pharmacology
|
All India exam
|
Pseudocholinesterase is synthesized by
A. Liver
B. Plasma
C. Muscle end plate
D. Nerve ending
|
Liver
|
c8a5c699-9bd4-4c35-95bd-771316484501
|
The transverse process of cervical veebrae is pierced by a foramen called foramen transversarium. It is not seen in thoracic and lumbar veebrae.Ref: Human Anatomy, B D Chaurasia, 4th Edition, Volume 3, Chapter 1, Page 40, 41; Textbook of Anatomy with Colour Atlas, Inderbir Singh, 4th Edition, Chapter 6, Page 84.
|
Anatomy
| null |
The difference between a typical cervical and thoracic veebrae is, which of the following:
A. Has a triangular body
B. Has a foramen transversarium
C. Superior aicular facet directed backwards & upwards
D. Has a large veebral body
|
Has a foramen transversarium
|
b6f76302-1666-43f3-9aa4-bb76433a7165
|
In adults decreased pituitary function is first shown by hypogonadism.
|
Medicine
| null |
Most common presenting feature of adult hypopituitarism is
A. Hypothyroidism
B. Hypogonadism
C. Addison’s disease
D. Hyperprolactinemia
|
Hypogonadism
|
95345767-4fb6-4816-8f1c-77fd6160a96b
|
(c) C* Point A marks the entry of infectious agent into the host* Point B marks the subclinical phase where symptoms and signs are not visible, but the disease agent induces tissue and physiological changes* Point C marks the Clinical horizon when symptoms and signs appear* Point D is present inside the Clinical phase after the Clinical horizon.ALSO REMEMBERNATURAL HISTORY OF DISEASE* Prepathogenesis phase* Pathogenesis phase:Begins with the entry of disease agent into the hostFinal outcome of the disease may be Recovery, Disability or DeathPathological changes are essentially below the level of Clinical horizonClinical stage begins when signs and symptoms appear
|
Social & Preventive Medicine
|
Concept of Health and Disease
|
Which point in the below natural history of disease marks the onset of symptoms?
A. A
B. B
C. C
D. D
|
C
|
fa486197-aa01-4961-9b8b-7db900d6170d
|
Schwannoma are well circumscribed encapsulated masses that abut the associated nerve without invading it
|
Anatomy
|
General anatomy
|
Verocay bodies are seen in
A. Memingioma
B. Hemangioma
C. Glioma
D. Shwannoma
|
Shwannoma
|
3895ac37-67b2-4e84-9dda-8b7c1a0bff91
|
Coicospinal fibers pass through the Medullary Pyramid Extra edge Tracts Function Lateral coicospinal and rubrospinal tracts Control distal limb muscles for fine motor and skilled voluntary movements. Anteriorcoicospinal tract and tectospinal, reticulospinal, and vestibulospinal tracts Control the postural adjustments and gross movements
|
Physiology
|
Nervous System
|
The fibers of the coicospinal tract pass through which structure?
A. Medial lemniscus
B. Medullary pyramid
C. Posterior funiculus
D. Medial longitudinal fasciculus
|
Medullary pyramid
|
da757b01-796d-4acf-8a72-884d1780659a
|
Ans. is 'd' i.e., SSPE o Subacute sclerosing panencephalitis (SSPE) is a rare complication of measles, which develops many years after the initial infection - PSM
|
Social & Preventive Medicine
| null |
Which of the following is the "Least common" complication of measles -
A. Diarrhoea
B. Pneumonia
C. Otitis media
D. SSPE
|
SSPE
|
a7d4c018-7c68-4747-9cd5-b87b5d220cfa
|
EQUIVALENT (RADIATION-WEIGHTED) DOSE:
The equivalent dose (HT) is used to compare the biologic effects of different types of radiation on a tissue or organ. Particulate types of radiation have a high LET and are more damaging to tissue than radiation with low LET, such as x rays. This relative biologic effectiveness of different types of radiation is called the radiation-weighting factor (WR).
The unit of equivalent dose is the sievert (Sv). For diagnostic x-ray examinations, 1 Sv equals 1 Gy.
The traditional unit of equivalent dose is the rem (roentgen equivalent man); 1 Sv equals 100 rem.
Oral Radiology, Principles and Interpretation / Stuart C. White, Michael J. Pharoah - 7th ed - pg - 15
|
Radiology
| null |
Which of the following facilitates comparison between different radiations?
A. Rad
B. Rem
C. Quality factor exposure
D. Roentgen
|
Rem
|
cf780ade-30c3-4c43-b56f-0608bdf588f1
|
Head circumference:-
Measured with a nonstretchable tape passing through the maximum point of occipital protuberance posteriorly and at a point just above the glabella anteriorly.
Head circumference must be compared with that of mother to know any familial variations.
If the head circumference is more than expected, always measure the both parents' head circumference, for benign familial megalencephaly is common.
At birth , it is around 34 cm.HC increases 2cm/ month for the first 3 months, 1cm/month for next three months and 0.5 cm per month for next 6 months.
|
Pediatrics
| null |
Mean head circumference at birth is
A. 48-51 cm
B. 38-40 cm
C. 42-45 cm
D. 33-35 cm
|
33-35 cm
|
54d581fc-bc92-40d3-a5ef-ece8727c42bc
|
Streptococci are catalase negative and beta hemolytic. Group A beta hemolytic streptococci can be differentiated from other beta hemolytic streptococci by bacitracin sensitivity. Streptococcus pyogenes is bacitracin sensitive whereas streptococcus agalactiae is bacitracin resistant. Both are beta hemolytic. Ref: Textbook of Microbiology, Ananthanarayan and Paniker, 7th Edition, Chapter 23, Page 203-205.
|
Microbiology
| null |
A farmer presents with pustules, which show Gram Positive Cocci on smear. Culture shows Beta hemolysis, and organisms are Catalase negative. To show that the identified organism is group A streptococci, which of the following test should be done?
A. Bacitracin sensitivity
B. Optochm sensitivity
C. Novobiocin sensitivity
D. Bile solubility
|
Bacitracin sensitivity
|
54384581-7d62-408c-9730-d87c55509823
|
Ref-KDT 7/e p108 Pyridostigmine acts for 3 to 6 hours as compared to 0.5 to 2 hourshours dur of action of neostigmine. It is less impoant than neostigmine Rest of the propeies are similar to neostigmine
|
Anatomy
|
Other topics and Adverse effects
|
Which of the following propeies make pyridostigmine different from neostigmine
A. It is more potent
B. It is longer acting
C. It produces less muscarinic side effects
D. It does not have any direct action on NM receptor
|
It is longer acting
|
043c2c51-76e1-4dbb-8ffa-78dcaffc2822
|
SSRIs are the drugs of choice for OCD. However, amongst the given options no drug is SSRI. Amongst the tricyclic antidepressants, clomipramine is the DOC.
|
Psychiatry
| null |
Drug of choice for obsessive - compulsive neurosis is :
A. Imipramine
B. CPZ
C. Carbamazapine
D. Clomipramine
|
Clomipramine
|
b3b5bce1-8db9-4b8c-a18b-2d9be31bd647
|
Ref: R Alagappan - Manual of Practical Medicine 4th Edition.pg no:184 ECG * May be normal initially and hence serial ECGs must be taken. * ST elevation and T-wave inversion with pathological Q-waves are typically seen in leads adjacent to the infarcted segment of myocardium. * Reciprocal ST depression or T-wave inversion in opposite leads. * A non-Q-wave infarct may occur and has a high risk of moality (as they are prone to develop dangerous arrhythmias and recurrent angina).
|
Medicine
|
C.V.S
|
What is diagnostic of fresh myocardial infarction In ECG-
A. QT interval prolongation
B. Pmitrale
C. ST segment elevation
D. ST segment depression
|
ST segment elevation
|
f512f87a-1215-49c1-b781-5c2f12b9d317
|
Ans. is `d i.e., AndrogensThe adrenal coex is divided into three zones (outer to inner) : Zona glomerulosa, zona fasciculata and zona reticularis.All three coical zones secrete coicosterone, but the active enzymatic mechanism for aldosterone biosynthesis is limited to the zona glomerulosa whereas the enzymatic machanisms for forming coisol and sex hormones are found in the two inner zones. Fuhermore, subspecialization occurs within the inner two zones, the zona fasciculata, secreting mostly glucocoicoids and the zona reticularis secreting mainly sex hormones.
|
Physiology
| null |
Major hormone secreted by zona reticularis of adrenal coex ?
A. Glucocoicoids
B. Mineralcoicoids
C. Aldosterone
D. Androgens
|
Androgens
|
cb85e971-03f7-4a50-84d9-cf0a30ce19b9
|
Ans. is 'a' i.e., Theophylline o Theophylline has low safety margin and therefore requires therepeutic drug monitoring.
|
Pharmacology
| null |
Which drug used in bronchial asthma needs monitoring-
A. Theophylline
B. Cromoglycate
C. Salmeterol
D. Terbutaline
|
Theophylline
|
ffb2c29d-89a1-43d0-aa44-ecd7f7ec71a4
|
*Lymphomas are divided broadly into Hodgkins and Non-Hodgkin&;s lymphomas. *Two-thirds of Non-Hodgkin&;s lymphoma present as generalized lymphadenopathy(Nodal sites).*One third of the cases present at an extranodal site. *Extra nodal sites include the gastrointestinal tract, upper aerodigestive tract, salivary glands, eye, mediastinum, lung, pleura, hea, spleen, liver etc. *The most common extranodal site is gastrointestinal tract, in which stomach is involved most often.
|
Pathology
|
Haematology
|
The most common extranodal site for non-hodgkin lymphoma is
A. Stomach
B. Brain
C. Intestine
D. Tonsils
|
Stomach
|
244e0aee-c262-4d75-8492-052e3ed61a08
|
Most common cause of childhood blindness is vitamin A deficiency Refer: Khurana 6th edition page number 382
|
Ophthalmology
|
Conjunctiva
|
Blindness in child is most commonly due to
A. Keratomalacia
B. Congenital cataract
C. Glaucoma
D. Injuries
|
Keratomalacia
|
854d6a1f-7def-4e0c-91af-9d0598ffa837
|
Ans. is 'c' i.e., Leaving home of first child
|
Social & Preventive Medicine
| null |
Stage of contraction of family stas at
A. Bih of first child
B. Bih of last child
C. Leaving home of first child
D. Marriage
|
Leaving home of first child
|
340f6da5-592b-4811-8671-e398e2a2c1f0
|
Phelp's sign Phelp sign This sign is seen on CT scan In CT- in case of glomus jugulare tumor the normal crest between the carotid canal and jugulare tumor is absent whereas it is not so in case of glomus tympanicum
|
ENT
| null |
Phelp's sign is seen in:
A. Glomus jugulare
B. Vestibular Schawannoma
C. Maniere's disease
D. Neurofibromatosis
|
Glomus jugulare
|
f9761f0f-021c-4957-bcb3-78a142129d47
|
Ref-KDT 6/e p40 Drugs acting and ionotropic receptor are fast acting where as those acting through nuclear receptors are slowest in action
|
Anatomy
|
Other topics and Adverse effects
|
Fastest acting receptor/transduction mechanism is
A. Adenylyl cyclase-cyclic AMP pathway
B. Phospholipase C-IP3:DAG pathway
C. Intrinsic ion channel operation
D. Nuclear receptor
|
Intrinsic ion channel operation
|
be8e8af2-8e56-40eb-803e-e3ab7f5702e8
|
C i.e. Indeterminate leprosy Points in our of diagnosing indeterminate leprosy: - Epidermal atrophyQ Non scaly & AnesthesiaQ (if present) Resident of high leprosy prevelence state? (Bihar)
|
Skin
| null |
A boy comes from Bihar with non-anesthetic hypopigmented atropic patch over face, diagonosis is
A. P. alba
B. P. versicolour
C. Indeterminate leprosy
D. Borderline leprosy
|
Indeterminate leprosy
|
2cff24a9-c1ec-47f8-bb2f-fe509bf38f2a
|
Ans. A Middle meningeal arteryRef: Netter's Clinical Anatomy, 3rd ed. pg. 460Structures transmitted via foramen ovale (M.A.L.E.)* Mandibular nerve-V3* Accessory meningeal artery* Lesser petrosal nerve* Emissary veinExtra edgeForamen rotundumMaxillary nerve V2Foramen LacerumInternal carotid arteryLesser petrosal nerveGreater petrosal nerveDeep petrosal nerveForamen spinosumMiddle meningeal arteryNervus spinosus (Meningeal Branch of mandibular nerve)Posterior trunk of middle meningeal veinCarotid canalInternal carotid arteryVenous and sympathetic plexus around the arterySince lots of questions are asked on the topic of base of skull, students are expected to memorise this diagram by drawing it yourself.
|
Anatomy
|
Neuroanatomy
|
Which structure is not transmitted by foramen ovale?
A. Middle meningeal artery
B. Accessory meningeal artery
C. Lesser petrosal nerve
D. Emissary vein
|
Middle meningeal artery
|
1a1fcb41-b8f9-42f8-b9bd-96117a390543
|
Ans. C: Heat sensationLateral spinothalamic tract carries fibers of all type of pain and temperature impulses (both hot and cold)Spinothalamic tractIt transmits information to the thalamus about pain, temperature, itch and crude touch.The pathway decussates at the level of the spinal cord, rather than in the brainstem like the posterior column-medial lemniscus pathway and coicospinal tract.Posterior column-medial lemniscus pathway/dorsal column-medial lemniscus pathway/dorsal white column-medial lemniscus systemIt is the sensory pathway responsible for transmitting fine touch, vibration and conscious proprioceptive information from the body to the cerebral coex as well as tactile pressure, barognosis, graphesthesia, stereognosis, recognition of texture, kinesthesia and two-point discrimination.The name comes from the two structures that the sensation travels up: the posterior (or dorsal) columns of the spinal cord, and the medial lemniscus in the brainstem.Because the posterior columns are also called dorsal columns, the pathway is often called the dorsal column-medial lemniscus system, or DCML for sho. (Also called posterior column-medial lemniscus or PCML pathway).The PCML is pathway is composed of rapidly conducting, large, myelinated fibersThe pathway is tested with the Romberg's test.Lesions to the posterior column-medial lemniscus pathway below the decussation of its fibers produce loss of sensation on the same side of the body as the lesion.Above the decussation produces loss of sensation on the opposite side of the body than the lesion
|
Physiology
| null |
Which of the following is not carried in dorsal column of spinal cord:March 2011
A. Proprioception
B. Vibratory sense
C. Heat sensation
D. Touch
|
Heat sensation
|
0623f75b-d859-4c1b-972b-e737be8445ea
|
Identification of modifiable risk factors provides a crucial approach to the prevention of dementia.. The findings are consistent with moderately raised plasma total homocysteine (>11 mmol/L), which is common in the elderly, being one of the causes of age-related cognitive decline and dementia Ref Harrison20th edition pg 2445
|
Medicine
|
C.N.S
|
Age related dementia has been associated with increased levels of
A. Homocysteine
B. Cysteine
C. Tourine
D. Methionine
|
Homocysteine
|
794eaa6e-8c04-4655-b2ad-898919cd4402
|
Ans. is 'b' i.e., Galleazzi fracture * "Closed reduction is usually not successful due to the deforming forces of the muscles. Hence, open reduction and internal fixation is the preferred method of treatment. Campbell noted this in 1941 and termed Galeazzi fracture as "Fracture of necessity".
|
Orthopaedics
|
Injuries Around the Fore Arm & Wrist
|
Fracture of necessity is used to describe -
A. Cottons fracture
B. Galeazzi fracture
C. Monteggia fracture
D. Rolando fracture
|
Galeazzi fracture
|
7221157a-034f-434d-9caa-0be1df43e3ce
|
ADP:O or P:O Ratio: The NAD-dependant dehydrogenases such as malate, pyruvate, a-ketoglutarate, isocitrate, etc. produce three high energy phosphate bonds for each pair of electrons transferred to O2 because they have P: O ratio of 3. Thus P: O ratio is a measure of how many moles of ATP are formed from ADP by phosphorylation per gram atom of oxygen used. This is measured as the number of moles of ADP (or Pi) that disappear per gram atom of oxygen used. Phosphate group esterified P:O ratio = ___________________________________ Electron pairs transferred P:O ratio x 7.3 Efficiency = ______________________ x 100 51 K.Cal However, P:O ratio in case of FADH2 is 2 and therefore efficiency is lower in that case.Ref: MN Chatterjea Textbook of Medical Biochemistry, 7th Edition, Page no: 142
|
Biochemistry
|
Respiratory chain
|
Aerobic oxidation of reduced cytochromes shows P/O ratio of
A. 4
B. 3
C. 2
D. 1
|
3
|
46c816fb-8129-4d37-8962-267642a78efe
|
The husband is suffering from Kaagener's syndrome, an autosomal recessive disorder characterized by infeility, situs inversus, chronic sinusitis, and bronchiectasis. The underlying cause of these varied manifestations are defects in the dynein arms, spokes of microtubule doublets of cilia in the airways and the reproductive tract. Since sperm motility is dependent on the functioning of cilia, infeility frequently accompanies this disorder. Situs inversus occurs because ciliary function is necessary for cell migration during embryonic development. Azoospermia is not a feature of Kaagener's syndrome, as sperm production or survival is not affected in this disorder. Germinal cell aplasia, also known as Seoli only syndrome, is characterized by oligospermia or azoospermia. Isolated gonadotropin deficiency is characterized by delayed or incomplete pubeal maturation. Ref: Federico M.J., Stillwell P., Deterding R.R., Baker C.D., Balasubramaniam V., Zemanick E.T., Sagel S.D., Halbower A., Burg C.J., Kerby G.S. (2012). Chapter 19. Respiratory Tract & Mediastinum. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e.
|
Pediatrics
| null |
A couple presents to a clinic for work-up of infeility after 5 years of unprotected intercourse. The wife denies any medical problems and notes regular menstrual cycles. The husband states that he has had chronic sinusitis and lower respiratory tract infections. Physical examination of the woman is unremarkable. Examination of the man is remarkable for dextrocardia. Fuher work-up of the husband will most likely reveal?
A. Azoospermia
B. Germinal cell aplasia
C. Immotile sperm
D. Isolated gonadotropin deficiency
|
Immotile sperm
|
973872fe-b32c-494b-99a4-258b553ef62c
|
(Through the f oramen of Bochdalek): Ref: 873 - LB (894-B & L 25th)Hernia through the foramen of Bochdolek - (Posterolateral) This is rarely the persistence of the pleuroperitoneal canal and the opening is in the dome of the diaphragm posteriorly* It is the most common diaphragmatic hernia in children* TRIAD of respiratory distress, apparent dextrocardia and a scaphoid abdomenHERNIA through the foramen of Morgagni: - (Anterolateral, retrosternal) This is an anteriorly placed hernia with the defect between the sternal and costal attachments of the diaphragm.The most commonly involved viscus is the transvere colon* Most frequent clinical presentation of congenital diaphragm hernia is respiratory distress due to severe hypoxemia
|
Surgery
|
Hernia
|
Most common diaphragmatic hernia in children is:
A. Through the foramen of Bochdalek
B. Through the foramen of Morgagni
C. Traumatic rupture of the diaphragm
D. Eventration of the diapliragm
|
Through the foramen of Bochdalek
|
bb4f7d51-4e48-45b6-b55d-f65c837eb20f
|
Ans is 'c' i.e., Generation time * Generation time - Period from receipt of infection to maximal infectivity.* Serial interval - Gap between onset of primary case and secondary case.
|
Social & Preventive Medicine
|
Epidemiology
|
Time period between entry of organism to body to maximum infectivity is -
A. Lead time
B. Median incubation period
C. Generation time
D. Serial inverval
|
Generation time
|
b108bf67-6fc6-49cf-9035-ce21564e1d89
|
When systolic and diastolic blood pressures fall in different categories, the higher category is taken to classify the individual's blood pressure. Classification of blood pressure measurements: Category Systolic BP Diastolic BP Normal <130 <85 High normal 130-139 85-90 Stage 1 hypeension 140-159 90-99 Stage 2 hypeension 160-179 100-109 Stage 3 hypeension >180 >110 Ref: Park 21st edition, page 344.
|
Social & Preventive Medicine
| null |
A 20 year old is found to have blood pressures of 134/82 and 136/83 on two separate occasions. He will be classified as:
A. Normotensive
B. High normal BP
C. Stage 1 hypeension
D. Stage 2 hypeension
|
High normal BP
|
17a0557a-cd50-42fc-9f04-c7691c2fa215
|
Mitochondrial granules are seen enveloping the spiral threads around the axial filament present in the body of the sperm. Sperm: The human sperm possesses a head, a neck, a connecting piece or body, and a tail.Head is oval or elliptical, but flattened,its anterior two-thirds are covered by a layer of modified protoplasm, which is named the head-cap, which probably facilitates the, entrance of the spermatozoon into the ovum. The head contains a mass of chromatin, regarded as the nucleus of the cell surrounded by a thin envelope.Neck contains the anterior centriole, it is situated at the junction of the head and neck.Connecting piece or body is rod-like. The posterior centriole is placed at the junction of the body and neck, from this centriole an axial filament runs backward through the body and tail. The sheath of the axial filament is encircled by a spiral thread, around which is an envelope containing mitochondrial granules, and termed the mitochondrial sheath.Tail is of great length, and consists of the axial thread or filament, surrounded by its sheath, but mitochondria is absent.Ref: Gray's Anatomy of the Human Body, 20th Edition, Page 756
|
Anatomy
| null |
Mitochondria of a sperm is seen in ?
A. Head
B. Neck
C. Body
D. Tail
|
Body
|
bec07264-b37b-4a12-a323-77e88f676fda
|
Ans : D (IP3-DAG) & E (Ca2+ channel) Source of Calcium Ions & in Smooth Muscle Contraction Mechanism InvolvedAlmost all the calcium ions that cause contraction enter the muscle cell from the extracellular fluid at the time of action potential or other stimulusSarcoplasmic reticulum (the source of intracellular Ca2+), which provides virtually all the calcium ions for skeletal muscle contraction, is only slightly developed in most smooth muscle.When an action potential is transmitted in caveolae (rudimentary' analogue of the transverse tubule system of skeletal muscle), this is believe to excite calcium ion release from the abutting sarcoplasmic reticulum tubules through opening of calcium channels (Guyton 11th/99, 90)Sometimes smooth muscle contraction or inhibition is initiated by hormone without directly causing any change in the membrane potential. In these circumstances, the hormone may activate a membrane receptor that does not open any ion channel but instead cause an internal change in the muscle fiber, such as release of Ca2+ from intracellular sarcoplasmic reticulum, the Ca2+ then induce contraction (Guyton 11th/98)IP3-DAG role (to favour as an ansiver)The acetycholine cause smooth muscle contraction by phospholipase C& IP.,, which increase the intracellular Ca2+ concentration-Gcrnong 22nd/83Role of CAMP & CGMP (Guyton 11th/98)CAMP & CGMP so called second messengers has many effects on smooth muscle, one of which is to change the degree of phosphorylation of several enzyme that indirectly inhibit contraction."An increase in CAMP dampens the contraction response of smooth muscle to a given elevation of sarcoplasmic Ca2+-Harper 2 7th/579
|
Physiology
|
Chemical Messengers: Receptors
|
Increase in cytosolic calcium from intracellular storage, during smooth muscle contraction is/are due to: (PGI Dec 2008)
A. CAMP
B. CGMP
C. CCMP
D. 1P.-DAG
|
1P.-DAG
|
0438dd44-725c-4110-94d7-279659a9b55f
|
Secondary TB is due to reactivation and involves Lung particularly the apical and posterior segments of upper lobe.
|
Pathology
| null |
Reactivation tuberculosis is almost excusively a disease of the -
A. Lungs
B. Bones
C. Joints
D. Brain
|
Lungs
|
0419bf47-4ed0-4c9d-8970-77a8e4a4180f
|
Dermatitis herpetiformis is an autoimmune blistering disease that is strongly associated with coeliac disease. Almsot all patient with dermatitis herpetiformis have evidence of villous atrophy on Intestinal biopsy, even if they have no gastrointestinal symptoms. Reference : Davidson, 23rd Edition, page no : 1256.
|
Medicine
|
G.I.T
|
Whcih vesiculobullous diseaes is associated with enteropathy?
A. Pemphigus
B. Linear IgA dermatosis
C. Chronic bullous disease of childhood
D. Dermatitis herpetiformis
|
Dermatitis herpetiformis
|
9bf0734f-da78-48f5-8db8-19d233168e6e
|
The pyramidal tracts include both the coicospinal and coicobulbar tracts. These are aggregations of upper motor neuron nerve fibres that travel from the cerebral coex and terminate either in the brainstem (coicobulbar) or spinal cord (coicospinal) and are involved in control of motor functions of the body.The coicospinal tract conducts impulses from the brain to the spinal cord. It is made up of a lateral and anterior tract. The coicospinal tract is involved in voluntary movement. The majority of fibres of the coicospinal tract cross over in the medulla, resulting in muscles being controlled by the opposite side of the brain. The coicospinal tract also contains Betz cells (the largest pyramidal cells), which are not found in any other region of the body.The nerves within the coicospinal tract are involved in movement of muscles of the body. Because of the crossing-over of fibres, muscles are supplied by the side of the brain opposite to that of the muscle. Ref: guyton and hall textbook of medical physiology 12 edition page number:765,766,767
|
Physiology
|
Nervous system
|
Pyramids are formed by
A. Arcuate nucleus
B. Vestibular nuclei
C. Interstitial cells of cajal
D. Lateral coicospinal tract
|
Lateral coicospinal tract
|
10fb2660-eda5-411a-8b91-a956eb8bddf6
|
Testicular feminization syndrome (androgen insensitivity syndrome): XY karyotype with a female phenotype androgens are present but do not act at a peripheral level due to a receptor defect. the embryological development, which is dependent on androgens in a male fetus, does not happen and hence by default a female form is made. breast development is seen due to peripheral conversion of androgens to estrogens The inguinal swellings described in the question are actually the testes
|
Gynaecology & Obstetrics
|
Intersex
|
A 16-year-old girl with primary amenorrhea comes to OPD with bilateral inguinal swelling. She has normal breast development with no pubic hair. USG shows absent uterus. The diagnosis is:
A. Androgen insensitivity syndrome
B. Turner syndrome
C. Mullerian agenesis
D. Klinefelters Syndrome
|
Androgen insensitivity syndrome
|
61db1de1-7932-4912-afb4-b2e029a8db71
|
B i.e. EstrogenIn chronic liver disease (especially cirrhosis) and pregnancy, impaired estrogen metabolism and consequent hyper estroenemiaQ leads to spider angiomata/nevi (superficial, toous aerioles, that unlike simple telangiectases, typically fill from the center outwards and occur invariably on upper half of body) and palmar erythema (mottled redness of thenar & hypothenar eminences).
|
Physiology
| null |
Cause of vasodilation in spider nevi
A. Testosterone
B. Estrogen
C. FSH
D. Hepatotoxin
|
Estrogen
|
9185edee-9a04-46c9-9bb5-a6fe1d49f662
|
A layer containing blood vessels * A mnemonic device for remembering the order in which the soft tissues overlie the cranium is SCALP: Skin, Connective tissue, Aponeurosis, Loose connective tissue, and Periosteum. * The scalp proper is composed of the outer three layers, of which the connective tissue contains one of the richest cutaneous blood supplies of the body. * The occipitofrontal muscle complex inses into the epicranial aponeurosis, which forms the intermediate tendon of this digastric muscle. This structure, along with the underlying layer of loose connective tissue, accounts for the high degree of mobility of the scalp over the pericranium. * If the aponeurosis is lacerated transversely, traction from the muscle bellies will cause considerable gaping of the wound. Secondary to trauma or infection, blood or pus may accumulate subjacent to the epicranial aponeurosis. Bone is too deep, as is the dural mater.
|
Surgery
| null |
A 2 year old man presents with superficial gash on his forehead. The wound is bleeding profusely, but examination reveals no fracture. The physician suspects a hypersensitive cardiac reflex. The patient's epicranial aponeurosis (galea aponeurotica) is penetrated, resulting in severe gaping of the wound. The structure overlying the epicranial aponeurosis is which of the following?
A. A layer containing blood vessels.
B. The dura mater.
C. The periosteum (pericranium).
D. The tendon of the epicranial muscles (occipitofrontails).
|
A layer containing blood vessels.
|
d70c9cf8-f21a-4aae-a3fd-cd7d0120222f
|
Ans. D Osseus labyrinthRef: Gray's Anatomy, 41st ed. pg. 644* Osseous labyrinth is considered as hardest bone of the body. It is embedded in petrous part of temporal bone, which is also known as "rock bone".* American edition of British encyclopedia states: "The labyrinth of the ear is formed of cochlea, 3 semicircular canals and a small cavity known as vestibulum into which cochlea and semicircular canal opens. These parts are formed of the hardest bone in body, almost equal in solidity to ivory and petrous portion of temporal bone.
|
Anatomy
|
Joints
|
Hardest bone of the body is?
A. Head of humerus
B. Calcaneum
C. Tibial condyle
D. Osseus labyrinth
|
Osseus labyrinth
|
68cc5bf3-b2f3-48c7-8e69-a0de005ee8dd
|
"A numerical value describing the relative status of a population on a graduated scale with definite upper and lower limits, which is designed to permit and facilitate comparison with other populations classified by the same criteria and methods". - Russell A.L.
"Epidemiologic indices are attempts to quantitate clinical conditions on a graduated scale, thereby facilitating comparison among populations examined by the same criteria and methods" - Irving Glickman.
|
Dental
| null |
Attempts to quantitate clinical conditions on a graduated scale, thereby facilitating comparison among populations examined by the same criteria and methods is:
A. Indices
B. Survey
C. Biostatistics
D. Analysis
|
Indices
|
26b982ce-a8ee-41e6-a1a5-2458fc1d0745
|
Epidemiological indices of TB Incidence of TB infection (Annual infection rate, Annual risk of infection - ARI) : percentage if population understudy who will be newly infected with TB among Non-infected in 1 year Express attacking force of TB in community In developing countries 1% ARI corresponds to : 50 SS +ve cases per 100000 general population. Tuberculin conversion index is the best indicator for evaluation of TB problem and its trend ' in the community Prevalence of TB infection Percentage of individuals who show a positive reaction to standard Tuberculin test. Represent cumulative experience of population in' recent as well as remote infection' with TB Tuberculin test is the only way of estimating the prevalence of infection in a population Incidence of disease Percentage of new TB cases per 1000 population. Reveals trend of problem, including impact of control measures. Is of utility only in countries where high propoion of new cases are detected and notification is reliable Sputum smear examination (AFB) is a reliable method for estimation. Prevalence of disease or case rate Percentage of individuals whose sputum is positive for TV bacilli on microscopic examination Best available practical index to estimate case load in community. Age specific prevalence is most relevant index Ref: Park 25th edition Pgno : 219-220
|
Social & Preventive Medicine
|
Communicable diseases
|
Incidence of TB in a community is measured by
A. Sputum positive
B. Tuberculin test positive
C. Sputum culture positive
D. Mantoux test positive
|
Sputum positive
|
60c937a6-f37d-4577-a46d-ec58cfb4a61d
|
Polyp is categorized and defined by ultrasound, saline sonography, hysteroscopy with or without histopathology It is treated by polypectomy Ref: Shaw Gynecology 17 e pg 132.
|
Gynaecology & Obstetrics
|
Disorders of menstruation
|
Treatment of choice for endocervical polyp is
A. Vaginal hysterectomy
B. Conisation
C. Polypectomy
D. Radiotherapy
|
Polypectomy
|
917f6de1-b1cc-435e-84da-ec2d9466b03d
|
Ans. (c) Pressure of gas(Ref: Ganong, 25th ed/p.629)Whether the air flow is laminar or turbulent is determined by Reynolds numberReynolds number =rDV/eWhere,r-Density of the gasD-Diameter of the airwaysV -Velocity of gase -Viscosity of gasPressure of gas is not in the formula for Reynolds number
|
Physiology
|
Respiratory System
|
When gases flow through an orifice which factor is least likely to affect turbulence
A. Density of gas
B. Viscosity of gas
C. Pressure of gas
D. Diameter of orifice
|
Pressure of gas
|
819068f4-79e8-4955-8a42-5a6681c85a77
|
Ans. is 'a' i.e., Lateral Sinus thrombophlebitis LATERAL SINUS THROMBOPHLEBITIS (SIGMOID SINUS THROMBOSIS) Lateral or sigmoid sinus thrombophlebitis arises from inflammation in the adjacent mastoid. It may occur as a complication of : ? Acute coalescent mastoiditis CSOM and cholesteatoma Clinical features Hectic Picket-Fence type of fever with rigor. Headache, Progressive anemia and emaciation. Griesinger's sign : - odema over the posterior pa of mastoid due to thrombosis of mastoid emissary veins. Papilloedema Tobey-Ayer test :- Compression of vein on the thrombosed side produces no effect while compression of vein on healthy side produces rapid rise in CSF pressure which will be equal to bilateral compression of jugular veins. Crowe-Beck test :- Pressure on jugular vein of healthy side produces engorgement of retinal veins. Pressure on affected side does not produce such change. Tenderness along jugular vein Imaging studies Contrast-enhanced CT scan can show sinus thrombosis by typical delta-sign. It is a triangular area with rim enhancement, and central low density area is seen in posterior cranial fossa on axial cuts. Delta-sign may also be seen on contrast enhanced MRI.
|
ENT
| null |
Presence of delta sign on contrast enhanced CT SCAN suggests presence of ?
A. Lateral Sinus thrombophlebitis
B. Cholesteatoma
C. Cerebellar abscess
D. Mastoiditis
|
Lateral Sinus thrombophlebitis
|
211abb46-f5a2-4373-b0be-5dda0ea24266
|
Bronchogenic sequestration refers to the presence of a discrete mass of lung tissue without any normal connection to the airway system.
Intralobar sequestrations are found most frequently in the posterior basal segment of the left lower lobe.
Blood supply to the sequestered area arises not from the pulmonary arteries but from the aorta or its branches.
Extralobar sequestrations are external to the lung. Found most commonly in infants as abnormal mass lesions, they may be associated with other congenital anomalies.
Intralobar sequestrations are found within the lung substance and are usually associated with recurrent localized infection or bronchiectasis.
|
Pathology
| null |
Bronchogenic sequestration is seen in which lobe -
A. Left lower lobe
B. Right upper lobe
C. Left middle lobe
D. Left upper lobe
|
Left lower lobe
|
837a30f4-823a-42a0-9246-33509701ab95
|
Ans. is 'a' i.e., Ambulatory patients There are 4 triage categories I. Green - Minor/Ambulatory 3. Yellow - Delayed 2. Red -- Immediate 4.Black - Dead or nonsalvageable Minor (Green) they should be separated from the general group at the beginning of the triage operations ( k/a "Walking wounded" these patients can be used to assist in treatment of those patients tagged as immediate. Immediate (Red) in these patients, ventilation is present only after repositioning the airway. respiratory rate is greater than 30 / min. delayed capillary refill (> 2 sec) unable to follow simple commands Delayed (Yellow) - any patient who does not fit into either the immediate or minor categories. Deceased (Black) - no ventilation present even after repositioning the airway. So in this question : Option 'a' ie Ambulatory pts --> Green Option 'b' ie Deed or moribund pts --> Black Option'c' ie High priority treatment or transfer --> Red Option 'd' ie Priority or transfer --> Yellow
|
Surgery
| null |
In triage green colour indicates -
A. Ambulatory patients
B. Dead or moribund patients
C. High priority treatment or transfer
D. Medium priority or transfer
|
Ambulatory patients
|
5b457a2e-6ae3-4b21-9f4e-73658ed9fbab
|
Vitamin D deficiency leads to impaired intestinal absorption of calcium, resulting in decreased serum total and ionized calcium values. This hypocalcemia results in secondary hyperparathyroidism, a homeostatic response that initially maintains serum calcium levels at the expense of the skeleton. Due to the PTH-induced increase in bone turnover, alkaline phosphatase levels are often increased. In addition to increasing bone resorption, PTH decreases urinary calcium excretion while promoting phosphaturia. This results in hypophosphatemia, which exacerbates the mineralization defect in the skeleton. Reference : page 2466 Harrison's Principles of Internal Medicine 19th edition
|
Medicine
|
Endocrinology
|
Which of the following is seen in Vitamin D deficiency-
A. Increased alkaline phosphatase
B. Decreased phosphate in urine
C. Hyperphosphatemia
D. Decreased alkaline phosphatase
|
Increased alkaline phosphatase
|
18c41cdd-95d1-4d06-bf66-c390c7abd7ee
|
Tacrolimus is also known as FK-506. It is an immunosuppressant macrolide antibiotic produced by Streptomyces tsukubaensis.
Muromonab CD3 is also known as OKT3. It is a monoclonal antibody against CD3 cells.
|
Pharmacology
| null |
FK 506 is a type of :
A. Immunoglobulin antibody
B. Non-depolarizing muscle relaxant
C. Macrolide antibiotic
D. Opioid anaesthetic
|
Macrolide antibiotic
|
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