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eb77de2e-b112-48a9-a06f-17f6eb732342 | Refer kDT 7/e p 156 It has also been used in the treatment of chronic open-angle glaucoma and acute angle-closure glaucoma It acts on a subtype of muscarinic receptor (M3) found on the iris sphincter muscle, causing the muscle to contract -resulting in pupil constriction (miosis). Pilocarpine also acts on the ciliary muscleand causes it to contract. When the ciliary muscle contracts, it opens the trabecular meshwork through increased tension on the scleral spur. This action facilitates the rate that aqueous humor leaves the eye to decrease intraocular pressure | Pharmacology | Autonomic nervous system | Pilocarpine reduce the intraocular pressure in person with closed angle glaucoma by
A. Reducing aqueous humour secretion
B. Contacting iris spincter muscle
C. Increasing aqueous humour outflow
D. Relaxin ciliary muscle
| Increasing aqueous humour outflow |
3b08b774-7629-472b-a942-12e036390577 | Nephelometry measures the interaction of antibodies and antigens in solution, detecting immune complex formation by monitoring changes in the scattering of an incident light. Ref: Imboden J.B. (2007). Chapter 3. Laboratory Diagnosis. In J.B. Imboden, D.B. Hellmann, J.H. Stone (Eds), CURRENT Rheumatology Diagnosis & Treatment, 2e. | Biochemistry | null | A variety of basic assays are used to detect autoantibodies. Nephelometry is based on the principle of:
A. Light attenuated in intensity by scattering
B. Refraction of light
C. Reduced transmission of light
D. Filtration of solutes by kidney
| Light attenuated in intensity by scattering |
c60ee27b-cb30-4075-8c71-925f924f5ffe | Pterygium It presents as a triangular fold of conjunctiva encroaching the cornea in the area of the palpebral apeure, usually on the nasal side, but may also occur on the temporal side. Deposition of iron seen sometimes in corneal epithelium anterior to advancing head of the pterygium called as stocker's line. Pas. A fully developed pterygium consists of three pas: i. Head (apical pa present on the cornea), ii. Neck (limbal pa), and iii. Body (scleral pa) extending between limbus and the canthus. Stocker's line in pterygium. Pterygium is a fibrovascular proliferative disorder in which conjunctival tissue grows medially to cover the clear cornea. On slit-lamp examination showed marked pterygium that extend from the nasal side of bulbar conjunctiva onto the cornea in the left eye Ref: Khurana; 4th ed; Pg 80 | Ophthalmology | Conjunctiva | Stocker&;s line is seen in
A. Pinguecula
B. Pterygium
C. Congenital ocular melanosis
D. Conjunctival epithelial melanosis
| Pterygium |
acd6b8e6-00d7-4195-bdb9-b2be3b5a842d | The lesion is a squamous cell carcinoma of the skin. Actinic keratosis, which is a hyperplastic lesion of sun-damaged skin, predisposes for squamous cell carcinoma. Another predisposing condition to remember is xeroderma pigmentosum, which predisposes for both squamous cell and basal cell carcinomas of skin. A nevus is a mole, containing characteristic cells called nevocellular cells. If the nevocellular cells are located at the dermal-epidermal junction (junctional nevus), in the dermis (dermal nevus), or both (compound nevus) they do not predispose for squamous cell carcinomas of the skin. Ref: Vujevich J.J., Goldberg L.H. (2012). Chapter 246. Cryosurgery and Electrosurgery. In L.A. Goldsmith, S.I. Katz, B.A. Gilchrest, A.S. Paller, D.J. Leffell, N.A. Dallas (Eds), Fitzpatrick's Dermatology in General Medicine, 8e. | Skin | null | A patient consults a dermatologist about a skin lesion on her neck. Examination reveals a 1-cm diameter,red, scaly plaque with a rough texture and irregular margins. Biopsy demonstrates epidermal and dermal cells with large, pleomorphic, hyperchromatic nuclei. Which of the following conditions would most likely predispose this patient to the development of this lesion?
A. Actinic keratosis
B. Compound nevus
C. Dermal nevus
D. Junctional nevus
| Actinic keratosis |
fb319f93-1dcd-4436-9e58-3510601e0035 | Ans. (c) Pleasure in touching opposite sexRef: The Essentials ofFSM by K.S. Narayan Reddy 31st ed. / 404* FROTTEURISM: rubbing the genitalia with the body of the person of other sex for sexual satisfaction.* Paraphilias: Abnormal 8c unorthodox sex play by using unusual objects or parts are know as paraphilia eg. Sadomasochism, Transvestism, Bestiality, Frotteurism, Homosexuality etc.* Bisexuality means hermaphrodite; an individual with both ovary 8c testis 8c external genitals of both sexes.Different Paraphilias/PerversionSexual perversionMode of sexual pleasureSadismPleasure in giving pain to sexual partnerMasochismPleasure on receiving painful stimulus from sexual partnerBondageSadism + masochism are found togetherFetischismSexual gratification by article of opposite sexFrotteurismSexual gratification by contact. Ex: rubbing genitalia on another personExhibitionismSatisfaction in exhibition of genitals with or without mastutbationTransvestism/ EonismPleasure in wearing clothes of opposite sexUranismSexual gratification by fingering, fellatio, cunnilingus etc.Buccal coitus or Sin of GomorrahFellatio is oral stimulation of penis by male or femaleCunnilingus is oral stimulation of female genitalsVoyeurism/ ScotophiliaAlso known as Peeping tomDesire to watch sexual intercourse or toobserve genitals of othersTrolismExtreme degree of voyeurism. Ex: A perverted husband enjoy watching his wife having sexual intercourse with another man.Urolangia/ CoprophiliaSexual excitement by sight or odor of urine or faeces.Tribadism/ LesbianismGratification of sexual desire of a women by another womenSodomy or Buggery of Greek Love* Anal sex* Gerantophilia -when passive agent is adult* Paederasty - when the passive agent is young boy (catamite)IncestSexual intercourse with close relativeBestialitySexual intercourse by a human being with a lower animal | Forensic Medicine | Sexual Offenses and Dowry Death | Frotteurism:
A. Pleasure in watching intercourse
B. Pleasure in using article of opposite sex
C. Pleasure in touching opposite sex
D. Pleasure in wearing opposite sex clothes
| Pleasure in touching opposite sex |
5161f3fb-1046-47e2-916f-e7266c0fb377 | an impoant fact about cailage matrix is that it is avascular, i.e. not supplied by capillariestherefore, chondrocytes within the matrix must receive nutrients and oxygen by diffusion from vessels that lie outside the cailagethis long-distance diffusion is possible because of the large volume of water trapped within the matrix(Refer: Manish Kumar Varshney's Essential Ohopedics Principles & Practice, 1st edition, pg no. 7, 347) | Orthopaedics | All India exam | Nutrient and oxygen reach the chondrocytes across perichondrium by
A. Capillaries
B. Diffusion
C. Along neurons
D. Active transpo
| Diffusion |
7c2228ca-b770-4cd6-b018-66056347cfb9 | B i.e. Acute psychosis- Delusions or hallucinations (suchas hearing voices in this case) with grossly disorganized speech and behavior (such as muttering to self, gesticulation, aggressiveness in this case) of acute onset with normal cognition & consciousness indicate the diagnosis of acute psychosis (i.e. psychosis of acute onset). This acute psychosis may be d/t psychotic disorder d/t general medical condition (such as high fever as in this case) or d/t brief psychotic disorder (DSMIVTR), or d/t acute and transient psychotic disorder (ICD-10). So here the term acute psychosis is used to depict the clinical picture not the cause of that clinical picture.Delirium can also present acute onset disorganized behavior (agitation) and speech (incoherent) with delusions or hallucinations but the delusions are poorly elaborated & transient, the course of disease is fluctuant (eg sun downing). And characteristically there is clouding of (disturbance in) consciousnesss (i.e. reduced clarity of awareness of the environment) and disorientation (change in cognition) in delirium. Just like psychosis clinical picture of delirium may also be d/t various reasons such as general medical condition / substance intoxication/ withdrawal.- Dementia is a chronic slow/insiduous process presenting with decrement in intellectual abilities (such as sho & long term memory, judgement, abstract thinking, impulse control, personal care and personality)Q.- Delusional disorder presents with nonbizarre delusions (involving situations that occur in real life) of at least 1 months durationQ. Apa from the impact of delusion (s) or its ramifications, functioning is not markedly impaired and behavior is not obviously odd or bizarre (i.e. criteria. A of schizophrenia has never been met). However, tactile or olfactory hallucinations may be present if they are related to delusional theme. | Psychiatry | null | A 20 year old boy c/o hearing of voices, aggressive behavior since 2 days. He has fever since 2 days. When asked to his family, they say that he has been muttering to self and gesticulating. There is no of psychiatric illness. Likely diagnosis is:
A. Dementia
B. Acute psychosis
C. Delirium
D. Delusional disorder
| Acute psychosis |
bdb1d94e-5332-4c82-a219-5c5d3fc7dcbe | Genital HPV infection is extremely common and most often cause no symptoms. A propoion of individuals infected with low-risk HPV types such as HPV-6 or HPV-11 will develop genital was, whereas a subset of women with high-risk HPVs such as HPV-16 or HPV-18 will develop preneoplastic lesions of cervical intraepithelial neoplasia (CIN). Low-grade cervical dysplasias are common and most regress spontaneously. In contrast, the minority of lesions that progress to high-grade dysplasias tend to persist and/or progress to carcinomas in situ before becoming invasive cancers. The majority of adenocarcinomas of the cervix and of squamous cell cancers (SCC) of the vulva, vagina, penis and anus are caused by HPV-16 and HPV-18 (together accounting for about 70% of cases globally), the remaining 30% being due to other high-risk HPV types (such as HPV-31, -33, -35, -39, -45,-51, -66). HPV is also associated with other cancers of the anus, head and neck, and rarely, recurrent respiratory papillomatosis in children. | Gynaecology & Obstetrics | null | Which type of Human papilloma virus is most commonly associated with Cervical cancer ?
A. HPV 16
B. HPV 24
C. HPV 32
D. HPV 36
| HPV 16 |
a85372d9-9495-4123-a848-4af2e297a3d6 | Ashley's rule States that male sternum lenth will be more than 149mm and female sternum lenth will be less than 149mm. | Forensic Medicine | null | Ashley's rule is used to :
A. Determine age using sternum
B. Determine sex using sternum
C. Determine age using mandible
D. Determine sex using mandible
| Determine sex using sternum |
20178e56-6120-4a3a-9468-53750351c780 | Ans. is 'd' i.e., HMG CoA reductase Hypolipidemic drugsHMG-CoA reductase inhibitors (statins) - Lovastatin. Simvastatin, Pravastatin, Atorvastatin, Rosuvastatin.Bile acid sequestrants (Resins) - cholestyramine, colestipol.Activate lipoprotein lipase (fibric acid derivatives) - clofibrate, gemfibrozil, bezafibrate, fenofibrate.4.Inhibit lipoly sis and triglyceride synthesis - Nicotinic acid.5,Other - Probueol, Gugulipid, Ezetimibe, Avasimibe, Torcetrapib.o Ezetimibe inhibits intestinal cholesterole absorption.o Avasimibe inhibits enzyme acyl Coenzyme A ; cholesterol acyl transferase-1 (ACAT-1) which causes esterification of cholesterol.o Torcetrapib inhibits cholesterol ester triglyceride transport protein -| HDL cholesterol. | Pharmacology | Hypolipidemic | Statins act on which enzyme -
A. Acyl CoAsynthetase
B. Acyl Co A reductase
C. HMG CoA Synthetase
D. HMG CoA reductase
| HMG CoA reductase |
cf773a89-7c49-4bb8-8d99-4ccae09dda4e | Ans. is 'a' i.e., Coeliac diseases Coeliac disea.se (CD) is a permanent intolerance of the small intestine to gluten, characterized by gluten-dependent changes in villous morphology and/or signs of immunological activation detectable in the lamina propria of intestinal mucosa. The presence of serum anti-endomysial antibodies (EMA) is generally considered to be highly suggestive for CD because of their high values of sensitivity and specificity. Other antibodies used for diagnosis Tissue transglutaminase, Antigliadin antibodies Treatment is Gluten-free diet | Pediatrics | null | Antiendomysial antibody is used in screening of ?
A. Myasthenia gravis
B. Auto immune hepatitis
C. Coeliac diseases
D. Graves disease
| Myasthenia gravis |
ced99966-5f49-4182-beff-3b34ee188939 | Modes Primordial Before the emergence of risk factor Health education Primary Risk factor but no disease yet Health promotion, specific protection Secondary Disease possible staed in the body Early diagnosis, Treatment Teiary Disease is already in progression Disability limitation , Rehabilitation | Social & Preventive Medicine | Levels of Prevention of Disease | Primary level of prevention is?
A. Prevention of emergence of risk factors
B. Prevention of disease in Pre-pathogenesis phase
C. Prevention of disease in incipient stage
D. Prevention of disability and rehabilitation
| Prevention of disease in Pre-pathogenesis phase |
2d4d1560-3f97-44ce-a319-388981604843 | Ans. (b) Secretory(Ref: Immunology, 8th edition, by David Male; pg 427)Epithelioid cells are transformed macrophages that have lost their phagocytic function but retained their secretory activity.Epithelioid cells contain numerous endoplasmic reticulum & golgi bodies.They secrete IL10, TNF alpha, TGF beta; | Pathology | Respiration | The most important function of epithelioid cells in tuberculosis is:
A. Phagocytosis
B. Secretory
C. Antigenic
D. Healing
| Secretory |
28e068d7-e49c-4855-bcab-f55d013b3677 | Ans. is 'd' i.e., Central serous retinopathy * Smoke stack pattern (small hyper fluorescent spot which ascends vertically like a smoke-stack), which gradually spreads laterally to take a mushroom or umbrella configuration, is a Fundus Fluorescein Angiography (FFA) finding of Central Serous Retinopathy.* Another important FFA finding of CSR is Ink-blot or enlarging dot pattern (small hyperfluorescent spot which gradually increases in size.* Among these the most common FFA finding is ink-blot pattern. | Ophthalmology | Retina | Smoke stake pattern is characteristic of?
A. Sickle cell retinopathy
B. Sarcoidosis
C. Acute retinal necrosis
D. Central serous retinopathy
| Central serous retinopathy |
1bb6a4dd-3815-4e73-a7fc-7b9269c97f5c | Res ipsa loquitur: means the thing or fact speaks for itself. Here the patient has to merely state the act of negligence. It must satisfy the conditions that in the absence of negligence, the injury would not have occurred ordinarily, the doctor had exclusive control over the injury-producing treatment or instrument and the patient was not guilty of contributory negligence. The case can be proved without medical evidence. Medical maloccurrence: in spite of good medical attention and care, an individual fails to respond properly or may suffer from adverse reactions of the drug. Therapeutic misadventure: is a case in which an individual has been injured or had died due to some unintentional act by a doctor or agent of the doctor or the hospital. eg: hypersensitivity reaction caused by penicillin, aspirin, etc. Novus actus interveniens: if the doctor is negligent, which results in a detion from the logical sequence of events, then the responsibility for the subsequent disability or death may pass from the original incident to the later negligent action of the doctor. eg: leaving of a swab or surgical instrument in the abdomen after the repair of an internal injury. Ref: Dr.K.S.Narayana Reddy, The Essentials of Synopsis of Forensic Medicine & Toxicology, 34th edition Pg.37,38,44. | Forensic Medicine | Medical Jurisprudence | Surgical scissors left in abdomen is covered under which doctrine -
A. Res ipsa loquitur
B. Medical maloccurrence
C. Therapeutic misadventure
D. Novus actus interveniens
| Res ipsa loquitur |
23467fb8-cc6c-4f1c-9e19-cb1c07fb1923 | Ans. d (Oral iron intolerance). (Ref. KDT, Pharmacology, 6th/pg.584)IRON THERAPY# Some iron preparations come with other compounds designed to enhance iron absorption, such as ascorbic acid,# Typically, for iron replacement therapy, up to 300 mg of elemental iron per day is given, usually as three or four iron tablets (each containing 50-65 mg elemental iron) given over the course of the day.# Ideally, oral iron preparations should be taken on an empty stomach, since foods may inhibit iron absorption.# A dose of 200-300 mg of elemental iron per day should result in the absorption of iron up to 50 mg/d.# The goal of therapy in individuals with iron-deficiency anemia is not only to repair the anemia, but also to provide stores of at least 0.5-1.0 g of iron.# Sustained treatment for a period of 6-12 months after correction of the anemia will be necessary to achieve this.# Of the complications of oral iron therapy, gastrointestinal distress is the most prominent and is seen in 15-20% of patients.# Typically, the reticulocyte count should begin to increase within 4-7 days after initiation of therapy and peak at 1 1/2 weeks.# The amount of iron needed by an individual patient is calculated by the following formula:Iron requirement (mg) =4.4 X bidt wt (kg) X Hb defucut (g/dL)Indications of parenteral Iron therapy# Oral iron intolerance# Failure to absorb oral iron# Non-compliance to oral therapy# In presence of severe anemia with bleeding.Oral Iron preparationsIron contentFerrous sulfate Hydrated salt20%Dried salt32-35%Ferrous gluconate12%Ferrous fumarate, succinate33%Colloidal ferric hydroxide50%Iron-calcium complex5% Iron therapy:Dosage ------200mg elemental iron per dayRise of Hb --------0.5-lgm% per week1st sign of response --------| Apetite, | fatigue within 12-24 hrs Reticulocytosis 3-4th DayIndication of Blood transfusion------Hb < 7gm% or CCFDuration of iron tablets ------At least 100 days after correction of Hb | Pharmacology | Hematology | Indication for intramuscular iron therapy?
A. Pregnancy
B. Postpartum period
C. Emergency surgery
D. Oral iron intolerance
| Oral iron intolerance |
5e647902-b8d1-4dca-917e-b2551e75e774 | Red tender nodules on her shin could be erythema nodosum; Erythema nodosum is a type of panniculitis, i.e. an inflammatory disorder affecting subcutaneous fat.Oral contraceptives which this newly married woman would take is likely hereOther causes are Neutrophilic dermatoses (Behcet's disease, Sweet's syndrome), iodides, bromides, sulfonamides, Sarcoidosis, Ulcerative colitis(also Crohn&;s), Streptococcus, Pregnancy, and Malignancy | Microbiology | All India exam | A 26-year-old recently married woman presents with tender nodules on her shin. Initial history taking should include questions about
A. Her stress level
B. Any new medications she may have staed
C. History of foreign travel
D. Insect bites to the legs
| Any new medications she may have staed |
ee76a177-3113-44ac-b856-d98c0e45ee98 | - Fatty acid found exclusively in breast milk: DHA (Docosa hexanoic acid) - It aids in development of brain by promoting myelination of neurons. OTHER ESSENTIAL FATTY ACIDS & THEIR RICH SOURCES: Linoleic acid, Arachidonic acid - Safflower oil Linolenic acid - flaxseed oil, soyabean oil Eichosa pentanoic acid - fish oils. | Social & Preventive Medicine | Proteins, Fats, Rich Sources | Fatty acid found exclusively in breast milk is:-
A. Linoleic acid
B. Linolenic acid
C. Docosa hexanoic acid
D. Eichosa pentanoic acid
| Docosa hexanoic acid |
8bbd2f2b-67a9-4907-b1e4-69c7c87a8688 | Ans. B: Diastolic murmur duration Mitral Stenosis Severity assessment on auscultation - Time interval between A2 and opening snap is inversely propoional to the severity of MS. - Duration (of low pitched, rumbling, diatolic murmur, heard at the apex) of murmur correlates with the severity of stenosis in patients with preserved CO. Echocardiography: Mitral Stenosis Severity Scales - Pressure half-time Normal : 30 to 60 milliseconds Abnormal : 90 to 400 ms Gray area : 60 to 90 ms Mild MS : 90 to 150 ms Moderate MS : 150 to 219 ms Severe MS : > 220 ms Mitral valve area Normal : 4 to 6 cm2 Mild MS : 1.5 to 2.5 cm2 Moderate MS : 1.0 to 1.5 cm2 Severe MS : End-diastolic pressure gradient Normal : 0 to 2 mm Hg Mild MS : 2 to 6mmHg Moderate MS : 6 to 10 mm Hg Severe MS : >10 mm Hg Mean pressure gradient Mild MS : < 5 mmHg Moderate MS : 6 to 12 mm Hg Severe MS : > 12 mm Hg | Medicine | null | Severity of mitral stenosis is determined by: March 2005
A. Intensity of S1 hea sound
B. Diastolic murmur duration
C. Opening snap
D. Intensity of diastolic murmur
| Diastolic murmur duration |
a29bb139-1b53-463c-b01d-8c6404f7f06d | Ans. (a) Ameobic liver abscessRef:Manipal Manual of surgery, 4th ed./521Refer to the above explanationHydatid cystUsually clinically silentEnlarged liver with smooth surface and is non tender.Pyogenic liver abscessMultiple abscess leading to spiky fever and enlarged liver.Hepatic adenomaPresents in young women on OCP and is solitary. Liver enlargement may or may not be seen. | Surgery | Hepatic Tumors, Cysts, and Abscesses | 30 year old patient with pain in right hypochondrium for 5 days with soft and tender liver and intercostal tenderness. He complains of catch in breath on inspiration and has a non productive cough. On examination the lung fields are clear, patient looks pale and emaciated. Probable diagnosis is
A. Amoebic liver abscess
B. Pyogenic live abscess
C. Hydatid cyst
D. Hepatic adenoma
| Amoebic liver abscess |
a689858e-3d24-44aa-83bf-57ee41f73fd8 | Jaundice
Jaundice is not a disease but rather a sign that can occur in many different diseases.
Jaundice is the yellowish staining of skin and sclerae which is caused by the high level of blood bilirubin.
On the basis of etiology, jaundice can be divided into 3 types : -
1. Prehepatic jaundice
Prehepatic jaundice is due to increased production of bilirubin which results in an increased bilirubin load presented to the liver.
The liver is normal and is able to conjugate the bilirubin at a normal rate; However, due to overproduction of bilirubin, conjugation capacity of the liver is overwhelmed and unconjugated bilirubin is increased → Unconjugated hyperbilirubinemia.
Prehepatic jaundice is caused by hemolysis, i.e., hemolytic anemia due to any cause, e.g., hereditary spherocytosis, Thalassemia, SCA, Malaria, Drugs (methyldopa, quinine) etc.
2. Hepatic jaundice
Here the cause lies within the hepatocytes which have either a defect in the conjugation process or in the excretion of conjugated bilirubin into the bile.
This type of jaundice is caused by all causes of hepatitis (infection, alcohol, drugs, toxin or autoimmune); in congenital hyperbilirubenemias; and in cirrhosis.
3. Post hepatic (extrahepatic) jaundice
Post hepatic jaundice is due to obstruction of the excretion into the bile, e.g., in stone in CBD, carcinoma pancreas, CBD carcinoma etc.
Conjugation capacity of hepatocytes are normal and they continue their conjugation process without any interference leading to conjugated hyperbilirubinemia. | Pathology | null | In post-hepatic jaundice, the concentration of conjugated bilirubin in the blood is higher than that of unconjugated bilirubin because -
A. There is an increased rate of destruction of red blood cells.
B. The unconjugated bilirubin is trapped by the bile stone produced in the bile duct.
C. The conjugation process of bilirubin in liver remains operative without any interference.
D. The UDP-glulcuronosyltransferase activity is increased manifold in obstructive jaundice.
| The conjugation process of bilirubin in liver remains operative without any interference. |
462aab28-4acc-43c7-9db2-5c3b6bb03667 | Staphylococcus aureus can be isolated from a tampon of a patient with toxic shock syndrome. S.aureus strains isolated from patients with toxic shock syndrome produce a toxin called toxic shock syndrome toxin-1 (TSST-1), which can be found in the vagina, on tampons, in wounds or other localized infections, or in the throat but viually never in the bloodstream. Streptococcal antigens cross-reactive with human tissues ; streptococcal antigen Human antigen Disease Hyaluronic acid Synol fluid Reactive ahritis Cell wall M protein Myocardium Acute rheumatic fever Cell wall C carbohydrate Cardiac Valves Acute rheumatic fever peptidiglycan skin antigens Guttate psoriasis Cytoplasmic membrane Glomerular capsular intima Acute glomerulonephritis Ref: Textbook of microbiology; Ananthanarayan and paniker's; 10th Edition; Pg:204 | Anatomy | Bacteriology | The causative organism can be best isolated in which of the following conditions.
A. Tampons in toxic shock syndrome
B. Rheumatic valvulitis
C. CSF in tetanus
D. Diptheritic myocarditis
| Tampons in toxic shock syndrome |
35d6d440-2a31-4dfc-8b0e-6a7946de9523 | Sudden cardiac death is defined as an unexpected death occurring within 1 hour after the beginning of symptoms in a patient who was previously hemodynamically stable. In asymptomatic patients presenting initially with cardiac disease, 20% will die within the first hour of symptoms. Electrolyte imbalance, hypoxia, and conduction system defect are additional factors that increase the risk of sudden death syndrome. Split first heart sound accentuated on inspiration occurs in normal individuals. In CHF, the CVP changes more than 1 cm when pressure is applied below the right costal margin to the liver (hepatojugular reflex) for a 30-second period.New York Classification of Functional changes in Heart DiseaseClassLimitation of Physical ActivityINoneIISlightIIIMarkedIVComplete (even at rest) | Surgery | Heart & Pericardium | A 63-year-old woman fell while crossing the street after her Thursday afternoon bridge game. Attempts at resuscitation for cardiac arrest by the emergency medical service (EMS) team were unsuccessful. The woman had previously been diagnosed as having aortic stenosis and left ventricular hypertrophy. In addition to these factors, which of the following predisposes to sudden cardiac death?
A. Split first heart sound
B. Hypokalemia
C. Soft murmur at left of sternum that varies with inspiration
D. Failure of the central venous pressure (CVP) to rise more than 1 cm H2O with 30-second pressure on the liver (hepato-jugular reflux)
| Hypokalemia |
d0d3e944-0e3f-44c1-bb82-39d4c75f93a7 | Ans. B. Activation of triglyceride lipase as a result of hormone-stimulated increases in cyclic AMP levelsa. Lipolysis is directly regulated by hormones in adipocytes. Epinephrine stimulates adenylate cyclase to produce cyclic AMP, which in turn stimulates a protein kinase.b. The kinase activates triglyceride lipase by phosphorylating it. Lipolysis then proceeds and results in the release of free fatty acids and glycerol.c. A futile re esterification of free fatty acids is prevented, since adipocytes contain little glycerol kinase to phosphorylate the liberated glycerol, which must be processed in the liver. Inhibition of lipolysis occurs in the presence of insulin, which lowers cyclic AMP levels. Lipoprotein lipase is not an adipocyte enzyme. | Biochemistry | Endocrinology | Which of the following regulates lipolysis in adipocytes?
A. Activation of fatty acid synthesis mediated by cyclic AMP
B. Activation of triglyceride lipase as a result of hormone-stimulated increases in cyclic AMP levels
C. Glycerol phosphorylation to prevent futile esterification of fatty acids
D. Activation of cyclic AMP production by insulin
| Activation of triglyceride lipase as a result of hormone-stimulated increases in cyclic AMP levels |
ba0dcbb0-c674-49e7-9ff7-0392aa11643a | Ans. (c) 45Ref: American Board of Anesthesiology American Society of Anesthesiologists, Book A 1996 q-67Breathing 100% oxygen will not change the oxygen saturation much. In arterial blood it is around 97% saturation which corresponds to a PO2 of 100 mm HgIn venous blood it is 75% saturation which corresponds to a mixed venous oxygen tension of around 40-45 mm Hg | Physiology | Respiratory System | What is the expected mixed venous oxygen tension, in mm Hg, in a normal adult after breathing 100% oxygen for 10 minutes?
A. 150
B. 740
C. 45
D. 573
| 45 |
29497165-f081-4d8d-be2c-f984baf70205 | Ans. is 'a' i.e., Rhomboidus Major * Lateral border of scapula (posteriorly) : Origins of teres minor and teres major.* Medial border of scapula : (i) Anteriorly : Insertion of serratus anterior; (ii) Posteriorly : Insertions of levator scapulae, rhomboideus major and minor. | Anatomy | Upper Extremity | Muscle attached to medial border of scapula is-
A. Rhomboidus Major
B. Teres Major
C. Deltoid
D. Infraspinatus
| Rhomboidus Major |
7f8740c8-0e45-4980-8598-a8deca16e8ff | Test for seminal stains
Creatine phosphokinase test
Acid phosphatase test
Florence test (Choline iodide crystals)
Barberio's test (Crystals of spesmin picrate). | Forensic Medicine | null | Seminal stain can be detected by
A. Phenolphthalein test
B. Reine's test
C. Barberio's test
D. Paraffin test
| Barberio's test |
13708d59-7927-4a1d-a0dd-335404c476cb | Oligohydramnios can be caused by - Renal anomalies Uteroplacental insufficiency: IUGR ACE inhibitors Premature rupture of membranes Amniocentesis (leak) Pre-ecclampsia Amnion nodosum NSAIDs Post term pregnancy over estimated gestational age The sonographic diagnosis of oligohydramnios is usually based on an AFI < 5 cm or a single deepest pocket of amnionic fluid of < 2 cm | Gynaecology & Obstetrics | Amniotic Fluid Dynamics | Oligohydramnios is seen in:
A. Renal agenesis
B. Cholangioma of placenta
C. Spina bifida
D. Esophageal atresia
| Renal agenesis |
8c1e4597-2e86-4607-9c32-39b97a9d3735 | Answer is D (aVR) The normal P wave is negative (inveed) in lead aVR. Characteristics of a Normal P Wave P wave results from spread of electrical activity through the atria (Atrial Depolarization) A normal p wave indicates that the electrical impulse responsible for the p wave originated in the sinus node and the normal depolarization of the right and left atria has occurred Normal P Wave is rounded, neither peaked nor notched. Width or duration of the P wave in time is 0.10 seconds or 2.5 small squares Height of the P wave is 2.5 mm (2.5 small squares) Sinus P waves are best seen in Lead II and V1 P wave is upright in most leads, mainly L1 L11 and aVF P Wave is inveed in aVR (and occasionally in aVL) P wave in VI may be biphasic with equal upward and downward deflection, notched and wide. Activation of right atrium produces positive component and activation of left atrium produces negative component. There should be one p wave preceding each QRS complex. More than one p wave before a QRS complex indicates a conduction disturbance. | Medicine | null | The normal P wave is inveed in lead :
A. LI
B. LII
C. aVF
D. aVR
| aVR |
9309b256-ce0c-4567-b8a9-98b29e161a19 | This patient is in a diabetic ketoacidotic coma. The goals in treating such a patient are to increase the rate of glucose utilization by insulin-dependent tissues, to reverse ketonemia and acidosis, and to replenish fluid imbalances. Oral hypoglycemic agents are commonly prescribed for the maintenance of NIDDM patients and would not be appropriate in an acute setting. Treatment with bicarbonate would result in only a transient elevation of pH. Since this is a life-threatening condition, monitoring the patient without treatment is unacceptable. Ref: D'Alessio D. (2011). Chapter 43. Endocrine Pancreas and Pharmacotherapy of Diabetes Mellitus and Hypoglycemia. In B.C. Knollmann (Ed), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e. | Pharmacology | null | A 55 year old diabetic man is brought to the emergency room in an unresponsive state. The following laboratory values are obtained: PCO2 19 mm Hg, HCO3 11 mEq/L, and pH 6.9. The most appropriate immediate treatment of this patient is ?
A. Administration of an oral hypoglycemic agent
B. Administration of bicarbonate
C. Administration of insulin
D. Close observation only
| Administration of insulin |
b59da329-20a5-4d6d-a676-1cd6957c9dfb | Ans. is 'a' i.e., Ampicillin Ampicillin: It is an ionized highly polar drug. In the duodenum it exes a zwitter ion effect and thus has a lower bioavailabilty. Though the oral absorption is incomplete it is adequate. It is an antibacterial drug acting both on gram positive and gram negative organisms. Main mode of excretion is by kidneys. It is paly excreted in bile and shows enterohepatic circulation. | Pharmacology | null | Which of the following antibacterial drug is polar?
A. Ampicillin
B. Penicillin G
C. Clavulanic acid
D. Cefepime
| Ampicillin |
e4e7d037-f105-4993-a7b1-9402f6475b84 | Gemellus muscle laterally rotates the femur at the hip joint. Superior gemellus muscle: Attaches proximally at the ischial spine; distally, the muscle attaches on the greater trochanter of the femur. The nerve to the obturator internus and superior gemellus muscles (L5, S1, S2) innervates this muscle.Inferior gemellus muscle: Attaches proximally on the ischial spine; distally, the muscle attaches at the greater trochanter of the femur. The nerve to the inferior gemellus and quadratus femoris muscles (L4, L5, S1) innervates this muscle. | Anatomy | null | The main action of muscle "Gamellius" is?
A. Medial rotation of thigh
B. Lateral rotation of thigh
C. Gluteus maximus
D. Gluteus medius and minimus
| Lateral rotation of thigh |
cf608eca-e84d-44ba-8273-b3d38760c8d5 | Ans. is 'a' i.e., Norepinephrine o Most pheochromocytomas contain and secrete both nor epinephrine and epinephrine and the percentage of norepine phrine is usually greater than in normal adrenal.Pheoch rornocvtom||AdrenalCan't suppress ACTHo Most of them secrete norepinephrineo Exclusively secrete nor epinephrine | Medicine | Adrenal | A patient with pheochromocytoma would secrete which of the following in a higher concentration?
A. Norepinephrine
B. Epinephrine
C. Dopamine
D. VMA
| Norepinephrine |
831f336a-fe91-45ce-a809-44fecf9efe01 | Cushing's reflex , is a physiological nervous system response to increased intra cranial pressure.Results in cushings triad - increased BP, irregular breathing and bradycardia. Usually seen in terminal stages of head injury . It can also be seen after iv administration of epinephrine. In head injury- CPP=MAP-ICP. CPP- cerebral perfusion pressure. MAP- Mean aerial pressure. ICP- intra cranial pressure Head injury causes increased ICP thus lowering CPP causing ischemia. When ICP approaches the level of mean systemic pressure , cerebral perfusion falls . Bodys response to fall in cerebral perfusion is raise systemic blood pressure and dialate cerebral vessels which increases cerebral blood volume and increases ICP followed by lowering CPP.And causes a vicious cycle. When aerial pressure lowers , a reflex called CNS ischaemic response is initiated by the hypothalamus . Hypothalamus activates sympathetic nervous system causing peripheral vasoconstriction and increased cardiac output. This increases aerial pressure and cerebral blood flow is restored. This response stimulates the baroreceptors in the carotid bodies thus slowing the hea rate drastically- bradycardia(baroreceptor reflex -refer image) 2) Marey's law- Explained by barereceptor reflex States that' hea rate is inversely propoional to blood pressue '(but not the vice versa) . Bainbridge reflex- infusion of saline or blood --- increased venous filling of atria--- stimulation of tachycardia producing atrial receptor(TPAR)---tachycardia | Physiology | Cardiovascular system | A Patient with increased BP and decreased hea rate is likely to have
A. Increased ICT
B. Deep sea diving
C. Brain tumor
D. Head tumor
| Increased ICT |
39c38a81-42c2-4755-8d91-257ea1c0bfb4 | Oral absorption of CQ is excellent. About 50% gets bound in the plasma. It has high affinity for melanin and nuclear chromatin: gets tightly bound to these tissue constituents and is concentrated in liver, spleen, kidney, lungs (several hundred-fold), skin, leucocytes and some other tissues. Its selective accumulation in retina is responsible for the ocular toxicity seen with prolonged use. ESSENTIALS OF PHARMAXOLOGY page no.822 | Pharmacology | Chemotherapy | Chloroquine is given as 600 mg loading dose because:
A. It is rapidly absoed
B. It is rapidly metabolized
C. It has increased tissue binding
D. It is rapidly eliminated
| It has increased tissue binding |
841bb5b4-521e-41dc-921e-13b57738ecca | Treatment of acute lymphangitis requires antibiotic and rest. | Surgery | Lymphatic System | Treatment of acute lymphangitis requires:
A. Antibiotic and rest
B. Immediate lymphangiography
C. Immediate multiple incisions
D. No special treatment
| Antibiotic and rest |
fa145bc3-1bdd-4945-ab10-067066f0d703 | Ans. b (Neurofibromatosis) (Ref. Harrison's Internal Medicine 17th ed., Chapter 374; RRM 7th ed., p.316)# Lisch nodules (iris hamartoma) and Optic gliomas = NF-1.# Glaucoma = Sturge Weber syndome.# Retinal angiomas = VHL# GlaucomaNEUROFIBROMATOSIS# Autosomal dominant inherited disorder- pure neurofibromas (= tumor of nerve sheath with involvement of nerve, nerve fibers run through mass)- neurilemmomas (= nerve fibers diverge and course over the surface of the tumor mass)(a) localized neurofibroma (most common, 90%)(b) diffuse neurofibroma (mostly solitary + not associated with NF1)(c) plexiform neurofibroma (PATHOGNOMONIC of NF1)Peripheral Neurofibromatosis (90%) = NEUROFIBROMATOSIS TYPE 1 = von Recklinghausen disease# autosomal dominant with abnormalities localized to the pericentromeric region of chromosome 17.- CLASSIC TRIAD:- Cutaneous lesions- Skeletal deformity- CNS manifestations# CNS and ocular MANIFESTATIONS- Lisch nodules= melanocytic iris hamartomas <2 mm in size- Optic pathway glioma- Hydrocephalus (Aqueductal stenosis)- Vascular dysplasia= occlusion / stenosis of distal ICA, proximal MCA/ACA- Plexiform neurofibromas are PATHOGNOMONIC for NF1- Erosion of bony elements with marked posterior scalloping# SKELETAL MANIFESTATIONS (in 25-40%)- Harlequin appearance to orbit (empty orbit) = partial absence of greater and lesser wing of sphenoid + orbital plate of frontal bone- Sharply angled focal kyphoscoliosis (50%) in lower thoracic + lumbar spine- Pseudarthrosis after bowing fracture (particularly in tibia) in 1st year of life# Others:- Cafe-au-lait spots= pigmented cutaneous macules >6 in number, >5 mm in greatest diameter; Coast of California.; Freckling.- Progressive pulmonary interstitial fibrosis with lower lung field predominance (up to 20%)- Pheochromocytoma- Renal artery stenosis: very proximal- Malignant peripheral nerve sheath tumor - most common malignant abdominal tumor in NF1 | Pathology | Central Nervous System | Lisch nodules (Pigmented Iris hamartomas) are seen in
A. Niemann Pick disease
B. Neurofibromatosis
C. Ochronosis
D. Glycogen storage disease
| Neurofibromatosis |
f09dc144-1aba-47bd-a9a6-20229683218e | Esters (aminoesters) :- Procaine, chlorprocaine, tetracaine (amethocaine), Benzocaine, Cocaine.
Amides (aminoamides) Lignocaine, Mepivacaine, Prilocaine, Bupivacaine, Etidocaine, Ropivacaine , Dibucaine. | Anaesthesia | null | Which one of the following is not an amide –
A. Lignocaine
B. Procaine
C. Bupivacaine
D. Dibucaine
| Procaine |
c54f1028-2883-4640-a40a-dd651e4ddc13 | Important complications of cataract surgery
After cataract (opacification of the capsule)
Vitreous prolapse & loss
Cystoid macular edema
Endophthalmitis
Aphakic glaucoma
Retinal detachment
Fibrous & endothelial growth
Neovascular glaucoma
Iris prolapse
Anterior uveitis (iridocyclitis)
Strait keratopathy & pseudophakic bullous keratopathy
Corneal endothelial damage | Ophthalmology | null | Complications of cataract surgery –a) Endophthalmitisb) Optic neuropathyc) Retinal detachmentd) Vitreous losse) Lagophthalmos
A. abcd
B. bcde
C. abde
D. acd
| acd |
36298097-ca97-41d9-8e31-d9cb86abe3cc | Ans. is 'd' i.e., Metastasis from another solid tissue tumor The most common cause of adrenal tumors is metastasis from another solid tumor like breast cancer and lung cancer. Malignant Percentage Adrenocoical carcinoma 2-5% Malignant pheochromocytoma <I% Adrenal neuroblastoma <0- 1% Lymphomas (incl. primary adrena lymphoma) <1% Metastases (most frequent : Breast, lung) 15% | Medicine | null | The most common cause of malignant adrenal mass is
A. Adrenocoical carcinoma
B. Malignant phaeochromocytoma
C. Lymphoma
D. Metastasis from another solid tissue tumor
| Metastasis from another solid tissue tumor |
cc030063-4379-4ff7-a30e-ed5e1d3b8159 | Ans. is'd' i.e., Disruption of scar with peritoneum intact Incomplete rupture :In an Incomplete uterine rupture, the mother's peritoneum remains intact.The peritoneum is the membrane that lines the abdominal cavity to suppo abdominal organs.It also acts as a channel for blood vessels and nerves.An incomplete uterine rupture is significantly less dangerous with fewer complications to the delivery process.Complete rupture:During a Complete uterine rupture, the peritoneum tears and the contents of the mother's uterus can spill into her peritoneal cavity.The peritoneal cavity is the fluid-filled gap that separates the abdomen walls and its organs.It is suggested that delivery cesarean section (C- section) should occur within approximately 10 to 35 minutes after a complete uterine rupture occurs.The fetal morbidity rate increases dramatically after this period. | Gynaecology & Obstetrics | null | Incomplete uterine rupture is defined as?
A. Disruption ofpa ofscar
B. Disruption of entire length of scar
C. Disruption of scar including peritoneum
D. Disruption of scar with peritoneum intact
| Disruption of scar with peritoneum intact |
a0d4ef6a-0025-497a-b0cd-0cf41a20895a | ANSWER: (B) 11-15 mm HgREF: Maingot's 10th ed p. 243The intrabdominal pressure during laparoscopy is monitored by insufflator and it is set between 12-15 mm Hg. | Surgery | Procedures - Cholecystectomy, Bile Duct Exploration, Store Extraction | Insufflation pressure during laparoscopy is?
A. 5-10 mm Hg
B. 11-15 mm Hg
C. 15-20 mm Hg
D. 20-25 mm Hg
| 11-15 mm Hg |
a7378558-eaa2-45e1-986f-7b43b69d4373 | The two staing materials of heme synthesis pathway are succinyl CoA and glycine. Pyridoxal phosphate is needed to activate glycine. ALA synthase catalyzes the conversion of succinyl CoA and glycine to delta aminolevulinate. This is the rate limiting enzyme in porphyrin biosynthesis in the mammalian liver. Synthesis of ALA occurs in mitochondria. Last 3 steps of heme synthesis occur in the cytoplasm. The 3 enzymes which catalyse the reactions in cytoplasm are ferrochelatase, protoporphyrinogen oxidase and coproporphyrinogen oxidase. Coproporphyrinogen oxidase catalyze conversion of coproporphyrinogen III to protoporphyrinogen III. Protoporphyrinogen oxidase catalyze conversion of protoporphyrinogen III to protoporphyrin III. Ferrochelatase catalyze conversion of protoporphyrin III to heme by incorporating heme into protoporphyrin. Ref: Murray R.K. (2011). Chapter 31. Porphyrins & Bile Pigments. 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 | Along with succinyl CoA which of the following amino acid serve as staing material in heme synthesis?
A. Lysine
B. Leucine
C. Glycine
D. Alanine
| Glycine |
a4172efb-f144-4fe8-a620-45413b5d8b81 | ANSWER: (D) GlaucomaREF: Goodman and Gillmans 11TH edition page 1103, http://en.udkipedia.org/wiki/Latanoprost "Latanoprost ophthalmic solution is a topical medication used for controlling the progression of glaucoma or ocular hypertension by reducing intraocular pressure. It is a prostaglandin analogue (more specifically an analogue of Prostaglandin F2a)""The PGF2a analogs consist of Latanoprost, travoprost, bimatoprost, and unoprostone. PGF2a analogs appear to lower IOP by facilitating aqueous outflow" through the accessory uveoscleral outflow pathway. The mechanism by which this occurs is unclear" | Pharmacology | A.N.S. | Latanoprost (PGF0 alf
A. Maintenance of ductus arteriosus
B. Pulmonary hypertension
C. Gastric mucosal protection
D. Glaucoma
| Glaucoma |
72ed7047-a899-4646-9395-812d5a5cc4c1 | Renshaw cells are inhibitory cells that transmit inhibitory signals to the surrounding motor neurons. This anterior motor neuron gets excitatory impulses from multiple sources, if all these excitatory inputs were sent to the muscles, muscle will fatigue early, so, there is some inherent check to reduce the excitability of these motor neurons & that is in form of Renshaw cell inhibition. This is recurrent type of inhibition. The inhibitory neurotransmitters Glycine and GABA are involved in Renshaw cell inhibition. | Physiology | Introduction to Central Nervous System | Renshaw cell inhibition is an example of:
A. Postsynaptic inhibition
B. Feed forward inhibition
C. Recurrent inhibition
D. Collateral inhibition
| Recurrent inhibition |
f7a77157-1bdc-4715-b377-492d1a4fddc6 | Infections caused by methicillin-sensitive S aureus, high-magnitude bacteremia (defined as >4 positive blood cultures ), and endocarditis. The most impoant test is a blood culture used to identify bacteria in the bloodstream. REFERENCE: www.mayoclinic.org | Microbiology | Bacteriology | Blood culture is positive in which infection of Staphylococcus aureus is
A. TSS
B. SSSS
C. Infective endocarditis
D. Impetigo
| Infective endocarditis |
ac3e3574-d48c-4618-be7c-75ce9a16454b | Gonadotropin levels gradually decline to reach prepubertal levels by age 1 to 2 years. | Gynaecology & Obstetrics | null | Gonadotropin levels decline to prepubertal levels by age
A. 6 month to 1 year of age
B. 1 year to 2 years of age
C. 2 years to 3 years of age
D. 3 years to 4 years of age.
| 1 year to 2 years of age |
49b875c4-3a3d-453f-994d-5953f1c5e511 | Ans) a (Anal) Ref: http://en.wikipedia.orgThe lithotomy position refers to a common position for surgical procedures and medical examinations involving the pelvis and lower abdomen. References to the position have been found in some of the oldest known medical documents including versions of the Hippocratic oath. The position is named after the ancient surgical procedure for removing kidney stones, gall stones and bladder stones via the perineum. The position is perhaps most recognizable as the 'often used' position for childbirth: the patient is laid on the back with knees bent, positioned above the hips, and spread apart through the use of stirrups.Obvious benefits from the position is that it provides good visual and physical access to the perineal region. The position is used for procedures ranging from simple pelvic exams to surgeries and procedures involving, but not limited to reproductive organs, urology, and gastrointestinal systems. Used for perianal surgeries like haemorrhoidectomy, fistulectomy, lateral sphinc-terotomy; perineal surgeries like APR & vaginal hysterectomy. | Surgery | Disorders of the Anal Canal | Which among the following surgery requires lithotomy position
A. Anal
B. Cardiac
C. Abdominal
D. Limb
| Anal |
8c107f2a-2e75-4d13-be2d-f67f211c5f67 | The common human hookworms are Ancylostoma duodenale and Necator americanus. The larger A duodenale is more pathogenic because it consumes more blood, up to 0.5 mL per worm per day. The adult worms attach with their mouthpas to the mucosa, from which they suck blood. Blood loss is the major sequel of infection which leads to iron-deficiency anemia. Chronic hookworm infection is a common cause of moderate and severe hypochromic microcytic anemia, and heavy infection can cause hypoproteinemia with edema. Chronic hookworm infection in children may lead to growth delay, deficits in cognition, and developmental delay. Ref: Dominguez S.R., Levin M.J. (2012). Chapter 43. Infections: Parasitic & Mycotic. 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 | Stool investigation of a child who presented with anemia revealed worm infestation. Which of the following worm infestation is associated with iron deficiency anemia?
A. Whipworm
B. Hookworm
C. Roundworm
D. Pinworm
| Hookworm |
3952d1c4-e3b1-4ee6-a36d-4bcc93ffbce7 | (C) Optic tract > It is difficult to localize a postchiasmal lesion accurately, because injury anywhere in the optic tract, lateral geniculate body, optic radiations, or visual cortex can produce a homonymous hemianopia, i.e., a temporal hemifield defect in the contralateral eye and a matching nasal hemifield defect in the ipsilateral eye | Ophthalmology | Miscellaneous | Homonymous hemianopsia is associated with lesion at
A. Visual cortex
B. Optic radiation
C. Optic tract
D. Optic chiasma
| Optic tract |
944ee0bf-859b-4b92-9739-11c6fb732924 | Pheochromocytomas are neoplasms composed of chromaffin cells. They follow rule of 10: - 10% of pheochromocytomas are extra adrenal - 10% of sporadic adrenal pheochromocytomas are bilateral - 10% of adrenal pheochromocytomas are biologically malignant. -10% of adrenal pheochromocytomas are not associated with hypeension. Ref: Robbins and cotrans 9e | Pathology | Endocrinology | Tumor that follows rule of 10 is
A. pheochromocytoma
B. Onocytoma
C. Lymphoma
D. Renal cell carcinoma
| pheochromocytoma |
306fa16c-7504-4ac0-bc11-675e49cf39bb | Hegar's sign refers to widening and softening of of the body or isthmus of the uterus. It usually occurs at 6-8 weeks of gestation. Softening and dilatation at the external os is caused by estrogen and progesterone. Chadwick's sign: It refers to bluish discoloration of cervix caused by congestion of pelvic vasculature. It is a presumptive sign of pregnancy. Jacquemier's sign: It refers to congested appearance of vaginal mucosa. Osiander's sign: It refers to increased pulsations felt in the lateral fornices at 8 weeks of gestation. Goodell's sign: It refers to softening of the cervix. Palmer's sign: refers to intermittent contractions of the uterus. Ref: Bernstein H.B., VanBuren G. (2013). Chapter 6. Normal Pregnancy and Prenatal Care. In A.H. DeCherney, L. Nathan, N. Laufer, A.S. Roman (Eds),CURRENT Diagnosis & Treatment: Obstetrics & Gynecology, 11e. Manual Of Obstretics, 3/e By Daftary page 54 | Gynaecology & Obstetrics | null | At how many weeks of gestation can Hegar's sign be elicited?
A. 8 weeks
B. 10 weeks
C. 12 weeks
D. 15 weeks
| 8 weeks |
d3a11700-d0e9-48d6-a258-85567b37f5fa | The major initiating response for peristalsis is local stretching of the gut. Peristalsis is a reflex that is initiated when the gut wall is stretched by the contents of the lumen. It occurs in all pas of the gastrointestinal tract from the esophagus to the rectum. The stretch initiates a circular contraction behind the stimulus and an area of relaxation in front of it. The wave of contraction then moves in an oral-to-caudal direction. This propels the contents of the lumen forward at rates that vary from 2 to 25 cm/s Ref: Ganong&;s Review of Medical Physiology 26th edition Pgno: 485 | Physiology | G.I.T | The major initiating response for peristalsis is
A. Hormonal
B. Local stretching of gut
C. Neural
D. Gastric acid
| Local stretching of gut |
6f0280d3-5e6b-45fc-a626-0a023679c6c6 | Ans. B. 160. (Ref Williams obstetrics 20th/pg. 1428; Danforth9s obstetrics and gynecology - pg.157)Fetal bradycardia is defined as fetal heart rate <110 bpm; fetal tachycardia is defined as fetal heart rate >160 bpmThe normal FHR baseline ranges from 120 to 160 beats per minute.Foetal tachycardia is defined as a baseline heart rate greater than 160 bpm and is considered a nonreassuring pattern.Fetal Bradycardia is defined as an abnormally low baseline FHR (<110 beats per minute). Bradycardia is a baseline fetal heart rate under 120 beats/min that lasts 15 minutes or longer. Bradycardias are defined as 80 to 100 beats/min, and severe bradycardias are less than 80 beats/min, | Gynaecology & Obstetrics | Miscellaneous (Gynae) | Fetal tachycardia is defined as heart rate more than___
A. 140
B. 160
C. 180
D. 200
| 160 |
903c92db-39d9-4375-8d01-7706cc54186e | Ref Harrison 19 th ed pg 1530 patients with pure or predominant AS have gradually increas- ing obstruction over years but do not become symptomatic until the sixth to eighth decades. Adult patients with BAV disease, however, develop significant valve dysfunction and symptoms one to two decades sooner. Exeional dyspnea, angina pectoris, and syncope are the three cardinal symptoms. | Anatomy | General anatomy | Angina pectoris and syncope are most likely to be associated with
A. Mitral stenosis
B. Aoic stenosis
C. Mitral regurgitation
D. Tricuspid stenosis
| Aoic stenosis |
0127d2ac-5b69-4e94-9e3e-b7b389c0122e | Mechanism of toxicity:Mercury reacts with sulfhydryl (SH) groups, resulting in enzyme inhibition and pathologic alteration of cellular membranes.Clinical presentation:Severe chemical pneumonitis and noncardiogenic pulmonary edema.Acute gingivostomatitis may also occur.Chronic intoxication:Classic triad Tremor Gingivostomatitis. Metallic tasteFrequent blushing ("erethism")Pain in the extremities, often accompanied by pinkish discoloration and desquamation ("pink disease") | Microbiology | All India exam | Frequent blushing ("erethism") is associated with poisoning of
A. Mercury
B. Lead
C. Phenolic acid
D. Carbolic acid
| Mercury |
5a29154d-e5fe-4d90-a2d6-327008e4a469 | DERIVATIVES OF MESONEPHRIC DUCT Both in Males and a Females Collecting tubules Minor and major calyces Pelvis Ureter Trigone of bladder In Males Epidydymis Vas derferens Seminal vesicles Mesoderm of prostate Ejaculatory duct In Females Ganers duct | Anatomy | General anatomy | Excretory poion of kidney is formed by?
A. Urogenital sinus
B. Mullerian duct
C. Mesonephric duct
D. Genital tubercle
| Mesonephric duct |
7dc5cef1-23cc-4530-908b-8cefba5301c8 | Sporotrichosis:- Treatment:- : * Lymphocutaneous disease:- itraconazole, terbinafine, saturated solution of potassium iodide (SSKI) * Disseminated infection:- Amphotericin B (AMB). Ref:- Dermatology review by Asra Ali; pg num:-364 | Dental | Fungal infections, Scabies, Pediculosis | Treatment of systemic or disseminated variant of sporotrichosis is
A. Itraconazole
B. Amphotericin-B
C. Griesofulvin
D. saturated solution of pottasium iodide
| Amphotericin-B |
ebdb2fa1-1d1c-4566-af3c-7fdce0bb4390 | Oblique view of the wrist is required for scaphoid fracture * Most common fractured bone in the wrist * Peanut shaped bone that spans both row of carpal bones * Does not require excessive force and often not extremely painful so can be delayed presentation * Pain over the anatomic snuff box * Pain is not usually severe * Often present late Scaphoid Fracture Treatment * Cast 6-12 weeks * Sho arm vs. long arm * Follow patient every 2 weeks with x-ray * CT and clinical evaluation to determine healing * Consider screwing early Ref: Maheshwari and Mhaskar 9th ed pg 367. | Orthopaedics | Forearm wrist and hand injuries | Oblique view in XRAY of hand is required for diagnosis of
A. Capitate
B. Scaphoid
C. Navicular
D. Hamate
| Scaphoid |
79c397b2-c837-4758-92fc-cd7a388100b0 | The mesosalpinx is the pa of broad ligament that suppos the uterine tube. The mesosalpinx extends inferiorly to meet the root of the mesovarium; it attaches the uterine tube to the mesometrium. The mesometrium is the pa of the broad ligament below the junction of the mesosalpinx and the mesovarium; it attaches the body of the uterus to the pelvic wall. The mesovarium is the pa of broad ligament that forms a shelf-like fold suppoing the ovary. It attaches the ovary to the mesometrium and mesosalpinx. The round ligament of the uterus is a connective tissue band that attaches the uterus to the inner aspect of the labium majus. It is found in the broad ligament, and it traverses the inguinal canal. Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 38. Anatomy. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e. | Gynaecology & Obstetrics | null | The pa of the broad ligament giving attachment and suppo to the uterine tube is the:
A. Mesometrium
B. Mesovarium
C. Mesosalpinx
D. Round ligament
| Mesosalpinx |
ad48794d-4eb0-4c23-8048-bf30bd9fe74f | CT scan of chest showing enlarged pulmonary aeries In interstitial lung diseases HRCT shows bilateral subpleural reticular changes,with traction bronchiectasis and honeycombing(idiopathic pulmonary fibrosis).and varies according to cause of ILD. In bronchiectasis CT shows: tram tracts and signet ring sign. | Medicine | Respiratory system | Most likely diagnosis ?
A. Interstitial lung disease
B. Pulmonary aery hypeension
C. Congestive hea failure
D. Bronchiectasis
| Pulmonary aery hypeension |
4cbf55a4-e677-4419-adf8-2068b2cd2a5f | TYPE II RESPIRATORY FAILUREThis type of respiratory failure is a consequence of alveolar hypoventilation and results from the inability to eliminate carbon dioxide effectively. Mechanisms are categorized by Impaired central nervous system (CNS) drive to breathe (drug overdose, brainstem injury, sleep-disordered breathing, and severe hypothyroidism), Impaired strength with failure of neuromuscular function in the respiratory system. Reduced strength can be due to impaired neuromuscular transmission (e.g., myasthenia gravis, Guillain-Barre syndrome, amyotrophic lateral sclerosis) or respiratory muscle weakness (e.g., myopathy, electrolyte derangements, fatigue).Increased load(s) on the respiratory system. The overall load on the respiratory system can be subclassified into Resistive loads (e.g., bronchospasm), Loads due to reduced lung compliance (e.g., alveolar edema, atelectasis, intrinsic positive end-expiratory pressure --see below), Loads due to reduced chest wall compliance (e.g., pneumothorax, pleural effusion, abdominal distention), and ads due to increased minute ventilation requirements (e.g., pulmonary embolus with increased dead-space fraction, sepsis).Ref: Harrison 19e pg: 1732 | Medicine | Respiratory system | Type II respiratory failure best relates to which of the following?
A. Alveolar hypoventilation
B. Alveolar flooding
C. Hypoperfusion of respiratory muscles
D. Lung atelectasis
| Alveolar hypoventilation |
a2a24a39-2295-4acc-846b-33d50aada3a1 | The four recti arise from a common annular tendon or tendinous ring of zinn. This ring is attached to the orbital surface of the apex of the orbit. It encloses the optic canal and the middle pa of the superior orbital fissure.The lateral rectus has an additional small tendinous head which arises from the orbital surface of the greater wing of the sphenoid bone lateral to the tendinous ring. The inferior oblique arises from the orbital surface of the maxilla, lateral to the lacrimal groove. The muscle is situated near the anterior margin of the orbit. Refer BDC sixth edition volume 3 page no: 266 ,267 Refer table 17.2 | Anatomy | Head and neck | Muscle that does not arises from the common tendinous ring at the apex of orbit is?
A. Superior Oblique
B. Inferior oblique
C. Superior rectus
D. Inferior rectus
| Inferior oblique |
167baac1-6fe1-4f57-a035-0bc05a3d6509 | Ans. is 'b' i.e., Microglial cellso Microglial cells are derived from mesenchymal (mesodermal) cells.Development of cells in CNSCells of originDeveloped mature cellsNeuroepithelial cellso Neuronso Glial cells (Macroglial cells)# Oligodendrocytes# Astrocytes# Ependymal cellsMesenchymal (mesodermal) cellso Microglial cells | Anatomy | Nervous System | Which of glial cell is mesodermal in origin -
A. Macroglial cells
B. Microglial cells
C. Oligodendrocytes
D. Ependymal cells
| Microglial cells |
d52ed8a8-4cfb-4798-8fb5-0a8bfa4b7e42 | ANSWER: (A) DiaphragmREF: Lee synopsis of anesthesia 13th e p. 182, Morgan 4th e p. 206-15Diaphragm is the most resistant muscle to muscle relaxants. | Anaesthesia | Neuromuscular Junction | Which muscle is most resistant to neuromuscular blockage?
A. Diaphragm
B. Ocular
C. Adductor pollicis
D. Intercostal muscles
| Diaphragm |
b594271d-ac4b-4ae7-afbc-96fee364ae28 | Cervical Fibroid is compared to "Lantern on dome of st Paul's catherdral". | Gynaecology & Obstetrics | null | Fibroid with a typical "Lantern on top of St Paul's cathedral" appearance is
A. Submucosal fibroid
B. subserosal fibroid
C. Cervical fibroid
D. Interstitial fibroid
| Cervical fibroid |
f820788b-4593-4383-806a-6008c7b07446 | B anthracis has a tendency to form very long chains of rods and in culture it is nonmotile and nonhemolytic. Colonies are characterized by a rough, uneven surface with multiple curled extensions at the edge resembling a "Medusa head." B anthracis has a D-glutamic acid polypeptide capsule of a single antigenic type that has antiphagocytic propeies. B anthracis endospores are extremely hardy and have been shown to survive in the environment for decades. On gelatin stab culture a characteristic inveed fir tree appearance is seen, with slow liquefaction commencing from top. Ref: Ray C.G., Ryan K.J. (2010). Chapter 26. Corynebacterium, Listeria, andBacillus. In C.G. Ray, K.J. Ryan (Eds), Sherris Medical Microbiology, 5e. | Microbiology | null | 'Inveed fir tree' appearance is characteristic of?
A. Bacillus anthracis
B. Haemophilus influenza
C. Yersinia pestis
D. Brucella
| Bacillus anthracis |
0198412e-cd8b-4b6d-a6a6-a7ae0e490bfb | Ans. A i.e. Retention cystBailey & Love (Surgery) states that ranula is an extravasation cyst, but CSDT (Surgey), Dhingra (ENT) & even internet references describe it as retention cyst. | Surgery | null | Ranula is a: March 2013 (a, d, e)
A. Retention cyst
B. Extravasation cyst
C. Edema of uvula
D. Edema of floor of mouth
| Retention cyst |
f2e06a80-f118-4bcd-9592-8097538ae461 | Layer/Lamina IV of cerebral coex. Layer/Lamina IV - "Internal granule cell layer" Contains predominately granule cells & nerve fibers. Specific sensory input through thalamocoical fibers terminate primarily in coical layer IV on stellate (granule cells). Diffuse non-specific sensory afferents are distributed through layer I-IV. OTHER LAYERS OF CEREBRAL COEX: Composed of 6 layers - Layer/Lamina I - "Molecular layer" Contains nerve fibers. Mainly dendrites of pyramidal cells & axons of granular cells. Layer/Lamina II - "External granule cell layer" Contains mainly granule cells. Layer/Lamina III - "External pyramidal cell layer" Contains mainly small to medium size pyramidal cells Some granular cells also present Layer/Lamina V - "Internal pyramidal cell layer" Contains large pyramidal cells. Descending tracts, i.e. projection fibers from coex (coicospinal tract, coicobulbar tract) are the axons of these pyramidal cells of Layer V Layer/Lamina VI - "Multiform layer" Contains all types of cells | Physiology | null | Which cerebral layer is referred as "Internal granule cell layer"?
A. Layer/Lamina IV
B. Layer/Lamina V
C. Layer/Lamina VI
D. Layer/Lamina VII
| Layer/Lamina IV |
918551e0-5546-40de-a5dd-5bc2f7ad7781 | Lymphoblast contain cytoplasmic aggregates of periodic acid-schiff (PAS)-positive material. | Pathology | null | Periodic acid schiff stain shows Block positivity
A. Myeloblasts
B. Lymphoblasts
C. Monoblasts
D. Megakaryoblasts
| Lymphoblasts |
00762651-bc8c-4f75-89fa-81e53f3b9448 | Answer- D. Autoimmune neutropenia of infancyIt is recognized as a fairly specific syndrome of early childhood.Low neutrophil numbers are often discovered during the course ofroutine investigation for benign febrile illness.The illness abates but the neutropenia persists, sometimes for months and occasionally for years.The prognosis is good and neutropenia is self-limited albeit protracted, and patients seldom develop serious bacterial infections. | Medicine | null | Which of the following inherited neutropenias show a self limited course?
A. Shwachman-Diamond syndrome
B. Dyskeratosis congenita
C. Chiediak higashi syndrome
D. Autoimmune neutropenia of infancy
| Autoimmune neutropenia of infancy |
824e0c8e-0f1e-46b2-ad56-59ff9d397fe9 | Ans. is 'a' i.e., 40 mgo The daily requirement for vitamin C --> 40 mg. | Social & Preventive Medicine | null | The daily requirement of Vitamin C is-
A. 40mg.
B. Ming
C. 200 mg
D. 500 mg
| 40mg. |
e30debe4-b1da-4023-956a-01560b484681 | The triacylglycerol, cholesterol ester and phospholipid molecules along with apoproteins B48, and apo-A are incorporated into chylomicrons. Four major groups of lipoproteins: Chylomicrons, derived from intestinal absorption of triacylglycerol and other lipids. Very low density lipoproteins (VLDL, or pre--lipoproteins), derived from the liver for the expo of triacylglycerol. Low-density lipoproteins (LDL, or -lipoproteins), representing a final stage in the catabolism of VLDL. High-density lipoproteins (HDL, or -lipoproteins), involved in cholesterol transpo and also in VLDL and chylomicron metabolism. Triacylglycerol is the predominant lipid in chylomicrons and VLDL, whereas cholesterol and phospholipid are the predominant lipids in LDL and HDL, respectively. Ref: Botham K.M., Mayes P.A. (2011). Chapter 25. Lipid Transpo & Storage. 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 | The chyle from intestine is rich with chylomicrons. Which of the following form the protein core of chylomicrons?
A. Triglyceride only
B. Triglyceride + cholesterol
C. Triglyceride + cholesterol + phospholipid
D. Only cholesterol
| Triglyceride + cholesterol + phospholipid |
22dba812-e588-4e97-be24-f665c33c4f98 | Ans. is 'b' i.e., KFDo White disease- AIDSo Poverty disease - Cholerao Hundred day cough: Pertussis (Whooping cough)o 5 day fever: Trench fevero 8th day disease: Tetanuso Black sickness: Kala azaro Black death: Plagueo Cerebrospinal fever: Meningococcal meningitiso Kochs phenomenon: Tuberculosiso Hansen s disease: Leprosyo Break-bone fever: Dengueo Slim disease: AIDSo Monkey fever: KFDo First disease/ Rubeolla: Measleso Second disease: Scarlet fevero Third disease/ German Measles: Rubellao Fourth disease: Duke's diseaseo Fifth disease: Erythema infectiosum (Parvovirus)o Sixth disease/Baby Measles/3-day fever: Exanthem subitum/ Roseola infantumo Barometer of Social Welfare (India): Tuberculosiso Father of Public Health: Cholerao River Blindness: Onchocerciasis | Social & Preventive Medicine | KFP | Which of the following is known as monkey fever -
A. Plague
B. KFD
C. Yellow fever
D. Trench fever
| KFD |
4202a3b2-8c62-45f4-a44d-a06266b3cfda | Direct D2 activators are bromcriptine , pergolide,pramipexole,ropinirole. ENtcapone and tolcapone are COMT inhibitors and selegiline is a MAO inbibitor used in PD.In PD there is decrease of dopamine in the substansia nigra. Ref:KDT 6/e p419 | Pharmacology | All India exam | Antiparkinsonian drug activating D2 receptors directly
A. Pramipixole
B. Entacapone
C. Benserazide
D. Selegiline
| Pramipixole |
5682968d-117f-42ac-a832-993d218f5fab | Ans. is 'd' i.e., Physostigmine o Atropine blocks cholinergic receptors. So, for atropine overdose, we require a drug that increases cholinergic action. o Physostigmine increases the concentration of Ach. Physostigmine counteracts central (because it crosses BBB) as well as peripheral symptoms of atropine toxicity (other anticholinesterases like neostigmine and pyridostigmine counteract only peripheral symptoms as they cannot cross BBB) --> Physostigmine is the DOC. | Pharmacology | null | Treatment of atropine toxicity -
A. 2-pralidoxime
B. Naloxone
C. Flumazenil
D. Physostigmine
| Physostigmine |
69d9e480-742a-4692-9ef8-8cdf1d99da4e | B i.e. Multiple Myeloma Old age, male sex & veebral involvement (lytic lesion) indicate towards diagnosis of Metastasis & Multiple myeloma. But Absence of primary and characterestic multiple punched out lesions on X-Ray skull is diagnostic of Multiple myelomaQ. Osteomalacia: - Looser's zoned or PseudofractureQ (Hallmark) Mnemonic - "Losse Pencilin Fish" - Pencilling-in- of veebral bodies - Cod - fish (marked biconvex) veebraeQ Hyper parathyroidism : - Brown tumorQ Mnemonic - - Sub periosteal ErosionQ "Brown Erosed Salt Basket" - Salt & Pepper or Pepper - Pot skullQ - Basket work appearanceQ of coex Renal Osteodystrophy(d/t CRF): - It combines findings of ostemalacia, hyperparathyroidism and bone sclerosis - Osteomalacia lit Looser's zone - Hyper PTH 1/t Subperiosteal Erosion of bone - Osteosclerosis Vt Rugger Jersey spineQ (End plate sclerosis with alternating bands of radiolucency) In children with CRF, the combination of rickets & hyperparathyroidism leads to Rotting Fence Post appearance.Q Multiple Myeloma: Two cardinal features are: Generalized reduction of bone density (Osteopenia) Localized areas of radiolucency (Punched outQ/Rain drop lesionsQ) in red marrow areas i.e. axial skeletal - spine & skull. In multiple Myeloma lytic lesions of spine are usually associated with some collapse & soft tissue extension i.e. paraveebral soft tissue shadows (differentiation from Metastasis). Differentiation from inflamatory lesions can be made as the interveebral disc space & aicular surfaces are not affected. | Radiology | null | 76 year old man presents with lytic lesion in the vebrae. X-Ray skull showed multiple punched out lesions. The diagnosis is
A. Metastasis
B. Multiple myeloma
C. Osteomalacia
D. Hyperparathyroidism
| Multiple myeloma |
1e2f190f-3bee-465e-94b2-c6664ab2e4bf | Vegetable fats are more unsaturated than animal fats, PUFA is found mostly in vegetable fats.
However, there are exceptions, as for example coconut and palm oils although vegetable oils, have an extremely high percentage of saturated fatty acids. On the other hand , fish oil contain good percentage of PUFA
Vegetable fats are less stable.
They contain high no. of unsaturated bonds which undergo spontaneous oxidation at the double bond forming aldehydes,ketones and resins.
Vegetable fats are less atherosclerotic;
In fact PUFA have a favorable effect on serum lipid profile. They decrease LDL and increase HDL ( good cholesterol ).Essential fatty acids ( high percentage in vegetable fat) decrease the platelet adhesiveness.
Vegetable fat contains less fat soluble vitamins (A,D,E & K vitamin).
For this reason Vanaspati Ghee is fortified with vit. A *& D by government regulation (DALDA) | Social & Preventive Medicine | null | Vegetable fat differs from animal oil in being –
A. More saturated
B. More stable
C. More atherosclerotic
D. Contains less fat soluble vitamin
| Contains less fat soluble vitamin |
22c5ed96-7f61-4836-9a7a-a1517d8c81ad | -Hemorrhagic shock has been divided into 4 classes according to ATLS course. Class 1 Class2 Class 3 Class 4 Blood volume lost as % of total < 15 % 15-30% 30-40% >40% Four Classes of Hemorrhagic Shock (According to the ATLS course) Parameter I II III IV Blood loss (%) 0-15% 15-30 30-40 >40 CNS Slightly anxious Mildly anxious Anxious or confused Confused or lethargic Pulse (beats/ min) <100 >100 >120 >140 Blood pressure Normal Normal Decreased Decreased Pulse pressure Normal Decreased Decreased Decreased Respiratory rate 14-20/min 20-30/min 30-40/min >35/min Urine (mL/hr) >30 20-30 5-15 Negligible Fluid Crystalloid Crystalloid Crystalloid + blood Crystalloid + blood Base deficit 0 to -2 mEq/L -2 to 6 mEq/L -6 to -10 mEq/L -10 mEq/L or less -Please refer to the above table as many such questions are asked from the table. | Surgery | Trauma | Amount of blood loss in class II circulatory failure/Haemorrhagic shock?
A. <15%
B. 15-30%
C. 30-40%
D. >40%
| 15-30% |
650490c8-230c-4b41-8029-8d20f12d6e1d | Ans. d. Subarachnoid hemorrhage Most likely diagnosis in an adult hypeensive male with sudden onset severe headache, vomiting with marked neck rigidity without focal neurological deficit would be subarachnoid hemorrhage. | Medicine | null | An adult hypeensive male presented with sudden onset severe headache and vomiting. On examination, there is marked neck rigidity and no focal neurological deficit was found. The symptoms are most likely due to:
A. Intracerebral parenchymal hemorrhage
B. Ischemic stroke
C. Meningitis
D. Subarachnoid hemorrhage
| Subarachnoid hemorrhage |
6bc67e67-e2c0-4ce7-a9a0-be96517d6388 | Ans: c (21 trisomy)Ref: Nelson Pediatrics, 19th ed., Pg. 384Trisomy 21, Down's syndrome seen in 1/600-800 births. Please note the clinical features which are often asked Hypotonia Dysplasia of the pelvis Flat face, cardiac malformations Speckled irises Simian crease (Brushfield spots) Varying degrees of mental Short, broad hands and growth retardation Hypoplasia of middle Upward slanted palpebral phalanx of 5th finger fissures and epicanthic folds Intestinal atresia, and high arched palate | Gynaecology & Obstetrics | Miscellaneous (Gynae) | Down's syndrome is due to:
A. 5/12 translocation
B. 18 trisomy
C. 21trisomy
D. 14/21 trisomy
| 21trisomy |
0b8458c4-1517-4ddd-9b82-29e005327ffe | Entamoeba histolytica is predominantly found in primates (including humans) and occasionally in dogs, cats, cattle and pigs.
The parasite has a worldwide distribution and is prevalent in tropical and subtropical countries.
Salmonella - The most common are animal reservoirs are chickens, turkeys, pigs, and cows; dozens of other domestic and wild animals also harbor these organisms.
Campylobacter jejuni - C. jejuni is carried by most of these animal reservoirs and is the predominant species isolated from chickens and cattle.
Y. Enterocolitica - dogs, sheep, wild rodents, and environmental water may also be a reservoir of pathogenic Y. enterocolitica strains.
Ref : http://parasite.org.au/para-site/text/entamoeba-text.html#:~:text=Host%20range%3A%20Entamoeba%20histolytica%20is,in%20tropical%20and%20subtropical%20countries | Microbiology | null | Man is the only reservoir for
A. Salmonella
B. Campylobacter jejuni
C. E. histolytica
D. Y. enterocolitica
| E. histolytica |
c4c6a97d-3520-4a45-8005-685b24060a6d | Denosumab is a monoclonal antibody against RANK - ligand which inhibits binding to RANK receptor and inhibits the activation of osteoclasts and inhibits bone resorption so it is used in treatment of Osteoporosis. | Pharmacology | NSAIDs, Gout and Rheumatoid Ahritis | Denosumab is used in:-
A. Osteomalacia
B. Osteoahritis
C. Osteoporosis
D. Osteosarcoma
| Osteoporosis |
0bfc4bd8-8a99-4f3a-ac5e-78a73be88807 | Viral Conjunctivitis is most commonly caused by Adenovirus. | Ophthalmology | null | Viral Conjunctivitis is most commonly caused by
A. Herpes simplex
B. Enterovirus
C. Adenovirus
D. Coxackie A Virus
| Adenovirus |
18b75565-80b4-40c8-a385-854d6cad5a35 | B i.e., Neck of fibula Common peroneal nerve winds around neck of fibula to enter peroneus longus muscle. Because of its subcutaneous position it can be easily palpated here & is very prone to injury. So fracture neck of fibula may cause foot drop. | Anatomy | null | Common peroneal nerve is related to which of the following structures
A. Shaft of tibia
B. Neck of fibula
C. Lower tibio-fibular joint
D. Shaft of fibula
| Neck of fibula |
8baf7744-5638-4479-8e6a-dd6b8b05f382 | Ans. is 'b' i.e., Adduction and medial rotation of arm Clinical features of Erb's palsy A) Muscles paralyzed: Mainly biceps brachii, deltoid, brachialis and brachioradialis. Partly supraspinatus, infraspinatus and supinator. B) Deformity (position of the limb) i) Arm : Hangs by the side; it is adducted and medially rotated. ii) Forearm : Extended and pronated. The deformity is known as 'policeman's tip hand' or 'porter's tip hand'. C) Disability: The following movements are lost. o Abduction and lateral rotation of the arm (shoulder). o Flexion and supination of the forearm. o Biceps and supinator jerks are lost. o Sensations are lost over a small area over the lower part of the deltoid. | Unknown | null | Upper limb deformity in Erb's palsy -
A. Adduction and lateral rotation of arm
B. Adduction and medial rotation of arm
C. Abduction and lateral rotation of arm
D. Abduction and medial rotation of arm
| Adduction and medial rotation of arm |
ba04ff8c-8f69-4464-8bb3-b96fa71744ef | Oxidase test: The test is used to identifying bacteria containing cytochrome oxidase. I t is useful in differentiating the oxidase negative Enterobacteriaceae from the oxidase positive Pseudomonas organisms and the oxidase positive group of vibrios and related bacterias (Aeromonas, Plesiomonas). Neisseria organisms also test positive. the presence of cytochrome oxidase can is detected through the use of an oxidase disc which acts as an electron donor to cytochrome oxidase. if the test bacterium oxidizes the disc, the disk turns pin indicating a positive test. If there is no change in color the test is negative for the bacterium REF:Ananthanarayan & Panicker's Textbook of Microbiology 8th Edition pg no: 675 | Microbiology | general microbiology | Which one of the following bacteria ois oxidase positive?
A. Vibrio
B. Pseudomonas
C. Clostridium
D. E.coli
| Vibrio |
f81f33e2-3042-4a59-874e-3d1c6d2f91d0 | Ans. is 'b' i.e., 450 mg TREATMENT REGIMEN SPUTUM EXAMINATIONS FOR PULMON ARY TBCategory of treatmentType of patientRegimentPre treatment sputumTest at monthIf result isTHEN -Start continuation phase, test sputum 6 monthsNew casesNew sputum smear-positive2(HRZE)3+-2 Category 1New sputum semar-negative+ +Continue intesive phase for one more montfRed BoxNew extra-pulmonaryNew others4 (HR)3 Complete the treatment in 7 monthsPreviouslySputum smear-positive Relapse2(HRZES}3 -Start continuation phase, test sputum again 6 months, completion of treatmentTreatedSputum smear-positive Fa ilure+ Category IISputum smear-positive1 (HRZE)3+3+Continue intensive phase for one more monthBlue Boxtreatment after default Others+5 (HRE)3 again at 4 months if sputum is positive sene sputum for culture and drug sensitivity as might be a case of MDR-TBo The number before the letters refers to the number of months of treatment. The subscript after the letters refers to the number of doses per week- H : Isomazid (600 mg), R : Rifampicin (450 mg), Z : Pyrazinamide (1500 mg), E : Ethambuiol (1200 mg), S : Streptomycin (750 mg). Patients who weight more than 60 kg receive additional Rifampicin 150 mg. Patients more than 50 years old receive streptomycin 500 mg- Patient in categories I and 11, Who have a positive sputum smear at the end of the initial intensive phase, receive an additional month of intensive phase treatment.o Examples of seriously ill extra-pulmonary TB cases are meningitis, disseminated TB, tuberculous pericarditis, peritonitis, bilateral or extensive pleurisy, spinal TB with neurological complications and intestinal and genito-urinary TB.o In rare and exeptional cases, patients who are sputum smear-negative or who have extra-pulmonary disease can have relapse or failure. This diagnosis in all such cases should always be made by an MO and should be supported by culture or histological evidence of current, active tuberculosis. In these cases, the patient should be categorized as 'other' and given category II treatment.o Any patient treated writb category I who has a positive smear at 5 months of treatment should be considered a Failure and started on category II treatment, afresh. If category I sputum smear-ve case fails to improve or if patient develops pulmonary signs and positive smear at the end of intensive phase, it is considered treatment failure. Start category II treatment and confirm failure by culture and perform DST. | Social & Preventive Medicine | Communicable Diseases | Dose of rifampicin in RNTCP is -
A. 600 mg
B. 450 mg
C. 300 mg
D. 100 mg
| 450 mg |
889d7522-a081-4024-ad90-38873c42d2c8 | Ans. a (Scoline). (Ref. KD Tripathi, Pharamacology, 6th ed., 150)SUXAMETHONIUM CHLORIDE OR SUCCINYL CHOLINE (SCOLINE)Introduction- It is a short acting muscle relaxant.- It is a phase II blocker.- Depolarising muscle i.e. depolarising block at motor end-plate.- It is dichlor ester of succinic acid.- The action lasts for 3-5 minutes.- Action is prolonged in liver disease.- Metabolised by pseudocholinesterase.- It gives good intubating condition in shortest time (less than one minute).Uses- Endotracheal intubation in dose of 1 to 2 mg/kg body weight.- To modify electroconvulsive therapy.- For procedures requiring short duration relaxation.- Excellent for operative abet and caesaerian section.Side effects(Mnemonic=ABRHAM on FTV)- Apnoea (Prolonged),- Bradycardia,- Raised intraocular pressure- Hyperkalemia- Ache (Myalgia/ Post-operative muscle ache)- Malignant hyperpyrexia- Fasciculation,- Tachyphylaxis- Ventricular fibrillationIts S/E can be prevented by- Self-taming with 10 mg suxamethonium given a minute before induction of an anaesthesia.PrecurarizationAlso remember:# Malignant hyperpyrexia:- It is due to release of Ca++ from sarcoplasmic reticulum in sensitive person- It can be caused also bya) Halothane,b) Methoxyflurane andc) Isoflurane- Rx- dantrolene.- Dantrolene is muscle relaxant acting directly on muscle. {MH 2006) | Anaesthesia | Muscle Relaxant | Fasciculations are caused by
A. Scoline
B. Ketamine
C. Halothane
D. Atracurium
| Scoline |
7ce757a5-9c27-47eb-9922-1e91e8f88a1d | The effective dose (E) is used to estimate the risk in humans. It is hard to compare the risk from a dental exposure with, for example, the risk from a radiographic chest examination because different tissues with different radiosensitivities are exposed.
The unit of effective dose is the Sv. | Radiology | null | What is the S.I. unit of effective dose?
A. Becquerel
B. Sievert
C. Gray
D. Roentgen
| Sievert |
b83bf1a4-62c4-4558-a167-05b2fdcdb506 | (Low PaO2/High PaCO2) (1684 -H17th)Respiratory failure - PaO2 <8.0 kPa (60mmHg) and PaCO2 > 6.5 kPa (50 mmHg)Type 1 - PaO2 low, PaCO2 normal or lowType II - PaCO2 raised, PaO2 low - Ventilatory failure* Most important - cause in chronic type II respiratory failure is - chronic bronchitis | Medicine | Respiratory | Type II Respiratory failure is characterised by (Davidson)
A. Low PaO2 /Low PaCO2
B. Normal PaCO2 / Low PaO2
C. Low PaO2 /High PaCO2
D. High PaO2 / Low PaCO2
| Low PaO2 /High PaCO2 |
4615d01b-e5ff-4bb2-a8d6-f613900007a5 | . The conjugation process of bilirubin in liver remains operative without any interference. | Pathology | null | In post-hepatic jaundice, the concentation of conjugatedbilirubin in the blood is higher than that ofunconjugated bilirubin because :
A. There is an increased rate of destruction of red blood cells.
B. The unconjugated bilirubin is trapped by the bile stone produced in the bile duct.
C. The conjugation process of bilirubin in liver remains operative without any interference.
D. The UDP- glulcuronoyltransferase activity is in creased manifold in obstructive jaundice.
| The conjugation process of bilirubin in liver remains operative without any interference. |
3d988571-2ccd-4e9c-98f4-63608bc68b43 | Beclard's hernia → is the femoral hernia through the opening of the saphenous vein (named after Pierre Augustin Beclard). | Surgery | null | Hernia into pouch of Douglas is __________ hernia :
A. Beclard's
B. Bochdaleks
C. Blandin's
D. Berger's
| Berger's |
fcaeb408-9b61-4332-87d0-f90a990e6185 | Total no.of female deaths due to complication of pregnancy, childbih or within 42 days of delivery from puerperal causes in an area during a given year. ---------------------------------------------------------------------------------------------------- x 1000 Total no. of live bihs in the same area and year. 6/360 x 1000= 0.0166 x 1000 = 16.6 Ref: Park, 20th Edition, Page 479. | Social & Preventive Medicine | null | A community has a population of 10,000 and a bih rate of 36 per 1000. 6 maternal deaths were repoed in the current year. The Maternal Moality Rate (MMR) is:
A. 14.5
B. 16.6
C. 20
D. 5
| 16.6 |
d8f139ee-da8c-43c3-9a5b-e7880e448e4c | Purpura fulminans is an acute, often fatal, thrombotic disorder which manifests as blood spots, bruising and discolouration of the skin resulting from coagulation in small blood vessels within the skin and rapidly leads to skin necrosis and disseminated intravascular coagulation caused by Neisseria meningitidis and varicella Ref Harrison20th edition pg 1078 | Medicine | Infection | Acute infectious purpura fulminans is caused by
A. Neisseria meningitidis and varicella
B. Gonococi
C. E. coli
D. Proteus
| Neisseria meningitidis and varicella |
c237c958-1fbe-4779-8960-16083e729536 | Brainstem
1. Medulla:responsible for regulating and/ or coordination of:
- Blood pressure.
- Breathing.
- Swallowing.
- Coughing.
- Vomiting.
2. Pons : participates in respiratory regulation and the relay of information from cerebral hemispheres to the cerebellum.
3. Midbrain : participates in coordination of visual and auditory systems. | Physiology | null | Not a component of Brain stem
A. Mid brain
B. Pons
C. Medulla
D. Spinal cord
| Spinal cord |
da4532de-1c98-4687-aaa7-00fbbf26a127 | B: The gastric phase is the period of greatest gastric secretion. This phase is responsible for the greatest volume of gastric secretions, and it is activated by the presence of food in the stomach.
A: The cephalic phase of stomach secretion is anticipatory and prepares the stomach to receive food. In the cephalic phase, sensations of taste, the smell of food, stimulation of tactile receptors during the process of chewing and swallowing, and pleasant thoughts of food stimulate centers within the medulla oblongata that influence gastric secretions.
C: The intestinal phase of gastric secretion primarily inhibits gastric secretions. It is controlled by the entrance of acidic chyme into the duodenum. The presence of chyme in the duodenum initiates both neural and hormonal mechanisms.
D: Deglutition the action or process of swallowing. | Pathology | null | The greatest volume of gastric secretion occurs during:
A. Cephalic phase
B. Gastric phase
C. Intestinal phase
D. Deglutition
| Gastric phase |
ea5f1823-e6eb-443b-a8ba-fd006d951f58 | The characteristics of conductive hearing loss are: 1. Negative Rinne test, i.e. BC > AC. 2. Weber lateralized to poorer ear. 3. Normal absolute bone conduction. 4. Low frequencies affected more. 5. Audiometry shows bone conduction better than air conduction with air-bone gap. Greater the air-bone gap, more is the conductive loss 6. Loss is not more than 60 dB. 7. Speech discrimination is good. Ref: Dhingra 7e pg 31. | ENT | Ear | A 38-year-old gentleman repos of decreased hearing in the right ear for the last two years. On testing with a 512 Hz tuning fork, the Rinne&;s test without masking is negative in the right ear and positive on the left ear. With Weber&;s test, the tone is perceived as louder in the right ear. The most likely diagnosis in the patient is
A. Right conductive hearing loss
B. Right sensorineural hearing loss
C. Left sensorineural hearing loss
D. Left conductive hearing loss
| Right conductive hearing loss |
725d026e-c8e8-49c1-9c1f-b7205515af74 | Deep pa of submandibular gland & hypoglossal neve are deep to mylohyoid muscle.Structures passing superficial to mylohyoid in anterior pa of digastric triangle are submandibular gland (superficial pa), facial vein, facial aery, mylohyoid nerve & vessels, hypoglossal nerve & submandibular nodes. | Anatomy | null | Structure superficial to mylohyoid in anterior digastric triangle are:
A. Deep pa of submandibular gland
B. Hypoglossal nerve
C. Pa of parotid gland
D. Mylohyoid aery & nerve
| Mylohyoid aery & nerve |
b304ec3c-d9e2-4eeb-be72-ff3d4178fb50 | Atrial A and B receptors are located at the venoatrial junctions and have distinct functions. Type A receptors react primarily to hea rate but adapt to long-term changes in atrial volume. Type B receptors increase their discharge during atrial distension. C fibers arise from receptors scattered through the atria; these discharge with a low frequency and respond with increased discharge to increase in atrial pressure. The A and B receptors are thought to mediate the increase in hea rate associated with atrial distension (such as can occur with intravenous infusions) known as the Bainbridge reflex. In contrast, activation of atrial C fibers generally produces a vasodepressor effect (bradycardia and peripheral vasodilation). Ref: Hoit B.D., Walsh R.A. (2011). Chapter 5. Normal Physiology of the Cardiovascular System. In V. Fuster, R.A. Walsh, R.A. Harrington (Eds), Hurst's The Hea, 13e. | Physiology | null | Which of the following physiological change take place by Bainbridge reflex?
A. Increase in HR
B. Decrease in HR
C. Increase in BP
D. Distension of large somatic veins
| Increase in HR |
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