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4f972d3b-144b-415c-9e27-f7e06138de1f | Recurrent scaly hypopigmented macule on the face of a child - P. alba Recurrent scaly hypopigmented macule on the face of an adult - P. versicolor Resident of the endemic zone with an anaesthetic patch over face - Indeterminate leprosy | Dental | null | A 7 years old child from Bihar is having hypo pigmented anaesthetic patch on his face. What is the most probable diagnosis?
A. Intermediate leprosy
B. Pityriasis alba
C. Nevus anemicus
D. Nevus achromicus
| Intermediate leprosy |
7a39b7b8-5fa7-4726-a532-babf8482b908 | Ans. is 'b' i.e., Robe koch Scientist Associated with Fracastorius Proposed a contagium vivuin (cause of infectious disease) Von Plenciz Suggested that each disease is caused by a separate agent Augustino Bassi Earliest discovery of pathogenic microorganism Davaine and Pollender Observed anthrax bacilli in blood of animal Louis Pasteur Father of microbiology (Also see above explanation) Robe Koch Father of medical microbiology Discovered M. tuberculosis and V cholerae Introduced staining techniques methods of obtaining bacteria in pure culture on solid media Suggested Koch's postulate Joseph Lister Father of Aseptic surgery Proved that sepsis could be prevented by Hand hygiene Antony Van Leeuwen hoek Invented microscope (Father of compound microscope) Father of Bacteriology Edward Jenner Father of Immunology Peyton Rous Isolated virus causing sarcoma in fowl Von Behring & Kitasato Described antibody | Microbiology | null | Mycobacterium tuberculosis was discoverd by ?
A. Louis pasteur
B. Robe koch
C. Lister
D. Jener
| Robe koch |
3051f2b1-bd67-4737-9954-30239b4ed4ab | Studdiford criteria : To diagnose the abdominal pregnancy Both the tubes and ovaries are normal without any recent injuries Absence of uteroperitoneal fistula Presence of pregnancy related exclusively to the peritoneal surface and young enough to eliminate the possibility of secondary implantation following the primary nidation in the tube. Ref: Dutta Obs 9e pg 177. | Gynaecology & Obstetrics | General obstetrics | Which of the following is used for abdominal pregnancy
A. Studiford criteria
B. Speigelberg criteria
C. Rubins criteria
D. Rotterdam criteria
| Studiford criteria |
41701f03-d960-4046-ae0b-57032e343298 | Farber disease (also known as Farber&;s lipogranulomatosis, ceramidase deficiency, "Fibrocytic dysmucopolysaccharidosis," and "Lipogranulomatosis" is an extremely rare autosomal recessive lysosomal storage disease marked by a deficiency in the enzyme ceramidase that causes an accumulation of fatty material sphingolipids leading to abnormalities in the joints, liver, throat, tissues and central nervous system. Normally, the enzyme ceramidase breaks down fatty material in the body's cells. In Farber Disease, the gene responsible for making this enzyme is mutated. Hence, the fatty material is never broken down and, instead, accumulates in various pas of the body, | Biochemistry | miscellaneous | Farber&;s disease is due to the deficiency of
A. Ceraminidase
B. Sphingomyelinase
C. Glucocerebrosisase
D. Neuraminidase
| Ceraminidase |
9c2a1890-7766-4beb-b113-5658719dbe8b | Demonstration of intracellular monosodium urate crystals (MSU) in synovial fluid from affected joint is diagnostic of gout. | Orthopaedics | null | A specific test for gout is -
A. Raised serum uric acid level
B. Raised uric acid in synovial fluid of joint
C. Raised urea level
D. Raised urease enzyme level
| Raised uric acid in synovial fluid of joint |
08831171-0348-4306-9e41-3095409611e6 | Seclusio pupillae/ring synaechiae/annular synaechiae is seen in severe iritis or recurrent uveitis, in which whole circle of pupillary margin becomes tied down to the lens capsule. It can lead to secondary angle closure glaucoma. Note: Occlusio pupillae/blocked pupil occurs when exudation in uveitis is extensive. They organize across the entire pupillary area and opaque fibrous tissue fills the pupillary area. Festooned pupil: Pupil dilatation with atropine leads to failure of dilation of adhered segments resulting in irregularly shaped pupil. Pupil will be miotic and sluggishly reacting in uveitis. Ref: Parson's diseases of the eye, 21st edition, page no: 230 | Ophthalmology | null | In severe cases of anterior uveitis whole circle of pupil gets adhered to lens capsule resulting in:
A. Occlusio pupillae
B. Seclusio pupillae
C. Festooned pupil
D. Mydriatic pupil
| Seclusio pupillae |
b259b28b-4d42-41fa-9a39-97d7b8b7dcb4 | Ans. is 'a' i.e., Adolescent health The RMNCH+A strategy is based on provision of comprehensive care through the five pillars, or thematic areas, of reproductive, maternal, neonatal, child, and adolescent health, and is guided by central tenets of equity, universal care, entitlement, and accountability. The "plus" within the strategy focusses on :Including adolescence for the first time as a distinct life stage.Linking maternal and child health to reproductive health, family planning, adolescent health. HIV, gender, preconception and prenatal diagnostic techniques.Linking home and community-based services to facility-based care.Ensuring linkages, referrals, and counter-referrals between and among health facilities at primary (primary health centre), secondary (community health centre), and teiary levels (district hospital). | Social & Preventive Medicine | null | In RMNCH+A Staegy, what is plus ?
A. Adolescent health
B. Reproductive health
C. DPT Vaccination
D. Newborn health
| Adolescent health |
8625ed41-d265-497a-8128-5d0f1837aae2 | Septic shock has already been described → in hyperdynamic stage there is vasodilation and ↓ TPR.
Neurogenic shock
Neurogenic shock occurs when there is Neurological injury as occur in head trauma or high cervical cord injury or cephalad migration of spinal anaesthesia.
Interruption of sympathetic vasomotor input occurs that causes vasodilatation, decreased heart rate and Cardiac output and shock.
Then what is the difference between neurogenic shock and hyperdynamic stage of septic shock ?
In septic shock, there vasodilatation ( ↓ TPR) due to NO with associated reflex sympathetic activity that increases heart rate and cardiac output.
On the other hand, in neurogenic shock there is decreased sympathetic drive that leads to decrease in all, i.e., peripheral resistance, cardiac output and heart rate. | Pathology | null | Peripheral resistance is decreased in which type of shock -a) Hypovolemic shockb) Neurogenic shockc) Septic shockd) Cardiogenic shock
A. a
B. c
C. ac
D. bc
| bc |
59101bd7-d67f-485f-8e90-6477f59694b9 | Multiple lytic lesions associated with keratin-positive cells strongly suggest metastatic bone cancer. Metastatic carcinoma is the most common tumor of bone, and skeletal metastases are found in at least 85% of cancer cases that have run their full clinical course. The vertebral column is the most commonly affected bony structure. Tumor cells usually arrive in the bone by way of the bloodstream. Some tumors (thyroid, gastrointestinal tract, kidney, neuroblastoma) produce mostly lytic lesions. A few neoplasms (prostate, breast, lung, stomach) stimulate osteoblastic components to make bone. The other choices are not keratin positive.Diagnosis: Metastatic bone cancer | Pathology | Osteology | A 50-year-old woman presents with lower back pain of 3 weeks in duration. Radiologic studies reveal several discrete lytic lesions in the lumbar back and pelvis. Laboratory studies show elevated serum levels of alkaline phosphatase. Serum calcium, serum protein, and peripheral blood smears are normal. Aspiration biopsy of a pelvic lesion shows keratin-positive cells. Which of the following is the most likely diagnosis?
A. Chondrosarcoma
B. Metastatic carcinoma
C. Osteochondroma
D. Osteosarcoma
| Metastatic carcinoma |
ef15f52d-dc57-45ca-8c4a-6b53211213a8 | Cretinism is congenital iron deficiency syndrome which can be preventable by intake in required amounts. Reference: GHAI Essential pediatrics, 8th edition | Pediatrics | Central Nervous system | Preventable causes of Mental Retardation are
A. Downs
B. Phenylketonuria
C. Cretinism
D. Cerebral palsy
| Cretinism |
389452f0-5f7b-4f38-ab3c-c6d78c028202 | Ans. (b) Linea semilunarisRef: Gray's 41st edn/1080-81; Keith L Moore clinical anatomy 4thed/ 193-4# HESSELBACH'S TRIANGLE* Medial border: Lateral margin the rectus sheath, also called linea semilunaris* Superolateral border: Inferior epigastric vessels* Inferior border: Inguinal ligament, sometimes referred to as Pouparts ligament. | Anatomy | Abdominal Wall | Medial border of Hesselbach's triangle is formed by:
A. Linea alba
B. Linea semilunaris
C. Inferior epigastric artery
D. Conjoint tendon
| Linea semilunaris |
757be73f-e0fc-4d08-89e6-b60cf98e500e | Vancomycin is a glycopeptide antibiotic used in the prophylaxis and treatment of infections caused by Gram-positive bacteria. Cefixine is an oral third generation cephalosporin antibiotic. It has good activity for gram-negatives. Metroridozole is highly active against gram-negative anaerobic bacteria, such as B. fragilis, and gram-positive anaerobic bacteria, such as C. difficile. Gentamicin is an aminoglycoside antibiotic, used to treat many types of bacterial infections, paicularly those caused by Gram-negative organisms. | Pharmacology | null | Which of the following are ineffective against gram negative bacteria?
A. Cefixime
B. Metronidazole
C. Vancomycine
D. Gentamycine
| Vancomycine |
b71eccc6-e106-4e49-bc48-b43c3011965b | Fracture neck of talus results from forced dorsiflexion of the ankle. Typically this injury is sustained in an aircraft crash where the rubber bar is driven forcibly against the middle of the sole of the foot (ATOR&;s fracture), resulting in forced dorsiflexion of the ankle, the neck being a weak area, gives way. Reference - Essential ohopaedics- Maheshwari -5th edn pg no 166. | Orthopaedics | Management in Orthopedics | Ator fracture is -
A. Fracture neck of talus
B. Fracture scaphoid
C. Fracture calcaneum
D. Fracture 5th metatarsal
| Fracture neck of talus |
c178af37-f2a7-4cd1-bb63-25b185556035 | Bilateral basal ganglia calcification is seen on CT brain in Krabbe disease. Fuher,Globoid cells are seen in microscopic exmaination,which is a diagnostic feature. C/F: Irritability, muscle weakness, feeding difficulties, episodes of fever without any sign of infection, stiff posture, and delayed mental and physical development. As the disease progresses, muscles continue to weaken, affecting the infant's ability to move, chew, swallow, and breathe. Affected infants also experience vision loss and seizures. Alexander disease- hypodensity of white matter, frontal lobe predominance Metachromatic Leukodystrophy- tigroid appearance on MRI Adrenoleukodystrophy- Hyperintense signal changes in parieto-occipital region & splenium of corpus callosum on MRI | Pediatrics | Lysosomal Storage Diseases | A 4-month-old child presents with excessive irritability & crying, unexplained hyperpyrexia, vomiting, difficulty feeding for last 15 days. On admission he has rigidity & visual inattentiveness; CT scan brain shows the following finding. What is the probable diagnosis?
A. Alexander disease
B. Krabbe disease
C. Metachromatic Leukodystrophy
D. Adrenoleukodystrophy
| Krabbe disease |
e598be7f-b11a-462f-97ee-7141f4b00ce1 | Prothrombin time test - Time needed for plasma to clot after addition of tissue thromboplastin and Ca2+ ions. | Pathology | null | Which is must for prothrombin time?
A. Thromboplastin
B. Prothrombin
C. Fibrinogen
D. Fibrin
| Thromboplastin |
460bbef5-309c-470c-a12f-e9e29117d465 | Ans. B. PANImage shows angiographic vascular pathologya. Most probably it is seen in PAN (Polyarteritis nodosa)b. It is medium vessel vasculitis of renal & visceral vessels sparing the pulmonary circulationc. In PAN, small aneurysms are strung like the beads of arosary known as Rosary sign. | Medicine | Immunology and Rheumatology | Following angiography findings are most likely seen in which condition:
A. Kawasaki
B. PAN
C. Takayasu
D. Giant cell arteritis
| PAN |
be60c527-3987-4ffe-950d-b174f23602b0 | Testosterone REF: Ganong's 22nd ed p. 430 Secondary sexual hair production in both man and woman is under control of androgens | Physiology | null | Axillary hair growth is caused by?
A. Testosterone
B. Estrogen
C. Prolactin
D. Estrogen in women and androgens in man
| Testosterone |
5126f908-5636-43ae-befd-a3c60abcdd36 | Ans. is 'a' i.e. Chylomicrons [Ref: Chatterjee & Shinde Biochemistry 6/e, p 338 (T21.2); Harper 26/e, p 206;Maximum content of TG's is seen in - Chylomicrons*Maximum content of exogenous TG's is seen in - Chylomicrons*Maximum content of endogenous TG's is seen in - VLDL*Maximum cholesterol is seen in - LDL*Chylomicrons are the lipoprotein particles lowest in density and largest in size, and contains the highest percentage of lipids and the smallest percentage of proteins. VLDLs and LDLs are successively denser, having higher ratios of protein to lipid. HDL particles are the densest.Composition of the lipoproteinsLipoproteinSourceDiameter (nm)Density (g/mL)CompositionMain Lipid ComponentsApolipoproteinsProtein (%)LipidChylomicronsIntestine90-1000<0.951-298-99TriacylglycerolA-I, A-II, A-IV,l B-48, C-I, C-II, C-III, EChylomicron remnantsChylomicrons45-150< 1.0056-892-94Triacylglycerol, phospholipids,cholesterolB-48, EVLDLLiver (intestine)30-900.95-1.0067-1090-93TriacylglycerolB-100, C-I, C-II, C-IIIIDLVLDL25-351.006-1.0191189Triacylglycerol, cholesterolB-100, ELDLVLDL20-251.019-1.0632179CholesterolB-100HDLLiver, intestine,VLDL, chylomicrons20-251.019-1.0633268Phospholipids, cholesterolA-I, A-II, A-IV, C-I, C-II, C-III, D,2 EHDL1HDL210-201.063-1.1253367HDL35-101.125-1.2105743PreP-HDL3<5>1.210 A-IAlbumin/free fatty acidsAdipose tissue >1.28199-1Free fatty acids 1 Secreted with chylomicrons but transfers to HDL.Associated with HDL2 and HDL3 subtractions.3Part of a minor fraction known as very high density lipoproteins (VHDL). | Biochemistry | Cholesterol and Lipoproteins | Triglycerides are maximum in
A. Chylomicrons
B. VLDL
C. LDL
D. HDL
| Chylomicrons |
a72a3592-5628-4457-8a9d-99d21b195bd6 | Ans. is 'a' i.e., Radial nerve RegionBoundariesContentsUpper triangular space of armSuperior: Teres minorInferior : Teres majorLateral: Long head of tricepsCircumflex scapular arteryLower triangular space of armSuperior: Teres majorMedial: Long head of tricepsLateral; Shaft of humerusRadial nerveProfunda brachii vesselsQuadrangular space of armSuperior: Teres minor, subscapularis, joint capsuleInferior :Teres majorMedial: Long head of tricepsLateral: Surgical neck of humerusAxillary nervePosterior circumflex humeral vessels | Anatomy | Upper Extremity | Which of the following structure passes through the triangular interval of the arm?
A. Radial nerve
B. Axillary nerve
C. Median nerve
D. Ulnar Nerve
| Radial nerve |
fc63a9c7-7582-4fa0-aab7-60f59bed1bc5 | Ans. is 'b* i.e., Seals the single strand nick between the .......... ProteinFunctionDNA polymerasesDeoxynucieotide polymerizationHelicasesProcessive unwinding of DNATopoisomerasesRelieve torsional strain that results from helicase-induced unwindingDNA primaseInitiates synthesis of RNA primersSingle-strand binding proteinsPrevent premature reannealling of dsDNADNA ligaseSeals the single strand nick between the nascent chain and Okazaki fragments on lagging strand | Biochemistry | DNA Replication | What is the function of DNA ligase ?
A. Unwinding (denaturation) of dsDNA to provide an ssDNA template
B. Seals the single strand nick between the nascent chain and Okazaki fragments on lagging strand
C. Initiation of DNA synthesis and elongation
D. Initiates synthesis of RNA primers
| Seals the single strand nick between the nascent chain and Okazaki fragments on lagging strand |
66219d6f-18e1-4d72-99a3-a0c61e277f89 | Cicatricial Pemphigoid:
Autoimmune blistering disease associated with autoantibodies directed against basement membrane zone target antigens.
Autoantibodies of IgG subclass, particularly IgG4, are associated with CP.
IgA antibodies have also been detected.
The two major antigens associated with CP are bullous pemphigoid antigen 2(BPAG2) and epiligrin (laminin-5). | Pathology | null | Which of the following antigens are associated with cicatricial pemphigoid?
A. BPAG2 and epiligrin
B. HLA DR5 and HLA B8
C. HLA DR52 and HLA DR3
D. HLA DQB2
| BPAG2 and epiligrin |
da50b434-53c9-4330-b171-e93f8ed2c634 | Ans. is 'a' i.e., Na channel inhibition inside gate o Local anesthetics act by inhibiting Na+ channels from inside.Mechanism of action of LAo Local anaesthetics block generation and conduction of nerve impulse at all part of neuron where they come in contact, without causing structural damage.o Thus not only sensory but motor impulses and autonomic control is also interrupted,o Mechanism of action# Normally Na+ channel in axonal membrane has following phases :LAs prolong the inactive state - channel takes longer to recover - refractory period of the fiber is increased.LAs first penetrate the axonol membrane to come inside and then their active species (cationic form) bind to Na+ channel from inside.Cationic form (active form) is able to approach its receptor only when the channel is open at the inner face - So resting nerve is resistant to block as Na+ channels are not activated and cationic form is not able to approach its receptor.So blockade develops rapidly when the nerve is stimulated repeatedly.Degree of blockade is frequency dependent - greater blockade at higher frequency of stimulation.Exposure to higher concentration of Ca+2 reduces inactivation of Na+ channels and lessens the block.o Order of blockade of fibres B > C > Ad > Aa, b & g (Autonomic > Sensory > Motor). Order of recovery is in reverse order.o Among sensory afferent order of block is : Temperature (cold before heat) > Pain > touch > deep pressure,o When applied to tongue, bitter taste is lost first followed by sweet and sour, and salty taste last of all.o Myelinated nerves are blocked earlier than nonmyelinated,o Smaller fibres are more sensitive than larger fibres. | Anaesthesia | Miscellaneous (Local and Regional Anesthesia) | Local anaesthetics act by-
A. Na channel inhibition inside gate
B. Na channel inhibition outside gate
C. K channel inhibition inside gate
D. K channel inhibition outside gate
| Na channel inhibition inside gate |
b33b9fc0-c517-4f35-ac53-4e3dd4251ef9 | Ans. is 'a' i.e., Rhinoscleroma o Biopsy of rhinoscleroma show's infiltration of submucosa writh plasma cells, lymphocytes, eosinophils, Mikulicz cells and Russell bodies. The latter two are the diagnostic features of the disease,Rhinoscleromao The causative organism is Klebsiella rhinoscleromatisor Frisch bacillus ^ which can be cultured from the biopsy material. The disease is endemic in several parts of world. In India, it is seen more often in northern than in the southern parts. Biopsy shows infiltration of submucosa with plasma cells, lymphocytes, eosinophils, Mikulicz cells & Russell bodies. The latter two are diagnostic features of the disease. The disease starts in the nose & extends to nasopharynx, oropharynx, larynx, trachea & bronchi. Mode of infection is unknown. Both sexes of any age may be affected. | ENT | Nose and PNS | Mikulicz and russel bodies are characteristic of -
A. Rhinoscleroma
B. Rhinosporidiosis
C. Plasma cell disorder
D. Lethal midling granuloma
| Rhinoscleroma |
a5ed5279-5bad-405b-bee6-7ba071121859 | The nigrostriatal pathway or the nigrostriatal bundle (NSB), is a dopaminergic pathway that connects the substantia nigra with the dorsal striatum (i.e., the caudate nucleus and putamen). Dopaminergic neurons of this pathway synapse onto GABAergic neurons. Glycine is an inhibitory neurotransmitter in the central nervous system, especially in the spinal cord, brainstem, and retina. Serotonin is a neurotransmitter and is found in all bilateral animals, where it mediates gut movements and the animal's perceptions of resource availability Ref Harrison20th edition pg 2765 | Medicine | C.N.S | Neurotransmitter in striatal pathway is?
A. Glutamine
B. Glycine
C. Serotonine
D. Dopamine
| Dopamine |
911e5564-6383-428f-9beb-63acb5cefa9e | Fatty acid synthesis takes place in cytoplasm.
Beta Oxidation occurs in mitochondria.
Heme synthesis and Urea cycle occur both in cytoplasm and mitochondria. | Biochemistry | null | Which of the following pathways does not occur in mitochondria
A. Beta oxidation
B. Urea cycle
C. Fatty acid synthesis
D. Heme synthesis
| Fatty acid synthesis |
e1ea77c2-eaa8-4aad-a2e9-9f28f589430a | DERM ATOM MYOSITIS:
DM is a distinctive entity identified by a characteristic rash accompanying, or more often preceding muscle weakness.
√ Heliotrope rash: The rash may consist of a blue-purple discolouration on the upper eyelids with edema
√ Gottron's sign: A flat red rash on the face and upper trunk and erythema of the knuckles with a raised violaceous scaly eruption.
√ Gottron's papules: Discrete erythematous papules overlying the metacarpal and interphalangeal joint
√ The erythematous rash can also occur on other body surfaces, including the knees, elbows, malleoli, neck and anterior chest (often in a V sign), or back and shoulders (shawl sign), and may worsen after sun exposure.
√ In some patients, the rash is pruritic, especially on the scalp, chest, and back. √ Dilated capillary loops at the base of the fingernails are also characteristic. The cuticles may be irregular, thickened, and distorted, and the lateral and palmar areas of the fingers may become rough and cracked, with irregular, "dirty" horizontal lines, resembling mechanics hands. | Dental | null | Gottron’s papules Seen in?
A. SLE
B. MTCD
C. Dermatomyositis
D. Rheumatoid arthritis
| Dermatomyositis |
5585da3c-5132-4b3d-89f5-cd27c8172713 | Cholestyramine and colestipol are bile acid sequestrants that bind bile acids in the intestine, thereby interrupting enterohepatic circulation of bile acids. This has an indirect effect to enhance LDL clearance and lower lipids in the blood. Atorvastatin and lovastatin are lipid-lowering drugs that competitively inhibit HMG-CoA reductase, an early step in cholesterol biosynthesis. Clofibrate and gemfibrozil are fibric acid derivatives that may increase the activity of lipoprotein lipase. Ref: Bersot T.P. (2011). Chapter 31. Drug Therapy for Hypercholesterolemia and Dyslipidemia. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e. | Pharmacology | null | A 67-year-old man with an 18-year history of type 2 diabetes mellitus presents for a routine physical examination. His temperature is 36.9 C (98.5 F), his blood pressure is 158/98 mm Hg and his pulse is 82/minute and regular. On examination, the physician notes a non tender, pulsatile, mass in the mid-abdomen. A plain abdominal x-ray film with the patient in the lateral position reveals spotty calcification of a markedly dilated abdominal aoic walI. Following surgery, the patient is placed on a low-fat diet to reduce the risk of continued progression of his atherosclerotic disease. A bile acid sequestrant is added to interrupt enterohepatic circulation of bile acids. Which of the following agents was MOST likely prescribed?
A. Atorvastatin
B. Cholestyramine
C. Clofibrate
D. Gemfibrozil
| Cholestyramine |
e4683651-a4c6-443f-a3a8-5c882269a11b | Vancomycin is a glycopeptide antibiotic that releases histamine leading to "Red man syndrome" | Pharmacology | null | Red man syndrome is caused by which drug:
A. Linezolid
B. Clindamycin
C. Vancomycin
D. Teicoplanin
| Vancomycin |
debc39c4-3315-4559-9a24-c93a240aab7f | Ans. is 'a' i.e., Propranolol Treatment and prophylaxis of migraineo For aborting an acute attack of migraine, sumatriptan (or any other triptan) is the drug of choice. Other drugs used for treatment are NSAIDs, ergotamine and dihydroergotamine, and intranasal butorphanol.o For Prophylaxis, Beta-blocker (propranolol) is the drug of choice. Other drugs used for prophylaxis are tricyclic antidepressants (amitriptyline), calcium channel blockers (cinnarizine, verapamil), serotonine antagonists (methysergide, cyproheptadine), MAO inhibitors and anticonvulsants (valproate, topiramate, gabapentine), fluxetin, onabotulinum toxine A, pepaverine andphenalzine. | Pharmacology | C.N.S | DOC for migraine prophylaxis -
A. Propranolol
B. Valproate
C. Topiramate
D. Ethosuxamide
| Propranolol |
da583f70-011e-43ad-9cb6-a17424c004a7 | The gap anteriorly is filled by a syol bursa. The coracoclavicular ligaments have a vital role to play in movements of the pectoral girdle. The conoid ligament limits anterior movement of the scapula with respect to the clavicle. The trapezoid limits posterior movement between these two bones | Anatomy | General anatomy | Which ligament transfers weight from peripheral to axial skeleton?
A. Coracoclavicular ligament
B. Acromio-clavicular ligament
C. Ligament of Bigelow
D. Stemo-clavicular ligament
| Coracoclavicular ligament |
05cb7042-9c17-4dc4-bb9f-7d56f3a27da6 | (c) Laryngomalacia(Ref. Current Diagnosis & Treatment Otolaryngology, Lalwani, 3rd ed., 481; Scott Brown, 8th ed., Vol 2; 333)Laryngomalacia, which is the most common congenital anomaly of the larynx, is the most common cause of congenital laryngeal stridor.Vocal cord palsy is the 2nd most common cause of congenital stridor. Laryngeal web, a rare malformation can also lead to stridor.Laryngeal papilloma is the most common benign tumour of the larynx in children. Here also the child presents with stridor. In laryngeal papilloma there is additionally hoarseness of voice as it involves the vocal cord, whereas in laryngomalacia which is supraglottic the cry of the child is normal. Also laryngeal papilloma is seen in children from 2 to 5 years whereas laryngomalacia disappears by 2 years of age. | ENT | Congenital Lesions and Stridor | Most common cause of stridor after birth:
A. Laryngeal papilloma
B. Laryngeal web
C. Laryngomalacia
D. Vocal cord palsy
| Laryngomalacia |
1adfd3e2-fdff-430c-aafd-69e0de77ddda | Ans. A. ScurvyScurvy-Radiographic findings:1. Osteoporosis2. Pencil thin cortex3. Wimberger's sign4. Trummerfeld zone of rarefaction5. Corner sign of Park6. Line of Frankel7. Subperiosteal hemorrhage | Radiology | Skeletal System | "Corner sign of park" is feature of:
A. Scurvy
B. Rickets
C. Battered baby syndrome
D. Sickle cell disease
| Scurvy |
60d9ec2d-fbb8-4ea5-98ed-4e55945cb383 | Ans. is 'c' i.e., Primitive atrium o The primitive atrium is divided into left and right atria by interatrial septum which is formed by fusion of septum primum and septum secundum. The sequnece of events are as follows# Septum primum arises from the roof of common atrium (primitive atrium) and grows caudally towards septum intermedium (fused AV cushions).# Foramen primum is formed between free border of growing septum primum and fused AV cushions (septum intermedium).# Shortly afterwards the septum primum fuses with septum intermedium (fused AV cushions), obliterating foramen primum# Foramen secundum is formed by degeneration of cranial part of septum primum.# Septum secundum grows caudally to the right of septum primum and overlaps the foramen secundum. The passage between septum primum and septum secundum is called foramen ovale. After birth, foramen ovale closes by fusion of septum primum with septum secundum. Failure of fusion of these two septa results in patent foramen ovale. | Anatomy | Pericardium & Heart | Septum secundum arises from -
A. Bulbus cordis
B. Primitive ventricle
C. Primitive atrium
D. Sinus venosus
| Primitive atrium |
195e8e2c-5d3b-46e3-96e8-05cd3fad31a0 | Ans. is 'c' i.e.,Paromomycin Drugs used for kala-azarParentral : Amphotericin-B (iv), Paromomycin (im), sodium stibogluconate (iv or im).Oral : Miltefosine | Pharmacology | null | Drug used for kala-azar
A. Diloxanide furoate
B. Metronidazole
C. Paromomycin
D. Spiramycin
| Paromomycin |
b4f4f84c-26a8-443b-a3ef-909b1ed32d5c | B i.e. Phase 2 blockade produced by succinylcholine - Sch is depolarizing/ non competitiveQ M.R. with shoest duration of actionQ (3-5 min) d/t rapid hydrolysis by pseudo cholinesteraseQ. It causes dual/ biphasic blockQ. It increases K. (ie hyperkalemiaQ 1/t diastolic cardiac arrest), intraocular & intragastric pressure and temperature (l/t) malignant Hypehermia)Q - Depolarizing block (phase I & II) caused by Succinyl cholineQ is also called Dual or Biphasic Block. In contrast to phase II depolarization block & Non depolarizing block, phase I depolarization block does not exhibit fade during tetanus or train-of-four, neither does it demonstrate post tetanic potentiation. Phase I block is potentiated by isoflurane, Mg, Li & Anticholine-esterase while phase II block is potentiated by enflurane. - The onset of paralysis by succinylcholine is signaled by visible motor unit contractions called fasciculation.Q Patients who have received suxamethonium have an increased incidence of postoperative myalgiaQ. This is more common in healthy female outpatients. Pregnancy & extremes of age seem to be protective. Succinylcholine releases a metabolite succinylmonocholine, causing excitation of the cholinergic receptors in the sinoatrial node resulting in bradycardia. Q Intravenous atropine is given prophylactically (paicularly in children, who are more susceptible) in children and always before a second dose of sch. - Prolonged apnea after suxamethonium is best managed by providing mechanical ventilation, maintaining anesthesia and continuous monitoring until muscle function returns to normal.Q Transfusion of fresh frozen plasma is beneficial (as it provides pseudocholinesterase) its infectious risks outweigh its potential benefits -Morgan Administration of purified pseudocholinesterase, blood or plasma may antagonize the block. However because of the risk associated with their use, infusion of banked blood or fresh frozen plasma cannot be recommended - Churchill. - Succinylcholine & mivacurium are metabolized by pseudocholinesterase, while esmolol and remifentanyl are metabolized by RBC es terase.(2 - Pseudo cholinesterase deficiency causes prolonged residual paralysis at normal Sch dose (1-2 mg/kg)Q whereas, phase 2 non-depolarization blockade occurs after administration of higher doses >6 (7-10) mg/kgQ Despite large decrease in pseudo cholinesterase activity (level) there is only moderate increase in duration of action of Sch. In contrast to the doubling or tripling of blockade duration seen in patients with low pseudo cholinesterase enzyme levels or hetozygous atypical enzyme, patients with homozygous atypical enzyme will have a very blockade (4-8 hrs) following Sch administration. | Anaesthesia | null | A 70 kg old athlete was posted for surgery, Patient was administered succinylcholine due to unavailability of vecuronium. It was administered in intermittent dosing (total 640 mg). During recovery patient was not able to respire spontaneously & move limbs. What is the explanation ?
A. Pseudocholinesterase deficiency increasing action of syccinylcholine
B. Phase 2 blockade produced by succinylcholine
C. Undiagnosed muscular dystrophy and muscular weakness
D. Muscular weakness due to fasciculation produced by succinylcholine
| Phase 2 blockade produced by succinylcholine |
20d211b9-a4b1-4b39-8fc4-163bb59cccd6 | Fibroadenomas are most often found in teenage girls. They are firm in consistency, clearly defined, and very mobile. The typical feature on palpation is that they appear to move freely through the breast tissue ("breast mouse"). | Surgery | Breast | An 18-year-old presents with a well- circumscribed 2 cm mass in her right breast. The mass is painless and has a rubbery consistency and discrete borders. It appears to move freely through the breast tissue. What is the likeliest diagnosis?
A. Carcinoma
B. Cyst
C. Fibroadenoma
D. Cystosarcoma phyllodes
| Fibroadenoma |
3224c26b-8f9e-4dac-9bcb-de5473f2a3c1 | Ref: Parks 23rd edition pg 852 Chi-square test offers an alternate method of testing the significance of difference between two propoions.Advantage: it can also be used when more than 2groups are to be compared. Ref:Parks 23rd edition pg 852 Tests of significance: Qualitative: Chi- square : 2 or more than 2 groups Mc Nemar test : 1 group. ( before and after intervention) Quantitative: Paired T test: 1 group Student T test/ unpaired T test: 2 groups Anova: more than 2 groups. | Social & Preventive Medicine | Biostatistics | A group tested for a drug shows 60% improvement as against a standard group showing 40% improvement. The best test to test the significance of result is-
A. Student T test
B. Chi square test
C. Paired T test
D. Test for variance
| Chi square test |
c7c97ac0-5fd8-4b9f-b757-d9b2b8f3d6b2 | Ans. (c) Renal cell CARef: Robbins 9th ed. 1952* Robbins 9th ed. States: "by far the most common malignant tumor is renal cell carcinoma, followed by Wilms tumor, which is found in children.* Incidence of RCC is: 85%* M > F (2:1)* Most of the RCC are sporadio AD (familial)Must KnowKIDNEY CA (extract from Robbins 9th ed)* MC benign tumor of kidney: Renal papillay adenoma* MC malignant tumor of kidney: RCC > Wilms tumor* MC kidney tumor associated with tuberous sclerosis: Angiomyolipoma* MC type of RCC: Clear cell CA (70 - 80%)* MC type of renal CA associated with dialysis: Papillary CA* MC renal CA associated with sicke cell trait: Medullary CA* Renal CA having best prognosis: Chromophobe I | Pathology | Miscellaneous (Kidney) | Most common malignant tumor of kidney:
A. Papillary carcinoma
B. Papillary adenoma
C. Renal cell CA
D. Wilms tumor
| Renal cell CA |
74ba5150-6106-44e1-aaea-6d65f7b5b8c3 | Ans. is 'a' i.e., Aromatic amino aciduria | Pediatrics | null | A 6 day old newborn infant develops lectonuria seizures and hypoglycemia. The likely diagnosis is?
A. Aromatic amino aciduria
B. Phenyl ketonuria
C. Intrauterine infectious
D. Tyrosinemia
| Aromatic amino aciduria |
960cee8e-863f-4b4e-9cce-77db6f1cf92a | The synopsis of forensic medicine & toxicology ; Dr k.s narayan reddy ; 28th edition ; pg.no 122 The choke bore present in a shot gun ,the distal 7-10 cm of the barrel is narrow . There are some shotguns which have a small poion of their bore near the muzzle end rifled ,which are called "paradox gun" . | Forensic Medicine | Mechanical injuries | Chocking is constricting device within the barrel at the muzzle end of -
A. Revolver
B. 303 rifle
C. Shot gun
D. Semiautomatic pistol
| Shot gun |
34866b06-b190-4ba3-9a0c-758c738fcede | INDERBIR SINGH&;S TEXTBOOK OF HUMAN HISTOLOGY-PAGE NO:321 Both in the male and female,the greater pa of urethra is lined by pseudo stratified columnar epithelium.a sho pa adjoining the urinary bladder us lined by transitional epithelium | Anatomy | General anatomy | Which of the following is lined by transitional epithelium
A. Stomach
B. Colon
C. Urethro verical junction
D. Prostate
| Urethro verical junction |
3b410d03-6a6a-4a5f-9087-f8aedc953fc7 | Classification of Primary Dentition given by Baume, 1959 | Dental | null | Who proposed the classification of primary dentition based on distal surface of second molar?
A. Angle
B. Baume
C. Simon
D. Dewey
| Baume |
9503f3ca-1816-4287-bf94-b2668feea13f | Singer&;s alkali denaturation test is performed for Vasa Pre. Detection of nucleated RBCs using apt test or Singer&;s alkali denaturation test is diagnostic of vasa pre. It is based on the fact that fetal hemoglobin is resistant to alkali denaturation. Both Apt and Kleihauer-Betke Test can be used to detect the presence of fetal blood within a sample. Apt Test Kleihauer Betke Test Reagent NaOH Citric acid Phosphate buffer Assessment Qualitative Quantitative Ref: DC Dutta&;s textbook of Obstetrics 8th edition Pgno: 301 | Gynaecology & Obstetrics | General obstetrics | Singer&;s Alkali denatuaion test is performed for:
A. Rh incompatibility
B. Vasa Pre
C. Abruptio placenta
D. Preterm labour
| Vasa Pre |
8f5871c7-a373-4f4b-8185-78e298dc42dc | C i.e. Calcium deposition in the atheromatous plaque Screening of asymptomatic coronary plaques on. CT scan (EBCT & MDCT) uses calcium depositionQ as a surrogate marker for detecting the presence & amout of atherosclerosis. CT attenuation within non calcified fibrous pique (91-116) is greater than within noncalcified lipid-rich plaques (47-71 HU). However, large variability currently prevents accurate classification of non calcified plaques by CT. Agatston Coronary Aery Calcification Scoring Coronary calcium is used as a surrogate marker to detect the presence and quantify the amount of atherosclerosis. Both electron beam (EB) CT and MD-CT permit accurate detection and quantification of coronary aery calcium. With the exception of renal failure patients, calcification occurs almost exclusively in the context of atherosclerosis. Agatston developed a scoring system, which takes into account the area (in pixels) and the CT density of calcified lesion (defining calcification as densities >130 Hounsfield units) for quantifying coronary aery calcification in patients evaluated with EB-CT scans using 3mm slice thickness. Each lesion in each slice is scored based on maximum density with a paicular scale i.e. 1 = 130 to 199 HU; 2 = 200-299 HU; 3 = 300-399HU; 4 = 400HU or greater. Then a total score is obtained by summing the scores from all slices, broadly indicating grade of coronary aery disease (& risk of cardiovascular events +- . 0 = No; 1 to 10 = Minimal; 11 to 100 = Mild; 101 to 400 = Moderate; >400 = Severe. Currently, MDCT calcium scoring is widely used to calculate coronary clacium load, using 2.5 to 3 mm norienhanced axial CT images obtained with a prospective ECG gated acquisition. Modified Agatston score equivalent, takes into account the area of each calcified lesion and the maximum CT value within the lesion. The volumetric and absolute mass quantfication scoring algorithms are also available, showing increased accuracy, consistency and reproducibility (however, not been validated in clinical setting). It is impoant to understand that the amount of coronary calcium correlates moderately to overall atherosclerotic plaque burden. On the other hand, not every atherosclerotic coronary plaque is calcified and calcification is a sign of neither stability nor instability of an specific plaque. The absence of coronary calcium rules out the presence of coronary aery stenoses with high predictive value. However, even pronounced coronary calcification is not necessarily a/whemodynamically relevant luminal narrowing. So even the detection of large amounts of calcium does not indicate the presence of significant stenoses & it should not prompt invasive coronary angiography in otherwise asymptomatic individuals. | Radiology | null | The patho-physiological phenomenon that occurs during atheromatous plaque formation and is used for screening of 'asymptomatic coronary plaques' on CT scan is:
A. Increased outer diameter of coronary aery
B. Decreased inner diameter of coronary aery
C. Calcium deposition in the atheromatous plaque
D. Lipoid degeneration in the plaque.
| Calcium deposition in the atheromatous plaque |
a7546f5c-c78a-4021-9e5f-6af608e99c67 | Ans. is'c'i.e., PAPP-A &beta HCG1st trimester aneuploidy screening:Human chorionic gonadotropin (either intact or free (b-hCG).Pregnancy-associated plasma protein A (PAPP-A).Fetal Down syndrome in 1st trimester:Higher serum free beta-hCG level.Lower PAPP-A levels.Trisomy 18 & 13:Lowered levels of both HCG PAPPP-A.2nd trimester analytes:Serum integrated screening.Accuracy of aneuploidy detection:Greater on combination with,Sonographic NT measurement. | Gynaecology & Obstetrics | null | Screening test used in first trimester for aneuploidy -
A. PAPP-A &estradiol
B. PAPP-A & AFP
C. PAPP-A &beta HCG
D. Beta HCG & inhibin
| PAPP-A &beta HCG |
8707a5b8-8fbc-445c-9c56-31d78521d3bc | Ans. is a, i.e. Continue the pregnancy for at least one weekIf delivery can be postponed for at least 7 days, the mother will develop antibodies and there will be transplacental transfer of antibodies to the neonate. The neonate will have passive immunity and will not develop the infection. Therefore, the best method to prevent neonatal infection is to continue the pregnancy for at least one week after the mother develops the rash. If delivery occurs within one week, the baby should be given VZIG soon after birth. | Gynaecology & Obstetrics | Medical & Surgical Illness Complication Pregnancy | A woman develops chickenpox at 39 weeks. She has a single fetus in the cephalic presentation. She has no other pregnancy complications.What is the best method to prevent neonatal infection?
A. Continue the pregnancy for at least one week.
B. Give varicella zoster vaccine to the neonate soon after birth
C. Give VZIG to the neonate soon after birth
D. Induce labor immediately
| Continue the pregnancy for at least one week. |
2c931453-2e94-4640-a41a-982e70a7c6ae | In the fasting state, glucose must be spared for use by the central nervous system (which is largely dependent on glucose) and the red blood cells (which are wholly reliant on glucose). Therefore, tissues that can use fuels other than glucose do so; muscle and liver oxidize fatty acids and the liver synthesizes ketone bodies from fatty acids to expo to muscle and other tissues.Ref: Harper&;s Biochemistry; 30th edition; chapter 14; overview of Metabolism & the Provision of Metabolic Fuels | Biochemistry | Metabolism of lipid | Which organs do not utilise ketone bodies?
A. Skeletal muscles
B. Cardiac muscles
C. Liver
D. RBC
| RBC |
b025f103-728c-45d6-ab7c-52b655ba9244 | Ans. is 'c' i.e., CO poisoing Hypoxic hypoxia (hypoxemia)Anemic hypoxiaStagnant hypoxiaHistotoxic hypoxiao Cyanosis presentCauses :* Hypoventilation as seen in interstitial lung disease & COPD* Cyanotic CHD* Reduced diffusion capacity* Right to left shunt, e.g. A V malformation* V/Q mismatch* High altitudeo Cyanosis absent Causes :* Anemia* CO poisoningo Cyanosis presento Causes :* CHF* Shock* Peripheral vasoconstrictiono Cyanosis absento Causes:* Cyanide poisoning | Physiology | Heart, Circulation, and Blood | Cyanosis is not seen in-
A. CHF
B. COPD
C. CO poisoning
D. High altitude
| CO poisoning |
cd7568d9-eaa3-49ae-b52a-7d99331dda43 | Ans is 'd' ie Pyloric stenosis This is a typical picture of pyloric stenosis a) Infant presenting in 4th week b) Non-bilious vomitting. c) With constipation and wt. loss. Lets see other options. Esophageal atresia a) Infant presents soon after bih with complaints of regurgitation of milk, saliva pours almost continuously from its mouth. Attempt to feed are met with 'Spitting up' or frank vomitting. b) Persistence in feeding may produce aspiration, choking and respiratory distress. c) Diagnosis can be confirmed by passing a rubber catheter into the esophagus through the mouth which will encounter an obstruction. Thus point (a) helps in ruling out oesophageal atresia. Choledochal cyst a) Presentation is not so early in infancy. Though its a congenital anomaly only 1/2 the cases present before 20yrs. of age and only 1/3 present in the 1st decade of life. b) Classical triad of symptoms --> i) Obstructive jaundice * ii) Upper abdominal pain* iii) Fever* (c) A palpable epigastric mass may be discovered. Beal atresia a) Vomitting will be bilious b) Infant presents in the 1st week of life. | Surgery | null | Make the diagnosis of a 26 day old Infant presenting with recurrent nonbilious vomiting with costipation and loss of wt?
A. Oesophageal atresia
B. Choledochal cyst
C. Ileal atresia
D. Pyloric stenosis
| Pyloric stenosis |
f64021c3-272b-4a12-927c-8f53cab837f2 | Abnormal Ig Bence Jones proteins Light chain of Ig ( Kappa or Lambda )WaldenstormmacroglobulinemiaIg M Heavy chain disease Fc pa of heavy chain CryoglobulinemiaPrecipitate at low temperature (Ref: Ananthanarayan 9th edition, 96-98) | Microbiology | Immunology | Which of the following is seen in cryoglobulinemia
A. IgG
B. IgM
C. IgA
D. IgE
| IgM |
9c91e766-bd52-4467-8b1f-e59a343ff751 | Ans. is 'c' i.e., Apo-C IIMajor activator of lipoprotein lipase is apo-CII | Biochemistry | null | Which apoprotein is the most impoant to activate lipoprotein lipase -
A. Apo-A I
B. Apo B48
C. Apo-C II
D. Apo-E
| Apo-C II |
a1421c4e-071b-4e2b-928e-c8b8e38fe80f | Congenital Rubella Syndrome (CRS):
CRS is said to have occurred if:
– Infant has IgM rubella antibodies shortly after birth, or
– IgG antibodies persist for more than 6 months
Major determinant of extent of fetal infection in CRS: Gestational age at which fetal transmission occurs,
– Infection in I trimester: MOST DISASTROUS TIME
1. Abortions
2. Still births
3. Skin lesions: blueberry muffin lesions
4. ‘Triad of Congenital Rubella Syndrome’
i. Sensorineural deafness
ii. Congenital heart defects (MC is PDA)
iii. Cataracts
– Infection in early part of II Trimester: Deafness (only)
– Infection after 16 weeks POG: No major abnormalities
Risk of fetal damage in CRS: | Social & Preventive Medicine | null | Risk of the damage of fetus by maternal rubella is maximum if mother gets infected in
A. 20-24 weeks of pregnancy
B. 24-28 weeks of pregnancy
C. 32-36 weeks of pregnancy
D. 6-12 weeks of pregnancy
| 6-12 weeks of pregnancy |
ead7d7aa-60a7-4d01-939b-b457f69cc21c | Ans. is 'b' i.e., Moderately hard Classification of hardness in waterClassificationLevel of hardness (mEq./litre)a) Soft waterb) Moderately hardc) Hard waterd) Very hard waterLess than 1 (< 50 mg/L)1 - 3 (50 - 150 mg/L)3 - 6 (150 - 300 mg/L)Over 6 (> 300 mg/L) | Social & Preventive Medicine | Environment and Health | If hardness level of water is 50-150 mg/L, the water is defined as -
A. Soft
B. Moderately hard
C. Flard
D. Very hard
| Moderately hard |
7055e62b-fc08-48ee-8522-348275eadf0a | Berson and Yalow discovered RIA in 1959 by which we can quantify antigens or hormones upto picograms-v sensitive than ELISA RIA /ELISA-indirect immunofluorescence tests Ref: Textbook of Microbiology Baveja 5th ed Pg 115 | Microbiology | Immunology | Berson and yellow 1st described the following test
A. RIA
B. ELISA
C. Immuno chromatography
D. Chemiluminescence assay
| RIA |
75068f4f-0ec8-45d1-99ad-1fd188fda199 | Anandamide is a neurotransmitter produced in the brain that binds to the THC receptors. It's been called the "bliss molecule," aptly named after ananda, the Sanskrit word for "joy, bliss, or happiness." It is considered an endocannabinoid -- a substance produced in the body that binds to cannabinoid receptors Ref: guyton and hall textbook of medical physiology 12 edition page number:699,700,701 | Physiology | Nervous system | Active agent of cannabis resemble which endogenous compound
A. Endorphin
B. Endomorphins
C. Anandamine
D. Enkaphalin
| Anandamine |
5fa39fef-a320-421a-949e-21023988ea7e | Ans. C: Hypophosphatemia CKD (Chronic kidney disease) is initially without specific symptoms and can only be detected as an increase in serum creatinine or protein in the urine. As the kidney function decreases: Blood pressure is increased due to fluid overload and production of vasoactive hormones, increasing one's risk of developing hypeension and/or suffering from congestive hea failure. Urea accumulates, leading to azotemia and ultimately uremia (symptoms ranging from lethargy to pericarditis and encephalopathy). Urea is excreted by sweating and crystallizes on skin ("uremic frost"). Potassium accumulates in the blood (hyperkalemia with a range of symptoms including malaise and potentially fatal cardiac arrhythmias) Erythropoietin synthesis is decreased (potentially leading to anemia, which causes fatigue) Fluid volume overload - symptoms may range from mild edema to life-threatening pulmonary edema Hyperphosphatemia - due to reduced phosphate excretion, associated with hypocalcemia (due to vitamin D3 deficiency). The major sign of hypocalcemia is tetany. Later this progresses to teiary hyperparathyroidism, with hypercalcaemia, renal osteodystrophy and vascular calcification that fuher impairs cardiac function. Metabolic acidosis, due to accumulation of sulfates, phosphates, uric acid etc. | Medicine | null | Which of the following is not seen in chronic renal failure: September 2010
A. Hyperkalemia
B. Metabolic acidosis
C. Hypophosphatemia
D. Hypocalcemia
| Hypophosphatemia |
0070d4f2-e496-4894-bcf2-6ac1e0b06114 | Most carotid imaging is now performed with Doppler ultrasound, CTA, MRA performed without exogenous contrast injection such as 2- or 3-dimensional time-of-flight (TOF) methods or contrast-enhanced MRA (CEMRA) performed dynamically after an intravenous bolus of gadolinium-based contrast.CEMRA is the most accurate method of carotid stenosis evaluation(Grainger and Allison&;s diagnostic radiology 6th edition, page 1475) | Radiology | All India exam | Carotid aery stenosis in -vivo screening choice is
A. USG
B. CT
C. MRI
D. Doppler
| Doppler |
259bf5d7-9628-4e76-932a-f65597d8b310 | MC cause of subarachnoid hemorrhage : Trauma > Spontaneous rupture of Berry Aneurysm | Surgery | Cerebrovascular Diseases | Most common cause of subarachnoid hemorrhage is:-
A. Hypeension
B. AV malformation
C. Berry aneurysm
D. Tumors
| Berry aneurysm |
427b35b9-c757-43ad-aeed-a30c18125aa8 | Abduction (opening) of the vocal folds: The posterior cricoarytenoid muscles pull the muscular processes posteriorly, rotating the vocal processes laterally and thus widening the rims glottides. Adduction (closing) of the vocal folds : The lateral cricoarytenoid muscles pull the muscular processes anteriorly, rotating the arytenoids so their vocal processes swing medially. When this action is combined with that of the transverse arytenoid muscles, which pull the arytenoid cailages together, the gap between the vocal folds is decreased. Air pushed through the rima glottidis causes vibration of the vocal ligaments. | ENT | null | Abductor of the larynx is:
A. Crico-arytenoideus posterior
B. Crico-arytenoideus lateralis
C. Arytenoideus transversus
D. Vocalis muscle
| Crico-arytenoideus posterior |
1271e620-fafd-413f-b74d-83f8d648c354 | Kala azar or visceral leishmaniasis is a protozoal disease.It is transmited from person to person by bite of female Phlebotomus argentipus.Transmission also occurs by contamination of bite wound or by crushing the insect during act of feeding.it may transmit by blood transfusion also. C/f : fever,splenomegaly,hepatomegaly along with anemia and weight loss.Darkening of the skin of face,hands,feet,and abdomen. Parks textbook of preventive and social medicine.K Park. Edition 23. page no:305,306 | Social & Preventive Medicine | Environment and health | Kala azar is spread by -
A. House fly
B. Black fly
C. Sand fly
D. Tse tse fly
| Sand fly |
23dd7dc8-d134-411c-b3db-1327a5b00d11 | - the polio is transmitted by faecal oral route by contaminmates food , water or hands. - in faeces, the virus is excreted as long as 3-4 months. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no:205 <\p> | Social & Preventive Medicine | Communicable diseases | Polio virus is shed in stool up to -
A. 6 weeks
B. 8 weeks
C. 10 weeks
D. 12 weeks
| 12 weeks |
6b54cc85-9c17-40ee-acb4-df2c5e0c17e5 | At a distance of 1 m , intensity of Whisper - 30 dB Normal conversation - 60 dB Shout - 90 dB Discomfo of the ear - 120 dB Pain in the ear - 130 dB Ref: Dhingra 7e pg 21. | ENT | Ear | During normal conversation sound heard at 1meter distance is
A. 60 dB
B. 80 dB
C. 90 dB
D. 120 dB
| 60 dB |
d77f0d8f-819f-40b3-af7b-d0ac8de446a4 | When buccal crown torque is incorporated in the wire, the roots of anterior teeth tend to converge towards centre like spokes of wheel. It has been often called wagon wheel effect. Following final space closure required torque is attained by incorporation of active root torque in the anterior segment. Due to wagon wheel effect, incorporation of palatal root/buccal crown torque during retraction causes loss of tip.
Orthodontics: Diagnosis and Management of Malocclusion and Dentofacial Deformities
THIRD EDITION Om P. Kharbanda | Dental | null | Wagon wheel effect is due to:
A. Less tip more torque
B. Less torque more tip
C. More tip and torque
D. Tipping and retraction of anterior teeth
| Less tip more torque |
9abee11b-6ff8-4a3a-972b-7dd32a2f3348 | Ans. (C) Tinea versicolor(Ref: CMDT -2010/110)Griseofulvin is used for dermatophytoses including Tinea capitis, Tinea cruris, Tinea pedis, Tinea unguum and Tinea corporis etc.Tinea versicolor is caused by a yeast Malassezia furfur. It is treated by selenium sulfide and ketoconazole shampoo. | Pharmacology | Chemotherapy: General Principles | Griseofulvin is not useful in one of the following:
A. Tinea capitis
B. Tinea cruris
C. Tinea versicolor
D. Tinea pedis
| Tinea versicolor |
9584453c-729d-4386-89c4-9f612b2c66e3 | Three drugs are commonly used for maintenance treatment to prevent recurrence of BPD:- Lithium (DOC), Valproate, and Carbanzezapine. Topiramate and Gabapentine can also be used. | Psychiatry | null | Drugs used for prophylaxis in BPD -a) Chlorpromazineb) Lithiumc) Carbamazepined) Zolpideme) Sodium valproate
A. ab
B. bc
C. bce
D. ace
| bce |
308ce2fc-5ac5-4f76-9ae1-6b6fca955189 | 1. Point source epidemic ( single exposure ) Sudden rise sudden fall. Cluster of cases in single IP. All cases develop within one incubation period of the disease E.g. Food poisoning , Bhopal gas tragedy. 2. Common source , continuous or repeated exposure epidemics Sharp rise Fall is interrupted by secondary peaks Eg. Contaminated well in a village,Water Borne Cholera. 3. Propagated source epidemic Gradual rise & gradual fall over long time. Person to person transmission E.g:- HEP. A, POLIO. | Social & Preventive Medicine | Time Distribution, Epidemics | Food poisoning is an example of:
A. Point source epidemic
B. Propagated source epidemic
C. Common source epidemic
D. Pandemic
| Point source epidemic |
cb50cded-1a26-469f-9df2-87be1173706c | Ans. is 'c' i.e., Cricothyroid o All intrinsic muscles are supplied by the reccurrent laryngeal nerve except cricothyroid which is supplied by the external laryngeal nerve.Nerve supply of larynxo The main cranial nerve innervating the larynx is the vagus nerve via its branches; superior laryngeal nerve (SLN) and recurrent laryngeal nerve (RLN).Sensory supply of larynxo Above the level of vocal cords, larynx is supplied by internal laryngeal nerve, a branch of superior laryngeal nerve.o Below the vocal cord, larynx is supplied by recurrent laryngeal nerve.Motor supply of larynxo All the intrinsic muscles of larynx are supplied by recurrent laryngeal nerve except for cricothyroid muscle.o Cricothyroid is supplied by external laryngeal nerve, a branch of superior laryngeal nerve. | ENT | Larynx | Which muscle of larynx is not supplied by recurrent laryngeal nerve -
A. Vocalis
B. Thyroarytenoid
C. Cricothyroid
D. Interarytenoid
| Cricothyroid |
4907cdb7-d768-4c4e-bfb0-76afdb03f0e6 | Subfascial Endoscopic Perforator Vein Surgery (SEPS) SEPS is a new endoscopic technique for the management of chronic venous insufficiency due to incompetent perforator veins. SEPS involves inseion of a rigid endoscope through the skin and superficial fascia to a plane above the muscle, such that perforator veins are visible as they exit the muscles. These perforator veins are dissected free from surrounding tissue and closed with the help of metal clips. Ref: Sabiston 20th edition Pgno: 1809 | Surgery | Vascular surgery | SEPS is a procedure used for :
A. Veins
B. Aeries
C. Lymphatics
D. AV fistula
| Veins |
1aaeab68-7822-4f8c-a2b6-67df3f623962 | Answer is A (Vitamin B12) Cyanocobalarnine (Vitamin B12) deficiency is the most common deficiency in patients with sho bowel syndrome associated with loss of ileum (ileal resection) since vitamin B12 is absorbed only in the ileum. `Cyanocobalamine (Vitamin B12) is the most common deficiency and occurs predictably after resection of 50-60 cm of the terminal ileum'. -- 'Complications in Surgery' (Lippincott Williams) 2"" (2011)/469 `Vitamin B12 and Bile acids are absorbed only in the ileum. Loss of ileum results in malabsorption of bile acids and vitamin B12 and consequent vitamin B12 deficiency'-- 'Sleisenger and Fordtran's Gastrointestinal Diseases' 81h/2258, 2264 Vitamin Deficiencies in Sho Bowel Syndrome Sho Bowel Syndrome with Extensive Jejunal Resection This is associated primarily with deficiency of fat soluble vitamins (A, D, E. K) The most common fat-soluble vitamins that are deficienci are vitamin A and D and to a lesser extent vitamin E followed by vitamin K. Vitamin A, D > Vitamin E >> Vitamin K Deficiency of vitamin K is uncommon as vitamin K is synthesized by colonic bacteria 60% of vitamin K is synthesized by colonic bacteria 40% of vitamin K is received by dietary intake Deficiency of vitamin K is therefore uncommon in patients with sho bowel syndrome who have an intact colon. Deficiency of vitamin K is however common in those patients with sho bowel syndrome who do not have a residual colon. Sho Bowel Syndrome with Extensive ileal resection This is associated primarily with deficiency of vitamin B12 since vitamin B12 is only absorbed in the terminal ileum. Fat soluble vitamin deficiencies may also occur due to fat malabsorption from decrease in concentration of bile acids / salts. (Bile acids are absorbed only from tr..; ileum) Vitamin B12 > Fat solubleVitamin The ileum has the capacity to adapt and compensate for jejunal resection. The jejunum does not have the capacity to adapt and compensate for ileal resection (as the terminal ileum has the exclusive capacity to reabsorb bile salts &vit BO | Medicine | null | Deficiency of which of the following vitamin is most commonly seen in sho bowel syndrome with ileal resection:
A. Vitamin B12 (Cyanocobalamine)
B. Vitamin B1 (Thiamine)
C. Folic Acid
D. Vitamin K
| Vitamin B12 (Cyanocobalamine) |
59237c3a-24ca-4557-a1c9-ec62de152b89 | Benefits of Serial Extraction
Serial extraction guides or encourages eruption of permanent teeth in a favorable position.
Reduces malposition of individual teeth.
Avoids loss of labial alveolar bone.
Reduces treatment time when active orthodontic treatment is required.
Textbook of ORTHODONTICS Sridhar Premkumar | Dental | null | Treatment objective for serial extraction:
A. To intercept a developing arch-length deficiency and to reduce or eliminate the need for extensive appliance therapy
B. Reduce arch-length deficiency
C. To plan for extensive appliance therapy
D. To reduce arch-length deficiency & to plan for extensive appliance therapy
| To intercept a developing arch-length deficiency and to reduce or eliminate the need for extensive appliance therapy |
da904c5f-5665-45f9-8bb2-739b107fc9c0 | Treatment* High inguinal ligation (near deep ring) of pampiniform plexus of veins* Microvascular sub inguinal ligation (best results)* Palomo's operation: ligation of Left Gonadal Vein in retroperitoneum * Alternative venous drainage cremasteric veins | Surgery | Testis and scrotum | In varicocele surgery, venous drainage is done by:
A. IVC
B. Aoa
C. Superior epigastric vein
D. Cremasteric vein
| Cremasteric vein |
d5e9c322-0861-4b2c-afa4-0369d52c8c73 | Ans. is 'b' i.e., Opistorchissinensis infectionCholangiocarcinomaCholangiocarcinoma is malignancy of the biliary tree, arising from bile ducts within or outside the liver.Risk factors : -Primary sclerosing cholangitisCongenital fibropolycystic disease of the biliary system (caroli disease, choledochal cyst).Exposure to thorotrast.Opisthorchis sinensis infection.PathologyCholangiocarcinoma are adenocarcinoma arising from bile ducts epithelium.Most are well to moderately differentiated.Markdly desmoplastic, with dens collegenous stroma separating the glandular elements.Cells are not bile stained, because bile is synthesized by hepatocytes and not by bile duct epithelium. | Pathology | null | Cholangiocarcinoma ?
A. Obesity
B. Opistorchissinensis infection
C. Salmonella carrier state
D. HBV infection
| Opistorchissinensis infection |
8a928b7f-2bf0-4ef0-a4fa-12fc088586ea | Hormone responsible for decidual reaction and arias Stella reaction in Ectopic as well as Intrauterine pregnancy is Progesterone Arias stella reaction is the localized hypersecretory endometrium seen in ectopic pregnancy. | Gynaecology & Obstetrics | Obstetrics | Hormone responsible for decidual reaction and arias Stella reaction in ectopic pregnancy is -
A. Oestrogen
B. Progesterone
C. HCG
D. HPL
| Progesterone |
b23fac5c-30bc-4734-8d33-ba1a8ed8414b | Compression of nerves at the intervertebral foramen indicates a disk herniation. A disk herniation is characterized by protrusion of the nucleus pulposus from the anulus fibrosus posterolaterally into the spinal canal or intervertebral foramen. The ligaments may be affected by the herniation but are not responsible for the compression of the spinal nerve roots. | Anatomy | Upper Extremity | |A 65-year-old male complains of severe back pain and inability to move his left lower limb. Radiographic studies demonstrate the compression of nerve elements at the intervertebral foramen between vertebrae L5 and S1. Which structure is most likely responsible for this space-occupying lesion?
A. Anulus fibrosus
B. Nucleus pulposus
C. Posterior longitudinal ligament
D. Anterior longitudinal ligament
| Nucleus pulposus |
993f8482-80ee-4a07-b03c-e3261c98c03e | “It is important (in tracheostomy) to refrain from causing any damage in the region of cricoid cartilage.
An exception to this rule is when a patient has laryngeal malignancy and under these circumstances tracheostomy should be placed high so as to allow resection of tracheostomy site at the time of laryngectomy”.
“ The high tracheostomy is generally avoided because of the postoperative risk of peri-chondritis of the cricoid cartilage and subglottic stenosis. In cases of carcinoma larynx with stridor when total laryn-gectomy would be done, high tracheostomy is indicated.” | ENT | null | A high tracheostomy may be indicated in-
A. Scleroma of the larynx
B. Multiple papillomatosis of larynx
C. Bilateral vocal cord paralysis
D. Carcinoma of larynx
| Carcinoma of larynx |
ae2bc2cd-28aa-4c39-9206-d8dd817cfb98 | Pernicious anemia is a chronic disease resulting from deficiency of Intrinsic factor leading to impaired absorption of Vitamin B12. Megaloblastic anemia is due to deficiency of Cobalamin/folate. Reference: Atlas and text of Hematology, 3rd edition, pg:102. Exam preparatory manual for UGs by Ramdas Nayak page no: 259 | Pathology | Haematology | Deficiency of the ' Intrinsic factor of Castle ' causes-
A. Megaloblastic anemia
B. Pernicious anemia
C. Cooley's anemia
D. Aplastic anemia
| Pernicious anemia |
fb29fc9f-7cb7-46d0-aa9a-9c3a9196d72e | Ans. is 'b' i.e., a ketoglutarate DehydrogenaseArsenite binds to the sulfhydryl group and hence inhibits the activity of enzymes which have lipoamide in the active site, Hence Arsenite inhibits Pyruvate Dehydrogenase and a ketoglutarate dehydrogenase of citric acid cycle, It is an example for non competitive inhibition, Succinate dehydrogenase is inhibited by malonate. | Biochemistry | null | In Citric acid cycle, which enzyme is inhibited by arsenite?
A. Isocitrate Dehydrogenase
B. a ketoglutarate Dehydrogenase
C. Succinate Dehydrogenase
D. Aconitase
| a ketoglutarate Dehydrogenase |
6c5a3efb-77ce-4c5a-8e37-67573fc2d02a | Cholesterol is first changed to form pregnenolone (common pathway). For this free cholesterol is released in the cytosol from cholesteryl esters of cytoplasmic lipid droplets and transferred into mitochondria. An enzyme called "cytochrome-P- 450-sidechain cleavage" enzyme (P450 sce) present in inner mitochondrial membrane hydroxylates cholesterol at C22 and C20 (also called "20, 22-desmolase") and then cleaves the side chain to form pregnenolone and isocaproic aldehyde. The enzyme requires molecular O2 and NADPH like all mono-oxygenases and also require FAD-containing Fp, a Fe2S2 protein (called adreno- doxin). Pregnenolone to 17-OH pregnenolone: Pregnenolone is transferred to smooth endoplasmic reticulum (ER), where it is conveed to 17-OH-pregneno- lone catalysed by the enzyme 17-aaa-hydroxylase. * Conversion of 17-OH pregnenolone to 17-OH progesterone: This is achieved by two enzymes, one is NAD+ dependent 3 bbb-OH-steroid dehydrogenase and the other is DDD4,5-isomerase. Alternatively, the same pregnenolone may be first conveed to 'progesterone' by the action of the two enzymes dehydrogenase and isomerase and it is acted upon by the enzyme 17-a-hydroxylase to form 17-OH progesterone. PROGESTERONE * Progesterone is the hormone of the corpus luteum, the structure which develops in the ovary from the ruptured Graafian follicle. It is also formed by the placenta, which secretes progesterone, during the later pa of pregnancy. Progesterone is also formed in the adrenal coex, as a precursor of both C19 and C21 coicosteroids. It is also formed in the testes. Chemistry: Progesterone may be regarded as a derivative of "pregnane" and is designated chemically as "4- pregnane-3, 20-dione". It is a C21 steroid and has a - CH3 group at C10 and C13. Biosynthesis: Progesterone has a role as an intermediate in the biogenesis of adrenocoical hormones and of androgens. Indirectly androstenedione and testosterone, it also serves as precursors for estrogens also. Progesterone is formed from acetate cholesterol, 'Pregnenolone' is the immediate precursor. Mechanism of action: It is similar to estrogen.Ref: Textbook of Medical Biochemistry, Eighth Edition, Dr (Brig) MN Chatterjea, page no: 590-591,603-604 | Biochemistry | Metabolism of lipid | Which steroid is formed from cholesterol without hydroxylation -
A. Progesterone
B. Glucocoicoid
C. Mineralocoicoid
D. Estradiol
| Progesterone |
31511966-141c-430f-8c68-4901a3a8bee5 | Ans. is 'b' i.e., Medial canthus of eye to angle of mandible Qhngren's lineo In head and neck cancer, Ohngren's line is a line that connects the medial canthus of the eye to the angle of the mandibleo The line defines a plane orthogonal to a sagittal plane that divides the maxillary sinus into (1) an anterior-inferior part, and (2) a superior-posterior part.o Tumours that arise in the anterior-inferior part, i.e. below Ohngren's line, generally have a better prognosis than those in the other groupo Addition to above a vertical line through pupil is also considered, which divides the above mentioned structures into 4 different regions. The structures at posterosuperior medial have worst prognosis and that at anteroinferior medial are least dangerous. | ENT | Tumors of Nose and PNS | Ohngren's line extends from-
A. Lateral canthus of the eye to angle of mandible
B. Medial canthus of eye to angle of mandible
C. Medial canthus of eye to tragus
D. Tragus to angle of mandible
| Medial canthus of eye to angle of mandible |
5611db90-44cb-4cc4-a58b-86f978f9f29e | Since there is mitral stenosis, more time for blood to enter LV. Therefore, increased transient time, so increase duration of murmur of S1 sound can be loud or soft. If sound is soft it tells us about calcified mitral valves but not of severity | Medicine | Murmurs | Severity of mitral stenosis is determined by :
A. Intensity of S1 hea sound
B. Diastolic murmur duration
C. Opening snap
D. Intensity of diastolic murmur
| Diastolic murmur duration |
23a64182-a281-465c-9125-c343b500110d | Probiotics are substances secreted by one organism which stimulates the growth of another.
Probiotics are useful in following conditions:
Rota virus diarrhea
Antibiotic associated diarrhea
Radiation induced diarrhea
Traveller’s diarrhea
Inflammatory bowel disease
Cancers | Microbiology | null | Probiotics are useful for -
A. Necrotizing enterocolitis
B. Breast milk jaundice
C. Hospital acquired pneumonia
D. Neonatal seizures
| Necrotizing enterocolitis |
f7c6e673-3268-4c7a-abf2-dff2426a1ae0 | Ans. is 'c' i.e., Involvement as antioxidant Vitamin C ( Ascorbic acid)o Ascorbic acid (Vitamin C) is also called antiscorbutic factor. It is very heat labile, especially in basic medium. Ascorbic acid itself is an active form. Maximum amount of vitamin C is found in adrenal cortex,o Ascorbic acid functions as a reducing agent and scavanger of free radicals (antioxidant). Its major functions are:- In collagen synthesis: - Vitamin C is required for post-translational modification by hydroxylation of proline and lysine residues converting them into hydroxyproiine and hydroxy lysine. Thus vitamin C is essential for the conversion of procollagen to collagen, which is rich in hydroxyproiine and hydroxylysine. Through collagen synthesis, it plays a role in formation of matrix of bone, cartilage, dentine and connective tissue.Synthesis of norepineph rine from dopamine by dopamine-b-monoxygenase (dopamineb-hydroxylase) requires Vitamin C.Carnitine synthesisBile acid synthesis :- 7-a-hydroxylase requires vitamin C.Absorption of iron is stimulated by ascorbic acid by conversion of ferric to ferrous ions.During adrenal steroid synthesis, ascorbic acid is required during hydroxylation reactions.Tyrosine metabolism : - Oxidation of P-hydroxy-phenylpyruvate to homogentisate.Folate metabolism : - Folic acid is converted to its active form tetrahydrofolate by help of Vitamin C. | Biochemistry | Vitamins | The main function of Vitamin C in the body is -
A. Coenzyme for energy metabolism
B. Regulation of lipid synthesis
C. Involvement as antioxidant
D. Inhibition of cell growth
| Involvement as antioxidant |
7359e741-ff3b-4683-b4e9-c05e18abdce1 | The lateral geniculate nucleus (LGN; also called the lateral geniculate body or lateral geniculate complex) is a relay center in the thalamus for the visual pathway. It receives a major sensory input from the retina. The LGN is the main central connection for the optic nerve to the occipital lobe, paicularly the primary visual coex. In humans, each LGN has six layers of neurons (grey matter) alternating with optic fibers (white matter And is resistant to neurofibrillary tangles Ref Harrison20th edition pg 2345 | Medicine | C.N.S | Which of the following areas of brain is most resistant to Neurofibrillary tangles in Aizeimer's disease -
A. Entorhinal coex
B. Hippocampus / Temporal lobe
C. Lateral Geniculate Body
D. Visual Association Area
| Lateral Geniculate Body |
dbe505ad-8995-4257-ad85-5f29e166c517 | Ans. is 'b' i.e.. Tyrosine o The term thyroid hormone denotes both thyroxine (T4) and triodothyronine (T3).o Both T4 and T are iodine derivatives of thyronine.o Thyronine is a condensation product of two molecules of amino acid tyrosine.o Thyroxine is 3, 5, 3', 5' - tetraiodothvronineandT, is 3,5,3'-triiodothyronine.o Thyroid hormones are synthesized and stored in the thyroid follicles as apart of thyroglobulin molecule. | Biochemistry | Miscellaneous (Structure & Function of Proteins) | Amino acid required for formation of thyroxine-
A. Tryptophan
B. Tyrosine
C. Glutamine
D. Cysteine
| Tyrosine |
1d3d342b-c8c8-4b75-9188-a13c5d0165ea | Ans. is 'd' i.e., Urea Renal handling of various plasma constrituents in a normal adult human on an average diet. Per 24 Hours SubstanceFitteredReabsorbedSecretedExcretedPercentage ReabsorbedNa+ (mEq)26,00025,850 15099.4K+(mEq)600560a5029093.3C1- (mEq)18,00017,850 15099.2HCO3-mEq)4,9004,900 0100Urea (mmol)870460 b 41053Creatinine (mmol)121clc12 Uric acid (mmol)50494598Glucose (mmol)800800 0100Total solute (mOsm)54,00053,40010070098.9Water (mL)180,000179,000 100099.4 SubstancePercentage ReabsorbedNa+(mEq)99.4K+(mEq)93.3CT (mEq)992HC03-(mEq)100Urea (mmol)53Uric acid (mmol)98Glucose ( mmol)100Total solute (mOsm)98.9Water (mL)99.4 | Physiology | Renal Tubular Reabsorption and Secretion | Minimal reabsorption from kidney is of -
A. Na+
B. Glucose
C. HCO3-
D. Urea
| Urea |
4b82e067-7edf-433d-a052-e9cbf7f8ad28 | Nagayama spots: Roseola infantum Koplik spots- Measles Forchheimer spots- Rubella | Pediatrics | Impoant Viral Diseases in Children | Nagayama spots are seen in:
A. Measles
B. Roseola infantum
C. Mumps
D. Rubella
| Roseola infantum |
49335a3f-c322-4e44-84e6-d7ac178c4f5b | Ans. c. Ganglion cells (Ref: Parsons 21st/280-281; www.nebi nlm.nih.gov.57(4) Jul-Aug 2009)Cells most commonly affected in glaucomatous optic atrophy are ganglion cells."Absence of the ganglion cell and nerve fiber layers is a hallmark of glaucoma". Robbins 8/e p1328"Glaucoma, the second leading cause of blindness, is characterized by changes in the optic disc and visual field defects. The elevated intraocular pressure was considered the prime factor responsible for the glaucomatous optic neuropathy involving death of retinal ganglion cells and their axons."- www.ncbi.nlm.nih.govGlaucomaGlaucoma, the second leading cause of blindness, is characterized by changes in the optic disc and visual field defects.The elevated intraocular pressure was considered the prime factor responsible for the glaucomatous optic neuropathy involving death of retinal ganglion cellsQ and their axons.Glaucoma, a leading cause of irreversible visual loss, is characterized by loss of retinal ganglion cells (RGC)Q and their axons over a period of many years.Mainly the ganglions cellsQ are affected in glaucoma patients, which may lead to glaucomatus optic atrophy.Glaucomatous optic neuropathy is characterized by changes in the optic disc and visual field defects.The morphologic changes in the optic disc are in the form of thinning of neuroretinal rim, pallor and progressive cupping of the optic discQ.The hemorrhage-associated retinal nerve fiber layer defects precede measurable changes of the optic disc configurationQ.The visual field defects in glaucoma are often detected only after 40% of the axons are lostQ. | Ophthalmology | General Considerations - Definition, Classification, Pathogenesis | Cells affected in glaucomatous optic neuropathy are:(AIIMS May 2014, Nov 2013)
A. Amacrine cells
B. Bipolar cells
C. Ganglion cells
D. Rods and cones
| Ganglion cells |
44c2ae85-378b-4506-abae-75970ef435ab | ANSWER: (D) Frontoethmoid recessREF: Sutton 7th ed vol 2 page 1519-1522, Grainger 5th ed chapter 62See previous question | Radiology | Respiratory System | Which of the following is not seen in coronal CT paranasal sinuses?
A. Ostiomeatal complex
B. Orbit
C. Sinus cavities
D. Frontoethmoid recess
| Frontoethmoid recess |
b8ccf49e-b0a4-4bb8-b228-9d824c6f1262 | The Levator Scapulae arise from the transverse processes of the Upper Cervical Veebrae and inses on the medial border of the Scapula. The other muscles are attached to the Spinous Processes of the Veebrae. | Anatomy | Back region | After a 26-year-old man's car was roadsided by a large truck, he is brought to the emergency depament with multiple fractures of the transverse processes of the cervical and upper thoracic veebrae. Which of the following muscles might be affected?
A. Trapezius
B. Levator scapulae
C. Rhomboid major
D. Serratus Posterior Superior
| Levator scapulae |
1aba8d6c-11e5-4496-bc72-63d74d91aff3 | An intrauterine gestational sac is reliably visualized with transvaginalsonography by 5 weeks, and an embryo with cardiac activity by 6 weeks The embryo should be visible transvaginally once the mean sac diameter hasreached 25 mm--otherwise the gestation is anembryonic. Cardiac motion isusually visible with transvaginal imaging when the embryo length reaches 5 mm. | Gynaecology & Obstetrics | Diagnosis of Pregnancy | At what size of mean gestational sac diameter measured on TVS with no embryonic pole is labelled as 'Anembryonic Gestation' -
A. 15mm
B. 20mm
C. 25mm
D. 30mm
| 25mm |
72d9171f-8533-4501-ad9a-5a44165dec8d | Diagnosis USG: Enlarged kidney with uniformly medullary echogenicity. IVP in ADPKD Stretching of the calyces by the cysts (spider leg or ball like deformity. Bubble appearance (calyceal distoion) Swiss cheese appearance. CT scan is IOC in ADPKD | Surgery | Kidney and ureter | The typical appearance of "spider leg" on excretory urography is seen in:
A. Hydronephrosis
B. Polycystic kidney
C. Medullary sponge kidney
D. Renal cell carcinoma
| Polycystic kidney |
8864856c-5c62-4ae3-aba2-53cb0af2a6c9 | The duodenum develops paly from the foregut and paly from the midgut. The opening of the bile duct into the second pa of the duodenum represents the junction of the foregut and the midgut. Upto the level of the opening, the duodenum is supplied by the superior pancreaticoduodenal aery, and below it by the inferior pancreaticoduodenal aery. Ref : B D Chaurasia's Human Anatomy , seventh edition , volume 2 , pg. no., 288. ( fig . 20. 13 - 289 page ). | Anatomy | Abdomen and pelvis | The aerial supply of duodenum is / are derived from ?
A. celiac trunk and inferior mesenteric aery
B. superior mesenteric aery and inferior mesenteric aery
C. celiac trunk and superior mesenteric aery
D. coeliac trunk only
| superior mesenteric aery and inferior mesenteric aery |
9230edd1-665c-4329-bb90-202765a1dd74 | The pathological reaction in granulomatous uveitis is characterised by infiltration with lymphocytes, plasma cells, with mobilization and proliferation of large mononuclear cells which eventually become epithelioid and giant cells and aggregate into nodules. Iris nodules are usually formed near pupillary border (Koeppe's nodules). and sometimes near collarette (Busacca nodule). | Ophthalmology | Uveal tract | Keoppe nodules are present on -
A. Cornea
B. Conjunctiva
C. Iris
D. Retina
| Iris |
2e501882-c9cf-446d-a013-31be7b8922b9 | Ans. A: Truncal vagotomy with gastrojejunostomyGastric outlet obstruction is manifested by obstruction at the level of the pylorus, which is the outlet of the stomach. Patients may develop vomiting, which may be projectile but non-bilious in nature, nausea or abdominal pain. An unusual finding that may lead to the diagnosis is the succussion splash, a splash-like sound heard over the stomach in the left upper quadrant of the abdomen on shaking the patient, with or without the stethoscope.The diagnosis is typically made by X-ray, which will show an absent air bubble in the stomach, or by CT scan.Causes of gastric outlet obstruction include peptic ulcer disease; tumours of the stomach, including adenocarcinoma (and its linitis plastica variant), lymphoma, and gastrointestinal stromal tumours; infections, such as tuberculosis; and infiltrative diseases, such as amyloidosis.Metabolic alkalosis may develop as a result of loss of acid.Traditionally severe cases of Gastric outlet obstruction are treated usually by a gastroenterostomy rather than a pyloroplasty. Truncal vagotomy leads to reduction of the maximal acid output by 50% as vagus nerves are sectioned which critically controls the secretion of gastric acid. | Surgery | null | Commonest operation done for gastric outlet obstruction with peptic ulcer is: March 2007
A. Truncal vagotomy with gastrojejunostomy
B. Truncal vagotomy with gastrojejunostomy
C. Highly selective vagotomy with pyloroplasty
D. Gastrojejunostomy
| Truncal vagotomy with gastrojejunostomy |
eda638ee-f543-43cd-b8b4-82e24b1eb7f9 | Ans. A: Heterosexual Intercourse. Heterosexual Intercourse is the most common route but the chance of infection is less (0.30%) ,looking to the other options. Average per act risk of getting HIVby exposure route to an infected source Exposure routeChance of infection Blood transfusion 90% Childbih (to child) 25% Needle-sharing injection drug use 0.67% Percutaneous needle stick 0.30% Receptive anal intercourse* 0.04-3.0% Inseive anal intercourse* 0.03% Receptive penile-vaginal intercourse* 0.05-0.30% Inseive penile-vaginal intercourse* 0.01-0.38% Receptive oral intercourse*SS 0-0.04% Inseive oral intercourse*SS 0-0.005% * assuming no condom useSS source refers to oral intercourseperformed on a man Most commonly, people get or transmit HIV through sexual behaviors and needle or syringe use. MC mode of transmission: Hetero-sexual In hetero-sexual transmission: Male to female is commoner (as compared to female to male) Chances of transmission with accidental needle prick: 0.3%. Less commonly, HIV may be spread From mother to child during pregnancy, bih, or breastfeeding. Although the risk can be high if a mother is living with HIV and not taking medicine, recommendations to test all pregnant women for HIV and sta HIV treatment immediately have lowered the number of babies who are born with HIV. In extremely rare cases, HIV has been transmitted by Oral sex--putting the mouth on the penis (fellatio), vagina (cunnilingus), or anus (rimming). In general, there's little to no risk of getting HIV from oral sex. Receiving blood transfusions, blood products, or organ/tissue transplants that are contaminated with HIV. This was more common in the early years of HIV, but now the risk is extremely small because of rigorous testing of the blood supply and donated organs and tissues. Eating food that has been pre-chewed by an HIV-infected person. The contamination occurs when infected blood from a caregiver's mouth mixes with food while chewing. The only known cases are among infants. Being bitten by a person with HIV. Each of the very small number of documented cases has involved severe trauma with extensive tissue damage and the presence of blood. There is no risk of transmission if the skin is not broken. Contact between broken skin, wounds, or mucous membranes and HIV-infected blood or blood-contaminated body fluids. Deep, open-mouth kissing if both paners have sores or bleeding gums and blood from the HIV-positive paner gets into the bloodstream of the HIV-negative paner. HIV is not spread through saliva. | Social & Preventive Medicine | null | Amongst the following, which carries the least chance of transmitting HIV infection: September 2010
A. Heterosexual Intercourse
B. Blood transfusion
C. Veical transmission
D. IV drug abusers
| Heterosexual Intercourse |
8886afcd-25a8-45dd-a39e-53efd054d341 | (B) Cyclooxygenase decreased # Aspirin acts by inhibiting cyclooxygenase enzyme, thereby inhibiting prostaglandin synthesis.> Leukotriens acts by inhibiting Lipooxygenase> Steroids acts by inhibiting phospholipase | Pharmacology | Miscellaneous (Pharmacology) | In Aspirin mechanism of action
A. Lipooxygenase decreased
B. Cyclooxygenase decreased
C. Phospholipase
D. Increased Lipoxygenase
| Cyclooxygenase decreased |
e35a7e69-a17b-4e4f-9063-e2a84394978a | Ans. is 'a' i.e., PAX8- PPARrl Various genes involved in thyroid carcinomas arePapillaryo Tyrosine kinase receptors RET or NTRK1o RAS mutationo BRAF oncogeneFollicularo RAS oncogene (NRAS, HRAS and KRAS)o PAX8- PPARrl translocationMedullaryo RETprotooncogne. | Pathology | Carcinogenesis | In follicular carcinoma chromosomal translocation is?
A. PAX8 -PPARrl
B. RET - PTC
C. ALK -NMP1
D. JAK - TEL
| PAX8 -PPARrl |
2f7bba9d-a3ca-4459-9358-436f8b338312 | Ans. is 'a' i.e. Automatic Cardioverter-defibrillators MR is considered among the safest imaging modalities for patients, even at very high field strengths, more than 3-4 tesla. But Ferromagnetic objects under magnetic field can be vulnerable to 4 adverse effects: Movement (causing structural injury), Current conduction (potentially causing electrical shock), Heating (possibly causing bum injury), and Artifact generation Serious injuries can be caused by attraction of ferromagnetic objects into the magnet, which would act as missiles if brought too close to the magnet. Ferromagnetic implants, such as aneurysm clips, may torque (turn or twist) due to the magnetic field, causing damage to vessels and even death. Metallic foreign bodies in the eye have moved and caused intraocular hemorrhage. Pacemakers and pacemaker leads are a contraindication, as the pacemaker can malfunction and cause arrhythmia or even death. However with growing expansion of MR, increasing number of implant medical devices are being MR safe. So newer pacemaker and aneurysm clips are being made which are MR safe. Absolute Contraindications for the MRI scan: Electronically, magnetically, and mechanically activated implants Ferromagnetic or electronically operated active devices like automatic cardioverter defibrillators Cardiac pacemakers- but there are pacemakers available from Medtronic which are safe in MRI environment but not so widely used. Metallic splinters in the eye Ferromagnetic hemostatic clips in the central nervous system (CNS) Patients with an implanted cardiac pacemaker have been scanned on rare occasions, but pacemakers are generally considered an absolute contraindication. Relative Contraindications for the MRI scan: Cochlear implants Other pacemakers, e.g. for the carotid sinus Insulin pumps and nerve stimulators Lead wires or similar wires (MRI Safety risk) Prosthetic heart valves (in high fields, if dehiscence is suspected) Hemostatic clips (body) Non-ferromagnetic stapedial implants Women with a first-trimester pregnancy Tattoos (only a problem in higher-strength magnetic field i.e. more than 3 tesla) | Radiology | Ultrasonography, CT, and MRI | An absolute contraindication of MRI is:
A. Automatic Cardioverter-defibrillators
B. Prosthetic cardiac valves
C. Insulin pump
D. Cochlear implants
| Automatic Cardioverter-defibrillators |
eef1689b-04b3-4d74-9ac9-a66111a20368 | Buccinator is supplied by facial nerve (7th nerve).
Mandibular nerve is nerve of 1st branchial arch & supplies all muscles derived from it, i.e. | Anatomy | null | Mandibular nerve does not supply:
A. Buccinator
B. Masseter
C. Tensor tympani
D. Temporalis
| Buccinator |
00cedd4a-f3d3-4b4c-b6dd-776a44c328cd | This child has : -
3 days history of upper respiratory tract infection.
Followed by stridor
These features suggest the diagnosis of croup.
Clinical manifestations of Croup
Most patients have an upper respiratory tract infection with some combination of -
Rhinorrhea
A mild cough
Pharyngitis
Low-grade fever
After 1-3 days signs and symptoms of upper respiratory tract obstruction become apparent -
Barking cough
Hoarseness
Inspiratory stridor
Symptoms are characteristically worse at night.
Symptoms often recur with decreasing intensity for several days and resolve completely in one week.
Agitation and crying aggravate the symptoms.
The child may prefer to sit up in bed or be held upright.
Chest X-ray
Characteristic narrowing of the subglottic region known as the steeple sign. | Pediatrics | null | A child with three days history of upper respiratory tract infection presents with stridor, which decreases on lying down position. What is the most probable diagnosis –
A. Acute Epiglottitis
B. Laryngotracheobronchitis
C. Foreign body aspiration
D. Retropharyngeal abscess
| Laryngotracheobronchitis |
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