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1130ac3f-006b-444a-8eec-5630f3350828 | All veins carry deoxygenated blood from the body to the heart with the exception of the pulmonary vein
which carries oxygenated blood from the lungs to the heart. | Pathology | null | As a general rule, veins carry
A. Urine
B. Lymph fluid
C. Oxygenated blood
D. Deoxygenated blood
| Deoxygenated blood |
3d03c4a0-ca11-400c-a61c-4710d36867d5 | Ans. D: Decreased AFP level Alpha-fetoprotein is made in the pa of the womb called the yolk sac and in the fetal liver, and some amount of AFP gets into the mother's blood. In neural tube defects, the skin of the fetus is not intact and so larger amounts of AFP is measured in the mother's blood. In Down syndrome, the AFP is decreased in the mother's blood, presumably because the yolk sac and fetus are smaller than usual. Estriol is a hormone produced by the placenta, using ingredients made by the fetal liver and adrenal gland. Estriol is decreased in the Down syndrome pregnancy. This test may not be included in all screens, depending on the laboratory. Human chorionic gonadotropin hormone is produced by the placenta, and is used to test for the presence of pregnancy. A specific smaller pa of the hormone, called the beta subunit, is increased in Down syndrome pregnancies. Inhibin A is a protein secreted by the ovary, and is designed to inhibit the production of the hormone FSH by the pituitary gland. The level of inhibin A is increased in the blood of mothers of fetuses with Down syndrome. PAPP-A, which stands for pregnancy-associated plasma protein A, is produced by the covering of the newly feilized egg. In the first trimester, low levels of this protein are seen in Down syndrome pregnancies. It is impoant to keep in mind that even the best combination of ultrasound findings and other variables is only predictive and not diagnostic. For true diagnosis, the chromosomes of the fetus must be examined. Amniocentesis is usually carried out between the 14th and 18th week of pregnancy. CVS is usually carried out between the 10th and 12th weeks of pregnancy. | Pediatrics | null | Which of the following is associated with Down syndrome: March 2010
A. Raised PAPP-A level
B. Decresed beta-HCG level
C. Raised estriol level
D. Decreased AFP level
| Decreased AFP level |
03fa88dd-6887-445c-a283-5aa7bd49bd90 | All enzymes (except isomerases) exhibit stereospecificity, that reacts only with one set of stereoisomers.Whereas isomerases conve substrate from one isomerase to another. Harper 30th edition pg: 60 | Biochemistry | Enzymes | One of the following groups of enzymes does not exhibit stereospecificity
A. Oxidoreductases
B. Isomerases
C. Lyases
D. Transferases
| Isomerases |
11bc5e56-5033-42bf-98f5-f01c744511a1 | Ans. is 'c' i.e., 98% of individuals Recommended Dietary allowance (RDA) o Also know as recommended daily allowance. o The RDA is the average daily dietary intake level that is sufficient to meet the nutrient requirments of nearly all (97 to 98%) individuals in a life stage and gender group. o The RDA applies to individuals, not to groups. o The estimated average requirement (EAR) serves as the foundation for setting RDA. If the standard detion (SD) of the EAR is available and the requirement for the nutrient is normally distributed, the RDA is set at 2 SDs above the EAR. RDA EAR 4- 2 SDFAR Adequate intake (AD o The adequate intake is set instead of an RDA if sufficient scientific evidence is not available to calculate an EAR. o The AI is based on observed or experimentally determined estimates of average nutrient intake by a group (or groups) of healthy people. o For example. the "adequate intake" for young infants for whom human milk is the recommended sole source of food for the first 4 to 6 months, is based on the estimated daily mean nutrient intake supplied by human milk for healthy, full term infants who are exclusively breastfed. RIM Vs Adequate intakes (Al) Although RDA and Al are used for the same purpose - setting goals for intake by individuals - The RDA differs from the Al. RDA is expected to meet the needs of 97 to 98% of the individuals, while it is not known what percentage of individuals arc covered by the adequate intake. o The adequate intake does not bear a consistent relationship to the EAR or the RDA because it is set without being able to estimate the average requirement. It is assumed that adequate intake is at or above the RDA if one could be calculated. o The adequate intake for a nutrient is expected to exceed the average requirement for that nutrient, and it should cover the needs for more than 98% of the individuals, but it might cover the needs of far fewer. o The degree to which adequate intake exceeds the average requirements is likely to differ among nutrients and population groups. For people with diseases that increases requirements or who have other special health needs, the RDA and adequate intake may serve as the basis for adjusting individual recommendations, qualified health professionals should adapt the recommended intake to cover the higher or lower needs. Tolerable upper intake level (UL) : - The highest average daily nutrient intake level that is likely to pose no risk of adverse health effects for almost all individuals in the general population. As intake increases above UL, the potential risk of adverse effect increases. | Social & Preventive Medicine | null | RDA cover of nutrient requirement of-
A. 50% of individuals
B. 75% of individuals
C. 98% of individuals
D. Same as adequate intake
| 98% of individuals |
9af5809d-a617-49a5-a9d8-526611306970 | "CT has become the gold standard for the assessment of abdominal trauma particularly solid parenchymal injury". | Radiology | null | Investigation of choice for diagnosis of splenic rupture –
A. Peritoneal lavage
B. Ultrasound
C. CT scan
D. MRI
| CT scan |
7e713303-4b10-4822-88bd-5f7c19c1e07c | Complicatiosn of Talar neck fracture
Malunion
Avascular necrosis (osteonecrosis) of body.
Non-union
Secondary osteoarthritis of ankle and subtalar joint. | Orthopaedics | null | Fracture of talus without displacement in x-ray would lead to -a) Osteoarthritis of ankleb) Osteonecrosis of head of talusc) Avascular necrosis of body of talusd) Avascular necrosis of neck of taluse) Non union
A. ac
B. bc
C. ad
D. b
| ac |
d2261cdf-564b-4b53-bce6-e379a650bb5d | Ans. is 'd' i.e., BAL Use of different chelating agentsDimercaprol (BAL)o Poisoning by As, Hg, Au, Bi, Ni, Sbo As an adjuvant to EDTA in lead poisoningo As an adjuvant to penicillamine in Cuo Contraindicated in iron and cadmium poisoning.Calcium disodium edetate (Ca Na,EDTA)o Lead poisoningo Also used in Zn, Cd, Mn, Cu, Fe poisoningo Mot used in mercury poisoningDesferrioxamine (obtained from an actinomycete)o Acute iron poisoningo Transfusion siderosiso Available only in injectable formPenicillamineo Wilson's disease (Hepatolenticular degeneration)o Copper/mercury poisoningo Chronic lead poisoningo Cystinuria and cystine stoneso Sclerodermao RADeferiproneo Acute iron poisoningo Iron load in liver cirrhosiso Both oral and injectable preparation available | Unknown | null | Chelating agent used in mercury poisoning is -
A. Calcium disodium edetate
B. Desferrioxamine
C. Penicillamine
D. BAL
| BAL |
e5f159bf-3ec9-4ba9-8c0e-de8ff0df4fed | -Lubiprostone acts by stimulating Cl- channel opening in the intestine, increasing liquid secretion in gut and decreasing transit time, therefore used for chronic constipation. -It has also been approved for constipation dominant irritable bowel syndrome in women. -Irritable bowel syndrome is a condition characterized by abdominal pain, bloating and altered bowel habits (diarrhea or constipation) For diarrhea dominant IBS, drugs that can be used are Loperamide or diphenoxylate New kappa opioid receptor antagonist- Fedotozine Reserpine analog - Mebeverine 5 HT3 antagonist - Alosetron (also reduces pain) Clonidine (also reduces distension induced pain ) For constipation dominant IBS, drugs effective are 5 HT4 agonists (tegaserod, prucalopride) Loxiglumide Lubiprostone Plecanatide | Pharmacology | Gastro-Intestinal Tract | Drug used in irritable bowel syndrome with constipation is
A. Lubiprostone
B. Loperamide
C. Alosetron
D. Clonidine
| Lubiprostone |
9fcc4663-56b6-4a6e-a535-caf7b16d65db | Dysgerminomas are usually unilateral and are the most common type of germ cell tumor seen in patients with gonadal dysgenesis. They are highly radiosensitive and chemosensitive. Serous cystadenoma is the most common epithelial cell neoplasm. 70% of these tumors are benign and surgery is the treatment of choice. Mucinous cystadenoma is the second most common epithelial cell tumor of the ovary. Surgery is the treatment of choice. Cystic teratoma: comprise approximately 10 to 25 percent of all ovarian neoplasms and 60 percent of all benign ovarian neoplasms. Surgical excision is the treatment of choice. Ref: Obstetrics and Gynecology By Charles R. B. Beckmann page 443. | Gynaecology & Obstetrics | null | Which of the following malignancy is MOST sensitive to radiotherapy?
A. Serous cystadenoma
B. Dysgerminoma
C. Mucinous cystadenoma
D. Teratoma
| Dysgerminoma |
cd6ef7dd-345d-44f7-8c57-193e747f7bb1 | Water in some areas naturally contains fluoride, and dental problems in children are fewer in these areas because tooth enamel is strengthened. Fluoride can be added to drinking water, but opposition to this practice, from ignorance or fear, is common. Copper deficiency can produce neurologic defects. Iodine deficiency can predispose to thyroid goiter. Selenium is a trace mineral that forms a component of glutathione peroxidase; deficiency may be associated with myopathy and heart disease. Serious illnesses from trace element deficiencies are rare. Zinc is a trace mineral that aids in wound healing; a deficiency state can lead to stunted growth in children and a vesicular, erythematous rash. | Pathology | Environment & Nutritional Pathology | An epidemiologic study evaluates the rate of dental caries and tooth abscesses among children living in communities within a metropolitan area. Investigators discover that the rate is high among children living in an upper-middle-class community but low in children living in a community below the poverty level. The levels of trace elements in the water supplies for those communities are measured. A higher level of which of the following minerals in the water is most likely to be associated with a lower rate of dental decay among the children living in the poor community?
A. Copper
B. Fluoride
C. Iodine
D. Selenium
| Fluoride |
0f3af128-25e2-4000-8ad7-1b3078efe483 | Gout / Hyperuricemia Gout refers to the disease that occurs in response to the presence of monosodium urate (MSU) crystals in joints, bones, and soft tissues.Causes of GoutIncreased productionDecreased renal excretionHypoxanthine-guanine phosphoribosyltransferase (HGP) deficiencyPhosphoribosylpyrophosphate (PRPP) synthetase overactivityGlucose -6-phosphatase deficiencyMyeloproliferative disorderLymphoproliferative disorderMalignanciesHemolytic disorderPsoriasisObesityEthanol abuseExcessive dietary purine ingestionCytotoxic drugsInherited isolated renal tubular defectRenal failureLead poisoningDiabetic ketoacidosisLactic acidosisHypothyroidismDrugs- thiazides, pyrazinamide, cyclosporineClinical featuresDiagnosisAcute gout -ahritis ( MP joint of big toe), bursitis (olecranon bursa )Chronic gout - increase in frequency of acute gouty attacksTophi - collection of solid urate in connective tissues, irregular firm painless nontender nodules on extensor surfaces of finger, hand, and elbow.Polarizing microscopy - identification of monosodium urate crystals Histology - birefringent urate crystals on biopsy Elevated uric acid levels24-hour urinary uric acid excretion Radiology - narrowing of joint space, sclerosis, cysts, osteophytes & calcified tophi.Treatment:Acute attack - NSAIDsChronic stage - Allopurinol, Probenecid, benzbromarone Definitive diagnosis of gout requires aspiration of the involved joint and demonstration of intracellular monosodium urate crystals in synol fluid. Under polarized light, these are demonstrated as "strongly negative birefringent needle-shaped crystals."(Refer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 2836-2839) | Medicine | All India exam | The diagnosis of gout is best established by the presence of
A. Synol uric add crystals
B. Intracellular uric acid crystals
C. Elevated serum uric acid
D. Involvement of the first metatarsal phalangeal joint
| Intracellular uric acid crystals |
b8d695f8-fee7-4700-87e5-de58da4a31ce | Body mass index(quetelet&;s index) Ponderal index Broca index Lorentz&;sformula Corpulence index. Among these BMI and Broca index are widely used. BMI is used an index for obesity. Ref- Park&;s textbook of Preventive and Social Medicine 24th edition. | Social & Preventive Medicine | Non communicable diseases | Obesity indices are -
A. Broca's index
B. Ponderal index
C. Quetelet index
D. Corpulence index
| Broca's index |
a6d6e5e5-d124-4b67-aa49-c20498776f74 | Ans. is 'c' i.e., IgA NephropathyOrganized glomerular deposits are seen in : Mesangial proliferative GN Memranous GN Membranoproliferative GNo IgA nephropathy is a type of mesangioproliferative GN. | Pathology | null | Organised glomemler deposits in kidney is present in-
A. Amyloidosis
B. Diabetes millitus
C. IgA nephropathy
D. Cry oglobulinemia
| IgA nephropathy |
e899ec1b-56b3-4f27-b8f6-1fa8ebef77bc | As Artemesinin compunds are contraindicated in pregnancy, Quinine is used for severe Falciparum malaria. | Pharmacology | null | Drug of choice for severe Falciparum malaria in pregnancy is:
A. Aresunate
B. Artemether
C. Chloroquine
D. Quinine
| Quinine |
a50748bd-c510-44a1-ac54-96cc82b7ed59 | The patient most likely has a type V hyperlipoproteinemia, which is associated with eruptive xanthomas secondary to increased triacylglycerol. Type V hyperlipoproteinemia is a combination of type I, characterized by elevated chylomicrons, and type IV, characterized by increased very-low-density lipoproteins (VLDL). Diabetic ketoacidosis and alcoholism are two of the most common factors that promote type V hyperlipoproteinemia. The absence of insulin characteristic of diabetic ketoacidosis decreases capillary lipoprotein lipase activity, so neither chylomicrons nor VLDL are properly metabolized in the liver. The increased triacylglycerol concentration that results from the accumulation of chylomicrons and VLDL in the blood produces a turbid specimen. Because chylomicrons have the lowest density, they form a turbid supranate in plasma left at 4°C overnight. The density of VLDL is slightly higher than that of chylomicrons, so it forms a turbid infranate. Presence of a supranate and infranate, as in this case, indicates type V hyperlipoproteinemia. A supranate without an infranate occurs in type I hyperlipoproteinemia, and an infranate without a supranate occurs in type IV hyperlipoproteinemia. Another feature of type V disease is hyperchylomicronemia. Clinical features include eruptive xanthomas caused by the deposition of triacylglycerol in the subcutaneous tissue. Once the triacylglycerol concentration is reduced, the xanthomas disappear. | Unknown | null | A 37-yrs-old man in DKA has yellowish papules scattered over his trunk and extremities. A tube of plasma that is collected from the patient develops a turbid supernate. This is consistent with which type of hyperlipoproteinemia?
A. Type I
B. Type II
C. Type III
D. Type V
| Type V |
edca7269-11e7-4fe8-8130-f784cd61acad | Ans. (c) ThyroidRef: Robbin's pathology 9th ed. /109* The most radio-sensitive organ sites in children in the order of sensitivity are thyroid, breasts, bone marrow and brain.* Exposure to ionizing radiation in first 2 decades predisposes a person for development of papillary CA. | Pathology | Etiology: Carcinogenic Agents | Radiation exposure during infancy has been linked to
A. Breast
B. Melanoma
C. Thyroid
D. Lung
| Thyroid |
a41db06b-1ebb-4e2e-824e-f1a62f7e996d | Ans. is 'b' i.e., Gentamicin o Has been explained in previous sessions. | ENT | Menier's Disease | Chemical labyrinthectomy by transtympanic route is done in Meniere's disease using which drug-
A. Amikacin
B. Gentamicin
C. Amoxycillin
D. Cyclosporine
| Gentamicin |
c973957e-8a58-42c7-9ed0-07ddafc05069 | Umbilical cord contain two aeries & one vein. Ref : Ghai essential of pediatrics, 19th edition, p.no402 ; Davidson principal and practice of internal medicine, 22nd edition, p.no:630 | Pediatrics | C.V.S | Umbilical cord has ____________
A. 1 vein and 2 aeries
B. 2 vein and 2 aeries
C. 1 vein and 1 aery
D. 2 veins and 1 aery
| 1 vein and 2 aeries |
41585522-f8c5-4f30-b48e-a37af93c0819 | (A) Spleen# Largest lymphatic organ in the human body is the spleen.> Primary function of the spleen is to purify the blood and store blood cells. It helps the immune system identify and combat foreign antibodies.> The spleen consists of white pulp and red pulp. The white pulp generates blood cells and synthesizes antibodies, and the red pulp removes old blood cells and filters the blood. | Anatomy | Misc. | Solid and largest lymphatic organ of the body is
A. Spleen
B. Thymus
C. Lymph node
D. Liver
| Spleen |
a873ee82-b46b-492e-b623-d4ca72682332 | ANSWER: (B) CimetidineREF: APPENDIX-39 below for "DRUGS CAUSING GYNAECOMASTIA"Repeat Pharmacology 2013 Session 2Indirect repeat Pharmacology 2012 Session II, 2006 APPENDIX - 39Causes Of Gynecomastia:IdiopathicDrugs (partial list)Physiologic causesNeonatal periodPubertyAgingObesityAlcoholAlkylating agentsAmiodaroneAnabolic steroidsAndrogensBicalutamideBusulfanChorionic gonadotropinCimetidineCiomipheneCyclophosphamideDiazepamDiethylstilboestro!Digitalis preparationsEstrogens (oral or topical)EthionamideFinasterideFlutamideGoserelinHAARTHaloperidolHydroxyzineIsoniazidKetoconazoleLeuprolideMarijuanaMethadoneMethyldopaMetoclopramideOmeprazoleOpioidsPenicillaminePhenothiazinesProgestinsProtease inhibitorsReserpineRisperidoneSomatropin (growth hormone)SpironolactoneTestosteroneThioridazineTricyclic antidepressants | Pharmacology | Adverse Drug Effect | Gynaecomastia and infertility is caused by?
A. Flutamide
B. Cimetidine
C. Ranitidine
D. Methotrexate
| Cimetidine |
6741fb1f-da35-472b-b6e8-baf898663b9d | Rivaroxaban and Apixaban are newer oral anticoagulants that act by inhibiting factor Xa. Newer oral anticoagulants that are currently being asked in the exams are: Direct thrombin inhibitor- Dabigatran Direct factor Xa inhibitors Apixaban Rivaroxaban Edoxaban Betrixaban | Pharmacology | Hematology | Apixaban is a new drug that acts by
A. Inhibiting TNF alpha
B. Inhibiting coagulation factor Xa
C. Inhibiting platelet aggregation
D. Activating plasminogen
| Inhibiting coagulation factor Xa |
be987604-79fd-4499-b753-4eac67f3ab2c | * Hyponatremic dehydration is treated by correction of intravascular volume with isotonic fluid (NS or LR). * An overly rapid (>12 mEq/L over the first 24 hr) or overcorrection of serum sodium concentration (>135 mEq/L) is associated with an increased risk of central pontine myelinolysis. | Pediatrics | Disorders of Gastrointestinal System Including Diarrhea | A child presents with acute diarrhea with signs of dehydration; On investigation, Na+ 125 mEq/L, K+ 3 meq/L, HCO3- 16 mEq/L and pH is 7.23. IV Fluid to be given is?
A. Normal saline
B. 3% saline
C. N/2 saline + 10% dextrose
D. N/3 saline + 5% dextrose
| Normal saline |
8a9efb57-c3c6-43aa-9d15-6b56667ab4f5 | Ref: Park s Textbook of Preventive and Social Medicine, 22nd edition. Pages 578,590Explanation:"The ICMR recommended daily allowance (RDA) for Iron is 38 mg/day during pregnancy and 30 mg/ day during lactation." (ICMR - Old Guideline)IRON REQUIREMENT DURING LACTATIONThere is no increase in iron requirement during lactation.Older ICMR guideline prescribed 30 mg/day.There is no additional tissue growth, so no additional need for iron.NOTEAs per recent ICMR guidelines (2010) Indian pregnant women needs 35 mg/day.Non pregnant women needs 21 mg/day.During lactation, 21 mg/day which is equal to pre-pregnancy requirement.During infancy iron requirement is fully met if baby is breastfed.Iron requirement in Indian Men - 17 mg/day. Iron Requirement Recent ICMR guidelines (2010)Iron Requirement ICMR (2M0M>ldMen17 mg/day28 mg/dayWomen-Non pregnant21 mg/day30 mg/dayPregnancy35 mg/day38 mg/dayLactation21 mg/dav30 mg/day | Social & Preventive Medicine | Nutrition and Health | Iron requirement in lactating mother is:
A. 30 mg/day
B. 34 mg/day
C. 36 mg/day
D. 38 mg/day
| 30 mg/day |
7a20cf92-9b6d-4582-82a2-8a7965d98503 | ANSWER: (A) 1.3 DREF: Khurana 4th Ed Pg 23The focal length (f) of a lens is the distance between the optical centre and the principal focus.Power of a lens (P) is defined as the ability of the lens to converge a beam of light falling on the lens. For a converging (convex) lens the power is taken as positive and for a diverging (concave) lens power is taken as negative.It is measured as reciprocal of the focal length in metres i.e. P = 1/f.The unit of power is dioptre (D). One dioptre is the power of a lens of focal length one metre.Hence, substituting in the formula, P=l/0.75 = 1,3 D | Ophthalmology | Elementary Optics | What is the power of a lens if the focal length is 0.75 m?
A. 1.3 D
B. 2.3 D
C. 3.3
D. 4.3 D
| 1.3 D |
097eb4b5-86b9-48f3-9f4d-30cb51e3697e | A cloning vector is a carrier DNA molecule to which human DNA fragment is attached. Normally, foreign DNA fragments cannot self-replicate within host cell. Therefore, they are joined to a vector DNA, that can replicate within host cell.The five major types of cloning vectors used are -i) Plasmidsii) Viral vectors/Bacteriophagesiii) Cosmidsiv) Bacterial Aificial Chromosomes (BACs)v) Yeast aificial chromosomes (YACs) | Biochemistry | null | Most commonly used vector for DNA cloning ?
A. Plasmid
B. Virus
C. Cosmid
D. Phage
| Plasmid |
c6b2a296-9253-4903-b67b-a0eaa1a03df1 | The primary features of borderline personality disorder (BPD) are unstable interpersonal relationships, affective distress, marked impulsivity, and unstable self-image. Individuals with BPD tend to experience frequent, strong and long-lasting states of aversive tension, often triggered by perceived rejection, being alone or perceived failure. They may show changeability between anger and anxiety or between depression and anxietyand temperamental sensitivity to emotional stimuli. The negative emotional states specific to BPD fall into four categories: destructive or self-destructive feelings; extreme feelings in general; feelings of fragmentation or lack of identity; and feelings of victimization. | Psychiatry | null | A young person presents with self mutilating behaviour and impulsivity. What is he most likely suffering from?
A. Dependent personality disorder
B. Borderline personality disorder
C. Adjustment disorder
D. Paranoid personality disorder
| Borderline personality disorder |
f583f579-a273-4ac1-a539-9a4a02502ba4 | Ans. is 'b' i.e., Widal test Heterophilic agglutination reaction . Some organisms of different class or species share closely related antigens. . When serum containing agglutinin (antibody) of one organism gives agglutination reaction with antigen of other organism, it is called heterophilic agglutination test. Examples are . Streptococcus M.G. agglutination test for primary atypical pneumonia. . Weil - Felix reaction for typhus fever . Paul Bunnell test fin- IMN. | Microbiology | null | Which is not a heterophile agglutination test ?
A. Weil Felix test
B. Widal test
C. Paul Bunnell test
D. Streptococcus
| Widal test |
49ee36ba-e4ba-43d6-88a5-68aac31166d1 | Ans. is 'c' i.e., Macrophages Macrophages and neutrophils are phagocytic cells that engulf a microbial pathogen after it has been identified by the innate immune system | Microbiology | null | Innate immunity involves ?
A. T-cells
B. B-cells
C. Macrophages
D. Antibodies
| Macrophages |
d5578ae7-8a16-4944-a3f0-d6c5304488e0 | Pathophysiology Airway hyper-reactivity (AHR) - the tendency for airways to narrow excessively in response to triggers that have little or no effect in normal individuals is integral to the diagnosis of asthma and appears to be related, although not exclusively, to airwayinflammation . Other factors likely to be impoant in the behaviour of airway smooth muscle include the degree of airway narrowing and neurogenic mechanisms. The relationship between atopy (the propensity to produce IgE) and asthma is well established and in many individuals there is a clear relationship between sensitisation and allergen exposure, as demonstrated by skin-prick reactivity or elevated serum-specific IgE. Common examples of allergens include house dust mites, pets such as cats and dogs, pests such as cockroaches, and fungi. Inhalation of an allergen into the airway is followed by an early and late-phase bronchoconstrictor response . Allergic mechanisms are also implicated in some cases of occupational asthma . In cases of aspirin-sensitive asthma, the ingestion of salicylates results in inhibition of the cyclo-oxygenase enzymes, preferentially shunting the metabolism of arachidonic acid through the lipoxygenase pathway with resultant production of the asthmogenic cysteinyl leukotrienes. In exercise-induced asthma, hyperventilation results in water loss from the pericellular lining fluid of the respiratory mucosa, which, in turn, triggers mediator release. Heat loss from the respiratory mucosa may also be impoant. In persistent asthma, a chronic and complex inflammatory response ensues, characterised by an influx of numerous inflammatory cells, the transformation and paicipation of airway structural cells, and the secretion of an array of cytokines, chemokines and growth factors. Examination of the inflammatory cell profile in induced sputum samples demonstrates that, although asthma is predominantly characterised by airway eosinophilia, neutrophilic inflammation predominates in some patients while in others scant inflammation is observed: so-called 'pauci- granulocytic' asthma. Ref Davidson edition23rd pg 568 | Medicine | Respiratory system | Mechanism of hypoxemia in asthma is
A. Hypoventilation
B. Diffusion decreased
C. Shunting
D. Ventilation perfusin mismatch
| Ventilation perfusin mismatch |
c7f9ccf9-02b1-4ae5-bce3-e44daa174541 | Ans. is 'c' i.e., Organophosphorus [Ref Parikh 6Th /e p. 10.43; Reddy 33`d% p. 5231Organophosphorus poisoning compounds are irreversible inhibitors of enzyme cholinesterase, an enzyme which hydrolyzes acetylcholine.Thus organophosphates inhibit cholinesterase and protect acetylcholine from hydrolysis. This results in increased concentration of acetylcholine and excessive cholinergic activity.They inhibit cholinesterase by phosphorylating the catalytic site of enzyme. Less than 50% of cholinesterase activity is indicative of poisoning.Clinical features of poisoning are due to excessive cholinergic activity. Local muscarinic manifestations at the site of exposure (skin, eye, GIT) occur immediately and are followed by complex, systemic effects due to muscarinic, nicotinic and central actions | Forensic Medicine | null | A patient with a recent history of convulsions, presented to emergency in subconscious state with blood pressure 60/90 mm/Hg, bradycardia & slow gasping respiration. There is increased lacrimation, salivation & sweating. On examination there is pin point pupil. Which of the following poisoning should be suspected?
A. Opioids
B. Phenobarbitone
C. Organophosphorus
D. Dhatura
| Organophosphorus |
403ad4bc-29dd-407a-8a2a-1176b6c39db1 | ANSWER: (B) Topical steroidsREF: Parson's 20th ed p. 173Treatment of phlyctenular keratoconjuctivit is:Topical steroids are drugs of choiceTopical antibiotics and atropine are used when cornea is involved Phlyctenular conjunctivitis:Delayed type IV hypersensitivity response to endogenousstaphylococcus proteins ( most common )tuberculous proteinsmoraxella and worm infestationusually unilateral, more common in girlsItching is most common symptomPhlycten or nodule near limbus is seen , pinkish, ulcerates at apexMiliary, ring, fascicular, sacrofulous ulcers are seenRemember spring catarrh is type I hypersensitivity to exogenous proteins like pollens and it is more common in boys. | Ophthalmology | Inflammations of Conjunctiva - Allergic and Granulomatous | Treatment of phlyctenular conjunctivitis is?
A. Systemic steroids
B. Topical steroids
C. Antibiotics
D. Miotics
| Topical steroids |
918e6157-4ed4-4a0a-9314-05d7d8675b65 | Microdermabrasion is resurfacing technique with superficial skin wound achieved with aluminium oxide crystals. Ref: Textbook of dermatosurgery & cosmetology, Satish S savant, E-2, P-620. | Skin | null | Microdermasion is done with:
A. Aluminium oxide crystals
B. Aluminium trihydrate crystals
C. Ferrous oxide crystals
D. Ferric oxide crystals
| Aluminium oxide crystals |
de1630df-7b39-43e1-b1fe-2435585188c5 | Scurvy is caused due ti deficiecy of ascorbc acid. Ascorbic acid is necessary for the post-transltional hydroxylation of proline and lysine residues. Hyroxyproline and hydrolysine are essential for the formation of crosslinks in the collagen, which gives the tensile strength to the fibers. This process is absolutely necessary for the normal production of suppoing tissues such as osteiod, collagen and intercellular cement substance of capillaries. REFERENCE: DM VASUDEVAN SEVENTH EDITION ; PAGE NO:497 | Biochemistry | Structure and function of protein | Defect in collagen formation is seen in
A. Scurvy
B. Hunter's syndrome
C. Marfan's syndrome
D. Osteogenesis imperfecta
| Scurvy |
b052b33f-9f4b-4637-9e3a-c4d9a0ec9650 | The information provided in the question is too less, but we have to come to a diagnosis based on the provided information. Lets see each option one by one.
Paralytic ileus
multiple air fluid levels are noted, hence ruled out.
Aganglionosis of the colon or Hirshprung's ds.
presents in infancy or childhood hence ruled out
Duodenal obstruction
multiple air-fluid levels are not noted, but the dominant symptom is recurrent, vomiting, which is not mentioned, hence ruled out.
Intestinal pseudo-obstruction
it's the most likely diagnosis, as air-fluid levels are not seen in it.
Harrison writes - "The symptom of chronic pseudo-obstruction are chronic or intermittent constipation, crampy abdominal pain, anorexia and bloating. Abdominal x-rays reveal gaseous distention of the large and small bowel and occasionally of the stomach. Air-fluid levels are unusual and should raise the possibility of mechanical obstruction."
Acute pseudoobstruction involves only the colon and presents with features of colonic obstruction (as described before). Air-fluid level is also not a feature of colonic obstruction.
About the fluid levels remember the following points
up to 3 to 5 fluid levels less than 2.5 cm in length may be normal.
multiple air-fluid levels are a feature of mechanical small intestinal obstruction and paralytic liens. They are not seen in colonic obstruction and pseudo-obstruction.
They may be seen in colonic obstruction if the ileocecal valve is incompetent. | Surgery | null | A 56-year-old woman has not passed stools for the last 14 days. Xray shows no air fluid levels. Probable diagnosis is -
A. Paralytic ileus
B. Aganglionosis of the colon
C. Intestinal pseudo-obstruction
D. Duodenal obstruction
| Intestinal pseudo-obstruction |
89556543-fa48-4987-b63b-faaef1603692 | Ans. is 'b' i.e., Tryptophan metabolism o Serotonin secretion is increased in carcinoid syndrome which causes flushingQ. VasoconstrictionQ, diarrheaQ and bronchospasm (respiratory distress),Metabolism of tryptophano Tryptophan is an essential amino acidQ, containing indol ringQ. Tryptophan is oxidized to produce alanine (which is glucogenic) and acetyl-CoA (which is ketogenic). Therefore, tryptophan is both glucogenic and ketogenic. Tryptophan is precursor for the biosynthess of niacinQ (a vitaminQ), serotonin (a neurotransmitter) and melatoninQ (a hormone).o Tryptophan metabolism occurs by two pathways: (i) kinurenine pathwayQ and (ii) serotonine pathway.1) Kynurenine pathway :- Tryptophan is oxidized to kynurenine, which is then converted to either niacin (nicotinic acid) or acetyl-CoA. In the reaction alanine is also produced. o Deficiency of tryptophan can cause deficiency of niacin (if also deficient in diet). This can leads to Pallegra: dermatitis, diarrhea and dementia.o For every 60 mg of tryptophan, 1 mg. equivalent of niacin can be generatedQ.o In vitamin B6 deficiency the metabolism is shuted to xanthurenic acid. Therefore, xantheurenic acid excretion is increased in urine.2) Serotonin pathway:- Tryptophan is first oxidized to serotonine which is further converted to melatonin. | Biochemistry | Amino Acid Metabolic Disorder | Xantheurenic acid is produced in -
A. Tyrosine metabolism
B. Tryptophan metabolism
C. Cysteine metabolism
D. Valine metabolism
| Tryptophan metabolism |
1ba6892b-c757-420a-9221-7cbd5e0b3ff7 | * All the symptoms of hypoglycemia are blocked by beta blockers except sweating as it has cholinergic innervation * Beta blockers (non selective) are contraindicated in : ABSOLUTE C/I Pheochromocytoma Decompensated hea failure symptomatic bradycardia AV block Asthma RELATIVE C/I Peripheral vascular disease | Pharmacology | Sympathetic System | The only reliable symptom of hypoglycemia in a patient on beta blocker therapy is
A. Tremor
B. Sweating
C. Tachycardia
D. Palpitations
| Sweating |
8b601ecb-a0fe-445d-994d-47698fca14e9 | Aoic dissection is a catastrophic illness characterized by dissection of blood in between and along the laminar planes of the media,with the formation of a blood filled channel within the aoic wall; this channel often ruptures through the adventitia and into various spaces, where it causes either massive hemorrhage or cardiac tamponade.Hypeension is the major risk factor for aoic dissection.Ref: Robbins Basic Pathology, 8th Ed, page 359-360 | Pathology | null | Which is the most common cause for dissecting aneurysm of thoracic aoa?
A. Atherosclerosis
B. Medial degeneration
C. Syphilis
D. Trauma
| Medial degeneration |
495db5da-8521-44ff-98a3-ce9fccf53b4d | A i.e. Injury to the spinal cord leading to quadriparesis or quadriplegia | Surgery | null | Careless handling of a suspected case of cervical spine injury may result in:
A. Injury to the spinal cord leading to quadriparesis or quadriplegia
B. Intracranial haemorrhage with cerebral imtation or unconsciousness
C. Cervical haematoma with compression of brachial vessels
D. Complete paralysis of the affected upper extremity
| Injury to the spinal cord leading to quadriparesis or quadriplegia |
6d34bca6-fb61-478d-804d-8e08be26339a | Angular pregnancy : It is defined as pregnancy implanted in one of the lateral angles of uterine cavity It may progress to term Ref: Dutta Obs 9e pg 168. | Gynaecology & Obstetrics | General obstetrics | Angular pregnancy refers to:
A. Ectopic pregnancy of Interstitial pa of FT
B. Intrauterine pregnancy
C. Heterotopic pregnancy
D. Ectopic pregnancy of broad ligament
| Intrauterine pregnancy |
19e9db4e-28f6-4009-be8e-fe2e4651ba07 | A bone is a rigid organ that constitutes part of the vertebrate skeleton.
Bones support and protect the various organs of the body, produce red and white blood cells, store minerals, provide structure and support for the body,
and enable mobility. | Radiology | null | Maximum radiation dose tolerable tissue is-
A. Hemopoietic tissue
B. Testis
C. Ovary
D. Bone
| Bone |
9a8bb386-410c-4e7d-861e-bb8b5e0d1483 | Angiotensin Converting Enzyme Inhibitors and Angiotensin Receptor Blockers should be discontinued 12 to 24 hours before surgery if taken only for hypertension, as they may produce hypotension, which is not responsive to conventional vasopressors.
Statins, Beta Blockers and Steroids should not be stopped abruptly before surgery as their abrupt discontinuation may increase the risk of serious (even life-threatening) complications. | Anaesthesia | null | A Patient is on regular medications for co-existing medical problems. Which of the following drugs may be stopped safely with minimal risk of adverse effects before an abdominal surgery –
A. Statins
B. Bta Blockers
C. ACE inhibitors/ACE Receptor Blockers
D. Steroids
| ACE inhibitors/ACE Receptor Blockers |
fba01264-4c46-40f8-8b51-ec66417f8363 | Transverse diameters of fetal skull are
Biparietal diameter: 9.5cm
Super-subparietal: 8.5cm
Bitemporal: 8cm
Bimastoid: 7.5cm | Gynaecology & Obstetrics | null | The widest transverse diameter of the fetal skull is
A. Biparietal diameter
B. Occipito-frontal diameter
C. Bitemporal diameter
D. Suboccipito-frontal diameter
| Biparietal diameter |
1994895e-7e59-4469-bed6-ce69b80ba297 | Coronary Sinus is the largest vein of hea.it ends by opening to posterior of Right atrium. <img src=" /> BD CHAURASIA'S HUMAN ANATOMY,VOL:1,6TH EDITION,PAGE NO:266 | Anatomy | Thorax | The coronary sinus
A. Lies in anterior pa of the coronary sulcus
B. Ends in right atrium
C. Has venae cordis minimae as its tributaries
D. Develops from right anterior cardinal vein
| Ends in right atrium |
ca330576-4643-4afc-a4cd-b09edb7231fd | Ans. is 'd' i.e., Monocyte macrophages In granulomatous inflammation o Main cells involved ----> Macrophages, CD-4 helper T cells. Epitheloid cells - Macrophages that develop epithelial like appearance. Multinucleated giant cells -4 Due to fusion of epitheloid cells. | Pathology | null | The epitheloid cell and multinucleated gaint cells of Granulomatous inflammation are derived from ?
A. Basophils
B. Eosinophils
C. CD 4 - T lymphocytes
D. Monocytes - Macrophages
| Monocytes - Macrophages |
25156396-585e-4eaf-b188-03cad542a8fe | Excessive use of regression causes neurotic illnesses. It is an immature defense mechanism in which person return to an earlier stage of development Eg- A PG Aspirant playing cricket in street with children | Psychiatry | Psychoanalysis | Most impoant cause of neurotic reaction is the excessive use of:
A. Projection
B. Regression
C. Suppression
D. Sublimation
| Regression |
5949e299-0e63-4844-a0f3-fbf913adf794 | Answer is C (CLL) Incidental finding of Lymphocytosis (80,000/mcL) in an elderly and asymptomatic patient suggests the diagnosis of CLL. Why is CLL the single best answer of choice here ? 'CLL is a disease of older patients wth 90% of cases occurring after the age of 50 years and median age of presentation is 65 years'. - CMDT The patient in question is aged 80 years and hence falls in the bracket of CLL. 'Typical B cell CLL is often fbund incidentally when a complete blood count is done for another reason'. -Harrison 16th / 648 The patient in question is asymptomatic and the findings represent incidental observation on a full blood count done for an obscure reason. 'The hallmark of CLL is absolute lymphocytosis. White cell count is usually greater than 20,000/mcL may be markedly elevated to several 100,000/mcL. Usually 75-80% of circulating cells are lymphocytes'. - CMDT The patient in question is presenting with a white cell count of 100,000/mcL and 80% of circulating cells are lymphocytes. This finding is consistent with the blood picture of CLL. | Medicine | null | 80 year old, asymptomatic man present with a Total Leucocyte Count of 1 lakh, with 80degA lymphocytes and 20% PMC's. What is the most probable diagnosis?
A. HIV
B. CML
C. CLL
D. TB
| CLL |
6984798d-a0b0-4b76-a9e2-c1c3d1742b0b | An anaerobic, gram-positive, motile bacillus | Microbiology | null | C.tetani is:
A. Aerobic, gram-positive, motile bacillus
B. An anaerobic, gram-negative, motile bacillus
C. An anaerobic, gram-positive, nonmotile bacillus
D. An anaerobic, gram-positive, motile bacillus
| An anaerobic, gram-positive, motile bacillus |
98eb8640-dfcd-4799-839c-7c8d28232fa3 | Ans. is 'a' ie. Post flap should be longer than the anterior flop Posterior flap should be longer than the anterior flap as the posterior skin has a good blood supply (and anterior skin has poor due to lack of muscle on anterior aspect). A good blood supply helps in easy healing of stump. - Equally sho anterior and posterior flaps are used only when the long post flap technique is not feasible because of previous wounds or extensive tissue ischemia. 'The longer (the stump) the better', is the general rule for amputation at all sites, but below knee amputation is an exception. The amputation level is kept proximal to the lower third of tibia, since the preponderance of tendinous structures in the lower third predispose to poor circulation and an unstable painful lump. The best level below the knee as, for, as prosthetic fitting is concerned is at the distal musculotendinous junction of the gastrocnemius muscle. Some other imp. points about BK amputation The fibula is transected slightly above the tibial level. No essential differences in healing rate is noted in pts. with or without popliteal pulses, but the absence of a femoral pulse is associated with a high failure rate for BK amputation. The nerves are pulled gently down, transected and then allowed to retract, and the vessels are ligated above the level of the end of tibia. | Surgery | null | Most Imp. technical consideration at the time of doing below knee amputation is -
A. Post. flap should be longer than the anterior flap
B. Stump should be long
C. Stump should be sho
D. Ant flap should be longer than post flap
| Post. flap should be longer than the anterior flap |
b1ddd30b-4a77-4191-bd6f-c6f5bd98062a | Ans. is 'c' i.e., Transduction Acquiring antibiotic resistance by viral colony (bacteriophage) is by transduction. . Drug resistance may be acquired in bacteria by Mutation Transduction (by bacteriophage ---> virus) Conjugation | Microbiology | null | Propey of acquiring antibiotic resistance from viral colony is by -
A. Transferance
B. Conjugation
C. Transduction
D. Mutation
| Transduction |
6dd6fbdc-bbfd-4835-b3cb-59af3eac096e | (Refer: Anantha Narayanan and Paniker’s Textbook of Microbiology, 9th edition, pg no: 19-20)
Motility of Enterobacteriaceae members | Unknown | null | Which of the following bacterium is non-motile?
A. Klebsiella spp
B. Citrobacter spp
C. Escherichia spp
D. Salmonella spp
| Klebsiella spp |
8bd61b57-f507-4502-8f0a-71aff202c13d | Ans. Hypointense on T1 weighed image and hyperintense on T2 weighed image | Radiology | null | CSF on MRI appears:
A. Hyperintense on T1 weighed image and hypointense on T2 weighed image
B. Hypointense on T1 weighed image and hyperintense on T2 weighed image
C. Hyperintense on T1 and T2 weighed images
D. Hypointense on T1 and T2 weighed images
| Hypointense on T1 weighed image and hyperintense on T2 weighed image |
bb6b9f1d-7c19-4f4f-96ec-ed7ecafbc91f | Ans. C. Exaggerated lumbar lordosisTuberculosis of the spine usually involves vertebral bodies and is of paradiscal type. It results in kyphosis and not lordosis due to collapse of vertebrae. | Orthopaedics | Tuberculosis of Bone & Joints | Which of the following is not a feature of Tuberculosis of the spine:
A. Back pain earliest symptom
B. Stiffness of back
C. Exaggerated lumbar lordosis
D. Cold abscess
| Exaggerated lumbar lordosis |
83cb719f-28d2-4130-a126-116ccb9f92fb | Pepsin is an enzyme that breaks down proteins into smaller peptides (that is, a protease). It is produced in the stomach and is one of the main digestive enzymes in the digestive systems of humans and many other animals, where it helps digest the proteins in food. Pepsin exhibits maximal activity at pH 2.0 and is inactive at pH 6.5 and above, however, pepsin is not fully denatured or irreversibly inactivated. Therefore, pepsin in the solution of up to pH 8.0 can be reactivated upon re-acidification. Lowering pH does not denature many proteins. Unfolding, yes; denaturation, no. Hydrogen bonds play an impoant role in stabilizing pepsin. Lowering pH does not necessarily break the hydrogen bond network. At least one aspayl residue in the catalytic site needs to be protonated for catalytic action, hence the function at low pH. We do not completely understand the stability of aspayl proteases or pepsin | Biochemistry | Enzymes | Which of the following enzymes is stable at acidic pH?
A. Pepsin
B. Trypsin
C. Chymotrypsin
D. Carboxypeptidase
| Pepsin |
ac91bf33-1006-4671-8f20-00c318561b05 | It is necessary to employ suckling mice for the isolation of coxsackie virus. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO:491 | Microbiology | Virology | The following virus can be grown only in suckling mice -
A. Coxsackie virus
B. Rhinovirus
C. Echovirus
D. Poliovirus
| Coxsackie virus |
c7915342-a3f9-4a29-8a8b-896b6de439ef | Ans. b. Stapedius tendon (Ref: Dhingra 5/e p6)'Facial recess or the posterior sinus is a depression in the posterior wall lateral to the pyramid. It is bounded medially by the vertical part of Vllth nerve, laterally by the chorda tympani and above, by the fossa incudis. Surgically, facial recess is important, as direct access can be made through this into middle ear without disturbing posterior canal wall.'- Dhingra 5/e p6. Boundaries of Facial RecessMedially* Vertical part of Vllth nerveQLaterally* Chorda tympaniQAbove* Fossa incudisQ | Anatomy | Ear | Which of the following does not contribute to the boundaries of facial recess?
A. Facial nerve
B. Stapedius tendon
C. Chorda tympani nerve
D. Short process of incus bone
| Stapedius tendon |
d0d9acdc-758a-4ee9-8c49-4268b44b6ac2 | The main reason of failure of trabeculectomy surgery is scarring and closure of drainage site
Antimetabolites prevent scarring and can be used to increase the success rate of trabeculectomy
The most commony used antimetabolites are mitomycin-C and 5-fluorouracil. | Pharmacology | null | Drug used for trabeculectomy
A. Mitomycin-C
B. Azathioprine
C. Cituximab
D. Ketorolac
| Mitomycin-C |
70c26cf5-08ab-46f2-b453-a6281613b4d7 | Post coital bleeding is the typical symptom of Cervical cancer It is managed by colposcopy and abnormal areas are biopsied Reference : Textbook of Gynaecology; Sheila balakrishnan; 2nd edition; Pg no: 299, 302 | Gynaecology & Obstetrics | Gynaecological oncology | 35 year old lady with post coital bleeding, Management is :
A. Clinical examination and Pap smear
B. Visual examination with Lugol iodine
C. Visual examination with acetic acid
D. Colposcopy
| Colposcopy |
8ce986e7-8e35-472b-a758-060d971764c2 | Poor bone penetration. - B lactams - Vancomycin - Aminoglycoside Good bone penetration (Higher concentration in Bone) * Tetracycline * Macrolide * Clindamycin | Pharmacology | Protein Synthesis Inhibitors | The drug having higher concentration in the bone:
A. Piperacillin
B. Vancomycin
C. Clindamycin
D. Paramomycin
| Clindamycin |
4e29d62e-fdb0-4637-9a68-bc6804c0d950 | Local anesthetics depress transmission in the group C fibre before they affect group A touch fibres. Ref: Ganong&;s Review of medical physiology;25th edition; pg: 95. | Physiology | Nervous system | Local anesthetics depress transmission first in
A. Group A alpha-fibers
B. Group A bita-fibers
C. Group B fibers
D. Group C fibers
| Group C fibers |
099c6fd5-2c90-4431-9b77-15a9534223d7 | Ans. is 'd' i.e., Aprepitant o Cisplatin can induce vomiting within 24 hours or after 2 days. DOC for the early vomiting is ondensetron while for delayed vomiting is aprepitant (substant P antagonist). | Pharmacology | null | Which drug is given in delayed vomiting after chemotherapy -
A. Metoclopramide
B. Hyoscine
C. Domperiodone
D. Aprepitant
| Aprepitant |
ad8703a3-7762-4682-a77d-31afd4048ccb | ANSWER: (B) MycoplasmaREF: Jawetz 24th edition Section III. Bacteriology Chapter 26Mycoplasma Cultures:1. The material is inoculated onto special solid media and incubated for 3-10 days at 37degC with 5% CO2 (under microaerophilic conditions), or into special broth and incubated aerobically. One or two transfers of media may be necessary before growth appears that is suitable for microscopic examination by staining or immunofluorescence. Colonies may have a "Fried Egg" appearance on agar. | Microbiology | Mycoplasma | Fried Egg Colonies are produced by?
A. Chlamydia
B. Mycoplasma
C. Niesseria
D. Diphtheria
| Mycoplasma |
45f67446-34c2-4e8a-a1d3-b763c4b62416 | Clinical assessment Haematemesis is red with clots when bleeding is rapid and profuse, or black ('coffee grounds') when less severe. Syncope may occur and is caused by hypotension from intravascular volume depletion. Symptoms of anaemia suggest chronic bleeding. Melaena is the passage of black, tarry stools containing altered blood; it is usually caused by bleeding from the upper gastrointestinal tract, although haemorrhage from the right side of the colon is occasionally responsible. The characteristic colour and smell are the result of the action of digestive enzymes and of bacteria on haemoglobin. Severe acute upper gastrointestinal bleeding can sometimes cause maroon or bright red stool . Ref Davidson edition23rd pg780 | Medicine | G.I.T | Which of the following is the most common presenting symptom of non-cirrhotic poal hypeension?
A. Chronic liver failure
B. Ascites
C. Upper gastrointestinal bleeding
D. Encephalopathy
| Upper gastrointestinal bleeding |
cdbdc1a8-e81e-4095-81f7-bd429592b67f | Ans. is 'a' i.e., 25% o We cannot calculate cofficient of variance here, because value of mean has not been provided (value of median is given). o Only in standard normal curve mean = median. o But in that case both are '0' (In standard normal normal curve mean = median = mode = 0) o I am clueless here. o It you take, value of median as mean than the answer will be 25%. | Social & Preventive Medicine | null | Median weight of 100 children was 12 kgs. The Standard Detion was 3.Calculate the percentage coefficient of variance -
A. 25%
B. 35%
C. 45%
D. 55%
| 25% |
5845360f-0f63-4c00-b2ef-d31fa8a08d28 | Ans. is 'b' IgM antibody of HBcAg (Ref. November 2001, Micro, Harrison 17/e p 1943-44,1933-34 & 16/e, p 1823-24). | Medicine | Virology | Acute infection of hepatitis B virus is diagnosed by:
A. IgM antibody of Hbs Ag
B. IgM antibody of Hbc Ag
C. IgG antibody of Hbs Ag
D. IgG antibody of Hbc Ag
| IgM antibody of Hbc Ag |
ff55298e-34c8-45c2-8bbd-e9720d4b1269 | Rhandomyosarcoma Rhabdomyosarcoma Arises from Mesenchymal tissues MC sites of origin : Head and neck (Parameningeal) > Extremities > Genitourinary tract > Trunk MC pediatric soft tissue sarcoma : Rhabdomyosarcoma Associated with : NF, Beckwith- Weidman syndrome, Li-Fraumeni and fetal alcohol syndrome Prognosis of Rhabdomyosarcoma Favourable primary sites Unourable primary sites Orbit Nonparameningeal head and neck Paratestis Vagina Extremity Parameningeal Ref: Devita 9th edition Pgno : 1780-1784 | Surgery | Urology | The prognosis of rhabdomyosarcoma is likely to be poor if the site of the tumour is
A. Orbit
B. Para testicular
C. Extremity
D. Urinary bladder
| Extremity |
621d0fa8-97a4-404f-b45e-4720e1739a4f | Ans. is 'c' i.e., Clear cell adenocarcinoma of vagina | Pathology | null | Intrauterine exposure of diethylstiboesterol is associated with -
A. Squamous cell carcinoma of cervix
B. Adenocarcinoma of endometrium
C. Clear cell adenocarcinoma of vagina
D. Sarcoma of uterus
| Clear cell adenocarcinoma of vagina |
4d34f335-a7a0-4e7b-a163-2cb757d9149d | The inferior head of the lateral pterygoid muscle attaches to the lateral surface of the lateral pterygoid plate of sphenoid bone. Its superior head attaches to the infratemporal crest of the greater wing of sphenoid bone. The deep fibers of the medial pterygoid muscle attaches to the medial surface of the lateral pterygoid plate. | Anatomy | null | The lateral pterygoid muscle attaches to which of the following?
A. Lateral surface of the lateral pterygoid plate.
B. Medial surface of the lateral pterygoid plate.
C. Lateral surface of the medial pterygoid plate.
D. Medial surface of the medial pterygoid plate.
| Lateral surface of the lateral pterygoid plate. |
f922d485-3312-4c75-bfdc-d60fdf15b64a | Peutz-Jeghers syndrome is rare but should be considered if pigmented spots are found on the lips, mouth, or hands. Hamartomas are not neoplasms; the name is derived from the Greek hamartos, which refers to the misfiring of a javelin. The tissues appropriate to the site misfire and are arranged in an irregular order. | Surgery | Small & Large Intestine | A 30-year-old male is diagnosed with Peutz-Jeghers syndrome. What findings is consistent with the diagnosis?
A. Adenomas
B. Hamartomas
C. Adenomatous polyps
D. Villoglandular polyps
| Hamartomas |
18a4d13c-d58d-4320-80b0-59f4142de7d8 | a. Lithium(Ref: Nelson's 20/e p 2211-2217, Ghai 8/e p 420-423)Maternal drugCongenital heart diseasePhenytoinVSD, ASD, coarctation of aorta, PDAValproateCoarctation of aorta, aortic stenosis, pulmonary atresia, VSDLithiumEbstein anomaly, Tricuspid atresiaAlcoholASD. VSD | Pediatrics | C.V.S. | Ebstein anomaly is due to maternal intake of:
A. Lithium
B. Copper
C. Cobalt
D. Nickel
| Lithium |
af74bc36-3c45-40e5-8451-6fbd0afd6ba9 | Ans. is 'a' i.e., Cardiac deformities o It causes Ebstein anomaly. | Pediatrics | null | The most common anomaly seen in the fetus of a mother taking lithum carbonate is -
A. Cardiac deformities
B. Neural tube defect
C. Limb reduction
D. Genitourinary de formi ties
| Cardiac deformities |
88c34357-7eac-4b07-a681-3274cbf087d0 | Refer Katzung 10/e p 429 D-Tubocurarine is a skeletal muscle relaxant that acts by competitive inhibition of NM receptors at neuron muscular junction | Pharmacology | Anesthesia | D Tubocurarine acts by
A. Inhibiting nicotinic receptors at myoneural junction
B. Inhibiting nicotinic receptors at autonomic ganglion
C. Producing depolarising block
D. By inhibiting re-uptake of acetyl choline
| Inhibiting nicotinic receptors at myoneural junction |
43f177c2-8ec9-4b91-8fa3-9f8666e9e23c | 2% Glutaraldehyde is knows as cidex (Aldehyde disinfectant) specially effective against tubercle bacilli, fungi and viruses. It is most commonly used for cystoscope, endoscope, bronchoscopes etc., which can’t be disinfected by heat.
Also used to treat corrugated rubber anesthetic tubes and face masks, plastic endotracheal tubes, metal instruments and polythene tubing.
Other choice:
70% alcohol is used as skin antiseptic. It acts by denaturing bacterial proteins.
Methylated ethyl alcohol is MC alcohol used for skin disinfection and hand washing.
2 - 3 percent formaldehyde (20 - 30 ml of 40% formalin in one litre of water) is used for spraying rooms, walls, furnitures and disinfecting blankets, beds and books. It is most effective at high temperature and relative humidity of 80-90%.
Sodium hypochlorite is recommended for sterilizing infant’s feeding bottles. It acts in the same way as bleaching powder and is more strong. | Microbiology | null | A chest physician performs bronchoscopy in the procedure room of the out patient department. To make the instrument safe for use in the next patient waiting outside, the most appropriate method to disinfect the endoscope is by :
A. 70% alcohol for 5 min
B. 2% glutaraldehyde for 20 min
C. 2% formaldheyde for 10 min
D. 1% sodium hypochlorite for 15 min
| 2% glutaraldehyde for 20 min |
69eb8ad9-e91a-4690-8900-03f12a71243e | Ans. is 'c' i.e., Cu-T 380A "The Cu-T 380A is approved for use for 10 years. However, the Cu-T 380A has been demonstrated to maintain its efficacy over at least 12 years of use" . --Park Intra-uterine devices o An intrauterine device is a long acting reversible contraceptive bih control device placed in the uterus. o There are two basic types of IUD --> Non-medicated and medicated. | Social & Preventive Medicine | null | Which IUCD acts for 10 yrs -
A. Cu-T 200 B
B. Nova-T
C. Cu-T 380A
D. Multi load-250
| Cu-T 380A |
c47191d7-2785-4598-919c-142135bc0da1 | The most common rheumatic disease in children is Juvenile idiopathic ahritis (JIA), Juvenile idiopathic ahritis represents a homogenous group of chronic disorders charcterized by Ahritis in >/= 1 joint Age at onset: <16 years Duration of disease: >/=6 weeks Ahritis is clinically defined as: Swelling or effusion, or the presence of 2 or more of the followin signs: Limitation of range of motion Tenderness or pain on motion Increased heat Ref: Nelson textbook of pediatrics 21st edition pgno: 1258 | Pediatrics | Musculoskeletal disorders | Most common rheumatic disease in children is ________
A. Juvenile idiopathic ahritis
B. Juvenile ankylosing spondylitis
C. Systemic lupus erythematosus
D. Morphea
| Juvenile idiopathic ahritis |
031f5052-1948-4511-a62a-9ef83e1a8d4d | Harmonic imaging is a newer technique in ultrasonography. Harmonic imaging exploits non-linear propagation of ultrasound through the body tissues. The high-pressure poion of the wave travels faster than low pressure resulting in distoion of the shape of the wave. This change in waveform leads to the generation of harmonics Advantages over conventional ultrasound * decreased aifacts * increased axial and lateral resolution * improved resolution in patients with large body habitus | Radiology | Fundamentals in Radiology | In which of the following form of imaging, Harmonic imaging is related-
A. Sonography
B. Digital radiography
C. MRCP
D. Nuclear imaging
| Sonography |
21ffa169-efaa-4e41-973f-7d84e6e2cbd2 | During aerobic glycolysis the number of net ATPs formed are 8. Steps involved in the formation of ATP during glycolysis are: Conversion of 2 molecules of glyceraldehyde 3 phosphate to 1,3 bisphoglycerate release 2 molecules of NADH which yield 6 ATP. Conversion of 2 molecules of 1,3 BPG to 3 phosphoglycerate yield 2 ATP. Conversion of 2 molecules of phosphoenol pyruvate to pyruvate yield 2 ATP. Steps involved in the consumption of ATP during glycolysis are: Conversion of glucose to glucose 6 phosphate Conversion of fructose 6 phosphate to fructose 6 bis phosphate Total ATP formed during glycolysis : 10 ATP utilised during glycolysis : 2 Net ATP formed during glycolysis : 8 Net ATP produced during anaerobic glycolysis is only 2. Ref: Medical Biochemistry By N. Mallikarjuna Rao page 160. | Biochemistry | null | What is the net amount of ATP's formed in aerobic glycolysis?
A. 5
B. 8
C. 10
D. 15
| 8 |
fc1ef4e7-de11-4d75-9018-83d0559265e8 | Ans. is 'a' i.e., Amebic liver abscess In amebic liver abscesses the liquified material within the abscess cavity is a mixture of RBCs, leucocytes and broken down liver cells. This looks chocolate or reddish brown in colour and is k/a 'chocolate' or 'anchovy' sauce. | Surgery | null | Anchovy sauce pus is a feature of ?
A. Amebic liver abscess
B. Lung abscess
C. Splenic abscess
D. Pancreatic abscess
| Amebic liver abscess |
2672889a-8b90-4813-b61e-dbbdfb0cf946 | Ans. is 'c' Erythromycin DOC for pertussis infection - ErythromycinDOC is one of the favorites of all paper setters. Below given list will be helpful to tackle these type of questions.Drug of choice for suspected or proved microbial pathogens (according to Harrison's 16th/e)Infective organismDrugs of choiceReferenceCommentsGram-Positive CocciPenicillinP.822AlternativeStaphylococcal inf.- Sensitive to penicillinNafcillin, cefazolin, Vancomycin- Sensitive to methicillinNafcillin or oxacillinP.822Cefazolin, Vancomycin- Resistant to methicillinVancomycinP.822TMP-SMX, Minocycline-Resistant to methicillin with intermediate or complete resistance to vancomycinUncertainP.822 * Streptococcal inf. Group A - PharyngitisBenzathine Penicillin GP.825 - ImpetigoBenzathine Penicillin GP.825 - Erysipelas/cellulitisSevere - Penicillin G mild to moderate - Procaine Penicillin GP.825 - Necrotizing Fascitis/myositisSurgical debridement + Penicillin G + ClindamycinP.825 - Pneumonia/empyemaPenicillin G + Drainage of empyemaP.825 - Streptococcal toxic shock syndromePenicillin G + Clindamycin + intravenous immunoglobulinP.825 Group BPenicillinP.829Penicillin is the t/t of choice for all group B streptococcal infectionGroup DEnterococci and non enterococcalCombination therapyIf penicillin allergicPenicillin or Ampicillin + Gentamycin Vancomycin in combination with GentamycinP.830Enterococci are resistant to all cephalosporins therefore this class of antibiotic should not be used for t/t of enterococcal infections.Viridans streptococciPenicillinP.831In neutropenic pts the t/t is first started with vancomycin (as they are often resistant to penicillin)* Streptococcus pneumoniaeFor otitis mediaAmoxicillin812,813Second line - Amoxicillin Third line - ceftriaxoneFor PneumococcalPneumoniaOral therapy - amoxicillin, quinolone eg. GatifloxacinParenteral - Penicillin, Ampicillin, therapy Ceftriaxone, cefotaxime, Quinolone * Streptococcus meningitis - Antibiotic susceptibility unknownT/t with ceftriaxone + vancomycin812, 813 - Susceptibility results availableSusceptible - Ceftriaxone Resistant - T/t with both ceftriaxone & Vancomycin - Life threating penicillin allergyT/t with imipenem Gram - negative Cocci * Meningococcus (Neisseria Meningitis)Penicillin for confirmed invasin meningococcal diseaseP.853Alternatives - Chloramphenicol, Meropenem* Moraxella CatarrhalisPenicillin/Clavulanic acid is highly appropriateP.863Alternatives - Cephalosporins (2nd or 3rd generation) Tetracyclines, Macrolides, Ketolide, Trimethoprim - Sulfamethoxazole* Gonococcal infectionCervix, urethra, pharynx RectumFirst line-Ceftriaxone, Ciprofloxacin ofloxacin861Alternative- Spectinomycin, Ceftizoxime, CefotetanGonococcal conjunctivitisCeftriaxone861 Ophthalmia neonatorumCeftriaxone861 Disseminated gonococcal infectionPatient tolerant of b lactam drugsCeftriaxone, Cefotaxime, Ceftizoxime Patient allergic to b lactam drugsCiprofloxacin, Ofloxacin, Spectinomycin Continuation therapyCiprofloxacin, Ofloxacin, Levofloxacin Gonorrhoeae EpididymitisCeftriaxone followed by doxycycline765 Gonococcal urethritisCefpodoxime or ceftriaxone or fluoroquinolones765 P1DORALRegimen A - Ofloxacin or levofloxacin Plus metronidazoleRegimen B - Ceftriaxone plus doxycycline plus metronidazolePARENTERALRegimen A - Cefotetan or cefoxitin plus GentamycinRegimen B - Clindamycin Plus gentamycin771 Gram-Positive bacilli:Ciprofloxacin or doxycycline +Rifampicin, penicillin or ChloramphenicolP. 710 Bacillus Anthrax ClostridiumGas gangrenePenicillin (i.v.) + clindamycinP.761 Clostridial sepsisPenicillin (i.v.) + ClindamycinP. 761 Suppurative deep tissue infectionsPenicillin (i.v.) + Gentamycin or third generation cephalosporinP. 761 Clostridium difficile (diarrhoea)Metronidazole and vancomycinP. 761use of vancomycin in first episodes is discouraged because of possible drug resistanceClostridium tetaniI.V. PenicillinP.841Some prefer metronidazoleDiphtheria (Respiratory)Erythromycin or Procaine penicillin834, 835Administration of diptheria antitoxin is the most important element in the t/t of respiratory diphtheriaListeria monocytogenesI.V. ampicillin or PenicillinP.839 Enteric Gram-negative bacilliCefotaxime, Ceftizoxime, Ceftriaxone ceftazidime, CefepimeFluoroquinolones, nitrofurantoinC.M.D.T. 2004 1487- 881. (37.1) Escherichia Coli SepsisUrinary infection Klebsiella infectionsCarbapenemsP.883Imipenem remain the most active antibiotic class against KlebsiellaSalmonellaCiprofloxacin, ceftriaxoneP.900Alternative-Azithromycin, ciprofloxacinShigellaIn developing countries In U.S.A.Nalidixic acid Ampicillin,Cotrimoxazole Ciprofloxacin, Azithromycin CefiximeP.906 CampylobacterErythromycinP.909 Yersinia pestis (Plague)StreptomycinP.925Gentamycin is considered as effectiveAlternative-Tetracycline & chloramphenicolOther Gram-Negative bacilliInitial t/t consists of cephalosporins such as Ceftriaxone or cefotaximeP.865Alternative - Penicillin + ChloramphenicolHaemophilus infectionsHaemophilus influenzae 'b' Haemophilus ducreyiThe recommended t/t is a single 1 gm oral dose of azithromycinP.867Alternative - Ceftriaxone ciprofloxacin, ErythromycinPertussisMacrolides Antibiotics - Erythromycin, clarithromycin, AzithromycinP.877Trimethoprim and sulfamethoxazole can be given to macrolide allergic patientsLegionellaNewer Macrolides - Azithromycin, clarithromycin, Respiratory Quinolones - levofloxacin, moxifloxacin GemifloxacinP.873 DonovanosisAzithromycin, Erythromycin, Tetracycline, DoxycyclineP. 933Azithromycin begin increasingly used as first choiceBrucellaMonotherapy - Streptomycin Dual therapy - Streptomycin & Tetracycline917, 916The gold standard is Ultra muscular streptomycin together with doxycyclineTularemiaStreptomycin (i.m.) for both adult & childrenP.921 Gardnerella VaginosisMetronidazoleP. 767 ChlamydiaChlamydia trachomatisAzithromycin1015-18Erythromycin is D.O.C. is pregnant womenChlamydia psittaci Chlamydia pneumoniaeTetracyclineErythromycin, Tetracycline, AzithromycinP. 1018Alternatives - FluoroquinolonesChlamydia urethritisAzithromycin or DoxycyclineP. 765 Rickettsial infections Rocky mountain spotted feverDoxycycline1001-02 Rickettsial PoxDoxycycline or Ciprofloxacin1001-02 Endemic typhusDoxycycline or Chloramphenicol1001-02 Epidemic typhusDoxycycline1001-02 Scrub typhusDoxycycline or Chloramphenicol1001-02 * Spirochetes P.983 Syphilis Primary, Secondary>> or early latentPenicillin G benzathine Late Latent cardiovascular or benign tertiaryNormal C.S.F. - Penicillin benzathine Abnormal C.S.F. T/T as neurosyphilis Neuro syphilisAqueous Penicillin G or Aqueous Penicillin G Procaine Syphilis in pregnancyAccording to stage LeptospirosisMild - Doxycycline, Ampicillin or AmoxicillinModerate/Severe - Penicillin G, Ampicillin,Amoxicillin, ErythromycinP.911 BorreliaRelapsing fever Lyme diseaseDoxycycline (or other tetracyclines) Erythromycin, ChloramphenicolP.995 Oral therapy - Adult - Doxycycline < 9 year AmoxicillinIntravenous therapy - Ceftriaxone Second choice - Amoxicillin Third choice - cefuroxime Second choice - Cefotaxime Third choice - Na PenicillinMycoplasmaErythromycin or doxycyclineCMDT 2004 P. 1489Alternatives - Clarithromycin Azithromycin, Fluoroquinolone Third generation cephalosporins or cefotaxime in the initial therapy as it also covers meningitis causing bacteriaActinomycetesActinomycosisNocardiaPenicillinP.939 Sulfonamides minocycline is an acceptable alternativeP.937Some believe that cotrimoxazole may be more effective but it poses a greater risk of hematological toxicityHelminthic infections * Cestodes H. NanaPraziquantelP. 1276 Taenia saginataPraziquantelP. 1273 Taenia SoliumPraziquantelP. 1274 * TrematodeSchistosomiasisPraziquantelP. 1271 Liver flukes Lung flukesPraziquantelPraziquantelP. 1271 * Nematodes (tissues) TrichinellaEnteric stage - Mebendazole & AlbendazoleP. 1254Trichinella larva in muscle (Drugs ineffective)* Intestinal Nematodes AscariasisAlbendazole, Mebendazole, Pyrantel Pamoate (used in Pregnant women)P. 1257 Hook wormAlbendazole, Mebendazole, Pyrantel PamoateP. 1258 StrongyloidiasisIvermectin,P. 1259Alternative - AlbendazoleTrichuriasis (Whipworm)Mebendazole or albendazoleP. 1259 Enterobiasis (Pinworm)Mebendazole, Albendazole, Pyrantel pamoateP. 1259 Extraintestinal Nematodes FilariaFilariasisTropical Pulmonary EosinophilaDiethyl carbimazole Diethyl carbimazoleP. 1262 P. 1263 OnchocerciasisIvermectin is the D.O.C.P. 1264 Dracunculiasis (Guinea worm)Metronidazole may relieve symptoms but has no proven activity against the wormP. 1265 Protozoal infections AmoebaAsymptomatic carrier Acute Colitis Amoebic liver abscessIodoquinol Paromomycin Metronidazole + Luminal agent MetronidazoleP. 1217 TrichomoniasisMetronidazoleP. 1252 GiardiasisMetronidazoleP. 1250 Toxoplasma infection Congenital infection Immunocompetent patients Immunocompromised patientsOral pyrimethamine and sulfadiazine usually do not require t/tTrimethoprim sulfamethoxazole (Alternative is dapsone - pyrimethamine)P. 1247 ANTIVIRAL Influenza A and B Prophylaxis TreatmentAmantadine or rimantadine Oseltamivir, Zanamivir, AmantadineP. 1028 t (162.1)Amantadine is used for influenza A onlyRSV InfectionRibavirin99 CMV-retinitis in immunocompromised host (AIDS)Ganciclovir Valganciclovir, Foscarnet, CidofovirVaricellaImmunocompetent host Immunocompromised hostAcyclovirAcyclovir" Herpes simplex EncephalitisAcyclovir" NeonatalAcyclovir GenitalPrimary (treatment) Recurrent (treatment)AcyclovirAcyclovir: KeratitisTrifluridineP. 10291 (162.1) Herpes zoster Immunocompromised host Immunocompetent hostAcyclovirValacyclovir>> Herpes zoster ophthalmicusAcyclovir" Condyloma acuminatumIFN-a2bIFN-a n3" Chronic hepatitis BIFN- a 2bLamivudineAdefovir Chronic hepatitis CIFN- a 2a or a 2b IFN- a 2b/ribavirin Pegylated-IFN- a 2b Pegylated-EFN- a 2b/ribavirin Pegylated-IFN- a 2a/ribavirin IFN ala conP. 10301 (162.1) Chronic hepatitis DIFN-a2a or -a2b" Antifungal"Intravenous amphotericin B is the drug of choice for the treatment of patient with disseminated histoplasmosis who are severely ill or immunosuppressed or whose infection involves the C.N.S."P. 1180 Histoplasmosis Acute pulmonaryNone" Chronic pulmonaryItraconazole"Alternatives - Amphotericin BDisseminated Immunocompetent patient less severeItraconazole Alternatives - Amphotericin BRapid progressive severe illness CNS involvement, HIV infectionAmphotericin B Alternatives - ItraconazoleCoccidioidomycosisPatients with ever or rapid progressive disseminated coccidioidomycosis are first given intravenous Amphotericin B patients whose condition improves or who have more indolent disseminated infection are given itraconazole1181-82 No risk factorsItraconazole or Fluconazole"Alternatives-ObservationRisk factors, severe illness, rapid progression or diffuse pulmonary infiltratesAmphotericin B Alternatives-Switch to Itraconazole or fluconazoleChronic dissemination (no CNS disease)Itraconazole or Fluconazole Alternatives-Amphotericin BMeningitisFluconazole"Alternatives-intrathecalAmphotericin BBlastomycosisI.V. Amphotericin B is the drug of choice for patients with rapidly progressive infections, severe illness or CNS lesions.1183-83 Rapid progressing or severe illnessAmphotericin B"Alternatives-Switch to nasale when condition stabilizeCNS diseaseAmphotericin B for 10-12 weeks Alternatives-Give fluconazole if patient improvesIndolent infectionItraconazole CryptococcosisDiseases in AIDS patientsAmphotericin BP. 1185Alternatives-itraconazoleDisease of Non AIDS patientsMeningitis - Amphotericin BPulmonary disease -Treatment immunosuppressed patients as for meningitis"Alternatives-Switch to fluconazoleAlternatives-itraconazoleCandidiasisCutaneousTopical Azole1187 VulvovaginalAzole cream or suppository or oral fluconazole"Alternatives-NystatinOropharyngealClotrimazole or fluconazole"Alternatives-NystatinEsophagealFluconazole tablet Alternatives-For azole Unresponsive diseaseDeeply invasiveNon neutropenic - Fluconazole or Amphotericin caspofungin Neutropenic - Amphotericin B AspergillosisFungus base of the lungSurgical resectionP. 1189Alternatives-Bead embolization for hemoptysisAllergic bronchopulmonary aspergillosisShort course of Glucocorticoids Alternatives-itraconazole prophylaxisInvasive aspergillosisVoriconazole liposomal or conventional Amphotericin B Alternatives-Amphotericin B colloidal dispersion or lipid complex itraconazole or caspofunginMucormycosisIntravenous amphotericin B is usefulP. 1190 Pityriasis versicolorAzole creams, Application of Selenium itraconazole is also effectiveP. 1192 SporotrichosisItraconazole is the drug of choiceP. 1193 MycetomaActinomycetomaEumycetomaStreptomycin Dapsone and Cotrimoxazole Rarely responds to chemotherapyP. 1192 PneumocystosisPneumocystis cariniiTrimethoprim, SulfamethoxazoleP. 1195These are D.O.C. for all forms of Pneumocystosis | Pharmacology | D.O.C | Treatment of whooping cough is :
A. Rifampicin
B. Tetracycline
C. Erythromycin
D. Ampicillin
| Erythromycin |
ac8c6eb7-5d0e-484e-9724-09e452e22dc1 | Procarbazine is a type of alkylating agent which can result in "Disulfiram reaction". Other side effects include cheese reaction, serotonin syndrome, behavioral and personality changes. | Pharmacology | null | Which of the following anticancer drug can result in "disulfiram reaction"
A. Lomustine
B. L-Asparginase
C. Procarbazine
D. Busulfan
| Procarbazine |
e3ce3de0-0e8c-4c75-a1ec-922b24ba09e2 | (C) Immediate surgery to prevent neurological complications # Cervical disc prolapse the management includes:> Heat and analgesics are soothing but, as with lumbar disc prolapse, there are only three satisfactory ways of treating the prolapse itself.> Rest: A collar will prevent unguarded movement; it may be made of felt, sponge-rubber or plastic. It seldom needs to be worn for more than a week or two.> Reduce: Traction may enlarge the disc space, permitting the prolapse to subside. The head of the couch is raised and weights (up to 8 kg) are tied to a harness fitting under the chin and occiput. Traction is applied intermittently for no more than 30 minutes at a time.> Remove: If symptoms are refractory and severe enough, if there is a progressive neurological deficit or if there are signs of an acute myelopathy then surgery is indicated The disc may be removed through an anterior approach; bone grafts are inserted to fuse the affected area and to restore the normal intervertebral height. If only one level is affected, and there is no bony encroachment on the intervertebral foramen, anterior decompression can be expected to give good long-term relief from radicular symptoms. | Orthopaedics | Miscellaneous | In a patient with cervical disc prolapse the management includes
A. Immediate restrictive exercises
B. Skeletal traction and manipulation
C. Immediate surgery to prevent neurological complications
D. Medical management only
| Immediate surgery to prevent neurological complications |
a47d8327-ba56-47b2-9108-a5e27cbc6682 | Ans. (a) Diagnosed cases under treatment* Iceberg Phenomenon of disease: Disease in a community may be compared to an iceberg- Floating tip is what physician sees in community, i.e., clinical cases- Vast submerged portion of iceberg represents hidden mass of disease i.e., latent, inapparent, pre-symptomatic and undiagnosed cases and carriers in community- Line of demarcation (water surface): Is between apparent and inapparent infections- Water surrounding iceberg: Healthy populationALSO REMEMBER* 'Epidemiologist is concerned with Hidden portion of iceberg' whereas Clinician is concerned with Tip of iceberg* 'Screening is done for Hidden portion of Iceberg' whereas diagnosis is done for tip of iceberg* Iceberg phenomenon of disease is not shown by:- Rabies- Tetanus- Measles- Rubella | Social & Preventive Medicine | Gram-Positive Infections - Corynebacterial Infections | Which one of the following does not represent the submerged portion of the iceberg?
A. Diagnosed cases under treatment
B. Undiagnosed cases
C. Pre-symptomatic cases
D. Carriers sub clinical cases
| Diagnosed cases under treatment |
1cf284da-38f3-4ca3-8d2d-98bff9087a03 | Ans. is 'c' i.e., Induction of lipogenesis ACTIONS OF INSULIN Insulin affects the metabolism of carbohydrates, lipids and proteins. Effects on carbohydrate metabolism The overall effect of insulin is to decrease blood glucose level. Insulin increases the utilization of glucose and decreases its production by its following actions : - i) Stimulation of oxidation of glucose by glycolysis especially in the liver and skeletal muscle. ii) Stimulation of glycogenesis i.e., insulin ours conversion of glucose into its storage form, glycogen. This action is seen in both liver and muscles. iii) Inhibition of gluconeogenesis. Insulin stimulates the uptake of glucose by myocytes (skeletal muscle, cardiac muscles), adipocytes (adipose tissue) and hepatocytes. Tissues that do not depend on insulin for glucose uptake include brain, erythrocytes (RBC), the epithelial cells of kidney & intestine, Liver, and Cornea & lens of eye. The mechanism through which insulin increases glucose uptake is different in different tissues. In the muscle and adipose tissues, insulin increase facilitated diffusion by increasing glucose transpoer (GLUT4 ) on the cell membrane. In the liver, insulin stimulates glucose entry into hepatocytes indirectly by induction of glucokinase so that the glucose entering the liver cells is promptly conveed to glucose - 6 - phosphate (glucose trapping). This keeps the intracellular glucose concentration low and ours entry of glucose into the liver. Thus, though the liver do not depend on insulin for glucose uptake, insulin stimulates glucose entry into hepatocytes. That means glucose entery can occur in liver without the action of insulin, but this is facilitated by insulin. On the other hand, myocytes (skeletal and cardiac muslces) and adipocytes (adipose tissue) are dependent on insulin for glucose uptake. Increased uptake of glucose in the glucose has following effects :- i) T Glycolysis :- It is due to induction of key enzymes of glycolysis by insulin. These key enzymes are glucokinase, phosphofructokinase and pyruvate kinase. ii) Increased glycogen synthesis (glycogenesis) :- It is due to induction of glycogen synthase. iii) Decreased glycogen break-down (Glycogenolysis) : - It is due to inhibition of enzyme phosphorylase. iv) Decreased gluconeogenesis :- It is due to inhibition of enzymes Pyruvate carboxylase, PEP carboxykinase, fructose 1, 6-bisphosphatase, glucose - 6 - phosphates. Effects on lipid metabolism Insulin induces lipogenesis by inducing enzyme acetyl CoA carboxylase, the rate limiting enzyme in fatty acid synthesis. Triglyceride synthesis is increased by induction of lipoprotein lipase. Lipolysis (13-oxidation) is decreased due to inhibition of hormone sensitive lipase, so that the fat in the adipose tissue is not broken down. Thus free fatty acid and glycerol are decreased. Because of antilipolytic action insulin decreases ketogenesis. There are two impoant lipases : - i) Lipoprotein lipase : - It hydrolysis the triglycerides of chylomicrons and VLDL into free fatty acid and glycerol in the vessels of skeletal muscles, cardiac muscles and adipose tissue. There FFA is taken up by the cells of these tissue and is conveed back into the triglyceride and the FFA is stored as triglyceride. So, lipoprotein lipase is involved in the synthesis of triglyceride. Lipoprotein lipase is stimulated by insulin, therefore insulin stimulates triglyceride synthesis. ii) Hormone sensitive lipase : - It is involved in lipolysis and cause degradation of stored triglyceride of adipose tissue into FFA and glycerol. FFA comes out into the blood raising the FFA levels of blood. Insulin inhibits hormone sensitive lipase therefore decreases FFA levels of blood. Effects on protein metabolism Insulin stimulates synthesis of protein (anabolism) and inhibits protein breakdown (catabolism). Insulin increases the active transpo of many amino acids into the tissue. In addition insulin increases protein synthesis by increasing the rate of synthesis of mRNA. | Physiology | null | Insulin causes ?
A. Inhibition of glycolysis
B. Gluconeogenesis
C. Induction of lipogenesis
D. Increased glycogenolysis
| Induction of lipogenesis |
d3aee949-a90b-4953-9725-d5f4ec11b751 | Ans. (a) Neonatal thyrotoxicosis.Notice the lid retraction and presence of stare sign. This coupled with history proves that the child has increased sympathetic drive and increased BMR. This is caused by transfer of thyroid stimulating immunoglobulin across the placenta. Image source .. style="font-size: 1.04761904761905em; color: rgba(0, 0, 0, 1); font-family: Times New Roman, Times, serif; margin: 0 0 0 8px; text-indent: 0"> | Pediatrics | Endocrinology | Which of the following is best diagnosis of this neonate who is excessively hungry, warm with flushed skin?
A. Neonatal Thyrotoxicosis
B. Neonatal lupus
C. Cretin
D. Progeria
| Neonatal Thyrotoxicosis |
bd06ab7c-18e6-4a0c-96f9-ebbe6245b4b1 | Coltiviruses form another species within the Reoviridae. The virus paicle is 80 nm in diameter with a genome consisting of 12 segments of double-stranded RNA, totaling about 29 kbp. Colorado tick fever virus, transmitted by ticks, is able to infect humans.Reference:Jawetz, Melnick, & Adelberg's Medical Microbiology; 27th edition; Chapter 37; Reoviruses, Rotaviruses, and Caliciviruses | Microbiology | Virology | Colorado tick fever is the only known human infection caused by
A. Reovirus
B. Coltivirus
C. Rotavirus
D. Corona virus
| Coltivirus |
de272a11-c3d5-4171-918b-b6d416befb09 | The number of tRNAs in most cells is more than the number of amino acids used in protein synthesis (20) and also differs from the number of amino acid codons in the genetic code (61)Ref: DM Vasudevan, 7th edition, page no: 596, 597 | Biochemistry | Metabolism of nucleic acids | Number of t-RNA present in cells is
A. 23
B. 25
C. 28
D. 30
| 23 |
0b863cbd-74d8-48df-9787-5cabfda414dd | ref: ref: Park&;s 23rd edition pg 137 Screening test must satisfy the criteria of acceptability, repeatablity and validity, desides others like yield, simplicity, safety, rapidity, ease of administration and cost. Specificity: defined as the ability of a test to correctly identify those who do not have the diesase, that is "true negatives". A screening test need not have high specificity. | Social & Preventive Medicine | Screening | Which of the following characteristics is not of much impoance in a screening test-
A. Low cost
B. High safety margin
C. High sensitivity
D. High specificity
| High specificity |
b3744288-04bc-4412-bedd-99fda5e8f4e7 | Patient in the question is showing features of cardiac tamponade. 2D echo is the investigation of choice in diagnosing tamponade. It shows reduced right ventricular cavity diameter and collapse of right ventricular free wall and right atrium. M - mode echocardiography is used to study valvular functions. Ref: Harrison's Principles of Internal Medicine 18e chapter 239. | Medicine | null | A 50 year old female presents to the OPD with shoness of breath. On examination she is hypotensive, has soft hea sounds and elevated JVP. Her ECG shows reduction in the amplitude of QRS complexes. Which of the following is the investigation of choice for diagnosing her condition?
A. USG
B. PET
C. 2 - D Echocardiography
D. M - mode Echocardiography
| 2 - D Echocardiography |
2bf3cc17-cf49-4fc2-bef7-290caaf2d1e2 | Ans is 'c' ie Thymoma Mediastinum- is situated b/w the lungs in the center of the thorax.It is divided into 3 compartmentsAnterior or Anterosuperior it lies in front of the anterior pericardium & tracheaMiddle mediastinum or Visceral compartment it lies within the pericardial cavity including the tracheaPosterior mediastinum or paravertebral sulci it lies posterior to the post pericardium & tracheaLocations of the common Mediastinal MassesAnterior mediastinumMiddle MediastinumPost. MediastinumThymoma (most common in Ant med.)LymphomaGerm cell tumorsMesenchymal tumorsThyroid & parathyroid massesThymic cystCysts (MC in Mid. Med.)pleuropericardialbronchogenicenterogenousneuroentericVascular masses (aneurysm)Lymph node enlargement (including lymphoma)Mesenchymal tumorsPheochromocytomaMC tumor in middle Mediastinum- LymphomaNeurogenic tumors (MC overall)MeningoceleGastroenteric cystMesenchymal tumorsPheochromocytomaLymphoma | Surgery | Mediastinum, Cysts, and Neoplasms | Not a posterior mediastinal tumor :
A. Neurofibroma
B. Lymphoma
C. Thymoma
D. Gastroenteric cyst
| Thymoma |
def5bcbb-25e9-4c20-bccd-72f6180d84ab | (a) Source: (Braunwald, 15/e, pp 318, 323, 822, 1061, 1917-1918.) Urticaria, or hives, is a common dermatologic problem characterized by pruritic, edematous papules and plaques that vary in size and come and go, often within hours. Mast cells may be stimulated by heat, cold, pressure, water, or exercise. Immunologic mechanisms can also cause mast cell degranulation. Folliculitis caused by Pseudomonas aeruginosa can cause a rash, often after exposure to hot tubs. The lesions would not be as diffuse, with a line of demarcation depending on the water level. These lesions are pustular and occur 8 to 48 h after soaking. Erythema multiforme produces target-like lesions and oral blisters often secondary to medications. Erythema chronicum migrans usually presents with a large, solitary annular lesion. | Skin | Miscellaneous | A 35-year-old woman develops an itchy rash over her back, legs, and trunk several hours after swimming in a lake. Erythematous, edematous papules are noted. The wheals vary in size. There are no mucosal lesions and no swelling of the lips. The most likely diagnosis is
A. Urticaria
B. Folliculitis
C. Erythema multiforme
D. Erythema chronicum migrans
| Urticaria |
b3a26a4b-588e-4f7b-bd20-b6734d9a8979 | Ans. (a) EmphysemaRef: Robbins 8thEdn /684y 685, Harrison 18,hed chapter 309, Nelson Textbook of Pediatrics, 18th ed chapter 390 | Pediatrics | Disorders of the Respiratory Tract | Alpha-1- antitrypsin deficiency presents as?
A. Emphysema
B. Bronchitectasis
C. Empyema
D. Bronchogenic carcinoma
| Emphysema |
024b28aa-a82e-4fb4-ab13-4d6c5c74a28d | Ans. a. Alopecia areataAlopecia areata is a form of non-scarring alopecia with the edges showing coudability sign and exclamation hairsAndrogenic alopecia presents with diffuse involvement of frontotemporal regions and vertex, sparing occiputTelogen effluvium presents with diffuse involvement of scalp, with a history of a precipitating factor 3-4 months earlier, e.g. severe febrile illness, crash dieting, mental stress etc. | Skin | General | A 35-year-old male presents with bald patches and with no scars. The patches are well demarcated with broken hair at the edges. Diagnosis is:
A. Alopecia areata
B. Androgenic alopecia
C. DLE
D. Telogen effluvium
| Alopecia areata |
d39d5666-ddc7-4ac6-928f-8bbb6ea122bf | All except streptogramins are used. Drug of choice for pseudomembranous colitis is metronidazole,in resistant cases vancomycin given orally. Fidaxomycin is newer class of macrolide type of antibiotic used specially for PMC Ref:KDT 6/e p799 | Pharmacology | All India exam | Drug not used for Pseudomembranous colitis
A. Metronidazole
B. Vancomycin
C. Fidaxomycin
D. Streptogramins
| Streptogramins |
32942fa1-4d1a-45b9-9504-b9fbad4bc125 | VSD is the most common congenital hea diseaseTOF is the commonest cyanotic congenital hea disease(Refer: Nelson's Textbook of Pediatrics, SAE, 1st edition, pg no. 2194 - 2195) | Pediatrics | All India exam | Which of the following is the most common congenital cardiac defect?
A. TOF
B. Transposition of great aeries
C. Ventricular septal defect
D. Atrial septal defect
| Ventricular septal defect |
d1c476cb-ab66-4448-9fb0-8b5f5f02f647 | Ans. is 'a' i.e., 10-19 years o Adolescence is usually the period 10 to 20 yr. | Pediatrics | Development and Epidemiology | WHO defi nes adolescent age between -
A. 10-19 years
B. 10-14 years
C. 10-25 years
D. 9-14 years
| 10-19 years |
7df377b7-9c68-4188-97e9-8c79a310ce27 | * Fatty change is particularly common in the liver but may occur in other non - fatty tissues as well e.g. in the heart, skeletal muscle, kidneys (lipoid nephrosis or minimum change disease) and other organs.* Fatty change, steatosis or fatty metamorphosis is the intracellular accumulation of neutral fat within parenchymal cells.* It includes, now abandoned, terms of fatty degeneration and fatty infiltration because fatty change neither necessarily involves degeneration nor an infiltration. The deposit is in the cytosol and represents and absolute increase in the intracellular lipids. | Pathology | Kidney | Fatty change is seen in?
A. Brain
B. Kidney
C. Adrenal
D. Bladder
| Kidney |
c77b8255-f7ad-4191-8fe6-955799542e7b | 4 & 6 {Description: Bradman's areas of Cerebral cortex) | Physiology | Miscellaneous Nervous System | Area number for Motor area include
A. 4 & 6
B. 1, 2 & 3
C. 5 & 7
D. 16 & 18
| 4 & 6 |
d04c91ec-91b8-4ed7-8249-0a0af15341cd | Most children are able to produce the bilabial sounds (made with the lips) of “b, p, m, w” first, since these are sounds visible on the lips.
They may also produce sounds (linguo-alveolar) such as “d, n, t” early on as well.
These sounds are called linguo-alveolar, since they are produced with the tongue behind the teeth against the alveolar ridge in the mouth. | Dental | null | First sound by child is:
A. Sibilant
B. Bilabial
C. Fricative
D. Monolabial
| Bilabial |
f89e32d4-f61d-44a9-a285-c8ac6f1d21d1 | Enzymes may be simple proteins , or complex enzymes, containing a non -protein pa, called the prosthetic group. The prosthetic group is called the co-enzyme.It is heat stable. The protein pa is named as apoenzyme.It is heat labile.The two poions combined together are called the HOLOENZYME. First group of co-enzymes: In the first group , the change occuring in the substrate is counter balanced by the co-enzymes.Therefore,such co-enzymes may be called as co-substrates or secondary substrates. These takes pa in reactions catalyzed by oxido-reductases by donating or accepting hydrogen atoms or electrons. Second group of coenzymes : These coenzymes take pa in reactions transferring groups other than hydrogen. A paicular group or radical is transferred from the substrate to another substrate. REFERENCE :DM VASUDEVAN TEXTBOOK EIGHTH EDITION , Page no :54 | Biochemistry | Enzymes | Function of coenzyme is to
A. Enhance the specificity of apoenzyme
B. Accept one of the cleavage products
C. Activate the substrate
D. Increase the active sites of apoenzyme
| Activate the substrate |
6e779578-ddd5-4969-aad2-949916f38726 | Robbins basic pathology 9th edition page no 131,(green box=Pathogenesis) Most patients with primary sjogren syndrome have auto antibodies to the ribo-nucleoprotien (RNP) antigensSS-A(RO) and SS-B(la). | Pathology | General pathology | Auto antibody in Sjogrens syndrome is?
A. Anti centromere antibody
B. Anti Ro & anti La
C. Anti ds DNA
D. Anti RNP
| Anti Ro & anti La |
f10dfda8-256a-403f-b570-96cebed67748 | Politzer bag maneuver used to test Eustachian tube Designed for those who can`t perform Valsalva test Politzer bag is connected to rubber tube- Tube is placed in one nostril and other is closed-Air is blown with pressure by pressing the bulb-Air enters nasopharynx - opens eustachian tube & enters middle ear- pops out TM | ENT | Anatomy of Middle Ear | Politzer bag maneuver used to test:
A. Eustachian tube
B. Larynx
C. Esophagus
D. Nasal cavity
| Eustachian tube |
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