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5a435162-567a-4ae6-9e8d-e5ee94169cdf | The presence of diffuse involvement of glomeruli and histologically showing enlarged hyper cellular glomeruli is suggestive of Acute infectious GN. It can be both infectious and non-infectious (SLE) but the most common infectious acute proliferative GN is post streptococcal GN. So, the likely answer is post streptococcal glomerulonephritis. | Pathology | Systemic Pathology | Examine the renal histopathology slide. What is the probable diagnosis?
A. Membranoproliferative GN
B. Rapidly profilerative GN
C. Post streptococcal glomerulonephritis
D. Diabetic nephropathy
| Post streptococcal glomerulonephritis |
a8d7aa5c-ddf4-4091-b912-61fe207915ee | Sigmoid diveiculitis Diveicular disease refers to acquired pseudo diveicular outpouchings of the colonic mucosa and submucosa. Rare below 30yrs but prevalence approaches 50% beyond 60yrs. Diveicula generally are multiple and the condition is referred to as diveiculosis. PATHOGENESIS Colonic diveicula tend to develop under conditions of elevated intraluminal pressure in the sigmoid colon TEXT BOOK OF ROBBINS BASIC PATHOLOGY NINTH EDITION PAGE.586 IMAGE REF: ROBBINS BASIC PATHOLOGY NINTH EDITION FIG: 14-25 PAGE 586 | Pathology | G.I.T | Diveiculum most common site is
A. Sigmoid colon
B. Ileum
C. Ascending colon
D. Transverse colon
| Sigmoid colon |
565d9b0e-bed6-4df3-861d-c7bfa9ecdd87 | C i.e Head's paradoxical reflex.Inflation of lungs, under ceain conditions, enhances inspiratory activity.Since inflation induces fuher inflation of lungs, the reflex is considered paradoxical.The vagal fibers mediating Head's paradoxical reflex carry information originating in receptors present in lungs.This reflex has a role in the initiation of respiration at bih. Ref: Understanding Medical Physiology By R.L. Bijlani, M.D., RL Bijlani MD SM DSc (Hon Causa) FAMS, S. Manjunatha, M.D., 2010, Page 245. | Physiology | null | "Inflation of lungs induces fuher inflation" is explained by:
A. Hering-Breuer inflation reflex
B. Hering-Breuer deflation reflex
C. Head's paradoxical reflex
D. J-reflex
| Head's paradoxical reflex |
a8f309e8-245c-460c-b443-e6001ed617cc | Harshmohan textbook of pathology 7th edition the microscopic structures of retinoblastoma characteristically arranged in rossettes. The rossettes are of 2 types 1. Flexner Wintersteiner rossettes characterised by small tumor cells arranged around a lumen with their nuclei away from the lumen. 2. Homer Wright rosettes- having radial arranarrangement of the tumor cells around the central neurofibrillar structure.. | Pathology | General pathology | Flexner-Wintersteiner rossette is seen in-
A. Hepatoblastoma
B. Nephroblastoma
C. Neuroblastoma
D. Retinoblastoma
| Retinoblastoma |
fdea496c-fd2a-415a-b788-196680960cf7 | (C) Neural crest # MERKEL CELLS, which are believed to be derived from the neural crest, contain many large (50-100 nm) dense-cored vesicles, presumably containing transmitters, which are concentrated near the junction with the axon. F.S. Merkel referred to these cells as Tastzellen or "touch cells" Merkel cells are found in the skin and some parts of the mucosa (stratum germinativum) of all vertebrates. In mammalian skin, they are clear cells found in the stratum basale (at the bottom of sweat duct ridges) of the epidermis approximately 10 pm in diameter. They also occur in epidermal invaginations of the plantar foot surface called rete ridges. Most often, they are associated with sensory nerve endings, when they are known as Merkel nerve endings (Merkel cell-neurite complex). They are associated with slowly adapting (SA1) somatosensory nerve fibers. They are associated with the sense of light touch discrimination of shapes and textures. They can turn malignant and form the skin tumor known as Merkel cell carcinoma.DERIVATIVES OF NEURAL CRESTDerivative of neural crestDeveloping partsNeurons1. Spinal posterior nerve root ganglion (dorsal root ganglia) 2. Sensory ganglia of V, VII, VIII, IX & X cranial nerves 3. Sympathetic gangliaPiamater & Arachnoid mater (Not duramater)--Schwann cellsNeurolemmal sheaths of all peripheral nervesAdrenal medullaChromaffin tissuePigment cells of skinMelanoblasts; Merkel's cells of epidermisMesenchyme of dental papilla & Odontoblasts--Cells from cranial part of neural crest (Somatomeres)Development of musculature of head & in formation of face | Anatomy | Misc. | Merkels cells of Epidermis are derived from
A. Neural tube
B. Notochord
C. Neural crest
D. Neural pore
| Neural crest |
30525681-a5ee-4629-b61a-04c0bd76ee77 | Ans. (d) Testicular torsion.Testicular torsion is most common between 10 and 25 years of age, although a few cases occur in infancy. Typically, there is sudden agonising pain in the groin and the lower abdomen. The patient feels nauseated and may vomit. Torsion of a fully descended testis is usually easily recognized. The testis seems high and the tender twisted cord can be palpated above it. The cremasteric reflex is lost.Image source- style="font-family: Times New Roman, Times, serif"> | Surgery | Miscellaneous (Testis & Scrotum) | A patient of 18 years of age presents with sudden agonising pain in the groin and the lower abdomen. The patient feels nausea and gives a history of vomiting. On physical examination, the testis seems high. The cremasteric reflex is lost. What is the most possible cause?
A. Epididymo-orchitis
B. Mumps orchitis
C. Idiopathic scrotal edema
D. Testicular torsion
| Testicular torsion |
a7f3389a-7a40-40a8-8a7b-dc5d78cdba62 | PLAP-most useful marker for bulk disease. Tumour marker for seminoma is PLAP. BETA HCG is also raised in 5-10% of pure seminomas as they contain syncytiotrophoblast like giant cells. | Surgery | Testis and scrotum | Placental alkaline phosphates is marker of:
A. Theca cell tumour
B. Teratoma
C. Choriocarcinoma
D. Seminoma
| Seminoma |
ad5dc668-ec74-4e7a-8acf-318d29fc0196 | Ans. B. Infectious MononucleosisThe given clinical situation suggests Infectious MononucleosisFeatures of Infectious Mononucleosis:* Cervical Lymphadenopathy* Fever* History of sore throat* >20% atypical lymphocytesHepatomegaly may be absent (Occurs only in 30% of cases) | Pediatrics | Viral Infections | An 8 year old boy presented with fever and bilateral cervical lymphadenopathy with prior history of sore throat. There was no hepatomegaly. The peripheral blood smear shows >20% lympho plasmacytoid cells. The most likely diagnosis is:
A. Tuberculosis
B. Infectious Mononucleosis
C. Acute lymphoblastic leukemia
D. Influenza
| Infectious Mononucleosis |
68ff9908-2480-44a0-b76d-a50dd05032f9 | Third nerve palsy can result in ptosis of the eyelid. There is also loss of the ability to open the eye, and the eyeball is deviated outward and slightly downward. With complete lesions, the pupil is dilated, does not react to light, and loses the power of accommodation. In diabetes, the pupil is often spared. The sixth cranial nerve can also be affected by diabetes, but this is much less common. | Medicine | C.N.S. | A 60-year-old man with diabetes acutely develops double vision and discomfort in his left eye. On examination, there is ptosis of the left eyelid, the eye is rotated down and out, and the pupil is 3 mm and reactive to light. The right eye is normal. Which of the following is the most likely diagnosis?
A. fourth nerve palsy
B. diabetic autonomic neuropathy
C. third nerve palsy
D. sixth nerve palsy
| third nerve palsy |
e0fbe3e6-1af1-416d-9534-f153483ce9e8 | Ans. is 'c' i.e., NK cellso Lethal midline granuloma or polymorphic reticulosis is a lymphoma of natural killer (NK) cells infected with EBV. | Pathology | null | Lethal midline granuloma arises from ?
A. T-cells
B. B-cells
C. NK cells
D. Macrophages
| NK cells |
66d59725-ee93-4dc9-986f-971aaf098de3 | Ans. b. Depth of focus increasesThe most common problems developed in adults between ages 41 to 60 may to seeing clearly at close distances, especially when reading and working on the computer.This normal change in the eyes focusing ability, called presbyopia. | Ophthalmology | Errors of Refraction | In near vision what is the change?
A. Power of lens decreases
B. Depth of focus increases
C. Lateral recti contraction
D. Zonular tension increases
| Depth of focus increases |
1063f072-8698-442c-b0ad-5d904f6d0e93 | Crude Bih rate: Annual number of live bihs per 1000 mid year population Here, CBR is 30 per 1000 population So for 5000 population - 30/1000 x5000 = 150 That implies, no of pregnant women is 150 Ref: Park 25th edition Pgno : 532 | Social & Preventive Medicine | Demography and family planning | In a community of 5000 people, the crude bih rate is 30 per 1000 people. The number of pregnant female is?
A. 150
B. 65
C. 175
D. 200
| 150 |
05a8b60e-7619-4b98-bbab-9ad7883ab979 | Patient is showing features suggestive of herpes simplex encephalitis. Clinical manifestations in viral encephalitis includes altered level of consiousness (confusion, behavioral abnormalities), mild lethargy to coma, evidence of both focal or diffuse neurologic signs and symptoms and focal or generalized seizures. Investigations: CSF shows lymphocytic leukocytosis, red blood cells due to hemorrhagic necrosis and elevated cerebrospinal fluid (CSF) protein levels. In HSV encephalitis80% will have abnormalities in temporal lobe and 10% have extra temporal abnormalities. The lesions are typically hyper intense on T2-weighted images. Brain biopsy has been the gold standard for defining HSV encephalitis, but now PCR for detection of HSV DNA in CSF has largely replaced biopsy for defining CNS infection. Acyclovir is used in the treatment. Ref: Harrison's Internal Medicine, 18th Edition, Pages 3421, 3437, Chapters 179, 379, 381. | Medicine | null | A young male presents with fever, followed by headache, confusion, focal seizures and right hemiparesis. MRI shows bilateral frontotemporal hyperintense lesion. Which of the following is the most likely diagnosis?
A. Acute pyogenic meningitis
B. Herpes simplex encephalitis
C. Neurocysticercosis
D. Carcinomatous meningitis
| Herpes simplex encephalitis |
0c2df0be-2729-46fd-af8f-6e4cd812b9d8 | Shake test: - Test done to check cold damage to Vaccine due to freezing. - Once the vaccine is frozen, it tends to form flakes which gradually settle to the bottom, after the l is shaken. - Thus, sedimentation occurs faster in a vaccine l which has been frozen as compared to control l. - These ls should be discarded irrespective of their expiry date. - Used for DPT, DT, TT or Hepatitis B | Pediatrics | Storage of vaccines | The shake test shown below can be done to know:
A. Whether vaccine was exposed to heat
B. Whether vaccine had been frozen at some point of time in the cold chain
C. Whether expiry date of vaccine has reached
D. Whether the vaccine needs to be mixed with normal saline
| Whether vaccine had been frozen at some point of time in the cold chain |
3d229f27-8d18-4198-a663-6d8c7ce506fb | Radiological Features of Hyperparathyroidism Subperiosteal resorption of terminal tufts of phalanges, lateral end of clavicle and symphysis pubis. Loss of lamina dura (i.e. thin coical bone of tooth socket surrounding teeth is seen as thin white line, is resorbed). Fig : Loss of Lamina Dura Brown Tumor Salt and Pepper appearance of skull Treatment: Direct parenteral supplementation of calcium. -Dental findings of other options : Osteomalacia- no tooth abnormality as such Rickets- enamel defect Deficiency of vitamin C- bleeding gums + dentine defects | Orthopaedics | Metabolic disorders - 1 | Absence of lamina dura in the alveolus occurs in:
A. Rickets
B. Osteomalacia
C. Deficiency of vitamin C
D. Hyperparathyroidism
| Hyperparathyroidism |
a200ac33-b573-4a9a-a75d-b46f2eb11769 | (B) (Methyldopa) (506 Dutta 7th)* Intravenous labetalol or hydralazine are drugs most commonly used to manage preeclampsia (56-H 8th).* Antihypertensive drugs are essential when the BP is 160/110 mm Hg to protect the mother from eclampsia, cerebral hemorrhage, cardiac failure and placental abruption.* First line therapy is either methyldopa or labetalol second line drug is nifedipine. DrugsMechanism of actionSide effectsContraindication and precautionsMethyldopa* Drug of the first choice* Central and peripheral antiadrenergic action* Effective and safe for both the mother and the fetusMaternal - Postural hypotension, hemolytic anemia, sodium retention, excessive sedation, Coomb's test may be positive.Fetal - Intestinal ileusHepatic disorder psychic patients congestive heart failure.Postpartum (risk of depression)HydralazineActs by peripheral vasodilatation as it relaxes the arterial smooth muscle. Orally it is weak and shouldbe combined with methyldopa or b blocker.It increases the cardiac output and renal blood flow* Maternal hypotension, tachycardia arrhythmia, palpitation, lupus-like syndrome, fluid retention.* Fetal - reasonably safe.* Neonatal - ThrombocytopeniaBecause of variable sodium retention diuretics should be used. To control arrhythmias propanol may be administered intravenously.LabetalolCombined a and b adrenergic blocking agents* Tremors, headache asthma, CHF.* Efficacy and safety with short-term use appear equal to methyldopa* Hepatic disorders* Asthma, CHF | Unknown | null | Drug of choice for hypertension in pregnancy-
A. Hydralazine
B. Methyldopa
C. Labetalol
D. Nifedipine
| Methyldopa |
1cbc1e30-83a5-441e-88ae-bdbb01c3c049 | (A) Retinopathy # Most common ophthalmic complication of diabetes mellitus is diabetic retinopathy, with diabetic retinopathy being the most common preventable cause of blindness> Ocular features of diabetes mellitus: Blurring of vision Cataract formation Diabetic pupil Diabetic retinopathy Macular edema Retinal neovascularization Vitreous hemorrhage Retinal detachment Neovascularization of the iris (i.e. Rubeosis iridis) Cranial nerveCN III, IV and VI palsy> Blindness is primarily the result of progressive diabetic retinopathy and clinically significant macular edema.> Diabetic retinopathy is classified into two stages: nonproliferative and proliferative. Nonproliferative diabetic retinopathy usually appears late in the first decade or early in the second decade of the disease and is marked by retinal vascular microaneurysms, blot hemorrhages, and cotton wool spots.> Mild nonproliferative retinopathy progresses to more extensive disease, characterized by changes in venous vessel caliber, intraretinal microvascular abnormalities, and more numerous microaneurysms and hemorrhages. The pathophysiologic mechanisms invoked in nonproliferative retinopathy include loss of retinal pericytes, increased retinal vascular permeability, alterations in retinal blood flow, and abnormal retinal microvasculature, all of which lead to retinal ischemia. | Medicine | Miscellaneous | Most common ophthalmic complication of diabetes mellitus is
A. Retinopathy
B. Cataract
C. Rubeosis iridis
D. Vitreous hemorrhage
| Retinopathy |
4a216eaf-1ff0-495f-8f85-6277019ddcfd | Hyaline casts
Normal urine , Febrile disease, diuretics thereapy, prerenal azotemia. | Medicine | null | Hyaline casts are seen in
A. Acute tubular necrosis
B. Thrombotic microangiopathy
C. Normal urine
D. Pyelonephritis
| Normal urine |
474c328c-5f55-4822-bde3-3c0e167a5281 | (B) Ageusia # Ageusia is the loss of taste functions of the tongue, particularly the inability to detect sweetness, sourness, bitterness, saltiness, and umami (the taste of monosodium glutamate). It is sometimes confused for anosmia--a loss of the sense of smell. Because the tongue can only indicate texture and differentiate between sweet, sour, bitter, salty, and umami most of what is perceived as the sense of taste is actually derived from smell. True aguesia is relatively rare compared to hypogeusia--a partial loss of taste--and dysgeusia--a distortion or alteration of taste.> Causes of Ageusia:> Neurological damage: Tissue damage to the nerves that support the tongue can cause ageusia, especially damage to the lingual nerve and the glossopharyngeal nerve.> Neurological disorders such as Bell's palsy, Familial dysautonomia, and Multiple sclerosis cause similar problems to nerve dam- age, as do certain infectious conditions like primary amoeboid meningoencephalopathy. The lingual nerve (which is a branch of the trigeminal V3 nerve, but carries taste sensation back to the chorda tympani nerve to the geniculate ganglion of the facial nerve) can also be damaged during otologic surgery, causing a feeling of metal taste.> Problems with the endocrine system:> Deficiency of vitamin B3 (Niacin) and zinc can cause problems with the endocrine system, which may cause taste loss or alteration. Disorders of the endocrine system, such as Cushing's syndrome, hypothyroidism and diabetes mellitus, can cause similar problems.> Ageusia can also be caused by medicinal side-effects from antirheumatic drugs such as penicillamine, antiproliferative drugs such as cisplatin, ACE inhibitors, and other drugs including azelastine, clarithromycin and zopiclone.> Other causes:> Local damage and inflammation that interferes with the taste buds or local nervous system such as that stemming from radiation therapy, glossitis, tobacco abuse, and denture use also cause ageusia. Other known causes include loss of taste sensitivity from aging (causing a difficulty detecting salty or bitter taste), anxiety disorder, cancer, renal failure and liver failure. | Physiology | Misc. | Absense of taste sensation is termed as:
A. Hypogeusia
B. Ageusia
C. Dysgeusia
D. Partial ageusia
| Ageusia |
9409edf0-7977-4824-ad70-2172bef513f5 | Adrenal neuroblastomas are malig8nant neoplasms arising from sympathetic neuroblsts in Medulla of adrenal gland Neuroblastoma is a cancer that develops from immature nerve cells found in several areas of the body.Neuroblastoma most commonly arises in and around the adrenalglands, which have similar origins to nerve cells and sit atop the kidneys. | Anatomy | miscellaneous | Hutchinsons secondaries In skull are due to tumors in
A. Lung
B. Breast
C. Adrenal
D. Liver
| Adrenal |
a19c7974-94c0-4955-8fd7-fd4117ba4f46 | D i.e. HaloperidolThe diagnosis of this lady is morbid grief When there is an exaggeration of one or more symptoms of normal grief or the duration becomes prolonged beyond 6 months without recovery, it is k/a morbid grief.Preoccupation with the memory of deceased is a characteristic featureQ.Idealization of deceased (ignoring his negative qualities).Sense of presence of deceased in the surroundings & misinterpretation of voices or faces of others as that of lost person. Rarely fleeting hallucinations may occur.Treatment - In morbid & complicated grief, medication depends on presenting clinical features.As this lady is mainly having problem of auditory hallucination (1/t sadness & anxiety) - antipsychotic like haloperidol is needed to treat her. | Psychiatry | null | An elderly house wife lost her husband who died suddenly of Myocardial infarction couple of years ago. They had been staying alone for almost a decade with infrequent visits from her son and grandchildren. About a week after the death she heard his voice clearly talking to her as he would in a routine manner from the next room. She went to check but saw nothing. Subsequently she often heard his voice conversing with her and she would also discuss her daily matters with him. This however, provoked anxiety and sadness of mood when she was preoccupied with his thought. She should be treated with:
A. Clornipramine.
B. Aiprazolam
C. Electroconvulsive therapy.
D. Haloperidol.
| Haloperidol. |
91a9521b-e773-44f9-a324-588a5c62e16d | C i.e. Spleen Breakdown of heme to bilirubin occurs in macrophages of the reticuloendothelial system mainly in the spleenQ also in the liver and bone marrow. | Physiology | null | Heme is conveed to bilirubin mainly in:
A. Kidney.
B. Liver.
C. Spleen
D. Bone marrow.
| Spleen |
21f84acb-da0f-43d8-8675-bc49b906e3da | RIFAMPACIN: Powerful enzyme inducer of the Hepatic Cytochrome P450 system. It increasesmetabolism of many drugs and as a consequence, can make them less effective, or even ineffective in some cases, by decreasing their levels in the plasma. Rifampicin can induce the metabolism of Indinavir and can result in therapeutic failure. Therfore rifampicin is avoided in the above patient. ISOENZYMES INDUCED BY RIFAMPACIN: CYP2C9 CYP2C19 CYP3A4 CYP1A2 | Pharmacology | Anti-HIV Drugs | Which of the following anti-tubercular drug is avoided in a HIV positive patient on zidovudine, lamivudine and indinavir therapy who develops TB?
A. Pyrazinamide
B. Isoniazid
C. Ethambutol
D. Rifampicin
| Rifampicin |
be546307-242e-4c27-ac06-d9cf5af4fa01 | Sunken eyes, mouth and tongue very dry , condition lethargy ,skin pinch goes back very slowly The patient has 2 / more signs there is severe dehydration Ref: Ghai pediatrics eighth edition pg no 293 | Pediatrics | Fluid and electrolytes | Which of the following is sign of severe Dehydration in a child
A. Lethargy
B. Irritability
C. Increased duration of skin pinch
D. Suken eyes
| Lethargy |
a2020a3f-4a0b-4c62-9ad6-a70b615d119b | Ans. a. ImpetigoNon bullous impetigo or impetigo contagiosa lesions have golden yellow, honey coloured crusting | Skin | Bacterial Infection of Skin | A 6-year-old child presents with lesions on face, covered with honey colored crusts. Pruritus is present. The possible cause can be:
A. Impetigo
B. Herpes
C. Chickenpox
D. Molluscum contagiosum
| Impetigo |
7ddf32c9-b8f9-4841-814f-170708151dd7 | Ans. is a, i.e. Ovarian pregnancySite of ectopicCriteria for diagnosisOvarian ectopicAbdominal ectopicCervical ectopicSpigelberg criteriaStuddiform ectopicRubin criteria/ Palmann criteria | Gynaecology & Obstetrics | Ecotopic Pregnancy | Spigelberg criteria is used in:
A. Ovarian pregnancy
B. Abdominal pregnancy
C. Cervical pregnancy
D. Tubal pregnancy
| Ovarian pregnancy |
057c1ee3-f001-4deb-836d-9eb3114b4c26 | Degree of freedom = (C-1) (R-1) Given rows = 3 ; columns = 2 DOF = (2-1) (3-1) = 1x2 = 2 | Social & Preventive Medicine | Central tendency, Dispersion | Calculate degree of freedom Material Location X Y Glass 8 23 Cupboard 56 3 Metal 1 14
A. 1
B. 2
C. 3
D. 4
| 2 |
9c11ac47-32b9-438f-84d4-3d210d1d04c3 | Alpha ketoglutarate dehydrogenase catalyses an oxidative decarboxylation reaction similar to that of pyruvate dehydrogenase. uses the same coenzymes as the PDH complex (their E3 components are identical). Like PDH complex, its E2 is inhibited by arsenic. | Biochemistry | TCA Cycle | Which of the following enzyme of TCA cycle is analogous to Pyruvate dehydrogenase complex?
A. Isocitrate dehydrogenase
B. Alpha ketoglutarate dehydrogenase
C. Malate dehydrogenase
D. Succinate dehydrogenase
| Alpha ketoglutarate dehydrogenase |
bd4cc417-21a0-4cea-88ef-bdbcba2c0b1b | Most of the primary auditory cortex is in the temporal lobe, but the association auditory cortices extend over much of the insular lobe and even onto the lateral portion of the paritetal lobe | Physiology | null | Auditory area located in which lobe:
A. Temporal
B. Parietal
C. Frontal
D. Occipital
| Temporal |
bd461837-3b0e-4a06-a7d5-1352431c2558 | Intermenstrual bleeding is classical symptom of endocervical polyp. | Gynaecology & Obstetrics | null | Classical symptom of endocervical polyp is
A. Cervical prolapse
B. Dyspareunia
C. Intermenstrual bleeding
D. Dysmenorrhea
| Intermenstrual bleeding |
cef97dd5-0cd5-47dd-a403-c8aa09d4bc20 | Response to Co2, PaCO2 is most impoant factor in control of ventilation under normal conditions. PCo2 is most impoant input regulating magnitude of ventilation under resting conditions. Changes in alveolar ventilation have immediate, pronounced effect on aerial Pco2 (unlike Po2). Even slight alterations from normal Pco2 induce significant reflex. Increased Pco2 increases ventilation. Blood Brain Barrier is permeable to Co2, so increased aerial Pco2 increases brain ECF Pco2 and , it stimulates central chemoreceptors which increases ventilation by stimulating respiratory centers. Regulation of respiration: The rhythmic discharges from the brain that produce spontaneous respiration are regulated by alterations in aerial Po2, PCo2, and H+ concentration. There are numerous factors that affect and control ventilation. Chemical control Co2 ( CSF and brain interstitial fluid H+ concentration) o2 ( carotid and aoic bodies) H+ ( carotid and aoic bodies) Nonchemical control Vagal afferents from receptors in the airways and lungs Afferents from the pons, hypothalamus, and limbic system Afferents from proprioceptors Afferents from baroreceptors: aerial, atrial, ventricular, pulmonary Preipheral (Carotid & Aoic) Chemoreceptors: The carotid bodies are located at the bifurcation of common carotid aery. They send afferents in the carotid sinus nerve to the glossopharyngeal nerve (IX) the aoic bodies are located between the arch of aoa and pulmonary aery afferents ascend in the recurrent laryngeal nerves to the vagus (X). Stimulation results from a decrease in carotid and aoic body tissue PO2. Central Chemoreceptors: situated near (beneath) the ventral surface of the medulla, near the origins of the vagi and glossopharyngeal nerves these are anatomically separate from the respiratory centres, and are bathed in brain ECF. This is impermeable to both H+ and HCO3 -, however CO2 diffuses readily and decreases pH of CSF within a few minutes, which subsequently increases ventilation. Ref: A Concise Textbook Of Physiology, By S. And Kutty, K.M., Page 101. | Physiology | null | The most impoant stimulant of respiratory centre is:
A. Alkalosis
B. Decrease PCo2
C. Increase PCo2
D. Decrease Pao2
| Decrease Pao2 |
9102f5b0-eec7-46f9-adee-40e8ade47bd0 | Septicemia (bacteremia) denotes the clinical condition in which bacteria are found in the circulation. It can be suspected clinically, but the final diagnosis is made by culturing the organisms from the blood. In patients with endotoxic shock, lipopolysaccharide released from Gram-negative bacteria stimulates monocytes/macrophages to secrete large quantities of TNF-a. | Pathology | Chemical mediators in plasma: Kinin system | An 80-year-old woman presents with a 4-hour history of fever, shaking chills, and disorientation. Her blood pressure is 80/40 mm Hg. Physical examination shows diffuse purpura on her upper arms and chest. Blood cultures are positive for Gram-negative organism. Which of the following cytokines is primarily involved in the pathogenesis of direct vascular injury in this patient with septic shock?
A. Interferon-g
B. Transforming Growth Factor-b (TGFb)
C. Platelet-derived growth factor
D. Tumor necrosis factor-a
| Tumor necrosis factor-a |
f5213ada-efac-491a-90e1-2d3d09e0e588 | Answer is A (Methaemoglobinemia) Pronounced cyanosis together with chocolate brown colour of 'freshly drawn blood suggests a diagnosis of methaemoglobinemia Methaemoglobinemia * * * Methaemoglobinemia is an uncommon but distinct cause of central cyanosis in the absence of hypoxemia or cardio vascular compromise Methaemoglobinemia occurs when a significant concentration of hemoglobin (Hb) is oxidized to methaemoglobin (Met Hb) When the haem moety (iron atoms) of' Hb molecule encounter a strong oxidizing agent iron loses an electron and switches from the Ferrous (2+) to Ferric (3+) state turning Hb to 'Met Hb' Methaemoglobin has such high oxygen affinity that viually no oxygen is delivered Presentation * * Methaemoglobinemia most commonly presents as cyanosis unresponsive to supplemental oxygen The most notable physical examination finding is generalized cyanosis which can manifest as muddy brown dark mucus membranes before proceding to global skin discolaration 'The charachteristic muddy appearance (chocolate brown) of freshly drawn blood can be a critical clue'-*Blood appears dark brown, brownish, muddy or chocolate in colour immediately after withdrawal. In contrast to normal venous blood, the color does not change with addition of oxygen or agitation in the air'- Diffirential diagnosis in Internal Medicine Methaemoglobinemia > 15% cause symptoms of cerebral ischaemia Methaemoglobinemia > 60% is usually lethal Diagnosis * The hest Methaemoglobinomia is * Methaemoglohin Assay' Treatment * The most effective emergency management for methaemaglobinemia is administration of Methylene bluee which serves as an antidote (intravenous) Methylene blue is not effective in patients with methaemoglobinemia due to Hemoglobinopathy MQ (Haemoglobin M) Methylene blue is contraindicated in patients with G6 PD deficiencyQ since it can cause severe hemolysis due to its potential for oxidation Outline of The Four Main Pathways to MetHb Production 1. Congenitally abnormal hemoglobin: Hemoglobin M Hemoglobin M is passed as an autosomal dominant trait affecting either the alpha or beta chain of hemoglobin; homozygous Hb M affecting both alpha and beta chains is incompatible with life. Amino acid substitution (often a tyrosine for histidine) near the heme iron facilitates iron oxidation. 2. Inherited enzyme deficiencies: NADH-dependent cytochrome b5 -reductase and cytochrome bc deficiency. Deficiency of either cytochrome b5 or its reducing enzyme, cytochrome b5-reductase, decreases reduction of MetHb back to Hb 3. Nitrite (NO2), other oxidants and oxygen-reducing compounds Nitrites are a common oxidizing source of MetHb production. Reducing agents paradoxically produce methemoglobinemia by reducing oxygen to a free radical or water to 1-1,O2, which then oxidizes hemoglobin. 4. "Sensitive" hemoglobin: Blue baby syndrome Bacteria in the immature gastrointestinal tracts of infants conve nitrate (NO3) to the powerful oxidant nitrite (NO,). Infants have a relative NADH-dependent reductase deficiency (only 50% of adult levels) and are more susceptible to oxidative injury. | Medicine | null | A patient with blood pressure of 90/60 mm Hg presents with pronounced cyanosis. Blood drawn from peripheral veins is observed to be chocolate brown in colour. The most likely diagnosis is:
A. Methaemoglobinemia
B. Hypovolemic shock
C. Cardiogenic shock
D. Hemorrhagic shock
| Methaemoglobinemia |
de396e96-6668-4cca-9bd7-e69620d07ee5 | Red degeneration of fibroid: It results from softening of surrounding connective tissue The capillaries tend to rupture and blood effused out into the myoma causing a diffuse reddish discoloration The tumor it self assumes a peculiar purple red colour and develops a fishy odour,if the tumor is carefully examined We may find some vessels and large veins in the capsule thrombosed This is the most common complication with fibroid during pregnancy . And the patient is usually febrile and with moderate leucocytosis and raised ESR, the condition is aseptic one. And ultrasound is useful for diagnosis Ref Shaw 16/e pg 395 | Gynaecology & Obstetrics | Anatomy of the female genital tract | A pregnant woman with fibroid uterus develops acute pain in abdomen with low grade fever and mild leucocytosis at 28 weeks ,the most likely diagnosis is
A. Preterm labour
B. Torsion of fibroid
C. Red degeneration of fibroid
D. Infection in fibroid
| Red degeneration of fibroid |
8b5ed778-8c5b-4928-b675-8ac2fefa8c45 | Ans. is 'a' i.e., Fracture of the proximal ulna with radial head dislocation Eponymous injuries of forearmNameInjuryMonteggia fracture dislocationFracture of upper third of ulna with dislocation of the radial headGalleazi fractureFracture of distal third of radius with dislocation or subluxation of inferior (distal) radio-ulnar jointEssex Lopresti lesionFracture of the radial head with distal radioulnar joint injury with tear in the interosseus membrane | Orthopaedics | Injuries of the Forearm | Monteggia fracture is -
A. Fracture of the proximal ulna with radial head dislocation
B. Radial head subluxation
C. Tear in interosseus membrane between radius and ulna with proximal ulna fracture
D. Distal radius Fracture with injury to Distal radio ulnarjoint
| Fracture of the proximal ulna with radial head dislocation |
29669f82-fa5f-48a7-8db4-dbdf88f5e614 | Ans. D: Instrumentation Instrumentation is by far the most common cause of perforation Boerhaave syndrome/Esophageal perforation, is rupture of the esophageal wall caused by excessive vomiting in eating disorders such as bulimia although it may rarely occur in extremely forceful coughing or other situations, such as obstruction by food. It can cause pneumomediastinum and/or mediastinitis (air or inflammation of the mediastinum) and sepsis. Boerhaave syndrome is a transmural perforation of the esophagus, distinct from Mallory-Weiss syndrome, a nontransmural esophageal tear also associated with vomiting. The term is useful for distinguishing it from iatrogenic perforation, which accounts for 85-90% of cases of esophageal rupture, typically as a complication of an endoscopic procedure, feeding tube, or unrelated surgery. It is associated with "Mackler's triad" which consists of vomiting, lower thoracic pain and subcutaneous emphysema which the later can be heard as Haman's crunch on physical examination. The most common anatomical location of the tear in Boerhaave syndrome is at left posterolateral wall of the lower third of the esophagus, 2-3 cm before the stomach. | Surgery | null | Commonest cause of esophageal perforation: March 2007
A. Boerhaave syndrome
B. Carcinoma of esophagus
C. Acid ingestion
D. Instrumentation
| Instrumentation |
3810ff6e-9750-4596-b3e2-27815b024b43 | Cervial plexus supplies Skin over the angle of the jaw and over the parotid gland. Lower margin of the lower jaw | Anatomy | null | Sensory supply for skin over angle of jaw is
A. Opthalmic nerve
B. Mandibular nerve
C. Cervical plexus
D. Maxillary nerve
| Cervical plexus |
643f473d-b481-4fd6-a6d9-1487ff253065 | Ans. is 'b' i.e., 25 hydroxyvitamin DThough, 1, 25 dihydroxyvitamin D (calcitriol) is the active form of vitamin D, its serum measurement does not provide any information about vitamin D status because it is often normal or elevated due to secondary hyperparathyroidism associated with vitamin D deficiency...Measurement of 25 hydroxyvitamin D (calcifedial) in serum provides more accurate information of vitamin D status. The usual values are :-< 20 ng/ml - Deficiency20-29 ng/ml - Insufficiency30-100 ng/ml - Normal> 100 ng/ml - Toxicity | Biochemistry | null | Form of vitamim D which is measured in serum ?
A. Cholecalciferol
B. 25 hydroxyvitamin D
C. 1,25 dihydroxyvitamin D
D. 24,25 dihydroxyvitamin D
| 24,25 dihydroxyvitamin D |
36bd2440-c375-4399-843a-b024711eaf7b | C5, C6, C7, C8 and C9 are the factors present in common terminal pathway. The classic activation pathway, mannose-binding lectin activation pathway and alternative activation pathway converge on the final common terminal pathway. The cleavage of C3 by each pathway (classic activation pathway, mannose-binding lectin activation pathway and alternative activation pathway) causes activation of C5, C6, C7, C8 and C9 in the terminal pathway, resulting in the formation of membrane attack complex (MAC) that gets attached to the target cells or bacteria and lyses them. Ref: Harrisons Principles of Internal Medicine, 16th Edition, Page 1913 & 1916. | Pathology | null | Which of the following factors are present in the final common terminal complement pathway?
A. C4
B. C3
C. C5
D. Protein B
| C5 |
334e83e9-cd7a-47c3-85e1-10ef5055dfda | A. i.e. (H. pylori) (594 - Basic pathology 8th)PEPTIC ULCER - two conditions are key for the development of peptic ulcers1. H. pylori infection(i) 70 - 90% persons with duodenal ulcer(ii) 70% persons with gastric ulcers2. Mucosal exposure to gastric acid and pepsin* NSAIDs are the major cause of peptic ulcer disease in persons who do not have H. pylori infection | Pathology | G.I.T. | Peptic ulcer is caused by
A. H. pylori
B. Campylobacter jejuni
C. Pneumocystis carinii
D. Crypto sporidium
| H. pylori |
1f1c9273-3f6b-4086-8a83-a66d4ce14203 | Ans. is 'c' i.e., Papillary type [Ref: Schwartz 9/e p1361 (8/e p1417); Harrison 17/e p.2242 (16/e, p.2122)\o "Papillary carcinoma accounts for 80% of ail thyroid malignancies in iodine-sufficient areas and is the predominant thyroid cancer in children and individuals exposed to external radiation." - Schwartzo Incidence of primaiy malignant tumors of thyroid gland (Harrison 17/e)Type of thyroid carcinomaApproximate PrevalencePapillary Carcinoma80-90%Follicular Carcinoma5-10%Medullary Carcinoma10%Anaplastic CarcinomaRareLymphomas1-2%o Also remembery Thyroid carcinoma is the most common malignancy of the endocrine system (Ref: Harrison, 17/e, p 2243) | Surgery | Thyroid Malignancies | The most common histologic type of thyroid cancer is -
A. Medullary type
B. Follicular type
C. Papillary type
D. Anaplastic type
| Papillary type |
ea8b00ad-c095-43ec-8b00-0fd8a41709b8 | Transection of the brainstem at the midpoint level with bilateral vagotomy causes apneusis. At mid pontine level lesion, the apneustic centre is intact while the pneumotaxic centre is seperated. Concurrent removal of vagus inputs causes this kind of abnormal pattern of breathing characterized by deep, gasping inspiration with a pause at full inspiration followed by a breif insufficient release. Effect of various Lesions and Brainstem Transection Label Level of transection Vagi intact vagi cut A Complete transection above pons Regular breathing continues Regular breathing continues but depth of inspiration increases B Mid-pontine level section Regular breathing continues Apneusis develops C Transection midway between pons and medulla Irregular but rhythmic respiration Irregular but rhythmic respiration D Complete transection below medulla Spontaneous respiration ceases Spontaneous respiration ceases Ref: Ganong&;s review of medical physiology 25th edition Pgno: 645-657 | Physiology | Respiratory system | Transection of the brain stem at the mid-pontine level with bilateral vagotomy causes ______
A. Ceasation of spontaneous respiration
B. Continuation of regular breathing
C. Irregular but rhythmic respiiration
D. Apneusis
| Apneusis |
9608c2df-2ccd-4c7d-aad1-a74c3fb723b4 | Development of kidneys - The definative human kidney arises from two distinct sources, 1). The secretory pa , I.e., excretory tubules or (nephrons) are derived from the lowest pa of the nephrogenic cord this pa is the metanephros, the cells of which form the metanephric blastema 2). The collecting pa of the kidney is derived from a diveiculum called the ureteric bud which arise from the lower pa of the mesonephric duct. Ref : Inderbir singh's Human Embryology, eleventh edition , pg. no., 265. | Anatomy | Head and neck | The ureteric bud develops from ?
A. mesonephric duct
B. metanephric duct
C. pronephric duct
D. genital sinus
| mesonephric duct |
3b14bc57-d2d9-4f89-8c7f-1af346656b66 | Answer- B. Acute appendicitisScoring system for Acute Appendicitis: Alvarado Score:The diagnosis of appendicitis is based primarily on clinical history and physical examination assisted by blood counts. A number of clinical and laboratory based scoring systems have been devised to assist diagnosis.The most widely used scoring system is Alvarado score. | Surgery | null | Alvarado score is used for
A. Acute cholecystitis
B. Acute appendicitis
C. Acute apncreatitis
D. Acute epidydimitis
| Acute appendicitis |
c84590de-de67-45f8-954e-d6d59797e486 | ADE is automated external defibrilater An automated external defibrillator (AED) is a poable electronic device that automatically diagnoses the life-threatening cardiac arrhythmias of ventricular fibrillation (VF) and pulseless ventricular tachycardia,and is able to treat them through defibrillation, the application of electricity which stops the arrhythmia, allowing the hea to re-establish an effective rhythm Ref Davidson 23rd edition pg 445 | Medicine | C.V.S | AED stands for?
A. Automatic external defibrillator
B. Automated external defibrillator
C. Automatic electrical defibrillator
D. Automated electrical defibrillator
| Automated external defibrillator |
a92806ee-27a1-4f85-ad1b-20054d79bf00 | Na+-K+ATPase, which actively moves Na+and K+ against their electrochemical gradient. The electrogenic Na K ATPase plays a critical role in cellular physiology by using the energy in ATP to extrude 3 Na+ out of the cell in exchange for taking two K+ into the cell. (REF.GANONG'S REVIEW OF MEDICAL PHYSIOLOGY 23rd EDITION page no.85.) | Physiology | General physiology | Na-K ATPase
A. 3 Na out / 2K in
B. 3Na in / 2K out
C. 2Na out / 3K in
D. 2Na in / 3K out
| 3 Na out / 2K in |
dc7afe58-d105-4feb-b348-0111d2e45678 | The complications of IVRA is mainly attributable to the use of the tourniquet. On inflation of the touniquet there is physiological deoxygenation. In patients with sickle cell disease this might lead to sickling crisis. In these patients IVRA causes stasis, local acidosis and hypoxia. Hence IVRA is best avoided in sickle cell disease patients. Adequate oxygenation of the patient would be prudent. Ref: Complications of regional anesthesia By Brendan T. Finucane, Page 216; Essentials of Regional Anesthesia By Alan David Kaye, Richard D. Urman, Nalini Vadivelu; McGlamry's comprehensive textbook of foot and ankle surgery, 3rd ed, Vol 2 By Alan S. Banks, E. Dalton MacGlamry, Page 180; Surgery and anesthesia in sickle cell disease (By M Koshy, SJ Weiner, ST Miller, LA Sleeper, E Vichinsky, AK Brown,Y Khakoo, and TR Kinney). | Anaesthesia | null | Which of the following anaesthetic modality is to be avoided in sickle cell disease?
A. General anaesthesia
B. Brachial plexus block
C. IV. Regional Anaesthesia
D. Spinal
| IV. Regional Anaesthesia |
db558c23-be76-4e79-8216-f8b725f97ec0 | Titin Location: Reaches from the Z line to the M line.Function: Largest protein in the body. Role in relaxation of the muscle.Ref: Harper&;s Biochemistry; 30th edition; Chapter 51 Muscle & the Cytoskeleton | Biochemistry | miscellaneous | Protein of muscle which helps in relaxation is
A. Nebulin
B. Titin
C. Desmin
D. Calcineurin
| Titin |
eca59089-c0d5-4293-974e-991b07fcd09a | Ans. is 'b' i.e., 3 years Medical Council recommends that the medical records of the indoor patient to be aintained for atleast a period of 3 years from the date of commencement of treatment. | Forensic Medicine | null | IPD records of patients are preserved for how many years ?
A. 1 year
B. 3 years
C. 5 years
D. 7 years
| 3 years |
06d76fcb-5fb9-4be7-9e91-b2f7ed646a39 | Ans. (d) Cerebral malaria(Ref: Malaria - Page 76)In malignant cerebral malaria caused by Plasmodium falciparum, brain vessels are plugged with parasitized red cells, causing ring hemorrhage which is accompanied by necrosis of surrounding parenchyma.The damage leads to formation of Durck's granuloma - collection of microglial cells surrounding area of demylienation | Pathology | Inflammation & Repair | Durck granuloma is seen in
A. Congenital syphilis
B. Cat scratch disease
C. Histoplasmosis
D. Cerebral malaria
| Cerebral malaria |
dfeeea7a-3dd8-4c52-94f4-8d5b459dbd48 | Sterilization is the most effective contraception to achieve NRR =1 Male sterilization Male sterilization or vasectomy being a comparatively* simple operation can be performed even in primary health centres by trained doctors under local anaesthesia. When carried out under strict aseptic technique, it should have no risk of moality. In vasectomy, it is customary to remove a piece of vas at least 1 cm after clamping. The ends are ligated and then folded back on themselves and sutured into position, so that the cut ends face away from each other. This will reduce the risk of recanalization at a later date. It is impoant to stress that the acceptor is not immediately sterile after the operation, usually until approximately 30 ejaculations have taken place. During this intermediate period, another method of contraception must be used. If properly performed, vasectomies are almost 100 per cent effective. Following vasectomy, sperm production and hormone output are not affected. The sperm produced are destroyed intraluminally by phagocytosis. This is a normal process in the male genital tract, but the rate of destruction is greatly increased after vasectomy. Vasectomy is a simpler, faster and less expensive operation than tubectomy in terms of instruments, hospitalization and doctor's training. Cost-wise, the ratio is about 5 vasectomies to one tubal ligation. Ref: Park 25th edition Pgno : 543 | Social & Preventive Medicine | Demography and family planning | The goal of NRR=1 can be best achieved by use of following contraceptive methods -
A. Condom 72/year
B. IUCD
C. Vasectomy
D. Oralpills
| Vasectomy |
a5e63927-e725-4e61-8f86-3cceff9d17a4 | The causative agent is Enterobius vermiculais & is diagnosed by NIH swab or perianal swab moistened with saline ie by applying the adhesive surface of cellophane tape to perianal skin in the morning & then this is examined on a glass slide inder microscope. Reference: Harrison20th edition pg 1102 | Medicine | Infection | A 6-year old child who presented with perianal pruritus, excoriation of skin and nocturnal enuresis was found to be infected with a parasite causing autoinfection. The causative agent is diagnosed by the -
A. NIH swab method
B. String test
C. Hetrazan test
D. Encysted larvae on muscle biopsy
| NIH swab method |
3923b210-4b02-44cc-9af9-cc3c1fe952c8 | Cocaine causes contraction band necrosis by blocking the reuptake of norepinephrine, resulting in excessive vasoconstriction of coronary vessels, leading to ischemia and infarction of hea tissue. Under these pathological conditions, myocardial cells switch to anaerobic metabolism and therefore glycolysis becomes the sole source of ATP substrate-level phosphorylations by phosphoglycerate kinase and pyruvate kinase. Phosphofructokinase-1 (PFK-1) is the rate-limiting enzyme of glycolysis, and its activity would therefore be increased. Phosphoenolpyruvate carboxykinase is a regulatory enzyme in gluconeogenesis, which is induced by coisol, epinephrine, and glucagon. It functions in the hepatic synthesis of glucose when energy levels from beta-oxidation of fatty acids are adequate. Pyruvate dehydrogenase produces acetyl-CoA from pyruvate and coenzyme A, bridging glycolysis and the Krebs cycle. It requires 5 cofactors, including NAD and FAD, which would no longer be produced by the electron transpo under hypoxic conditions, decreasing its activity. Succinate dehydrogenase is a key enzyme of the Krebs cycle, producing a reduced equivalent of FAD to feed into the electron transpo chain. It is also known as Complex II. The Krebs cycle only functions if oxygen is in appropriate concentrations since it is regulated by the levels of NADH, which is only consumed by the electron transpo chain if there is enough oxygen. The absence of oxygen leads to an accumulation of NADH and a subsequent decrease in the enzyme activities of the Krebs cycle. Ref: Bender D.A., Mayes P.A. (2011). Chapter 20. Gluconeogenesis & the Control of Blood Glucose. 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 | A histological section of the left ventricle of a deceased 28-year-old male shows classic contraction band necrosis of the myocardium. Biological specimens confirm the presence of cocaine and metabolites. Activity of which of the following enzymes was most likely increased in the patient's myocardial cells sholy prior to his death?
A. Phosphoenolpyruvate carboxykinase
B. Phosphofructokinase-1
C. Pyruvate dehydrogenase
D. Succinate dehydrogenase
| Phosphofructokinase-1 |
2a06d9ee-4cdd-4eb4-8f28-c2799af3b39b | Ans: (c) TapewormRef: K.D. Chatterjee, 13th edition, Page 212-222Nematodes based on mode of infection:Mode of InfectionOrganismsIngestionEggsEnterobius , Ascaris , Irichuris (EAT)Larva within intermediate hostDrancunculus medinensisEncysted larva in muscleTrichinella spiralisPenetration of skinStrongyloides, Ancylostoma ,Necator (SAN)Blood sucking insectsFilariaInhalation of dust containing eggsAscaris, Enterobius | Microbiology | Parasitology | Parasites not transmitted through soil:
A. Pin worm
B. Hookworm
C. Tapeworm
D. Roundworm
| Tapeworm |
ffd29814-4b7d-4e36-85e4-c61e782384f3 | Phosphorylation occurs at the hydroxyl groups of serine, threonine, and tyrosine. A protein kinase is a kinase enzyme that modifies other proteins by chemically adding phosphate groups to them (phosphorylation). Phosphorylation usually results in a functional change of the target protein (substrate) by changing enzyme activity, cellular location, or association with other proteins. The chemical activity of a kinase involves transferring a phosphate group from a nucleoside triphosphate (usually ATP) and covalently attaching it to one of three amino acids that have a free hydroxyl group.Most kinases act on both serine and threonine, others act on tyrosine, and a number (dual specificity kinases) act on all three. There are also protein kinases that phosphorylate other amino acids, including histidine kinases that phosphorylate histidine residues. | Microbiology | All India exam | Which of the following does not undergo phosphorylation by protein kinases?
A. Threonine
B. Tyrosine
C. Asparagine
D. Serine
| Asparagine |
6f2173d7-b66f-422c-92a9-02dc927e8f2c | Ans. is b i.e. Amniocentesis In a pregnant lady with H/0 previous Down syndrome, the chances of recurrence are increased. Extensive screening should be carried out in all such females. Now in the question given - female is presenting at 18 weeks and investigation of choice is being asked which will definately be amniocentesis. At 18 weeks Screening test : quad test I Triple test. Investigation of choice : Amniocentesis. In first trimester (or 1st screening test Combined test Investigation of choice chorionic villi sampling. Screening test selectior Women presenting to ANC clinic before 14 weeks. Nuchan translucency + free phCG +PAPP-A (k/a combined test) Based on result if | Gynaecology & Obstetrics | null | Which of the following is the investigation of choice in a pregnant lady at 18 weeks of pregnancy with past history of delivering a baby with Down's syndrome :
A. Triple screen test
B. Amniocentesis
C. Chorionic villous biopsy
D. Ultrasonography
| Amniocentesis |
dd19b7e6-2446-4e43-85fc-9ed7a57f96f1 | Ans. is 'c' i.e., Henoch schonlein purpurao HSP is not hypersensitivity angitis. But the best answer amongst the given options is HSP because it is the most impoant differential of hypersensitivity angitis.Hypersensitivity angitis Hypersensitivity vasculitis or hypersensitivity angitis or leukocytoclastic angitis is a small vessel vasculitis due to hypersensitivity reaction.It is usually to a known drug, e.g. cefoperazone, autoantigens or infectious agents.Immune complexes lodge in the vessel wall, attracting polymorphoneuclear leukocytes who in turn release tissue-degrading substances leading to an inflammatory process.Hypersensitivity angitis usually present with skin manifestation, e.g. palpable purpura, but sometimes nerves, kidneys, joints and hea may also be involved.Diagnostic criteriao At least 3 out of the 5 criteria are requiredAge > 16Use of possible triggering drug in relation to symptoms.Palpable purpuraMaculopapular rashSkin biopsy showing neutrophil infiltrate around vessel.o Henoch-schonlein purpura is the most impoant differential. | Pathology | null | Hypersensitivity angitis is seen in -
A. SLE
B. Polyaeritis nodosa
C. Henoch schonlein purpura
D. Buergers disease
| Henoch schonlein purpura |
2f0c9c23-e65f-41ba-9bfe-9de99370a2f7 | (Ref: Katzung, 14th ed. pg. 59; KDT, 6th ed. pg. 27)Enzyme induction involves microsomal enzyme in liver as well as in other organ.It increases the rate of metabolism 2 - 4 fold. Therefore, effect of drug decreases.Enzyme inhibitors also involves microsomal enzyme.It inhibits the microsomal enzyme, which decreases drug metabolism rate and increases duration of drug action.Let us take an example of warfarin, which is used as an anti thrombotic agent.#Warfarin + enzyme inducer = Thrombosis (warfarin metabolism increases and action of warfarin diminishes rapidly and thrombotic condition arises).#Warfarin + enzyme inhibitor = Bleeding (warfarin metabolism decreases and duration of warfarin action increases and patient develops bleeding tendency)Drugs which are enzyme inducers and enzyme inhibitors Enzyme inducersEnzyme inhibitorsGriseofulvinPhenylbutazonePhenytoinErythromycinRifampicinAllopurinol, AmiodaroneSmokingCiprofloxacinCarbamazipineOmeprazolePhenobarbitoneCimetidineBarbiturateKetoconazoleDDTValproateRemembered as: GPRS Cell Phone Battery DeadMn: PEACOCK ValaMost of the anti epileptic are enzyme inducers except VALPROATE (an inhibitor)Most of the antimicrobial are enzyme inhibitors except GRISEOFULVIN (an Inducer) | Pharmacology | General Pharmacology | Which of the following drug is an enzyme inducer?
A. Rifampicin
B. Isoniazid
C. Ketokonazole
D. Erythromycin
| Rifampicin |
eebcf59f-4836-4016-a11a-c976f4c63955 | Tranta's spots (Horner tranta's spots) are discrete white raised dots along the limbus and are composed of degenerated eosinophils. | Ophthalmology | null | Trantas spots are seen in –
A. Vernal conjunctivitis
B. Eczematous conjunctivitis
C. Ophthalmia nodosa
D. Tularemia
| Vernal conjunctivitis |
23e42325-bd2d-49cf-a4c4-c502c82aa672 | * Microscopically, the bone is of five types, namely lamellar (including both compact and cancellous), woven, fibrous, dentine and cement. 1. Lamellar bone: Most of the mature human bones, whether compact or cancellous, are composed of thin plates of bony tissue called lamellae. These are arranged in piles in a cancellous bone, but in concentric cylinders (Haversian system or secondary osteon) in a compact bone. 2. Woven Bone: seen in fetal bone, fracture repair and in cancer of bone 3. Fibrous bone is found in young foetal bones, but are common in reptiles and amphibia. 4. Dentine and 5. Cement occur in teeth. * Compact bone ( coical bone) In shaft (diaphysis) of long bone - lamellae arranged to form Haversian system - Bone marrow Yellow which stores fat after pubey. It is red before pubey - Hard and ivory-like * Cancelled bone spongy, or trabecular bone - In the epiphyses of long bone - arranged in a meshwork, so Haversian systems are not present - bone marrow red, produce RBCs, granular series of WBC and platelets - spongy * Nails are made of a tough protective protein called keratin - consists of the nail plate, the nail matrix and the nail bed below it, and the grooves surrounding it (Reference : BDC Handbook of General Anatomy , 5th edition, pg 39) | Anatomy | General anatomy | Haversian system is seen in
A. Coical bone
B. Cancellous bone
C. Teeth
D. Nail
| Coical bone |
cc40d3a2-ae63-4c4f-aa83-32d663267e66 | Except for a few rare situations, vitamin B12 (cyanocobalamin) deficiency is usually a result of pernicious anemia, an autoimmune disease of the stomach. Vitamin B12 is required for DNA synthesis, and its deficiency results in large (megaloblastic) nuclei.Diagnosis: Vitamin B12 deficiency, pernicious anemia | Pathology | Environment & Nutritional Pathology | A 50-year-old woman presents with easy fatigability, a smooth sore tongue, numbness and tingling of the feet, and weakness of the legs. A complete blood count shows a megaloblastic anemia that is not reversed by folate therapy. Hemoglobin is 5.6 g/dL, WBC count is 5,100/mL, and platelets are 240,000/mL. This patient most likely has a deficiency of which of the following vitamins?
A. Vitamin B1 (thiamine)
B. Vitamin B2 (riboflavin)
C. Vitamin B12
D. Vitamin K
| Vitamin B12 |
23385633-8f8f-4f63-b064-25046cfb2f37 | Ans. (b) Serotype BRef: Harrison 19th ed. /1002* There are currently three vaccines available in the USA to prevent meningococcal disease, all quadrivalent in nature, targeting serogroups A, C, W-135, and Y.* Meningococcal polysaccharide or conjugate vaccines provide no protection against serogroup B disease and MenB vaccines provide no protection against serogroup A, C, W or Y disease. For protection against all 5 serogroups of meningococcus it is necessary to receive both vaccines.* Only recently vaccine targeting serogroup B has also been created and is protein based.TRADE NAMETYPE OF VACCINESEROGROUPS INCLUDEDYEAR LICENSEDAPPROVED AGESMenomunePolysaqccharideA, C, W, Y19812 year and olderMenactraConjugateA, C, W, Y20059 months-55 yearsMenveoConjugateA, C, W, Y20102 months-55 yearsMenHibrixConjugateC, Y, and Hib20126 weeks-18 monthsTrumenbaProteinB201410-25 yearsBexseroProteinB201510-25 years | Medicine | Bacteriology | Quadrivalent Meningococcal vaccine is not used for?
A. Serotype A
B. Serotype B
C. Serotype C
D. Serotype Y
| Serotype B |
97ca9bd4-a163-45db-95bf-6b9808be0659 | Duct of Bartholins gland opens on the inner side of Labium minus external of hymen. | Gynaecology & Obstetrics | null | Duct of Bartholins gland opens
A. On outer side of Labium minus
B. On inner side of Labium majus
C. On outer side of Labium majus
D. On inner side of Labium minus
| On inner side of Labium minus |
f48f7c7f-c95f-439a-9a59-5b02414e31ae | Ans. D. Phosphorous-32Some useful radionuclides used in clinical radiotherapyRadionuclideEnergy Half-life Medical uses* Radium-2260.83mv1625 yearsfor brachytherapy but not used now a days* Cobalt-601.25mv5.4 yearsteletherapy & brachytherapy* Caesium-1370.666mv30 yearsteletherapy & brachytherapy* Iridium-1920.380mv72 daysbrachytherapy only* Iodine-1250.030mv60 daysbrachytherapy* Iodine-1310.61mv8 daysunsealed radioiodine for thyroid cancer Rx* Gold-1980.412mv 2.7 days brachytherapy* Strontium-902.24mv30 yearsfor shield (mould) in eye tumors* Phosphorous-321.71mv14 daysintraperitoneal | Radiology | Miscellaneous | For shield (mould) in eye tumors which of the following is preferred?
A. Iodine-131
B. Gold-198
C. Strontium-90
D. Phosphorous-32
| Phosphorous-32 |
254654bc-e37a-4fff-8c83-d291703a9fa0 | Ghrelin is a growth hormone secreatagogue and the only gut harmone with orexigenic propey It is primarily produced in the stomach. In children ,it's value is inversely related with body mass index and insulin values. robbins 8/e 441-2 9/e 444 | Anatomy | General anatomy | In prayer Willi syndrome, which of the following is increased
A. A. LH
B. B. FSH
C. C. TSH
D. D. Ghrelin
| D. Ghrelin |
bde66087-8329-4e46-b7ee-e8756bae2d88 | Madonna-Putana complex Psychogenic male erectile disorder Can be organic or psychologic or both. Inability to have arousal towards a woman , the man desires. Men have arousal only with women whom they see as degraded. | Psychiatry | Sexual Disorders | Which of the following is associated with Madonna-Putana complex ?
A. Female arousal disorder
B. Male hypoactive sexual desire disorder
C. Male erectile disorder
D. Anorgasmia
| Male erectile disorder |
99fde1c6-9563-4388-a59f-09f1c20691bb | b. Indomethacin therapy(Ref: Nelson's 20/e p 2197, Ghai 8/e p 417)Indomethacin, a Prostaglandin inhibitor is used in medical closure of Ductus arteriosus. | Pediatrics | C.V.S. | Ductus arteriosus closes in response to:
A. Decrease in peripheral oxygen saturation
B. Indomethacin therapy
C. Prostaglandin E1
D. Increase in pulmonary vascular resistance
| Indomethacin therapy |
7686a2bb-8369-4e3d-a666-dcb780c43633 | Laboratory diagnosis of HIV infection
Laboratory diagnosis is made by:
A. Antibody detection
It is the most common method used for diagnosis of HIV infection.
ELISA is the most sensitive test and therefore is the screening test of choice.
Western blot is the most specific (Confirmatory) test and therefore is the’gold standard’ for diagnosis.
Antibodies test usually nucleic acid or antigen.
B. Detection of HIV nucleic acid or antigen
P24 antigen detection by ELISA can be done 16 days after infection (earlier than antibody detection).
Nucleic acid detection tests are the earliest to become positive (12 days after infection), Most commonly used test is reverse transcriptase PCR, (RT-PCR), other methods used are DNA-PCR, RNA-PCR, RNA-bDNA (branched DNA), and RNA-NASBA (nuclei acid sequenced based assay).
C. Virus isolation
Co-cultivation of the patient’s lymphocyte with uninfected lymphocytes in the presence of IL-2.
Not suitable as a routine diagnostic procedure.
In infected individual HIV can be isolated from
Blood
Semen
Saliva
Urine
Lymphocytes
Cervical secretions
Tears
Breast milk | Microbiology | null | A person has unprotected sex 3 weeks back, To rule out HIV infection the best test is
A. P 24 antigen assay
B. ELISA
C. Western blot
D. Lymphnode biopsy
| P 24 antigen assay |
cbc5f62f-3587-4936-9967-fef25b85fb10 | Brain abscesses in congenital cyanotic heart diseases occur due to hematogenous seeding of bloodborne bacteria. These blood borne bacteria bypass the pulmonary capillary bed d/t right to left shunt. They commonly infect parietal & frontal lobes (territory of middle cerebral artery). | Surgery | null | Brain abscess in cyanotic heart disease is commonly located in
A. Cerebellar hemisphere
B. Thalamus
C. Temporal lobe
D. Parietal lobe
| Parietal lobe |
a8d54e61-b164-450b-a2b8-6644ca290abc | Ans. is 'b' Anxiety Antianxiety Drugs areBenzodiazepinesB BlockersBuspironeMeprobamate & Hydroxyzine | Psychiatry | Generalized Anxiety Disorder | Beta blockers are indicated in -
A. Phobic disorders
B. Anxiety
C. Schizophrenia
D. Mania
| Anxiety |
38a8db59-5e9c-4932-97ad-7a45e05fe75c | Vasomotor Reversal Of Dale - Adrenaline has biphasic effect on blood pressure. - a1 - Strong receptor thus more effect. - b2 - Sensitive receptor thus stimulated at low dose too. When adrenaline is given IV at high doses 1st BP will increase due to stimulation of a1 > b2 & then BP will decrease due to b2 stimulation. When adrenaline is given IV at high dose with a blocker, exaggerated fall of BP occurs called as Vasomotor Reversal of Dale. In adrenaline producing pheochromocytoma, If person is treated by alpha blocker, then this phenomenon will occur and thus death can occur due to severe hypotension. Therefore alpha blocker is always combined with beta blocker in adrenaline producing tumor. | Pharmacology | ANS | Which of the following drug's use alone is to be avoided in a patient with adrenaline producing pheochromocytoma?
A. Phentolamine
B. Enalapril
C. Clonidine
D. Methyldopa
| Phentolamine |
3cab37ef-d13f-48b2-a541-ebe18e23f69a | (A) Spironolactone > Spironolactone is a steroid chemically related to the mineralocorticoid aldosterone> Spironolactone is an aldosterone antagonist. | Pharmacology | Miscellaneous (Pharmacology) | Which one of the following is an Aldosterone antagonist?
A. Spironolactone
B. Amiloride
C. Triameterine
D. Acetazolamide
| Spironolactone |
81456612-8165-4b7a-8400-8590c2718643 | .sterilizers which operate at high temperatures and pressure are called autoclaves.they generate steam under pressure or saturated steam which is the most effective sterilizing agent.they fall in two categories,grvity displacement autoclaves and high speed pre-vaccum autoclaves.works on the same principle as that of a pressure cooker.widely used in the hospital and laboratry practice.it destroys all forms of life,including spores.most effective method for the sterilization of linen,dressings,gloves,syringes,and culture media.not suitable for sterilization of plastic and sharp instruments. ref:park&;s textbook,ed 22,pg no 120 | Social & Preventive Medicine | Epidemiology | Disinfection by autoclaving is NOT recommended for -
A. Sputum
B. Linen
C. Sharp instrument
D. Glass syringes
| Sharp instrument |
4fb9c253-7910-4396-a1b9-b638e800737a | Ans. is 'c' i.e., Pantoprazole Pantaprazole - it is more acid stable and has higher oral bioavailability. It is also available for i.v. administration; paicularly employed in bleeding peptic ulcer and for prophylaxis of acute stress ulcers. | Pharmacology | null | Which proton pump inhibitor can be used IV ?
A. Omeprazole
B. Rabeprazole
C. Pantoprazole
D. Fomeprazole
| Pantoprazole |
faa86e89-7ffa-411c-a4fa-36d8e98c9bda | Predictors of poorer outcome in schizophrenia:Age below 20Dilated ventricles, brain atrophy in CT or MRINegative symptoms (e.g., flat affect, povey of thought, apathy, asociality); obsessive-compulsive symptomsIrregular occupational recordInsidious onsetSlow rate of progressionmalesYears of duration prior to assessmentCannabis useAbsence of precipitating factorsStressful lifeFamily history of schizophrenia (not affective disorder)Presence of other adverse social factorsPrenatal adverse eventsPresence of ceain gene polymorphism, e.g., COMT. NMDA2APRef: Meltzer H.Y., Bobo W.V., Heckers S.H., Fatemi H.S. (2008). Chapter 16. Schizophrenia. In M.H. Ebe, P.T. Loosen, B. Nurcombe, J.F. Leckman (Eds),CURRENT Diagnosis & Treatment: Psychiatry, 2e. | Psychiatry | null | A 70 year old female with psychiatric symptoms diagnosed of having schizophrenia. Which is the poor prognostic factor in schizophrenia?
A. Acute onset
B. Middle age
C. Family history of affective disorder
D. Gradual onset
| Acute onset |
07f998af-96f3-46a3-837a-e29439c9dead | Year → World Health Day (WHD) Theme
2004 → Road safety is no accident
2005 → Make every mother and child count
2006 → Working together for health
2007 → International health security: Invest in health, build a safer future
2008 → Protecting health from climate change
2009 → Health facilities in emergencies | Social & Preventive Medicine | null | The slogan for WHO 2005 –
A. Road safety
B. Maternal and child health
C. Aging
D. Physical activity
| Maternal and child health |
9cd56341-0590-417b-81b6-36cdafa88d76 | The incidence of mental illness is the maximum if the causal factors affect a paicular period of first five years of life crucial points in the life cycle of human being which are impoant from the view of mental health are prenatal period, first five years of life, school child , adolescence, old age. ref ;(page no;832)23rd edition of PARK&;s textbook of Preventive and Social medicine | Social & Preventive Medicine | Social science, Mental health & Genetics | The incidence of mental illness is the maximum if the causal factors affect a paicular period -
A. Perinatal period
B. First five years of life
C. School age
D. Adolescence
| First five years of life |
8be51d84-561b-48b8-ada0-baa667efb3a8 | Rough endoplasmic reticulum is associated with protein synthesis, protein folding and miss folded protein degradation. Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:10,11,12 | Anatomy | General anatomy | Miss folded proteins might be produced due to defect of:
A. Cholesterol
B. Mitochondrial
C. Rough endoplasmic reticulum
D. Smooth endoplasmic reticulum
| Rough endoplasmic reticulum |
4fa29ea9-bf76-4f1d-a099-a176bb6d76f0 | Apgar score is an objective method of evaluating the newborn&;s condition. It includes Hea rate, Respiratory effo, Muscle tone, Reflex irritability and Color. It is generally performed at 1min and again at 5 min after bih. Reference : page 126 Ghai Essential Pediatrics 8th edition | Pediatrics | New born infants | APGAR score include A/E
A. Respiratory effo
B. Hea rate
C. Respiratory rate
D. Colour
| Respiratory rate |
1843ee69-8b1b-412b-8399-e0a332048ce1 | Ans. (b) Breast cancer(Ref Internet source)Bloom and Richardson grading for cancer breast is based on* Tubules formation* Nuclear pleomorphisms* Mitotic counts | Surgery | Breast | Bloom Richardson staging is for?
A. Prostate cancer
B. Breast cancer
C. Ovarian cancer
D. Penile cancer
| Breast cancer |
b238694b-0485-440c-90be-acbbaff1c551 | Amniocentesis is ideally performed between 14-16weeks of gestation. Early amniocentesis can be carried out at 12-14 weeks under ultrasonographic guidance. The fetal cells so obtained are subjected for cytogenetic analysis. Fetal fibroblasts and fluid for biochemistry are used for study. Chorionic villus sampling : is carried out transcervically between 10 - 12 weeks and transabdominally from 10 weeks to term. Trophoblast cells are used for study. Cordocentesis: Is done between 18-20 weeks of gestation. Fetal WBCs are used for study. Ref: Textbook of Obstetrics By DC Dutta 6th edn page 107-8. | Gynaecology & Obstetrics | null | Which is the MOST appropriate gestational age for performing amniocentesis?
A. 10-12 weeks
B. 12-16 weeks
C. 20-25 weeks
D. 25-30 weeks
| 12-16 weeks |
8569215f-996c-4919-8070-f7bcd5fdbe16 | A combined T cell and B cell immunodeficiency that is a rare autosomal recessive metabolic disorder that has material basis in mutation in the PNP gene and characterized mainly by decreased T-cell function. Ref-Sathyanarayana 4/e | Biochemistry | Metabolism of nucleic acids | Deficiency of purine nucleoside phosphorylase causes
A. Complement deficiency
B. Cellular immunodeficeincy
C. Humoral immunodeficeincy
D. Combined immunodeficeincy
| Cellular immunodeficeincy |
5bbdce5d-aafa-4bae-86ad-701e3569c8f8 | Nuclear senile cataract: The usual degenerative changes are intensification of the age- related nuclear sclerosis associated with dehydration and compaction of the nucleus resulting in a hard cataract. It is accompanied by a significant increase in water insoluble proteins. However, the total protein content and distribution of cations remain normal. There may or may not be associated deposition of pigment urochrome and/or melanin derived from the amino acids in the lens. The nucleus may become diffusely cloudy (greyish) or tinted (yellow to black) due to deposition of pigments. In practice, the commonly observed pigmented nuclear cataracts are either amber, brown (cataracta brunescens) or black (cataracta nigra) and rarely reddish (cataracta rubra) in colour. Ref:- A K Khurana; pg num:- 176,178 | Ophthalmology | Lens | Cataracta brunescens result due to deposition of
A. Copper
B. Iron
C. Melanin
D. Keratin
| Melanin |
620a2090-2315-4c74-b4f3-888bb0656f83 | Side effects of impoant CNS drugs Midazolam Ataxia, Blackouts in elderlyTolcapone Hepatotoxic Phenytoin Hirsuitism , Gingival hyperplasia , Osteomalacia , Teratogen , Megaloblastic anemia , Ataxia, Lymphadenopathy, Hyperglycemia , Arrhythmias, Vitamin K deficiency Valproate Irreversible hepatic necrosis in older children, Acute pancreatitis Zonisamide,, Topiramate Renal stones VigabatrineIrreversible visual field defectsFelbamate Aplastic anemia Thioridazine Male sexual dysfunction, Retinal damage, Least extra pyramidal symptomsClozapine Agranulocytosis , Myocarditis Risperidone Extra pyramidal symptoms HaloperidolExtra pyramidal symptoms , Akathisia Olanzapine Risk of stroke and death Ziprasidone , Pimozide QT prolongation Quetiapine Cataract Iloperidone Ohostatic hypotension Lithium in expectant mothers Ebstein's anomalyFormic acid Retinal damage Opioids Tolerance & addiction (Refer: Rang and Dale's Clinical Pharmacology, 7th edition, pg no: 557-559) | Anatomy | All India exam | The least extrapyramidal side effects are seen with which of the following phenothiazine?
A. Clozapine
B. Triflupromazine
C. Fluphenazine
D. Thioridazine
| Thioridazine |
34f0c089-0cea-4465-8b44-ac596a6e019a | TEST : 1. CKD - EPI - cystatin C method (BEST) ; Cystatin - C is produced by nucleated cells 2. Modification of diet in renal disease formula GFR= 186.3 x (serum creatinine level ( mg/dl))-1.154 x age-0.203 x ( 0.742 if female ) x (1.21 if black) 3. Cockroft Gault formula 4. Creatinine clearance 5. Inulin clearance | Medicine | Chronic Kidney Disease & Diabetic Nephropathy | Which is not a variable of MDRD (Modification of Diet in Renal Disease) formula?
A. Age
B. Gender
C. Race
D. Weight
| Weight |
d7846780-47d2-4499-a96e-ffd79d5e3f3c | Ans. is d, i.e. Prominent posterior enhancementRef: Transvaginal Ultrasound by Melvin G. Dodson 1st/ed, p86This is a very important QuestionIMPORTANT: The appearances of endometrium on transvaginal ultrasound during different stages of normal menstrual cycle has been summarized here.A. Just after menstruation (days 3-7)Single hyperechoic thin lines (central endometrial echo)B. At the time of ovulationHalo presentRelatively thin anterior posterior endometrial thickness (<6mm)No posterior enhancementQThree line sign.Q/Trilaminar appearanceC. Luteal phaseMaximum endometrial thicknessHyperechoic endometriumLoss of haloQLoss of three line signQProminent posterior enhancementQ | Gynaecology & Obstetrics | Gynaecological Diagnosis | Feature of post ovulatory endometrium on ultrasound is:
A. Single hyperechoic thin line
B. Three line sign
C. Prominent halo
D. Prominent posterior enhancement
| Prominent posterior enhancement |
a685d38a-b695-48f7-a12e-f5f9631b3046 | " It occurs predominantly on the skin and can involve viually any organ, perhaps except the brain. The initially described form, now known as classic KS, predominantly involves the lower extremities of elderly men. KS is now the most common tumor seen in HIV-infected patients Ref : Bailey and love surgery text book 27th Ed. | Surgery | All India exam | Kaposi sarcoma is commonly seen in ?
A. Upper limbs
B. Lower limbs
C. Head and Neck
D. Trunk
| Lower limbs |
a0f97d39-a0d2-4734-92c0-21e220abde4f | Tension band wiring is indicated in the treatment of two types of olecranon fracture. First type is a clean break with separation of the fragments, and second type is comminuted fracture of the olecranon with displced fragments. A crack in the olecranon without displacement is treated by immobilising the elbow in an above elbow plaster slab in 30 degrees of flexion. | Surgery | null | Tension band wiring is indicated in fracture of which of the following ?
A. Fracture humerus
B. Olecranon
C. Fracture tibia
D. Fracture spine
| Olecranon |
aa618f4a-22da-4ec7-8c8c-cb96c4ca840c | It is the inflammation of conjunctiva with formation of very large sized papillae. Etiology :It is a localised allergic response to a physically rough or deposited surface (contact lens, prosthesis, left out nylon sutures). Probably it is a sensitivity reaction to components of the plastic leached out by the action of tears. ref: A K KHURANA OPHTALMOLOGY,E4, Page-77 | Ophthalmology | Conjunctiva | Giant papillary conjunctivitis is seen
A. Trachoma
B. Contact lens
C. Phlytenular conjunctivitis
D. Vernal kerato conjunctivitis
| Contact lens |
2fe98876-8ad2-48fa-a194-a2ae1c639f55 | Ans. is 'd' i.e., Echocardiography Investigations o Investiation of choice to identify individual cardiac chamber enlargement - 2D-echocardiography. o Inv estigation of choice for pericardial effusion - 2D-echocardiography. o Investigation of choice for valvular heart disease - 2D-echocardiography. o Investigation of choice for cardiomyopathy -2D-echocardiography. o Investigation of choice for cardiac temponade - 2D-echocardiography. o Investigation of choice for aortic dissection in stable patient - MRl. o Investigation of choice for aortic dissection in unstable patient - TEE. o Investigation of choice for ventricular function and size - Echocardiography o Investigation of choice for congenital heart disease - Echocardiography, o Investigation of choice for pericardial defect - MRI. o Investigation of choice for radiotherapy/chemotherapy induced myocardial damage - Endomyocardial biopsy o Investigation of choice for myocardial perfusion and viability (reversible ischemia) - Nuclear cardiac imaging (thallium scan or Technetium scan) o Most sensitive investigation for air embolism - Trans-esophageal echocardiography. o Second most sensitive investigation for air embolism - PrecordiaJ Doppler o Best x-ray view for right atrial enlargement - Left anterior oblique view, o Best x-ray view for left atrial enlargement - Right anterior oblique view with barium swallow | Radiology | Cardiac and Pericardiac Imaging | Best investigation for pericardial effusion is -
A. MRI
B. CT
C. X ray
D. Echocardiography
| Echocardiography |
fe8a375f-60e8-4847-be60-00827ca4e430 | Ans. is 'd' i.e., ChromophobicHistopathological findings of perinuclear halo and plant cell appearance are seen in chromophobe cell carcinoma ofRCC.o Electron microscopic finding consisting of numerous 150-300 nm microvesicles is the single most distinctive and defining feature of chromophobe cell ca. | Pathology | null | Histopathology showing large cells with plant like apperance with perinuclear halo is seen in which type of renal cell carcinoma ?
A. Onchocytoma
B. Granular cell carcinoma
C. Angiosarcoma
D. Chromophobic
| Chromophobic |
becce6b6-3172-4498-a86f-a688db6c40fc | Brimonidine (0.2% : 2 times/day). It is a selective alpha-2-adrenergic agonist and lowers IOP by decreasing aqueous production. Because of increased allergic reactions and tachyphylaxis rates it is not considered the drug of first choice in POAG. It is used as second drug of choice and also for combination therapy with other drugs Ref.AK Khurana 4th edition page no 223 | Ophthalmology | Glaucoma | Selective alpha 2 agoinst used in glaucoma -
A. Timolol
B. Epinephrine
C. Dipivefrine
D. Brimonidine
| Brimonidine |
f4802146-6def-4136-905e-6f2d462b0cf7 | Mucor is an opportunistic mold that causes mucormycosis. At least 50% of reported cases are associated with uncontrolled diabetes, and many of the remaining patients are immuno- suppressed. It appears as black crusting in the nose and sinuses and spreads rapidly to involve the cerebrum. Biopsy reveals nonseptate hyphae, which confirms the diagnosis. Treatment is directed toward control for diabetic ketoacidosis and use of amphotericin B. | Surgery | Miscellaneous | A 63-year-old man with insulin-dependent diabetes develops a black, crusting lesion in the nose and left maxillary sinus. Biopsy reveals nonseptate hyphae, which confirms the diagnosis of what? SELECT ONE.
A. Erysipelas
B. Eczema
C. Scarlet fever
D. Mucor mycosis
| Mucor mycosis |
3ff98111-521c-49d1-adbe-94a61f36b4e2 | Diaphragmatic palsy Bilateral diaphragmatic paralysisUnilateral diaphragmatic paralysisMost common cause of bilateral diaphragmatic paralysis are:High spinal cord injuryThoracic trauma (cardiac surgery)Multiple sclerosisAnterior horn disease Muscular dystrophyMost patients present with hypercapnic respiratory failure, frequently complicated by cor pulmonale and right ventricular failure, Atelectasis and pneumonia.The degree of diaphragmatic weakness is best quantitated by measuring trans diaphragmatic pressures.Treatment of choice is assisted ventilation for all or pa of each day.If the nerve to the diaphragm is intact, diaphragmatic pacing may be a ble alternativeUnilateral palsy is MC than bilateral, MC cause is nerve invasion from malignancy, usually a bronchogenic carcinoma.Diagnosis is suggested by an elevated hemidiaphragm on the CXR.Confirmation is best established with the "sniff test"(when the patient is observed with fluoroscopy while sniffing, then paralyzed diaphragm will move paradoxically upward due to the negative intrathoracic pressure).Patients with unilateral paralyzed diaphragm are usually asymptomatic, vital capacity and total lung capacity is reduced about 25%.No treatment if CXR is normal and patient is asymptomatic(Refer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 2221) | Pathology | All India exam | Paradoxical respiration is seen in
A. Multiple fracture ribs
B. Diaphragmatic palsy
C. Bulbar polio
D. Severe asthma
| Diaphragmatic palsy |
dc3b5e3b-9a1d-4000-8747-8ff108aa2980 | Ans. A. HGPRTaseSlide 1 showing nibbling of lips and fingers; slide 2 showing bite marks on hand inflicted by self. Self-mutilation seen in Lesch Nyhan Syndrome; characteristic of the disease in children.Clinical signs and symptoms seen in Lesch Nyhan Syndrome:a. Biochemical: Hyperuricemia, can result ini. Gout (Joint pains)ii. Nephrolithiasis (abdominal pain, may be radiating in nature)iii. Tophib. Neurological:i. Mental Retardation (Poor performance in school)ii. Dystonia, variablec. Neuropsychiatric:i. Aggressive Behaviour (frequent fight, quarreling with siblings)ii. Self-Mutilation Tendency (associated with muscle loss; biting, chewing, etc.)d. Inheritance is XLR, enzyme absent is HGPRTase; in some patient, where the enzyme is not absent, but only diminished, have a less severe condition called Kelley Seegmiller Syndrome, where neurological and neuropsychiatric symptoms are either absent or very mild. | Biochemistry | Miscellaneous (Bio-Chemistry) | In this child Which of the following enzymes is likely to be deficient?
A. HGPRTase
B. Adenosine deaminase
C. APRTase
D. Acid maltase
| HGPRTase |
44f0c695-f77a-4458-800a-e80df0764407 | Musculature of the first pharyngeal arch includes the muscles of mastication (temporalis, masseter, and pterygoids), anterior belly of the digastric, mylohyoid, tensor tympani, and tensor palatini. The nerve supply to the muscles of the first arch is provided by the mandibular branch of the trigeminal nerveRef: Langman's embryology 11th edition Chapter 16. | Anatomy | null | Musculature of first pharyngeal arch is supplied by which cranial nerve?
A. V
B. VII
C. IX
D. X
| V |
e57a329a-1aa2-4b8b-96f6-587f69390031 | MAOI * IMPOANCE First class of antidepressant drugs that were introduced * MECHANISM There are three monoamines namely dopamine, adrenaline and serotonin. These mon amines are degraded by monoamine oxidase. MAOI inhibit this enzyme and acts increasing monoamines * DRUGS Phenelezine Tranylcipromine * USE ATYPICAL DEPRESSION, depression with reverse vegetative symptoms * SIDE EFFECTS Hypeensive crisis Cheese reaction When a patient on MAOI takes tyramine rich food like tyramine there will be increased release of monoamines. These excess monoamines cannot be degraded by MAO as it is blocked by MAOI. Thus, this may result in hypeensive crisis. Paresthesia's due to pyridoxine deficiency LIKE IPRONIAZID WEIGHT gain SEXUAL dysfunction Ref. Kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no, 955 | Psychiatry | Pharmacotherapy in psychiatry | which of the following antidepressent causes hypeensive crisis
A. dapoxetine
B. duloxetine
C. clomipramine
D. phenelezine
| phenelezine |
e57551b1-32bf-4f6c-b97a-d61c6d6e34f7 | Elective lap cholecystectomy is a clean-contaminated surgery, single preoperative IV antibiotic during decisive period is sufficientThere is no evidence that fuher doses of antibiotics after surgery are of any value in prophylaxis against infectionWhen wounds are heavily contaminated or when an incision is made into an abscess, a 5-day course of therapeutic antibiotics may be justifiedRef: Bailey and Love 27e pg: 53 | Surgery | General surgery | In an elective lap cholecystectomy with no gross spillage, antibiotics required are
A. Single dose of Preoperative IV antibiotic followed by a 5 day course of oral antibiotics
B. Post operative IV antibiotics for 1 day followed by a 5 day course of oral antibiotics
C. Single dose of Preoperative IV antibiotic only
D. 5 day course of oral antibiotics only
| Single dose of Preoperative IV antibiotic only |
1ef63795-7bef-4c88-8824-9d6ea36b147c | The clinical history corresponding to the diagnosis of pulmonary embolism. For a patient presenting with acute breathlessness and chest pain and in whom right ventricular dilatation with tricuspid regurgitation and mild elevation of pulmonary aery pressure is noted, a pulmonary embolus should be the initial diagnosis to be considered. Ref: Deep Vein Thrombosis and Pulmonary Embolism, Page 253, 254; Feigenbaum's Echocardiography, 7th Edition, Page 762. | Surgery | null | A patient developed breathlessness and chest pain, on second postoperative day after a total hip replacement. Echo-cardiography showed right ventricular dilatation and tricuspid regurgitation. What is the most likely diagnosis?
A. Acute MI
B. Pulmonary embolism
C. Hypotensive shock
D. Cardiac tamponade
| Pulmonary embolism |
d8dbe580-286b-4b6a-bbe8-bc7c8a4a27d8 | Sporotrichosis:
Dimorphic fungi
Causes subcutaneous infections. | Microbiology | null | Dimorphic with subcutaneous Mycosis is
A. Histoplasmosis
B. Rhinosporidiosis
C. Sporotrichosis
D. Blastomycosis
| Sporotrichosis |
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