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1301534f-397c-49c9-a09d-b4d04770bc3d | Most fibers from the lateral geniculate nucleus (LGN) end in layer 4 of the primary visual coex. Ref: Ganong's Review of Medical Physiology, 22nd Edition, Page 161; Berne and Levy Physiology, 5th Edition, Page 129. | Physiology | null | Most affernt fibers from the lateral geniculate nucleus terminate in the primary visual coex is:
A. Layer 1
B. Layer 2 and 3
C. Layer 4
D. Layer 5 and 6
| Layer 4 |
21b58724-2e4c-4a78-86f0-401280e11c97 | Ans. is 'c' i.e., Aspergillus Diagnosis of Aspergillus infection: o Histologic examination of affected tissue reveals either infarction, with invasion of blood vessels by many fungal hvphae, or acute necrosis, with limited inflammation and hyphae. o Aspergillus hyphae are hyaline, narrow, and septate, with branching at 45deg: no yeast forms are present in infected tissue. o Hyphae can be seen in cytology or microscopy preparations, which therefore provide a rapid means of presumptive diagnosis. | ENT | Head & Neck Infections | A diabetic with orbital cellulitis and maxillary sinusitis shows hyaline, narrow, septate and ranching hyphae with invasion of the blood vessels fungus on microscopy. Which is the causative fungus ?
A. Candida
B. Rhizospora
C. Aspergillus
D. Histoplasma
| Aspergillus |
4305dbde-56fb-4145-9478-4392cd99c850 | As dura is not punctured in epidural anesthesia, chances of postdural puncture headache, meningitis and arachnoiditis are less. | Anaesthesia | null | Epidural anaesthesia decrease risk of – a) Headacheb) Hypotensionc) Meningitisd) Arachnoiditis
A. abc
B. ad
C. bc
D. acd
| acd |
0fb4c8ba-06e5-40bc-bb6f-7d42cbba6df0 | Biochemical functions of Vitamin K The functions of vitamin K are concerned with blood clotting process. lt brings about the post- translational (after protein biosynthesis in the cell) modification of ceain blood clotting factors. The clotting factors ll (prothrombin), Vil, lX and X are synthesized as inactive precursors (zymogens) in the liver. Vitamin K acts as a coenzyme for the carboxylation of glutamic acid residues present in the proteins and this reaction is catalysed by a carboxylase (microsomal). lt involves the conversion of glutamate (Clu) to y-carboxyglutamate (Gla) and requires vitamin K, O2 and COz. The formation of y-carboxyglutamate is inhibited by dicumarol, an anticoagulant found in spoilt sweet clover. Warfarin is a synthetic analogue that can inhibit vitamin K action Vitamin K is also required for the carboxylation of glutamic acid residues of osteocalcin, a calcium binding protein present in the bone. The mechanism of carboxylation is not fully understood. lt is known that a 2,3-epoxide derivative of vitamin K is formed as. an intermediate during the course of the reaction. Dicumarol inhibits the enzyme (reductase) that conves epoxide to active vitamin K. Ref : Biochemistry by U. Satyanarayana 3rd edition Pgno : 130 | Biochemistry | All India exam | Gamma Carboxylation of what requires vitamin K
A. Glutamine
B. Glutamic Acid
C. Glycine
D. Aspaate
| Glutamic Acid |
a20b05b3-292f-4d3f-8c37-6a750c56f54c | Ans is 'b' i.e. Dermatitis herpetiformis o Among given options only dermatitis herpetiformis is a gluten sensitivity disorder and aggravates on on eating gluten (wheat, rye, barley).Other features in favour of diagnosis areo Intense itching (characteristic feature)o Distribution of lesion - buttock, trunk and scalpo Age group - DH is commonly seen in 2nd to 3rd decade.o Has been explained in previous sessions. | Skin | Eosinophilic Dermatoses | 12 years old male presented with intensely itchy grouped vesicles on buttock, trunk and scalp. On exposure to wheat they exaggerate. Diagnosis is -
A. Herpes simplex
B. Dermatitis herpetiformis
C. Pemphigus vulgaris
D. Bullous impetigo
| Dermatitis herpetiformis |
fcb3a478-0394-4019-a961-895418c7baf1 | Ans. is 'a' i.e., Lower border of LI * Spinal cord begins at foramen magnum and, in adults, ends at lower border of LI.StructureExtends uptoAdult spinal cordInfant spinal cordLower border of L} or upper border of L2Upper border of L3 vertebraeFilum terminalePiamaterTip of coccyxDural sheathSubdural spaceSub arachnoid spaceS2 vertebra | Anatomy | Neuroanatomy | What is the extent of spinal cord in an adult?
A. Lower border of L1
B. Tip of Coccyx
C. Upper border of L3
D. S2
| Lower border of L1 |
baecb9cc-1a82-4b24-b4bf-039591c233b1 | HBV-DNA can be measured by PCR in the blood. Viral loads are usually in excess of 105 copies/mL in the presence of active viral replication, as indicated by the presence of e antigen. In contrast, in individuals with low viral replication, who are HBsAg- and anti-HBe-positive, viral loads are less than 105 copies/mL. The exception is in patients who have a mutation in the pre-core protein, which means they cannot secrete e antigen into serum . Such individuals will be anti-HBe-positive but have a high viral load and often evidence of chronic hepatitis. These mutations are common in the Far East, and those patients affected are classified as having e antigen-negative chronic hepatitis. They respond differently to antiviral drugs from those with classical e antigen-positive chronic hepatitis. Measurement of viral load is impoant in monitoring antiviral therapy and identifying patients with pre-core mutants. Specific HBV genotypes (A-H) can also be identified using PCR. In some settings, these may be useful in guiding therapy, as genotype A tends to respond better to pegylated interferon-alfa compared to genotypes C and D. Ref Davidson edition23rd pg 875 | Medicine | G.I.T | The following is a marker of acute hepatitis B infection-
A. DNA polymerase
B. Hepatitis core antigen
C. Anti HBs
D. IgG to core antigen
| DNA polymerase |
84ccdd2e-85e7-4cf7-8ddc-06df9ccf024a | Criteria of screening test
Acceptability – The test should be acceptable to population to which it is going to be applied.
Repeatability (reliability, precision, reproducibility) – The test must give consistent results when repeated more than once on the same individual or material under the same condition.
Validity (accuracy) – It refers to what extent the test accurately measures which it purports to measure. (it means it expresses the ability of a test to separate or distinguish those who have the disease from those who do not). Accuracy refers to closeness with which measured values agree with “true” value.
It has two components:
i. Sensitivity – Ability of test of identify correctly all those who have disease.
ii. Specificity – Ability to test to identify correctly all those who do not have disease.
So, if test gives the same reading for a sample on repeated testing means test is precise (i.e., reliable, reproducible, repeatable). | Dental | null | If a biochemical test gives the same reading for a sample on repeated testing, it is inferred that the measurement is:
A. Precise
B. Accurate
C. Specific
D. Sensitive
| Precise |
54fa918b-28dd-4e10-8f60-d76dea9266cc | Gantacurium represents a new class of nondepolarizing neuromuscular blockers called asymmetric mixed-onium chlorofumarates. Ref: Miller's anesthesia-7th ed , Chapter 29. | Anaesthesia | null | Example of asymmetric mixed-onium chlorofumarate is:
A. Rocuronium
B. Vecuronium
C. Gantacurium
D. Atracurium
| Gantacurium |
c7c86bc0-c79c-4afc-b2e7-1e08bb0e507e | The optic cup and its derivatives--the retina and optic nerve--develop from the diencephalon. | Anatomy | Eye, Nose and Ear | The optic cup is an evagination of which of the following?
A. Telencephalon
B. Diencephalon
C. Mesencephalon
D. Metencephalon
| Diencephalon |
afd86569-9254-475f-be0f-d6c8db0a29f1 | "High-dose penicillin G and clindamycin, along with third-generation cephalosporins, should be given intravenously until the patient's toxicity abates. The mainstay of management is early surgical excision of the necrotic tissue " Bailey and love 26th edition Pg 430 | Surgery | General surgery | Best treatment for gas gangrene
A. Surgical debridement
B. Debridement with tetanus toxin
C. Debridement with iv penicillin
D. Debridement with polyvalent antitoxin
| Debridement with iv penicillin |
8356d9a0-27b4-4931-9f3f-0953c5ca0887 | Ans. is 'b' i.e., a, b, g o Radium emits a, b and g rays. Radium also produces neutrons when mixed with beryllium. | Radiology | Physics of Radiotherapy | Radium emits which of the following?
A. b, g
B. a, b, g
C. a, b
D. Neutrons
| a, b, g |
59b9cdbb-7839-4348-9985-2d19d0726e8b | Flumazenil is absorbed orally ;oral bioavailability is ~16% but its not used orally .On I.v .injection ,action of flumazenil stas in seconds &last for 1-2 hours ;elimination t1/2 is 1 hour due to rapid metabolism. REF: KD Tripathi 8th ed. | Pharmacology | Central Nervous system | Duration of action of flumazenil is:
A. 5 minute
B. 10 minute
C. 20 minute
D. 1-2 hours
| 1-2 hours |
29a59fba-6225-4d49-a0cc-ffc1324506f8 | Ans. is 'a' i.e., Renal transplant recipientPredisposing factors of cryptococcal meningitis are AIDS, hematologic malignancies, transplant recipients and patients on immunosuppressive or steroid therapy. | Microbiology | Mycology | Cryptococcal meningitis is common in:
A. Renal transplant recipient
B. A gamma globulinemia
C. Neutropenia
D. IgA deficiency
| Renal transplant recipient |
0ad73f37-daf5-4eb9-877e-ba9d75a05e5a | Option 4 is correct=the number of mitosis per high power field Leiomyosarcomas typically take the form of soft, hemorrhagic, necrotic masses. The diagnostic features of ove leiomyosarcoma include tumor necrosis, cytologic atypia, and mitotic activity. Robbins basic pathology 9th edition page no 694,heading=leiomyosarcomas..box=Morphology ref img | Pathology | Breast | With regard to the malignant behavior of leiomyosarcoma, the most impoant criterion is
A. Blood vessel penetration by tumor cells
B. Tumor cells in lymphatic channels
C. Lymphocyte infiltration
D. The number of mitoses per high power field
| The number of mitoses per high power field |
b3d0114f-293f-4a86-bd39-fc55069b4f7e | Ans is 'a' ie Ca Colon Radioimmunoguided surgery (RIGS) is a new technology capable of detecting minimal neoplastic lesions using radiocolloids, intraoperatively. It has numerous uses in oncology, it uses colloid radiotracers, monoclonal antibodies or non-immunological tracers. Its uses are Radioguided Occult Lesion Localization (ROLL) and Sentinel Lymph-Node Biopsy (SLNB).The malignancies mentioned in the above given web addresses of Pubmed, in which RIGS is being used are:Breast cancerColorectal cancerNon-small cell lung cancer | Surgery | Colon and Rectum - Polyps and Carcinoma | In which case Immunoguided surgery is done
A. CA colon
B. CA pancreas
C. CA jejunum
D. CA anal canal
| CA colon |
b396b65b-e4bf-4db9-9270-4c5d317a4af2 | Ans. is 'd' i.e., Bone marrow * In multiple myeloma plasma cells can infiltrate the bone marrow diffusely or may be present in sheet like masses that completely replace normal elements.* Plasma cells may be normal plasma cells but mostly they are atypical plasma cells (variants of plasma cell) produced by intracellular accumulation of intact or partially degraded immunoglobulins. These atypical plasma cells are :i) Flame cellsii) MOTT cells* Intracellular inclusions are Russel bodies (cytoplasmic), Dutcher bodies (nuclear), crystalline rods and fibrils.* Dutcher bodies, which are attributed to immunoglobulin filled cytoplasm invaginating into the nucleus creating the appearance of an intranuclear inclusion. | Pathology | Blood | Dutcher bodies are seen in?
A. Brain
B. Liver
C. Spleen
D. Bone marrow
| Bone marrow |
8ba14fb8-4711-4acd-8362-fe2ac5d583f7 | Ans. is 'b' i.e., SurgeryPlacental Site Trophoblastic TumorArises from the placental bed trophoblasts and invades the myometrium.Most of these tumors run a benign course, malignancy is rare.Tumor is resistant to chemotherapy.Hysterectomy is the recommended treatment. | Gynaecology & Obstetrics | null | Treatment of choice for placental site trophoblastic disease is -
A. Observation
B. Surgery
C. Chemotherapy
D. Radiotherapy
| Surgery |
3dce91ab-2d5c-4ba2-a16f-85047dca6cf4 | Ans. is 'd' i.e., ng/ml Prostate specific antigen* It is a glycoprotein produced only in the prostatic cells (both benign & malignant). It facilitates liquefaction of semen.* It is neither sensitive nor specific for early prostate carcinoma (it is prostate specific and not prostate cancer specific)y nevertheless it gives some help in making a diagnosis.# Normal serum level - less than 4 ng/ml# 4-10 ng/ml - this range is common for both BHP and Ca.# More than 10 ng/ml - approx 75% will have cancer.* Since PSA is not specific for Ca, PSA Velocity & PSA density are used to detect Prostate cancer.* PSA velocity is the rate of change in PSA levels over time and is expressed most commonly as the PSA doubling time. For men with a PSA above 4, PSA velocity of more than .75 ng/ml year is suggestive of Ca. While for those with lower PSA levels, rates above 0.5 ng/mL per year should be used to advise biopsy.* PSA density is calculated by dividing the serum PSA by the estimated prostate weight (measured by TRUS). It was developed to correct for the contribution of BPH to the total PSA level.# Values <0.10 are consistent with BPH.# >0.15 suggest cancer | Surgery | Prostate & Seminal Vesicles | PSA is measured in which units
A. gm/ml
B. mg/ml
C. mcg/ml
D. ng/ml
| ng/ml |
387a397a-b143-40af-9633-1b2f94991ac7 | Angle’s postulate was that the upper first molars were the key to occlusion and that the upper and lower molars should be related so that the mesiobuccal cusp of the upper molar occludes in the buccal groove of the lower molar. If the teeth were arranged on a smoothly curving line of occlusion and this molar relationship existed , then normal occlusion would result.
Angle then described three classes of malocclusion, based on the occlusal relationships of the first molars:
Class I: Normal relationship of the molars, but line of occlusion incorrect because of malposed teeth, rotations, or other causes.
Class II: Lower molar distally positioned relative to upper molar, line of occlusion not specified.
Class III: Lower molar mesially positioned relative to upper molar, line of occlusion not specified.
Reference: Contemporary orthodontics, Proffit 6th ed page no 2 | Dental | null | In Angle's classification for malocclusion, key tooth is:
A. MB cusp of Permanent Max. 1st molar
B. DB cusp of Permanent Max. 1st molar
C. MB cusp of Permanent Max. 2nd molar
D. MB cusp of Permanent Mand. 1st molar
| MB cusp of Permanent Max. 1st molar |
487bedd7-1bd7-4fda-a516-b9dbd60dda9a | Ans. A. Delusion of persecution Delusion of persecution is the most common type of persistent delusional disorder. | Psychiatry | null | Which is the most common type of persistent delusional disorder ?
A. Delusion of persecution
B. Somatic delusion
C. Delusion of jealousy
D. Delusion of grandeur
| Delusion of persecution |
301be874-e1b4-469c-89ee-f44aa1fee33b | Ref Robbins 8/e 118-119 ; 9/e p 119 Physiologic Effects of Vitamin K Vitamin K serves as an essential cofactor for a carboxylase that catalyzes carboxylation of glutamic acid residues on vitamin K-dependent proteins. The key vitamin K-dependent proteins include: Coagulationproteins: factors II (prothrombin), VII, IX and X. | Anatomy | General anatomy | Vitamin k associated clotting factors are
A. 9,10
B. 1,5
C. 7,8
D. 1,81
| 9,10 |
152bf82f-5a4d-4ddd-8bbe-e2af0e936b49 | Ans. a (Entacapone) (Ref. KDT 6th/pg. 415)ADRENERGIC DRUGSSr NoStep/siteActionDrugResponse1.Synthesis of NAInhibition Utilization of same synthetic pathwaya-methyl-p-tyrosine a-methyl dopaDepletion of NAReplacement of NA by a-methyl NA(false transmitter)2.Axonal uptakeBlockadeCocaine, desipra- mine, guanethidine, antihistaminics, ephedrinePotentiation of NA (endo- and exogenous), inhibition of tyramine3.Granular uptakeBlockadeReserpineDepletion of NA (degraded by MAO)4.Nerve impulse coupled release of NAInhibitionGuanethidine, bretyliumLoss of transmission5.Granular NADisplacementGuanethidineInitially sympathomimetic, depletion later.6.Membrane NA poolExchange diffusionTyramine, ephedrineIndirect sympathomimetic7.MetabolismMAO inhibition COMT inhibitionNialamid tranylcy- promine Tolcapone, entacaponePotentiation of NA (slight),| Of tyramine (marked) Potentiation of NA (slight)8.ReceptorsMimickingPhenylephrine Clonidinea1 sympathomimetica2-inhibition of NA release, |sympathetic outflow IsoprenaiineSalbutamolb1+ b2 - sympathomimeticb2-sympathomimetic BlockadePhenoxybenzaminePrazosinYohimbinePropranololMetoprolola1 + a2 - blockadea1- blockadea2 - blockadeb1 + b2 - blockadeb1 - blockadePergolidePergolide, another ergot derivative, directly stimulates both D1 and D2 receptors.It too has been widely used for parkinsonism, and comparative studies suggest that it is more effective than bromocriptine in relieving the symptoms and signs of parkinsonism, increasing "on-time" among response fluctuators, and permitting the levodopa dose to be reduced.PramipexolePramipexole, which is not an ergot derivative, has preferential affinity for the D3 family of receptors. It is effective when used as monotherapy for mild parkinsonism.RopiniroleRopinirole, another nonergoline derivative, is a relatively pure D2 receptor agonist that is effective as monotherapy in patients with mild disease and as a means of smoothing the response to levodopa in patients with more advanced disease and response fluctuations.RasagilineRasagiline, another monoamine oxidase B inhibitor, is more potent than selegiline in preventing MPTP- induced parkinsonism and is currently under study as a neuroprotective agent.TolcaponeSelective COMT inhibitors such as tolcapone and entacapone also prolong the action of levodopa by diminishing its peripheral metabolism. | Pharmacology | C.N.S | Anti-parkinsonism drug that is selective COMT inhibitor?
A. Entacapone
B. Ropinirole
C. Pergolide
D. Pramipexole
| Entacapone |
9a580e1a-b525-4a65-9935-a0619feb7d29 | Insulin- A polypeptide hormone secreted by the islets of Langerhans and functioning in the regulation of the metabolism of carbohydrates and fats, especially the conversion of glucose to glycogen, which lowers the blood glucose level.Ref: Ganong&;s review of medical physiology; 24th edition; page no: 431 | Physiology | Endocrinology | Hormone synthesized as peptide precursor is/are
A. Insulin
B. PTO
C. Renin
D. Thyroid hormone
| Insulin |
64907cdc-3ef0-475b-b78b-2633c05c2711 | HUMAN EMBRYOLOGY-INDERBIR SINGH TENTH EDITION-PAGE NO:188Caecum and appendixThe caecal bud is a diveiculum that arises from the post aerial segment of the midgut Loop. The caecum and appendix are formed by the enlargement of this bud. The proximal pa of the bud grows rapidly to form the caecum. Its distal pa remains narrow and forms the appendix | Anatomy | General anatomy | The derivative of midgut among the following is
A. Rectum
B. Appendix
C. Liver
D. Stomach
| Appendix |
6f15d9bf-48c6-4a16-af29-9c6e865e48b4 | Ans. C Collecting tubule and ductRef: BDC, 6th ed. vol. II pg. 315-16* The kidney consists of an outer renal cortex and an inner renal medulla that contains the renal pyramids which drain into - Calyx - Pelvis.* Cortex forms a continuous smooth outer zone with a number of projections (cortical columns) that extend down between the pyramids.* It contains the renal corpuscles and the renal tubules except for parts of the loop of Henle which descend into the renal medulla. It also contains blood vessels and cortical collecting ducts.* The renal cortex is the part of the kidney where ultrafiltration occurs. | Anatomy | Abdomen & Pelvis | Kidney cortex contains:
A. Loop of henle
B. Pyramids
C. Collecting tubule and duct
D. Calyces
| Collecting tubule and duct |
7c49853e-b89a-4f3c-8191-83ae435071fb | Ans. is 'd' i.e., Duchenne's muscular atrophy X-linked Recessive disordersMusculoskeletalHematologicalImmuneMetabolicNervous* Duchene muscular dystrophy* Chronic granulomatous disease* Hemophilia A & B* G-6-PD deficiency* Agamma - globulinemia* Wiskott - Aldrich synd.* Diabetes insipidus* Lesch Nyhan syndrome* Fragile - X- syndrome* Colour blindnessX-linked dominant disorders* Vitamim D resistant (X-linked hypophosphatemic) Rickets.* Familial hypophosphatemia.* Incontinentia pigmenti. | Pathology | Genetics | X-linked muscular dystrophy is?
A. Myotonic dystrophy
B. Spinal muscular atrophy
C. Neurogenic muscular atrophy
D. Duchene muscular dystrophy
| Duchene muscular dystrophy |
024fa1a0-4c04-4a69-aea9-f26b971df0cb | VITREOUS LIQUEFACTION (SYNCHYSIS) Vitreous liquefaction (synchysis) is the most common degenerative change in the vitreous. Causes of liquefaction: 1. Degenerations such as senile, myopic, and that associated with retinitis pigmentosa. 2. Post-inflammatory, paicularly following uveitis. 3. Trauma to the vitreous which may be mechanical (blunt as well as perforating). 4. Thermal effects on vitreous following diathermy, photocoagulation and cryocoagulation. 5. Radiation effects may also cause liquefaction. Ref:- A K KHURANA; pg num:-244 | Ophthalmology | Vitreous and retina | Synchysis refers to
A. Collapse of the vitreous
B. Black spots in front of the eyes
C. Liquefaction of the vitreous
D. Detachment of the vitreous
| Liquefaction of the vitreous |
89801c30-6f2a-4a30-8b12-cc14876c9791 | Vitamin D from the skin or diet is metabolized primarily in the liver to 25-hydroxyvitamine D3. 25D is the 'storage' form of vitamin D and is used to determine the vitamin D status of individuals. The last and rate limiting step in the synthesis of 'active' 1,25D is catalyzed by the mitochondrial enzyme 1 hydroxylase and is conventionally known to take place in kidneys. | Biochemistry | null | Vitamin D from the skin or diet is metabolized primarily in the liver to 25-hydroxyvitamine D3. What is the rate limiting enzyme in Vitamin D synthesis?
A. 25 cholecalciferol
B. 1, 25-dihydroxycholecalciferol
C. 24, 25- dihydroxycholecalciferol
D. 7-dehydrocholesterol
| 1, 25-dihydroxycholecalciferol |
95aefc1d-3f4b-49b0-bb84-445d18d25138 | Ans. is 'a' i.e., | BT and | PTT Von willebrand diseaseo Von willebrand disease is characterized by the deficiency of vWF, while the synthesis of factor VIIIc is normal,o vWF has two major function: -i) Helps in platelet adhesionii) Stabilizes factor VIIIc.o So, deficiency of vWF results in manifestation of both.Platelet adhesion defecto Bleeding from small venules and capillaries of skin and mucous membrane e.g., epistaxis.o Menorrhagia and GI bleeding,o Proioged bleeding time (TBT)Coagulation defect (due to factor VIII dysfunction)o Bleeding into weight bearing joints.o Large post traumatic ecchymoses or hematoma,o Prolonged bleeding after any form of surgical procedure or a laceration,o Prolonged PTT.o vWF can be assayed by restocetin agglutination test which measures the ability of restocetin to promote the interaction between vWF and platelet membrane glycoprotein Ib-IX.o Von willebrand disease is of follow ing types: -Type I (most common 70%) - Autosomal dominant, with reduced quantity of vWF.Type II (25%) - Autosomal dominant, with qualitative defect of vWF.Type III - Autosomal recessive, with reduced quantify of vWF.Hemophilia A & Hemophilia B|PTT Normal BT Normal PTVon-Willebrand disease| PTT |BT Normal PTPlatelet dysfunction| BTo Bemard-soulier syndrome o Glanzmann's thrombastheniaNormal PT & PTTo ITP Henoch Schonlein purpuraNormal BT, PT & PTT | Medicine | Platelet Disorders | Features of Von Willebrand disease are -
A. | BT and | PTT
B. | PT and | PTT
C. | PT
D. | CT
| | BT and | PTT |
d237cc57-eef2-45f4-83b5-3b8b43bab93b | The design of choice for endodontic microsurgery is the sulcular full-thickness flap
The mucogingival flap or Luebke-Ochsenbein flap is preffered for crowned anterior teeth for esthetic reasons. This flap which includes scalloped horizontal incision provides a guide for meticulous repositioning of the flap.
The first known record for endodontic flaps was by Partsch. He is credited with the Partsch incision or semilunar incision. It is a submarginal curved flap. There is limited surgical access, proor wound healing, and laximum disruption of the blood supply to the adjacent tissues. | Dental | null | The design of choice for endodontic microsurgery is the:
A. Sulcular flap.
B. Sulcular partial-thickness flap.
C. Sulcular full-thickness flap.
D. Envelope flap.
| Sulcular full-thickness flap. |
6acf39b0-a165-4b78-90fe-ec999c8d0ccd | Atresia refers to defects caused by the incomplete formation of a lumen. Many hollow organs originate as strands and cords of cells whose centers are programmed to die, thus forming a central cavity or lumen. Atresia of the esophagus is characterized by partial occlusion of the lumen, which was not fully established in embryogenesis. Dysplasia (choice C) is caused by abnormal organization of cells into tissues, which is a situation that results in abnormal histogenesis. Tuberous sclerosis is a striking example of dysplasia, in which the brain contains aggregates of normally developed cells arranged into grossly visible "tubers." Ectopia (choice E) is an anomaly in which an organ is outside its normal anatomic site.Diagnosis: Esophageal atresia | Pathology | Genetics | The mother of a newborn boy is alarmed that her baby regurgitates at every feeding. An endoscopic examination reveals that the child's esophagus is almost completely occluded. This finding represents an example of which of the following errors of morphogenesis?
A. Aplasia
B. Atresia
C. Dysplasia
D. Dysraphic anomaly
| Atresia |
27a37d0c-501f-409a-a9c0-916de9b0e467 | Transthoracic echocardiography (TTE) is usually the initial investigation of suspected pericardial disease. It is cheap and widely available and has high accuracy for detecting pericardial effusions and signs of tamponade. TTE is also helpful for guiding diagnostic or therapeutic pericardiocentesis. Restricted acoustic windows limit its evaluation of the entire pericardium; loculated collections, intrapericardial blood clot, and pericardial thickening may be difficult to assess.CT and MR are indicated when TTE is inconclusive or when loculated or hemorrhagic effusion or pericardial thickening is suspectedIOC for aoic dissection-- MRI IOC for pericardial effusion= M- mode ECHOIOC for valvular disease = 2 D - ECHO IOC FOR RADIOTHERAPY CAUSED FIBROSIS= BIOPSY(Grainger and Allison&;s diagnostic radiology 6th edition, page 240) | Radiology | All India exam | Investigation of choice for pericardial effusion is
A. MRI
B. CT
C. X ray
D. Echo
| Echo |
a49d4ba7-61f5-45fc-8a8c-6a9921bd13df | Gram positive organism causing gray colored coating (pseudomembrane) is Corynebacterium diphtheriae . So the specific stain is Albe stain. Contents of Albe stain:-Stain A- glacial acetic acid, malachite green ,toluidine blueStain B- KI + I2 | Microbiology | Systemic Bacteriology (Gram Positive Bacilli, Gram Negative Bacilli) | A patient is having thick, gray coating on the throat and tonsils, followed with fever, chills and swollen glands in the neck. Microscopic examination of nasopharyngeal or pharyngeal swab showed gram positive organism with a special stain. The constitutes of the stain are:-
A. Crystal violet. Gram's iodine
B. Toluidine blue, malachite green, glacial acetic
C. Carbol fuchsin, acid alcohol, and methylene blue
D. Methylene blue
| Toluidine blue, malachite green, glacial acetic |
eaaac980-c33a-46d8-a316-02e213207922 | Femoral hernia REF: Sabiston 18th ed chapter 44 The likelihood of strangulation and need for hospitalization also increase with aging. Strangulation, the most common serious complication of a hernia, occurs in only 1% to 3% of groin hernias and is more common at the extremes of life. Most strangulated hernias are indirect inguinal hernias; however, femoral hernias have the highest rate of strangulation (15%-20%) of all hernias, and for this reason, it is recommended that all femoral hernias be repaired at the time of discovery. | Surgery | null | Hernia with highest rate of strangulation is?
A. Direct inguinal hernia
B. Indirect inguinal hernia
C. Femoral hernia
D. Incisional hernia
| Femoral hernia |
65177662-775b-4ebe-9a44-4da3b44784ad | The tumor is compressing the facial nerve, which runs through the internal acoustic meatus along with the vestibulocochlear nerve, which provides sense of taste to the anterior two thirds of the tongue via the chorda tympani and also mediates all of the facial muscles, except the muscles of mastication. The mandibular branch of the trigeminal nerve courses through the foramen ovale and mediates motor to the muscles of mastication and sensory to the lower third of the face. The maxillary branch of the trigeminal passes through the foramen rotundum and is sensory to the middle third of the face. The jugular foramen has the glossopharyngeal, vagus, and accessory nerves coursing through it. Finally, the superior orbital fissure has the ophthalmic branch of the trigeminal nerve coursing through it, along with the oculomotor, trochlear, and abducens nerves. | Anatomy | Head & Neck | A 63-year-old man with hearing loss in his left ear complains of a loss of taste and drooling from the left side of his mouth. A CT scan shows a tumor compressing the nerve entering the skull through which of the following openings?
A. Foramen ovale
B. Foramen rotundum
C. Internal acoustic meatus
D. Jugular foramen
| Internal acoustic meatus |
37e100e7-52d2-4744-aa7a-daa3992d56e0 | Patient is suffering from cavernous venous thrombosis, as a complication of chronic ethmoidal sinusitis. The facial veins make clinically impoant connections with the cavernous sinus through the superior ophthalmic veins. Cavernous sinus thrombosis usually results from infections in the orbit, nasal sinuses, and superior pa of the face. Think Detail: Cavernous sinus: is located on the side of the body of sphenoid. The cavernous sinuses consist of extradural venous plexuses surrounded by a dural fold. Structures Within its cavity Internal carotid aery Abducent nerve Carotid sympathetic plexus Lateral wall Oculomotor nerve Trochlear nerve Opthalmic division of trigeminal nerve Maxillary division of trigeminal nerve Tributaries: Anteriorly Opthalmic veins (connects with the facial vein) Posteriorly Superior petrosal sinus (connects with transverse sinus) Inferior petrosal sinus (conncets with internal juglar vein) Medially Anterior and posterior intercavernos sinuses (connects the two cavernous sinuses) Superiorly Superficial middle cerebral vein (from latwral surface of the brain) Cerebrsl veins from inferior surface of brain Cavernous sinus thrombosis (CST) is a late complication of facial or paranasal sinus infection, resulting in thrombosis of the cavernous sinus and inflammation of its surrounding anatomic structures, including cranial nerves. Clinical features: Infection of the cavernous sinus is characterized by sepsis, orbital pain, chemosis, proptosis, and ophthalmoplegia. Cavernous sinus thrombosis results in paresis of cranial nerves III, IV, and VI and the opthalmic and maxillary divisions of the cranial nerve V. The diagnosis is based primarily on clinical data. CT and MR imaging can provide diagnostic information.Treatment is with broad spectrum antibiotics and should be staed early .This has high moality. Cavernous sinus syndrome: is characterized by multiple cranial neuropathies. The clinical presentation includes impairment of ocular motor nerves, Horner's syndrome, and sensory loss of the first or second divisions of the trigeminal nerve in various combinations. The pupil may be involved or spared or may appear spared with concomitant oculosympathetic and parasympathetic involvement. Ref: 1) Comprehensive opthalmology,by AK Khurana,4th Edition, Page 384-389; 2) Parsons ' Diseases of the Eye, 20th Edition, Page 456-459; | Ophthalmology | null | A 19 year old young girl with previous history of repeated pain over medial canthus and chronic use of nasal decongestants, presented with abrupt onset of fever with chills & rigor, diplopia on lateral gaze, moderate proptosis & chemosis. On examination optic disc is congested. Most likely diagnosis is:
A. Cavernous sinus thrombosis
B. Orbital cellulitis
C. Acute Ethmoidal sinusitis
D. Orbital apex syndrome
| Cavernous sinus thrombosis |
69644927-c705-4384-868e-c400a82d4966 | Ans. A. Medial medullary syndromeImage shows one sided deviation of tongue, i.e. paralysis of XIIth nervea. This occurs in Medial Medullary syndrome or Dejerine syndromeb. It occurs due to occlusion of anterior spinal arteryc. It is characterized by Ipsilateral XIIth nerve paralysis with contralateral hemiplegia. | Medicine | C.N.S. | Following sign is seen in which condition:
A. Medial medullary syndrome
B. Lateral medullary syndrome
C. Benedict syndrome
D. Millar Gubler syndrome
| Medial medullary syndrome |
4dd294a3-7283-48b3-9d33-09f043ebad8a | Ans. is 'b' i.e., Multiple myelomaFactors affecting ESR 1. Plasmao RBCs carry a negative electric charge, whereas plasma carries a postive charge.o Any condition in plasma that increases its positive charge, increases rouleaux formation and increases ESR by lengthening stage I.o Following factors increase positive charge and ESR : -i) Fibrinogen ----> Any condition which increases fibrinogen level will increase ESR - e.g.,a) Infectionb) Inflammationc) TBii) Globulin --> Conditions which increases globulin level will increase ESR.a) Kala azarb) Multiple myelomac) Some lymphoproliferative disordersd) Rheumatic feveriii) Cholesterol --> Hypercholesterolemia increases ESR.o Any condition in plasma that decreases its positive charge, decreases rouleaux formation and decreases ESR.i) Albumin --> Hyperalbuminemia decreases ESR.ii) Decreased fibrinogen ---> In afibrinogenemia, ESR is zero.2. RBCso Increase in blood count as in polycythemia decreases ESR due to the jostling (or pushing one another) effect on the cells.o Anemia increases the ESR by opposite effect, there are two exceptions.i) Sickle cell anemiaii)Microcytic hypochromic anemia (iron deficiency, Thalassemia)o In last two types of anemia, ESR decreases because altered red cell shape prevents rouleux formation.3. Physiological variationso ESR is low in infancyo ESR is high at pubeyo ESR is greater in women than man.4. Ohterso ESR is decreased in congestive hea failureo ESR is increased in acute myocardial infarction. | Pathology | null | ESR in increased in -
A. Sickle cell anemia
B. Multiple myeloma
C. Polycythemia vera
D. Thalassemia
| Multiple myeloma |
a2b365ff-3410-452a-8658-902bf6df89ea | The most anterior layer of the retina, through which light passes first, is the retinal ganglion layer. Light then passes through the other cell layers of the retina until it reaches the photoreceptors in the posterior region of the retina. Visual processing/Phototransduction occurs in the opposite direction(Photoreceptors- ganglion cell layer) | Physiology | Special Senses | Light entering the eye passes through which retinal layer first?
A. Inner nuclear layer
B. Outer nuclear layer
C. Outer plexiform layer
D. Retinal ganglion layer
| Retinal ganglion layer |
d119ce91-883a-4ae9-ba51-44de27d95efd | Most common quadrant for breast carcinoma upper outer quadrant. | Surgery | null | Least common quadrant for breast carcinoma is
A. Upper outer
B. Upper inner
C. Lower outer
D. Lower inner
| Lower inner |
6ea031de-d4a8-4be6-984d-a0ca40be1080 | Ans. B. IB* Angiofibroma is the most common benign tumor of the nasopharynx.* It is typically seen in young adolescent males, i.e. occurs near puberty, hence called juvenile nasopharyngeal angiofibroma.Clinical features:* Recurrent episodes of profuse epistasis* Unilateral nasal obstruction* Nasal bones leading to broadening of nasal bridge* Red fleshy mass can be seen in the nasal cavityInvestigations* CECT: It is the golden test* Antral sign/Holman Miller sign seenStaging of angiofibromaRadkowski ClassificationsIALimited to nose and/or nasopharyngeal vault BExtension into 1 paranasal sinusIIAMinimal extension through sphenopalatine foramen into sphenopalatine/pterygomaxillary fossa BFills sphenopalatine fossa bowing the posterior wall of the maxillary antrum anteriorly or extending into the orbit via the inferior orbital fissure CExtends beyond sphenopalatine fossa into infratemporal fossaIIIAErosion of skull base--minimal intracranial extension BErosion of skull base--extensive intracranial extension with or without cavernous sinus invasionTreatment:* Surgical excision* Radiotherapy is indicated in stage III, when tumor has intracranial extension. | ENT | Nose and PNS | A 16-year-old male complains of nasal obstruction, nasal blockage, a mass is seen in the nasopharynx with minimal extension into sphenoid sinus. What is the stage of nasopharyngeal fibroma?
A. IA
B. IB
C. IIA
D. IIB
| IB |
8543f2ce-ec1f-44bc-baca-421f6b8c1730 | Adverse effects :Mefloquine is bitter in taste; common reaction is dizziness, nausea, vomiting, diarrhoea, abdominal pain and sinus bradycardia. These are usually mild and largely dose related, but may be severe in some. Major concern has been a variety of neuropsychiatric reactions (disturbed sense of balance, ataxia, errors in operating machinery, strange dreams, anxiety, hallucinations, rarely convulsions) occurring in some recipients. These are dose related and subside in 1-3 weeks. Rare events are haematological, hepatic and cutaneous toxicity. Mefloquine appears to be safe during pregnancy, but should be avoided in 1st trimester unless absolutely essential. ESSENTIALS OF PHARMACOLOGY page no.824 | Pharmacology | Chemotherapy | Which antimalarial drug is known to cause neuropsy-chiatric adverse reaction?
A. Aesunate
B. Aimisnin
C. Quinine
D. Mefloquine
| Mefloquine |
08fd1340-756c-46ef-b8a8-10c66ede7188 | (C) Thiamine # DEMENTIA is the progressive decline in cognitive function due to damage or disease in the brain beyond what might be expected from normal aging.> Although dementia is far more common in the geriatric population, it may occur in any stage of adulthood.> This age cutoff is by definition, as similar sets of symptoms due to organic brain dysfunction are given different names, such as developmental disorders, in populations younger than adulthood.> In dementia, affected areas in cognition may be memory, attention, language, and problem solving.> Especially in the later stages of the condition, affected persons may be disoriented in time (not knowing what day of the week, day of the month, or even what year it is), in place (not knowing where they are), and in person (not knowing who they are).> Symptoms of dementia can be classified as either reversible or irreversible depending upon the etiology of the disease. Less than 10 percent of cases of dementia are due to causes which may presently be reversed with treatment. | Psychiatry | Miscellaneous | Dementia is produced by deficiency of vitamin
A. Vitamin A
B. Vitamin D
C. Thiamine
D. Pyridoxine
| Thiamine |
fe50a882-04a1-45b4-a8fb-6fed0b2eb168 | Ans. is 'a' i.e., Infiltration anaesthesia Infiltration anaesthesiao It is the injection of local anaesthetic directly into tissue without taking into consideration the course of cutaneous nerve.o It can be so superficial as to include only the skin, it also can include deeper structureso It is used for minor surgeries, e.g. incision & drainage, suturing etc.o Adrenaline can be used along with LA to prolong its duration of action and to prevent its systemic absorptiono However adrenaline containing solution should not be used into tissues supplied by endarteries, e.g. in fingers and toes, ear, nose, and penis because vasoconstriction may lead to gangrene.Conduction blockA. Field blocko Is produced by subcutaneous injection of a solution of local anaesthetic in order to anaesthetize the region distal to the injection.o For example, subcutaneous infiltration of the proximal portion of the volar surface of the forearm results in extensive area of cutaneous anaesthesia that starts 2 to 3 cm distal to the site of injection.B. Nerve blocko LA is injected around a peripheral nerve or a plexus. Examples are -Upper limb - brachial plexus and wrist blockHead & Neck - Stellate ganglion block, trigeminal nerve block.Thorax & abdomen - Interc4ostal nerve & celiac plexuso Note - Most common complication of brachial plexus block is pneumothorax. | Anaesthesia | Miscellaneous (Local and Regional Anesthesia) | Local anaesthetic injected directly into the tissue -
A. Infiltration anaesthesia
B. Nerve block
C. Field block
D. Bier's block
| Infiltration anaesthesia |
7ac725b5-a59d-48cc-ac6a-242ec2ce1826 | Fibrous pericardium in supplied by phrenic Nerve. Visceral pericardium does not have somatic sensation. | Anatomy | null | Fibrous pericardium in supplied by
A. Pericardiophrenic Nerve
B. Phrenic Nerve
C. T2 to T6 intercostal nerves
D. Vagus nerve
| Phrenic Nerve |
fa39bc4c-eb92-4bd1-9331-02c0440326ce | Ans. a. Chronic tension headache (Ref: Harrison 19/e p107t, p2587t, 2593-2594, 18/e p122, 2849)Tension-type Headache:Tension-type headache (TTH) is commonly used to describe a chronic head-pain syndrome characterized by bilateral tight, bandlike discomfortQ.Pain typically builds slowly, fluctuates in severity, and may persist more or less continuously for many daysQ.Headache maybe episodic or chronic (present >15 days per month)Q.A useful clinical approach is to diagnose TTH in patients whose headaches are completely without accompanying features such as nausea, vomiting, photophobia, phonophobia, osmophobia, throbbing, and aggravation with movementQ.Such an approach neatly separates migraineTemporal arteritis:Women account for 65% of casesMigraine:Pain often preceded by auraQFibromyalgia:Fibromyalgia (FM) is characterized by chronic widespread musculoskeletal pain and tenderness.Patients with FM have an increased prevalence of other syndromes associated with pain and fatigueQ.More common in womenQCommon Causes of HeadachePrimary HeadacheSecondary Headache* Tension-type (69%)* Migraine (16%)* Idiopathic stabbing (2%)* Exertional (1%)* Cluster (0.1%)* Systemic infection (63%)* Head injury (4%)* Vascular disorders (1%)* SAH (<1%)* Brain tumor (0.1%)Tension-Type Headache (TTH)Tension-type headache (TTH) is commonly used to describe a chronic head-pain syndrome characterized by bilateral tight, handlike discomfortQ.Pathophysiology:Pathophysiology is incompletely understoodQ.It seems likely that TTH is due to a primary disorder of CNS pain modulation alone, unlike migraine, which involves a more generalized disturbance of sensory modulation.Clinical Features:TTH: Chronic head-pain syndrome characterized by bilateral tight, bandlike discomfortQ.Pain typically builds slowly, fluctuates in severity, and may persist more or less continuously for many daysQ.Headache maybe episodic or chronic (present > 15 days per month)Q.A useful clinical approach is to diagnose TTH in patients whose headaches are completely without accompanying features such as nausea, vomiting, photophobia, phonophobia, osmophobia. throbbing, and aggravation with movementQ.Such an approach neatly separates migraine.Treatment: Tension-Type HeadacheAnalgesics (acetaminophen, aspirin, or NSAIDs).Behavioral approaches including relaxation can also be effective.Chronic TTH: Amitriptyline is the only proven treatmentQThere is no evidence for the efficacy of acupuncture.MigraineCluster Headache* LateralizedQ usually frontotemporal, can be generalized* All age groupsQ are affected* FemalesQ are affected more than males* Family history presentQPresentation:* Pain often preceded by auraQ* Builds up graduallyQ* May lasts for several hoursQ or longer* Usually throbbingQ but maybe dull* Onset is after awakeningQ and quietened by sleepQ* Lateralized, periorbitalQ or less commonly temporal* All ages >10 yearsQ with peak at 30-50 yrsQ* Male preponderanceQ (90%): Men affected 7-8 times more than females.* Hereditary factors usually absentQPresentation:* Pain (periodic attacks 1-2/day)* Begins without warningQ* Reaches crescendo within 5 minutesQ* Lasts for 45 minutesQAssociated symptoms:* Nausea, vomiting, diarrheaQ* Photophobia and visual disturbance in the form of photopsia and fortification spectraQ* Paraesthesia with tingling and numbnessQ* Other focal neurological symptoms such as clumsiness and weaknessQ.* Excruciating, deep, explosive pain but only rarely pulsatileQ* Commonly awakens patients from sleepQAssociated symptoms:* Homolateral lacrimationQ* Reddening of eyeQ* Nasal stuffinessQ* PtosisQ* NauseaQTemporal ArteritisAverage age of onset is 70 yearsQWomen account for 65% of cases.Typical presenting symptoms: Headache, polymyalgia rheumatica, jaw claudication, fever, and weight lossQ.Headache is the dominant symptom, often appears in association with malaise and muscle achesQ.Head pain maybe unilateral or bilateralQ and is located temporally in 50% of patients but may involve any and all aspects of the cranium.Pain usually appears gradually over a few hours before peak intensity is reached; occasionally, it is explosive in onset.The quality of pain is only seldom throbbing; it is almost invariably described as dull and boring, with superimposed episodic stabbing pains similar to the sharp pains that appear in migraine.Most patients can recognize that the origin of their head pain is superficial, external to the skull, rather than originating deep within the cranium (the pain site for migraineurs).Scalp tenderness is present, often to a marked degree; brushing the hair or resting the head on a pillow maybe impossible because of painQ.Headache is usually worse at night and often aggravated by exposure to coldQ.Additional findings may include reddened, tender nodules or red streaking of the skin overlying the temporal arteriesQ, and tenderness of the temporal or, less commonly, the occipital arteries.ESR is often, though not always, elevatedQ; a normal ESR does not exclude giant cell arteritis.A temporal artery biopsy followed by immediate treatment with prednisone 80 mg dailyQ for the first 4-6 weeks should be initiated when clinical suspicion is high.FibromyalgiaFibromyalgia (FM) is characterized by chronic widespread musculoskeletal pain and tenderness.Patients with FM have an increased prevalence of other syndromes associated with pain and fatigueQ.More common in womenQClinical Features:MC presenting complaint: "Pain all over."QPain is typically above and below the waist on both sides of the body and involves the axial skeletonQ (neck, back, or chest).Pain is poorly localized, difficult to ignore, severe in its intensity, and associated with a reduced functional capacity.QFibromyalgia classification criteriaHistory of chronic widespread pain > 3 monthsQ>11 of 18 tender pointsQNeuropsychological Symptoms: Fatigue, stiffness, sleep disturbance, cognitive dysfunction, anxiety, and depressionQ. | Medicine | Headache | A 70-years-old retired military person with good previous medical record complains of bi-temporal headache which is decreased in lying down position. He states that he gets relief by giving pressure over bilateral temples. The patient also complains of loss of appetite with feeling feverish. Diagnosis is:
A. Chronic tension headache
B. Temporal arteritis
C. Migraine
D. Fibromyalgia
| Chronic tension headache |
7273f0e1-d1aa-472b-89de-7cfbc9e87a67 | - In BBT, the rise of temperature signifies ovulation. - Since maximum survival of ovum post ovulation is 3 days, the unsafe period is 3 days post rise of body temperature. Other natural methods of contraception are: Calender method / feile period method/ safe period method/ rhythm method Cervical mucus method Symptothermic method Coitus interruptus Abstinence - most effective method | Social & Preventive Medicine | Natural Methods, Barrier Methods, IUDs, OCPs | In basal body temperature method, after the rise of temperature, the unsafe period lasts for :-
A. 24 hours
B. 48 hours
C. 72 hours
D. 120 hours
| 72 hours |
6e9e2952-e746-4c28-bd65-e1e4dc89ecc8 | Otoacoustic emissions (OAEs) are objective, noninvasive, and rapid measures (typically less than 2 minutes) used to determine cochlear outer hair cell function. OAE testing is commonly used in newborn hearing screening because of its speed and noninvasive nature. It is also used in confirming pure-tone test results obtained from young children, in patients for whom a functional hearing loss is suspected, for audiometric configuration confirmation, for ototoxic drug monitoring, and in hearing aid candidacy. More recently, OAEs, in conjunction with ABR, can be used in identifying individuals with auditory neuropathy, also termed auditory dyssynchrony. Ref: Sweetow R.W., Sabes J.H. (2012). Chapter 45. Audiologic Testing. In A.K. Lalwani (Ed), CURRENT Diagnosis & Treatment in Otolaryngology--Head & Neck Surgery, 3e. | Pediatrics | null | Which is the best screening test to evaluate hearing in a neonate?
A. Pure Tone Audiometry
B. Stapedial Reflex
C. Otoacoustic Emissions
D. Brainstem evoked auditory response
| Otoacoustic Emissions |
33411849-200f-4a5c-85a6-3d69fd9a312a | Phenytoin follows nonlinear (or zero-order) kinetics at therapeutic concentrations, because the rate of metabolism is close to the maximum capacity of the enzymes involved Ref-KDT 6/e p31 | Anatomy | General anatomy | A Toxic doses, zero order kinetics is seen in
A. Pencillin
B. Phenytoin
C. Valproate
D. Carbamazepine
| Phenytoin |
9d6dab05-675e-42b8-96ac-f5aba868555f | There is an overall reduction in the incidence of PID with OCPs but Chlamydial PID may increase. This is classically an indolent PID where the patient has no pain, no discharge. | Gynaecology & Obstetrics | Contraceptives | The use of combined oral contraceptive pill is associated with an increased incidence of:
A. Bacterial vaginosis
B. Chlamydial endocervicitis
C. Vaginal was
D. Genital herpes
| Chlamydial endocervicitis |
6e3ec920-eff1-4912-9e61-3181e3e947b4 | Ans-A Ampulla .The most common site of ectopic pregnancy is a fallopian tube (as if and in fallopian tube the most common site is Ampulla (55%).Sites of ectopic pregnancy in fallopian tube in decreasing order of frequency :AmpullaIsthmusInfundibulumInterstitial | Unknown | null | The most common site of implantation in ectopic pregnancy is -
A. Ampulla
B. Fimbriae
C. Body
D. Infundibulum
| Ampulla |
c4d050b6-9c49-4370-9e33-cf93a6c99b95 | Vitamin A is important in maintaining epithelial surfaces. Deficiency of this vitamin can lead to squamous metaplasia of respiratory epithelium, predisposing to infection. Increased keratin buildup leads to follicular plugging and papular dermatosis. Desquamated keratinaceous debris in the urinary tract forms the nidus for stones. Ocular complications of vitamin A deficiency include xerophthalmia and corneal scarring, which can lead to blindness. Vitamin B1 (thiamine) deficiency causes problems such as Wernicke disease, neuropathy, and cardiomyopathy. Vitamin D deficiency in children causes rickets, characterized by bone deformities. Vitamin E deficiency occurs rarely; it causes neurologic symptoms related to degeneration of the axons in the posterior columns of the spinal cord. Vitamin K deficiency can result in a bleeding diathesis. | Pathology | Environment & Nutritional Pathology | An epidemiologic study observes increased numbers of respiratory tract infections among children living in a community in which most families are at the poverty level. The infectious agents include Streptococcus pneumoniae, Haemophilus influenzae, and Klebsiella pneumoniae. Most of the children have had pneumonitis and rubeola infection. The study documents increased rates of keratomalacia, urinary tract calculi, and generalized papular dermatosis in these children as they reach adulthood. These children are most likely to have a deficiency of which of the following vitamins?
A. Vitamin A
B. Vitamin B1
C. Vitamin E
D. Vitamin D
| Vitamin A |
3b71f9a9-a205-4ba2-8554-2d5d98acbca5 | Ans. is 'b' i.e., Staphylococcus Impetigo Impetigo is a highly contagious, Gram-positive bacterial infection of superficial layer of epidermis. Impetigo occurs in Two forms : ? 1. Non - bullous impetigo (Impetigo contagiosa) It is the most common bacterial infection of children (occurs mainly in children in contrast to Bullous impetigo which occurs in infants). It is caused by both staphylococcus aureus and hemolytic group A streptococcus (Str. pyogens), though it is mostly caused by staph aureus. Most commonly occurs on face, i.e., around nose & mouth; and exposed pas, i.e., arms, legs. Presents erythematous macule/papule which changes into vesicle which soon ruptures with formation of crusting. Crust has characteristic features : - Honey-yellow colour in streptococcal impetigo. Waxy in staphylococcal impetigo. Lesion heal without scarring. Mucous membrane involvement is rare. Lymphadenopathy is common 2. Bullous impetigo It is caused by staphylococcus aureus most often phage type 71. It usually occurs in infants and manifests as vesicle that develop into bulla and later a pustule without any surrounding erythema. It mainly occurs on face. Mucous membrane may be involved (in contrast to impetigo contigiosa). Lymphadenopathy is rare. | Skin | null | Bullous impetigo is caused by ?
A. Streptococcus
B. Staphylococcus
C. Staphylococcus
D. Y. Pestis
| Staphylococcus |
b0a1ac53-3bf5-43a3-ab0f-7b77a0ff9fa6 | Ans. A. Dopaminergica. There is a system of dopaminergic neurons in nigrostriatal dopaminergic system with cell bodies in substantia nigra and axon endings in caudate nucleus.b. In Parkinson's disease there is loss of dopaminergic cells in the substantia nigrawhich leads to striatal dopamine depletion.c. As DOPAMINE activates excitatory D1 receptors in the direct pathway and represses inhibitory D2 receptors in the indirect pathway, this depletion leads to decreased activity of the direct pathway and increased activity of the indirect pathway | Physiology | Nervous System | In substantia nigra, the major neurotransmitter is:
A. Dopaminergic
B. Acetylcholine
C. Noradrenaline
D. GABA
| Dopaminergic |
1bac9c7a-4d6b-4dc2-9a52-b9db24579498 | Anti D in Rh negative women: Anti-D immune globulin is given prophylactically to all D negative, unsensitized women at approximately 28 weeks' gestation, and a second dose is given after delivery if the newborn is D-positive. There are various recommendations regarding a second dose after 6 weeks of the first injection (i.e. at 34 weeks) but it is not being practiced. Following delivery, anti-D immune globulin should be given within 72 hours. 40 percent of neonates born to D-negative women are also D negative,so Anti-D given only if newborn is confirmed to be D positive Post-natally, within 72 hours all women who deliver an Rh (D) positive baby should have quantification of feto-maternal haemorrhage to guide the appropriate dose of anti D prophylaxis If immune globulin is missed following delivery, it should be given as soon as the omission is recognized, because there may be some protection up to 28 days postpaum | Gynaecology & Obstetrics | RH Incompatibility | Rh negative mother, ICT negative was given Anti D at 28 week of pregnancy. Which of the following is the follow up schedule?
A. Give another dose of Anti D within 72 hour postpaum depending on the baby blood group and DCT
B. Give another dose of Anti D 72 hour postpaum irrespective of baby blood group
C. Anti-d immuno globulin has no effect on the status of the Indirect coombs test
D. Next dose of anti D at 34 weeks
| Give another dose of Anti D within 72 hour postpaum depending on the baby blood group and DCT |
a655c4fb-d4ea-4a6a-b77c-5f7ab5cc4b75 | Ans. b (Epinephrine metabolite) (Ref. Robbins Pathologic basis of disease 7th/ 887-888; Table 18-4)Dubin-Johnson syndrome# Hereditary defect in hepatocellular excretion of bilirubin glucuronides across the canalicular membrane due to absence of the canalicular protein, the multidrug resistance protein 2 (MRP2; located on chromosome 10q24), that isresponsible for transport of bilirubin glucuronides and related organic anions into bile.# The liver is darkly pigmented owing to coarse pigmented granules within the cytoplasm of hepatocytes.# Electron microscopy reveals that the pigment is located in lysosomes, and it appears to be composed of polymers of epinephrine metabolites., not bilirubin pigment.# The liver is otherwise normal.# Apart from chronic /recurrent jaundice (fluctuating intensity), patients are asymptomatic and have normal life span.OTHER HEREDITARY HYPERBILIRUBINEMIASCrigler-Najjar syndrome type I# The enzyme UGT1A1 is completely absent.6# The liver is incapable of synthesizing a functional enzyme, and the colorless bile contains only trace amounts of unconjugated bilirubin.# The liver is morphologically normal by light and electron microscopy.# However, serum unconjugated bilirubin reaches very high levels, producing severe jaundice and icterus.# Without liver transplantation, this condition is invariably fatal.Crigler-Najjar syndrome type II# It is a less severe, nonfatal disorder in which UGT1A1 enzyme activity is greatly reduced, and the enzyme is capable of forming only monoglucuronidated bilirubin.# Almost all patients develop normally and the only major consequence is extraordinarily yellow skin from high levels of circulating unconjugated bilirubin; but there is a risk of neurologic damage from kemicterus.# Phenobarbital improves bilirubin glucuronidation by inducing hypertrophy of hepatic endoplasmic reticulum.Gilbert syndrome# It is a relatively common, benign, somewhat heterogeneous inherited condition presenting with mild, fluctuating hyperbilirubinemia.# Main cause is reduction in hepatic bilirubin glucuronidating activity (UGT1A1) to about 30% of normal.# Gilbert syndrome has no clinical consequence except for the anxiety.Rotor syndrome# It is a rare form of asymptomatic conjugated hyperbilirubinemia with multiple defects in hepatocellular uptake and excretion of bilirubin pigments.# The liver is not pigmented.# As with Dubin-Johnson syndrome, patients with Rotor syndrome exhibit jaundice but otherwise live normal lives. | Pathology | Liver & Biliary Tract | Which of the following pigments accumulates in liver in Dubin-Johnson syndrome?
A. Monoglucuronate bilirubin
B. Epinephrine metabolite
C. Bilirubin pigment
D. Melanotic pigment
| Epinephrine metabolite |
6cd5b8b6-92de-4d4f-948a-edc28912e378 | Floor of 4th ventricle (Rhomboid fossa) It is diamond or rhomboidal shaped and is formed by posterior surface of pons (upper triangular pa or pontine pa) and dorsal surface of medulla (lower triangular pa or medullary pa) junction of pons and medulla forms intermediate pa. Features of 4th ventricle are :? Median sulcus (a midline groove) divides the floor into two symmetrical halves. Medial eminence is present an each side of median sulcus. It presents facial colliculus formed by genu (recurving fibers) of facial nerve looping around abducent nucleus. Facial colliculus lies in pons (i.e. in pontine pa of floor). Hypoglossal triangle overlying hypoglossal nucleus and vagal triangle overlying dorsal nucleus of vagus. Both of these triangle lie in the medulla (medullary pa of floor). Vestibular area overlies vestibular nuclei, paly in pons and paly in medulla. Sulcus coeruleus, a bluish area due to presence of pigmented neurons containing substantia ferruginea. Superior and inferior ea. | Anatomy | null | Floor of 4th ventricle has ?
A. Infundibulum
B. Vagal triangle
C. Mammillary body
D. Tuber cincrium
| Vagal triangle |
fbe5853c-1451-4c8b-a6ab-f5b573f17e50 | Vocal nodule (singer's or screamer's node) Seen symmetrically on the free edge of vocal cord, at the junction of anterior one third, with the posterior two thirds (i.e. area of maximum vibration of cord). Vocal nodules are bilateral. Mostly seen in teachers, vendors, actors or pop singers as they speak in unnatural low tones or at high intensities for prolonged periods. symptoms include: hoarseness breathlessness a "rough" voice a "scratchy" voice a harsh-sounding voice shooting pain from ear to ear feeling like you have a "lump in your throat" neck pain less ability to change your pitch voice and body tiredness Vocal polyp is typically unilateral but arising from the same position as vocal nodule. Treatment Voice rest and speech therapy (Speech therapy re-education in voice production are essential in preventing recurrence) Microlaryngoscopic excision of nodules--Using microsurgical instruments or laser differential diagnosis is VOCAL CORD POLYP- Usually unilateral at the junction of anterior and middle third of vocal cord. caused by Voice abuse, chronic irritation like smoking Sudden shouting results in hemorrhage and submucosal edema. Treatment is Microlaryngeal excision. Acute laryngitis is a temporary condition caused by overusing the vocal cords. It can also be caused by an infection. Acute laryngitis may be caused by viral infections. Acute pharyngitis is inflammatin of the pharynx causing Pain or irritation in the throat that can occur with or without swallowing, often accompanies infections, such as a cold or flu. | ENT | ENT Q Bank | A 35 yr old male female singer presents with complains of hoarseness, vocal fatigue & pain in neck on prolonged phonation. Direct laryngoscopy shows bilateral pin head size swelling on Ant.1/3 & post 2/3 junction of vocal cord. What could be the probable diagnosis ?
A. Vocal polyp
B. Vocal nodule
C. Acute laryngitis
D. Acute pharyngitis
| Vocal nodule |
ae18677d-998c-4d9c-8a58-901d395d32fc | A metanalysis of 31 studies found lamotrigine and levetiracetam to carry the lowest risk of malformations(Ref: William's Obstetrics; 25th edition) | Gynaecology & Obstetrics | All India exam | Lowest risk of malformations is seen with which of the following antiepileptic drug?
A. Phenobarbitone
B. Valproate
C. Lamotrigine
D. Carbamazepine
| Lamotrigine |
6a3f485a-48ca-4cee-bf08-ae07feddf874 | REF : textbook of ohopedics, John ebnezer, 4th edition ,pg.no.311 Three column concept of spine stability was given by Denis *The anterior column consists of anterior half of the veebral body , anterior pa of the disk & anterior longitudinal ligament. * The middle column consists of posterior half of the body & the disk , posterior longitudinal ligament. *The posterior column consists of the posterior veebral arch consisting of transverse process , spinous process & the accompanying ligaments. One column injury is stable , 2 column injury is unstable - it is a dangerous spine for it may injure the spinal cord. | Orthopaedics | Spinal injuries | Column concept of spine stability was given by -
A. Denis
B. Frenkel
C. Wilson
D. Todd
| Denis |
6e0ac85f-9a0c-433c-8b18-9625d484a699 | Ans; a (Synthesis of type I collagen) Ref: Robbins, ed, p. 1279Osteogenesis imperfecta is due to deficiency in the synthesis of Type I collagen structures affected are - bone, joints,eyes, ear, skin and teethCytogenetic abnormality:Mutation in the genes that codes for a1, and a2 chains of collagen autosomal dominant inheritanceClinical features:All types are characterized by extreme skeletal fragilityOther features are blue sclera, hearing impairment,Dentiogenesis imperfecta, growth retardation etcREMEMBER:Type of osteogenesis imperfecta incompatable with life = type IIType of osteogenesis imperfecta with normal sclera = type IVBRIDGE:Van der hoeve's syndrome - AD osteogenesis imperfecta, blue sclera, hearing loss | Pathology | Osteology | In osteogenesis imperfecta the defect is in the:
A. Synthesis of type I collagen
B. Mineralisation of osteoid
C. Osteoclast function
D. Osteoblast formation
| Synthesis of type I collagen |
30fee938-7827-45b8-9db7-4d7b71d0cd20 | Isoniazid inhibits the endogenous syntheisis of Niacin so,the patient developed dermatitis,diarrhea,dementia. Prolonged treatment with Isoniazid leads to Pyridoxine deficiency,which is required for endogenous synthesis of niacin Reference: Harpers illustrated biochemistry 30th edition | Biochemistry | Metabolism of protein and amino acid | A 30 year old male patient was on Isoniazid therapy for Tuberculosis.He developed rashes on exposed pas of body.He has disoriented memory. Family members gives history of diarrhea also.What is the diagnosis?
A. Isoniazid neuropathy
B. Tuberculosis skin lesions
C. Niacin deficiency
D. Some other drugs has caused this
| Niacin deficiency |
3caa1963-12c3-4399-87a7-7f6dc029b1a5 | In stage II cervical cancer, the incidence of nodal involvement is 25%-40%. Most tumors are not radioresistant, and distant metastasis (i.e., a more advanced stage) are a late complication of more advanced stages of the disease. | Surgery | Urethra & Penis | What is the most common cause of failure of radiotherapy for stage II cervical carcinoma?
A. Liver metastasis
B. Bone metastasis
C. Para-aortic node metastasis
D. Resistance of the central tumor
| Para-aortic node metastasis |
7effcd3e-b1a2-43cb-9168-d9ef4cce9915 | Ans. (b) Fat embolism* Fat embolism usually manifests following Long bone fractures* MC after Closed fractures > Open fractures* MC in Young (more bone marrow) > Old* MC in Long bones (Femur) > Pelvis> Smaller bones* 90% will develop fat emboli after traumatic fracture but only 1-5% develop fat embolism syndrome* Also seen in other causes like- Pancreatitis, Fatty liver, Steroid therapy, Liposuction etc.* Fat embolism is a clinical diagnosis and not a Chemical diagnosis.* It manifests in 24-72 hours. Rare in < 24 hours and > 72 hours* Classic Triad- Hypoxemia + Petechial Rash + neurological abnormalities* Hypoxemia early finding, Petechial rash is late finding* Platelet count - Normal* Purtschers Retinopathy +* Lipiduria+* Treatment: Immobilization of fracture, Mechanical Ventilation, Steroids. | Surgery | Acute Arterial Occlusion | A young male presented with dyspnea, bleeding and petechial hemorrhage in the chest after 2 days following fracture shaft of the femur right side. Most likely cause is:
A. Air embolism
B. Fat embolism
C. Pulmonary thromboembolism
D. Amniotic fluid embolism
| Fat embolism |
2730f920-08de-4a6e-8a59-e045aa4cfb95 | Clinical Diagnosis - DDH based on the following 1. Abduction is limited (especially in flexion) 2. Asymmetric thigh folds Oolani's Test--the first two alphabets O and R (Oolani for Reduction) and for Reduction we do abduction of hip. It is similar to 2nd pa of Barlow's test McMurray circumduction test is used to evaluate individuals for tears in the meniscus of the knee | Orthopaedics | Pediatric Ohopedics | A female with H/o oligohydramnios during her pregnancy, brings her newborn baby to OPD, on noticing asymmetric thigh folds in her child. The examiner performs flexion, IR and abduction, which produces a click sound. Which is the test done by the examiner?
A. Oolani test
B. Von Rosen test
C. Mc Murray's test
D. Barlow's test
| Oolani test |
d0cdb418-5640-4797-99dc-4f662352b236 | Ans. (a) StomachRef Schackelford Page 256 7th edition* Best conduit for esophageal replacement-- Stomach* Best conduit for short segment replacement of esophagus-- Jejunum* Best conduit in cases of corrosive injury to stomach and esophagus-- Colon | Surgery | Oesophagus | Most desirable structure to anastomose with esophagus is:
A. Stomach
B. Jejunum
C. Colon
D. Duodenum
| Stomach |
78133f9a-c5f7-4f6b-8037-70231bf030d2 | Ans. (C) 800 mcg sublingual(Ref: WHO recommendations for prevention and treatment of PPH 2012)According to WHO 2012 recommendationsOxytocin is drug of choice for treatment and well as prevention of post partum hemorrhage.Alternatives are ergometrine, fixed dose combination of oxytocin and ergometrine and misoprostolMisoprostol is recommended as 600 microgram orally for prevention of PPH and 800 microgram sublingually for treatment of PPH.The use of tranexamic acid is recommended for the treatment of PPH if oxytocin and other uterotonics fail to stop bleeding or if it is thought that the bleeding may be partly due to trauma. | Pharmacology | Endocrinology | WHO recommended dose of misoprostol in the treatment of post partum hemorrhage is
A. 400 mcg oral
B. 600 mcg sublingual
C. 800 mcg sublingual
D. 1000 mcg oral
| 800 mcg sublingual |
afe585cf-e3f9-48db-b638-2f86fd947200 | A VIRINAE B VIRINAE VIRINAE Includes HSV 1 HSV 2 HHV 3 Affects Ganglionic cells Includes HHV 5 HHV 6 HHV 7 Affects salivary glands Includes HHV 4 HHV 8 Affects B cells HHV - 3 - varicella zoster HHV - 4 - EBV HHV - 5 - Cytomegalo virus HHV - 8 - Kaposi saroma causing virus HSV - 1 - Herpes simplex virus 1 HSV - 2 - Herpes simplex virus 2 | Microbiology | FMGE 2019 | Which of the following virus is from Herpes virus family?
A. Rubella
B. Measles
C. Rabies
D. EBV
| EBV |
97b478bb-b924-480c-bb58-b6f35700ab42 | Prematurity is the most impoant risk factor for necrotizing enterocolitis, although term infants also sometimes develop the condition. Clinical series have repoed that between 60 and 95% of affected babies are premature, and the incidence is markedly increased in babies born at lower gestational ages. Many other purpoed risk factors have also been cited but seem to have a lesser effect, including perinatal asphyxia, respiratory distress syndrome, umbilical catheterization, hypothermia, shock, patent ductus aeriosus, cyanotic congenital hea disease, polycythemia, thrombocytosis, anemia, exchange transfusion, congenital GI anomalies, chronic diarrhea, non-breast milk formula, nasojejunal feedings, hypeonic formula, and colonization with necrogenic bacteria. It may simply be that any already fragile baby, paicularly if premature, who has other significant underlying disease, is at increased risk for developing necrotizing enterocolitis. Ref: Thilo E.H., Rosenberg A.A. (2012). Chapter 2. The Newborn Infant. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e. | Pediatrics | null | Which of the following is considered the MOST impoant risk factor for necrotizing enterocolitis?
A. Perinatal asphyxia
B. Polycythemia
C. Prematurity
D. Respiratory distress syndrome
| Prematurity |
c00eca28-e929-41f9-97a6-edb08106d48c | 7 - 9 days "From the time a feilized ovum enters the uterine cavity from the fallopian tube (which occurs 3-4 days after ovulation) until the time ovum implants (7-9 days after ovulation) the uterine secretions called uterinemilk provide nutrition for the early dividing ovum" "At the time of implantation, on days 21-22 of menstrual cycle the predominant morphologic feature is edema of the endometrial stroma." Impoant facts : Oogenesis begins in ovary at 6-8 weeks of gestation.deg Maximum number of oocytes (6-7 million) are attained at 20 weeks of gestation.deg All the primary oocytes in the ovary of a newborn are arrested In the late prophase (of meiosis) till pubey.deg At pubey as a result of mid cycle preovulatory surge, meiosis is resumed and compTetedjust prior to ovulation.deg Therefore first polar body is released just prior fo ovulation The second division stas immediately after_ it and is arrested in metaphase.deg At the time of feilization second division is completed which results in the release of oocyte and second polar body. Therefore second polar body release occurs only at the time of feilisation.deg LH surge preceedes ovulation by 34-36 hours.o LH peak preceedes ovulation by 10-16 hours.o Prior to ovulation :- Follicle reaches a size of 18-20mm. - Endometrium is 9-10 min trick.o - Endometrium show triple line on USG.o Ovulation occurs 14 days before the next menstruation.deg Maximum action of corpus luteum is at 22 day of menstruationdeg (following which it stas regressing ~ 8 years after ovulation).deg In absence of feilisation and implanation the corpus leteum persists for 12-14 days.o Maximum growth of corpus lutem of pregnancy is at 8th week of gestation and degenerates at 6 months of gestation.o Feilisation occurs in the ampullary pa of fallopian tube.deg Feilised egg enters the uterus on day 18 - 19 of the cycle.deg | Gynaecology & Obstetrics | null | After how many days of ovulation embryo implantation occurs ?
A. 3 - 5 days
B. 7 - 9 days
C. 10 - 12 days
D. 13 - 15 days
| 7 - 9 days |
4ae5e8a4-6143-40e7-a113-06ebeea2ec00 | Rheumatoid Arthritis + Pneumoconiosis nodules = Caplan's syndrome.
Neutropenia + Splenomegaly + Nodular RA = Felty's syndrome. | Medicine | null | Caplan's syndrome is
A. Splenomegaly + Neutropenia
B. Rheumatoid Arthritis + Pneumoconiosis
C. Pneumoconiosis + Splenomegaly
D. Pneumoconiosis + Neutropenia
| Rheumatoid Arthritis + Pneumoconiosis |
6e8de49f-8b2c-4d53-b257-6776f209b9cd | Ans. is 'b' i.e., LateralProfunda femoris aery arises from lateral side of femoral aery about 4 cm below the inguinal ligament. | Anatomy | null | Profunda femoris aery at its origin lies on which side of the femoral aery ?
A. Medial
B. Lateral
C. Posterior
D. Posteromedial
| Lateral |
2ccede39-a077-45a2-b0ca-79e637bdaa59 | Ovarian Hyperstimulation syndrome It is an iatrogenic complication of ovulation induction with exogenous gonadotropins and clomiphene-induced cycles Charecteristic feature of OHSS is an increase in capillary permeability resulting in fluid shift from intravascular to extravascular spaces Mechanism of Action Probably mediated by increased ovarian secretion of vasoactive substances including Vascular endothelial growth factor , elements of Renin-Angiotensin system and other cytokines Risk factors Young age, low body weight, PCOS, higher doses of gonadotropins and previous episodes of hyperstimulation Mild illness Charecterised by Ovarian enlargement, lower abdominal discomfo, mild nausea and vomiting, diarrhea and abdominal discomfo. Managed by outpatient basis with analgesics and bedrest; monitored by daily weight checkup, urinary frequency, clinical examination to detect ascites, lab tests of hematocrit, electrolytes and serum creatinine Serious illness Characterised by severe pain, rapid weight gain, tense ascites, hemodynamic instability, respiratory diffiulty, progressive oliguria leadng to renal failure, ovarian rupture and thromboembolic phenomenon Hospitalization and treated according to symptoms Ref: Clinical Gynecologic Endocrinology and Infeility; Eigth Edition; Chapter 31 | Gynaecology & Obstetrics | Reproductive physiology and hormones in females | A patient treated for infeility with clomiphene citrate presents with sudden onset of abdominal pain and distension with ascites the probable cause is
A. Uterine repture
B. Ectopic pregnancy rupture
C. Multifetal pregnancy
D. Hyperstimulation syndrome
| Hyperstimulation syndrome |
5a7a4b63-18f2-4dc2-91ac-35c8c4e4fab0 | Menetrier disease /Hyperplastic hypersecretory gastropathy Mean age 30-60 years Rare disorder associated with excessive secretion of transforming growth factor (TGF)-a, which is an EGF receptor (EGFR) ligand, and hyperactivation of the epidermal growth factor receptor on gastric epithelial cells. Excessive EGFR activation causes diffuse hyperplasia of foveolar epithelium within the body and fundus Hypoproteinemia occurs to albumin loss across the gastric mucosa Secondary symptoms such as weight loss, diarrhea, and peripheral edema are commonly present Enlarged rugae are present in the body and fundus but the antrum is generally spared Risk of gastric adenocarcinoma is increased -Histology shows characteristic feature that is: Hyperplasia of surface and glandular mucous cells Marked intraepithelial lymphocytosis. Diffuse or patchy glandular atrophy The glands are elongated with a corkscrew-like appearance and cystic dilation present | Pathology | Systemic Pathology | A 42-year-old man presents with long-standing abdominal pain after meals, which is relieved by over-the-counter antacids. The patient has lost 9 kg (20 lb) in the past year. Physical examination reveals peripheral edema and ascites. Laboratory studies show decreased serum albumin but normal serum levels of transaminases and gastrin. Gross and microscopic examination of this patient's stomach would most likely show which of the following pathologic changes?
A. Atrophic gastritis
B. Enlarged rugal folds
C. Intestinal metaplasia
D. Multiple hemorrhagic ulcers
| Enlarged rugal folds |
1f4a594c-c7ca-4253-b07c-fd3e5e94c2f6 | *myasthenia gravis is an autoimmune disease,most commonly caused by antibodies to acetylcholine receptors in the post junctional membrane of the neuromuscular junction ,which are found in around 80%of affected patients. Ref Harrison20th edition pg 2378 | Medicine | C.N.S | Antibody found in patients of myaesthenia gravis is directed against
A. Acetycholine
B. Acetycholine receptors
C. Acetycholine vesicles in nerve terminal
D. Actin-myosin complex of the muscle
| Acetycholine receptors |
c38bf251-62b7-4aaa-a391-c104dcc87a40 | In old literature, it was called as serum glutamate oxaloacetate transaminase (SGOT). AST needs pyridoxal phosphate (vitamin B6) as co-enzyme. Normal serum level of AST ranges from 8 to 20 U/L. It is a marker of liver injury and shows moderate to the drastic increase in parenchymal liver diseases like hepatitis and malignancies of the liver.Ref: DM Vasudevan, Page no: 269 | Biochemistry | Enzymes | Which of the following liver enzymes is predominantly mitochondrial?
A. SGOT (AST)
B. SGPT (ALT)
C. GGT
D. 5' Nucleotidase
| SGOT (AST) |
37d870d9-1b0a-4bad-8baf-9223fce09cbd | The normal P wave in lead V1 may be biphasic with a positive component reflecting right atrial depolarization, followed by a small (<1 mm2 ) negative component reflecting left atrial depolarization. Ref Harrison 20th edition pg 1455 | Medicine | C.V.S | The normal P wave is biphasic in lead
A. V1
B. LII
C. aVF
D. aVR
| V1 |
8b98449b-b9ee-42db-b2b0-17b6434aad96 | Ans. is b i.e. 32 weeks Friends, I had to search a lot for this answer but all in vain. Only Nelson Paediatric throws some light on this issue : "Pulmonary surfactant is a heterogenous mixture of phospholipids and proteins secreted into the saccular or alveolar sub-phase by the type ll pneumocytes. Its presence is first recognised in characteristic secretory organelles known as lamellar bodies as early as the 24th week of gestation. However, surfactant lipids of which the most abundant is phosphatidyicholine, are not detectable in the amniotic fluid until the 30th week of gestation, suggesting that there is a chronologic gap between surfactant synthesis and secretion. Labour probably shoens this gap because phospholipids are consistently found in the air spaces of infants born before the 30th week of gestation." From the above lines it is clear : Surfactant synthesis occurs in 24th week of gestation, it appear in amniotic fluid in 30th week of gestation. Since 30 weeks is not given in options, I would personally go with 32 weeks, when surfactant will absolutely be detected in amniotic fluid, whereas at 28 weeks it can detected only if preterm labour occurs. | Gynaecology & Obstetrics | null | Surfactant appears in amniotic fluid at the gesta?tional age of :
A. 20 weeks
B. 32 weeks
C. 36 weeks
D. 26 weeks
| 32 weeks |
7a075a1c-d492-4f80-8481-ac8a6ca159db | Screening refer to 'the search for unrecognized disease or defect by means of rapidly applied tests, examinations or other procedures in apparently healthy individuals'
For screening a disease the most important parameter is sensitivity
Sensitivity is defined as the ability of a test to identify correctly all those who have the disease i.e., true positives as it reflects the ability to detect those who have the disease amongst the hidden cases in the community.
For confirming a patient as diseased most important parameter is specificity
Specificity is defined as the ability of a test to identify correctly all these who do not have the disease i.e., true negative.
Memo: ELISA is a sensitive test for HIV: ELISA is used as screening test for HIV
Western blot is a specific test for HIV : Western blot is used as a confirmatory test for HIV.
Usefulness of a screening test is given by sensitivity
Statistical index of diagnostic accuracy → specificity | Social & Preventive Medicine | null | The usefulness of a 'screening test' in a community depends on its -
A. Sensitivity
B. Specificity
C. Reliability
D. Predictive value
| Sensitivity |
35263021-5b59-43ea-99cc-76cf015b1219 | Ans. is 'c' > 'd' ie splitting of glomerular basement membrane > sub endothelial deposits Both the features mentioned in the options d & c are present in membranoproliferative glomerulonephritis.Membranoproliferative glomerulonephritis is of 2 typesTYPE I characterized byDeposition of subendothelial* immune on complexes in the glomerular capillarySplit basement membrane (Double contour or tram track appearance)Type II Characterized by:Dense intramembranous* deposits electron microscopyRemember the only other condition where subendothelial deposits are seen is - SLE.Glomerular depositsSub epithelialDiffuse proliferative glomerulonephritis*Membranous glomerulopathy*.IntramembranousMembranoproliferative glomerulonephritis type II *Mesangial Focal segmental glomerulonephritis*Henoch Schonlein purpura * | Pathology | Glomerular Diseases | Which of these is the characteristic feature of membranoproliferative glomerulonephritis-
A. Sub epithelial deposits
B. Foamy cells
C. Splitting of glomerular basement membrane
D. Sub endothelial deposits.
| Splitting of glomerular basement membrane |
50c9ed23-19a7-480d-950a-973876d73c50 | Ans-A i.e., Oxytocin Oxytocino Oxytocin is a nonapeptide,o It is secreted by the posterior pituitary along with vasopressin (ADH).o Both oxytocin and ADH are synthesized within the nerve cell bodies in the supraoptic and paraventricular nuclei of the hypothalamus; are transported down the axon and stored in the nerve endings within the neurohypophysis.o They are stored in separate neurons as complexes with their specific binding proteins (Neurophysin).o ActionsUterusIt increases the force and frequency of uterine contraction.Estrogens sensitize the uterus to oxytocin, while progestins decrease the sensitivity.The increased contractility is restricted to the fundus and body,, lower segment is not contracted, may even be relaxed at term.BreastOxytocin contracts myoepithelium of mammary alveoli and forces milk into bigger sinusoids - Milk ejection or milk letdown reflex.CVSHigher doses cause vasodilation - Brief fall in BP, reflex tachycardia, and flushing.The umbilical vessels are constricted oxytocin may help their closure at birth.KidneyOxytocin in high doses exerts ADH like action -->> water retention can occur. | Unknown | null | Main hormone acting upon uterus to initiate labor-
A. Oxytocin
B. Estrogen
C. Progesterone
D. Cortisole
| Oxytocin |
aa68d709-b4b6-4186-8ad1-42f7f3f437c9 | In fungal ulcer, usually a big hypopyon is present even if the ulcer is small.Unlike the bacterial ulcer,the hypopyon may not be sterile as the fungi can penetrate into the anterior chamber without perforation. Reference:Comprehensive ophthalmology,AK Khurana,6th edition,page no.106 | Ophthalmology | Cornea and sclera | Non -sterile hypopyon is seen in -
A. Pneumococcus infection
B. Pseudomonas infection
C. Fungal infection
D. Gonococcal infection
| Fungal infection |
c79aae07-b997-4c94-8807-90fb1297819d | OSTEOPETROSIS:
Roentgenographic features:
Medullary cavities are replaced by bone and the cortex is thickened.
Density of bone may be such that, the roots of the teeth are nearly invisible on dental roentgenogram.
Ends of long bones are bulbous called Erlenmeyer's flask deformity.
In osteopetrosis, there is normal appositional bone growth, but failure of physiologic root resorption.
On X-ray, bones might appear club-like or show an appearance of a bone within bone (Endobone). Vertebrae are extremely radiodense and may show alternating bands, known as the "rugger-jersey" sign.
Lab findings of Osteopetrosis:
Myelophthisic anemia (as bone marrow is replaced by bone).
Hypocalcemia (Shafer reports normal serum calcium, phosphorus and alkaline phosphatase levels).
Secondary hyperparathyroidism. | Pathology | null | X-ray of a patient shows the following changes: Bulbous ends of long bones, normal appositional bone growth and there is failure of physiologic root resorption. Lab finding shows myelophthisic anemia. What can be the probable diagnosis?
A. Fibrous dysplasia
B. Osteomyelitis
C. Osteopetrosis
D. Paget's disease
| Osteopetrosis |
3c21f444-3630-4021-8c51-26ab483d116b | Old patient along with lytic circumscribed punched out X-ray appearance suggests multiple myeloma Multiple myeloma most often presents as multifocal destructive bone tumors composed of plasma cells throughout the skeletal system. It shows sheets of atypical plasma cells. | Pathology | Plasma Cell Disorders and Multiple myeloma | A 70-year-old male has a pathologic fracture of femur. The lesion appears a lytic on X-rays film with a circumscribed punched out appearance. The curetting from fracture site is most likely to show which of the following?
A. Diminished and thinned trabecular bone
B. Sheets of atypical plasma cells
C. Metastatic prostatic adenocarcinoma
D. Malignant cells forming osteoid bone
| Sheets of atypical plasma cells |
9d40c400-1f32-4a65-9ea9-e3e4c3c3c84a | As parathyroids on the opposite side are preserved and not dealt with during surgery hypoparathyroidism is not seen after hemithyroidectomy. | Surgery | All India exam | Not a common complication of hemithyroidectomy
A. Hypoparathyroidism
B. Reactionary hemorrhage
C. Recurrent laryngeal nerve palsy
D. External laryngeal nerve palsy
| Hypoparathyroidism |
ed366945-d705-4c75-8cea-4bf202fec9a5 | In ICDS supplementary nutrition is given to children below 6 years, nursing and expectant mothers from low-income group.Each child 6-72 months of age get 500 Cal and 12-15Gm of proteinSeverely malnourished child 6-72 months of age get 800 Cal and 20-25Gm of proteinEach pregnant and nursing women to get 600 Cal and 18-20Gm of proteinPark 23e pg: 591 | Social & Preventive Medicine | Maternal and child care | Diet given to pregnant lady under ICDS is
A. 3000Kcal with 60grams of protein
B. 800Kcal with 25grams of protein
C. 500Kcal with 12grams of protein
D. 600Kcal with 18grams of protein
| 600Kcal with 18grams of protein |
f7d17358-64c7-4deb-9cea-16c5d5b38d78 | Pharyngoconjunctival fever is caused most commonly by serotypes 3 and 7, but serotypes 2, 4 and 14
also, have been documented as etiologic agents.
Ocular infections caused by Adenovirus -
i. Epidemic keratoconjunctivitis → Serotypes 8, 19, 37
ii. Follicular conjunctivitis → Serotypes 3,7
iii. Pharyngoconjunctival fever - Serotypes 3, 7
Adeno Virus
Non-enveloped, DNA (ds DNA) Virus
Has characteristic morphology consisting of an icosahedral shell composed of 20 equilateral triangular faces and 12 vertices → space vehicle appearance.
Human adenovirus grows only in tissue culture of human origins, such as human embryonic kidney, HeLa or HEP-2.
The cytopathic effect in tissue culture → cell rounding and aggregation into grape-like clusters.
Adenovirus has been used as a vector for gene therapy.
Adenovirus cause infections of the respiratory tract and eyes and less often of the intestine and urinary tract.
Most frequently affect infants and children
Clinical manifestations
□ Most common manifestation in children is an acute upper respiratory tract infection with prominent rhinitis.
□ Most common manifestation in an adult is ARDS | Microbiology | null | Pharyngoconjunctival fever is caused by -
A. Adenovirus 3 and 7
B. Adenovirus 11, 21
C. Adenovirus 40, 41
D. Adenovirus 8, 19
| Adenovirus 3 and 7 |
04b969f1-dda2-4a4b-8c12-284b3a619f5d | Sequestrum is the dead bone separated out from the living bone by the granulation tissue. The factors responsible for bone death in chronic osteomyelitis are: raised intravascular pressure Vascular stasis and small vessel thrombosis periosteal stripping bacterial toxins Sequestrum is the hall mark of chronic osteomyelitis Ring sequestrum causes : Ring sequestrum * Amputation stump * Pin tract infection Cylindrical/pencil like Infants Green Pseudomonas osteomyelitis Black Amputation stump due to exposure of bone with air. | Orthopaedics | Joint and Soft tissue infections | Ring sequestrum causes:
A. Typhoid osteomyelitis
B. Chronic osteomyelitis
C. Amputation stump
D. Tuberculosis osteomyelitis
| Amputation stump |
6b3a5bd8-29ae-471f-a887-484621447d46 | Ans. is 'a' i.e.* Thermogenin o Amongst the given options, a, b and c are uncouplers.o However, only thermogenin, among these three is a natural (physiological) uncouplex.Uncoupleso As the name suggests, these componds block the coupeling of oxidation with phosphorylation. These compounds allow the transfer of reducing equivalents in respiratory' chain but prevent the phosphorylation of ADP to ATPQ by uncoupling the linkage between ETC and phosphorylation. Thus the energy instead of being trapped by phosphorylation is dissipated as heat. Uncouplers may beNatural:- Thermogenin, thyroxineSynthetic :- 2, 4-dinitrophenol (2, 4-DNP), 2, 4-dinitrocresol (2, 4-DNC), and CCCP (chlorocarbonylcyanidephenvl hvdrazone).o Thermogenin is an uncoupler protein present in brown adipose tissue (brown fat0). It uncouples oxidation and phosphorylation by acting as a channel for IT ions so that hydrogen ion gradient cannot build up. Oxidation occuring in brown adipose tissue without generation of ATP results in production of heatQ . | Biochemistry | Respiratory Chain | Which of the following is physiological uncoupler-
A. Thermogonin
B. 2, 4nitrophenol
C. 2, 4Dinitrophenol
D. Oligomycin
| Thermogonin |
6bad93ce-f227-415b-b299-fa8c7c82fd80 | In most patients laryngomalacia is a self-limiting condition. Treatment of laryngomalacia is reassurance to the parents and early antibiotic therapy for upper respiratory tract infections. Tracheostomy is required only in severe respiratory obstruction. Surgical intervention (supraglottoplasty i.e. reduction of redundant laryngeal mucosa) is indicated for 10% of patients. Main indications for surgery are: Severe stridor Apnea Failure to thrive Pulmonary hypeension Cor pulmonale | ENT | null | Most common mode of treatment for laryngomalacia is:
A. Reassurance
B. Medical
C. Surgery
D. Wait and watch
| Reassurance |
9aed191e-4ca7-4aa4-bb58-8d444b704552 | Ans. A: C- fiberAlpha fibers are the thickest (fiber diameter of 12-20 micrometer) and fastest conduction velocity (of 70-120 mis) whereas C-fibers are the thinnest (fiber diameter of 0.3-1.2 micrometer) and slowest conduction velocity (of 0.5-2 m/s) | Physiology | null | Sensory fiber with least conduction velocity:September. 2005
A. C- fiber
B. Alpha fiber
C. beta fiber
D. Gamma fiber
| C- fiber |
e74349c7-0d7c-4cab-9472-38dbfd4c16dc | Radiopaque refers to that portion of the radiograph that appears light or white. Radiopaque structures are dense and absorb or resist the passage of the X-ray beam, E.g., Enamel, dentin and bone.
Nasal septum
On the panoramic radiograph, it appears as a vertical radiopaque partition that divides the nasal cavity.
Reference: Freny R Karjodkar Oral Radiology Principles and Interpretation 2nd edition page no 251 | Radiology | null | Which of these structures appears radiopaque?
A. Maxillary sinus
B. Nasal fossa
C. Nasal septum
D. Mental foramen
| Nasal septum |
d4f8ccc1-bb25-4209-a951-725d03dd72ad | Androgen binding protein is a protein secreted by testicular Seoli cells along with inhibin and mullerian inhibiting substance. Androgen binding protein probably maintains a high concentration of androgen in the seminiferous tubules.Ref: Ganong&;s review of medical physiology; 24th edition; page no: 421 | Physiology | Endocrinology | Seoli cell secrets
A. Androgen binding protein
B. Testosterone
C. LH
D. FSH
| Androgen binding protein |
d7b0c506-5aba-47c4-8314-f083e0c93216 | * High plasma protein binding (PPB) of a drug decreases its distribution into tissue and thus lower the volume of distribution. * As only free drug can be metabolized or excreted, high PPB usually increases the duration of action. * With higher PPB, there is more chance of getting displaced by other drugs leading to more drug interactions. * Drugs with high plasma protein binding have lesser glomerular filteration as proteins cannot be filtered across the glomerulus. | Pharmacology | Pharmacokinetics | High plasma protein binding of a drug results in:-
A. Decreased glomerular filtration
B. High volume of distribution
C. Lowers duration of action
D. Less drug interaction
| Decreased glomerular filtration |
a8b70198-2795-4dcd-a6f8-2066403c55f2 | ANSWER: (C) ECTREF: Kaplan synopsis 10th ed p. 557ECT is therapy of choice depression with:Suicidal tendencyPsychomotor retardationPsychotic and delusional features with somatic syndromeIntolerance , contraindication, refractory to drugs | Psychiatry | Pharmacotherapy Management of Children and Adolescents | Treatment of depression with suicidal tendencies is?
A. Clozapine
B. Mitrazapine
C. ECT
D. Olenzapine
| ECT |
3847c743-34e9-4c9d-a493-21582033a3f4 | PEEP & CPAP can cause barotrauma which may result in pneumothorax, pneumoperitoneum, penumopericardium/ cardiac tamponade. | Anaesthesia | null | Complication of positive pressure ventilation –
A. Pneumothorax
B. Bradycardia
C. Decreased ventilation
D. Arrhythmias
| Pneumothorax |
f10fe683-0482-41ec-8387-a275cadddc1b | SEROUS OTITIS MEDIA, SECRETORY OTITIS MEDIA, MUCOID OTITIS MEDIA, "GLUE EAR" This is an insidious condition characterized by accumulation of nonpurulent effusion in the middle ear cleft. The fluid is nearly sterile. The disease affects children of 5-8 years of age. Hearing loss. This is the presenting and sometimes the only symptom. It is insidious in onset and rarely exceeds 40 dB. Deafness may pass unnoticed by the parents and may be accidentally discovered during audiometric screening tests. Ref : Diseases of ENT by Dhingra 6th edition Pgno : 64 | ENT | Ear | The most common cause of conductive deafness in children is
A. ASOM
B. Wax
C. Serous otitis media
D. Otosclerosis
| Serous otitis media |
14a9d171-cee5-4ffa-a67c-f2e441af2daa | Recurrent severe infection is an indication for clinical evaluation of immune status. Live vaccines, including BCG attenuated from Mycobacterium tuberculosis, should not be used in the evaluation of a patient's immune competence because patients with severe immunodeficiencies may develop an overwhelming infection from the vaccine. For the same reason, oral (Sabin) polio vaccine is not advisable for use in such persons. Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition | Microbiology | Immunology | A young girl has had repeated infections with Candida albicans and respiratory viruses since the time she was 3 months old. As pa of the clinical evaluation of her immune status, her responses to routine immunization procedures should be tested. In this evaluation, the use of which of the following vaccines is contraindicated?
A. Diphtheria toxoid
B. Bordetella peussis vaccine
C. Tetanus toxoid
D. BCG
| BCG |
fe2e1548-36ce-49a6-b6b5-19254bbf113e | Choanal atresia
Choana, also called posterior nares, is an opening in the posterior part of each nasal cavity, through which the nasal cavity communicates with nasopharynx.
Choanal atresia is a congenital anomaly characterized by closure of one or both posterior nasal cavies (i.e., choana). It is due to the persistence of bucconasal membrane.
Approximately 60- 70% of cases are unilateral and are more common on the right side.
Bilateral cases occur in 20-30% of patients and 50% of these patients are associated with other congenital anomaly, i.e.,
CHARGE syndrome
→ Coloboma, Heart defects, Choanal atresia, Retarded growth, Genitourinary abnormalies and Ear defects.
Diagnosis - Unilateral lesions go unnoticed until the child presents with persistent unilateral nasal discharge.
There is the absence of air bubbles in nasal discharge.
A simple test for unilateral choanal atresia is to have the child attempt nose blowing with opposite nostril occluded by external pressure.
Failure to detect any air movement is suspicious for complete obstruction.
Bilateral choanal atresia presents as respiratory distress in newborn and requires support immediately after birth. | ENT | null | Choanal atresia is due to the persistence of
A. Bucconasal membrane
B. Oropharyngeal membrane
C. Laryngotracheal fold
D. Tracheoesophageal fold
| Bucconasal membrane |
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