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ec6babf8-6e3e-49af-aa46-c746a914850b | Answer- A (Tuberous sclerosis)AML is a benign clonal neoplasm consisting of varying amounts of mature adipose tissue, smooth muscle and thick-walled vessels. | Surgery | null | An 8 years old child has left sided flank pain and mental retardation. On ultrasound, a hyperechoic lesion in the right kidney and multiple lesions in the liver are noted. CT examination of the abdomen revealed -50 to -80 HU density of these lesions. The most probable diagnosis is:
A. Tuberous sclerosis
B. Hereditary hemangioblastoma
C. Autosomal recessive polycystic kidney disease
D. von Hippel-Lindau syndrome
| Tuberous sclerosis |
7fb8a42b-2574-49f6-bf60-439ad7a8adbe | The most common source of epistaxis is Kisselbach's vascular plexus on the anterior nasal septum. Predisposing factors include foreign bodies, forceful nose-blowing, nose-picking, rhinitis and deted septum | Surgery | Facial Injuries and Abnormalities | A 72-year-old man presents to the emergency depament complaining of frequent nose-bleeds. What is the most likely site of acute epistaxis?
A. Turbinate
B. Septum
C. Maxillary sinus
D. Ethmoid sinus
| Septum |
1a84297e-5c01-4cca-9241-3f13978026de | In the video ,structure being examined has originated from Anterior Tibial Aery =Dorsalis Pedis Aery Pulse can be palpated readily lateral to the Extensor Hallucis Longus Tendon (or medially to the Extensor Digitorum Longus Tendon) on the dorsal surface of the foot, distal to the dorsal most prominence of the navicular bone which serves as a reliable landmark for palpation. It arises at the anterior aspect of the ankle joint and is a continuation of the anterior tibial aery. =Popliteal Aery is palpated at popliteal fossa =Post Tibial Aery-The posterior tibial aery pulse can be readily palpated halfway between the posterior border of the medial malleolus and the achilles tendon | Anatomy | Blood supply, canals and triangle of lower limb | Given below shows an examination technique. The structure being examined originated from:-
A. Popliteal Aery
B. Anterior Tibial Aery
C. Post Tibial Aery
D. Dorsal Arch of Foot
| Anterior Tibial Aery |
ecc6f4a8-9d72-4c0c-8ace-d3bf5dcb1c4a | Key guideline aspects of WHO recommended drinking water quality: –
Colour < 15 true colour units (TCU)
Turbidity < 5 nephlometric turbidity units (NTU)
pH: 6.5 – 8.5
Total dissolved solids (TDS) < 600 mg/litre
Zero pathogenic microorganisms
Zero infectious viruses
Absence of pathogenic protozoa and infective stages of helminthes
Fluorine < 1.5 ppm (0.5 – 0.8 ppm: Optimum level)
Nitrates < 50 mg/litre
Nitrites < 3 mg/litre
Gross alpha radiological activity < 0.5 Bq/litre (New Guideline — WhO)
Gross beta radiological activity < 1.0 Bq/litre (New Guideline — WhO). | Social & Preventive Medicine | null | Proposed guideline values for Radioactivity in Drinking water is
A. Gross a activity 1.0 Bq/L and Gross b activity 10.0 Bq/L
B. Gross a activity 1.0 Bq/L and Gross b activity 0.1 Bq/L
C. Gross a activity 0.1 Bq/L and Gross b activity 1.0 Bq/L
D. Gross a activity 10 Bq/L and Gross b activity 1.0 Bq/L
| Gross a activity 0.1 Bq/L and Gross b activity 1.0 Bq/L |
50b0b136-937b-4408-86e2-a18d77e6ab92 | In middle ear pathology usually there is conductive deafness. With a unilateral conductive hearing loss, the tone is perceived in the affected ear. With a unilateral sensorineural hearing loss, the tone is perceived in the unaffected ear. | ENT | null | In conductive deafness of right ear, Weber's test will show?
A. Lateralised to right side
B. Lateralised to left side
C. Normal
D. Centralised
| Lateralised to right side |
823f1bec-b55b-41e9-abe5-a0e858ce1776 | Ans. is 'c' i.e., HLA - B5 Thromboangitis obliterans (Berger disease) Thrombangitis obliterans is a distinctive disease that is characterized by segmental, thrombosing acute and chronic inflammation of medium sized and small sized aeries, and sometimes secondarily extending to veins and nerves. Thromboangitis obliterans occurs almost exclusively among heavy-cigarrete-smoking persons. It is more common in men but incidence is increasing in women because of increasing smoking habit in women. o Buerger disease is associated with HLA B-5 and HLA-A9. In thrombongitis obliterans there is acute and chronic segmental inflammation of vessels with accompanied thrombosis in the lumen. Typically, the thrombus contains microabscesses with a central focus of neutrophils surrounded by gran u lomatous inflammation. Later, the inflammatory process extends into contiguous veins and nerves and in time all three structures (aeries, veins and nerves) become encased in fibrous tissue, a characterstic that is very rare with other form of vasculitis. Clinical manifestations Thrombangitis obliterans affects vessels of upper and lower extremities. Symptoms are due to vascular insufficiency, i.e. Ischemia of toes, feet and fingers that can lead to ulcer and frank gangrene. Due to neural involvement, there may be severe pain, even at rest. | Pathology | null | Thromboangitis obliterans is associated with ?
A. HLA B27
B. HLA - DR4
C. HLA - B5
D. HLA - DR2
| HLA - B5 |
3110facf-3a67-4a68-a82d-fd0b1f2001a1 | Ans. is 'c' i.e., 72 hours Platelets are provided as a pooled preparation from one or several donors, usually as a 6-unit bag, which is the usual amount given to an average-sized adult. Each unit contains approximately 8 x 101deg platelets and should increase the platelet count by about 7000-10,000/ pL in a 75kg adult. Platelets stored at room temperature can be used for up to 5 days and have a life span of 8 days. Those stored at 4degC are useful for only 24 hours (only 50-70% of total platelet activity is present at 6 hours) and have a life span of only 2-3 days. ABO compatibility should be observed for platelets, but is not essential. For each donor used, there is a similar risk of transmitting hepatitis and HIV as for one unit of blood. Platelet should be administered through a 170pm filter. | Medicine | null | Platelets in stored blood do not live after
A. 24 hours
B. 48 hours
C. 72 hours
D. 96 hours
| 72 hours |
d62fc2c1-44e4-4c05-a182-c6e262450782 | Ref Harrison 19 th ed pg 1548 AyatoSys pulsqtpuls of liver and marked hepatomegaly are characteristic features of tricuspid regurgitation. | Medicine | C.V.S | Hepatomegaly with liver pulsations indicates
A. TR
B. MR
C. Pulmonary hypeension
D. MS
| TR |
d4fca8ed-a3c3-4227-9294-5a1cd92d6a2f | Ans:A.)0.5 degree Fahrenheit. Before ovulation, there is only a small amount of progesterone present in your body and your basal body temperatures (your resting temperatures) are in the lower range. After ovulation, when there is increased progesterone secreted from the corpus luteum, temperatures become elevated. The temperature elevation that occurs after ovulation is sufficient to be measured with a BBT thermometer . The rise in temperature is usually about 0.4 degrees Fahrenheit or 0.2 degrees Celsius. | Gynaecology & Obstetrics | null | Rise in BBT after ovulation is by :
A. 0.5 degree Fahrenheit
B. 1.0 degree Fahrenheit
C. 0.5 degree Celsius
D. 1.0 degree Celsius
| 0.5 degree Fahrenheit |
33860565-6383-42b3-928d-75ce858ce0a4 | Choristomas, forms of heterotopia, are closely related benign tumors, found in abnormal locations. The two can be differentiated as follows: a hamaoma is an excess of normal tissue in a normal situation (e.g. a bihmark on the skin), while a choristoma is an excess of tissue in an abnormal situation (e.g. pancreatic tissue in the duodenum). | Pathology | General pathology | Ectopic rest of normal tissue is known as -
A. Choristoma
B. Hamaoma
C. Pheudotumor
D. Lymphoma
| Choristoma |
7b5854a9-ba69-482b-9f76-9a49efef85db | Classification of hepatitis
In the new classification system of Hepatitis, Grading refers to the assessment of necroinflammatory activity.
Chronic hepatitis represents a series of liver disorders of varying causes and severity in which hepatic inflammation and necrosis continue for at least 6 months.
Earlier chronic hepatitis was categorized into three types depending upon histopathological features. These are
Chronic persistent hepatitis
Chronic lobular hepatitis
Chronic active hepatitis
Now, this categorization has been replaced by more informative classification based upon a combination of clinical serological and histological variables.
Now the classification is based upon —
It's cause
Its histologic activity or grade
It's a degree of progression or stage
(a) Classification by cause —
In this, the hepatitis is classified according to the cause - such as viral hepatitis, autoimmune hepatitis, drug-associated hepatitis.
(b) Classification by Grade —
This classification is based upon an assessment of necroinflammatory activity.
An assessment of following histological features is made on liver biopsy -
Periportal necrosis
Piecemeal necrosis
Bridging necrosis
Portal inflammation
(c) Classification by stage —
This classification is based upon the degree of fibrosis.
It reflects the levels of progression of the disease.
Staging is based upon the degree of fibrosis as follows
0 = No fibrosis
1= Mild fibrosis (limited to portal tract)
2 = Moderate fibrosis (Portal and periportal fibrosis)
3 = Severe fibrosis including bridging fibrosis
4 = Cirrhosis | Pathology | null | Regarding Chronic Viral Hepatitis -
A. Hepatitis A virus infection is a common cause in children
B. Morphological classification into Chronic Active Hepatitis and Chronic Persistent Hepatitis are important
C. Fatty change is pathognomic of Hepatitis C virus infection
D. Grading refers to the extent of necrosis and inflammations
| Grading refers to the extent of necrosis and inflammations |
8589bfdf-a5e8-4c2b-9b2c-6e5d7fa018ad | Even if you don't know about all the options and you just know about P body you can answer this question. The P body is a cytoplasmic organelle involved in mRNA metabolism. Here is where miRNA-mRNA complexes are temporarily stored. They can either undergo degradation or mRNA can be released back for translation. Nucleolus is the pa of nucleus and is the site of rRNA formation. Cajal bodies are regions within the nucleus that are enriched in proteins and RNAs involved in mRNA processing. They are the main sites for the assembly of small nuclear ribonucleoproteins (snRNPs). Nuclear speckles, also known as interchromatin granule clusters, are nuclear domains enriched in pre-mRNA splicing factors. | Biochemistry | Organelles | Which of the following cellular body is NOT found in nucleus?
A. P-bodies
B. Nucleolus
C. Cajal bodies
D. Interchromatin granule clusters
| P-bodies |
a99baba6-bb97-4bb0-a2c8-3e165f18203a | Torsional limit is the amount of rotational torque that can be applied to a "locked" instrument to the point of breakage (separation).
Obviously, an instrument should have sufficient strength to be rotated and worked vigorously without separating in the canal.
Smaller instruments (less than size 20) can withstand more rotations without breaking than larger (greater than size 40) instruments.
Ref :Principles and Practice of Endodontics, Richard E Walton, 3rd edition, pg no:156 | Dental | null | What is torsional limit?
A. Amount of apical pressure that can be applied to a file to the point of breakage
B. The beginning of plastic deformation of the instrument
C. Amount of rotational torque that can be applied to a “locked” instrument to the point of breakage
D. Amount of force necessary so that a file does not return to its original shape upon unloading of the force
| Amount of rotational torque that can be applied to a “locked” instrument to the point of breakage |
0d016065-bf04-4122-8243-6d2be310c274 | Ans. a (Basal ganglia). (Ref. Ganong, Physiology 21st ed., 265)NUCLEUS ACCUMBENS# Nucleus accumbens is located at the base of the striatum, and is a part of basal ganglia.# Addiction is associated with the reward system, particularly with nucleus accumbens.# The medial frontal cortex, the hippocampus, and the amygdala are concerned with memory, and they all project to the nucleus accumbens.# Drugs that block the postsynaptic D3 receptors reduce the rate of self-stimulation and these receptors are mainly located at nucleus accumbens. | Anatomy | Cerebellum and Brainstem | Nucleus accumbens is related to which of the following?
A. Basal ganglia
B. Brain stem
C. Thalamus
D. Cerebellum
| Basal ganglia |
f3e47a23-03c0-4478-8640-efd90dc95be6 | Ans. is 'c' i.e., Right apical parenchymal regionPrimary T.B. includes :?An area of grey white (size of approx. 1-1.50 cm) inflammatory consolidation - called ghon's focus. o Lymph node.Lymphatics and lymphatic channel.Cavity and fibrosis is seen in secondary T.B.Inhaled tubercule bacilli implanted in the distal air spaces of the lower pa of upper lobe or upper pa of the lower lobe, close to the pleura. This area is about 1 to 1.5 cm with caseating necrosis known as Ghon's focus.Primary complex or Ghon's complex of tuberculosis consists of 3 components :Pulmonary compound or Ghon's focus.Draining lymphaticsCaseating hilar lymphnodeAssman's focusThe initial lesion in secondary tuberculosis at the apex of lung (infraclavicular) without any lymph node involvement is called Assman's focus.Ghon's complexThe initial lesion in primary tuberculosis at the periphery of the lung along with the enlarged peribronchial lymph node is called Ghon's complex. | Pathology | null | Ghons focus lies at ?
A. Left apical parenchymal region
B. Right apical parenchymal region
C. Sub pleural caesous lesion in right upper lobe
D. Sub pleural caesous lesion in left upper lobe
| Sub pleural caesous lesion in right upper lobe |
f088fc3c-6c39-4d13-82a7-46a89faf91ba | Case Notification can be done online through NIKSHAY, Which is case based online TB notification system developed by the central TB Division. Ref: Pg.no: 318;IAPSM Textbook of Community Medicine. | Social & Preventive Medicine | Communicable diseases | Which is case based online TB notification system developed by the central TB Division
A. Nischinth
B. Nikshay
C. laksha
D. Yaksma
| Nikshay |
54f65873-b2d3-4556-ac81-cc5df04ef2cf | APGAR is used to quantitatively evaluate newborns condition after bih by giving scores between 0 and 2 in each of 5 different categories assigned at 1 and 5 minutes of life. The 5 criteria used were hea rate, respiration's, muscle tone, reflex irritability and color. APGAR score for HR less than 100 is 1, grimace on nasal suction score is 1, feeble cry score is 1, floppy score is 0 and blue color score is 0. So the total score is 3. Signs 0 1 2 Heabeats per minute Absent Slow (<100) >100 Respiratory effo Absent Slow, irregular Good, crying Muscle tone Limp Some flexion of extremities Active motion Reflex irritability No response Grimace Cry or cough Color Blue or pale Body pink, extremities blue Completely pink Ref: Raab E.L., Kelly L.K. (2013). Chapter 9. Normal Newborn Assessment & Care. In A.H. DeCherney, L. Nathan, N. Laufer, A.S. Roman (Eds), CURRENT Diagnosis & Treatment: Obstetrics & Gynecology, 11e | Pediatrics | null | What is the APGAR score of a child born blue with HR 70/ mt, floppy with feeble cry and grimacing on nasal suction?
A. 3
B. 2
C. 4
D. 5
| 3 |
23800c7d-f450-4618-8ad1-dec07afbca40 | Ans. is 'b i.e., Ovarian cancer Functional ovarian cyst o Endometrial carcinoma o Benign breast disease (fibroadenosis) Ovarian malignancy o Urerine fibroid o Premenstural tension & dysmenorrhoea Pelvic inflammatory disease o RA o Osteoporosis Ectopic pregnancy o Colon cancer o Acne | Pharmacology | null | Combined oral pill reduces the risk of ?
A. Breast cancer
B. Ovarian cancer
C. Cervical cancer
D. Vaginal cancer
| Ovarian cancer |
9f4fdb68-9c73-4aab-9ca1-0795a41db7f3 | Platyhelminthes (flukes & tapeworms) DOC for all the platyhelminths is praziquantel DOC for Fasciola hepatica (liver fluke) is triclabendazole DOC for dog tapeworm is albendazole DOC for trichomoniasis is metronidazole Surgery is done for rhinosporidiosis Nematodes DOC for nematodes is albendazole DOC for filaria is diethyl carbamazine DOC for strongyloidiasis & onchocerca volvulus is Ivermectin | Pharmacology | FMGE 2019 | Praziquantel is used for the treatment of
A. Strongyloidiasis
B. Trichomoniasis
C. Schistosomiasis
D. Rhinosporidiosis
| Schistosomiasis |
ac47df4c-9a66-44f9-b67b-16953833820d | When symptoms are not marked, breathing exercises, decongestant nasal drops, and antihistaminics. When symptoms are marked adenoidectomy is done. (Ref: Diseases of Ear, Nose and Throat, PL Dhingra; 7th edition, pg no. 276) | ENT | Pharynx | In Adenoids hyperophy, treatment is
A. Nasal decongestants
B. Antibiotics
C. B-blockers
D. B2-agonists
| Nasal decongestants |
62400aaa-4f1e-4fc9-b2a3-093c34c51c19 | Range: The difference between the smallest and largest value results in a set of data.
Simplest and most common method to measure variation is range.
Reference: Essentials of Preventive and Community Dentistry, Soben Peter, 4th ed page no 395 | Dental | null | Simplest and most common method to measure variation is:
A. Mean
B. Median
C. SD
D. Range
| Range |
305a31db-f7e9-49c1-9a5d-b94a210bedaa | Ans. is 'a' i.e., Bile salts in urineTestsUsed forRothera's test (nitroprusside test) Ketone bodies in urine :- acetone and acetocetate Gerhardt's test (ferric chloride test) Ketone bodies in urine :- acetoacetate. Benedict's test Reducing sugars in urine Fehling's test Reducing sugars in urine Hay's sulpher test Bile salts in urineFouchet's (borium sulphate test) Bile pigment : bilirubin Gmelin's (nitric acid) test Bile pigment : bilirubin Vanden Bergh test Bile pigment : bilirubin Ehrlich's test Bilinogens (stercobilinogen, urobilinogen) Schlesinger's test Bilins (stercobilin, urobilin). Ehrlich's aldehyde test Porphobilinogen and urobilinogen in urine | Biochemistry | null | Hay's sulpher test is used to detect which of the following ?
A. Bile salts in urine
B. Reducing sugar in urine
C. Ketone bodies in urine
D. Urobilinogen in urine
| Bile salts in urine |
8e412bc1-b871-4c09-9a69-407089314770 | spontaneous splenic rupture, which remain widely accepted to date: Mechanical effect of distention secondary to leukemic infiltration of the spleen, paicularly the capsule; splenic infarct with capsular hemorrhage and subsequent rupture; Ref Davidson edition23rd pg812 | Medicine | G.I.T | Commonest cause of rupture of spleen is
A. Chronic malaria
B. Infectious mononucleosis
C. Leukemia
D. Chronic kala azar
| Leukemia |
d78f6470-7851-4412-98b6-a286818093e1 | Ans. d. Stomach and intestine Breslau's Second Life Test (Stomach Bowel test) Principle: It assumes that a live born child would respire and therefore would also swallow some air into the stomach and bowelQ. Thus detecting the presence of air in stomach and intestine (positive test) proves live bih (even in absence of positive hydrostatic lung test if there had been some obstruction in respiratory However, negative test (absence of air in stomach and bowel) does not always mean still-bih since air does not necessarily enter stomach in adequate amounts during act of breathing. Procedure: The stomach and intestine are removed separately after tying double ligature at each end, place them both in water. They float in water if respiration has taken place, otherwise they will sink No medicolegal value Because air may be swallowed by child in attempting to free the air passage of fluid obstruction in case of still-bih. It is useless in putrefaction Other Tests in Infanticide For Lungs Static test or Fodere's testa: Weight of lung before (30-40 g) and after 66 gm) is measured. The increase in weight of lung is due to increased blood flow Ploucquet's testa: Weight of lung is doubled after respiration (Before respiration-1/70 of body weight, after respiration-1/35 of body weight) Hydrostatic test (Raygat's test)a: It is based on a fact that on breathing, the volume of lungs is increased, which more than compensates the weight of additional blood, due to which their specific gravity is diminished. For Middle Ear Werdin's test: Before bih, the middle ear contains gelatinous embryonic connective tissue. With respiration, the sphincter at the pharyngeal end of eustachian tube relaxes and air replaces the gelatinous substance in few hours to five weeks. This is not reliable | Forensic Medicine | null | There is a case of infanticide. During the post-moem examination, the doctor performs Breslau's second life test. This test detects changes in which of the following organ
A. Brain
B. Hea
C. Lung
D. Stomach and intestine
| Stomach and intestine |
eae3b67e-8648-4e2e-9c8f-59a92bacf93a | Ans. is 'd' i.e., 90% SAR of some impoant infectious diseases Measles Rubella Chicken pox Peussis Mumps 80% 90 - 95% -- 90% -- 90% 86% | Social & Preventive Medicine | null | Secondary attack rate of peussis in unimmunization household contacts of peussis
A. 30%
B. 40%
C. 60%
D. 90%
| 90% |
d4bc2db7-2248-49cf-bab9-b9077a1d2075 | Behcet&;s Disease: A delay in the diagnosis of Behcet&;s disease is common. Knowing what to look for can help you take control of the disease Eye Inflammation -Occurs in more than 50% of patients and can result in blurry vision, sensitivity to light pain and redness. Can lead to blindness if untreated. Mouth Sores - One of the most common and earliest signs . Look like canker sores on lips , tongue, cheek lining or the roof the mouth. Skin Sores Occur in 60-90% of patients. Can look like bumps resembling acne anywhere on the skin or as red, tender nodules on the legs, arms, face and neck. Genital Sores Appear in about 75% of people. Tend to be larger and deeper than oral sores and often scar. Joint Pain & Swelling - Ahritis or spondylitis affect 50% of patients. Can affect an individual or multiple joints, causing pain, swelling, and stiffness. REF : HARRISONS 21ST ED | Medicine | All India exam | A 25yr old male presented to OPD with complain of recurrent oral ulcers and congested eyesOn enquiry he has h/o prior hospital admission for venous thrombosis What is the condition he is suffering from
A. SLE
B. Reiter's syndrome
C. BEHCETS DISEASE
D. Wegner's Granulomatous
| BEHCETS DISEASE |
e69985aa-39d2-4eef-9e51-9d727f2167a4 | Ans. (c) MaxillaryRef: Dhingra's 4th ed p-195 | ENT | Nose and PNS | Most common site of carcinoma of paranasal sinus is?
A. Frontal
B. Ethmoid
C. Maxillary
D. Sphenoid
| Maxillary |
9e3ed819-0878-4455-88e4-2fbc54d5552f | Many chemicals can, when properly used, significantly contribute to the improvement of our quality of life, health and well-being. But other chemicals are highly hazardous and can negatively affect our health and environment when improperly managed.10 chemicals or groups of chemicals of major public health concern are: Air pollution Arsenic Asbestos Benzene Cadmium Dioxin and dioxin-like substances Inadequate or excess fluoride Lead Mercury Highly hazardous pesticides Ref : | Social & Preventive Medicine | null | Which of the following are not included under 10 chemicals of major public health concern by WHO:
A. Arsenic
B. Asbestos
C. Dioxin
D. Radium
| Radium |
12296266-9971-474b-8ebe-c3a07f71883d | Ans. is 'a' i.e., Folic acid deficiency * Megaloblastic anemia is an anemia which results from inhibition of DNA synthesis during red blood cell production.* It is characterized by many large immature and dysfunctional red blood cells (megaloblasts) in the bone marrow, and also by hypersegmented neutrophills.* Vit B12 and folic acid are required for DNA synthesis. Any factor that results in deficiency of vit B12 or folic acid will lead to defective DNA synthesis. Inadequate DNA synthesis results in defective nuclear maturation. However, the synthesis of RNA and proteins is not altered, so cytoplasmic maturation proceeds in advance of nuclear maturation - Nuclear/Cytoplasmic asynchrony that results in formation of megaloblasts.Important causes of megaloblastic anemiaVitamin BJ2 deficiency* Decrease intake: Inadequate diet, vegetarianism.* Impaired absorption : Intrinsic factor deficiency (pernicious anemia, gastrectomy), intestinal diseases (crohn's disease, ileitis, ileal resection, lymphoma, systemic sclerosis), fish tapeworm infestation (D. latum), blind loop syndrome (bacterial overgrowth), diverticuli of bowel, chronic pancreatitis.* Increased requirment: Pregnancy, hyperthyroidism, disseminated cancer.Folate deficiency* Decrease intake: Inadequate diet, alcoholism, infancy.* Impaired absorption : Malabsorption state, intestinal diseases.* Increased requirment: Pregnancy, infancy, disseminated cancer.* Others : Hemodialysis, antifolate drugs (methotrexate, phenobarbitone, phenytoin, trimethoprim, primidone, triametrene, azathioprine.Rare causes* These are : Hereditary orotic aciduria, hypothyroidism, Di-Gueglielmo syndrome, congenital dyserythropoietic anemia, thiamine and pyridoxine deficiency. | Pathology | Blood | Megaloblastic anemia is due to?
A. Folic acid deficiency
B. Vitamin B6 deficiency
C. Defect in RNA synthesis
D. Defect in protein synthesis
| Folic acid deficiency |
4ed53669-818e-4a3c-87d0-7ebae729cd64 | Sinusoidal Pattern:
Stable baseline heart rate of 120 to 160 beats/min with regular oscillations.
Amplitude of 5 to 15 beats/min (rarely greater).
Long-term variability frequency of 2 to 5 cycles per minute.
Fixed or flat short-term variability.
Oscillation of the sinusoidal waveform above or below a baseline.
Absence of accelerations.
Causes of Sinusoidal Pattern:
Serious fetal anemia due to Rh-isoimmunisation/rupture vasa previa / feto maternal hemorrhage / twin to twin transfusion.
Drugs — Meperidine, morphine, alpha prodine and butorphanol.
Amnionitis.
Fetal distress (+/–).
Umbilical cord occlusion. | Gynaecology & Obstetrics | null | Sinusoidal heart rate pattern is seen in:
A. Placenta previa
B. Vasa previa
C. Battledore placenta
D. Succenturiate placenta
| Vasa previa |
f8266a58-ee21-4053-ab67-6534c473efa3 | Ans: A (QT prolongation) Ref: Harrison's Principles of Internal Medicine, 18ed.Explanation:Clinical Manifestations of HypocalcemiaPatients with hypocalcemia may be asymptomatic if the decreases in serum calcium are relatively mild and chronic.Moderate to severe hypocalcemia is associated with paresthesias, usually of the fingers, toes, and circumoral regions due to increased neuromuscular irritability.Chvostek's sign (twitching of the circumoral muscles in response to gentle tapping of the facial nerve just anterior to the ear) may be elicited.Carpal spasm may be induced by inflation of a blood pressure cuff to 20 mmHg above the patient's systolic blood pressure for 3 min (Trousseau's sign).Severe hypocalcemia can induce seizures, carpopedal spasm, bronchospasm. laryngo- spasm, andECG: Prolongation of the QT interval.Clinical Manifestations of HypercalcemiaMild hypercalcemia (up to 11-11.5 mg/dL)It is usually asymptomaticRecognized only on routine calcium measurements.Vague neuropsy chiatric symptoms, like trouble concentrating, personality changes, or depressionAssc with peptic ulcer disease or nephro-lithiasis, and increased fracture risk.More severe hypercalcemia (>12-13 mg/dL)CNS symptoms: Lethargy, stupor, or comaGastrointestinal symptoms (nausea, anorexia, constipation, or pancreatitis).Decreased renal concentrating ability, causing polyuria and polydipsia.Bone pain or pathologic fractures (in longstanding hyperparathyroidism).ECG changes: Bradycardia. AV block, and Short QT interval | Medicine | C.V.S. | ECG change seen in hypocalcemia: (Repeat 2011)
A. QT prolongation
B. Prolonged PR interval
C. Shortened PR interval
D. QT Shortening
| QT prolongation |
f2d8ca39-c3cb-496c-878a-34fb412d91e8 | Ans: D (18 %) Determination of Burn Size Sabiston 19th/523# Burn size is generally assessed by the so-called rule of nines . In adults, each upper extremity and the head and neck are 9% of TBSA, the lower extremities and the anterior and posterior aspects of the trunk are 18% each, and the perineum and genitalia are assumed to be 1% of TBSA.# Another method of estimating smaller burns is to consider the area of the open hand (including the palm and extended fingers) of the patient to be approximately 1% of TBSA and then transpose that measurement visually onto the wound for a determination of its size. This method is helpful when evaluating splash burns and other bums of mixed distribution. Figure (L & B 26th/389): The Lund and Browder chartAge in year0151015AdultA Head986543B Thigh234444C leg223333 Adult Body% of totalPartBSAArm9%Head9%Neck1%Leg18%Anterior trunk18%Posterior trunk18% Fig: Relative percentage of area affected by growthFig. Estimation of burn using the rule of nine (From American Burn 4s- sociation: Advanced burn life support providers manual, Chicago 2005, American Bum Association)Child Body% of totalPartBSAArm9%Head & Neck18%Leg14%Anterior trunk18%Posterior trunk18% | Surgery | Initial Care of the Burn Patient | Burn involving one lower limbs in adult correspondence to area:
A. 4.50%
B. 9%
C. 13.50%
D. 18%
| 18% |
fa0cd48b-e903-4467-a64f-9acab04f3d36 | Cardiac amyloidosis may affect the way electrical signals move through the hea (conduction system). This can lead to abnormal heabeats (arrhythmias) and faulty hea signals (hea block). The condition can be inherited. This is called familial cardiac amyloidosis Ref Davidson 23rd edition pg 456 | Medicine | C.V.S | Amyloidosis of hea presents with -
A. Arrhythmia
B. AV block
C. |Ed mass/voltage
D. AS
| Arrhythmia |
4918392d-6ba5-4553-9bf2-cc4b5744244e | Carotid body tumor is the most common type of paraganglioma in the head and neck region, followed by the glomus jugular tumor. Carotid body tumor grows slowly, rarely metastasizes, and may secrete catecholamines. The tumor usually is supplied by the external carotid artery, and dissection to remove it off the carotid bifurcation may be difficult and cause bleeding. Malignancy occurs in 6% of patients. | Surgery | Miscellaneous | A 40-year-old woman is suspected of having a carotid body tumor. Which one of the following is most characteristic of such a tumor?Carotid body tumor
A. They secrete catecholamines.
B. They are more common at sea level.
C. They arise from structures that respond to changes in blood volume.
D. They arise from the structures that respond to changes in PO2.
| They arise from the structures that respond to changes in PO2. |
aa61320f-a139-4ff6-b1a0-251125bf76e1 | APUD (amine precursor uptake and decarboxylation) cells are neuroendocrine cells found in respiratory system, G.I. tract and other organs; they manufactrure amines (e.g. 5-HT). These cells form carcinoid tumors. | Physiology | Respiratory System Pa 1 | Neuroendocrine cells in the lungs are:
A. Dendritic cells
B. Type I pneumocytes
C. Type II pneumocytes
D. APUD cells
| APUD cells |
2c9629ac-1c00-4a49-b0b1-68248bd55d70 | Bupropion This inhibitor of DA and NA uptake has excitant rather than sedative propey. It is metabolized into an amphetamine like compound. It has been marketed in a sustained release formulation as an aid to smoking cessation. In clinical trials it has been found to yield higher smoking abstinence and quitting rates than placebo. Bupropion may be acting by augmenting the dopaminergic reward function. Better results have been obtained when it is combined with nicotine patch. The nicotine withdrawal symptoms were less severe in bupropion recipients. However, long-term efficacy is not known, and it can cause insomnia, agitation, dry mouth and nausea, but not sexual side effects. Seizures occur in over dose; the dose of 150 mg BD should not be exceeded. Ref: K D Tripathi 8th ed. | Pharmacology | Central Nervous system | Dopamine and noradrenaline reuptake inhibitor is:
A. Clozapine
B. Bupropion
C. Zolpidem
D. Miazapine
| Bupropion |
b8fbf315-07b4-4587-8b4a-d9cb786bf049 | * Pseudotumour cerebri(idiopathic intracranial hypeension) usually occur in obese young women . Ref Harrison20th edition pg 2456 | Medicine | C.N.S | Pseudotumor cerebri is seen in
A. Obese women in the age group 20-40 yrs
B. Obese males 20-40 yrs.
C. Thin females 50-60 yrs.
D. Thin males 50-60 yrs.
| Obese women in the age group 20-40 yrs |
e9ad66fe-0c0c-46c3-98d8-2032a5e0d0dd | - Child given is presenting with classical history of hemolytic uremic syndrome In HUS, there is initial history of diarrhea caused d/t E-coli which causes damage to endothelial cells resulting in thrombotic microangiopathy affecting kidney. Typical Causative agent: Escherichia coli strain O157:H7 infection; Endothelial damage by Shiga-like toxin Characterized by triad of Renal failure, Anemia, Thrombocytopenia Peripheral findings - Presence of Schistocytes. As it causes hemolytic anemia, | in haptoglobin level & | in serum indirect bilirubin is seen Low fibrinogen and elevated D-dimer level is usually seen in DIC | Pathology | Hemolytic Anemias: Basic concepts and classification | A young child presented with history of passage of dark colored with urine with reduced urine output. He has a past history of abdominal pain, fever, and bloody diarrhea for 4 days which resolved on its own. There is absence of peripheral edema or rashes. Investigations show anemia, thrombocytopenia, and elevated blood urea nitrogen and serum creatinine. Which of the following findings is most expected finding in this patient?
A. Elevated haptoglobin level
B. Elevated serum indirect bilirubin
C. Elevated thrombin and prothrombin time
D. Low fibrinogen and elevated D-dimer level
| Elevated serum indirect bilirubin |
db88be30-8b40-4025-b452-17c59a344a96 | B i.e. Posterior chamber Classical signs of aphakia are - a deep anterior chamber, iridodonesis (tremulousness of iris), only 2 images on Purkinje's test, dark (jet black) papillary reflexQ and highly hypermetropic small disc on fundus examination with markedly defective vision for both far and near d/t high hypermetropia and absence of accommodationQ. A scar mark around limbusQ is found in surgical aphakia. Because of high hypermetropia, an aphakic eye requires the correcting spectacle lens of about 10-11 D worn in the usual position if the eye were previously emmetropic. The retinal image of aphakic eye wearing spectacles is about 25% (quaer) magnified/ larger than the emmetropic image. Hence vision of even 6/6 with 10-11 D glasses is not quite as good as it seems. Because of the disparity of images, correcting unilateral aphakia with spectacles when there is good vision in other eye 1/ t an intolerable diplopia. With contact lenses, a comfoable binocular vision may be attained in aphakia. However, posterior chamber intraocular (in bag) lens implantation is the best available method of correcting aphakiaQ - The optical rehabilitation of aphakia is best done by IOL implants and best site for intraocular lens implants is posterior chamber or within capsular bag Q and this is the normal anatomical position. Whereas anterior chamber lens has more complications like corneal endothelial damage, secondary glucoma, uveitis etc. - With incision in upper pa of cornea, the sutureless phacoemulsification produces 0.5-1D 'against the rule' astigmatism (since cornea is flattened in veical meridian) whereas, extra capsular cataract extraction (ECCE) performed with sutures produces 1 D to 3 D 'with the rule' astigmatism (which gradually reduces after suture removal & thee after). Aphakia Aphakia means absence of crystalline lens from eye. However from optical point of view, it may be considered a condition in which the lens is absent from the pupillary area. Causes of aphakia are - congenital absence of lens, surgical aphakia (most common), traumatic absorption or extrusion of lens and posterior dislocation of lens Optical changes of aphakia eye are: - Total power of eye is reduced to +44 D from + 60 D Q - Eye becomes highly hypermetropic (10-11 D) Q - All accommodation is lost Q - The anterior focal point becomes 24 mm (15 nun for normal eye) in front of the cornea - The posterior focal point becomes 31 mm (24 mm for normal eye) behind the cornea i.e. about 7 mm behind the eye ball (anteroposterior length of eye ball is 24 mm) Signs of aphakia are - deep anterior chamber, jet black pupil, iridodonesis (i.e. tremulousness of iris) and purkinje's image test shows only two images (normally four images are seen). Main symptoms of aphakia is marked defective vision for both far and near d/t high hypermetropia and loss of accommodationQ. Erythropsia and cynopsia (seeing red & blue images) occurs d/t excessive entry of UV and infrared rays in absence of lens Features Aphakia Pseudoaphakia (Ae-phakia) Definition Absence of It is correction of crystalline lens aphakia with an from it normal aificial intraocular position (pupillary lens (i.e. presence of area) in eye. an IOL implant). Surgical scar Limbal scar may be Mostly seen (unless seen in surgical but very small) near absent in congenital absence of lens limbus Anterior Deep (>4 mm) and Normal or slightly chamber wide deep ( Iridodonesis Tremulousness of Usually absent or very iris characteristically present & is inarkedQ mild Purkinje Only 2 images are All 4 images (just like image test seen with absence of 3rd & 4f5 images normal are seen) Pupil Jet black papillary Black in color but reflexQ when light is thrown shining reflexes are observed in pupillary area and presence of IOL is confirmed Fundus Hypermetropic Relatively normal examination small discQ sized disc Retinoscopy High Refractive status is & Refraction hypermetropiaQ variable and may be and astigmatism. 1. Emmetropia (ideal) Roughly + 10 to + occurs if exact 11D cylindericalQ power IOL glasses are required implanted; patient in previously needs plus (+) emmetropic eyes. glasses for near An addition +3 to vision only +4 D is required for 2. Consecutive near vision to myopia occurs compensate for when implanted IOL accommodation over corrects the refraction of eye; patient require glasses for distant vision/ myopia and may or may not need glasses for near vision. 3. Consecutive hypermetropia occurs when under power IOL is implanted; patient requires plus (+) glasses for distance vision & additional + 2D to + 3D for near vision. | Ophthalmology | null | Best IOL is:
A. Ant chamber
B. Post chamber
C. Iris suppoed
D. Angle suppoed
| Post chamber |
96eea8f3-3fd7-4e2e-b965-0b0a38a7f042 | (A) Posterior urethral valves # Posterior urethral valves: These constitute an important cause of distal urinary tract obstruction in boys.> Dribbling, abnormal urinary stream, palpable bladder and recurrent UTI are the usual presenting features.> The presence of severe obstruction in the urinary tract in utero may lead to renal dysplasia.> Mild to moderate impairment of renal function may be present at birth.> The diagnosis is made on MCU, which shows dilated posterior urethra and valves at its junction with anterior urethra. | Surgery | Miscellaneous | Most common cause of urinary retention in children includes
A. Posterior urethral valves
B. Urethral stenosis
C. Urethral aplasia
D. Ectopic ureteric opening
| Posterior urethral valves |
4da05b93-ba48-4e84-bddf-55483d8955a9 | Ans. (c) Bifocal for pediatric aphakiaRef: Diagnosis and Management of Ocular Motility Disorders by Alec M. Ansons, Helen Davis 3/e, p. 36These are straight type/ executive type bifocals with a central lie dissecting the visual axis, such that the top of the reading segment passes just below the middle of the pupil when the eye is in the primary position. Indicated in*Aphakia in children*As low vision aids in children*In selected cases of treatment od accommodative esotropia with convergence excessBifocals preferred in presbyopia/adults are usually D shaped | Ophthalmology | Elementary Optics | Spectacle shown below is used in
A. Bifocal for presbyopia
B. Bifocal for adult aphakia
C. Bifocal for pediatric aphakia
D. Progressive bifocal for presbyopia
| Bifocal for pediatric aphakia |
632165f8-b2fa-4fac-9d71-91368d100870 | Dead fetus if retained for more than 4-5 weeks, release thromboplastin which leads to DIC Ref: Datta Obs 9e pg 304. | Anatomy | Abnormal labor | A patient at 22 weeks gestation is diagnosed as having IUD which occurred at 17 weeks but did not have a miscarriage. The patient is at increased risk of :
A. Septic aboion
B. Future infeility
C. Consumptive coagulopathy with hypofibrinogenemia
D. Ectopic pregnancy
| Consumptive coagulopathy with hypofibrinogenemia |
5adb902b-138f-4776-9960-4ac6b5258624 | * LAs are weak bases. These require penetration inside the neuron for their action. For entry in the neuron, LAs have to cross the neuronal membrane. * Unionized drugs (lipid soluble) can easily cross the membrane, therefore addition of NaHCO3 in the local anaesthetic solution (weak bases are un-ionized in the alkaline medium) makes them rapid acting. * Adrenaline increases the duration of action by causing vasoconstriction. * Methylparapben is the preservative added in LA solution. | Pharmacology | Anaesthesia | An agent added to local anesthetics to speed the onset of action is:
A. Methylparapben
B. Bicarbonate
C. Fentanyl
D. Adrenaline
| Bicarbonate |
9f21fc0b-e389-4b03-b3ec-0e9ad6335ca3 | Gastro duodenal aery is the most common aery involved in duodenal ulcer hemorrhage. Also, remember A peptic ulcer is the most common cause of massive upper gastrointestinal bleed (Duodenal ulcers > Gastric ulcers) Bleeding ulcers in the duodenum are usually located on the posterior surface of the duodenal bulb. Ref : Bailey & Love 25/e p1045 | Anatomy | G.I.T | Aery to bleed in duodenal ulcer haemorrhage -
A. Splenic aery
B. Gastroduodenal aery
C. Left gastric aery
D. Sup. mesenteric aery
| Gastroduodenal aery |
ac5b8795-5e6d-4abd-890f-58e120cb2718 | Ans. is 'a' i.e., Mucosal erosions and swelling of the GI mucosa Abdominal pain in HSPo The second most frequent symptom of Henoch-Schonlein purpura is abdominal pain, which occurs in up to 65 percent of cases. The most common complaint is colicky abdominal pain, which may be severe and associated with vomiting. Stools may show gross or occult blood; hematemesis may also occur. The pain may mimic that of an acute abdomen. Severe cases may proceed to intussusception, hemorrhage and shock. Younger children are less likely to exhibit gastrointestinal symptoms. Endoscopic evaluation often shows mucosal erosions and swelling | Pediatrics | Urinary Tract | Abdominal pain in Henoch Schonlein purpura is due to -
A. Mucosal erosions and swelling of the G1 mucosa
B. Gastrointestinal hemorrhage
C. Volvulus
D. Associated pancreatic inflammation
| Mucosal erosions and swelling of the G1 mucosa |
3dc7cfae-f1fa-4b38-9b68-c95eebbad9ff | Since the person in the question is showing a hostile behavior which is impairing his academic activities for the last 6 months, the most appropriate next step would be to rule out Oppositional defiant disorder.Oppositional defiant disorder is a recurrent pattern of negativistic, hostile or defiant behavior that lasts longer than 6 months and creates disturbances in at least one of the domains of child functioning including social, academic or occupational impairment. The symptoms of this disorder is usually evident around 6-8 years. Ref: Kaplan and Sadock's Comprehensive Textbook of Psychiatry, 9th Edition, Page 3586, 3580. | Psychiatry | null | An 8 year old child has shown of lack of interest in studies for last 6 months. He has frequent quarrels with his parents and has frequent headaches as anexcuse to avoid school. What would be the most appropriate clinical diagnosis in this patient?
A. Rule out migraine
B. Rule out depression
C. Rule out an oppositional defiant disorder
D. Leave him as normal adolescent problem
| Rule out an oppositional defiant disorder |
8645b537-d9e7-4c02-9cab-4b8243d03a55 | Ans. is 'a' i.e., 10% o Measles-associated mortality is usually higher among the very' young and very old.o Mortality in developing countries may be as high as 10 to 15% due to one or several factors, including the early age of infection, malnutrition, diarrhea, concomitant-secondary bacterial infections, and lack of access to good medical care.o Most common cause of death is pneumonia in children and encephalitis in adults. | Social & Preventive Medicine | Demography | Mortality rate of measles in developing countries-
A. 10%
B. 20%
C. 30%
D. 40%
| 10% |
1616a1f9-40d0-4c00-a173-e4c6034e812d | Ans. is' b' i.e., Junction of anterior cerebral and anterior communicating artery Most common sites of Berry's Aneurysma. Junction of anterior cerebral and anterior communicating arteryb. Bifurcation of MCAc. Trifurcation of CIAd. Bifurcation of basilar artery | Surgery | Cerebrovascular Disorders | Most common site of berry's aneurism is -
A. Trifurcation of internal carotid artery
B. Junction of anterior cerebral and anterior communicating artery
C. Bifurcation of basilar artery
D. Middle cerebral artery
| Junction of anterior cerebral and anterior communicating artery |
c7678a67-e905-42c6-ad81-0152b1d05398 | In hyaline membrane disease the basic pathology is surfactant defeciency.surfactant is a lipoprotein containing phospholipids like phosphatydylcholine and phosphatydylglycerol. Surfactant is produced by type ll alveolar cells of lungs which helps to reduce surface tension in alveoli,in its absence surface tension increases and alveoli tend to collapse during expiration.During inspiration more negative pressure is needed to keep alveoli patent.There is inadequate oxygenation and increased work for breathing. Ref : ESSENTIAL PEDIATRICS,O.P.GHAI,PG NO:143, 7th edition | Pediatrics | Respiratory system | Hyalin emembrane disease presents as
A. Pulmonary edema
B. Hea failure
C. Acute respiratory distress syndrome
D. Pulmonary embolism
| Acute respiratory distress syndrome |
9bdd1eaf-3d9a-4ba7-8cb1-d43b15147e35 | The formula method states that the right lateral pterygoid moves the mandible left, whereas the left lateral pterygoid moves the mandible right. | Physiology | All India exam | Which muscleft is the chief mover of the mandible towards the left
A. Left medial pterygoid
B. Left lateral pterygoid
C. Right medial pterygoid
D. Right lateral pterygoid
| Right lateral pterygoid |
585f4738-c9a0-4373-9d1c-0a052c1cf6fe | Order of depolarization in the heart.
- First- Left side of interventricular septum
- Moves to right across the mid-portion of the septum
- Apex of heart
- Along ventricular walls to AV groove (Endocardium to epicardium)
- Last- Posterobasal portion of the left ventricle, pulmonary conus, uppermost portion of the septum. | Physiology | null | Which of the following is the order of activation after stimulation of Purkinje fibers is
A. Septum → Endocardium → Epicardium
B. Endocardium → Septum → Epicardium
C. Epicardium → Septum → Endocardium
D. Septum → Epicardium → Endocardium
| Septum → Endocardium → Epicardium |
ae9e7059-d561-4b9f-a9f3-dfc9255ee7f0 | Treatment for Obesity includes * Dieting. * Exercise.and also the various modalities of surgery indicated is the following, * Veical banded gastroplasty. * Gastric bypass. * Laparoscopic gastroplasty or gastric bypass. * Jaw wiring. * Biliopancreatic diversion. * Jejuno-ileal bypass ref: SRB&;s manual of surgery, ed 3, pg no 90 | Surgery | G.I.T | Bariatric surgical procedures include
A. Gastric Banding
B. Gastric Bypass
C. Biliopancreatic diversion
D. Ileal Transposition
| Ileal Transposition |
96343aec-f5b4-4eef-8a25-eb597271b931 | A i.e. Collecting DuctOsmolality of urine depends on the action of vasopressin on the collecting ductsQ. Alteration in water metabolism by vasopressinUrine isotonic to plasmaGFR (ml/min)% of filteredwaterreabsorbedUrine volume(L/d)Urine concentration(mosm /kg H20)Gain /Loss of water inexcess of solute (L/d)12598.72.4290 Vasopressin present12599.70.51400Q (almost 5 timeof plasma)1.9 gainNo vasopressin (Diabetesinsipidus)12587.123.33020.9 loss | Physiology | null | Hypeonic urine is excreted due to absorption of water in:
A. Collecting ducts
B. DCT
C. Ascending pa of loop of Henley
D. Descending pa of loop of Henley
| Collecting ducts |
f648c5a5-db4a-40f2-8466-a55dd5529bac | Ref: Synopsis of Forensic medicine and Toxicology (Dr.K.S.Narayana Reddy) Pg 200 In females impotence is of an active nature , leading to vaganismus . vaginisumus is a spasmodic contraction of vagina due to hyperesthesia .it's a classical example of psychosomatic illness .anatomically, it may affect the perineal muscles exclusively or may felt as a constriction of the levator ani , right up to vaginal fornices .this a definite cramp like spasam of the adductor muscles .the vagainal hypersthesia stas at the vaginal introitus . the spastic contraction of the vaginal outlet is completely involuntary reflex, at vaginal penetration. In fully developed state, penetration by the penis is impossible.thus she becomes impontant. In case of Gonadal dysgenesis , Hermaphrodits and Absence of ovary ,it doesn't interfere with vaginal penetration and paicipation in coitus, those females are not impotent but may be infeile. | Forensic Medicine | Sexual offences and infanticide | Impotent female is having -
A. Gonadal dysgenesis
B. Hermaphrodits
C. Vaginismus
D. Absence of ovary
| Vaginismus |
417e4104-370f-4905-b3f8-ef4fc6fa06c6 | D. i.e. (C6 - vertebra ) (444 - Grey 14th)The bifurcation of the common carotid artery in to the internal and external carotid arteries can be palpated just beneath the anterior border of sterno cleidomastoid muscle at the level of the superior border of the thyroid cartilage. This is a convenient site to take the carotid pulse (748- Snell 8th) (C3 - C4 junction)The artery may be compressed against the prominent transverse process of the sixth cervical vertebra (chassaignac's tubercle) and above this level it is superficial and its pulsation can be easily fet (444 - Gray - anatomy 14th)* Best radiographic view for fracture of Cl C2 vertebra is odontoid view*** C7 has longest spinous process*** Subclavian Artery in patients with upper limb hemorrhage - compressed against the upper surface of the fist rib (third part of subclavian artery | Surgery | Neck | Rupture of the carotid artery in the neck region. Which of the following site pressure is applied
A. C3 vertebra
B. C4vertebr
C. C5 vertebra
D. C6 vertebra
| C6 vertebra |
56a13627-8079-42bd-8b35-83bf1db7ba86 | Ref: Nelson's Textbook of Pediatrics. 19th Edition.Explanation:The Holliday-Segar MethodIn the Holliday-Segar Method, fluid and electrolyte requirements are empirically based on the caloric needs of the average hospital patient.The same formula is used for calculating calorie requirement as well as fluid requirementRelation of Body Weight to Maintenance fluidsFor each kilogram in this rangeDaily fluid requirement per kilogramFirst 1-10 kg100 ml/kg/dayNext 11 -20 kg50 ml/kg/dayFor >20 kg20 ml/kg/dayFor 10kg child. Maintanence fluid for 24 hours = 10 x 100 = 1000 ml/dayFor 15 kg child, Maintanence fluid for 24 hours = 10 x 100 + 5x 50 = 1250 ml/dayFor 25 kg child, Maintanence fluid for 24 hours = 10 x 100 + lOx 50 + 5x 20 = 1600 mL/day | Pediatrics | Maintenance and Replacement Therapy | Daily maintanence fluid for a child weighing 10 kg is:
A. 1000 ml/day
B. 800 ml/day
C. 500 ml/day
D. 1200 ml/day
| 1000 ml/day |
5773c439-9541-4cd5-8e6c-53ab01c956f9 | Ans. is'b'i.e., Chromosomal anomaliesAntenatal soft ultrasound markers are fetal sonographic findings that are generally not abnormalities as such but are indicative of an increased age adjusted risk of an underlying fetal aneuploidic or some non chromosomal abnormalities. | Radiology | null | Soft markers on ultrasonography are helpful in diagnosing?
A. Fetal age
B. Chromosomal anomalies
C. Fetal size
D. Site of pregnancy
| Chromosomal anomalies |
7a8e50ea-20c0-428b-a647-c6e7a88a52e7 | ACHILLES TENDON RUPTURE: A ripping or popping sensation is felt, and often heard, at the back of the heel. This most commonly occurs in spos requiring an explosive push-off: squash, badminton, football, tennis, netball. The patient will often repo having looked round to see who had hit them over the back of the heel, the pain and collapse are so sudden.The typical site for rupture is at the vascular watershed about 4 cm above the tendon inseion onto the calcaneum. The condition is often associated with poor muscle strength and flexibility, failure to warm up and stretch before spo, previous injury or tendinitis and coicosteroid injection. REF:Apley&;s system of ohopaedics - 9th edn - pg no 615. | Orthopaedics | Miscellaneous | There is spontaneous rupture of the Achilles tendon in an 18 year old male. It is most likely to be due to excess stress beyond -
A. Tendon strength
B. Bone strength
C. Muscle strength
D. Musculotendinous junction strength
| Tendon strength |
816fe5df-b8b2-42d9-834a-e792aca7b59f | (Ref: KDT 6/e p840) Cyclosporine causes hyper and not hypoglycemia | Pharmacology | Other topics and Adverse effects | Which of the following is NOT an adverse effect of cyclosporine?
A. Hirsutism
B. Nephrotoxicity
C. Hypeension
D. Hypoglycemia
| Hypoglycemia |
26ec59a9-b350-4626-bbe9-6f0e67dd8652 | A. i.e. Stratified Squamous non Keratinizing | Anatomy | null | Epithelium of cornea is
A. Stratified squamous non Keratinizing
B. Stratified squamous Keratinizing
C. Collumnar Keratinized
D. Collumnar non Keratinized
| Stratified squamous non Keratinizing |
74d23164-78c6-4276-abb0-dd4af7b75e4b | After bih, the left umbilical vein are obliterated and forms the ligamentum teres hepatisLigamentum teresIt is the obliterated fibrous remnant of the left umbilical vein of the fetus.It originates at the umbilicus.It passes superiorly in the free margin of the falciform ligament.From the inferior margin of the liver, it may join the left branch of the poal vein or it may be in continuity with the ligamentum venosumOther fetal remnantsUmbilical aeries forms medial umbilical ligamentDuctus venosus forms ligamnetum venosusmDuctus aeriosus forms ligamnetum aeriosum | Anatomy | null | Ligamentum teres is:
A. Remnant of ductus aeriosus
B. Remnant of umbilical vein
C. Remnant if ductus venosus
D. Remnant of umbilical aery
| Remnant of umbilical vein |
8e15e1af-1fd1-4be8-aa64-af0cd7748572 | In boys, the first visible sign of pubey and hallmark of SMR2 is testicular enlargement, beginning as early as 9 1/2 years. This is followed by penile growth during SMR3. Peak growth occurs when testis volumes reach approximately 9-10 cm3 during SMR4. Under the influence of LH and testosterone, and prostate enlarges. The left testis normally is lower than the right. Some degree of breast hyperophy, typically bilateral, occurs in 40-65% of boys during SMR2-3 due to a relative excess of estrogenic stimulationIn girls, the first visible sign of pubey and the hallmark of SMR2 is the appearance of breast buds, between 8 and 12 years of age. Menses typically begins 2-2 1/2 years later, during SMR3-4 (median age, 12 years; normal range, 9-16 years), around the peak height velocity. Less obvious changes include enlargement of the ovaries, uterus, labia, and clitoris, and thickening of the endometrium and vaginal mucosa | Microbiology | All India exam | The Earliest sign of male pubey is
A. Pubic hair
B. Axillary hair
C. Hoarseness of voice
D. Testicular enlargement
| Testicular enlargement |
028f43bb-c2b1-464f-b68f-a7fb7fb23772 | Mechanism of action of Tetanospasmin is Inhibition of GABA release. C. tetani produces:- Tetanolysin:heat labile, oxygen labile hemolysin. It plays no role in the pathogenesis. Tetanospasmin or tetanus toxin (TT) : neurotoxin responsible for the pathogenesis of tetanus: - It is oxygen stable but heat labile; coded by plasmid. - Mechanism of action: Toxin acts pre-synaptically at the inhibitory neuron terminals and prevents release of inhibitory neurotransmitter GABA and glycine - leads to spastic muscle contraction. -Strychnine poisoning has a similar mechanism except that it acts post-synaptically. - BT (Botulinum Toxin) blocks the release of acetylcholine in neuromuscular junction, which leads to flaccid paralysis. Options 2, 3 4: Mechanism of Action of some impoant Bacterial Toxins: Heat Labile toxin of E.coli Increase cAMP Heat stable toxin of E.coli Increase cGMP Botulism toxin Inhibit release of acetylecholine from peripheral nerves Tetanus toxin Inhibit release of glycine and GABA at presynaptic terminals Diphtheria toxin Inhibit protein synthesis by inactivating EF 2 | Microbiology | Systemic Bacteriology (Gram Positive Bacilli, Gram Negative Bacilli) | Mechanism of action of Tetanospasmin:-
A. Inhibition of GABA release
B. Inhibition cAMP
C. Inactivation of Ach receptors
D. Inhibition of cGMP
| Inhibition of GABA release |
77e6d65a-1886-411c-a1af-801e8a9093ab | Fibrous Dysplasia (FD) Asymptomatic, self-limiting developmental regional alteration of bone in which the normal architecture is replaced by fibrous tissue and nonfunctional trabeculae-like osseous tissue. It is self-limiting (thus it is not a true neoplasm) * Represents a group of disorders with variety of clinical patterns * Mutation in GNAS 1 gene Clinical forms of fibrous dysplasia of the jaws * Monostotic: localized to a single bone Juvenile and aggressive juvenile Adult * Polystotic: involves several bones Craniofacial McCune-Albright syndrome Jaffe syndrome ref " maheswari 9th ed | Orthopaedics | Tumors | Characteristic radiological feature of fibrous dysplasia-
A. Thickened bone matrix
B. Coical erosion
C. Ground glass appearance
D. Bone enlargement
| Ground glass appearance |
e0b70935-18c6-49e7-8824-a6cad57ceb32 | Pubeal changes before the age of 8 years in girls and 9 years in boys are considered as Precocious pubey Most common cause of precocious pubey in girls - Idiopathic Others causes: Congenital lesions of the hypothalamus-pituitary Acquired lesions--trauma, infection, neoplasm-- tuberculosis (TB) meningitis in childhood Pa of a specific syndrome--McCuneAlbright (5%), von Recklinghausen's neurofibrobromatosis Endocrine/metabolic disorders | Gynaecology & Obstetrics | Pubeal Changes | A 9-year-old girl presents for evaluation of regular vaginal bleeding. History reveals the thelarche at the age of 7 years and adrenarche at the age of 8 years. The most common cause of this condition in girls is:
A. Idiopathic
B. Gonadal tumors
C. McCune-Albright syndrome
D. Hypothyroidism
| Idiopathic |
17e3f11a-a5ee-4eba-b79c-b2a4564376f5 | A frameshift mutation is caused by a deletion or inseion in a DNA sequence that shifts the way the sequence is read. | Pediatrics | Types of Genetic Disorders | Frameshift mutation occurs due to:
A. Transition
B. Transversion
C. Inseion
D. Point mutation
| Inseion |
9be458de-2090-4e4e-b278-609654a475f5 | Ans. is 'D' i.e., Epinephrine o The question is very simple. o Adrenocorticotropin hormone ( ACTH), as the name indicates, stimulate adrenal cortex. o Epinephrine is secreted by adrenal medulla other three hormones (given in question) are secreted by adrenl cortex, o ACTH has its main and most important effect on secretion of glucocorticoids (cortisol). o The effect on secretion of mineralocorticoids (aldosterone) and androgens (DHEA : dehydroepiandrosterone) in minimal (but some effect is there, which is not major regulatory mechanism). o It should be remembered that, though ACTH does not have a direct effect on epinephrine secretion, it increases epinephrine secretion indirectly as epinephrine secretion is dependent on cortisol. | Unknown | null | Not controlled directly by ACTH-
A. Glucocorticoids
B. Aldosterone
C. DHEA
D. Epinephrine
| Epinephrine |
ea9a7b25-59ee-4f1b-b398-9afb7e6d7373 | Ans. a (Altered sensorium) (Ref. Harrison's - 18th/pg. Ch. 45).Hyponatremia may be due to water excess, diabetes, lipidemia etc. Drugs known to release ADH will cause dilutional hyponatremia include morphine, tricyclics, nicotine, NSAIDs, etc. The individual present with confusion, anorexia, lethargy and cramps. When sodium drops abruptly, seizures, hemiparesis and coma can develop.CLINICAL FEATURES OF HYPONATREMIA# The clinical manifestations of hyponatremia are related to osmotic water shift leading to increased ICF volume, specifically brain cell swelling or cerebral edema.# The symptoms are primarily neurologic.# Patients may be asymptomatic or complain of nausea and malaise.# As the plasma Na+ concentration falls, the symptoms progress to include headache, lethargy, confusion, and obtundation.# Stupor, seizures, and coma do not usually occur unless the plasma Na+ concentration falls acutely below 120 mmol/L or decreases rapidly.# Loss of Na+ and K+, followed by organic osmolytes, from brain cells decreases brain swelling due to secondary transcellular water shifts (from ICF to ECF).# The net effect is to minimize cerebral edema and its symptoms.Composition of World Health Organization Oral Rehydration Solution (ORS) A,BConstituentConcentration, mmol/LNa+90K+20Cl-80Citrate10Glucose110Also know:*SLADH is characterized by hypotonic hyponatremia with euvolemia. Low plasma osmolality (<280 mOsm/Kg) with high urine osmolality (>100-150 mOsm/Kg) in suspected patients is diagnostic.* Pneumonia, hyponatremia and diarrhea are almost classic for Legionella.* Under most physiologic conditions, sodium, urea, and glucose generate the osmotic pressure of blood. Plasma osmolality is calculated according to the following expression: Posm = 2Na+ + Glu + BUN (all in mmol/L), or, using conventional laboratory values in which glucose and BUN are expressed in milligrams per deciliter: Posm = 2Na+ + Glu/18 + BUN/2.8. The calculated and determined osmolality should agree within 10-15 mmol/kg H20. When the measured osmolality exceeds the calculated osmolality by >15-20 mmol/kg H20, one of two circumstances prevails. Either the serum sodium is spuriously low, as with hyperlipidemia or hyperproteinemia (pseudohyponatremia), or osmolytes other than sodium salts, glucose, or urea have accumulated in plasma. | Medicine | Fluid & Electrolyte | Earliest clinical indicator of sodium loss is
A. Altered sensorium
B. Reduced skin turgor
C. Arrhythmia
D. Orthostatic hypertension
| Altered sensorium |
5e209771-0870-4a23-b611-4794943e09ee | Disulfiram is an aldehyde dehydrogenase inhibitor that can be used for de-addiction of chronic alcoholics. Due to inhibition of aldehyde dehydrogenase, there is accumulation of acetaldehyde that leads to several distressing symptoms (which strengthens the resolution of a person to quit alcohol). | Pharmacology | Opioids and Alcohols | The combination of alcohol and disulfiram results in nausea and hypotension as a result of accumulation of:
A. Acetaldehyde
B. Acetate
C. Methanol
D. NADH
| Acetaldehyde |
3d5df235-057d-4847-a5fc-53bf46beb4a3 | Sabiston writes-"Since its introduction in 1980, cisplatin has emerged as the cornerstone of combination therapy in esophageal cancer.
As a single agent, it has a response rate of 25% to 30%. Given in combination with 5-fluorouracil, a response rate of 50% may be achieved, and this is an established chemotherapeutic regimen for esophageal cancer." | Surgery | null | In oesophageal ca which Neoadjuvant chemotherapy is used -
A. Cisplatin
B. Cyclophosphamide
C. Doxorubicin
D. Methotrexate
| Cisplatin |
f05f06d5-0b70-4174-821b-d645b11ba239 | Most common sites of metastases in choriocarcinoma are:
Lung (80%) > Vagina (30%) > Pelvis (20%) > Liver (10%) and Brain (10%) | Gynaecology & Obstetrics | null | Choriocarcinoma commonly metastasize to:
a.Brain
b. Lung
c. Vagina
d. Ovary
e. Cervix
A. ab
B. bc
C. cd
D. de
| bc |
6bb751f8-dfa4-4e0c-93ec-0e69682ad4be | We know that Ringer's lactate is the preferred agent during initial 24 hrs. Nasogastric intubation is done to decrease the risk of emesis and possible aspiration (as parlytic ileus develops in a pt. with significant burn) Dextran is a colloid and can be used in 2nd 24 hrs., however albumin is the preferred and most widely used colloid. Blood has also role in burn patient. The need for Blood replacement is significant in extensive burns. Besides injury to red blood cells and their decreased half-life resulting in their early destruction, many patients may be anaemic. Hence, repeated and frequent transmission to maintain a hematocrit around 35% is necessary. Ref Bailey and love 27e p625 , Srb`s manual of surgery p133 | Anatomy | General anatomy | In burns least useful is
A. Normal saline
B. Blood
C. Dextran
D. Ringer lactate
| Blood |
29a8fcef-cac1-4c7a-82e0-9dcdc89c64cd | Ans. is 'a' i.e., Panacinar-emphysema Pathogenesis of Emphysemao The most accepted theory in the pathogenesis of emphysema is protease - antiprotease mechanism which is responsible in the pathogenesis of two common forms of emphysema, i.e. centriacinar and panacinar.o The alveolar wall destruction results from an imbalance between proteases (mainly elastase) and antiproteases in the lung.o Proteases (elastase) cause destruction of alveolar wall, while antiproteases prevent this damage,o a1 antitrypsin is the major antiprotease (antieiastase) secreted by neutrophils during inflammation.A. Pathogenesis of panacinar emphysemao Panacinar emphysema is associated with congenital deficiency of a1.-antitrypsin.o This results in unchecked overactivity of neutrophil elastase that causes destruction of alveolar wall,o As a,-antitrypsin is deficient throughout the acinus, the acini are uniformly involved from the respiratoiy bronchiole to the terminal blind alveoli.o Neutrophils are the major cells in the pathogenesis of panacinar emphysemaB. Pathogenesis of centriacinar emphysemao Centriacinar emphysema is associated with smoking.o Nicotine acts as a direct chemoattractant for neutrophils and macrophages,o So, in centriacinar emphysema, both neutrophils and macrophages play central role,o Smoking enhances activity of neutrophil and macrophage elastase.o Macrophage elastase is not inhibited by a1-antitrypsin and indeed can proteolvticallv digest this antiprotease,o Beside protease - antiprotease mechanism, oxidant - antioxidant imbalance also plays an important role in the pathogenesis of smoking related emphysema.o Normally, the lung contains a healthy complement of antioxidants (superoxide dismutase, glutathione),o Tobacco smoke contains abundant reactive oxygen species (free radicals) which deplete these antioxidant mechanisms.o Free radicals cause tissue damage as well as they inactivate a(-antitrypsin, resulting in functional a,- antitrypsin deficiency even in patients without enzyme deficiency. | Pathology | Obstructive Lung Diseases | Alpha 1 antitrypsin deficiency is associated with-
A. Panacinar-emphysema
B. Centriacinar-emphysema
C. Paraseptal-emphysema
D. Irregular-emphysema
| Panacinar-emphysema |
ef6b0423-eef2-448a-b53e-55703fe4f3aa | Stereognosis is the ability to identify an object by its touch, texture. The object is placed in hands and is identified without seeing it. Fine touch sensation from the upper limb is carried toward coex in fasciculus cuneatus. The tract also carries the finer aspects of touch. Perception of touch occurs in the somatosensory coex I (areas 3, 1, 2); analysis and interpretation of the touch is done in the somatosensory coex II (areas 5, 7). | Physiology | Sensory System | Stereognosis will be lost in the lesion of:
A. Fasciculus gracilis
B. Fasciculus cuneatus
C. Anterior spinothalamic tract
D. Lateral spinothalamic tract
| Fasciculus cuneatus |
cd71f884-ffdb-46f4-8db5-aa0e38de8533 | Brachioradialis Boundaries of cubital fossa- Laterally - Medial border of brachioradialis. Medially - Lateral border of pronator teres. Base - It is directed upwards, and is represented by an imaginary line joining the front of two epicondyles of the humerus. Apex - It is directed downwards, and is formed by the area where brachioradialis crosses the pronator teres muscle. Ref: Gray&;s anatomy text book of anatomy BD chaurasia 21st Ed. | Anatomy | All India exam | Lateral boundary of cubital fossa is formed by:
A. Brachioradialis
B. Pronator teres
C. Brachialis
D. Biceps
| Brachioradialis |
fefe8db3-8264-40cd-8dc9-7b0582bd9f97 | Ans. is 'b' i.e., Nitrous oxide Second gas effecto If another inhalation agent is (eg Halothane) is being given at the same time with N2O2 it also will be delivered to lung from the cylinder (due to negative intraalveolar pressure).Also Remembero Concentration effect and secondary gas effect - during inductiono Diffusion hypoxia - during recovering.o All these occur with N2O only (Xenon also causes these effects). | Anaesthesia | Miscellaneous General Anesthesia | Second gas effect is seen with -
A. Ether
B. Nitrous oxide
C. Desflurane
D. Sevoflurane
| Nitrous oxide |
7620f0a6-a7e6-4573-b525-e0849f7a25d2 | (Refer: Ganong’s Review of Medical Physiology, 24th edition, pg no: 43-44)
Intercellular junctions
Connects the cell membranes of the neighboring cells also known as junctional complexes | Unknown | null | Example of electrical synapse:
A. Tight junction
B. Gap junctions
C. Anchoring junction
D. Neuromuscular junction
| Gap junctions |
31117f1b-6870-4655-bd34-9f166f70b54f | Diarrhea, dementia, and dermatitis are the classic triad for pellagra (niacin deficiency). The diagnosis is based on clinical suspicion and response to therapy, and can be confirmed by demonstrating low levels of the urinary metabolites 2-methylnicotinamide and 2-pyridone. Small doses of niacin (10 mg/day) with adequate dietary tryptophan will cure pellagra secondary to nutritional deficiency. | Medicine | Endocrinology | A 52-year-old alcoholic notices a skin rash on his chest, and also has symptoms of diarrhea and abdominal pain. On examination, he has a scaly and pigmented rash on the sun-exposed areas of his skin, the abdomen is soft, and his short-term memory is impaired. He has dermatitis, diarrhea, and dementia syndrome.For the patient with vitamin deficiency or excess, select the most likely diagnosis
A. niacin
B. thiamine
C. pyridoxine
D. vitamin C
| niacin |
d93522e3-8ae1-451e-a688-daec2e5dfe08 | There are many types of glycogen storage diseases, each caused by a different enzymatic abnormality. The best-known types of glycogen storage disease are those that have hepatic hypoglycemic pathophysiology (eg, von Gierke disease) or those that have muscle energy pathophysiology (McArdle disease). InMcArdle' symptoms usually develop in adulthood, and it is marked by cramps and muscle injury with strenuous exercise, but not with usual activities. Gaucher and Tay-Sachs disease are lysosomal storage diseases. | Medicine | Endocrinology | A 19-year-old man presents to the clinic complaining of early fatigue and muscle cramps while playing sports. He is fine when walking or doing less intense levels of work. On physical examination, he appears well and the vital signs are normal. Muscle bulk, tone and strength in the proximal muscles are normal. There is no muscle fatigue with repetitive arm grip exercises. After an exercise stress test, his serum creatine kinase (CK) is elevated and lactate level is normal. Which of the following is the most likely diagnosis?
A. Gaucher disease
B. Tay-Sachs disease
C. McArdle disease (glycogen storage disease)
D. hemochromatosis
| McArdle disease (glycogen storage disease) |
a3716633-52bb-4b96-a5ce-68f5406639eb | The only swelling among the 4 options which will show translucency is Lymph cyst. | Surgery | All India exam | A 36-year-old lady presents with a 20 yrs duration fluctuant and translucent swelling on right side of her neck. No other history available. No other findings on examination of neck. What is the most probable diagnosis?
A. Lymph cyst
B. Lymph node
C. Colloid nodule
D. Cold abscess
| Lymph cyst |
52beca06-66a5-495d-a2bf-5f9d73b57e06 | After a fixed number of divisions, normal cells becomes arrested in a terminally nondividing state.
How does the normal cells count their divisions i.e. How, do the cells find out that now they do'nt need to divide further.
Cells achieve this through telomer shortening
Telomers are short repeated sequences of DNA present at the linear ends of chromosome that are important for ensuring complete replication of chromosome ends.
It consists of many arrays of TTAGGG repeats at tellninal of 3' ending strand. It confers stability to chromosomes. With each successive division there is some shortening of the telomers.
Once the telomers are shortened beyond a certain point the ends of the chromosome are seen as broken i1 NA, which signals cell cycle arrest.
The broken NA leads to activation of p53 dependent cell cycle check points causing proliferative arrest or apoptosis.
Thus telomere shortening functions as a clock that counts cell division.
How do the germ cells keep on dividing throughout their life???
In germ cells telomere shortening is prevented by the sustained function of the enzyme telomerase.
Telomerase is a reverse transcriptase and is responsible for telomer synthesis and maintaining the length of telomer.
It is RNA dependent DNA polymerase. It has one segment that is complimentary to TTAGGG repeat and is used as template for the replication of telomeric sequence.
This enzyme is absent from most somatic cells and hence they suffer progressive loss of telomers and they exit the cell cycle. Telomerase is present in Germ cells thus explaining the ability of these cells to self replicate extensively. If loss of telomere is the basis of finite life span then how do cancer cells continue to divide actively????
In cancer cells telomerase activity is reactivated. Telomerase activity has been detected in more than 90% of human tumours.
Thus telomerase activity and maintenance of telomere length are essential for the replicative potential in cancer cells. | Pathology | null | Tumorogenesis in aging is due to -
A. Telomerase reactivation
B. Telomerase inactivation
C. Increased apoptosis
D. Suppression of proto-oncogenes
| Telomerase reactivation |
89eba139-5884-4de5-a7a2-866a0ce50614 | Adenomyosis is a benign condition characterised by the presence of benign endometrial glands and stroma within the myometrium, Common cause of diffuse uterine enlargement and menstrual irregularities. Vaginal adenosis is a DES-related precursor lesion for clear cell adenocarcinoma. Extrammary paget's disease is an intraepithelial adenocarcinoma. Endometrial hyperplasia is a precursor lesion of endometrial carcinoma. | Gynaecology & Obstetrics | Endometriosis & H | The lesion listed below that would most likely pursue a benign course is :-
A. Vaginal adenosis
B. Adenomyosis
C. Extramammary Paget's disease
D. Endometrial hyperplasia
| Adenomyosis |
76205fac-06be-44e5-ac70-a42c5942d456 | Canakinumab and Anakinra are IL-1 inhibitors used in the treatment of gout. | Pharmacology | null | Canakinumab is a monoclonal antibody against:
A. IL-1
B. IL-2
C. IL-5
D. IL-6
| IL-1 |
d5050f74-0d57-41a2-8b48-42b4337dc4ac | Melaena refers to the passage of typical black, tarry coloured foul smelling stool. It signifies upper GI bleed. At least 50-60 ml bleeding should be there to cause melaena. Reference : page 834 SRB's manual of surgery 5th edition | Surgery | Urology | Minimum amount of GI bleed to cause malena is
A. 10 ml
B. 40 ml
C. 60 ml
D. 115 ml
| 60 ml |
7db23073-08bb-4054-82aa-760e55108a90 | Ans. is 'b' i.e., T1- T5 * Parasympathetic supply to heart - Vagus.* ympathetic supply to heart - T1- T5Innervation of Heart* Innervations of heart are :-A) Sympathetic innervation of heart:# All parts of the heart (SA node, atria, AV node and ventricles) recieve sympathetic innervations.# The sympathetic innervation on right side is distributed primarily to the SA node, while on the left side is distributed primarily to the AV node.# Sympathetic fibers are mostly distributed to the epicarium.# Sympathetic discharge has following effects :i) Positive ionotropic (Increase in force of contraction).ii) Positive chromotropic (Increased heart rate).iii) Positive dromotropic (Increased conduction).iv) Positive bathmotropic (increased automaticity).v) Decreased refractory period of all types of cardiac cells. -# The main neurotransmitter is nor-adrenaline.B) Parasympathetic innervation of heart:# Parasympathetic fibers to the heart reach through the vagus nerve.# The right vagus is distributed mainly to SA node while the left vagus mainly innervates the AV node. Vagal fibers are mostly endocardial in distribution.# Vagal stimulation has following effects :i) Negative chronotropic (decreased heart rate).ii) Negative dromotropic (decreased conduction).iii) Increased refractory period of all types of cardiac cells.# But vagal stimulation does not have a negative inotropic effect because vagal (parasympathetic) fibers do not innervate the myocardial cells of the ventricles in sufficient numbers; there is slight decrease in force contraction of atria only.# Major neurotransmitter is acetylcholine. | Physiology | Heart, Circulation, and Blood | Sympathetic innervation of heart is by -
A. T1-T3
B. T1 - T5
C. c) T3-T7
D. L1 - L5
| T1 - T5 |
a23d6bed-8155-46ef-916b-10886fc17537 | A non-coding RNA (ncRNA) is a functional RNA molecule that is transcribed from DNA but not translated into proteins. Epigenetic related ncRNAs include miRNA, siRNA, piRNA, and lncRNA. In general, ncRNAs function to regulate gene expression at the transcriptional and post-transcriptional level. | Biochemistry | Metabolism of nucleic acids | Non-coding RNAs are
A. siRNA
B. miRNA
C. tRNA
D. mRNA
| siRNA |
d6b7eda2-1233-413c-a589-6dd7473ae5c3 | Ans. a (Graze abrasion) (Ref. Reddy FMT 23rd ed. 145)ABRASIONS (GRAZES, SCRATCHES, BRUSH BURNS)# Loss/crushing of outer skin layer due to impact with a rough surface- Tangential impact produces a moving abrasion:* Indicates direction.* Trace material (e.g., grit).- Direct impact produces an imprint abrasion:* Pattern of causative object.# All abrasions reflect site of impact (contact bruises).# Assessment of age difficult.# Postmortem abrasion - Brown, leathery. | Forensic Medicine | Injuries by Blunt Force | 'Brush burns' are synonymous with
A. Graze abrasion
B. Scalds
C. Electrical injury
D. Injury by a brush
| Graze abrasion |
c7adea89-80f3-4715-950a-4b0b133f8e84 | Physical examination reveals petechiae (pinpoint, nonraised, purplish red spots caused by intradermal hemorrhage) on the chest and stomach. Catalase-positive and coagulase negative The patient is probably suffering from bacterial endocarditis caused by S. epidermidis infection of the prosthetic hea valve. S. epidermidis Coagulase-negative organism Unable to ferment mannitol Sensitive to novobiocin Resistant to penicillin. Patients with congenital hea malformations, acquired valvular defects (for example, rheumatic hea disease), prosthetic valves, and previous bacterial endocarditis show an increased incidence of bacterial endocarditis. Intravenous drug users also have a high risk for infection. S. viridans can be ruled out, because streptococci are catalase negative, which is a feature that distinguishes them from catalase-positive staphylococci. S. aureus is coagulase positive so it is ruled out. S. saprophyticus is coagulase negative but resistant to novobiocin, hence also ruled out here | Unknown | Integrated QBank | A 57-year-old man arrives at the emergency room complaining of weakness, fatigue, and intermittent fever that has recurred for several weeks. The patient had a cardiac valvular prosthesis implanted 5 years ago. Blood cultures grew ceain gram-positive cocci on which catalase and coagulase test were done. The gram-positive organisms failed to ferment mannitol, and their growth was inhibited by novobiocin. CATALASE TEST SLIDE COAGULASE TEST Lesions seen on skin What is the most likely infectious agent?
A. Staphylococcus aureus
B. Staphylococcus epidermidis
C. Staphylococcus saprophyticus
D. Streptococcus viridans
| Staphylococcus epidermidis |
2f9d014b-5875-4c85-ada4-dca4a72536bc | Cobblestone appearance is severe papillary hyperplasia in upper palpebral conjunctiva Refer: Khurana 6th edition page number 73 | Ophthalmology | Conjunctiva | Cobblestone appearance is seen in
A. Spring Catarrh
B. Viral conjunctivitis
C. Bacterial conjunctivitis
D. Phlyctenular conjunctivitis
| Spring Catarrh |
a9f58246-3b51-4e63-b200-9835291680fb | Motor proteins: Molecular motors include the proteins: myosin kinesin dynein They move along a track- microtubules or microfilaments - and pull larger structures such as vesicles, fibers, or paicles. Such movement can be used for intracellular transpo or movement of the cell's entire framework. | Physiology | Cell Membrane and transpo protiens | Not a molecular motor:
A. Kinesin
B. Dynein
C. Actin
D. Myosin
| Actin |
d526af5d-44c1-459a-912b-52f2b4fe4133 | Ans. is 'a' i.e., Fever(ref Dhingra 6h/e p. 258]Fever is a symptom in case of acute tonsillitis, not chronic tonsillitis.Chronic tonsillitis is characterized by:- Recurrent attacks of sore throat or acute tonsillitis. | ENT | null | Which of the following is not a feature of chronic tonsillitis?
A. Fever
B. Halitosis
C. Recurrent attacks of sore throat
D. Choking spells at night
| Fever |
b0547567-2eb8-46d4-94d8-9ffc26815626 | Pain during injection is an important and common feature of Rocuronium Injection. | Anaesthesia | null | Which of the following muscle relaxants causes maximal pain on injection –
A. Succinyl choline
B. Vecuronium
C. Rocuronium
D. Cistracurium
| Rocuronium |
5a787da9-6f9a-429c-bbc0-cb0833505608 | Answer- A. Intercostal vesselsThe most common cause of massive haemothorax in blunt injury to chest is continuing bleeding from torn intercostal vexels or occasionallyfrom the internal mammary aety. | Surgery | null | Most common cause of bleeding for massive hemothorax in blunt trauma to chest is from
A. Intercostal vessels
B. Bronchial vessels
C. Pulmonary vessels
D. Internal mammary aery
| Intercostal vessels |
e2925cfa-68ad-4684-a46b-f978223f9ba2 | Four types of hiatus hernia are present. Type I, or sliding hiatal hernia comprising at least 95% of total. Pathology is the weakening of the phrenoesophageal ligament attaching the gastroesophageal junction to the diaphragm at the hiatus. Incidence of sliding hernias increases with Age and conceptually, results from wear and tear Intraabdominal pressure Hereditary factors The main significance of sliding hernias is the propensity of affected individuals to have GERD. Ref: Harrison, E-18, P- 2429 | Medicine | null | The main clinical significance of sliding type hiatus hernia is:
A. Propensity for GERD
B. High risk of barrett's esophagus
C. High chance for dieulafoy's lesion
D. Dysphagia is common
| Propensity for GERD |
ccb6a62f-b594-4b96-bf14-c5ebe0e8fe9e | The posterior surface of prostate is separated from the rectum by the fascia of Denonvilliers which is the obliterated rectovesical pouch of the peritoneum. | Anatomy | null | The fascia of Denonvilliers -
A. Membranous layer of fascia of the thigh
B. Perirenal fascia
C. Fascia between the rectal ampulla and the prostate and the seminal vesicles
D. Posterior layer of perirenal fascia
| Fascia between the rectal ampulla and the prostate and the seminal vesicles |
01c89b56-ee99-4991-8fa3-5b4ec90acde9 | Ans.D.30ExplanationMMSE or Folstein test is a simplified form of routine cognitive status examination. It is routinely used to track improvement and deterioration. It includes following points:Orientation to time-5Orientation to place-5Registration-3Attention and calculation-5Recall-3Language-2Repetition-1Complex commands-6Total score-30, score less than 24 indicates cognitive impairment. | Psychiatry | Organic Mental Disorder | How many items are there in Mini mental state examination (MMSE)?
A. 10
B. 15
C. 20
D. 30
| 30 |
99eb3e35-77af-4842-9dcc-9ae2848b0c35 | (C) (Calcium) (4.8 Ganong 24th edition, 18 A.K. Jain 5th)Exocytosis is the Ca^ dependant process.Exocytosis: here-substances secreted by the cell are trapped within vesicles or granules which fuse with the cell membrane and release their contents to the ECF. This leaves the contents of the vesicles or granules outside the cell and cell membrane intact.It requires Ca++ and energy. Hormones, digestive enzymes and synaptic transmitters are examples of substances transported out of the cell by this process.Endocytosis: includes phagocytosis, pinocytosis, clathrin mediated endocytosis, caveolate-dependant uptakeand nonclathrin/noncaveolae endocytosis. | Physiology | General | Ion required for exocytosis is -
A. Potassium
B. Sodium
C. Calcium
D. Magnesium
| Calcium |
839b70fc-6778-4230-ac13-606644372991 | (b) Clouding of air cells of mastoid(Ref. Cummings, 6th ed., 2161)X-ray mastoid and CT scan shows clouding of air cells because of the collection of exudates in them. Later on mastoid pneumatisation is lost and a single mastoid cavity may be seen. | ENT | Disorders of Middle Ear (Otitis Media) | Essential radiological feature of acute mastoiditis is:
A. Temporal bone pneumatization
B. Clouding of air cells of mastoid
C. Rarefaction of petrous bone
D. Thickening of temporal bone
| Clouding of air cells of mastoid |
d5c564e6-36c1-42b4-834b-04cdfd549f85 | The gestational sac --an anechoic fluid collection that represents the exocoelomic cavity--may be seen by 4.5 weeks.A caveat is that a gestational sac may appear similar to other intrauterine fluid accumulations--the so-called pseudogestational sac. This pseudosac may be seen with ectopic pregnancy and is easier to exclude once a yolk sac is seen. Typically, the yolk sac is visible by 5.5 weeks and with a mean gestational-sac diameter of 10 mm. Thus, the diagnosis of a uterine pregnancy should be made cautiously if the yolk sac is not yet seen.Ref: William&;s Obstetrics; 24th edition; chapter 19 | Gynaecology & Obstetrics | General obstetrics | Pseudogestational sac is seen in
A. Missed aboion
B. Threatened aboion
C. Inevitable aboion
D. Ectopic pregnancy
| Ectopic pregnancy |
94d3ba3e-a852-45a0-a71f-f07be92a41b2 | a. 60:40(Ref: Nelson's 20/e p 286-290, Ghai 8/e p 150-161)Human milk contains two types of proteins 60% is: whey and 40% is casein; helps in quick & easy digestion. | Pediatrics | Nutrition | The average whey/casein ratio in breast milk is:
A. 60:40:00
B. 80:20:00
C. 0.888888889
D. 40:60
| 60:40:00 |
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