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fc7fa9e4-b4dd-4a61-afc9-6056e2c7e0e8 | Ans. is 'b' i.e., Loa - Loa Loiasis . Loiasis is caused by L. Loa (the African eye worm) . Habitat of adult worms is subcutaneous connective tissue of man; often in the sub-conjuctival tissue of the eye. . The worm passes its life cycle in two hosts : - Man - Chrysops (Mango or deer flies) . C/Fs --> Asymptomatic microfilaremia Calabar (fugitive) swelling - subcutaneous swelling Nephropathy Encephalopathy rare Cardiomyopathy Calabar swelling is due to hypersensitivity reaction to the adult worm. | Microbiology | null | Calabar swelling is produced by?
A. Onchocerca volvulus
B. Loa loa
C. Burgia malayi
D. Wuchereria bancrofti
| Loa loa |
5132236d-fc4d-46ce-9bf7-7a56ad3f5ee1 | First generation antihistaminics cause sedation and anticholinergic side effects.
Sedative action of TCAs appears immediately and these drugs (particularly clomipramine, maprotiline and bupropion) lower the seizure threshold.
Benzodiazepines are used as sedative drugs. | Pharmacology | null | Which of the following is not used as a sedative, but causes sedation as a side effect :
A. Digitalis, Antiarrhythmics
B. Antihistaminics, antidepressants
C. Macrolides
D. Benzodiazepines
| Antihistaminics, antidepressants |
63d27f7c-858a-4a66-aa81-04c3ee889fe3 | Ans. is 'b' i.e., 8-12 hours o Half life of various clotting factors (in hours) :-* Firinogen - 100-150# Factor III -6# Factor X - 45-52* Prothrombin -60# FactorVIII-8-12# FactorXI -48-84* Factor V-24# Factor IX - 24# Factor XII - 150 # WVF-30 | Physiology | Blood: Hemostasis and Blood Coagulation | Half life of factor VIII -
A. 2-4 hours
B. 8-12 hours
C. 6 minutes
D. 60 days
| 8-12 hours |
f6b6c605-50ba-44a5-b0cb-872378a89a57 | The clinically suspected diagnosis is meningitis, which is confirmed by the abnormal cerebrospinal fluid. The markedly increased lymphocytes suggests acute lymphocytic meningitis, which is distinguished from acute pyogenic meningitis (increased neutrophils as well as lymphocytes). Acute lymphocytic meningitis is usually viral in origin. Among the many viruses that have been implicated, mumps, herpes, Epstein-Barr, echovirus, and Coxsackievirus are the most common. Escherichia coli and Haemophilus influenzae cause acute pyogenic meningitis. Mycobacterium tuberculosis and Treponema pallidum cause chronic meningitis. Ref: Levinson W. (2012). Chapter 37. DNA Enveloped Viruses. In W. Levinson (Ed),Review of Medical Microbiology & Immunology, 12e. | Microbiology | null | A 32 year old man presents to the emergency room with a severe headache. Nuchal rigidity is found on physical examination. Lumbar puncture demonstrates cerebrospinal fluid with markedly increased lymphocytes. Other cell populations are not increased. Which of the following agents is the most likely cause of his symptoms?
A. Escherichia coli
B. Haemophilus influenzae
C. Herpes virus
D. Mycobacterium tuberculosis
| Herpes virus |
e8642b30-506f-4616-8349-869732011482 | ANS. DPlasma concentration of drug varies with time follows the graph as shown below. Certain drugs can be secreted in breast milk and therefore transferred to the infant. Care should be taken to decrease this to the minimum possible levels.Least plasma concentration of the drug will be just before the next loading dose. Hence, the least chance for the drug to be concentrated in milk and thereby transferred to the infant would be at the time just before taking next dose. Hence advice mother to lactate just before taking next dosage of the drug. | Pharmacology | General Pharmacology | What instruction do you give to a mother who is lactating regarding intake of drug?
A. No advice as most of drug are not secreted into breast milk
B. Give longer half-life drugs
C. Tell the mother to feed when it is least efficacious
D. Lactate Just before she take the next dose, when the plasma concentration of drug would be least.
| Lactate Just before she take the next dose, when the plasma concentration of drug would be least. |
ab508393-9d3a-442e-970c-c11dc84088ec | Bullous Pemphigoid (BP) * Most common autoimmune bullous disorder with chronic nature; typically in patients over 60 Autoantigen: - * BPAG2 (collagen XVII): 180 kDa (NC16A domain), transmembrane hemidesmosomal protein * BPAG1: 230 kDa, cytoplasmic plaque protein Clinical features:- Often presents with initial uicarial lesions which evolve into large, tense bullae over medial thighs, groin, abdomen, and legs; +- pruritus initially with subsequent tenderness; no constitutional symptoms unless extensive disease; 10-35% with oral involvement Drug-induced:- Furosemide, NSAIDs, phenacetin, PCN-derivatives, gold, potassium iodide, captopril, enalapril, D-penicillamine, sulfasalazine Histology:- Subepidermal bulla with || eosinophils and lymphocytes in papillary dermis, +- neutrophils. Investigations:- * DIF: linear C3 and IgG (latter weaker) at BMZ * IIF: + in 60-80%; IIF on salt-split skin (SSS) shows binding to epidermal side of split (roof of blister) Treatment:- Oralcoicosteroid, steroid-sparing agent (azathioprine, mycophenolate mofetil, etc), TCN + nicotinamide, dapsone; good prognosis. Ref:- Sima Jain; pg num:- 130 | Dental | Vestibulobullous disorders | A 85 yr old female developed multiple blisters on trunk and thighs. Nikolsky&;s sign is negative. The lesions came on and off. The most probable diagnosis is
A. Lichen planus
B. Pemphigus vulgaris
C. Bullous pemphigoid
D. Lepra reaction
| Bullous pemphigoid |
b4204556-5cea-4250-838b-9cf55761c302 | Ans. is 'c' i.e., Increased heart rate Compensatory mechanisms in acute hemorrhageo In acute hemorrhage there is compensatory sympathetic stimulation which causes1) Generalized vasoconstriction with increased total peripheral resistance (TFR).2) Increased heart rate (tachycardia).Increased cardiac contractility.Increased renin release causing sodium and water retention through RAA system.Shift of fluid from intracellular and interstitial space into vascular space. | Physiology | Circulation: Circulatory Shock and Its Treatment | Compensatory mechanism in acute hemorrhage-
A. Decreased myocardial contractility
B. Decreased heart rate
C. Increased heart rate
D. Increased respiratory rate
| Increased heart rate |
9e28076f-844d-4a69-b195-dd548b77e278 | Integrated Child Development Services (ICDS) scheme- Under ICDS scheme, there is an anganwadi worker for every 400-800 population- The beneficiaries include nursing mothers, pregnant women, other women (15-45 years), children below the age of 6 years and adolescent girls.Park 23e pg: 903 | Social & Preventive Medicine | Health care of community & international health | ICDS stands for
A. Integrated child development services
B. Integrated child development scheme
C. International child development services
D. Indian child development scheme
| Integrated child development services |
4246d36e-38dc-4855-a10c-734530d407c0 | Ans. is 'c' i.e.. Ileocecal tuberculosis Tuberculosis of the small intestine occurs in two forms.o Primary infection is usually due to bovine strain of mycobacterium tuberculosis and results from ingesting infected milk. In India the human strain may also cause such primary tuberculosis. This produces hyperplastic tuberculosis,o Secondary infection occurs due to swallowing of tubercle bacilli in a patient with pulmonary tuberculosis. This leads to ulcerative tuberculosis, the more common form of intestinal tuberculosis.Hyperplastic tuberculosiso Caused by ingestion of Mycobacterium tuberculosis by pts with a high resistance to the organism. The infection established itself in lymphoid follicles and the resulting chronic inflammation causes thickening of the intestinal wall and narrowing of the lumen. There is early involvement of the regional lymph nodes which may caseate.o Untreated sooner or later subacute intestinal obstruction will supervene often together with the impaction of an enterolith in the narrowed lumen,o It usually occurs in the ileocecal region.o Clinical featuresAttacks of acute abdominal pain with intermittent diarrhoea.Sometimes the presenting picture is of a mass in the rt iliac fossa in a pt with vague ill health.Features of blind loop syndrome may develop due to stasis, distention and chronic infection in the segment of ileum proximal to obstruction.o Barium meal radiography will revealPersistent narrowing of the affected segtnent ie the terminal ileum and the caecum.The caecum is pulled up and may become subhepatic,As the caecum is pulled up the ileo-caecal angle is widened. Normal ileo-caecal angle is 90" In ileocaecal tuberculosis this angle may increase upto 150dego Treatment: This depends on the presence or absence of obstructive symptoms.ATT is given in both cases.If obstruction is present ileocaecal resection is best method of tft (along with ATT)Ulcerative tuberculosiso It is usually secondary to pulmonary tuberculosis and results from swallowing tubercle bacilli in the sputum (cf. Hyperplastic tuberculosis is usually primary there is no pulmonary tuberculosis)o Usually longer parts of the terminal ileum is involved.o There are multiple ulcers in the terminal ileum lying transversely o Pt presents with diarrhoea and wt losso Barium meal shows - Absence of filling of the lower ileum, caecum and most ofthe ascending colon as a result of narrowing and hypermotility of the ulcerated segment,o Treatment:A course of A TT is adequate Operation is rarely required. in rare events of perforation or intestinal obstruction. | Surgery | Miscellaneous (Small & Large Intestine) | Pulled up cecum is seen in -
A. CA colon
B. Carcinoid
C. Ileocecal tuberculosis
D. Crohn's disease
| Ileocecal tuberculosis |
2d1c26fe-8e41-4205-b352-0c167f84679a | For children between 6months and 6 years, anemia is defined as defined as hb less than 11g/dl.REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION. PAGE NO - 623 | Social & Preventive Medicine | Nutrition and health | According to the WHO criteria, anaemia in infants of 6 months age is defined as Hb less than -
A. 100 gm\/litre
B. 105 gm\/litre
C. 110 gm\/litre
D. 115 gm\/litre
| 110 gm\/litre |
d236cea6-50ce-43d5-9b1f-9659e7c20544 | The primary role of propranolol in thyrotoxicosis is to attenuate the effects of catecholamines, and it is also a weak inhibitor of extrathyroid conversion of T4 to T3. When given it is useful in reducing the hea rate, tremor, agitation, psychotic behavior, diarrhea, fever and diaphoresis. It doesn't alter the metabolic rate. | Pharmacology | null | A patient suffering from thyrotoxicosis is given propanolol. Which of the following is not controlled by propranolol given to this patient?
A. Anxiety
B. Tachycardia
C. Tremor
D. O 2 consumption
| O 2 consumption |
34533b10-05fb-4417-8703-82fda9a4d266 | Many patients with secundum ASDs have an incomplete bundle branch block on their ECG. This is in contradistinction to patients with ostium primum defects, who often have a left axis detion. Although the ECG is not pathognomonic of the defect, the findings are sometimes helpful along with other clinical and diagnostic information toward elucidating the nature of the defect. | Surgery | Thorax And Mediastinum | An electrocardiogram (ECG) in a patient with a systolic ejection murmur that shows an incomplete bundle branch block in the precordial lead is most consistent with:
A. A secundum ASD.
B. A sinus venosus ASD with PAPVR.
C. An ostium primum ASD.
D. A complete AV canal defect
| A secundum ASD. |
41334fc6-5020-4cf2-9ba0-a0deebe8676d | Ans. d. Progressive supranuclear palsy The most likely diagnosis in a 60-year old female presenting with decreased movements for the last 2 years with rigidity and veical large square wave jerks is progressive supranuclear palsy. "Progressive supranuclear palsy should be considered whenever a middle aged or elderly person person presents with history of repeated falls and has an extrapyramidal syndrome accompanied by nuchal dystonia and paralysis of voluntary down gaze." Parkinson's disease A degenerative disorder caused by degeneration of substantia nigra (pars compacta), and idiopathic in etiology. Clinical feature: Tremors, rigidity and bradykinesia. Lewy body dementia Progressive cognitive decline and dementia are essential for diagnosis Other features: fluctuating cognition, recurrent well formed detailed visual hallucinations, spontaneous features of Parkinsonism Multisystem atrophy Characterized by: Autonomic failure involving urinary incontinence or an ohostatic decrease of blood pressure within 3 min of standing by at least 3o mm Hg systolic or 15 mm Hg diastolic, Poorly levodopa responsive parkinsonism Cerebellar syndrome (gait ataxia with cerebellar dysahria, limb ataxia or cerebellar oculomotor dysfunction) Progressive supranuclear palsy Marked impairment of voluntary downward gaze and horizontal gaze.Q Extended rather than flexed dystonic posturingQ Absence of tremorQ Poor response to antiparkinsonian medicationQ Supranuclear Gaze Palsy (Steel-Richardson syndrome) A degenerative disorder where in there occurs loss of neurons in midbrain, pons, basal ganglion and cerebellum "Progressive supranuclear palsy should be considered whenever a middle aged or elderly person person presents with history of repeated falls and has an extrapyramidal syndrome accompanied by nuchal dystonia and paralysis of voluntary down gaze Factors which distinguish this from Parkinson's Marked impairment of voluntary downward gaze and horizontal gaze.Q Extended rather than flexed dystonic posturingQ Absence of tremorQ Poor response to antiparkinsonian medicationQ | Medicine | null | A 60-year old female presented with decreased movements for the last 2 years with rigidity and veical large square wave jerks. The most likely diagnosis is:
A. Parkinson's disease
B. Lewy body dementia
C. Multisystem atroph
D. Progressive supranuclear palsy
| Progressive supranuclear palsy |
de6ce662-36b2-4ac9-985f-f962bb0e0c9e | Acute-phase proteins are plasma proteins, mostly synthesized in the liver, whose plasma concentrations may increase several hundred-fold as part of the response to inflammatory stimuli.
Three of the best-known of these proteins are:
C-reactive protein (CRP).
Fibrinogen.
Serum amyloid A (SAA) protein.
Acute-phase proteins have beneficial effects during acute inflammation, but prolonged production of these proteins (especially SAA) in states of chronic inflammation can, in some cases, cause secondary amyloidosis.
Chronically elevated plasma concentrations of hepcidin reduce the availability of iron and are responsible for the anemia associated with chronic inflammation.
Systemic effects of inflammation:
Fever: Cytokines (TNF, IL-I) stimulate production of PGs in hypothalamus.
Production of acute-phase proteins: C-reactive protein, others; synthesis stimulated by cytokines (IL-6, others) acting on liver cells.
Leukocytosis: Cytokines (CSFs) stimulate production of leukocytes from precursors in the bone marrow.
In some severe infections, septic shock: Fall in blood pressure, disseminated intravascular coagulation, metabolic abnormalities; induced by high levels of TBF and other cytokines.
Reference-Robbins BASIC PATHOLOGY 10th edition pg-87 | Pathology | null | Which of the following acute-phase reactants is responsible for the anemia associated with chronic inflammation?
A. Fibrinogen
B. Serum amyloid (SAA)
C. C-reactive protein (CRP)
D. Hepcidin
| Hepcidin |
b08340fc-5c0a-474e-b0df-8e24a8f0d3e6 | The baroreflex or baroreceptor reflex is one of the body's homeostatic mechanisms that help to maintain blood pressure at nearly constant levels. The baroreflex provides a rapid negative feedback loop in which an elevated blood pressure reflexively causes the hea rate to decrease and also causes blood pressure to decrease. Decreased blood pressure decreases baroreflex activation and causes hea rate to increase and to restore blood pressure levels. The baroreflex can begin to act in less than the duration of a cardiac cycle (fractions of a second) and thus baroreflex adjustments are key factors in dealing with postural hypotension, the tendency for blood pressure to decrease on standing due to gravity. The baroreceptors are stretch-sensitive mechanoreceptors. At low pressures, baroreceptors become inactive. When blood pressure rises, the carotid and aoic sinuses are distended fuher, resulting in increased stretch and, therefore, a greater degree of activation of the baroreceptors. At normal resting blood pressures, many baroreceptors are actively repoing blood pressure information and the baroreflex is actively modulating autonomic activity. Active baroreceptors fire action potentials ("spikes") more frequently. The greater the stretch the more rapidly baroreceptors fire action potentials. Many individual baroreceptors are inactive at normal resting pressures and only become activated when their stretch or pressure threshold is exceeded. Ref: guyton and hall textbook of medical physiology 12 edition page number:216,217,218 | Physiology | Nervous system | Hea rate increase with one of the following?
A. Stimulation of trigeminal nerve pain receptor
B. Increased intracranial tension
C. Decreased stimulation of Baroreceptors
D. Increased parasympathetic stimulation
| Decreased stimulation of Baroreceptors |
78b9320b-760a-4344-ba07-3c32e0818461 | Systemic sclerosis:
Characterized by ultimate induration and atrophy of skin and fixation of epidermis to deeper subcutaneous tissues. The skin becomes hardened and atrophic and cannot be wrinkled or picked up because of its firm fixation to the deep connective tissue. This contracture of skin gives a mask-like appearance to the face of claw-like appearance to hands.
Scleroderma can be circumscribed (morphea) or linear (Coup de sabre).
The tongue becomes stiff and board like, causing the patient difficulty in eating and speaking.
Reduced opening of mouth and fixation of jaw as a result of involvement of the peritemporo mandibular joint tissues making dental care very difficult.
Some times deposition of calcium in affected areas is also found.
Radiographic features:
- Extreme widening of PDL, two to four times normal thickness is diagnostic.
- Bone resorption of angle of mandibular ramus and partial or complete resorption of condyles and/or coronoid processes of the mandible are also seen.
Overall, increased collagen in tissues is characteristic feature of systemic sclerosis or scleroderma. | Pathology | null | Pathologic calcification is seen in
A. Scleroderma
B. Lichen planus
C. Dystrophic epidermolysis bullosa
D. Lupus erythematosus
| Scleroderma |
c0818f28-4816-47d1-8302-cc564ecad134 | Horizontal eye movements (Fast one or saccadic) are triggered by the centro lateral frontal lobes i.e. left lateral gaze palsy is caused by right frontal lobe Abducens nuclear lesions produces a complete lateral gaze palsy Ref | Ophthalmology | Ocular motility and squint | Left sided lateral gaze is affected in lesion of -
A. Right frontal lobe
B. Right occipital lobe
C. Left occipital lobe
D. Left frontal lobe
| Right frontal lobe |
69e9f8f7-262c-4a12-9f1f-aefb6f47af03 | Ans. (a) TB kidneyThe clinical history is suggestive of sterile pyuria. The gross morphology shows greyish white are caseating necrotic material which is formed in patches, predominantly in the cortical areas involving the while circumference of the kidney. Hence, the first possibility is renal TB. | Pathology | Kidney | A patient presented with pus in urine. Urine culture was done which was negative. After a sudden onset renal failure the patient died. On autopsy the following finding was seen in kidney. What is the most likely diagnosis?
A. TB kidney
B. Infected renal cysts
C. Renal cell carcinoma
D. Renal stones
| TB kidney |
0e53c7b1-799f-4418-8f1d-491d3c04d66e | Frontal lobe lesion manifest as: (Anterior Cerebral Aery occlusion) Aggressive and antisocial behaviour Abulia Apathy Urge incontinence Magnetic gait/Gait apraxia O/E: Primitive reflexes like grasp and rooting reflex are present. | Medicine | Stroke and TIA | 29 yrs male was brought to OPD by his wife giving history of aggressive behaviour with decreased social interaction and lack of self care. O/E grasp reflex present, CT scan would be showing lesion of which lobe ?
A. Frontal lobe
B. Occipital
C. Temporal
D. Parietal
| Frontal lobe |
299dba36-069a-4d07-8d10-43df68529660 | Left gonadal artery and sigmoid mesocolon are related to the anterior surface of the abdominal part of the left ureter.
Internal iliac artery is related to the posterior surface of pelvic part of the ureter.
Inferior mesenteric artery (not a superior mesenteric artery) is related to left ureter medially. | Anatomy | null | Left ureter is related to -a) Quadratus lumborumb) Left gonadal vesselsc) Superior mesenteric veind) Sigmoid mesocolone) Internal iliac artery
A. abc
B. bde
C. ace
D. bce
| bde |
f43339d4-9256-480d-8622-3f23aa1c37d2 | IgA antibody is involved in local immunity at the level of the mucous membrane. It also arises early in disease, is short lived, and will disappear similarly as IgM. | Microbiology | Immunology | A patient with cerebellar problems and spider angiomas is diagnosed with a combined T-cell and B-cell deficiency known as ataxia- telangiectasia. In addition to a defect in this patient's DNA repair enzymes, which immunoglobulin is the primary antibody in saliva, tears, and intestinal and genital secretions, and is also deficient in this illness?
A. IgG
B. IgA
C. IgM
D. IgD
| IgA |
cad067c3-0686-4877-903d-c20d8ccc4ab4 | Ans: C i.e. Kilogram/ metre2 Body Mass Index is defined as the weight in kilograms divided by the square of the height in metres (Kg/m2) | Social & Preventive Medicine | null | Body Mass Index is expressed as: March 2012, March 2013 (c, g)
A. Gram/metre2
B. Gram/ centimetre2
C. Kilogram/ metre2
D. Kilogram/centimetre2
| Kilogram/ metre2 |
39964155-a6f0-43c8-bd39-47c87f08cdc7 | Gastric ulcers like duodenal ulcers cause pain, bleeding, and obstruction and can perforate.The most frequent complication of gastric ulceration is a perforation. Most perforations occur along the anterior aspect of the lesser curvatureHaemorrhage occurs in approximately 35% to 40% of patients.The incidence of malignancy ranges from 6% to 30% and increases with the size of the ulcer.Sabiston 20e pg: 1233 | Surgery | G.I.T | Most common complication of chronic gastric ulcer is
A. Tea pot stomach
B. Adenocarcinoma
C. Perforation
D. Haemorrhage
| Perforation |
23971d51-8244-4d04-95ff-c54e908347af | Ans. is 'd' i.e., Hyoscine o Motion sickness is more easily prevented than cured.o Transdermal hyoscine (scopolamine) is the best agent for the prevention of motion sickness.o Antihistamines can also be used for prevention. | Pharmacology | Anti Cholinergic | Most effective agent to prevent motion sickness is-
A. Ephedrine
B. Nedocromil
C. Cyproheptidine
D. Hyoscine
| Hyoscine |
00566935-875a-4b28-86cd-f1ff68280fe5 | Ans. is 'a' i.e., Parotid salivary gland Acinic cell tumor These are relatively uncommon tumors, representing only 2 to 3% of Salivary gland tumors. Composed of cells resembling the normal serous acinal cells of salivary glands. Most arise in the parotids - The remainder arise in submandibular glands. Minor Salivary glands are rarely involved because they have only a scant number of Serous Cells May be bilateral and multicentric. | Pathology | null | Acinic cell carcinomas of the salivary gland arise most often in the ?
A. Parotid salivary gland
B. Minor salivary glands
C. Submandibular salivary gland
D. Sublingual salivary gland
| Parotid salivary gland |
3822a78e-88c3-48ba-9d75-8254220a3680 | There are no absolute contraindications to the use of electroconvulsive therapy (ECT), but some conditions are relative contraindications, they are:Space-occupying intracerebral lesions (except for small, slow growing tumors without edema or other mass effect)Conditions with increased intracranial pressureUnstable vascular aneurysms or malformationsIntracerebral hemorrhagePheochromocytomaRecent myocardial infarctionRef: Loosen P.T., Shelton R.C. (2008). Chapter 18. Mood Disorders. In M.H. Ebe, P.T. Loosen, B. Nurcombe, J.F. Leckman (Eds), CURRENT Diagnosis & Treatment: Psychiatry, 2e. | Psychiatry | null | A patient with major depressive disorder brought by her mother complaining that she tried hanging herself. She had so many attempts before and she talks more about deaths. Electroconvulsive therapy (ECT) is suggested. Which of the following is the absolute contraindication to ECT?
A. Brain rumour
B. Myocardial disease
C. Aoic aneurysm
D. No absolute contraindication
| No absolute contraindication |
6553360a-576c-46a0-9ed3-118c9cc0c85e | Varicocele is the most common cause of male infertility. | Surgery | null | Which is the most common cause of male infertility
A. Smoking
B. Varicocele
C. Epididymitis
D. Idiopathic
| Varicocele |
ecdacc04-6369-4fb1-a791-73f9a796fb2a | BASDAI(Bath Ankylosing Spondylitis disease activity index) Used to know effectiveness of drug therapy On a scale of 1-10 it is measured by various factors like discomfo, pain, morning stiffness etc If the value is >4 there is suboptimal control of disease | Surgery | Trauma | BASDAI criteria is indicated in
A. Ankylosing spondylitis
B. Rheumatic Ahritis
C. Kawasaki Disease
D. Any autoimmune disease
| Ankylosing spondylitis |
27645fbc-0642-4689-8465-62e9f48af013 | Tuning fork tests and their interpretation Test Normal Conductive deafness SN deafness Rinne AC>BC (Rinne +ve) BC>AC (Rinne -ve) AC>BC Weber Not lateralized Lateralized to poorer ear Lateralized to better ear. | ENT | DNB 2018 | A patient has Rinne test +ve for left ear and weber test is lateralized to right ear, what type of deafness may be seen in this case?
A. Left conductive HL
B. Right conductive HL
C. Left sensorineural HL
D. Right sensorineural HL
| Left sensorineural HL |
03116128-cd45-484a-aafc-b11f4f50b82a | Baroreceptor system opposes either increases or decreases in aerial pressure, it is called a pressure buffer system, and the nerves from the baroreceptors are called buffer nerves.Ref: Guyton and Hall textbook of medical physiology 13th edition. Page: 221 | Physiology | Cardiovascular system | The blood pressure regulatory system that is labeled as a buffer system is
A. Baroreceptor
B. Chemoreceptor
C. Kidney
D. CNS ischemic response
| Baroreceptor |
a6e85470-310a-47ff-ac79-e6a9802d1d7e | Ans. is 'd' i.e., Pulmonary valve Endocarditis in rneumatic fever Mitral valve involved almost all the cases of Acute Rheumatic Fever. Almost 25% of MR is asociated with aoic regargitation. Tricuspid regurgitation is seen in 10-30% cases. Pulmonary valve involvement is never seen. | Pediatrics | null | Least common valve involved in rheumatic fever?
A. Aoic valve
B. Tricuspid valve
C. Mitral valve
D. Pulmonary valve
| Pulmonary valve |
0298a527-253e-4da8-b617-00530b799454 | Mucosal neuromas are made up of nerve cells, often with thickened perineurium, intewined with one another in a plexiform pattern. Multiple endocrine neoplasia type 2B is a genetic disease that causes multiple tumors on the mouth, eyes, and endocrine glands. It is the most severe type of multiple endocrine neoplasia,differentiated by the presence of benign oral and submucosal tumors in addition to endocrine malignancies. Ref Harrison 20th edition pg 530 | Medicine | Oncology | Multiple submucosal neuromas is most likely associated with -
A. Multiple endocrine neoplasia type 2B
B. Ovarian carcinoma
C. Testicular teratoma
D. Pancreatic beta cell carcinoma
| Multiple endocrine neoplasia type 2B |
1f44c028-cadc-44ce-a4d2-a0bbedf914fa | The Wrist radiograph shows a immature skeleton and the lower ends of radius and ulna showing cupping,splaying and fraying suggestive of Rickets | Radiology | Musculoskeletal Radiology | A Hand radiograph of a child given suggests the diagnosis of?
A. Scurvy
B. Rickets
C. Hyperparathyroidism
D. Osteogenesis imperfecta
| Rickets |
43f49022-83b5-40f5-967e-bd4a4d4a348c | nedocromil and sod.cromoglycate- mast cell stabilizers Sodium cromoglycate (Cromolyn sod.) is a synthetic chromone derivative which inhibits degranulation of mast cells (as well as other inflammatory cells) by trigger stimuli. Release of mediators of asthma-like histamine, LTs, PAF, interleukins, etc. are restricted. Nedocromil sodium has propeies similar to those of cromolyn Sodium Pharmacology and pharmacotherapeutics Satoskar 24th page no. 586 ESSENTIALS OF MEDICAL PHARMACOLOGY 7th EDITION KD TRIPATHI PG NO.229 | Pharmacology | Respiratory system | Release of histamine and leukotrienes from mast cells is prevented by:
A. Zileuton
B. Nedocromil sodium
C. Zafirlukast
D. Fexofenadine
| Nedocromil sodium |
eb09f8db-d795-45c2-a852-875d694abac9 | Ans. (c) Papillary dermisRef: Surgery Sixer 2nd edition, Page 892* First degree: Involves only epidermis* Second degree: Involves epidermis and some part of dermis. (Also known as partial thickness burns)Further divided into:* Superficial second degree or superficial partial thickness involves upper part of dermis* Deep second degree or deep partial thickness extends up to reticular layer of dermis.* Third degree or full thickness burns -- involves full thickness of dermis* Fourth degree burns -- involves subcutaneous fat and deep structures. | Surgery | Plastic & Reconstructive Surgery | Which layer involved in blister formation in a superficial partial thickness burn:
A. Epidermis
B. Dermis
C. Papillary dermis
D. Reticular dermis
| Papillary dermis |
6e5be42e-f370-4272-95a6-5680d0ccb542 | Ans. (d) Rapidly progressive Glomerulo-nephritisRef: Robbiris pathology 9th ed. /912-915* RBC casts are a feature of glomerular damage. Normally < 3 RBC/HPF are going to leak. But in case of glomerular damage the number of RBC in urine will exceed the limit mentioned above and these RBC get impinged on tamm- horsfall protein. The resultant RBC casts can be seen under microscopic examination of urine.* Bladder schistomiasis will cause hematuria and eosinophiluria.* Renal vein thrombosis is a complication of severe dehydration and causes a painful enlarged kidney with hematuria.* Minimal change disease is the most common cause of nephritic syndrome and causes proteinuria.Also knowDifferent Renal Casts and conditions where they are seen:* Hyaline cast: MC type; seen in normal individuals in dehydration or vigorous exercise * Muddy brown cast: seen in acute tubular necrosis* Waxy casts: nephritic syndrome* Fatty casts: pathognomonic for high urinary protein nephrotic syndrome.* White blood cell casts: pyelonephritis | Pathology | Glomerular Diseases | RBC cast is seen in?
A. Minimal change disease
B. Renal vein thrombosis
C. Bladder schistomiasis
D. Rapidly progressive Glomerulo-nephritis
| Rapidly progressive Glomerulo-nephritis |
f89fdba6-62bb-46fd-bda5-af610b529256 | Psedomonas is inherently resistant to most of the antibiotics. Cephalosporins such as ceftazidime ,cefoperazone, ceftolozane and cefepime are used to treat it | Anatomy | Bacteriology | 3. Drug used in the Pseudomonas treatment
A. Cefixime
B. Ceftazidime
C. Ampicillin
D. Cotrimoxazole
| Ceftazidime |
507087b4-4908-4633-a10e-5943cd2eee8a | Ans. (d) CD46(Ref: Wintrobes I2th/pg 2523)CD46 (Complement Membrane Cofactor Protein): It is a receptor to a number of pathogens, such as herpes virus 6, M protein of group A streptococci, Neisseria gonorrhoeae, and Escherichia coli. | Pathology | Misc. (W.B.C) | Host receptor for streptococcus pyogenes is?
A. CD4
B. CD21
C. CD44
D. CD46
| CD46 |
79eb80d0-7a00-4be6-98f6-0d115fa4997d | Ans. B SerotoninLow concentrations of 5-hydroxyindoleacetic acid (5-HIAA- metabolite of serotonin) in CSF associated with higher suicide risk | Psychiatry | Mood Disorders | Which of the following is associated with suicide risk?
A. Noradrenaline
B. Serotonin
C. GABA
D. Dopamine
| Serotonin |
048b366b-609e-4fe1-841e-7fbacdaf286a | C i.e. Left lateral spinothalmic tract The anterior/ ventral - spinothalmic tract carries crude touch and pressueQ from opposite half of body; whereas lateralspinothalmic tract carries pain and temperature from the opposite half of body. Therefore any lesion in lateral spinothalmic tract will result in loss of pain and temperature sensation contralaterally below the level of lesion; and lesion of anterior spinothalmic tract will 1/ t loss of crude touch & pressure sensation contralaterally. | Anatomy | null | An anterolaternal corodotomy relieving pain in right leg is effective because it interrupts the
A. Left dorsal column
B. Left ventral spinothalmic tract
C. Left lateral spinothalmic tract
D. Right lateral spinothalmic tract
| Left lateral spinothalmic tract |
491a7cd5-2279-4d87-979d-023a778b78db | • Anorectal malformations are associated with VACTERL abnormalities. | Surgery | null | A Neonate is brought with history of not having passed meconium on examination there is no anal opening but a dimple. Investigation of choice is -
A. X-ray erect posture
B. X-ray supine posture
C. Gastrograffin study
D. Invertogram
| Invertogram |
02200fb4-27cc-4305-8fb4-7fe4808c06e1 | Ans. is 'a' i.e., Staphylococcus aureus o Acute osteomyelitis may be : -Primary (hematogenous) : - Organisms reach the bone through blood stream.Secondary: - Organism gain emery directly through wound such as in compound fractures or surgical operation,o Hematogenous osteomyelitis is the commonest form of osteomyelitis and most common source of bone and joint infection is hematogenous.o It is caused most commonly by staphylococcus aureus.o Other causative organisms are streptococcus, pneumococcus, and gram negative bacilli.o Infection by pseudomonas becomes proportionally much more common in !YT drug abuser. But, the most common organism is staphylococcus aureus. | Orthopaedics | Infection of Bones & Joints | M.C. organism in acute osteomyelitis -
A. Staphylococcus aureus
B. Salmonella
C. Pseudomonas aeruginosa
D. Streptococcus pneumonia
| Staphylococcus aureus |
c524b80b-8102-4219-b13a-63fd276b9417 | Meningococci are capsulated, unlike gonococci. Based on their capsular polysaccharide antigens, they are classified into at least 13 serogroups, of which A, B, C, X, Y and W-135 are most impoant. Reference: Textbook of Microbiology; Anathanarayan and panicker's; 10th edition; Page no: 230 | Microbiology | Bacteriology | Meningococci differs from gonococci in that they
A. Are intracellular
B. Possess a capsule
C. Cause fermentation of glucose
D. Are oxidase positive
| Possess a capsule |
bd0e5286-b52a-49c6-a014-5b245dcd17f9 | Hyperhydrosis responds best to sympathectomy . Indications of Sympathectomy (BARA CHEF) Buerger's disease Atherosclerosis producing ischemia of limbs Raynaud's disease Acrocyanosis Erythrocyanosis Frost bite Hyperhydrosis Peripheral vascular insufficiency Causalgia | Surgery | Aerial disorders | Which of the following best responds to sympathectomy?
A. Buerger's disease
B. Hyperhydrosis
C. Raynaud's disease
D. Acrocyanosis
| Hyperhydrosis |
73beb125-23e1-4ec0-b63a-b191cb6c60cf | The central process in the complement is the activation of C3 which is the major component of complement. In classical pathway, activation of C3 is achieved by C42 (C3 convease). The activation of C3 without the prior paicipation of C142 is known as alternate pathway. The first example of alternate pathway was that of properdin system as a group of serum proteins contributing to antimicrobial defence without requiring specific antibodies. The activator in this system was zymogen, a polysaccharide from the yeast cell wall, but many other substances can also be used to activate the pathway. Theses include bacterial endotoxins, IgA & D, cobra venom factor & nephritic factor. Ref: Ananthanarayanan & Paniker's microbiology 8th Ed Page 120. | Microbiology | null | Which is the immunoglobulin which activates complement by alternate pathway?
A. Ig E
B. Ig A
C. Ig M
D. Ig G
| Ig A |
78c57e83-d210-4ded-96ca-ba1deba007a4 | Health education : Facilitate learning
Propaganda or publicity : Knowledge instilled in the mind of people. | Social & Preventive Medicine | null | Propaganda is defined as –
A. Forcing of knowledge into mind
B. Active aquiring of knowledge
C. Requiring knowledge after thinking
D. Training of people to use judgment before acting
| Forcing of knowledge into mind |
693cf8db-f1ae-4939-9130-da5a5fb23250 | Ans. is 'c' i.e., Three point fixation * K-nail is used for transverse or short oblique fracture of femur, especially in isthemic area.* K-nail (Kuntscher cloverleaf intramedullary nail) provides three points fixation due to elastic deformation.* These three points of fixation are both ends of bone (2 points) and isthmus (3rd point). | Orthopaedics | Management In Orthopedics | K nail work on the pricliple of -
A. One point fixation
B. Two point fixation
C. Three point fixation
D. Four point fixation
| Three point fixation |
326dff05-eb4e-403b-8449-136265f44e71 | Ref Harrison 19 th ed pg 630 The anemia is primarily due to a failure of EPO production by the diseased kidney and a reduction in red cell survival. In ceain forms of acute renal failure, the correlation between the anemia and renal function is weaker. Patients with the hemolytic-uremic syndrome increase eryth- ropoiesis in response to the hemolysis, despite renal failure requiring dialysis. | Anatomy | Haematology | Anemia in chronic renal failure is due to
A. Decreased erythropoietin production
B. Iron deficiency
C. Hypoplastic bone marrow
D. Decreased folate levels
| Decreased erythropoietin production |
1a15e330-8e55-4c23-bb37-4568776f5f57 | Primordial prevention aims at preventing the emergence of risk factors. This is the primary prevention in its purest sense, that is, prevention of emergence or development of risk factors in countries or population groups in which they have not yet appeared. Ref: Park's Textbook of Preventive and Social Medicine; 24th edition - Page no. 45 | Social & Preventive Medicine | Concept of health and disease | Primordial prevention is done in a population
A. With risk factors
B. Without risk factors
C. With low prevalence of disease
D. With disease
| Without risk factors |
e4b8bafb-bc5c-4757-83ad-037c00fa11a2 | Variable number of tandem (one after another) repeats (VNTR), is unique for any individual & therefore serves as molecular DNA fingerprint. VNTR may be short tandem (microsatellite) or large tandem (minisatellite) repeats. | Biochemistry | null | DNA fingerprinting is based on possessing in DNA of -
A. Constant Tandem Repeat
B. Variable Number Tandem Repeats (VNTR)
C. Non-repeatative sequence
D. Exon
| Variable Number Tandem Repeats (VNTR) |
92101996-5056-435e-9091-35abdad25fc9 | Ans. c. Congenital syphilis Clinical Presentation of Syphilis Early Congenital Syphilis: Snuffles (rhinitis)Q is earliest feature. Lesions are vesicobullousQ, and snail track ulcers on mucosa Clinical Presentation of Syphilis Late Congenital Syphilis: Characterized by Hutchinson's triad (interstitial keratitis + 8th nerve deafness + Hutchinson's teeth i.e. pegged central upper incisors)Q Saddle nose, sabre tibia, mulberry molarsQ Bull dog's jaw (protrusion of jaw) Rhagadesdeg (linear fissure at mouth, nares) Frontal bossing, hot cross bun deformity of skull Clutton's jointdeg (painless swelling of joints, most commonly both knee) Palatal perforationdeg Higaumenakis sign (periostitis leads to unilateral enlargement of sterna end of clavicle) Primary Syphilis: Painless, indurated, nonbleeding, usually single punched out ulcer (hard chancre)Q Painless, rubbery shotty lymphadenopathy Secondary Syphilis: Bilateral symmetrical asymptomatic localized or diffuse mucocutaneous lesiondeg (macule, papule, paulosquamous and rarely pustule) Non-tender generalized lymphadenopathyQ Highly infectious condylomata late, in warm moist interiginous areas Moth eaten alopecia, ahritis, proteinuriaQ Teiary Syphilis: Gumma, neurosyphilis/tabes dorsalisQ Ostitis, periostitis Aoitis, aoic insufficiency, coronary stenosis and nocturnal anginaQ | ENT | null | Olympian f"-ow and I hi:odes
A. CMV inclusion disease
B. Ectodermal dysplasia
C. Congenital syphilis
D. Hyper IgE syndrome
| Congenital syphilis |
b79492e4-22b2-4d06-a163-a67f99da0ed5 | Blood volume expansion begins early in the first trimester, increases rapidly in the second trimester, and plateaus at about the 30th week. Cardiac output increases approximately 40% during pregnancy, with maximum values achieved at 20-24 weeks' gestation. Stroke volume increases 25-30% during pregnancy, reaching peak values at 12-24 weeks' gestation. Vascular resistance decreases in the first trimester, reaching a nadir of approximately 34% below nonpregnancy levels by 14 to 0 weeks of gestation with a slight increase toward term. Ref: Flick A.A., Kahn D.A. (2013). Chapter 8. Maternal Physiology during Pregnancy & Fetal & Early Neonatal Physiology. In DeCherney A.H., Nathan L, Laufer N, Roman A.S. (Eds), CURRENT Diagnosis & Treatment: Obstetrics & Gynecology, 11e. | Gynaecology & Obstetrics | null | Which of the following is the LEAST likely physiological change in pregnancy?
A. Increase in intravascular volume
B. Increase in cardiac output
C. Increase in stroke volume
D. Increase in peripheral vascular resistance
| Increase in peripheral vascular resistance |
7ae763ce-fb83-4025-8834-2535363cfbce | History of Laparoscopic Cholecystectomy Dr. Ku Semm, the father of 'Pelviscopy', performed the first laparoscopic appendectomy in 1980 Eric Muhe performed the first laparoscopic cholecystectomy in 1982. He used a modified operating laparoscope placed at the umbilicus after establishing pneumoperitoneun In 1987, Phillip Mouret performed the first video laparoscopic cholecystectomy by using a camera attached to the laparoscope Ref: Blumga 5th edition Pgno :512 | Anatomy | G.I.T | The technique of laparoscopic cholecystectomy was first described by
A. Eric Muhe
B. Philip Moure
C. Ku semm
D. Eddie Reddick
| Eric Muhe |
7595f69c-d234-485c-a53c-f6f32558e294 | Gestational trophoblastic neoplasia (GTN) Invasive mole: Develops after molar pregnancy only. Very rarely follows other gestations PSTT (Placental Site Trophoblastic Tumor): may follow any type of gestation Choriocarcinoma: 2/3rd cases after normal delivery, 1/3rd cases after molar pregnancy Epitheloid Trophoblastic tumor: remote antecedant pregnancy NOTE: After a nonmolar pregnancy, persistent GTN always has the histologic pattern of choriocarcinoma. Histologic characterization of choriocarcinoma depends on sheets of anaplastic syncytiotrophoblast and cytotrophoblast without chorionic villi. The choriocarcinoma is classically a soft, fleshy, yellow-white tumour with a marked tendency to form large pale areas of ischemic necrosis, foci of cystic softening, and extensive haemorrhage. | Gynaecology & Obstetrics | Twin Pregnancy, Molar Pregnancy, Gestational Trophoblastic disease and contraception in special situations (Sour Grapes!) | Which of the following is the most common form of persistent trophoblastic disease that follows a non molar pregnancy?
A. Choriocarcinoma
B. Invasive mole
C. Placental site trophoblastic tumor
D. Paial mole
| Choriocarcinoma |
4eca9834-7ec0-4163-bc74-80a90a842f21 | Ans. (a) Needle Thoracocentesis* History is clearly indicative of Tension Pneumothorax- hence urgent need is Thoracocentesis at 2nd ICS. MCL. | Surgery | Trauma | A person had an accident and came to casualty with contusion on left precordium. There was decrease in breath sounds on left side, trachea deviated to right side and normal heart sounds. Which of the following is the first line of management?
A. Needle thoracocentesis
B. Chest tube thoracocentesis
C. Pericardiocentesis
D. Open surgery
| Needle thoracocentesis |
3064cd1f-d9a3-4830-a969-e6b1324abef7 | Eruption sequence of Temporary Dentition Lower medial incisor 6 to 8 months Upper medial incisor 7 to 9 months Upper lateral incisor 7 to 9 months Lower lateral incisor 10 to 12 months First molar 12 to 14 months Canine 17 to 18 months Second molar 20 to 30 months | Forensic Medicine | Human identification | Arrange the following tooth in the order of age of eruption of temporary teeth Upper lateral incisor Lower lateral incisor Lower medial incisor Upper medial incisor
A. 1-2-4-3
B. 3-2-1-4
C. 3-4-1-2
D. 2-3-4-1
| 3-4-1-2 |
d322f687-c57a-4362-9756-e2e0db75919c | Answer is C (Altered mental status) : `Early signs of elevated ICP include drowsiness and a diminished level of consciousness (altered mental status). Coma and unilateral papillary changes are late signs and require immediate intervention.' -Harrisons | Medicine | null | The earliest manifestations of increased intracranial pressure following head injury is :
A. Ipsilateral papillary dilatation
B. Contralateral papillary dilatation
C. Altered mental status
D. Hemiparesis
| Altered mental status |
b107dcff-c435-420a-972f-f91628165c77 | Fat content is highest in beef. REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION.PAGE NO - 582 | Social & Preventive Medicine | Nutrition and health | Fat content is highest in _____-
A. Beef
B. Mutton
C. Chicken
D. Fish
| Beef |
359068eb-8bf2-4571-9092-40b6fdc100ed | Ans. is 'a' i.e., Pyogenic infection in infancy Tom smith arthritis (septic arthritis of infancy)o Tom smith arthritis is the septic arthritis of hip joint, occurs in infancy. At this stage head of the femur is cartilaginous and is rapidly and completely destroyed by the pyogenic process. Onset is acute with abscess formation, which heals rapidly after spontaneous bursting outside or after incision and drainage. Quite often it is a delayed presentation and the child is brought for consultation when he begins to walk with a limp. On examination:-i) Limb is shortii) Hip movements are increased in all directions.iii) There is instability with positive telescoping. | Orthopaedics | Infective Arthritis | Tom smith's arthritis is due to -
A. Pyogenic infection in infancy
B. TB
C. RA
D. OA
| Pyogenic infection in infancy |
3f885a29-7ba3-4a15-ae4f-386df0545d5e | Most women with fever in the postpaum period have endometritis. Urinary tract infection is the next most common infection. caesarean section is easily the most common identifiable risk factor for development of puerperal infection. Fever and a soft, tender uterus are the most prominent signs of endometritis. Risk factors are, Prolonged rupture of the membranes (>24 hours) Chorioamnionitis An excessive number of digital vaginal examinations Prolonged labor (>12 hours) Toxemia Intrauterine pressure catheters (>8 hours) Fetal scalp electrode monitoring Preexisting vaginitis or cervicitis Operative vaginal deliveries Caesarean section Intrapaum and postpaum anemia Poor nutrition Obesity Low socioeconomic status Coitus near term Ref: Poggi S.B. (2013). Chapter 21. Postpaum Hemorrhage & the Abnormal Puerperium. In A.H. DeCherney, L. Nathan, N. Laufer, A.S. Roman (Eds),CURRENT Diagnosis & Treatment: Obstetrics & Gynecology, 11e. | Gynaecology & Obstetrics | null | 8 days after cesarean section a new mother presented with fever of 101.4degF. On examination her uterus is soft and extremely tender. Puerperal infection is confirmed. She mostly have:
A. Vaginitis
B. Endometritis
C. Parametritis
D. Salpingitis
| Endometritis |
98a251f1-f206-4b59-aac2-f1669a108ece | Montgomery tracheal tube is designed to give the surgeon a complete program for creating a secondary airway-from initial incision through long-term tracheostomy care. It is a tracheal cannula system used in place of tracheostomy tubes. The system provides long-term access to the tracheal airway in situations that require an aificial airway or where access is needed for pulmonary hygiene. It is so designed that the thin inner flange of the cannula is shaped to fit snugly against the contour of the inner anterior tracheal wall. No tube projects into the tracheal lumen. All tracheal cannulas are made of flexible implant grade silicone to assure patient comfo and safety while reducing complications. | ENT | null | Montgomery tube used in ENT procedure is a:
A. Double barrel tub
B. Lobster tail tube
C. Airway tube
D. Silicone tube
| Silicone tube |
fc7760f3-17a1-4a21-a65f-baa50d529373 | Ans; A (G0) "The cell cycle consists of G, (presynthetic), S (DMA synthesis), G, (premitotic), and SI (mitotic) phases.Quiescent cells are in a physiologic state called Ga. Tissues may be composed primarily of quiescent ceils in Gv but most mature tissues contain some combination of continuously dividing cells, terminally differentiated cells, stem ceils, and quiescent ceils that occasionally enter into the cell cycle"- Abeloff's Clinical Oncology/ 4^/428;Phases of Cell CycleThe cell cycle consists of four distinct phases: G, phase. S phase (synthesis91, G\ phase (collectively known as interphase) and M phase (mitosis)Q,M phase is itself composed oftwo tightly coupled processes: mitosis, in which the cell's chromosomes are divided between the two daughter cells, and cytokinesis, in which the cell's cytoplasm divides in half forming distinct cells.Activation of each phase is dependent on the proper progression and completion of the previous one. Ceils that have temporarily or reversibly stopped dividing are said to have entered a state of quiescence called G phaseS Phase# Th e ensuing S phase starts when DNA synthesis commenceswhen it is complete, all of the chromosomes have been replicated, i.e., each chromosome has two (sister) chromatids.# During this phase, the amount of DNA in the cell has effectively doubled, though the ploidv of the cell remains the same.StatePhaseAbbreviationDescriptionQuiescent/ senescentGap 0G0A resting phase where the cell has left the cyde and has stopped' dividing. Gap 1G1Cells increase in size in Gap 1. The checkpoint control mechanism ensures that everything is ready' for DNA synthesis.SynthesisSDNA replication occurs during this phase.Interphase Gap 2G2During the gap between DNA synthesis and mitosis, the cell will continue to grow. The G, checkpoint control mechanism ensures that everything is ready to enter the M (mitosis) phase and divide.Cell growth stops at this stage and cellular energy' is focused on the orderly' division into two daughter cells. A checkpoint in the middle of mitosis (Metaphase Checkpoint) ensures that the cell is ready to complete cell division.Cell divisionMitosisM Fig: Sequence of events during the cell cycle | Pathology | Cellular Pathology | Difference between active & resting cell depend on which phase of cell cycle:
A. G0
B. G1
C. G2
D. M
| G0 |
42ca0f7b-4904-48b9-9d1c-f4f85ef871c0 | Methotrexate is a analogue of folic acid and it prevents the synthesis of DNA by inhibiting the enzyme dihydrofolate reductase. It has been extensively used in medical termination of pregnancy, ectopic pregnancy, gestational trophoblastic disease and placenta accreta. It has been included in the "Category X" of the FDA risk categories classification. The commonly repoed side effects are leukopenia, thrombocytopenia, bone marrow aplasia, ulcerative stomatitis, hemorrhagic enteritis, elevated liver enzymes, alopecia, pneumonitis and diarrhea. It produces cranio-facial abnormalities in the fetus though it is not teratogenic. It is better to be avoided in women who are pregnant or in those who are planning for a pregnancy in the near future. Cyclosporine is a immunosuppressant that can be safely used in pregnancy. It is used in conditions like SLE, Multiple Sclerosis and renal transplant (associated with pregnancy). The other immunosuppressants that can be used in pregnancy are cyclophosphamide, prednisone and azathioprine. As malaria is a life threatening infection in pregnancy, the benefits obtained outweighs the risks that evolve from the use of anti-malarials. Chloroquine is used both in the treatment and in the prevention of malaria in pregnancy. Pyrazinamide is used in the treatment of active tuberculosis in pregnant mothers. It is given along with isoniazid, rifampicin and ethambutol for a period of nine months. Ref: Berek and Novak's Gynecology, Issue 935, Volume 2007 By Emil Novak, Page 622 ; Textbook of Obstetrics by D.C. Dutta, 6th Edition, Pages 510-13, 282-83, 295-96 | Gynaecology & Obstetrics | null | The drug that is never advised in pregnancy is:
A. Methotrexate
B. Cyclosporine
C. Chloroquine
D. Pyrazinamid
| Methotrexate |
57e9823a-e879-4af7-867f-aa027221e26a | Ans. is 'a' i.e., Immunocompetent T cells in graft tissue Graft versus host disease Graft versus host disease occurs in any situation in which immunologically competent cells or their precursors are transplanted into immunologically crippled patients and the transferred cells recognize alloantigens in the host. Graft versus host disease occurs most commonly in the setting of allogenic bone marrow transplantation but may also follow transplantation of solid organs rich in lymphoid cells (e.g. the liver) or transfusion of unirradiated blood. Recipients of bone marrow transplants are immunodeficient because of either their primary disease or prior treatment of the disease with drugs or irradiation. When such recipients receive normal bone marrow cells from allogenic donors, the immunocompetent, T cells present in the donor marrow recognizes the recipient's HLA antigen as foreign antigen and react against them. Both CD4+ and CD8+T cells recognize and attack host tissues. In clinical practice GVH can be so severe that bone marrow transplants are done only between ILIA matched donor and recipient. Acute GVH disease occurs within days to weeks after allogenic bone marrow transplantation. Although any organ may be affected, the major clinical manifestation results from involvement of the immune system and epithelia of the skin, liver and intestines. Involvement of the skin in GVH disease is manifested by a generalized rash leading to desquamation in severe cases. Destruction of small bile ducts gives rise to jaundice and mucosal ulceration of the gut results in bloody diarrhoea. Immunodeficiency is a frequent accompaniment of GVH disease. The immunodeficiency may be a result of prior treatment, myeloablative preparation for the graft, a delay in repopulation of the recipient's immune system and attack on host's immune cells by grafted lymphocytes. Affected individuals are profoundly immunosuppressed and are easy prey to infections. Although many different types of organisms may infect patients, infection with cytomegalovirus is paicularly impoant. | Microbiology | null | Graft versus host disease is due to ?
A. Immunocompetent T cells in graft tissue
B. Immunocompetent T cells in host
C. Immunocompetent B cells in graft tissue
D. Immunocompetent B cells in host
| Immunocompetent T cells in graft tissue |
d9ae47c5-3868-4669-9089-b0bf89e14a54 | Given scenario suggests diagnosis of Weil's disease/ Ictero-haemorrhagic disease/ Leptospirosis Leptospirosis - Caused by Leptospira interrogans Leptospira is an actively motile spirochete Mode of transmission: Zoonotic , by contact with water or moist soil contaminated with rat's urine or dead rats. 3 R associated with leptospirosis - Rat urine , Rice (Paddy field worker) and Rainy water Incubation period - 5-14 days. Disseminated Leptospirosis AKA Weil's disease is characterized by : High-grade fever (febrile illness) and conjuctivitis, jaundice and hemorrhages (Ictero-hemmorhagic disease) and impairment of kidney functions Lab diagnosis: a) Serological tests: - MAT - 1) Microscopic agglutination test (Preferred) 2) Macroscopic agglutination test b) PCR for Leptospira species Culture media: 1) EMJH medium 2) Koaokoff medium 3) Fletcher's medium Treatment: Leptospirosis is treated with antibiotics, such as doxycycline or penicillin, which should be given early in the course of the disease. Intravenous antibiotics ( penicillin/ ceftriaxone/cefotaxime ) may be required for persons with more severe symptoms. | Microbiology | Systemic Bacteriology (Haemophilus, Yersinia, Spirochaetes, Ricketssia, Chlamydia, Mycoplasma and Miscellaneous Bacteria) | A sewerage worker presents to OPD with acute febrile illness alongwith jaundice and conjunctivitis. His blood sample was taken and sent to lab . Lab findings are suggestive of kidney failure and elevated hepatic enzymes. Which of following is likely diagnosis ?
A. Malaria
B. Leptospirosis
C. Peussis
D. Typhoid
| Leptospirosis |
cb229460-76f8-4706-aabd-49bfcf2ac14b | The most common congenital esophageal anomaly is esophageal atresia, occurring in about 1 in 5,000 live bihs. Reference: Harrisons Principles of Internal Medicine, 18th Edition | Medicine | null | The most common congenital esophageal anomaly is which of the following?
A. Esophageal atresia
B. Esophageal psuedodiveiculum
C. Congenetal web
D. Schatzki ring
| Esophageal atresia |
5fea06ae-c794-427c-aa17-5fc64d69718e | Ans: C i.e. 2015 Governments have set a date of 2015 by which they would meet the Millennium Development Goals/ MDGs, i.e. eradicate extreme povey and hunger; achieve universal primary education; promote gender equality; improve maternal health; combat HIV/ AIDS, malaria and other communicable diseases; ensure environmental sustainability; and develop a global panership for development. | Social & Preventive Medicine | null | Millennium Development goals are to be achieved by: March 2012
A. 2005
B. 2010
C. 2015
D. 2020
| 2015 |
636d6e7c-212d-4411-88e8-453f5685ca9d | Nihilistic delusion is seen severe depression where patient denies the existence of himself & world. Also called as "Cotard syndrome". | Psychiatry | null | Mood congruent delusion seen in Depression
A. Delusion of grandeur
B. Delusion of nihilisim
C. Delusional parasitosis
D. Delusion of reference
| Delusion of nihilisim |
95bc9027-5a53-442b-b6d3-c479cc4a59bc | The anterior continuation of the cavernous sinus, the superior ophthalmic vein, passes through the superior orbital fissure to enter the orbit. Veins of the face communicate with the superior ophthalmic vein. Because of the absence of valves in emissary veins, venous flow may occur in either direction. Cutaneous infections may be carried into the cavernous sinus and result in a cavernous sinus infection which may lead to an infected cavernous sinus thrombosis. The cavernous sinus is located lateral to the pituitary gland and contains poions of cranial nerves III, IV, V1, V2 and VI, and the internal carotid aery. | Anatomy | null | A 46-year-old man sustains a spider bite on his upper eyelid, and an infection develops. The physician is very concerned about spread of the infection to the dural venous sinuses of the brain emissary veins. With which of the following dural venous sinuses does the superior ophthalmic vein directly communicate?
A. Cavernous sinus
B. Occipital sinus
C. Sigmoid sinus
D. Superior petrosal sinus
| Cavernous sinus |
eb5981c0-5a4c-4a9a-9d70-6a2aed54cda8 | Answer- B. Growth of eyelashes from Meibomian OrificesDistichiasis is a rare disorder defined as the abnormal grorvth of lashes from the orifces of the meibomian glands on the posterior lamella of the tarsal plate. | Ophthalmology | null | Distichiasis is
A. Increased number of lashes in the lower eyelid
B. Growth of eyelashes from Meibomian Orifices
C. Hyperpigmentation of eyelashes
D. Increased thickness of eyelashes
| Growth of eyelashes from Meibomian Orifices |
99285b60-26e9-4e92-b212-91febc803b29 | The child has Kawasaki's syndrome (mucocutaneous lymph node syndrome). In this disorder, small, medium, and large aeries are affected, with transmural inflammation and variable necrosis. About 20% of affected children have damage to the coronary vessels; some develop coronary aery aneurysms. In 1-2% of cases, sudden death may occur from aneurysm rupture or thrombosis producing infarction.Good to know:Abdominal aoic aneurysms are associated with atherosclerosis.Aneurysms of aoic root are usually associated with syphilis.Berry aneurysms are caused by congenital defects in the vessel wall, and are associated with polycystic kidney disease. Ref: Waller B.F. (2011). Chapter 55. Nonatherosclerotic Coronary Hea Disease. In V. Fuster, R.A. Walsh, R.A. Harrington (Eds), Hurst's The Hea, 13e. | Pathology | null | A very ill 3-year-old child is brought into the emergency room with a fever. On physical examination, the child has large cervical lymph nodes and a desquamating skin rash that involves the palms, soles, and mouth. This child should be monitored for the development of which of the following conditions?
A. Abdominal aoic aneurysm
B. Aneurysm of the aoic root
C. Berry aneurysm
D. Coronary aery aneurysm
| Coronary aery aneurysm |
ec11ccad-6faa-4e2a-82bb-1569a9836dcf | Answer is C and E (William syndrome and Rubella) Peripheral pulmonic stenosis is often associated with various congenital and acquired conditions including Rubella and williams syndrome. | Medicine | null | Peripheral pulmonic stenosis is associated with
A. Subaoic stenosis
B. Takayasu's aeritis
C. William syndrome
D. Coarctation of syndrome
| William syndrome |
3941f530-4ec6-4be6-af7d-a132197c625e | Schistocytes are typically irregularly shaped, jagged, and have two pointed ends. A true schistocyte does not have central pallor.
Helmet cells are also known as schistocytes / triangle cells / burr cells are a Feature of microangiopathic diseases including disseminated intravascular coagulation (DIC), thrombotic microomgiopathies (TTP), mechanical artificial heart valves and hemolytic Uremic syndrome (HUS). | Pathology | null | Helmet Cells are characteristic of
A. Hemolytic uremic syndrome
B. Polysplenia
C. Spherocytosis
D. Acanthocytosis
| Hemolytic uremic syndrome |
fdfdc54c-df08-4f84-b066-7a2f244abe8a | Superficial second degree burns Involve upper layer of dermis (papillary dermis) Erythematous Blisters are seen Blanch to touch Painful Heals without scarring in 7-14 days Ref: Sabiston 20th edition Pgno :506-507 | Surgery | General surgery | Blisters are seen in
A. 1st degree burn
B. Superficial 2nd degree burn
C. Deep 2nd degree burn
D. 3rd degree burn
| Superficial 2nd degree burn |
6bd16a82-bf65-4771-867e-24cbafdc6522 | Apt testKleihauer-Betke testSource of SampleMaternal or NeonatalMaternalPrincipleAdding 1% NaOH destroys adult HbA but not fetal HbFAdding acid destroys adult HbA but not fetalHbFAssessment TypeQualitativeQuantitativeResultPositive means blood is of fetal originRepoed in estimated milliliters of fetal bloodNote:When fetal blood needs to be differentiated from maternal bloodApt Test is used (Qualitative estimation)When the amount of fetal blood needs to be estimatedKleihauer-Betke test is used(Quantitative estimation)Approximate volume of fetal blood entering into the maternal circulation is to be estimated by Kleihauer-Betke test using acid elution technique to note the number of fetal red cells per 50 low power fields.If there are 80 fetal erythrocytes in 50 low power fields in maternal peripheral blood films, it represents a transplacental hemorrhage to the extent of 4ml of fetal blood.(Refer: Mudaliar and Menon&;s Clinical Obstetrics, 11th edition, pg no:227) | Pathology | All India exam | Fetal and maternal blood can be differentiated by
A. Kleihaurbetke test
B. Apt test
C. Bubbling test
D. Osmotic fragility test
| Apt test |
32bab35a-c62d-4485-88a5-39c98c199412 | Ans is 'b' i.e. Doctor's feelings towards the patient TransferenceTransference is the phenomenon whereby unconsciously transfer feelings and attitudes from a person or situation in the past on to a person or situation in the present. The process is at least partly inappropriate to the present.Characteristic features of TransferenceTransference is unconsciousIt is at least partly inappropriate to the presentIt is the transferring of a relationship, not a personOnly an aspect of a relationship, not the entire relationship, is transferredPoints to noteThe process of transference is not conscious, and the patient unwittingly projects a needed aspect of a previously experienced or wished-for relationship on to doctor.Because it is a relationship that is "transferred", the patient and doctor are expected to take complementary roles.So a patient who is afraid that he or she is seriously ill may adopt a helpless child-like role and project an omnipotent parent-like quality on to the doctor, who is then expected to provide a solution.Projection and transferenceTransference involves the projection of a mental representation of previous experience on to the present.Other people are treated as though they are playing the complementary role needed for the projected relationship.There are subtle (unconscious) behavioural "nudges" to take on these feelings and behavioursExamples to explain transferenceSuppose a patient is in a session with a therapist and the therapist says something that sets him of and he get way angry at him.He lash back with anger and says things that really have nothing to do with him at all.He has said something that triggers another relationship from the past and that anger from the old relationship gets transferred onto him.Another example is love transference and this is very common in therapyA lady patient go to see therapist and starts having strong feelings about him. He reminds her of someone from the past - her father and now seems to be transferring feelings that she had towards her father on to the therapist and she wants him to meet the needs that she had towards daddy.CountertransferenceDefinitionCountertransference is the response that is elicited in the recipient (therapist) by the other9s (patient9s) unconscious transference communications.Countertransference response includes both feelings and associated thoughts.When transference feeling are not an important part of the therapeutic relationship, there can obviously be no countertransference.CountertransferenceIncludes the feelings evoked in the doctor by the patient's transference projections.These can be a useful guide to the patient's expectations of relationships.They are easier to identify if they are not congruent with the doctor's personality and expectation of his or her role.Awareness of the transference-countertransference relationship allows reflection and thoughtful response rather than unthinking reaction from the doctor.The degree to which the projected role is congruent with some aspect of the personality of the recipient will affect the likelihood of his or her adoptions it.An understanding of transference and countertransference is essential to good practice in psychiatry. Being aware of the hidden agenda in the clinical relationship will help the doctor recognize some of the patients wishes and fears which are not full conscious and which can contribute to conflict or intense dependency. The doctor is then more likely to stand back a little from patients emotional demand and avoid getting caught up in agenda.Mr D was a young man with a long history of unstable relationships, depressive episodes and alcohol misuse attending a day hospital. He was often hostile to his keyworker whom he accused of not caring whether he lived or died. The keyworker was an experienced community psychiatric nurse and was confident that she was neither negligent nor uncaring about her patient. She was aware that Mr D projected a scenario in which he was neglected and at risk, while she was experienced as a callous uncaring parent. Her recognition of this transference allowed her to remain calm and supportive and not to retaliate.<< A role may be congruent with an aspect of the therapist's personality and he or she may unconsciously accept and collude with the projection.Ms E had a long history of repeated treatment episodes for eating disorder, depression and relationship problems. Following a move to university, the university general practitioner referred her to the local psychiatric service for treatment. She confided in the young SHO that he was the first doctor to whom she had been able to talk freely, and that she had told him things she had never told previous doctors. The doctor enjoyed this idealisation and accepted that he had a special relationship with the patient. | Psychiatry | Psychoanalysis and Psychotherapy | Counter transference is -
A. Patient's feelings towards therapist
B. Doctor's feelings towards the patient
C. Psycic connection between patient and diseas
D. Type of Defence mechanism
| Doctor's feelings towards the patient |
c16dcef6-d6c0-4d0a-a28d-0f8b46d3732f | A new drug/ vaccine is launched in the market after phase III (RCT). Phase IV is 'Post marketing surveillance phase' Is the longest phase in a clinical trial. Should be carried out life long (minimum 10-25 years). Is done for finding 'long term side effects and rare side effects' of the drug. | Social & Preventive Medicine | RCT, Trials | Phase 4 clinical trials is carried out:
A. Before the marketing approval of a drug
B. After a drug is marketed
C. For drugs used in rare disease
D. For drugs used in pediatric patients
| After a drug is marketed |
1468c629-941d-4e6e-babd-0254b0f7a2db | b. 10(Ref: Nelson's 20/e p 595)Important genes and their chromosomal location:Gene (Associated diseases)Chromosomal locationRb (Retinoblastoma)13q14.3p53 (Li-Fraumeni syndrome, sarcomas)17q13.1APC (Carcinoma Colon)5q21NF1 (Neurofibromatosis 1)17q11NF2 (Neurofibromatosis 2)22p12WT1 (Wilm's tumor)11p13RET (MEN2 syndrome)10q | Pediatrics | Genetics And Genetic Disorders | RET proto oncogene is located on which chromosome:
A. 9
B. 10
C. 11
D. 12
| 10 |
6c6a45c8-5e43-45f5-87bb-f0756a61e4f5 | Multi step.theory of carcinogenesis Phy.attributes are .self sufficient in growth signal .local invasion ,metastasis .karyotic pattern .hormonal response .response to Anti malignant drugs Evading apoptosis All these acquired in a step wise fashion This phenomenon is tumour progression | Pathology | Cardiovascular system | With reference to neoplasia, the term 'tumor progression means
A. Spread of cancer to distant sites
B. Rate of growth of tumors
C. Abi1ity of cancer cells to resemble their normal counterpa
D. Sequential appearnace of features of increasing malignancy
| Sequential appearnace of features of increasing malignancy |
42704339-3d53-479b-be41-bb9bd4425157 | The disease process described is myasthenia gravis (MG), a neuromuscular disease marked by muscle weakness and fatigability. Myasthenia gravis results from a reduction in the number of junctional acetylcholine receptors as a result of autoantibodies. Antibodies cross-link these receptors, causing increased endocytosis and degradation in lysosomes. A decreased number of available acetylcholine receptors results in decreased efficiency of neuromuscular transmission. MG patients also have autoantibodies against muscle-specific tyrosine kinase (MuSK) receptors. MG presents with weakness and fatigability, particularly of cranial muscles, causing diplopia, ptosis, nasal speech, and dysarthria. Proximal limb weakness also occurs. Diseases of the central nervous system (poliomyelitis, Friedreich ataxia, or multiple sclerosis, as in the option b, c, and d) cause changes in reflexes, sensation, or coordination. ALS, a pure motor disorder, causes fasciculations and muscle atrophy as a result of lower motor neuron involvement. McArdle disease, a glycogen storage disease, causes muscle cramping and occasionally rhabdomyolysis with heavy exertion but only very rarely with usual daily activities.Ten percent of myasthenia patients have thymic tumors. Surgical removal of a thymoma is necessary because of local tumor spread. Even in the absence of tumor, 85% of patients clinically improve after thymectomy. It is common practice to perform thymectomy in most patients with generalized MG who are between puberty and age 55. | Medicine | C.N.S. | A 20-year-old woman complains of weakness that is worse in the afternoon, worse during prolonged activity, and improved by rest. When fatigued, the patient is unable to hold her head up or chew her food. She often notes diplopia when driving home from work. On physical examination, she has no loss of reflexes, sensation, or coordination. Which of the following is the likely pathogenesis of this disease?
A. Autoantibodies directed against the postsynaptic acetylcholine receptor causing neuromuscular transmission failure
B. Destruction of anterior horn cells by virus
C. Progressive muscular atrophy caused by spinal degeneration
D. Demyelinating disease
| Autoantibodies directed against the postsynaptic acetylcholine receptor causing neuromuscular transmission failure |
06c1eb6f-b385-44ec-bbf0-21ec594a095d | Ans. A. CraniopharyngiomaTumors arising from the brain are common in children. Certain genetic syndromes and familial factors increase the risk of occurrence of brain tumors. Over 2/3 of brain tumors in children are infratentorial. They can be classified as:* Cerebellar Tumors: Medulloblastoma, Astrocytoma* Brainstem Tumors: Glioma of the brainstem, Ependymoma of the IV ventricle* Supratentorial tumors: Craniopharyngioma, Glioma of the cerebral hemispheres, hypothalamic glioma, Glioma of optic nerve. | Pediatrics | Childhood Tumors | Which of the following are supratentorial tumors?
A. Craniopharyngioma
B. Medulloblastoma
C. Astrocytoma
D. Ependymoma
| Craniopharyngioma |
f2ae21f4-7c6c-4831-aa59-81123a0e86e4 | RETROPERITONEAL LIPOMA These swellings sometimes reach an immense size Retroperitoneal lipoma is often malignant (liposarcoma) and may increase rapidly in size A retroperitoneal lipoma sometimes undergoes myxomatous degeneration Clinical Features Swelling or indefinite abdominal pain More common in women Diagnosis Diagnosis is usually by ultrasound and CT scanning. | Surgery | Plastic Surgery and Skin Lesions | Lipoma becomes malignant commonly at which site:
A. Subcutaneous
B. Sub-aponeurotic
C. Retroperitoneal
D. Intermuscular
| Retroperitoneal |
a48a15e7-1bb5-417a-a943-25e08552fd6e | As a compensatory mechanism, metabolic acidosis leads to alveolar hyperventilation with a fall in PaCO2. Normally, PaCO2 falls by 1-1.3 mm Hg for every 1-mEq/L fall in serum HCO3- concentration, a compensatory response that can occur fairly quickly Ref Davidson 23rd edition pg 345 | Medicine | Fluid and electrolytes | . If blood gas analysis reveal pH = 7.52, pCO2=3O; pO2= 105.This will be compensated by?
A. Compensatory respiratory acidosis
B. Compensatory respiratory alkalosis
C. Compensatory metabolic acidosis
D. Compensatory metabolic alkalosis
| Compensatory metabolic acidosis |
5f56ffb6-97b2-474b-9110-e76759b1ac88 | Ans. B: Interstitial keratitis Hutchinson's triad is named after Sir Jonathan Hutchinson. It is a common pattern of presentation for congenital syphilis, and consists of three phenomena: interstitial keratitis, Hutchinson incisors (notching of the two upper central incisors in the permanent dentition), and eighth nerve deafness | Ophthalmology | null | Corneal lesion seen in Hutchinson triad associated with congenital syphilis is: September 2006
A. Disciform keratitis
B. Interstitial keratitis
C. Phylectenular keratitis
D. Mooren ulcer
| Interstitial keratitis |
550e9be0-2b76-4f06-b5af-46923c33b94b | Triiodothyronine, also known as T3, is a thyroid hormone. It affects almost every physiological process in the body, including growth and development, metabolism, body temperature, and hea rate. Production of T3 and its prohormone thyroxine (T4) is activated by thyroid-stimulating hormone (TSH), which is released from the pituitary gland.T3 is the true hormone. Its effects on target tissues are roughly four times more potent than those of T4. Of the thyroid hormone that is produced, just about 20% is T3, whereas 80% is produced as T4. Roughly 85% of the circulating T3 is later formed in the liver and pituitary by removal of the iodine atom from the carbon atom number five of the outer ring of T4. In any case, the concentration of T3 in the human blood plasma is about one-foieth that of T4. This is observed in fact because of the sho half-life of T3, which is only 2.5 days. This compares with the half-life of T4, which is about 6.5 days.Ref: Ganong&;s review of medical physiology; 24th edition | Physiology | Endocrinology | Half-life of T3
A. 10 hours
B. 2 day
C. 6 days
D. 10 days
| 2 day |
52291eaf-2ced-4051-b033-ad1ecd788e8a | Ans. is 'a' i.e., 1, 3, 5 days ANTI-TYPHOID VACCINES The old parenteral killed whole-cell vaccine was effective but produced strong side-effects. So, they are not used now. Two safe and effective vaccines are now licensed and available : - 1.The Vi polysachharide vaccine It is composed of purified Vi capsular polysaccharide from the Ty2 strain of S.Typhi. It is administered subcutaneously or intramuscularly. Only one dose is required. The vaccine confers protection 7 days after injection. To maintain protection, re-vaccination is recommended every 3 years. The vaccine is licensed for individuals aged 2 years. - It does not elicit immune response in children < 2 years. The vaccine is stable for 6 months at 37deg C and for 2 years at 20degC. The recommended storage temprature is 2-8degC. The Vi polysaccharide vaccine can be co-administered with other vaccines relevant for international travellers-such as yellow fever and hepatitis A Acyclovir is given to prevent the development of systemic disease in varicella infected immunosuppresed patients & can halt the progression of zoster in adults. Varicella zoster immunoglobulin given within 72 hrs of exposure can prevent chicken pox and is recommended in exposed immunocompromised persons. A live attenuated varicella vaccine is recommended for children between 12-18 months. It is effective even if given within 3-5 days after exposure. 2.The Ty 21a oral vaccine It is an orally administered, live attenuated Ty2 strain of S.Typhi in which multiple genes (including for Vi Capsular polysaccharide) have been mutated chemically. This lyophilized vaccine is available in 2 preparations : ? 1. Enteric coated capsules - Used for travellers to developing countries. It is used in individuals 5 years of age. 2.Liquid suspension - Used by public health programmes for young children in developing countries. It can be administered from the age of 2 years. Vaccine is administered on 1, 3 and 5the day, i.e., a 3-dose regimen is recommended. Vaccine confers protection 7 days after the last dose. The recommendation is to repeat this series (3 doses) every 3 years for people living in endemic areas, and every year for individuals travelling from non-endemic to endemic countries. Ty 21 a requires storage at 2-8degC, it retains potency for approximately 14 days at 25degC. Proguanil and antibacterial drugs should be stopped from 3 days before until 3 days after giving Ty 21 a, as these drugs may harm live bacteria. The vaccine is not efficacious if administered at the time of ongoing diarrhea. Avoided during diarrhoea as efficacy will reduce. Can be given to HIV +ve, asymptomatic persons with CD4 cell count of > 200/mm3 Well tolerated and has low rates of adverse events. Not recommended in congenital or acquired immunodeficiency, acute febrile illness, acute intestinal infection and in patients on antimitotic drugs May be given simultaneously with live vaccines of polio, cholera, yellow fever and MMR. | Social & Preventive Medicine | null | Typhoid oral vaccine is given ?
A. 1, 3, 5 days
B. 1, 2, 3 days
C. 1, 2, 4 days
D. 1, 7, 14 days
| 1, 3, 5 days |
f1c82e81-ab79-4bb0-835c-8c6686628a85 | In multiple myeloma- bone lesions are most common in veebral column. The pain usually involves the back and ribs, and unlike the pain of metastatic carcinoma, which often is worse at night, the pain of myeloma is precipitated by movement. Persistent localized pain in a patient with myeloma usually signifies a pathologic fracture. The most common site of lytic lesion in multiple myeloma is veebra>skull>ribs. Distal to elbow and knee lesions are not seen. | Medicine | Lymphoma and Plasma cell disorder | Commonest site of lytic lesion in multiple myeloma is:
A. Veebral column
B. Femur
C. Clavicle
D. Pelvis
| Veebral column |
40e51276-aaf1-4cc8-8141-3905da5cbe9b | The feeding tube length can be measured by following the normal route for tube i.e. Nasal ala - to ear lobe - to epigastium Since the distance between the nasal ala and ear lobe is almost equal to the distance between the epigastrium and umbilicus, the length can be measured from ear lobe to umbilicus. | Anatomy | General surgery | The length of the feeding tube to be inseed for transpyloric feeding is measured from the tip of
A. Nose to the umblicus
B. Ear lobe to the umblicus
C. Nose to the pelvis
D. Ear lobe to the pelvis
| Ear lobe to the umblicus |
5101bc72-2325-44e8-8086-ec73130153ed | Difference in expression of gene in the sibling as inherited by the father is termed as mosaicism. It results from a mutation that occurs during embryonic, fetal, or extrauterine development. When mutation occur during from nondisjunction at an early embryonic mitotic division chromosomal mosaicism occurs. Somatic mosaicism is characterized by a patchy distribution of genetically altered somatic cells. Anticipation refers to an unusual pattern of inheritance in which symptoms manifest at earlier ages and with increasing severity as traits are passed to subsequent generations. Ref: Kopp P., Jameson J.L. (2012). Chapter 61. Principles of Human Genetics. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e. Tsaic A.C., Manchester D.K., Elias E.R. (2012). Chapter 37. Genetics & Dysmorphology. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e. | Medicine | null | Difference in expression of gene in the sibling as inherited by the father is termed as:
A. Mosaicism
B. Anticipation
C. Mutation
D. Replication
| Mosaicism |
647a6092-baba-4abd-bb16-8723eef4fe1d | Infantile atopic dermatitis (2 months - 2 years): More commonly involves extensors.
Childhood atopic dermatitis (2 - 10 years): Commonly involves flexors
Adolescent atopic dermatitis (> 10 years): Commonly involves flexors, hand & feet. | Dental | null | Infantile atopic dermatitis commonly involves
A. Flexors
B. Extensors
C. Head & neck
D. Perianal area
| Extensors |
63b79c3e-4652-4dcd-b5c8-acc1c922333f | Ans. is 'b' i.e., < 5 cm Oligohydramnios1) AFI <5 cm or single largest vertical pocket < 2cm2) Amniotic fluid less than 100 mLEtiologyChromosomal AbnormalitiesUteroplacental Insufficiency* Congenital anomalies (e.g., renal agenesis and posterior urethral valves)* IUGR* Postdatism/postterm pregnancy* PROM* Twin-to-twin transfusion* Hypertension* Preeclampsia* NSAIDs, angiotensin-converting enzyme inhibitors* Idiopathic | Gynaecology & Obstetrics | Carcinoma Ovary | Oligohydroamnios is AFI-
A. <8cm
B. <5cm
C. <2 cm
D. <1 cm
| <5cm |
8353de61-7c64-4e09-8c60-54d33ddce638 | Thoracic duct is continuation of cysterna chyli. It passes through aoic hiatus beginning at lower border of T12 . At T5 it crosses to left side andopens into the left venous (jugulo-subclan) angle - junction of the left internal jugular and subclan vein, at the beginning of left brachio-cephalic vein. | Anatomy | Thorax- wall and Bronchopulmonary segment | Thoracic duct opens into:
A. Subclan vein
B. Internal jugular vein
C. Right brachiocephalic vein
D. Left brachiocephalic vein
| Left brachiocephalic vein |
4e96a28e-a5e0-49a5-9b41-f93a08586580 | A cross-section of a typical small nerve has many large nerve fibers that constitute most of the cross-sectional area. However, a more careful look revealsmany more small fibers lying between the large ones. The large fibers are myelinated, and the small ones are unmyelinated. The average nerve trunk contains about twice asmany unmyelinated fibers as myelinated fibers. The central core of the fiber is the axon, and the membrane of the axon is the membrane that actually conducts the action potential. The axon is filled in its center with axoplasm, which is a viscid intracellular fluid. Surrounding the axon is a myelin sheath that is often much thicker than the axon itself. About once every 1 to 3 millimeters along the length of the myelin sheath is a node of Ranvier. The myelin sheath is deposited around the axon by Schwann cells in the following manner: The membrane of a Schwann cell first envelops the axon. The Schwann cellthen rotates around the axon many times, laying down multiple layers of Schwann cell membrane containing the lipid substance sphingomyelin. This substance is an excellent electrical insulator that decreases ion flow through the membrane about 5000-fold. At the juncture between each two successive Schwann cells along the axon, a small uninsulated area only 2 to 3 micrometers in length remains where ions still can flow with ease through the axon membrane between the extracellular fluid and the intracellular fluid inside the axon. This area is called the node of Ranvier.Ref: Guyton and Hall textbook medical physiology, 13th edition. | Physiology | Nervous system | Node of Ranvier is seen in
A. Cell body
B. Dendrites
C. Axons
D. Terminal butons
| Axons |
f1c81b43-99ef-4eca-87a4-e4b45eef4798 | Malingering/Nonorganic hearing loss (also called pseudohypacusis)
Ocassionally patients wilfully or subconsciously exaggerate their hearing loss.
This is functional hearing loss or pseudohypacusis or malingering
– The signs in the test behavior that suggest functional component include:
a. Inconsistent responses
b. Significant differences between the threshold obtained using ascending and descending administration of test stimuli
c. A discrepancy of > 8 dB between the SRT (speech reception threshold) and the pure tone average of 500–2000 Hz
d. Positive Stenger test
Stenger Test
It is used to identify unilateral or asymmetrical functional hearing loss. It is based on the concept that when both ears are stimulated simultaneously by a tone equal in frequency and phase, the auditory percept is lateralized to the ear with better hearing.
If speech stimulus is used in Strenger test it is k/a Speech Stenger test or modified Stenger test.
Other objective tests which can diagnose functional involvement are:
––acoustic reflexes: Pt saying hearing loss but normal acoustic reflex indicates NOHL
––auditory brainstem response
––otoacoustic emission
Also Know
Other tuning fork tests which can be used to detect malingering but are now outdated are:
Teel’s test
Lombard’s test
Chamini-Moos test
Gault test | ENT | null | Which one of the following test is used to detect malingering -
A. Stenger's test
B. Buinge's test
C. Weber 's test
D. Rinne's test
| Stenger's test |
2373fcae-6c51-4afb-92c7-574f70259807 | The thick filament or the myosin is made up of the heavy chain of myosin and light chain of myosin The myosin molecule is composed of six polypeptide chains- Two heavy chains, each with a molecular weight of about 200,000 and four light chains with molecular weights of about 20,000 each. The two heavy chains wrap spirally around each other to form helix, which is called the tail of the myosin molecule. One each end of these chains is folded into a globular polypeptide structure called myosin head. These heads contain an actin-binding site and a catalytic site that hydrolyses ATP. Thus, there are two free heads at one end of the double-helix myosin molecule. The four light chains are also pa of the myosin head, two to each head. These light chains help control the function of the head during muscle contraction. Ref: Guyton and Hall Textbook of Medical Physiology 13th edition Pgno: 78-79 | Physiology | General physiology | The thick filament is made up of Heavy chain of myosin Light chain of myosin Dystrophin Titin
A. 1, 3, and 4
B. 2, 3 and 4
C. 1 and 2
D. 3 and 4
| 1 and 2 |
342b67bf-2129-4bf8-8540-93deab81ccaf | Ans. is 'a' i.e., PhenytoinSome important drugs causing megaloblastic anaemiao Methotrexateo Phenytoino Cytosine arabinosideo Phenobarbitoneo Pentamidineo Pyrimethamineo Zidovudineo 5-Fluorouracilo Sulfasalazineo Triamtereneo Primidoneo Trimethoprimo Azathioprine | Pharmacology | Adverse Drug Effect | Megaloblastic anemia is caused by -
A. Phenytoin
B. Lithium
C. Lead
D. Chloroquine
| Phenytoin |
a15da526-c1cc-4933-a4a2-54cbc36f7211 | Enterococci causes a wide variety of infections ranging from less serious, for example, urinary tract infections, to very serious, such as septicemia. A Gram-positive coccus resistant to penicillin must be assumed to be enterococcus until other more definitive biochemical testing places the isolate in one of the more esoteric groups of Gram-positive cocci. Once isolated, there are a variety of tests to speciate enterococci. However, penicillin-resistant, non-b-lactamase-producing, vancomycin-resistant, Gram-positive cocci are most likely Enterococcus faecium. There are a variety of mechanisms for vancomycin resistance in E. faecium and they have been termed Van A, B, or C. These isolates have become one of the most feared nosocomial pathogens in the hospital environment. Unfounately, no approved antibiotics can successfully treat vancomycin-resistant enterococci (VRE), only some experimental antibiotics such as Synercid. Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition | Microbiology | Bacteriology | A 70-year-old female patient was readmitted to a local hospital with fever and chills following cardiac surgery at a major teaching institution. Blood cultures were taken and a Gram-positive coccus grew from the blood cultures within 24 hours. Initial tests indicated that this isolate was resistant to penicillin. The most likely identification is
A. image_question
B. image_question
C. image_question
D. image_question
| image_question |
dce8cce5-13b0-4d8d-9431-a4227a2a8456 | Penicillin is the drug of choice for treatment of leptospirosis. Tetracycline or doxycycline may also be used. Ref: Park 21st edition, page 267. | Social & Preventive Medicine | null | What is the recommended drug for treatment of leptospirosis?
A. Penicillin
B. Tetracycline
C. Azithromycin
D. Erythromycin
| Penicillin |
ddbafd09-7344-4f74-a726-934e0b7a4bdd | Posterior uveitis(choroiditis) is a painless condition,usually characterised by visual symptoms due to associated vitreous haze and involvement of the retina. | Ophthalmology | Uveal tract | Most common symptom of posterior uveitis -
A. Pain
B. Photophobia
C. Lacrimation
D. Diminished vision
| Diminished vision |
2dd15eef-7099-4cf6-b99f-7b7322c84b41 | Ans. C. DNase Ia. DNA ligase is used for joining of DNA molecules.b. DNA polymerase I is used for synthesis of double stranded cDNA.c. Polynucleotide kinase is used for T-32 end labeling of DNA or RNA. | Biochemistry | Molecular Genetics | The enzyme used for the mapping of hypersensitive sites in recombinant DNA research is?
A. DNA ligase
B. DNA polymerase I
C. DNase I
D. Polynucleotide kinase
| DNase I |
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