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c502b189-722a-411f-8beb-0f0a4faa9896 | Ans. a (Blow out fracture of the floor of the orbit) (Ref. Grainger Diagnostic Rad 4th/2527; Ref . Q. 159. Of MH-2207)BLOW-OUT FRACTURE is caused by fracturing of the orbital walls with herniation of orbital contents and subsequent tethering of the globe, resulting in pain and diplopia. It usually involves the orbital floor with 'trap-door deformity' on skull AP view or characteristic "Tear drop" sign on X-ray PNS.Also Know:# Tripod Fracture: zygomaticomaxillary fracture# "pyramidal" fracture = Le Fort II fracture (fracture medial orbital and lateral maxillary walls).# Bare orbit sign: Neurofibromatosis# Coke-bottle sign: thyroid ophthalmopathy# "Mushroom-shaped" posterior segment mass: choroidal melanoma# Calcification is pathognomonic of: Retinoblastoma# Most common intraorbital tumor in adults: Cavernous hemangioma. | ENT | Nose and PNS | "Tear drop" sign on X-ray PNS is seen in
A. Blow out fracture of the floor of the orbit
B. Comminuted fracture of the maxilla
C. Fracture of the nasal bone
D. Fracture of the mandible
| Blow out fracture of the floor of the orbit |
204d5328-da8f-4ae6-8e91-7b4cafa01289 | Ans. (a) Couinaud'sRef: Bailey and Love 26th edition page 1066* Couinaud divided the liver into multiple segments- 8 segments* He is a French Anatomist | Surgery | Liver | Which classification is used to divide the liver into segments?
A. Couinaud
B. Muhe
C. Starzl
D. Anatomical
| Couinaud |
8980a262-df85-4c2a-a508-c8975cb3dcdf | When a cirrhotic patient presents with upper GI bleed, the single most impoant diagnostic as well as therapeutic procedure to be performed is endoscopy (although after intravenous fluid resuscitation and correction of coagulation abnormalities) If varices are found they are treated by either Endoscopic variceal ligation or Endoscopic Sclerotherapy Endoscopic variceal ligation is now the t/t of choice (has replaced sclerotherapy) Ref : Schwaz 9/e p1113 | Anatomy | G.I.T | In a patient with compensated liver cirrhosis presented with history of variceal bleed. The treatment of choice in this patient is -
A. Propranolol
B. Liver transplantation
C. TIPS (Transjugular intrahepatic poal shunt)
D. Endoscopic sclerotherapy
| Endoscopic sclerotherapy |
c630a539-d29a-4e01-9a3f-19af15384684 | In case of anterolateral thoracotomy, which is usually a transverse or a veical incision staing from fouh intercostal space, incision is made lateral to sternal in order to avoid injury to the adjacent vessels which include internal mammary aery. Superficial epigastric aery is the terminal branch of internal mammary aery and hence not at a risk in emergency thoracotomy. Intercostal vessels lie parallel to rib margin and hence not injured near sternal margin. Ref: General Thoracic Surgery, Volume 1 edited by Thomas W. Shields, Joseph LoCicero, Carolyn E. Reed, Richard H. Feins, Volume 1, Page 394 | Surgery | null | During an emergency thoracotomy, the incision is made > 1cm lateral to the sternal margin. This will preserve which of the following structures?
A. Intercostal aery
B. Superficial epigastric aery
C. Internal mammary aery
D. Intercostal vein
| Internal mammary aery |
c21b2211-2b4f-4cc3-a3c6-31817a867e4f | Ans. is 'a' i.e., Group A Streptococci Rheumatic fevero Rheumatic fever (RF) is an acute, inununologically mediated, multisystem inflammatory disease classically occurring a few weeks after an episode of group A streptococcal pharyngitis; occasionally, RF can follow streptococcal infections at other sites, such as the skin. | Pathology | Rheumatic Fever | Causative organism of rheumatic fever -
A. Group A Streptococci
B. Staphylococci
C. Group B Streptococci
D. Group D Streptococci
| Group A Streptococci |
bda4eeca-8d5a-418c-90ba-9a3c90fc01ba | (A) Amygdala # Kliiver-Bucy syndrome is a behavioral disorder that occurs when both the right and left medial temporal lobes of the brain malfunction. People with lesions in their temporal lobes show similar behaviors.> They may display oral or tactile exploratory behavior (socially inappropriate licking or touching); hypersexuality; bulimia; memory disorders; flattened emotions (placidity)-, and an inability to recognize objects or inability to recognize faces.> The full syndrome rarely, if ever, develops in humans. However, parts of it are often noted in patients with extensive bilateral temporal damage caused by herpes or other encephalitis and dementias of degenerative or post-traumatic etiologies.> This disorder may be caused by many conditions, including facial or cerebral trauma; infections; Alzheimer's disease; Niemann Pick disease of the brain; or cerebrovascular disease. | Medicine | Miscellaneous | Kliiver-Bucy syndrome is associated with lesion in the following area of brain
A. Amygdala
B. Cerebral cortex
C. Hippocampus
D. Mammillary body
| Amygdala |
c3653ee1-d4b3-4bd3-962b-fe81aeab98b9 | B i.e. Fixed dilated pupil not responding to light Cooling of body & rigor mois is a sign of molecular or cellular death. - Somatic (systemic, clinical or brain) death is cessation of spontaneous breathing, circulation and brain activity (as indicated by flat isoelectric EEG, deep unconsciousness with no response to external stimuli or internal need). Surest sign of brain stem death is fixed dilated pupil not constricting (responding) to light.Q | Forensic Medicine | null | Surest sign of brain stem death
A. Absent Doll's eye reflex
B. Fixed dilated pupil not reacting to light
C. Cheyne Stokes breathing
D. Decerebrate posture
| Fixed dilated pupil not reacting to light |
af90d178-d794-4bfa-b083-fb3fd86e900b | Astereognosis/Stereoanaesthesia- Loss of ability to recognize size and shape of an object.
Seen in- lesion of somatosensory cortex, lesion of tractus cuneatus, lesion of tractus gracilis.
Somatosensory cortex lesion- proprioception and tactile sensations are lost while pain and temperature sensations are preserved.
Tractus cuneatus- formed by fasciculus cuneatus (spinal cord) and nucleus cuneatus (medulla). Pass through lateral portion of dorsal column. Carries sensations of dorsal column- proprioception and tactile sensations from upper part of the body.
Tractus gracilis- formed by fasciculus gracilis (spinal cord) and nucleus gracilis (medulla). Pass through medial portion of dorsal column. Carries sensations of dorsal column- proprioception and tactile sensations from lower part of the body. | Physiology | null | Stereoanesthesia is due to lesion ofa) Nucleus Gracilisb) Nucleus cuneatusc) Cerebral cortexd) Spinothalamic tract
A. abc
B. bc
C. acd
D. bcd
| abc |
37995a81-8832-4afc-bd52-48359786c5e7 | Ans. is 'c' i.e., Susceptible to diphtheria Shick test . Shick test is no longer in use. It was used for the susceptibility of for diphtheria. . It was an intradermal test, in which after intradermal injections of diphtheria toxin in one forearm (usually left) and toxoid in other forearm two readings were taken one at 24-48 hrs and second at 5-7 days. . Interpretation of the test : - Reaction in control arm indicates hypersensitivity - Reaction in test arm : at 24 - 48 hrs --> Hypersensitivity at 5 - 7 days --> Susceptibility Type of reaction Observation inference Negative reaction No reaction on either arm, (toxin neutralized by circulating antitoxin) No susceptibility No hypersensitivity Positive reaction No reaction on control arm, Circumscribed erythematous reaction caused by toxin on the test arm that persists. No hypersensitivity Susceptibility present Pseudoreaction Diffuse erythematous reaction on both areas, appearing with in 24 hrs and fading by 4 days. Combined reaction Both areas initially show Hypersensitivity present pseudoreaction followed by positive reaction on test arm Susceptibility present | Microbiology | null | Positive shick's test indicates that person is ?
A. Immune to diptheria
B. Hypersensitive to diptheria
C. Susceptible to diptheria
D. Carrier of diptheria
| Susceptible to diptheria |
5b7e48f0-5c0e-41aa-8dc3-325244f33bae | Ans. C. Active TransportFree amino acids are absorbed across the intestinal mucosa by sodium-dependent active transport. There are several different amino acid transporters, with specificity for the nature of the amino acid side-chain.Transporters of Amino AcidsFor Neutral Amino acidsFor Basic Amino acids and Cysteine.For Imino Acids and GlycineFor Acidic Amino acidsFor Beta Amino Acids (Beta-Alanine)Meister's CycleFor absorption of Neutral Amino acids from Intestines, Kidney tubules and brain.The main role is played by Glutathione (GSH).For transport of 1 amino acid and regeneration of GSH 3 ATPs are required.Disorders associated with Meister's Cycle Oxoprolinuria5 Oxoprolinase deficiency leads to OxoprolinuriaDisorders associated with absorption of amino acidsHartnup's DiseaseMalabsorption of neutral amino acids, including the essential amino acid tryptophan SLC6A19, which is the major luminal sodium-dependent neutral amino acid transporter of small intestine and renal tubules, has been identified as the defective proteinBlue Diaper Syndrome or Drummond Syndrome IndicanuriaTryptophan is specifically malabsorbed and the defect is expressed only in the intestine and not in the kidney. Intestinal bacteria convert the unabsorbed tryptophan to indican, which is responsible for the bluish discoloration of the urine after its hydrolysis and oxidationCystinuriaDibasic amino acids, including cystine, ornithine, lysine, and arginine are taken up by the Na-independent SLC3A1/ SLC7A9, in the apical membrane which is defective incystinuri(a).Most common disorder associated with Amino acid malabsorptionLysinuric Protein Intolerance(SLC7A7) carrier at the basolateral membrane of the intestinal and renal epithelium is affected, with failure to deliver cytosolic dibasic cationic amino acids into the paracellular space in exchange for Na+ and neutral amino acidsOasthouse Urine Disease (Smith Strang Disease)A methionine-preferring transporter in the small intestine was suggested to be affected. Cabbage-like odor, containing 2-hydroxybutyric acid, valine, and leucineIminoglycinuriaMalabsorption of proline, hydroxyproline, and glycine due to the proton amino acid transporter SLC36A2 defectDicarboxylic AciduriaExcitatory amino acid carrier SLC1A1 is affected.Associated with neurologic symptoms such as POLIP (polyneuropathy, ophthalmoplegia, leukoencephalopathy, intestinal pseudo-obstruction | Biochemistry | Proteins and Amino Acids | Amino acid absorption is by:
A. Facilitated transport
B. Passive transport
C. Active transport
D. Pinocytosis
| Active transport |
be937085-bdc9-4487-aea6-4b5b2aa4cd96 | Ans. is 'd' i.e., First case defected by investigator [Ref: Park 22nd/e d. 92 & 21st/e p. 9/1o Primary caseo Index case--First case of communicable disease introduced into the population.First case to come to attention of the investigator.o It is not always necessary that primary case will be index case : -When the first case noticed by the investigator is also the first case of the population - Primary case and index case are the same.When the first case nociced by the investigator is not the first case of the population (primary case) - Index case and primary case are different.o Secondary cases - Cases those developing from contact with primary case. | Social & Preventive Medicine | Infectious Disease Epidemiology | Index case is the -
A. First case in a community
B. Case getting infection from primary case
C. Case getting infection from secondary case
D. First case detected by investigator
| First case detected by investigator |
653e1924-a0e6-4c37-8671-d25d8832c02e | Clean contaminated surgery :
Wound is exposed to not only skin but also GI tract / Respiratory tract / Urinary tract organism in controlled enviroment.
Hence Gastrojejunostomy surjery belongs to this category. | Surgery | null | Gastrojejernostomy surgery belongs to
A. Clean surgery
B. Contaminated surgery
C. Clean contaminated surgery
D. Dirty surgery
| Clean contaminated surgery |
00d1d295-5998-4780-b5c8-3541ce055bd0 | Gaisbock syndrome is characterised by secondary polycythemia. It occurs mainly in male sedentary individuals, on a high-calorie diet. Prevalence is unknown. The clinical picture includes mild obesity, hypeension and decrease in plasma volume with relative increase in hematocrit, blood viscosity, serum cholesterol, triglycerides and uric acid. The reduction in plasma volume seems related to the elevation of the diastolic blood pressure. Prognosis is impaired by the development of cardiovascular complications. | Medicine | Haematology | Gaisbock syndrome is better known as?
A. Primary familial polycythemia
B. High-altitude erythrocytosis
C. Spurious polycythemia
D. Polycythemia vera
| Spurious polycythemia |
7acb1377-ee33-4ba0-96af-d6389e13e975 | T3| T4| - Positive Na- K+ ATPase activity in the cells (3 Na outside 2 K+ inside) | K Influx | K| | Thyrotoxic Periodic Paralysis | Medicine | Diseases of Thyroid | Thyrotoxic periodic paralysis leads to extreme muscle weakness due to?
A. Hypokalemia
B. Hypocalcemia
C. Hypomagnesemia
D. Hyponatremia
| Hypokalemia |
44fd2133-14eb-4365-845e-3b7739786c2f | THFA is the carrier of One Carbon groups The folic acid is first reduced to 7,8-dihydrofolic acid and fuher reduced to 5,6,7,8-tetrahydrofolic acid (THFA) . Both reactions are catalyzed by NADPH dependent folate reductase. The THFA is the carrier of one-carbon groups. One carbon compound is an organic molecule that contains only a single carbon atom. The following groups are one carbon compounds: Formyl (-CHO) Formimino (-CH=NH) Methenyl (-CH=) Methylene (-CH2-) Hydroxymethyl (-CH2OH) Methyl (-CH3). One carbon groups bind to THF through N5 are Formyl, Formimino or methyl N10 are Formyl Both N5 and N10 are Methylene and Metheny Ref: DM Vasudevan - Textbook of Biochemistry, 8th edition, page no: 475 | Biochemistry | vitamins | vitamin involved in 1 carbon metabolism
A. Folic acid
B. Thiamine
C. biotin
D. niacin
| Folic acid |
697b6579-7c0e-4b03-a149-96b25aa0d146 | Yolk sac tumor of the testis: Raised a-fetoprotein level (AFP). Schiller-Duval bodies. Schiller-Duval body: It is the characteristic feature of the endodermal sinus tumor. This is a glomerulus-like structure composed of a central blood vessel enveloped by germ cells within a space lined by germ cells. Endodermal sinus tumor: 1. Schiller-Duval body 2. PAS-positive hyaline droplets Ref: RAM DAS NAYAK EXAM PREPARATORY MANUAL FOR UNDERGRADUATES 2nd ed. pg no: 684 | Pathology | Urinary tract | Schiller-Duval bodies are seen in-
A. Teratoma
B. Seminoma
C. Yolk sac tumour
D. Chorio Carcinoma
| Yolk sac tumour |
01dab660-369d-42be-9871-53164591f758 | Ans. A. Depersonalization disorderDepersonalization:Depersonalization is a sense of unreality or strangeness concerning the self, manifested by feeling detached from and being an outside observer of one's mental processes or body.A patient who experiences depersonalization may describe feeling like things "I have stepped outside of myself and am watching myself doing things".Derealization:Derealization refers to feeling detached from one's environment so that the sense of the reality of the external world is lost.E.g, I feel as if everything is unreal and those around me are actors in a play or two dimensional cardboard figures. | Psychiatry | null | Which one of the following disorders is related to sense of unreality?
A. Depersonalization disorder
B. Derealization disorder
C. Delusion
D. Phobias
| Depersonalization disorder |
0a5e5d05-5d36-4eca-a464-cec53a160ea0 | Ans. is 'b' i.e., Freud * The credit for invention of psychoanalysis belong to Sigmund FreudImportant contributors in psychiatryTermCoined by* Demence precoce* Moral Emil* Dementia precox* Kraepelin* Catatonia, cyclotymia* Kahlbaum* Hebephrenia* Hecker* Schizophrenia* Eugen Bleuler* Ambivalence* Eugen Bleuler* Free association* Sigmund Freud* Psychoanalysis, Psychodynamics* Sigmunnd Freud* Id, ego, Superego* Sigmund Freud* Psychiatry* Johann christion Reil | Psychiatry | Psychoanalysis | Term psychoanalysis was coined by?
A. Eysenck
B. Freud
C. Jung
D. Adler
| Freud |
19de9e2f-472f-40ab-8530-767da4bb3910 | Sigmoid sinus thrombosis/lateral sinus thrombosis is an inflammation of inner wall of lateral venous sinus with formation of an intra sinus thrombus It occurs as a complication of chronic suppuration of middle ear or acute coalescent mastoiditis, and cholesteatoma Picket fence fever temperature never comes back to normal baseline. Remittent fever. Complications of CSOM - Intra temporal Intracranial Mastoiditis Meningitis - m/c Petrositis Brain abscess Facial paralysis Extradural abscess Labyrinthitis Subdural abscess Lateral sinus thrombophlebitis Otitic hydrocephalus | ENT | Complications of Chronic Otitis Media | CSOM with Picket fence fever is seen in
A. Meningitis
B. Sigmoid Sinus Thrombosis
C. Brain Abscess
D. Extradural Abscess
| Sigmoid Sinus Thrombosis |
77ded5ec-a12d-469a-a16f-fd7871c27c98 | Some amino acids (isoleucine, tryptophan, phenylalanine, and tyrosine) are both glucogenic and ketogenic because their degradation pathway forms multiple products.a. Amino acids that are converted to pyruvate (see Figure I).(1). The amino acids that are synthesized from the intermediates of glycolysis (serine, glycine, cysteine, and alanine) are degraded to form pyruvate.(a). Serine is converted to 2-phosphoglycerate, an intermediate of glycolysis, or directly to pyruvate and NH4+ by serine dehydratase, an enzyme that requires PLP.(b). Glycine, in a reversal of the reaction utilized for its synthesis, reacts with methylene-FH4 to form serine.1. Glycine also reacts with FH4 and NAD+ to produce CO2 and NH4+ (glycine cleavage enzyme).2. Glycine can be converted to glyoxylate, which can be oxidized to CO2 and H2 O or converted to oxalate.(c). Cysteine forms pyruvate. Its sulfur, which was derived from methionine, is converted to H2 SO4 , which is excreted by the kidneys.(d). Alanine can be transaminated to pyruvate.b. Amino acids that are converted to intermediates of the TCA cycle (see Figure II).(1). The carbons from the four groups of amino acids form the TCA cycle intermediates: a-ketoglutarate, succinyl-CoA, fumarate, and oxaloacetate.(a). Amino acids that form a-ketoglutarate (see Figure III).1. Glutamate can be deaminated by glutamate dehydrogenase or transaminated to form a- ketoglutarate.2. Glutamine is converted by glutaminase to glutamate with the release of its amide nitrogen as NH4+ 3. Proline is oxidized so that its ring opens, forming glutamate semialdehyde, which is oxidized to glutamate.4. Arginine is cleaved by arginase in the liver to form urea and ornithine. Ornithine is transaminated to glutamate semialdehyde, which is oxidized to glutamate.5. Histidine is converted to formiminoglutamate (FIGLU). The formimino group is transferred to FH4, and the remaining five carbons form glutamate.(b). Amino acids that form succinyl-CoA (see Figure IV)1. Four amino acids are converted to propionyl-CoA, which is carboxylated in a biotin requiring reaction to form methylmalonyl-CoA, which is rearranged to form succinyl-CoA in a reaction that requires vitamin B12 (seen previously in the metabolism of odd-chain number fatty acids).a). Threonine is converted by a dehydratase to NH4+ and a-ketobutyrate, which is oxidatively decarboxylated to propionyl-CoA.In a different set of reactions, threonine is converted to glycine and acetyl-CoA.b). Methionine provides methyl groups for the synthesis of various compounds; its sulfur is incorporated into cysteine; and the remaining carbons form succinyl-CoA.i. Methionine and ATP form S-adenosylmethionine (SAM), which donates a methyl group and forms homocysteine.ii. Homocysteine is reconverted to methionine by accepting a methyl group from the FH4 pool via vitamin B12 .iii. Homocysteine can also react with serine to form cystathionine. The cleavage of cystathionine produces cysteine, NH4+ , and a-ketobutyrate, which is converted to propionyl-CoA.c). Valine and isoleucine, two of the three branched-chain amino acids, form succinyl-CoA (see Figure IV).i. The degradation of all the three branched-chain amino acids begins with a transamination followed by an oxidative decarboxylation catalysed by the branched-chain a-keto acid dehydrogenase complex (Figure V). This enzyme, like pyruvate dehydrogenase and a-ketoglutarate dehydrogenase, requires thiamine pyrophosphate, lipoic acid, CoA, flavin adenine dinucleotide (FAD), and NAD+.ii. Valine is eventually converted to succinyl-CoA via propionyl-CoA and methyl malonyl-CoA.iii. Isoleucine also forms succinyl-CoA after two of its carbons are released as acetyl-CoA.(c). Amino acids that form fumarate1. Three amino acids (phenylalanine, tyrosine, and aspartate) are converted to fumarate (see Figure II).a). Phenylalanine is converted to tyrosine by phenylalanine hydroxylase in a reaction requiring tetrahydrobiopterin and O2 (Figure VI).b). Tyrosine, obtained from the diet or by hydroxylation of phenylalanine, is converted to homogentisic acid. The aromatic ring is opened and cleaved, forming fumarate and acetoacetate.c). Aspartate is converted to fumarate via reactions of the urea cycle and the purine nucleotide cycle.d). Aspartate reacts with IMP to form AMP and fumarate in the purine nucleotide cycle.(d). Amino acids that form oxaloacetate (see Figure II)1. Aspartate is transaminated to form oxaloacetate.2. Asparagine loses its amide nitrogen as NH4+ , forming aspartate in a reaction catalyzed by asparaginase.c. Amino acids that are converted to acetyl-CoA or acetoacetate (see Figure VI).(1). Four amino acids (lysine, threonine, isoleucine, and tryptophan) can form acetyl-CoA, and phenylalanine and tyrosine form acetoacetate. Leucine is degraded to form both acetyl-CoA and acetoacetate.Pellagra is caused by a dietary deficiency of niacin, beriberi is caused by a lack of thiamine (vitamin B-,), scurvy caused by a lack of vitamin C, and rickets from a lack of vitamin D.I. Amino acids derived from the intermediates of glycolysis. These amino acids can be synthesized from glucose and can be reconverted to glucose in the liver.II. The degradation of amino acids. A. Amino acids that produce pyruvate or the intermediates of the TCA cycle. These amino acids are considered glucogenic because their carbons can produce glucose in the liver. B. Amino acids that produce acetyl-CoA or ketone bodies. These amino acids are considered ketogenic. CoA, coenzyme A; HMG-CoA, hydroxymethylglutaryl-CoA; TCA, tricarboxylic acid.III. Amino acids related through glutamate. These amino acids contain carbons that can be converted to glutamate, which can be converted to glucose in the liver. All of these amino acids except histidine can be synthesized from glucose.IV. Amino acids that can be converted to succinyl-CoA. The amino acids methionine, threonine, isoleucine, and valine, which form succinyl-CoA via methyl malonyl-CoA, are all essential. Because succinyl-CoA can form glucose, these amino acids are glucogenic. The carbons of serine are converted to cysteine and do not form succinyl-CoA by this pathway. A defect in cystathionine synthase causes homocystinuria. A defect in cystathionase causes cystathioninuria. B12-CH3, methyl cobalamin; N5-CH3-FH4, N 5- methyl tetrahydrofolate; PLP, pyridoxal phosphate; SAM, S-adenosylmethionine; TCA, tricarboxylic acid.V. The degradation of the branched-chain amino acids. Valine forms propionyl-CoA. Isoleucine forms propionyl-CoA and acetyl-CoA. Leucine forms acetoacetate and acetyl-CoA. CoA, coenzyme A; FAD, flavin adenine dinucleotide; HMG-CoA, hydroxymethylglutaryl-CoA.VI. A. Ketogenic amino acids. Some of these amino acids (tryptophan, phenylalanine, and tyrosine) also contain carbons that can form glucose. Leucine and lysine are strictly ketogenic; they do not form glucose. B. A deficiency in various steps leads to the diseases indicated. CoA, coenzyme A; NAD, nicotinamide adenine dinucleotide; NADP, nicotinamide adenine dinucleotide phosphate; PKU, phenylketonuria; PLP, pyridoxal phosphate; TCA, tricarboxylic acid cycle. | Biochemistry | Vitamins and Minerals | Which dietary deficiency of a vitamin can cause Pellagra.
A. Vitamin C
B. Niacin
C. Vitamin D
D. Biotin
| Niacin |
1d939c71-c8f5-42a8-94a1-62b3f85c2445 | Ans. is 'c' i.e., Presence of depression Good prognostic factors :- Acute onset; late onset (onset after 35 years of age); Presence of precipitating stressor; Good premorbid adjustment; catatonic (best prognosis) & Paranoid (2nd best); sho duration (< 6 months); Married; Positive symptoms; Presence of depression; family history of mood disorder; first episode; pyknic (fat) physique; female sex; good treatment compliance & good response to treatment; good social suppo; presence of confusion or perplexity; normal brain CT Scan; outpatient treatment. | Psychiatry | null | Good prognostic factor for schizophrenia is ?
A. Blunted affect
B. Early onset
C. Presence of depression
D. Male sex
| Presence of depression |
87ac2153-96e5-4df6-ba4d-389eaab02de1 | SO arises from the bone above and medial to the optic foramina. It runs forward and turns around a pulley- " the trochlea" and is inseed in the upper and outer pa of the sclera behind the equator. Ref;A.K.Khurana; 6th edition;Page no:336 | Ophthalmology | Ocular motility and squint | Longest and thinnest extrocular muscle -
A. SR
B. IR
C. SO
D. IO
| SO |
863563ce-3fce-491b-92f6-3bc13d8a2d16 | The formation of peptide bonds is catalysed by peptidyl transferase, an activity intrinsic to the 23 S r-RNA of 50 S subunit in prokaryotes and 28 S r-RNA of 60 S subunit in eukaryotes. So, it is referred to as ribozyme & indicates a direct role of r-RNA in protein synthesis. | Biochemistry | null | Ribosomes has following enzymatic activity?
A. Peptidyl transferase
B. Peptidase
C. Aminoacyl tRNA synthetase
D. GTPase
| Peptidyl transferase |
eef0905b-965f-4a6b-bd06-604bded9c566 | Ref:Park's Textbook of Preventive and Social Medicine 25th Ed | Social & Preventive Medicine | Biostatistics | Mean Hb values in two population groups are compared by
A. Paired t test
B. Unpaired t test
C. Chi square test
D. Fischer test
| Unpaired t test |
44951bf6-36b2-4283-b511-3075505c9e1b | Glutaraldehyde is especially effective against the tubercle bacilli, fungi, and viruses. It is less toxic and irritant to eyes and skin than formaldehyde. It has no deleterious effects on the cement or lenses of instruments such as cystoscope and bronchoscopy It can be safely used to treat corrugated rubber,nanestheticubes, face masks, plastic endotracheal tubes, metal instruments a, d polythene tubings REF:Ananthanarayan and Panicker's Textbook ofMicrobiology 8th Edition pg no:36 | Microbiology | general microbiology | A chest physician performs bronchoscopy in the procedure room of the out patient depament. To make the instrument safe for use in the next patient waiting outside, the most appropriate method to disinfect the endoscope is by -
A. 70 % alcohol for 5 min
B. 2% glutaraldehyde for 20 min
C. 2% formaldehyde for 10 min
D. 1% sodium hypochlorite for 15 min
| 2% glutaraldehyde for 20 min |
47f7e154-421c-4628-bc72-a8edf7c3c33c | Conversion of arginine residues to Citrulline in the histones is an essential step in the formation of neutrophill extracillular traps. | Pathology | null | Most important amino acid for formation Neutrophilic extracellular trap (NET) is
A. Leucine
B. Methionine
C. Citrulline
D. Valine
| Citrulline |
86275511-77fc-43c3-a868-423d1cde049a | The Diabetes Control and Complications Trial (DCCT) found definitive proof that a reduction in chronic hyperglycemia can prevent many of the complications of type 1 diabetes mellitus (DM). This multicenter randomized trial enrolled over 1400 patients with type 1 DM to either intensive or conventional diabetes management and prospectively evaluated the development of retinopathy, nephropathy, and neuropathy. The intensive group received multiple administrations of insulin daily along with education and psychological counseling. The intensive group achieved a mean hemoglobin A1C of 7.3% versus 9.1% in the conventional group. Improvement in glycemic control resulted in a 47% reduction in retinopathy, a 54% reduction in nephropathy, and a 60% reduction in neuropathy. There was a nonsignificant trend toward improvement in macrovascular complications. The results of the DCCT showed that individuals in the intensive group would attain up to 7 more years of intact vision and up to 5 more years free from lower limb amputation. Later, the United Kingdom Prospective Diabetes Study (UKPDS) studied over 5000 individuals with type 2 DM. Individuals receiving intensive glycemic control had a reduction in microvascular events but no significant change in macrovascular complications. These two trials were pivotal in showing a benefit of glycemic control in reducing microvascular complications in patients with type 1 and type 2 DM, respectively. Another result from the UKPDS was that strict blood pressure control resulted in an improvement in macrovascular complications Ref - pubmed.com | Medicine | Endocrinology | The diabetes control and complication trial (DCCT) provided definitive proof that reduction In chronic hyperglycemia helps to improve -
A. Microvascular complications of type 1 DM
B. Microvascular complications of type 1 DM
C. Microvascular complications of type 2 DM
D. Macro vascular complications of type 2 DM
| Microvascular complications of type 1 DM |
4a02e1aa-2942-4fe9-87b5-cda43f5c2684 | Ans. b. Type I pneumocytes Bleomycin toxicity is characterized by destruction of Type I pneumocytes.Histopathotogy of Lung in Bleomycin Toxicity* Endothelial cell edema and blebbing* Necrosis of type 1 pneumocytes* Proliferation of fibroblast and fibrosis* Hyperplasia and metaplasia of type II pneumocytes* Inflammatory infiltrate with PMNBleomycin* Bleomycin is well known to cause pulmonary toxicity.* Incidence of bleomycin induced pulmonary toxicity is 5% for a total cumulative dose of 450 units and 15% for higher dosages.* Bleomycin is concentrated preferentially in the lung and is inactivated by hydrolase enzyme. This enzyme is relatively deficient in lung tissue. This may explain relative sensitivity of bleomycin to lung tissue.Type I pneumocytes are more vulnerable to bleomycin toxicity' and are destroyed by bleomycinPathological Features of Bleomycin Toxicity* Early endothelial cell damage* Destruction uf type 1 pneumocytes* Migration of type II pneumocytes into alveolar spaces inducing interstitial changesFollowing destruction of type I pneumocytes repair is characterized by hyperplasia and dysplasia of type II pneumocytes. Fibro- blast proliferation with subsequent pulmonary fibrosis is probably the basis for irreversible changes induced by Bleomycin. | Pharmacology | Anti-Neoplastic Agents | Bleomycin toxicity is characterized by destruction of:
A. Endothelial cells
B. Type I pneumocytes
C. Type II pneumocytes
D. Alveolar macrophages
| Type I pneumocytes |
42df5375-5026-4824-81fc-7c72d7a13f5a | Ans. c. Common peroneal nerve Common peroneal nerve (L4, L5, Sl, S2) is the smaller terminal branch of sciatic nerve. The larger terminal branch of sciatic nerve is the tibial nerve. The common peroneal nerve is relatively unprotected as it traverses the lateral aspect of the head of fibula and is easily compressed at this site.' Common Peroneal Nerve Injury Common peroneal nerve (L4, L5, Sl, S2) is the smaller terminal branch of sciatic nerve. The larger terminal branch of sciatic nerve is the tibial nerve. The common peroneal nerve is relatively unprotected as it traverses the lateral aspect of the head of fibula and is easily compressed at this site. Common Modes of Injury Fracture of neck of fibula Plaster on the leg Lathi injury on the lateral side of knee joint Clinical Features: Injury to common peroneal nerve results in paralysis of all muscles in the anterior and lateral compament of the leg (dorsiflexors of the ankle and eveors of the foot) which results in: Loss of eversion of foot and dorsiflexion of the ankle causes foot drop Foot drop and toes drags on the floor while walking Foot comes down suddenly producing a distinctive plop Variable loss of sensation on the anterolateral aspect of the leg and dorsum of the foot Aicular loss the lateral side of the knee joint In common peroneal nerve injury, only eversion and dorsiflexion is lost, while inversion and plantar flexion remains normal, therefore ankle reflex is intact. | Surgery | null | A policemen foo..a a person ln ing unconscious in iglu lateral position on the road with superficial injury to the face, bruises on the right arm, and injury to the lateral aspect of right knee. Nerve most probably injured:
A. Femoral nerve
B. Radial nerve
C. Common peroneal nerve
D. Trigeminal nerve
| Common peroneal nerve |
833c680b-868a-47d2-a03b-7c9972141b05 | REF:HARRISONS PRINCIPLE&;S OF INTERNAL MEDICINE 18TH EDITION | Medicine | Immune system | HLA B27 histocompatibility antigen is correlated With
A. Sjogren's disease
B. Ankylosing spondylitis
C. Felty's syndrome
D. Scleroderma
| Ankylosing spondylitis |
5ac2cc09-7a22-477e-b98a-6d3c938893ed | Ans. is 'a' i.e., Stomach Dieulafoy's lesion* Dieulafoy's lesion is a medical condition characterized by a large tortuous arteriole most commonly in the stomach wall (submucosal) that erodes and bleeds.* It can cause gastric hemorrhage but is relatively uncommon. It is thought to cause less than 5% of all gastrointestinal bleeds in adults* Dieulafoy's lesions are characterized by a single large tortuous small artery in the submucosa which does not undergo normal branching or a branch with caliber of 1-5 mm (more than 10 times the normal diameter of mucosal capillaries). The lesion bleeds into the gastrointestinal tract through a minute defect in the mucosa which is not a primary ulcer of the mucosa but an erosion likely caused in the submucosal surface by protrusion of the pulsatile arteriole.* Approximately 75% of Dieulafoy's lesions occur in the upper part of the stomach within 6 cm of the gastroesophageal junction, most commonly in the lesser curvature. | Anatomy | Abdomen & Pelvis | Dileufloy's lesion is seen in -
A. Stomach
B. Jejunum
C. Oesophagus
D. Anus
| Stomach |
af06c382-fa50-4f62-b9d4-bd722954415b | Ans. B: Urea The descending pa of the thin segment of the loop of Henle is highly permeable to water and moderately permeable to most solutes and little or no active reabsorption. The thick ascending limb of the loop of Henle reabsorbs about 25% of the filtered loads of sodium, chloride and potassium as well as large amount of calcium, bicarbonate and magnesium. It also secretes hydrogen ions into the tubular lumen | Physiology | null | Substance which is not absorbed in the loop of Henle: March 2005
A. K+
B. Urea
C. CI?
D. Na+
| Urea |
281a7260-b0ee-4e90-9e0b-88bd05fb693c | Fluoxetine is a selective serotonin Reuptake Inhibitor (SSRI) and SSRIs have shown the greatest efficiency in PMS treatment. Premenstrual syndrome (PMS), also called Premenstrual Tension (PMT), is a symptom complex, recognised primarily by cyclic changes, associated with ovulatory cycles. It occurs 7 to 14 days prior to menstruation and spontaneously resolves after menses. It always occurs in the luteal phase of the cycle. Symptoms include: Pain: Headache, breastpain, abdominal cramps, muscle stiffness, backache and generalise body ache. Water retention: Breast volume increase, bloating and weight gain. Behavioural changes: Low performance, difficulty in concentration, irritability, depression, forgetfulness, low judgement, anxiety, loneliness, feeling like crying, hostility, increased appetite and cravings and sleeplessness. Autonomic changes: Dizziness, faintness, nausea, vomiting and hot flushes Treatment: Psychosomatic symptoms: SSRIs, Vitamin B1, B6 and E Breast pain: Danazol, Bromocriptine and GnRH analogues Pelvic pain and bloatedness: OCP and Mirena IUCD General measures: Excercise, relaxation and hobbies like Meditation and Yoga Ref: Shaw&;s textbook of Gynaecology 17th edition PGno: 127 | Gynaecology & Obstetrics | Disorders of menstruation | A 28 year old woman, suffers from emotional liability and depression, about 10 days prior to her menses. She repos that once she begins to bleed, she feels back to normal. She also gives a history of premenstrual fatigue, bloating and breast tenderness. What would be the best treatment for the patient?
A. Evening primrose oil
B. Vitamin B6
C. Fluoxetine
D. Progesterone
| Fluoxetine |
f9401c1c-b9cd-43d5-928a-0cf204326f7f | Hyponatremia in CKD population is associated with increased moality, but the effect on renal outcome was unknown.. Hyponatremia (serum sodium <120 mEq/L) was associated with excessive volume and volume depletion, measured as total body water by bioimpedance analysis, in diuretic users, but not in diuretic non-users Ref Davidson 23rd edition pg 366 | Medicine | Fluid and electrolytes | In hyponatremia following renal failure, serum sodium should be maintained at what levels ?
A. 120 mEq/L
B. 125 mEq/L
C. 130 mEq/L
D. 135 mEq/L
| 120 mEq/L |
1d33a6f3-018f-4042-883f-3c1fd7ecd4cc | D i.e. Open angle glaucoma Conditions associated with altered refraction Feature Found in Frequent change of presbyopic glasses Open angle glaucoma Q Second sight/ Myopic Shift/Improvement in near vision Senile immature nuclear cataract Fluctuation of refractory error Diabetic cataract Frequent change of glasses Coical or nuclear cataract Primary Open Angle Glaucoma/ Chronic Simple Glaucoma It is chronic, slowly progressive, bilateral disease characterized by - adult onset, 10P > 21 mmHg at some point in the course of disease, an open angle, glaucomatous optic nerve head damage and visual field loss. It presents with painless progressive loss of vision Q, frequent change in presbyopic glasses Q and difficulty in near work owing to accommodative failure. | Ophthalmology | null | Rapid change of presbyopic glass is a feature of
A. Senile cataract
B. Retinal detatchment
C. Intumescent cataract
D. Open angle glaucoma
| Open angle glaucoma |
2c528ae4-9e61-4789-8d93-3c139d02998b | Alopecia areata may be associated with atopy, downs syndrome, vitiligo, pernicious anemia, myxedema , diabetes or hypeension in the family. Sho,1-2 mm fractured hairs can frequently be seen at the active margins of alopecia areata. These hairs are described as exclamation mark hairs because these characteristic hairs fracture at their distal end and taper proximally to a pencil point giving them appearance of an exclamation mark . nail pitting is a common finding in alopecia areata . Ref Harrison20th edition pg 1236 | Dental | Anatomy of skin | Alopecia areata is not associated with which of the folllowing condition?
A. Exclamation sign
B. Atopy
C. Pitting nails
D. Geographical tongue
| Geographical tongue |
e49161b3-15c9-4e3f-a90b-0d857f39c76c | HIV transmission in absence of intervention:
MTCT of HIV in developed countries: 20% (15-25%)
MTCT transmission of HIV in developing countries: 30% (25-35%) | Social & Preventive Medicine | null | Risk of mother to child HIV transmission in pregnant woman at the time of delivery, and after delivery in non breast feeding woman is
A. 5-10%
B. 15-30%
C. 10-15%
D. More than 50%
| 15-30% |
0c4c9422-b509-440b-9ab9-389aaced86a2 | Autoclave: Recommended condition- 121–124°C temperature for 15 min at 1.1 bar pressure
Alternate: 134–138°C temperature for 3 min at 2.2 bar pressure
Hot air oven: 160°C temperature for 120 min or 180°C temperature for 30 min | Microbiology | null | Condition required for autoclave is?
A. 121°C temperature for 20 min
B. 121°C temperature for 15 min
C. 100°C temperature for 60 min
D. 100°C temperature for 90 min
| 121°C temperature for 15 min |
84021fac-4a52-47bd-b87c-70201fc0f5e6 | Ref: Harrison's Principles of Internal Medicine. 18th edition, Page 2188Explanation:OSAHS is defined as the coexistence of unexplained excessive daytime sleepiness with at least five obstructed breathing events (apnea or hypopnea) per hour of sleep.EPWORTH SLEEPINESS SCOREHow often are you likely to doze off or fail asleep in the following situations, in contrast to feeling just tired'* This refers to your usual way of life in recent times.Even if you have not done some of these things recently, fry to work out how they would have affected you.Use the following scale to choose the most appropriate number for each situation:= would never doze.= slight chance of dozing.= moderate chance of dozing.= high chance of dozing.* Sitting and reading--* Watching TV--* Sitting, inactive in a public place (e.g., a theater or a meeting)--* As a passenger in a car for an hour without a break--* Lying down to rest in the afternoon when circumstances permit--* Sitting and talking to someone--* Sitting quietly after lunch without alcohol--* In a car, while stopped for a few minutes in traffic--TOTAL--DiagnosisSleep history from the patient and partner, with both completing.Sleep questionnaires.Epworth Sleepiness Score.Assessment of:o Obesity.o Jaw structureo Upper airwayo Blood pressureo Hypothyroidismo Acromegaly.Polysomnography.The apnea-hypopnea index or apnoea-hypopnoea index (AHI)It is an index of sleep apnea severity that combines apneas and hvpopneas.The apneas (pauses in breathing) must last for at least 10 seconds and are associated with a decrease in blood oxygenation.Combining these gives an overall sleep apnea severity score that evaluates both number sleep disruptions and degree of oxygen desaturation (low blood level).The AHI is calculated by dividing the number of events by the number of hours of sleep.AHI values are typically categorized as:o Mild = 5-15/hro Moderate = 15-30/hro Severe = > 30/hTREATMENT: OBSTRUCTIVE SLEEP APNEAWhom to Treat-Indications for TreatmentGroup IPatients who have an:o Epworth Score >1Lo Troublesome sleepiness while driving or working.o >15 apneas + hypopneas per hour of sleep.Treatment is definitely indicated in this group- Maximum benefit.Treatment improves:o Symptomso Sleepinesso Drivingo Cognitiono Moodo Quality of lifeo Blood pressure.Group 2Patient who have:o Similar degrees of sleepiness as Group Io 5-15 events per hour of sleep.Treatment is indicated-But benefit is less than Group 1.Treatment improves:o Symptomso Subjective sleepiness.No significant improvement in cognition and quality of life.No improvements in Blood pressure.Group 3Patients who are/have:o Nonsleepy subjects.o Less than 5 events per hour of sleep.Treatment is not indicated.No benefit with treatment.Life style modifications advised.MANAGEMENT OPTIONSLifestyle ModificationsWeight loss.Alcohol Reduction-Alcohol acutely decreases URT dilating muscle tone.CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP)Blowing the airway open during sleep, usually with pressures of 5-20 mmllg.CPAP improves the following in patients with OSAHS:o Breathing during sleepo Sleep qualityo Sleepinesso Blood pressureo Vigilanceo Cognitiono Driving abilityo Moodo Quality of life.The main side effect of CPAP is airway drying (decreased by using heated humidifier).CPAP is effective for both Moderate and Severe disease.Most common treatment modality used in OS A.MANDIBULAR REPOSITIONING SPLINT (MRS)Also called oral devices.Holds lower jaw and tongue forward causing widening the pharyngeal airway.MRSs improve the follow ing in OSAHS patients:o Breathing during sleep.o Daytime somnolenceo Blood pressure.There are many devices with differing designs with unknown relative efficacy.Self-reports of the use of devices long-term suggest high dropout rates.SurgeryBariatric surgery can be curative in the morbidly obese.Tonsillectomy can be highly effective in children but rarely in adults.Tracheostomy is curative but rarely used because of the associated morbidity rate but should nor be overlooked in severe cases.Jaw advancement surgery--particularly maxillomandibular osteotomy--is effective in young and thin patients with retrognathia (posterior displacement of the mandible).There is no clear evidence that pharyngeal surgery , including uvulopalatopharyngoplasty (whether by scalpel, laser, or thermal techniques) helps OSAHS patients.DrugsNo drugs are clinically useful in the prevention or reduction of apneas and hypopneas.In CPAP refractory patients. Modafinil can be tried with limited success.Choice of TreatmentCPAP and MRS are the two most widely used and best evidence-based therapies.CPAP is the current treatment of choice.MRSs are evidence-based second-line therapy in those who fail CPAP.In younger. thinner patients, maxillomandibular advancement should be considered.Note:In the given case, patient has 5 events/hour of sleep. He is also obese, diabetic, smoker and hypertensive. So the next step in management is to advocate life style modifications to treat obesity advise smoking cessation and follow-up. | Medicine | Diabites & Inappropriate Antidiuretic Hormone | An obese, diabetic patient with hypertension who is also a smoker, currently on anti-hypertensive and OHA drugs presents with complains of apnea during night. Polysomnography reveals 5 apneic episodes and 1 hypoapneic episode in one hour. What will be best next line of management is: (E. REPEAT 2007)
A. Nasal CPAP
B. Uvulopharyngopalatoplasty
C. Mandibular sling
D. Diet and weight reduction
| Diet and weight reduction |
e002aab4-2a95-4f63-bca4-bb7c054eb9c3 | Ans. is 'b' i.e., Osteogenesis imperfect * Blue scleral discoloration is caused by thinning or transparency with resultant visualization of the underlying uvea.* Causes of blue sclera are: Osteogenesis imperfecta, Marfan syndrome, Ehler - Danlos syndrome, Pseudoxanthoma elasticum. | Ophthalmology | Sclera | Blue sclera is seen in -
A. Alkaptonuria
B. Osteogenesis imperfect
C. Down syndrome
D. Kawasaki syndrome
| Osteogenesis imperfect |
9edee9c3-3343-4f76-821b-44edb74dacd5 | HLEG Recommendations
High Level Expert Group (HLEG, Planning Commission, GOI) on Universal health Coverage has suggested 3½ year MBBS course for serving rural population
HLEG was developed for XII Five Year Plan
Rural doctors will be called as ‘Community Health Officers’
3½ Degree given: B.Sc. Community Health | Social & Preventive Medicine | null | A 3 year graduate MBBS programme was suggested by which committee?
A. Sundar Committee
B. Expert Level Committee on Universal Health Coverage
C. Srivastava Committee
D. Krishnan Committee
| Expert Level Committee on Universal Health Coverage |
4c00e498-9483-4d46-90e1-05db764595c1 | Refer katzung 11e p 237 * Mechanism of action Like all other class I antiarrhythmic agents, quinidine primarily works by blocking the fast inward sodium current (INa). ... The effect of blocking the fast inward sodium current causes the phase 0 depolarization of the cardiac action potential to decrease (decreased Vmax). | Pharmacology | Cardiovascular system | Quinidine exes action on hea by
A. Ca+ Channel blocker
B. Kt Channel blocker
C. Na+ Channel opener
D. Cl+ Channel opener
| Kt Channel blocker |
0ddd485d-1d97-49b3-8f1a-aceb36b938ba | Epinephrine is a non selective adrenergic agonist and a valuable resuscitative drug because of its effects at multiple adrenergic receptor subtypes. In the treatment of anaphylaxis, epinephrine increases myocardial contractility, accelerates hea rate, causes constriction of vascular smooth muscle, and causes relaxation of bronchial smooth muscle. The principal pharmacologic effects of epinephrine that are beneficial in anaphylaxis are mediated : alpha-1 receptors in vascular smooth muscle, resulting in vasoconstriction, beta-1 receptors in the hea, resulting in increased contractility, and beta-2 receptors in bronchial smooth muscle, resulting in relaxation and relief of bronchoconstriction. (One simple mnemonic for the respective locations of beta1 and beta2 receptors is "one hea, two lungs.") Beta-2 receptors are also found, however, in vascular smooth muscle (especially in skeletal muscle beds), were, just as in bronchial smooth muscle, they promote relaxation. (Epinephrine dilates skeletal muscle vascular beds to maximize oxygen delivery for the "fight-or-flight" response.) The resulting vasodilation in skeletal muscle vascular beds would, by itself, tend to decrease blood pressure, which might tend to worsen the effects of anaphylactic shock, but this effect is mitigated by the intense alpha-1 receptor stimulation, causing vasoconstriction in multiple beds. The principal action of alpha-2 receptors is at the presynaptic nerve terminal, where receptor stimulation reduces the release of norepinephrine from the nerve terminal. Epinephrine does stimulate these receptors, but it does not really contribute to the beneficial actions of epinephrine in resuscitation. Alpha-2 receptors are not located in the hea (except at presynaptic nerve terminals), alpha-2 receptors do not have a significant beneficial effect in resuscitation, and beta-1 receptors are not located in bronchial smooth muscle, but are located in the hea. Beta-1 receptors are located in the hea, not in bronchial smooth muscle. The adrenergic receptor that produces bronchial smooth muscle relaxation is beta-2. Alpha-2 receptors are located primarily at presynaptic nerve terminals, and because the beta-2 receptors in vascular smooth muscle cause vasodilation, this not a helpful effect of epinephrine in this case. Also Know: Epinephrine is indicated for the treatment of anaphylactic reactions and acute asthma exacerbations. It is considered a first-line agent in the treatment of cardiac arrest (i.e., pulseless ventricular tachycardia/ventricular fibrillation, asystole, and pulseless electrical activity). Epinephrine also causes bronchodilation and antagonizes the effects of histamine. Epinephrine significantly increases myocardial oxygen consumption and thus can exacerbate ventricular irritability in the setting of myocardial ischemia. Extravasation causes necrosis and sloughing, and requires prompt infiltration of the affected area with phentolamine. Ref: Miller B.A., Clements E.A. (2011). Chapter 24. Pharmacology of Vasopressor Agents. In J.E. Tintinalli, J.S. Stapczynski, D.M. Cline, O.J. Ma, R.K. Cydulka, G.D. Meckler (Eds), Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e. | Pharmacology | null | In the beginning of resuscitation effos, 0.5 mg of epinephrine is administered subcutaneously. Which adrenergic receptors, in which tissues, are responsible for the beneficial effect of epinephrine in this patient?
A. Alpha-1 receptors in vascular smooth muscle, alpha-2 receptors in the hea, and beta-1 receptors in bronchial smooth muscle
B. Alpha-1 receptors in vascular smooth muscle, alpha-2 receptors at presynaptic nerve terminals, beta-1 receptors in bronchial smooth muscle
C. Alpha-1 receptors in vascular smooth muscle, beta-1 receptors in the hea, and beta-2 receptors in bronchial smooth muscle
D. Alpha-2 receptors in vascular smooth muscle and beta-2 receptors in vascular smooth muscle
| Alpha-1 receptors in vascular smooth muscle, beta-1 receptors in the hea, and beta-2 receptors in bronchial smooth muscle |
53863cc7-5dfe-4c90-be6a-b0cd962e04da | (B) Emphysema# FACTORS AFFECTING FRC> FRC Increases with: Increased height Erect position (30% more than in supine) Decreased lung recoil (E.g. emphysema)> FRC Decreases with: Obesity, Muscle Paralysis (especially in supine) Restrictive lung disease (E.g. Fibrosis, Pregnancy) Anaesthesia FRC does not change with age> Emphysema is a condition of the lung characterized by abnormal permanent enlargement of the airspaces distal to the terminal bronchiole, accompanied by destruction of their walls and without obvious fibrosis.> Principal antielastase activity in serum and interstitial tissue is alpha 1 -AT (others are secretory leukoprotease inhibitor in bronchial mucus and serum alphal -macroglobulin), and the principal cellular elastase activity is derived from neutrophils (other elastases are formed by macrophages, mast cells, pancreas, and bacteria). Neutrophil elastase is capable of digesting human lung, and this digestion can be inhibited by alphal-antitrypsin.> The most plausible hypothesis to account for the destruction of alveolar walls is the protease-antiprotease mechanism. This hypothesis is based on two important observations, one clinical and one experimental. The first is that homozygous patients with a genetic deficiency of the protease inhibitor alphal -AT have a markedly enhanced tendency to develop pulmonary emphysema, which is compounded by smoking.# Emphysema is classified into distinct pathologic types:> The most important types being centriacinar and panacinar.# Centriacinar emphysema, the type most frequently associated with cigarette smoking, is characterized by enlarged airspaces found (initially) in association with respiratory bronchioles.> Centriacinar emphysema is most prominent in the upper lobes and superior segments of lower lobes and is often quite focal.# Panacinar emphysema refers to abnormally large airspaces evenly distributed within and across acinar units.> Panacinar emphysema is usually observed in patients with a1 AT deficiency.> Pulmonary function testing shows airflow obstruction with a reduction in FEV1 and FEV1/FVC With worsening disease severity, lung volumes may increase, resulting in an increase in total lung capacity, functional residual capacity, and residual volume.> In patients with emphysema, the diffusing capacity may be reduced, reflecting the parenchymal destruction characteristic of the disease. | Medicine | Miscellaneous | Residul lung volume increased in
A. Obesity
B. Emphysema
C. Bacterial pneumonia
D. Idiopatic pulmonary fibrosis
| Emphysema |
a1ae7e34-0cc1-4c25-832a-ad3e869b04bb | Ans. (d) Homonymous hemianopiaRef.: Harrison's 19th ed. /198-199* Unilateral optic nerve lesion: Unilateral blindness* Binasal hemianopia: Bitemporal optic chiasma lesion. Two different lesions compressing the chiasma from the lateral parts.* Bitemporal hemianopia: Binasal retinal damaged optic chiasmal lesion. Commonest lesion is pituitary adenoma.* Homonymous hemianopia: lesion at optic tract AND optic radiation* Homonymous superior quadrantonopia: All superior quadrantonopia goes to the temporal lobe (pie in the sky).* Homonymous inferior quadrantonopia: All inferior quadrantonopia goes to the parietal lobe (Pie on the floor).* Homonymous hemianopia w/ macular sparing: Lesion in occipital cortex les | Ophthalmology | Lesions of the Visual Pathway | Lesion of optic tract causes?
A. Binasal hemianopia
B. Bitemporal hemianopia
C. Homonymous superior quadrantonopia
D. Homonymous hemianopia
| Homonymous hemianopia |
5a4d3e7d-5358-48ef-b7ac-57e7e7a5b3a8 | Oliver Wendell Holmes coined the term anesthesia. In 1846, Holmes coined the word anesthesia. In a letter to dentist William T. G. Moon, the first practitioner to publicly demonstrate the use of ether during surgery, he wrote: "Everybody wants to have a hand in a great discovery. All I will do is to give a hint or two as to names--or the name--to be applied to the state produced and the agent. The state should, I think, be called "Anaesthesia." This signifies insensibility--more paicularly ... to objects of touch." Ether was used for frivolous purposes ("ether frolics"), but not as an anesthetic agent in humans until 1842, when Crawford W. Long and William E. Clark independently used it on patients for surgery and dental extraction, respectively. However, neither Long nor Clark publicized his discovery. Four years later, in Boston, on October 16, 1846, William T.G. Moon conducted the first publicized demonstration of general anesthesia for surgical operation using ether. The dramatic success of that exhibition led the operating surgeon to exclaim to a skeptical audience: "Gentlemen, this is no humbug!" Joseph Priestley produced nitrous oxide in 1772, and Humphry Davy first noted its analgesic propeies in 1800. Gardner Colton and Horace Wells are credited with having first used nitrous oxide as an anesthetic for dental extractions in humans in 1844. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e | Anaesthesia | General anaesthesia | Who coined term anaesthesia
A. Moon
B. Holmes
C. Morgan
D. Priestly
| Holmes |
5794f9a3-3751-4aaa-9a66-c8d595fb3029 | Diagnosis: Marginal zone lymphoma, MALT lymphoma Marginal Zone Lymphoma is an indolent tumor develop due to chronic B cell stimulation either by H.pylori or Auto immune disorders Translocation (11:18) involved | Pathology | Non Hodgkin Iymphoma | A 55-year-old man presents with recurrent epigastric pain. Upper GI endoscopy and gastric biopsy reveal a neoplastic, lymphocytic infiltrate invading glandular tissue. Giemsa staining is positive for Helicobacter pylori. Which of the following is the most likely diagnosis?
A. Burkitt lymphoma
B. Marginal zone lymphoma
C. Follicular lymphoma
D. Mantle cell lymphoma
| Marginal zone lymphoma |
389308bb-d6dc-408b-b364-15fe5627d57a | Methotrexate is a weak acid and is reabsorbed in acidic urinary pH. Higher plasma concentration may result in toxicity. Therefore, to decrease the reabsorption through renal tubules, high urinary pH must be maintained. | Pharmacology | null | Maintenance of high urinary pH is important during methotrexate treatment because:
A. Bladder irritation is reduced
B. It decreases renal tubular secretion of methotrexate
C. Leucovorin toxicity is increased in a dehydrated patient
D. Methotrexate is a weak acid
| Methotrexate is a weak acid |
34b433b0-90ba-447c-ae08-32c3b3aa43a1 | Both glucocerebrosides and galacto cerebrosides are present however galactocerebrosides are most commonly seen on neural cells and are abundant | Biochemistry | miscellaneous | Cerebrosides consist mostly of this
A. Glucose
B. Galactose
C. Fructose
D. Arabinose
| Galactose |
859927e4-cb26-4fc8-8245-c2e988870663 | Saccades are sudden, jerky conjugate eye movements that occur as the gaze shifts from one object to another. Supranuclear eye movement systems include : Saccadic system Smooth pursuit system Vergence system Vestibular system Optokinetic sysytem Position maintenance system Ref;A.K.Khurana;6th edition; Page no: 341 | Ophthalmology | Ocular motility and squint | Which of the following best defines the "Saccade"-
A. Voluntary slow eye movements
B. Involuntary slow eye movement
C. Abrupt, involuntary slow eye movements
D. Abrupt, involuntary rapid eye movements
| Abrupt, involuntary rapid eye movements |
5231c88b-72d2-458c-84c2-0054e526725b | Ans. is 'a' i.e., Trachoma Adult inclusion conjunctivitiso It is a type offollicular conjunctivitis caused by serotypes D to K of chlamydia trachomatis-in sexually active young adults.o The primary source of infection is urethritis in males and cervicitis in females.o Transmission may occur either through contaminated fingers or through contaminated water of swimming pools (Swimmingpool granuloma).o Presentation is similar to other acute follicular conjunctivits with mucopurulent discharge,o The disease runs a benign course and often evolves into the chronic follicular conjunctivitis. | Ophthalmology | Inflammations of Conjunctiva - Infective | Inclusion conjunctivitis is caused by-
A. Trachoma
B. Pneumococcus
C. Candida
D. Neisseria
| Trachoma |
0de41bd1-4c73-48eb-80b0-386daafdea24 | This is the case of pneumonia shows signs of consolidation lung :
Reduced thoracic movements.
Increased vocal fremitus and vocal resonance.
Dull note on percussion.
Bronchial breath sounds. | Medicine | null | A 25 years old male smoker presents with high grade fever with chills and severe right sided pleuritic chest pain and cough with expectoration physical examination of the patient is likely to show
A. Increased percussion sounds
B. Decreased vocal fremitus
C. Bronchial breath sounds
D. Decreased vocal resonance
| Bronchial breath sounds |
38888c1e-f85f-4d38-ab27-3856cdb47cf3 | Adenine is always paired with thymine by the formation of two hydrogen bonds. Guanine is always paired with cytosine by the formation of three hydrogen bonds.
Thus, the C-G bonds are more resistant to denaturation. | Biochemistry | null | Triple bonds are found between which base pairs
A. A–T
B. C–G
C. A–G
D. C–T
| C–G |
d669b0d5-71b1-495f-9fa3-5c0d2651f676 | ANSWER: (C) BradycardiaREF: KDT 4th Ed p. 94EFFECTS OF ATROPINE:CNS* Stimulates medullary , vasomotor and respiratory center* Depresses vestibular excitation , hence anti motion sickness* Suppresses cholinergic activity in basal ganglia, hence decreases tremor.* High doses may cause cortical excitation , restlessness , disorientation and hallucinationsCVS* Tachycardia* Abbreviates A-V refractory period* Facilitates A-V conduction* No consistent effect on BPEYE* Mydriaisis* Abolition of light reflexes* Cycloplegia* Rise of IOTSmooth musdes* All visceral smooth muscles are relaxed* Constipation* Bronchodilation* Urinary retention* Urinary bladder and ureter relaxation* Effect on uterus is minimal* Effect of biliary tract is less markedGlands* Decrease sweat, salivary , tracheobronchial and lachrymal secretions* Decreases secretion of acid and pepsinBody temperature* riseLocal anesthetic* effect present | Pharmacology | Anti Cholinergic | Which is not an effect of atropine?
A. Rise of body temperature
B. Decreased salivary secretion
C. Bradycardia
D. Increased A-V conduction
| Bradycardia |
ed825676-114b-4799-871b-3dfc47798255 | Ans. is b, i.e. 16-20 weeksRef. Dutta Obs 9/e, p 63: Reddy 27/e, p 434"Quickening (feeling of life) denotes the perception of active fetal movements by the women. It is usually felt about the 18th week Q, 2 weeks earlier in multiparae. Its appearance is a useful guide to calculate the expected date of delivery with reasonable accuracy" Ref. Dutta Obs, 9/e, p 63"Quickening is felt between 16th to 20th week Q" --Reddy 27/e, p 343PhenomenonTimePalpation of fetal part20 weeksActive fetal movement felt by placing a hand on abdomen20 weeksExternal ballottement20 weeksInternal ballottement16-28 weeksFHS audible by Stethoscope18-20 weeksFetal movement can be detected by Doppler10 weeksLightening38 weeks | Gynaecology & Obstetrics | Physiological changes during Pregnancy | An expectant mother feels quickening at:
A. 12-18 weeks
B. 16-20 weeks
C. 26 weeks
D. 24-28 weeks
| 16-20 weeks |
dbcc3722-a3eb-4303-8a87-d1c903c63f32 | Ans. A. BromocriptineAll of the drugs listed are D2 blockers which are associated with hyperprolactinemia except bromocriptine which is D 2 agonist. | Pharmacology | C.N.S | Drug which do not cause hyperprolactinemia:
A. Bromocriptine
B. Haloperidol
C. Reserpine
D. Chlorpromazine
| Bromocriptine |
67b13bc8-a7cd-4c61-ab1c-60eaccdecdae | Mirena is a progestin releasing device, it releases levonorgestrel into the uterus at a rate of 20 microgm/d. It has a T-shaped radiopaque frame, with its stem wrapped with a cylinder reservoir, composed of a polydimethylsiloxane-levonorgestrel mixture. Cu T 380A is another progestin releasing device. It has a polyethylene and barium sulfate, T-shaped frame wound with copper. Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 32. Contraception. | Gynaecology & Obstetrics | null | What is the rate of release of levonorgestrel into the uterus from Mirena, a progestin releasing intrauterine device?
A. 20 microgm/d
B. 30 microgm/d
C. 50 microgm/d
D. 70 microgm/d
| 20 microgm/d |
4fb19f04-e93b-4961-9a9c-e20fcbdb194f | Ans. B: Metronidazole Drugs causing Disulfiram like reaction Metronidazole Cefamandole Cefoperazone Chlorpropamide Sulfonylureas Quinacrine Griseofuvin Chloramphenicol Tinidazole Procarbazine Ritonavir Nitrofurantoin Chloramphenicol Chloral hydrate | Pharmacology | null | Disulfiram like reaction is commonly caused by which of the following: March 2005
A. Penicillin
B. metronidazole
C. Tetracycline
D. erythromycin
| metronidazole |
23febf88-8f87-495d-8005-9979e455d6d6 | Glassgow Coma Scale (GCS) Maximum score - 15, minimum score - 3 Best predictor of outcome : Motor response Patients scoring 3 or 4 have an 85% chance of dying or remaining vegetative, while scores above 11 indicate only a 5-10% likelihood of death Table given as image Ref : Harrison's 19th edition Pgno :1777 | Surgery | Trauma | Best Prognostic factor for head injury ?
A. Age of patient
B. Glasgow coma scale
C. Mode of injury
D. Presence of facial trauma
| Glasgow coma scale |
a5f2949b-e03f-4f7a-8d79-aa0d173db831 | -The pleural effusion encountered in this patient represents excess fluid in a body cavity. Transudate-Edema fluid with low protein content Exudate-Edema fluid with high protein content. Purulent exudate or effusion contains a prominent cellular component (PMNs). Serous exudate or effusion is characterized by the absence of a prominent cellular response and has a yellow, straw like color. Fibrinous exudate (choice A) does not contain leukocytes. Serosanguineous exudate (choice D) contains RBCs and has a red tinge. Diagnosis: Bacterial pneumonia, pleural effusion | Pathology | Basic Concepts and Vascular changes of Acute Inflammation | A 36-year-old woman with pneumococcal pneumonia develops a right pleural effusion. The pleural fluid displays a high specific gravity and contains large numbers of polymorphonuclear (PMN) leukocytes. Which of the following best characterizes this pleural effusion?
A. Fibrinous exudate
B. Lymphedema
C. Purulent exudate
D. Serosanguineous exudate
| Purulent exudate |
8e458cff-e2eb-4a7d-be60-5d2aadab905b | Pulmonary surfactant composed of myelin and lecithin is mainly secreted continuously by Type II pneumocyte beginning from 20th week of gestation. Also Know: Surfactant has both lipid (90%) and protein (10%) component. About half of the lipids are dipalmitoylphosphatidylcholine and the remaining are phosphatidylglycerol, cholesterol and other lipids. Half of the proteins are apoproteins and other half is composed of proteins normally found in blood plasma. Function of surfactant: The surfactant greatly reduces the surface tension allowing easier expansion and collapse of alveoli during during respiration and the resulting changes in pressure. It also helps the alveoli to expand and shrink at the same rate thereby reducing the chance for isolated overexpansion and total collapse of alveolar sacs. Ref: The Big Picture: Medical Biochemistry by Lee W. Janson, chapter 17 | Physiology | null | Which of the following type of cell is concerned with the production of surfactant?
A. Type I Pneumocytes
B. Type II Pneumocytes
C. Alveolar macrophages
D. Clara cells
| Type II Pneumocytes |
86110f1c-75ea-4834-9c63-41941a70079a | Familial adenomatous polyp(FAP) is inherited as an autosomal dominant neoplastic condition (chromosome 5q21). It has a high potential for malignant transformation. It presents in younger age group- 15-20 yrs; equal in both sexes. It commonly involves the large intestine but can also occur in stomach, duodenum and small intestine. Reference : page 899 SRB's manual of surgery 5th edition | Surgery | Urology | Gene responsible for FAP is located at
A. Chromosome 5
B. Chromosome 8
C. Chromosome 15
D. Chromosome X
| Chromosome 5 |
2dae497d-fa62-4c17-b93a-9454223aa9a4 | Epithelioid cells. These are so called because of their epithelial cell-like appearance, are modified macrophages/ histiocytes which are somewhat elongated, having a vesicular and lightly-staining slipper-shaped nucleus, and pale staining abundant cytoplasm with hazy outlines so that the cell membrane of adjacent epithelioid cells is closely apposed.Epithelioid cells are weakly phagocytic. It is suggested that epithelioid cells could play an impoant role in fibrosis possibly by the secretion of a fibroblast activating factor. Ref:Harsh Mohan - Textbook of Pathology, 6th Edition.page no.148 &Immunobiology,elsevier,Volume 221, Issue 12, Pages 1329-1432. | Pathology | dermatology and infectious disease | The most impoant function of epithelioid cells in tuberculosis is -
A. Phagocytosis
B. Secretory
C. Antigenic
D. Healing
| Secretory |
46686ff7-1daf-4389-8788-f82db1916eb0 | Ans.: A (Selenium) ' Selenium deficiency causes Keshan disease(endemic cardiomyopathy)"Shinde 7th/594Possible causes of cardiomyopathy include; www.may- odinic.com/heaith/cardiomyopa thy/DS00519/DSECTION# Long-term high blood pressure# Defects in heart valve# Heart tissue damage from a previous heart attack# Chronic rapid heart rate# Metabolic disorders, such as thyroid disease or diabetes# Nutritional defdencies of essential vitamins or minerals, such as thiamin (vitamin B-l), selenium, calcium and magnesium# Pregnancy# Excessive use of alcohol over many years# Abuse of cocaine or antidepressant medications, such as tricyclic antidepressantsUse of some chemotherapy drugs to treat cancerSome viral infections, which may injure the heart and trigger cardiomyopathyIron buildup in your heart muscle (hemochromatosis)Genetic conditionsReversible cardiomyopathy due to carnitine deficiency from renal tubular wasting.Table (Harrison 18th/595): Deficiencies of MetalsElementDeficiencyBoronNo biologic function determinedCalciumReduced bone mass, osteoporosisCopperAnemia,, growth retardation, defective keratinization and pigmentation of hair, hypothermia, degenerative changes in aortic elastin, osteopenia, mental deteriorationChromiumimpaired glucose toleranceFluoride| Dental cariesIodineThyroid enlargement, |T4, cretinismIronMuscle abnormalities, koilonychia, pica, anemia, 4work performance, impaired cognitive development, premature labor, Tperinatal maternal mortalityManganeseImpaired growth and skeletal development, reproduction, lipid and carbohydrate metabolism; upper body rashMolybdenumSevere neurologic abnormalitiesSeleniumCardiomyopathy, heart failure, striated muscle degenerationPhosphorusRickets (osteomalacia), proximal muscle weakness, rhabdomyolvsis, paresthesia, ataxia, seizure, confusion, heart failure, hemolysis, acidosisZincGrowth retardation, !taste and smell, alopecia, dermatitis, diarrhea, immune dysfunction, failure to thrive, gonadal atrophy, congenital malformations | Biochemistry | Nutrition & Digestion | Cardiomyopathy is/are due to deficinency of:
A. Selenium
B. Phosphorus
C. Boron
D. Zinc
| Selenium |
88f371df-24c9-4d47-afee-37bfb16e2d93 | WHO Classification for Anovulation Hypothalamic pituitary failure: Hypogonadotropic Hypogonadism Hypothalamic pituitary dysfunction/PCOS: Normogonadotropic Hypogonadism Ovarian failure: Hypergonadotropic Hypogonadism Hyperprolactinemia Anovulation and ovulatory dysfunction can be caused by a number of factors. The most common cause of ovulatory dysfunction is PCOS. Other potential causes of irregular or absent ovulation: Obesity Underweight Extreme exercise Hyperprolactinemia Premature ovarian failure Perimenopause, or low ovarian reserves Thyroid dysfunction Extremely high levels of stress | Gynaecology & Obstetrics | Polycystic Ovarian Syndrome | The most common cause of Anovulation is:
A. Polycystic Ovarian Disease
B. Hyperprolactinemia
C. Premature ovarian failure
D. Low ovarian reserves
| Polycystic Ovarian Disease |
8692e0a7-207d-4497-a39a-e35e57edcbd0 | Arterial Supply of thyroid gland:-
Mainly supplied by:
Superior thyroid arteries (this is branch of external carotid artery)
Inferior thyroid arteries (this is a branch of the thyrocervical trunk that arises from the subclavian artery) | Anatomy | null | Which of the following Artery supplies the thyroid gland?
A. Internal carotid artery
B. Thyrocrvical trunk
C. Lingual artery
D. Subclavian artery
| Thyrocrvical trunk |
ac58d8c3-c0a5-4a5c-a6dd-407b5f941af2 | (d) Fasciotomy- As patient is clinically a case of compartment syndrome -pain on passive stretch and he has paraesthesias so fasciotomy is indicated.- Remember Pulses can be normal in compartment syndrome. | Orthopaedics | Injuries Around Shoulder | Dye is injected in one of the extremities in a child and is followed by pain and swelling of upper limb, paraesthesias of fingers, stretch pain and normal peripheral pulses, management is:
A. Aspiration
B. Anti-Inflammatory
C. Observation
D. Fasciotomy
| Fasciotomy |
416c4d0a-88bc-4e9d-b634-a476f82cd5ba | ANSWER: (B) 150REF: Park 20th edition page 678"The size of the opening of mosquito net is of utmost importance- the size should not exceed 0.0475 inch in any diameter. The number of holes in one square inch is usually 150" | Social & Preventive Medicine | Entomology | Number of holes per square inch of a standard mosquito net is?
A. 100
B. 150
C. 250
D. 175
| 150 |
53349460-5ad4-4718-a18d-bf77552ef2f4 | In its secretory form, IgA is the main immunoglobulin found in mucous secretions, including tears, saliva, sweat, colostrum, and secretions from the genitourinary tract, gastrointestinal tract, prostate, and respiratory epithelium. It is also found in small amounts in the blood Ref: Ananthanarayan & Parker's textbook of microbiology 9th edition pg:97 | Microbiology | Immunology | Bronchial secretion secretes -
A. IgA
B. IgE
C. IgM
D. IgG
| IgA |
f2865a7a-d23f-4067-aef4-e3429b5edaeb | Given features suggests the diagnosis of Turner's syndrome. Turner's syndrome Most common sex chromosomal disorder in phenotypic females. Results from complete or paial loss of one X chromosome (45, XO) Features: Sho stature Coarctation of aoa Cubitus valgus Streak ovaries, infeility, amenorrhea Peripheral lymphedema at bih Low posterior hairline Webbing of neck Broad chest and widely spaced nipples | Pathology | FMGE 2019 | 16-year-old girl with sho height, amenorrhea with widely spaced nipple. Karyotyping is;
A. 45 X0
B. 46 XO
C. 47 XXX
D. 46XY
| 45 X0 |
4391b5ba-bb1c-4121-bb8c-3ef74e72df85 | The probable diagnosis is gout . Gout is the most common inflammatory ahritis in men and in older women. It is caused by deposition of monosodium urate monohydrate crystals in and around synol joints due to abnormal purine metabolism . Ref Davidsons 23e p1013 | Medicine | Miscellaneous | A person presented with swelling of the right 3rd toe. X ray shows deposition of multiple crystals. A defect in which of the following pathway caused the problem.
A. Purine salvage pathway
B. Uric acid pathway
C. Urea cycle
D. CORI cycle
| Uric acid pathway |
799f4b03-5e03-48b1-aa94-8028613d63b0 | Answer- A. Stool consistencyThe Bristol stool scale(Bristol stool cha (BsC)) is a diagnostic medical tool designed to classifr the form of human feces into seven categories.The seven types ofstcol areType 1 Separate hard lumps, like nuts (hard to pass); also known as goat faecesType 2: Sausage-shaped but lumpyType 3: Like a sausage but with cracks on its surfaceType 4: Like a sausage or snake, smooth and softType 5: Soft blobs with clear cut edges (passed easily)Type 6: Fluft pieces with ragged edges, a mushy stoolType 7: Watery, no solid pieces, entirely liquid | Medicine | null | Bristol cha is used fore
A. Stool consistency
B. Nocturnal enuresis
C. Mental retardation
D. Cognitive development
| Stool consistency |
12779871-da86-4049-b466-ff22fdc99569 | Middle superior alveolar nerve arise from infra orbital branch of maxillary nerve in the infra orbital groove and canal.Course of superior alveolar nerve:It is given off from the maxillary nerve just before its exit from the infra orbital foramen. It descends in a canal in the anterior wall of the maxillary sinus, and divides into branches which supply the incisor and canine teeth. It communicates with the middle superior alveolar branch, and gives off a nasal branch and supplies the mucous membrane of the anterior pa of the inferior meatus and the floor of the nasal cavity. Ref: Essentials of Anatomy By I. B. Singh, 2nd Edition, Page 391 | Anatomy | null | Middle superior alveolar nerve is a branch of which of the following nerve?
A. Facial Nerve
B. Lingual nerve
C. Maxillary nerve
D. Mandibular nerve
| Maxillary nerve |
15a49c64-0768-4b8f-a660-7a946e7d456b | Answer is option 2,beta interferon Early treatment with high-dose interferon beta-1a reverses cognitive and coical plasticity deficits in multiple sclerosis. Mori F1, Kusayanagi H, Buttari F, Centini B, Monteleone F, Nicoletti CG, Bernardi G, Di Cantogno EV, Marciani MG, Centonze D. Author information Abstract Acute inflammation is associated with cognitive deficits and alterations of coical plasticity in multiple sclerosis (MS). We tested whether early treatment with high-dose interferon (IFN) beta-1a, known to reduce inflammatory activity, improves coical function and cognitive deficits in MS. | Pharmacology | Central Nervous system | Drug of choice for relapsing remitting multiple sclerosis is:
A. Alpha IEN
B. Beta IFN
C. Gamma IFN
D. Natalizumab
| Beta IFN |
392be5ef-3e33-439d-ac4f-8512cdae8aea | Scalenus medius lies posterior to the subclan aery and thus need not be divided to expose the aery. Whereas, sternocleidomastoid & scalenus anterior lie anteriorly and omohyoid lies superiorly and thus are cut during exposure of the subclan aery. | Anatomy | null | Exposure of left subclan aery by supraclavicular approach does not require cutting of ?
A. Sternocleidomastoid
B. Scalenus anterior
C. Scalenus medius
D. Omohyoid
| Scalenus medius |
aa65a52e-e8f0-4032-a48d-53c632901d2f | The phospholipids are arranged in bilayers with the polar head groups oriented towards the extracellular side and the cytoplasmic side with a hydrophobic core (Fig. 2.4A). The distribution of the phospholipids is such that choline-containing phospholipids are mainly in the external layer and ethanolamine and serine containing phospholipids in the inner layer. The cholesterol content of the membrane alters the fluidity of the membrane. When cholesterol concentration increases, the membrane becomes less fluid on the outer surface, but more fluid in the hydrophobic core. The effect of cholesterol on membrane fluidity is different at different temperatures. At temperature below the Tm cholesterol increases fluidity and thereby permeability of the membrane. At temperatures above the Tm, cholesterol decreases fluidity.Ref: DM Vasudevan, page no: 11 | Biochemistry | membrane structure and function | Bilayer cell membrane contains
A. Cholesterol
B. Triacyl glycerol
C. Cholesterol ester
D. Glycerol
| Cholesterol |
366a082b-043e-4ba6-bb32-88aaf218f3a7 | HBeAg appears in blood concurrently with HBsAg or soon afterward. Circulating HBeAg is an indicator of active intrahepatic viral multiplication, and the presence in blood of DNA polymerase, HBV DNA and virions, reflecting high infectivity. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO-547 | Microbiology | Virology | Presence of Hbe Ag in patients with hepatitis indicates -
A. Simple carriers
B. Late convalescence
C. High infectivity
D. Carrier status
| High infectivity |
1006bf7f-3f22-4d8a-8aa9-afec553ab43d | Mc Ewan sign is seen in stage of coma of acute alcohol intoxication. Stage of coma of alcohol intoxication: In this stage, the motor and sensory cells are deeply affected, speech becomes thick and slurring, coordination is markedly affected, causing the patient to become giddy, stagger and possibly to fall. The person passes into a state of coma with steorous breathing. The pulse is rapid and temperature subnormal. The pupils are contracted, but stimulation of the person, e.g., by pinching or slapping, causes them to dilate with slow return (Mc Ewan Sign). Ref: The Essentials of Forensic Medicine and Toxicology by KS Narayan Reddy, 27th edition, Page 502. | Forensic Medicine | null | A patient in emergency depament shows Mc Ewan sign. This sign is positive in the following condition:
A. Cyanide poisoning
B. Alcoholism
C. Lead
D. Arsenic poison
| Alcoholism |
27394771-575e-4b40-8dca-c30c4074bd9d | Chr. Lead poisoning = Plumbism = Saturnism = Saturnine poisoning- ALA in urine, Coproporphyrin in urine, facial pallor, Basophilic stippling/Punctate basophilia (dark blue, pin-head spots in cytoplasm of RBCs), Buonian line (blue line gums' margin, PbS, 50-70% cases, near carious/diy teeth, Lead palsy, Pb encephalopathy, wrist drop, foot drop, Colic, Constipation, Menstrual irregularity, Sterility, Nephropathy, X-ray- radio-opaque bands at metaphyses of long bones, Pb >0.03mg% in blood is diagnostic.) Ref: Krishnan vij Textbook of Forensic Medicine and Toxicology; 5th ed; Page no: 469 | Forensic Medicine | All India exam | Buonian line is seen in poisoning
A. Lead
B. Arsenic
C. Copper
D. Silver
| Lead |
ccafccc7-f95a-47ac-9e4a-0d75ddb0f53a | Avascular necrosis is an infarction of bone that is associated with (1) long-term corticosteroid use, such as in patients with systemic lupus erythematosus (most common cause), (2) sickle-cell disease, (3) trauma, (4) Legg-Perthes disease, or (5) Kienbock disease involving the scaphoid (navicular) bone. OsgoodSchlatter dis ease is a localized inflammation that produces pain in the tibial tuberosity at the point of attachment of the patellar tendon, which results in prominence of the tibial tuberosity that persists throughout life. It usually occurs during the pubertal growth spurt and is not an example of avascular necrosis. | Unknown | null | Avascular necrosis of bone is LEAST likely to be associated with?
A. Osgood -Schlatter disease
B. Legg-Perthes disease
C. Long-term use of corticosteroids
D. Sickle-cell disease
| Osgood -Schlatter disease |
64900aa6-187d-416d-b9a3-72130b15da19 | Fasciculations are the characteristic feature of depolarising block. Succinylcholine is the depolarising muscle relaxant. d-tubocurare, vecuronium and pancuronium are the non-depolarising muscle relaxants. | Anaesthesia | Muscle relaxants | Fasciculation are caused by
A. Suxamethonium
B. Pancuronium
C. d-TC
D. Vecuronium
| Suxamethonium |
5d4b6b3c-5011-4173-af56-41527e98baeb | - Amongst the choices, third generation is most effective with a failure rate of only 0.2/HWY. PEARL INDEX OF DIFFERENT CONTRACEPTIONS: Male condoms 2-14 / HWY Female condoms 5-21 / HWY Centchroman 1.84 - 2.84 /HWY OCPs 0.1 - 2 /HWY Sterilization 0.1 / HWY Vaginal sponge 9-20 / HWY | Social & Preventive Medicine | Natural Methods, Barrier Methods, IUDs, OCPs | The most effective contraceptive available is:
A. Combined Oral contraceptive pill
B. Progestin injectable
C. Third generation IUCD
D. Centchroman
| Third generation IUCD |
01b716d6-07e8-49a1-a842-eb6249287249 | The area postrema (AP) has been implicated as a chemoreceptor trigger zone for vomiting (emesis) for over 40 years. The AP is located on the dorsal surface of the medulla oblongata at the caudal end of the fourth ventricle. It is one of the so-called circumventricular organs that serve as an interface between the brain parenchyma and the cerebrospinal fluid (CSF)- containing ventricles. The AP lacks a specific blood-brain diffusion barrier to large polar molecules (i.e., a “blood-brain barrier”) and is thus anatomically positioned to detect emetic toxins in the blood as well as in the CSF.
The NTS (nucleus of the solitary tract) may serve as the beginning of a final common pathway by which different emetic inputs trigger vomiting. | Physiology | null | Vomiting centre is situated in which part of brain?
A. Hypothalamus
B. Amygdala
C. Pons
D. Medulla
| Medulla |
b3bc881c-8105-4170-ae1f-b1718551862c | MANIPULATION
Powder/liquid system:
Powder/liquid ratio - 4:1 to 6:1 by weight.
The bottles are shaken gently. Measured quantity of powder and liquid is dispensed onto a cool glass slab. The bulk of the powder is incorporated into the liquid and spatulated thoroughly in a circular motion with a stiff bladed stainless steel spatula. Zinc oxide eugenol exhibits pseudothickening. Although it appears to thicken early during spatulation, further vigorous spatulation or stropping loosens the mix. Smaller increments are then added, until the mix is complete.
For temporary restorations, a thick putty-like consistency is recommended.
Oil of orange is used to clean eugenol cement from instruments.
Reference – Manappallil p; 101 | Dental | null | A 41 year old male complains of pain in lower right back tooth region. Intraoral examination reveals deep caries in relation to 47 and IOPA examination reveals deep dentinal caries not involving the pulp. Dentist excavates the caries and restored it with zinc oxide eugenol. Which of the following substance can be used to clean this cement from the instruments?
A. Essential oil
B. White rosin
C. Clove oil
D. Oil of orange
| Oil of orange |
84005893-dc82-4db3-bbb5-1cb3b0728506 | The inheritance of a number of birth defects is multifactorial. Most normal human traits are inherited neither as dominant nor as recessive mendelian attributes, but rather in a more complex manner. For example, multifactorial inheritance determines intelligence, height, skin color, body habitus, and even emotional disposition. Similarly, most of the common chronic disorders of adults represent multifactorial genetic diseases and are well known to "run in families." Such maladies include diabetes, atherosclerosis, and many forms of cancer and arthritis, and hypertension. The inheritance of a number of birth defects is also multifactorial (e.g., cleft lip and palate, pyloric stenosis, hypospadias, and congenital heart disease). The concept of multifactorial inheritance is based on the notion that multiple genes interact with various environmental factors to produce disease in an individual patient. Such inheritance leads to familial aggregation that does not obey simple mendelian rules (see choices A, B, D, and E). As a consequence, the inheritance of polygenic diseases is studied by the methods of population genetics, rather than by the analysis of individual family pedigrees.Diagnosis: Hypospadias, multifactorial inheritance | Pathology | Genetics | The parents of a 2-year-old boy with hyposadias (urethra opens on the ventral aspect of the penis) visit a genetic counselor to discuss the chances that a similar birth defect will occur in their future offspring. This birth defect shows which of the following patterns of inheritance?
A. Autosomal recessive
B. Autosomal dominant
C. Multifactorial
D. X-linked dominant
| Multifactorial |
87587a99-b0fc-4e4b-bdef-8b205b43cd25 | Ileal (Meckel) diverticulum, which is an outpouching of the distal ileum, is twice as prevalent in males as in females. The diverticulum is clinically important because ulceration of the diverticulum with pain, bleeding, perforation, and obstruction is a complication that may require emergent surgery. Signs and symptoms frequently mimic appendicitis or peptic ulcer. Internal hemorrhoids are thrombosed tributaries of the middle rectal vein, which can prolapse into the anal canal. External hemorrhoids are thrombosing in the veins of the external rectal venous plexus. Diverticulosis is ordinarily an outpouching of the wall of the large intestine. This primarily affects the aged and does not cause bleeding in most cases. Borborygmi are sounds created by gas and intestinal contents as they pass through the gastrointestinal tract. | Anatomy | Abdomen & Pelvis | A 12-year-old male is admitted to the hospital with profuse rectal bleeding but appears to be free of any associated pain. Which of the following is the most common cause of severe rectal bleeding in the pediatric age group?
A. Internal hemorrhoids
B. External hemorrhoids
C. Diverticulosis
D. Ileal (Meckel) diverticulum
| Ileal (Meckel) diverticulum |
34cc11bd-e64a-4991-b4b7-a481822262ec | Ref BDC volume3,6th edition pg 76Nasolacrimal duct begins at the lower end of the lacrimal sac, runs downwards, backward and laterally and opens into the inferior meatus of the nose.A fold of mucous membrane called hasners valve forms an imperfect valve at the lower end of the duct. | Anatomy | Head and neck | Valve of Hasner
A. Opening of nasolacrimal duct
B. Sphenoidal sinus opening
C. Frontal sinus opening
D. Ethmoidal sinus opening
| Opening of nasolacrimal duct |
383d1aef-cfed-431c-8565-49cefcc38de4 | Ans. is 'c' i.e., Maceration Dead born : A deadborn child is one which has died in utero and shows one of the following signs after it is completely born :? 1) Rigor mois : Rigor mois may occur in dead fetus before bih or at bih. 2) Maceration : Maceration is a process of aseptic autolysis. It occurs when a dead fetus remains in the uterus for 3-4 days surrounded by liquor amnii but with exclusion of air. Skin slippage is the earliest sign (occurs within 12 hours). There is gas in the great vessels and chambers of hea (Robe's sign). Except for lung and uterus, which remain unchanged for a long time, all other organs become soft, oedematous and loose there morphology. The one impoant radiological sign suggestive of maceration is 'Spaulding's sign' i.e. skull bones override each other. The smell is somewhat rancid. 3) Putrefaction (decomposition) : If the membranes are ruptured after death of fetus and air gains entry into liquor amnii, fetus undergoes putrefaction instead of maceration. Body is greenish, foul smelling and bloated. 4) Mummification : It results when there is deficient blood supply, scanty liquor and no air enters uterus. Body is thin, shrivelled dark brown and emitting smell like rotten cheese. | Forensic Medicine | null | Spalding sign is seen in ?
A. Drowning
B. Mummification
C. Maceration
D. Starvation
| Maceration |
bfb91821-247c-4b72-9e59-733abf763553 | - the case in tuberculosis is defined as the one in which sputum positive for acid fast bacilli is detected. Reference: Park's textbook of preventive and social medicine, 23rd edition, pg no:182 <\p> | Social & Preventive Medicine | Communicable diseases | A 'case' in TB is defined as -
A. X-ray positive
B. Culture positive
C. Sputum AFB positive
D. Tuberculosis positive
| Sputum AFB positive |
d18f9c3b-015e-45f7-949f-96f6043e32cd | Dukes' classification was originally described for rectal tumours but has been adopted for histopathological repoing of colon cancer as well. Dukes' classification for colon cancer is as follows: A: confined to the bowel wall; B: through the bowel wall but not involving the free peritoneal serosal surface; C: lymph nodes involved.Dukes himself never described a D stage, but this is often used to describe either advanced local disease or metastases to the liver.Dukes classified carcinoma of the rectum into three stages: A: The growth is limited to the rectal wall (15%); prognosis excellent. B: The growth is extended to the extrarectal tissues, but no metastasis to the regional lymph nodes (35%): prognosis reasonable. C: Secondary deposits in the regional lymph nodes (50%); prognosis is poor. These are subdivided into C1, in which the local pararectal lymph nodes alone are involved, and C2, in which the nodes accompanying the supplying blood vessels are implicated up to the point of division.A stage D is often included, which was not described by Dukes which signifies the presence of widespread metastases, usually hepatic.Reference : page 1180 and 1230 Bailey and Love's sho practice of surgery 25th edition | Surgery | Urology | Dukes classification is used for
A. Pancreas carcinoma
B. Gastric carcinoma
C. Urinary bladder carcinoma
D. Colo-rectal carcinoma
| Colo-rectal carcinoma |
75faa606-cda7-463e-b281-90acfa606785 | Given features suggests the diagnosis of Turner's syndrome. Turner's syndrome Most common sex chromosomal disorder in phenotypic females. Results from complete or paial loss of one X chromosome (45, XO) Characterized by hypogonadism in phenotypic females. | Pathology | Genetics | A 19-year-old female with sho stature, wide spread nipples and primary amenorrhea most likely has a karyotype of: (AI 2003)
A. 47, XX + 18
B. 46, XXY
C. 47, XXY
D. 45 X0
| 45 X0 |
bdf3d8c0-f7a8-4ca7-a53b-fabd67836774 | Ans. is 'a' i.e., DNA dependent RNA polymerase The major enzyme involved in transcription (i.e. synthesis of DNA to RNA) is RNA polymerase.It is DNA dependent RNA polymerase.DNA dependent DNA polymerase DNA plymerase (In DNA replication)DNA dependent RNA polymerase - RNA polymerase (In transcription)RNA dependent DNA polymerase -> Reverse transcripatase (In reverse transcription) | Biochemistry | null | RNA polymerase is
A. DNA dependent RNA polymerase
B. RNA dependent DNA polymerase
C. DNA dependent DNA polymerase
D. RNA dependent RNA polymerase
| DNA dependent RNA polymerase |
f40e6647-478c-47e4-a766-b300e3f97823 | Ans. (a) Papillary cancerRef: Page 765. Bailey and love 26th edition* Lateral aberrant thyroid is a metastatic node from papillary cancer which is not palpable | Surgery | Thyroid Gland | Lateral aberrant thyroid is node from
A. Papillary cancer
B. Follicular cancer
C. Thyroid lymphoma
D. Medullary cancer
| Papillary cancer |
197a89cf-e96f-46d4-8c94-cb20c8754973 | Ref: Katzung, 14th ed. pg. 960; KDT, 6th ed. pg. 820* Mercaptopurine is synthetic purine used in cancer chemotherapy.* Use: Childhood acute leukemia. | Pharmacology | Anti-Cancer | Mercaptopurine is
A. Purine analogue
B. Nucleoside analogue
C. Pyrimidine analogue
D. Anti tumor antibiotics
| Purine analogue |
661fc876-212c-42ba-a914-007b8ae89639 | Surveillance after treatment
Clinical surveillance of cases after completion of treatment is an important part of the current recommendations for multidrug therapy.
It is essential for the assurance of the long-term success of treatment and for the early detection of any relapses.
The recommendations are -
i) Paucibacillary leprosy → clinical examination at least once a year for a minimum period of 2 years after completion of treatment.
ii) Multibacillary leprosy → clinical examination at least once a year for a minimum period of 5 years after completion of treatment. | Dental | null | In multibacillary leprosy, the follow-up examination after adequate treatment should be done yearly for –
A. 3 years
B. 3 years
C. 5 years
D. 10 years
| 5 years |
9c943635-033a-480d-9b6d-e0c7f1dbf1ad | Macrophages release IL-1 which stimulates the T-helper cells.
The T-cells in response proliferate and release IL-2 which in turn stimulates still further T-cell proliferation and B cell proliferation and differentiation into plasma cells.
Thus
Macrophages release→IL-1*
T-helper cells release→ IL-2* | Pathology | null | Interleukin secreted by macrophages, stimulating lymphocytes is:
A. IL-1
B. INF alpha
C. TNF alpha
D. IL-6
| IL-1 |
9794cb0c-3082-4730-a5eb-abe42042eb3d | Acute hemorhagic conjunctivitis is caused by Enterovirus 70. REF:ANATHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO:493 | Microbiology | Virology | Which of the following is associated with acute hemorrhagic conjunctivitis -
A. Rhabdovirus
B. Enterovirus
C. Calcivirus
D. Echovirus
| Enterovirus |
fcf32c18-a61e-4426-9abc-1d9f396edba6 | Glasgow Outcome Score (GOS)Good recovery 5Moderate disability 4Severe disability 3Persistent vegetative state 2Dead 1Bailey and Love 26e pg:320 | Surgery | Trauma | In traumatic brain injury, Glasgow outcome score of 4 stands for
A. Good recovery
B. Moderate disability
C. Severe disability
D. Persistent vegetative state
| Moderate disability |
ce38f74a-885f-467e-a26b-ec8bfae33bb0 | In chronic disease the mitral valve is viually always involved. The mitral valve is affected in isolation in roughly two thirds of RHD, and along with the aoic valve in another 25% of cases. Tricuspid valve involvement is infrequent, and the pulmonary valve is only rarely affected. | Pathology | Rheumatic Fever | Which of the following cardiac valves is not commonly involved in rheumatic fever?
A. Mitral
B. Aoic
C. Pulmonary
D. Tricuspid
| Pulmonary |
05902eb4-3f22-47d9-84fd-79c9d0da9a8a | Ans. (B) Pelvis"Krogman's degree of accuracy"The accuracy of estimating the sex from skeletal remains depends upon the number of bones available.If the entire skeleton is available, the accuracy is 100%;Pelvis alone is available, it is 95%Skull alone, it is 90%Skull + pelvis, the accuracy is 98% | Forensic Medicine | Law & Medicine, Identification, Autopsy & Burn | Which of the below given bone is best suitable for sex determination
A. Skull
B. Pelvis
C. Femur
D. Tibia & Fibula
| Pelvis |
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