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ad91b07f-fdfd-4196-9d34-b7616c929ddc | Ans: a) Golgi apparatus N-Glycosylation begins in the ER and completed in Golgi. Trimming and fuher addition of sugars take place in Golgi. There are 3 types of N-glycosylation. 1. High-mannose type 2. Complex type 3. Hybrid type To form high-mannose chains, the glucose and some of the peripheral mannose residues are removed by glycosidases in Golgi. To form complex type, the glucose residues and four of the mannose residues are removed by glycosidases in the endoplasmic reticulum and Golgi, then N-acetyl glucosamine, galactose, and N-Acetylneuraminic acid are added in reactions catalyzed by glycosyltransferases in the Golgi apparatus. Hybrid chains are formed by paial processing, forming complex chains on one arm and mannose units on the other arm. | Biochemistry | Organelles | Trimming and fuher modification of N-linked glycoproteins takes place at
A. Golgi apparatus
B. Endoplasmic reticulum
C. Peroxisomes
D. Lysosomes
| Golgi apparatus |
720d854f-f942-45bc-b194-fd4785835ee4 | CONTRIBUTIONS OF FREUD o Father of psychoanalysis He founded a type of psychotherapy called psychoanalysis. It is nothing but analyzing the psych(MIND) o Interpretation of dreams According to Freud dreams are royal road to unconscious In dreams several conflicts that are present in the unconscious comes to the consciousness in the form of dreams Thus by analyzing ones dreams we could understand the unconscious conflicts o Psychosexual stages of life o Freud divided development into 5 stages namely psycho sexual development o It is divivded namely oral , anal , phallic, latent, genital phase. o Conversion disorders conversion disorder is conveing a psychological pain to physical symptoms present physical symptoms which has some connection with unconscious conflict is called SYMBOLIZATION present physical symptoms which has some resemblance with illness in family members, which is called MODELLING patient has illness like neurological deficit but they have apparent in concern towards their own illness which is known as LA BELLE INDIFFERENCE main defense mechanism in conversion disorder is REPRESSION o Repression defence mechanism * REPRESSION is called QUEEN of defense mechanisms o COUCH and FREE ASSOSIATION * He introduced a technique called as a couch technique where he makes the patient lie on the couch, he asks the patient to speak from 'cabbages to kings. This method is called FREE ASSOSIATION. By allowing the patient to speak whatever that comes to their mind randomly so that by analyzing their thoughts we could understand the conflict in the unconscious. o Topographical theory of mind Freud gave topographical theory mind It is divided into pre conscious, unconscious, conscious Later he disregarded topographical theory of mind and gave structural theory of mind o Structural theory of mind It is divided into id, ego, super ego Id= instinctual desires like anger, hunger, sexual instinct Ego= function of mind to work based on ego to avoid guilt from super ego Super ego= based on moral principle, obtained from family members and relatives, teachers Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition pg no. 845 | Anatomy | Treatment in psychiatry | who gave the concept of latent and manifest dreams
A. freud
B. master and johnson
C. benedict morel
D. erik erikson
| freud |
5de33d00-7267-4c32-ba12-4c9d6598d9af | Answer- A. Duodenal perforationLong term therapy with autocoids led to an ulcer that eventually perforated and now the patient has presented early signs of peritonitis.Clinical features of perfontion of duodenal ulcerPerforated duodenal ulcer is characterized by sever constant onset epogastric painPatient looks ill and lies unusually stillTachycardiaShallow respirationTender with intense guarding and rigidityIf the air has escaped into peritoneal cavity then liver dullness may be absentPeptic ulcer perforation leads to chemical peritonitis initially. | Surgery | null | Patient is on autocoids for 1 year complains of severe pain epigasrium relieved iv antacids now complains of pain in right iliac fossa and epigastrium with fever and loss of liver dullness diagnosis
A. Duodenal perforation
B. Diveiculitis
C. Gastroenteritis
D. Enteric perforation
| Duodenal perforation |
d0ecc061-5478-442a-9b20-b8c8b3558069 | Based on differences in cellular organisation and biochemistry this kingdom has been divided into two groups: prokaryotes and eukaryotes. Bacteria and blue-green algae are prokaryotes while fungi, other algae, slime moulds and protozoa are eukaryotes. Bacteria are prokaryotic microorganisms that do not contain chlorophyll. They are unicellular and do not show true branching except in the so-called higher bacteria (Actinomycetes). Ref: Textbook of Microbiology; Ananthanarayan and Paniker; 9th edition. | Microbiology | general microbiology | Prokaryote among the following is?
A. Bacteria
B. Mycoplasma
C. Fungi
D. Blue green algae
| Bacteria |
7dda38e3-853f-43b2-8975-d2d244084280 | Musculature of the tongue is mainly derived from myoblasts originating in the occipital somites. Thus, the tongue musculature is innervated by hypoglossal nerve. | Anatomy | null | Tongue muscles are derived from -
A. Occipital somites
B. Pharyngeal pouch
C. Hypobranchial emminence
D. Neural crest Palate
| Occipital somites |
50f93d83-ad0c-420e-8242-ff48870adb1a | Ans. is 'd' ie. USG and follow up Management of Pancreatic Pseudocyst A pancreatic pseudocyst may resolve spontaneously so it is followed with serial ultrasound studies. Indications of Surgical intervention: (Ref: Bailey and Love 25/e 1145; CSDT 13/e p583; Harrison 17/e p) i) Age of cyst more than 12 weeks without resolution ii) Size of cyst greater than 6 cm. iii) Symptomatic iv) Development of complications (eg. haemorrhage, perforation, g.i. obstruction) But note that these indications for intervention are just a generalization used for teaching the undergraduates. These are not specific indications for interventions. Therapeutic interventions are advised (irrespective of size and duration) when - the pseudocyst is symptomatic or - increasing is size on follow up studies, or - any complication (rupture, hemorrhage, or abscess) arise or - there is suspicion of malignancy. Thus expectant management is adequate (irrespective of size) if the patient is asymptomatic and serial u/s studies show that the cyst is resolving. Surgical methods a) Internal Drainage - most preferred surgical management in uncomplicated pseudocyst is internal drainage. The three options are Cystojejunostomy Cystogastrostomy Cystoduodenostomy Internal drainage can be done either open surgical or laparascopic or by percutaneous catheter-based methods (transgastric puncture and stent placement to create a cystogastrostomy) b) Excision of Pseudocyst - is hardly done and is usually limited to pseudocyst involving the tail of the pancreas. c) External drainage - is done in:? - infected pseudocyst - for immature pseudocyst with thin nonfibrous walls that does not allow safe internal drainage. - in an unstable pt. in whom more complex surgical intervention is precluded. d) Transpapillary pancreatic duct stent : Because pseudocysts often communicate with the pancreatic ductal system, two newer approaches to pseudocyst management are based on main duct drainage, rather than pseudocyst drainage per se. A stent is passed into the pseudocyst through the papilla of Vater. this drainage, paicularly when incomplete, can allow bacteria to enter the pseudocyst and lead to development of an infected pseudocyst. Another transpapillary approach involves placing a stent across the duct defect rather than into the cyst through the defect. By excluding pancreatic juice from the pseudocyst, this bridging intraductal stent may permit the duct disruption to heal and the pseudocyst to resolve without drainage (analogous to the use of common bile duct stents in the setting of a cystic duct leak). | Surgery | null | After 3 wks of duration pancreatic pseudocyst 5 cm in size should be managed by which method
A. Cystogastrostomy
B. Needle aspiration
C. External drainage
D. USG and follow up
| USG and follow up |
05c0c6fd-8ee4-471f-9789-50a4ac2ed9c0 | Preferred treatment is microlaryngoscopy and excision. As the recurrence is common, repeated excisions may be required. Tracheostomy is avoided to prevent distal spread. Interferon therapy has not shown sustained benefit. | ENT | Larynx | A 3-year-old male child presents with multiple laryngeal papillomas with hoarse voice and slight airway distress. Papillomas are involving the glottis. The best treatment is:
A. Tracheostomy and observation
B. Steroids
C. Interferon therapy
D. Microlaryngoscopy and excision
| Microlaryngoscopy and excision |
8191969b-3ee1-4cfa-acd0-2111b8dab3db | Gout is the most common inflammatory ahritis in men and in older women. It is caused by deposition of monosodium urate monohydrate crystals in and around synol joints due to abnormal purine metabolism . Ref Davidsons 23e p1013 | Medicine | Immune system | Gout is a disorder of-
A. Purine metabolism
B. Pyriniidine metabolism
C. Ketone metabolism
D. Protein metabolism
| Purine metabolism |
d72d010c-c6b1-4139-b56c-5b2bddbc74cf | Lymphangiosarcoma is a rare tumor that develops as a complication of long-standing (usually more than 10 years lymphedema. | Surgery | null | The most common site of lymphangiosarcoma is
A. Liver
B. Spleen
C. Post mastectomy edema of arm
D. Retroperitoenum
| Post mastectomy edema of arm |
508df2ff-a2b3-4308-933a-44f79bd1ac39 | (A) Secondary deposits> Most common secondary deposits from visceral primary malignancy occurs in the site of vertebral spine.> Most common primary bone marrow malignancy is multiple myeloma> Most common primary malignant bone tumor is osteosarcoma. | Orthopaedics | Miscellaneous | Most common tumor of vertebral spine in adults
A. Secondary deposits
B. Multiple myeloma
C. Lymphoma
D. Hemangioma
| Secondary deposits |
a80adf07-5438-4436-a8e1-c2bd790f6393 | Skeletal muscle is not supplied by general visceral fibres Inderbir Singh&;s textbook of human Histology Seventh edition | Anatomy | General anatomy | General visceral fibres do not supply
A. Smooth muscles
B. Skeletal muscles
C. Cardiac muscles
D. Glands
| Skeletal muscles |
ac21efef-cc53-470c-a10f-0cbfb21fcea8 | Infants born to narcotic addicts are more likely than other children to exhibit a variety of problems, including perinatal complications, prematurity, and low bih weight. The onset of withdrawal commonly occurs during an infant's first 2 days of life and is characterized by hyperirritability and coarse tremors, along with vomiting, diarrhea, fever, high-pitched cry, and hyperventilation; seizures and respiratory depression are less common.The production of surfactant can be accelerated in the infant of a heroin-addicted mother. | Surgery | null | An infant born at 35 weeks' gestation to a mother with no prenatal care is noted to be jittery and irritable, and is having difficulty feeding. You note coarse tremors on examination. The nurses repo a high-pitched cry and note several episodes of diarrhea and emesis. You suspect the infant is withdrawing from
A. Alcohol
B. Marijuana
C. Heroin
D. Cocaine
| Heroin |
36c00e39-a06f-48b5-9893-114a9545f1d8 | Alanine, Cysteine and Threonine can also produce oxaloacetate but pyruvate only. Aspaate can directly produce oxaloacetate in a single step, i.e. transamination reaction. | Biochemistry | Classification and metabolism of amino acids | Which of the following amino acid can produce oxaloacetate directly in a single reaction?
A. Alanine
B. Cysteine
C. Threonine
D. Aspaate
| Aspaate |
daf6dadd-6bc3-4ca9-a1b6-ceb2cd266d0f | Phosphofructokinase (PFK) is --300 amino acids in length, and structural studies of the bacterial enzyme have shown it comprises two similar (alpha/beta) lobes: one involved in ATP binding and the other housing both the substrate-binding site and the allosteric site (a regulatory binding site distinct from the active site, but that affects enzyme activity). The identical tetramer subunits adopt 2 different conformations: in a 'closed' state, the bound magnesium ion bridges the phosphoryl groups of the enzyme products (ADP and fructose-1,6- bisphosphate); and in an 'open' state, the magnesium ion binds only the ADP, as the 2 products are now fuher apa | Biochemistry | null | Which element is required by phosphofructokinase?
A. Magnesium
B. Inorganic phosphate
C. Manganese
D. Copper
| Magnesium |
61e9c5b9-2004-4871-bd24-f71a493fd437 | The constitution came into force on 7 th April 1948 which is celebrated every year as "world health Day ".A world health day theme is chosen each year to focus attention on a specific aspect of public health (refer pgno:919 park 23rd edition) | Social & Preventive Medicine | Health care of community & international health | World health day -
A. 7th April
B. 7th July
C. 7th Dec
D. 7th Feb
| 7th April |
0e684e09-0bed-4689-b42d-924f2947be1e | Refer Katzung 10/e p 544 Anticoagulants are mainly used for venous thrombosis and are highly effective in treatment and prophylaxis of deep vein thrombosis Warfarin is most commonly used drug in a patient with chronic atrial fibrillation Aspirin and heparin in combination are recommended for unstable angina | Pharmacology | Respiratory system | Which of the following is not used for thrombo prophylaxis
A. Heparin
B. Warfarin
C. Antithrombin 3
D. Aspirin
| Antithrombin 3 |
d4e2f0d4-ae66-4976-b62a-82d38bb3acfd | Laryngeal mirror is warmed by:
Dipping the mirror in warm water.
Heating the glass surface against some heat such as bulb or spirit lamp. | ENT | null | Laryngeal mirror is warmed before use by placing -
A. Glass surface on flame
B. Back of mirror on flame
C. Whole mirror into flame
D. Mirror in boiling water
| Glass surface on flame |
b1c7f572-c1ec-4e7f-922b-4ea300a9196d | Ans. is 'c' i.e., Paired T-test o Paired T - test : is applied to paired data when each individual gives a pair of observation, such as when observations are made both before and after the play of a factor. e.g. Pulse rate before and after administration of a drug. | Social & Preventive Medicine | null | When observations are made before and after the exposure to the factor, it is
A. Chi-square test
B. Unpaired T-test
C. Paired T-test
D. Paired T-test
| Paired T-test |
a9b3e1b3-39a8-49ce-bcd3-c8a45776b9c1 | PNH is due to complement regulatory protein deficiency (DAF and CD59). | Microbiology | null | Which of the following is not due to complement deficiency?
A. SLE
B. PNH
C. Glomerulonephritis
D. Neisseria infection
| PNH |
6e28c1d2-224b-44d4-9bfd-0c72a12a595e | Ref -KDT 6/e p172 Flunarizine, sold under the brand name Sibelium among others, is a drug classified as a calcium antagonist which is used for various indications. It is not available by prescription in the United States or Japan. The drug was discovered at Janssen Pharmaceutica in 1968 | Anatomy | Other topics and Adverse effects | Which of the following drugs is used for the prophylaxis of migraine but not for angina pectoris
A. Verapamnil
B. Diltiazem
C. Flunarizine
D. Amlodipine
| Flunarizine |
25ffd786-6fc8-482e-9968-83e1686aca68 | Pulmonary sarcoidosis is classified on a chest radiograph into 5 stages based on Scadding criteria:- Stage 0: Normal chest radiograph Stage I: Hilar or mediastinal nodal enlargement only Stage II: Nodal enlargement and parenchymal disease Stage III: Parenchymal disease only Stage IV: End-stage lung (pulmonary fibrosis) Rest 3 scoring systems are used for the assessment of Cystic fibrosis. | Medicine | Sarcoidosis | Which of the following scoring system is used to see chest involvement in Sarcoidosis?
A. Brasfield scoring system
B. Wisconsin scoring system
C. Shwachman-Kulczycki scoring system
D. Scadding scoring system
| Scadding scoring system |
4ea9ae26-fdc7-4898-873c-805416fde5e2 | Dermographism:-Type of physical uicaria- induced by mechanical stimulus also called as Skin writing Rapid appearence of wheal flare at the site of brisk firm stroke made with a firm object.Lesions are often linear/ assume the shape of eliciting stimulus.Local erythema followed by edema.Most common physical uicaria seen in young adults sometimes symptomatic pruritus is present before the onset of lesions IADVL textbook of dermatology, cutaneous vascular responses, page 661 | Dental | Dermatitis | Following is a type of physical uicaria -
A. Dermographism
B. Uicaria pigmenthosa
C. Uicaria vasculitis
D. Auto-immune uicaria
| Dermographism |
917d7923-d50a-4ba8-86ff-7e58c75a1935 | Rapidly' progressing hirsutism points to developing androgen secreting tumors, which could be a Leydig seoli tumor of the ovary. For which estimation of androgens specifically serum testosterone should be an initial investigation along with a pelvic scan A 17 OH progesterone should be estimated as well to rule out a late onset Congenital adrenal hyperplasia. | Gynaecology & Obstetrics | Polycystic Ovarian Syndrome | A 20 yrs old young girl, presents with history of rapidly developing hirsutism and Amenorrhea with change in voice. To establish a diagnosis you would like to proceed with which of the following tests in blood:
A. 17-OH progesterone
B. DHEA
C. Testosterone
D. LH +FSH estimation
| Testosterone |
13869871-09e6-4f51-9137-2e3252fdc06a | Mumps Caused by virus of family of RNA paramyxovirus Incubation period of 14-21 days Mode of transmission : Respiratory / air droplets Source of infection: Cases Period of communicability: 4-6 days before symptoms & 7days after symptoms High secondary attack rate = 86% Most common complication is aseptic meningitis ; orchitis Live attenuated vaccine is available for disease ,with strain Jeryll Lynn strain | Social & Preventive Medicine | VBDs, Arboviral & Viral Infections, Surface Infections | Disease caused by virus of family of RNA paramyxovirus, with incubation period of 14-21 days with high secondary attack rate with most common complication of aseptic meningitis. Live attenuated vaccine is available for disease with strain JeryII Lynn strain. Name of disease is?
A. Measles
B. Mumps
C. Rubella
D. Chicken pox
| Mumps |
efa4b086-82c1-4139-86c8-6e07ba764f2b | The superior and inferior ophthalmic veins drain into the facial vein and cavernous sinus. | Anatomy | null | The superior and inferior ophthalmic veins drain into the:
A. Internal jugular vein
B. Pterygoid plexus
C. Frontal vein
D. Facial vein
| Facial vein |
a07fdb39-ea23-4b28-b06d-2e4ffe1d6a2e | Criteria for the diagnosis of Diabetes mellitus : * Symptoms of diabetes plus random blood glucose concentration >= 11.1 mmol/L (200 mg/dL) or * Fasting plasma glucose >= 7.0 mm/L (126 mg/dL) or * Glycosylated haemoglobin >= 6.5% or * 2-hr plasma glucose >= 11.1 mmol/L (200 mg/dL) during an oral glucose tolerance test. Normal fasting blood glucose : 70-110 mg/dL Reference : page 2401 Harrison's Principles of Internal Medicine 19th edition | Medicine | Endocrinology | Diabetes melitus is diagnosed if fasting blood glucose is ?
A. >100
B. >126
C. >110
D. >116
| >126 |
74fec65f-0b0e-4d6a-a249-ef7910925e73 | (20%) (1896-H) (628-CMDT-09) (2011-H17th)* The term hemorrhagic pancreatitis is less meaningful in a clinical sense because variable amounts of interstitial hemorrhage can be found in pancreatitis as well as in other disorders such as pancreatic trauma, pancreatic carcinoma, and severe CHF (1896-H)* Prognosis (674-CMDT-05)Mortality rate for acute pancreatitis have declined from at least 10% to around 5% in the past 20 years, but the mortality rate of severe acute pancreatitis (more than three Ranson criteria) remains at least 20%, especially when hepatic cardiovascular or renal impairment is present in association with pancreatic necrosis.* Recurrence are common in alcoholic pancreatitis* Mortality rate for undrained pancreatic abscess approaches 100% (1900-H) | Medicine | G.I.T. | The mortality rate in Acute hemorrhagic pancreatitis is
A. 20%
B. 40%
C. 50%
D. 60%
| 20% |
9e778c0c-9852-4c40-b8ef-514f8c7621c0 | • PE is the most common preventable cause of death among hospitalizedpatients.PE and DVT occurring after total hip or knee replacement is currently taken as unacceptable, and steps are taken to prevent it by giving subcutaneous fondaparinux.
• For patients who have DVT, the most common history is a cramp in the lower calf that persists for several days and becomes more uncomfortable as time progresses. For patients who have PE, the most common history is unexplained breathlessness. | Medicine | null | A 65 year old woman after total knee implant surgery complains of calf pain and swelling in the leg from last 2 days. Later she
complains of breathlessness and dies suddenly in the ward. Probable cause?
A. Myocardial infarction
B. Pulmonary embolism
C. Stroke
D. ARDS
| Pulmonary embolism |
2be74c37-de9e-4323-94a3-256cc16237b3 | (Ref: Katzung, 14th ed. pg. 418-19; KDT 6th ed. pg. 405)Hypersensitivity reactions like rashes, DLE, lymphadenopathy and neutropenia require that phenytoin to be stopped. | Pharmacology | C.N.S | A patient with recent onset primary generalized epilepsy, develops drug reaction and skin rash and neutropenia due to phenytoin sodium. The most appropriate course of action is:
A. Shift to sodium valproate
B. Shift to clonazepam
C. Shift to ethosuximide
D. Restart phenytoin after 2 weeks
| Shift to sodium valproate |
715d906a-f9e6-4edb-a642-c2f5cf41ce6c | Eutrophication or hyperophication, is when a body of water becomes overly enriched with minerals and nutrients which induce excessive growth of algae. This process may result in oxygen depletion of the water body. One example is an "algal bloom" or great increase of phytoplankton in a water body as a response to increased levels of nutrients. Eutrophication is often induced by the discharge of nitrate or phosphate-containing detergents, feilizers, or sewage into an aquatic system. Ref: https://en.m.wikipedia.org/wiki/Eutrophication | Social & Preventive Medicine | Environment and health | Eutrophication of water bodies is mainly caused by -
A. Carbonates and oxides
B. Hydrocarbons and mentals
C. Carbonates and sulphates
D. Phosphates and nitrate
| Phosphates and nitrate |
bb72b999-cd89-4f65-bd5d-25a655dd6b12 | Answer is A (Paroxsmal cold Haemoglobinuria) Chronic hemolysis due to paroxysmal cold Haemoglobinuria may be associated with iron deficiency 'In chronic extravascular hemolysis iron is tenaciously conserved. In chronic intravascular hemolysis large amounts of iron are lost in the urine as free haemoglobin, muthemoglobin and hemosiderin and the patient may become iron deficient'- Hematology for Students. Amongst the options provided paroxysmal cold haemoglobinuria is a cause for intravascular hemolysis and hence the single best answer of choice Thalassemia, Hereditary spherocytosis and G6-PD deficiency are all associated with extravascular hemolysis and are likely to present with iron overload and not iron deficiency | Medicine | null | Chronic Hemolysis from which of the following conditions may be associated with iron deficiency:
A. Paroxysmal cold Haemoglobinuria
B. Thalassemia
C. Hereditary spherocytosis
D. G 6PD deficiency
| Paroxysmal cold Haemoglobinuria |
304f635a-2806-4c4e-989d-9897de109bc0 | SCABIES:-Caused by Sarcoptes scabiei var hominis.Clinical features:Itching- generalised, worse at night.this is due to delayed type 4 hypersensitivity reaction. Classic lesion: Burrow-Thread like wavy tunnel in stratum corneum.They appear as serpiginous or S shaped greyish,thread like elevations with a vesicle at one end indicating the presence of mite.seen at interdigital web, feet areola,scrotum. Burrows are pathognomic of scabies. iadvl textbook of dermatology page429 | Dental | Fungal infections, Scabies, Pediculosis | Characteristic lesion of scabies is -
A. Burrow
B. Fissure
C. Vesicle
D. Papule
| Burrow |
d89538b7-6ed4-4b06-b822-736f459c5da5 | Ans. (a) aPTTRef: Robbins and Cotran Pathologic Basic Disease 9th Ed; Page No-119* The extrinsic pathway is clinically evaluated by the prothrombin time (PT), which is a measure of factors II, V, VII, X, and fibrinogen.Diatheses* The intrinsic pathway can be evaluated by the partial thromboplastin time (PTT), which is a measure of factors II, V, VIII, IX, X, XI, XII, and fibrinogen.Coagulation cascadeIntrinsic pathwayExtrinsic pathway* Mainly in vitro pathway of coagulation but it may be activated in vivo also.* This pathway may involve contact activation with interactions of the so- called contact factors: factor XII (Hageman factor), prekallikrein, and high- molecular weight kininogen, as well as factor XI.* In vivo activation occurs due to contact activation of factor XII from subendothelial collagen and other components like platelets following endothelial injury.* It is probably initiated by the tissue factor-factor Vila complex (from the extrinsic pathway), activating factor IX to factor IXa. Factor IXa, in turn, leads to the conversion of factor X to factor Xa, catalyzed by factor Villa.* It is mainly in vivo pathway but it may be activated in vitro also.* In vivo it is initiated by tissue factor, which activates factor VII and forms a Vila tissue factor complex.* The Vila tissue factor complex initiates coagulation through the activation of factor X to factor Xa (and additionally factor IX to factor IXa).* Factor Xa converts prothrombin (factor II) to thrombin (factor lla).* In the conversion of prothrombin to thrombin factor-Va acts as a cofactor.* In vitro activation occurs due to exposure of blood to tissue derived thromboplastin reagents (tissue factor).Extra MileLaboratory Assessment of Coagulation Pathways* Prothrombin time (PT):* Normal range is 11-16 seconds.* Used for assessment of extrinsic and the common coagulation pathways.* It is prolonged by:o Deficiency of VII, X, V, prothrombin (II) and Fibrinogen (I).o Warfarin treatment* Activated Partial Thromboplastin Time (aPTT):# Normal range is 30-40 seconds# Used for intrinsic and the common coagulation pathways.# It is prolonged by:o Deficiency of XII, XI, IX, III, X, V, prothrombin (II) and Fibrinogen (I).o Heparin treatment* Thrombin Time (TT):# Normal range is 11-14 seconds# Use for assessment of conversion fibrinogen into fibrin.# It depends upon adequate fibrinogen levels.# It is elevated in dysfibrino genemia, afibrinio genemia, DIC and heparin like inhibitors. | Pathology | Blood | For detection of intrinsic pathway of coagulation which one is used?
A. aPTT
B. PT
C. BT
D. CT
| aPTT |
bea1c269-dc6e-4ee2-ab28-9f235aa28947 | Ans. is 'd' i.e., Oral First pass metabolism is seen with oral and rectal routes. Maximum first pass metabolism is seen with oral route. In rectal route, drug absorbed into external hemorrhoidal veins bypasses liver, but not that absorbed into internal haemorrhoidal veins -First pass metabolism occurs, but less than oral route (avoids first pass metabolism to 50%). Most rapid onset of action is seen with I. route. Bioavailability by I. V route is 100%. | Pharmacology | null | Maximum first pass metaboilsm is seen by which route ?
A. Intravenous
B. Interaaerial
C. Rectal
D. Oral
| Oral |
23ce684b-1841-4777-97d7-6efa101ae951 | Ans is option 2 - Enalapril ACE inhibitors and ARB&;s are specifically indicated to reduce progression of renal disease. Ref Harrison 19 /2428 | Medicine | Endocrinology | A 50 years old male with 2 diabetes mellitus is found to have 24 hour urinary albumin of 250 mg. Which of the following drugs may be used to retard progression of renal disease -
A. Hydrochlohiazide
B. Enalapril
C. Amiloride
D. Aspirin
| Enalapril |
364fcc68-4071-444e-bcbe-45e8ccad8849 | Conversion of phenylalanine to tyrosine: The reaction involves hydroxylation of phenylalanine at p-position in benzene ring. Enzyme: Phenylalanine hydroxylase. Present in liver and the conversion occurs in Liver. Coenzymes and cofactors: The enzyme requires the following for its activity: * Molecular oxygen * NADPH *F e++ and * Pteridine (folic acid) coenzyme: Tetrahydrobiopterin- FH4 The reaction is complex and takes place in two stages as shown below: I. Reduction of O2 to H2O and conversion of phenylalanine to tyrosine. Reduced form of pteridine, FH4 acts as H-donor to the molecular O2. II. Reduction of dihydrobiopterin, FH2 by NADPH, catalyzed by the enzyme Dihydrobiopterin reductase.Ref: Textbook of medical biochemistry, MN Chatterji, 8th edition, page no: 495 | Biochemistry | Structure and function of protein | H4-biopterin (tetrahydrobiopterin) is required for metabolism of
A. Arginine
B. Lysine
C. Phenylalanine
D. Tryptophane
| Phenylalanine |
03f7c9c2-7ec9-471c-ace8-a1093f79e913 | Chicken fat and red current jelly seen in post moem clot | Anatomy | All India exam | Cardiac polyp is seen in
A. Acute nephritis
B. Endocarditis
C. Septicaemia
D. Postmoem clot
| Postmoem clot |
782d6938-7b95-4e1b-aff7-4311aa025fbd | Wegener's granulomatosis is characterised by granulomatous vasculitis of the upper and lower respiratory tracts together with glomerulonephritis.Lung involvement typically appear as multiple,bilateral,nodular cavitary infiltrates and clinically expressed as cough,hemoptysis,dyspnea,and chest discomfo.Renal involvement can appear as proteinuria,hematuria,and red blood cell casts,and progressing to renal functional impairment and renal failure. Ref:Harrison's medicine-18th edition,page no:2789,2790. | Medicine | Respiratory system | The presence of multiple cavities in the lung with hematuria is suggestive of-
A. Wegener's granulomatosis
B. Tuberculosis
C. Renal cell carcinoma
D. Systemic lupus erythematosus (SLE)
| Wegener's granulomatosis |
a388695c-040b-4f2d-99d4-e2a3628246fc | Sarcoidosis is a multisystem non caseous granulomatous disorder associated with hypercalcemia in about 10 % of patients .due to increased production of vitamin D by granuloma itself. Ref Davidson edition23rd pg 608 | Medicine | Respiratory system | Granulomtous condition showing hypercalcemia A/E
A. TB
B. Sarciodosis
C. Berylliosis
D. SLE
| Sarciodosis |
c3ca2ec8-36c4-47d0-b1b5-c89172443acc | Since there is end to end gastroduodenal anastomosis in billroth 1 there are more chances of anastomotic leak | Surgery | null | Anastomotic leaks are most commonly seen in
A. Billroth 1
B. Roux en y gastrojejunostomy
C. Polya gastrectomy
D. Antral gastrectomy
| Billroth 1 |
21e8b417-234a-4f0e-bf20-5d6c797e28fd | All 4 phases may be seen in different parts of the same lung
Congestion (1-2 days)
Red hepatization (2nd-4th day)
Gray hepatization (5th-8th day)
Resolution (8th-9th day) | Pathology | null | Gray hepatization of lungs is seen on the day -
A. 1
B. 3-Feb
C. 5-Mar
D. 7-May
| 7-May |
c7086a43-6847-483b-9e47-17d46f6f9540 | Vitamin A solution contains 1 lac IU per ml solution
Vitamin A is given in NIS of India till 5 years age (Recent guidelines)
– At 9 months age: 1 lac IU (1 ml)
– Every 6 months, till 5 years age: 2 lac IU (2 ml) each
– Total dose given: 17 lac IU (9 doses). | Social & Preventive Medicine | null | The Vitamin A supplement administered in “Prevention of nutritional blindness in children programme” contains
A. 25,000 IU/ml
B. 3 lakh IU/ml
C. 1 lakh IU/ml
D. 5 lakh IU/ml
| 1 lakh IU/ml |
3155eccf-fdc9-4538-88ea-81407700fb48 | Ref-Katzung 10/e p906 It is a recombinant IL-2 used for the treatment of renal cell carcinoma and malignant melanoma | Anatomy | Other topics and Adverse effects | Immunostimulant used for the treatment of malignant Melanoma Norma is
A. Levamisol
B. BCG
C. Aldesleukin
D. Methotrexate
| Aldesleukin |
4e842c4f-baca-4846-8904-ce8459dd8cab | Osgood-Schlatter disease(OSD)is a chronic fatigue injury due to repeated microtrauma at the patellar ligament inseion onto the tibial tuberosity, usually affecting boys between ages 10-15 years. Osgood-Schlatter disease is seen in active adolescents, especially those who jump and kick, which is why it is seen more frequently in boys. Clinically, patients present with pain and swelling over the tibial tuberosity exacerbated with exercise. Illustration of Osgood-Schlatter disease. | Radiology | Musculoskeletal Radiology | What could be the possible diagnosis as per the given X-ray?
A. Osgood schattler disease
B. Pellegrinl Stieda lesion
C. SLAP tear
D. Segond Fracture
| Osgood schattler disease |
8d881f5e-5240-453f-b97b-eafce93ec13c | Minimal/Critical diameters of the Pelvis: If any of the following diameter is less than critical diameter, Pelvis is said to be contracted | Gynaecology & Obstetrics | null | One of the following features can be used to define contracted pelvis
A. Transverse diameter of inlet is 10 cm
B. AP diameter of inlet is 12 cm
C. Platypelloid pelvis
D. Gynaecoid pelvis
| Transverse diameter of inlet is 10 cm |
1459020c-a7a5-4a34-b80f-38b27075e293 | Wayson's stain is a basic fuchsin - methylene blue, ethyl alcohol - phenol microscopic staining procedure. It is a modified methylene blue stain used for diagnosing bubonic plague. Giemsa / Wayson stain revels the typical safety- pin apperance of the organism. In Bubonic plague the infected flea bite is usually on the legs and is marked by a small pustule or ulceration. More often the lymph nodes draining the area of the flea bite become affected and the resulting adenitis produces intensely painful swellings or buboes in the inguinal axillary or cervical regions depending upon the position of the bite. Ref: ALevinson W. (2012). Chapter 20. Gram-Negative Rods Related to Animal Sources (Zoonotic Organisms). In W. Levinson (Ed), Review of Medical Microbiology & Immunology, 12e. | Microbiology | null | A 30 year old farmer presents with the features of high fever, painful inguinal lymphadenopathy, vomiting and diarrhoea with hypotension. Which of the following stain will be helpful in making the diagnosis?
A. Wayson's stain
B. Neisser stain
C. Albes stain
D. McFadyean's stain
| Wayson's stain |
26b1a380-7d06-49c1-b6b7-0c081a074f46 | Ans is 'b' i.e., ltraconazole o First choice drug for aspergillosis Voriconazole/Amphotericin B o Second choice drug for aspergillosis --> ltraconazole | Pharmacology | null | Best for systemic aspergillosus infection ?
A. Ketoconazole
B. Itraconazole
C. Fluconazole
D. Flucytocine
| Itraconazole |
fb6a892d-a588-4245-8ea3-109c3644b8ac | Ans is 'd' i.e. Von-Gogh * Dramatic self mutilation occurring in schizophrenia has also been called Von-Gogh syndrome.Culture-bound syndrome (folk illness)* It is a combination of psychiatric and somatic symptoms that are considered to be a recognizable disease only within a specific society or culture. There is no objective biochemical or structural alterations of body organs or functions, and the disease is not recognized in other cultures.Important culture-bound syndromesNameGeographical localization* Ataque de nervios* Hispanic people as well as in the Philippines* Dhat syndrome* India, Taiwan* Khyal cap* Combodia* Ghost sickness* Native Americans* Kufungisisa* Zimbabwe* Maladi moun* Haiti* Nervios* Latin America* Shenjing shuairuo* Chinese* Susto* Central America and South America* Taijin kyofusho* Japan* Amok* Indonesia; Malaysia* Koro* South-east Asia, India, China* Latah* Indonesia; Malaysia* Windigo* Indigenous people of north-east America | Psychiatry | Miscellaneous | Which of the following is not a culture bound syndrome
A. Amok
B. Latah
C. Dhat
D. Von-Gogh
| Von-Gogh |
16647cc5-923b-4acc-8261-123f1b3cc121 | Epidemic dropsy It is caused by contamination of mustard oil with 'Argemone oil'. Sanguinarine is the alkaloid toxin contained in argemone oil. The symptoms of epidemic dropsy consist of sudden,non-inflammatory, bilateral swelling of legs, often associated with diarrhoea, dyspnea, cardiac failure & death may follow. Some patients may develop glaucoma. The disease may occur at all ages except breast-fed infants. Moality varies from 5-50 per cent. | Social & Preventive Medicine | Miscellaneous | In Epidemic dropsy disease, toxin is:-
A. Ergot toxin
B. Sanguinarine
C. BOAA
D. Alkaloids
| Sanguinarine |
f7851b1b-d2dd-4722-b134-2cf6a278131a | Specific infections like syphilis, lupus, leprosy, and rhinoscleroma may cause destruction of the nasal structures leading to atrophic changes. Atrophic rhinitis can also result from long-standing purulent sinusitis, radiotherapy to nose or excessive surgical removal of turbinates. Extreme detion of nasal septum may be accompanied by atrophic rhinitis on the wider side. | ENT | null | A female presented with long standing nasal obstruction. She also complaints about comments from her friends telling about foul smell coming from her nose which she could not recognise. On evaluation, atrophic rhinitis is diagnosed. What can be the etiology in this patient to develop secondary atrophic rhinitis?
A. Chronic sinusitis
B. Nasal trauma
C. Oropharyngeal cancer
D. Strong hereditary factors
| Chronic sinusitis |
d12e78d3-6249-49de-8d70-680af7a2e738 | Patient has an “aleukemic” leukemia in which leukemic blasts fill the marrow, but the peripheral blood count of leukocytes is not high. The staining of the blasts suggests the presence of monoblasts (peroxidase negative and nonspecific esterase positive). So, the likely diagnosis for her is M5 leukemia, which is characterized by increased chances of tissue infiltration and organomegaly.
Other options:
Acute lymphoblastic leukemia is typically seen in children and young adults.
Acute megakaryocytic leukemia is typically accompanied by myelofibrosis and is rare. The blasts react with platelet-specific antibodies.
Acute promyelocytic leukemia (M3-AML) has many promyelocytes filled with azurophilic granules, making them strongly peroxidase positive. | Pathology | null | A 42-year old female presents with the complaint of bleeding gums for the past 20 days. Intra-oral examination shows thickened and friable gums. Also, she has hepatosplenomegaly with generalized non tender lymphadenopathy. The blood count reveals: Hemoglobin 11.4 g/dl, Platelet count 90,000/mm3, WBC count 4600/mm3. The bone marrow biopsy shows 100% cellularity, with many large blasts that are peroxidase negative and nonspecific esterase positive. Which of the following is the most likely diagnosis for this patient?
A. Acute lymphoblastic leukemia
B. Acute megakaryocytic leukemia
C. Acute promyelocytic leukemia
D. Acute monocytic leukemia
| Acute monocytic leukemia |
a744c6bb-c72d-49e0-a0d4-e1a49e62e7cf | Osteomeatal complex lies in the middle meatus. It is final common drainage pathway for the maxillary,frontal,and anterior ethmoid sinuses into the nasal cavity. Ref.Scott Brown 7/e,Vol 2 p 1345 | ENT | Nose and paranasal sinuses | Osteomeatal complex(OMC) connects:
A. Nasal cavity with maxillary sinus
B. Nasal cavity with sphenoid sinus
C. The two nasal cavities
D. Ethmoidal sinus with ethmoidal bulla
| Nasal cavity with maxillary sinus |
f6cdf47a-5e9c-42ac-9abb-e8aa3d128bcd | Paralysis occurs when potassium levels are <2.5 mEq/L. It usually stas in legs and moves to arms | Pediatrics | Disorders of Sodium and Potassium | The clinical consequences of hypokalemia in skeletal muscle include muscle weakness and cramps. What is the level of Serum Potassium at which Paralysis Is a possible complication of hypokalemia?
A. Serum Potassium at 2.0 mEq/L
B. Serum Potassium at 2.5 mEq/L
C. Serum Potassium at 3.0 mEq/L
D. Serum Potassium at 3.5 mEq/L
| Serum Potassium at 2.5 mEq/L |
088c9d93-1b8e-48e9-978b-f9dd690b1eac | Summon (subpoena) is a legal document compelling attendance of a witness in a court of law. | Forensic Medicine | null | A subpoena is a kind of -
A. Decomposed body tissue
B. Designation
C. Document
D. Court tribunal
| Document |
1dfebf58-56d7-48e7-ab5c-0d9c699e2e01 | Harrison's textbook of internal medicine 17the edition *CSF revealed a high leucocyte count (up to 1000/microL),usually with predominance of lymphocyte s ,but sometimes with predominance of neutrophils in early stage ,protein count of 1-8g/L and low glucose concentration . | Medicine | C.N.S | Which of the following is the classical CSF finding seen in TBM?
A. Increased protein, decreased sugar, increased lymphocytes
B. Increased protein, sugar and lymphocytes
C. Decreased protein, increased sugar and lymphocytes
D. Increased sugar, protein and neutrophils
| Increased protein, decreased sugar, increased lymphocytes |
bd4ef677-9e38-4540-9533-c9775ed7e3c2 | Sleeping sickness
Fever
Loss of nocturnal sleep
Headache
Feeling of oppression
Pruritis and maculopapular rashes
Weight loss
Arthralgia
Hepatosplenomegaly
Lymphadenopathy, particularly of the posterior triangle of the neck → Winter bottom's sign | Microbiology | null | Winter bottom's sign in sleeping sickness refers to-
A. Unilateral conjunctivitis
B. Posterior cervical lymphadenopathy
C. Narcolepsy
D. Transient erythema
| Posterior cervical lymphadenopathy |
1c3b18a3-b1a6-438b-a752-30411f8deb2a | Ans. is 'a' i.e., Pseudomembranous colitis & 'b' i.e., Nosocomical diarrhea * Cl difficle causes Clostridium difficle - associated diseases (CDAD).* CDAD is the most commonly diagnosed diarrheal illness acquired in the hospital.* C. difficle is acquired exogenously, most frequently in the hospital.* C. difficle is the most common bacterial cause of nosocomial diarrhea.* Diarrhea is the most common symptom of CDAD.* Pseudomembranous colitis is the advanced form of CDAD.* CDAD is almost exclusively associated with antibiotic use. It is caused most commonly by 2nd generation cephalospirinsy clindamycin, ampicillin and fluoroquinolones.* Other important risk factors (beside antibiotic use) are old age, GI surgery, use of electrical thermometer, use of antacids and PPIs, and prolonged hospital stay.* Pseudomembranous colitis is caused by two large toxins of Cl difficle1) Toxin A (enterotoxin) : Causes disruption of cystoskeleton by glycosylation of GTP-binding proteins.2) Toxin B (cytotoxin) : Has effect similar to toxin A. | Microbiology | Bacteria | Clostridium difficile causes -
A. Pseudomembranous colitis
B. Nosocomical diarrhea
C. Gas gangrene
D. Food poisoning
| Pseudomembranous colitis |
8fc055da-d19c-4db3-90ba-93c2cf84d8a3 | The tendon of inseion of adductor pollicis on the medial side of base of proximal phalanx of thumb contains a sesamoid bone.Reference: Textbook of anatomy, Upper limb, and thorax, Vishram Singh, 2nd edition, page no.144 | Anatomy | Upper limb | The muscle of hand that contains a sesamoid bone is
A. Flexor pollicis brevis
B. Flexor pollicis longus
C. Opponens pollicis
D. Adductor pollicis
| Adductor pollicis |
511ee778-4f6c-494c-b702-1b2c80b52bcd | Pearl index is defined as the number of failures per 100 woman years of exposure (HWY) Failure rate per Hundred Women Years = Total accidental pregnancies X 1200/ Total months of exposure Reference : Park&;s textbook of preventive and social medicine, 23rd edition, Page no: 510 | Social & Preventive Medicine | Demography and family planning | Pearls index
A. Per 10 woman years
B. Per 100 woman years
C. Per 1000 woman years
D. Per 10,000 woman years
| Per 100 woman years |
0e6b6057-7402-42b3-80d8-45e87a23bf77 | A small percentage of cancers present with enlarged lymph nodes in the jugular chain or pulmonary metastases with no palpable abnormality of the thyroid.
The primary tumor may be no more than a few millimetres in size and is termed occult. Such primary foci of papillary carcinoma may also be discovered in thyroid tissue resected for other reasons.
The term occult was formally applied to all papillary carcinomas less than 1.5 cm in diameter but the preferred terminology now is microcarcinoma for cancers less than 1 cm in diameter.
These have an excellent prognosis although those presenting with nodal or distant metastases justify more aggressive therapy". - Love & Bailey | Surgery | null | Occult thyroid malignancy with nodal metastasis is seen in -
A. Medullary carcinoma
B. Follicular ca
C. Papillary ca
D. Anaplastic ca
| Papillary ca |
1cae03a9-20b4-401c-9bd7-dc3714181799 | The pear shapped tumour from the cranial nerve VIII continue to enlarge and compress the trigeminal nerve. Cranial nerve 5 is the earliest nerve to be involved in Acoustic neuroma. The tumor is almost always arises from the Schwann cells of the vestibular, but rarely from the cochlear division of VIIIth nerve within the internal auditory canal. As it expands, it causes widening and erosion of the canal and then appears in the cerebellopontine angle. Here, it may grow anterosuperiorly to involve the IXth, Xth, and XIth cranial nerves. | ENT | null | Which cranial nerve is affected the earliest in acoustic neuroma?
A. CN 5
B. CN 7
C. CN 10
D. CN 9
| CN 5 |
07c5bf22-1ebb-4b91-a2fb-9c9830767761 | Decrease affinity of oxygen with hemoglobin-Oxygen hemoglobin curve shift to right -increaseddelivery of oxygen to the tissue Increase affinity of oxygen with hemoglobin -Oxygen hemoglobin curve shift to left- Increased delivery of oxygen to the HEMOGLOBIN in lungs Factors increase hydrogen ions (acidosis ) Increase CO2 Increase in temperature Increase in 2,3 DPG Exercise Pregnancy High altitude Hemoglobin S Factors decrease hydrogen ion (alkalosis ) Decrease CO2 Decrease in temperature Fetal hemoglobin Methemoglobinemia 2,3-Bisphosphoglycerate also known as 2,3-Disphosphoglycerate (2,3 BPG or 2,3-DPG) is the most abundant organic phosphate in the erythrocyte. 2,3-BPG is produced in the erythrocytes from an intermediate (1,3-bisphosphoglycerate) of glycolysis. This sho pathway is referred to as Rapapo-Leubering cycle. | Biochemistry | JIPMER 2018 | Which of the following decreases affinity of oxygen with hemoglobin?
A. Decreased H+ ions
B. 2,3 BPG
C. Decrease in temperature
D. Decreased sorbitol
| 2,3 BPG |
c08c3f20-0027-4c7b-99c2-4a8a4bacad6b | The organisms appear as large, nonseptate hyphae with branching at obtuse angles. Round or ovoid sporangia are also frequently seen in the tissue section.
Histopathologically, mucormycosis should be differentiated from aspergillosis in which the former has an acute angulating branched hyphae of smaller width and latter has septate branched hyphae.
Reference: Shafer’s Textbook of ORAL PATHOLOGY Eighth Edition page no 349 | Pathology | null | Non-septate hyphae with a tendency to branch at 90 degree angle is characteristic of:
A. Mucormycosis
B. Aspergillosis
C. Cryptococcus neoformans
D. Coccidioides immitis
| Mucormycosis |
6eb8fff2-6fd0-45d6-899c-fb8ce9c03aaf | Urea is a toxic waste product and it reabsorbed in minimal level.Ref: Ganong&;s Review of Medical Physiology; 24th edition; page no: 678 | Physiology | Renal physiology | Minimum reabsorption through renal tubule, among the following
A. Glucose
B. HCO3
C. Urea
D. Uric acid
| Urea |
0a447dda-60da-4c72-9dd8-9ed8099de88e | Formocresol is a solution of 19% formaldehyde, 35% cresol in a vehicle of 15% glycerine and water. To prepare a 1:5 concentration of this formula, first thoroughly mix 3 parts of glycerin with 1 part of distilled waler, then add 4 parts of this preparation to 1 part Buckley’s formocresol, and thoroughly mix again.
Key Concept
In formocresol, we use 19% formaldehyde and 35% cresol i.e. ratio of 1:2. | Dental | null | In formocresol, ratio of formalin to cresol:
A. 3:02
B. 2:03
C. 1:02
D. 2:01
| 1:02 |
65679a84-a18f-462a-86c9-9a0c7b9eec0b | Caudate lobe is segment I Quadrate lobe is segment IVa The caudate lobe (segment I) is the dorsal poion of the liver and embraces the IVC. It lies posterior to the left poal triad inferiorly and left and middle hepatic vein superiorly. Caudate lobe is unique in sense that it receives blood supply from both the right & left poal pedicles. bile ducts drain into both right & left hepatic ducts. its venous drainage is directly into the vena cava Ref : Schwaz 9/e p1095 | Anatomy | G.I.T | The caudate lobe of liver corresponds to which segment of Counaud's classification
A. Segment I
B. Segment II
C. Segment III
D. Segment IV
| Segment I |
10fcf69a-608c-4078-9366-bd836ec901f4 | Ans. is 'c' i.e., Chemostat device Bacterial cultures can be maintained in a state of exponentional growth over long periods of time using a system of continuous culture. Continuous culture, in a device called chemostat, can be used to maintain a bacterial population at a constant density, a situation that is, in many ways, more similar to bacterial growth in natural environments. In a chemostat microbial cells are grown at a steady state where cell biomass production, substrates and products concentrations remains constant, and growth occurs at a constant rate. These features make a chemostat unique and powerful tool for biological and physiological research. | Microbiology | null | Continuous cell culture of bacteria
A. U tube
B. Craige tube
C. Chemostat device
D. Agar dilution method
| Chemostat device |
8f70097e-fa15-4f35-85bb-da68c9c83024 | The superior vena cava syndrome usually is caused by neoplasms that compress or invade the superior vena cava, such as bronchogenic carcinoma or mediastinal lymphoma. -produces a characteristic clinical complex consisting of marked dilation of the veins of the head, neck, and arms associated with cyanosis. -Pulmonary vessels also can be compressed, causing respiratory distress. | Pathology | Lung Tumor | Which is the most common tumor associated with superior vena cava syndrome?
A. Lung cancer
B. Lymphoma
C. Metastasis
D. Thyroid cancer
| Lung cancer |
600057d1-acc5-4004-8a9a-64a218df1850 | Ans. is a, i.e. Tay-Sachs diseaseRef. JB Sharma TB of Obs pg 161; Williams Obs 25/e, p 296Ref Operative Obs and Gynae by Randhir Puri, Narendra Malhotra 1/e, p 261, 262; Obs. and Gynae Beckmann 5/e, p 45In chorionic villous biopsy, trophoblastic tissue is obtained from the chorionic villi, followed by biochemical or molecular (DNA) analysis or chromosomal analysis of this tissue to diagnose various conditions.Conditions which require molecular or DNA analysisConditions which require biochemical analysis* Hemoglobinopathies* Sickle cell disease* Alpha thalassemia* Beta thalassemia* Hemophilia A or B* Duchenne muscular dystrophy* Cystic fibrosis* Alpha-1 antitrypsin deficiency* Tay Sach's disease* Tay Sach's disease* Niemann Pick disease* Gaucher's disease* Urea cycle defects* Amino acid disorder* Congenital adrenal hyperplasia* PhenylketonuriaFor diagnosis of Tay Sach's disease biochemical analysis and DNA analysis of chorionic villous sample is done (not DNA analysis). For rest all options only DNA analyses would do that is why I am picking that option. | Gynaecology & Obstetrics | Diagnosis in Obstetrics | DNA analysis of chorionic villus/amniocentesis is not likely to detect:
A. Tay-Sach's disease
B. Hemophilia A
C. Sickle cell disease
D. Duchenne muscular dystrophy
| Tay-Sach's disease |
113a2d25-3955-4c22-af7e-c5f7a06cbaa5 | Tuberculosis is a chronic, communicable disease in which the lungs are the prime target. The disease is caused principally by Mycobacterium tuberculosis hominis (Koch bacillus), but infection with other species occurs, notably M. tuberculosis bovis (bovine tuberculosis). Primary tuberculosis consists of lesions in the lower lobes and subpleural space, referred to as the Ghon focus. The infection then drains to hilar lymph nodes. The combination of Ghon focus and hilar lymphadenopathy is known as "Ghon complex." The typical lesion of tuberculosis is a caseous granuloma, with a soft core surrounded by epithelioid macrophages, Langhans giant cells, lymphocytes, and peripheral fibrosis. Noncaseating granulomas (choice D) are a feature of sarcoidosis, among other causes.Diagnosis: Primary tuberculosis | Pathology | Infectious Disease | A 37-year-old man is admitted to the hospital with a productive cough, fever, and night sweats. An X-ray film of the chest shows an ill-defined area of consolidation at the periphery of the right middle lobe and mediastinal lymphadenopathy. Sputum culture grows acid-fast bacilli. Lymph node biopsy in this patient would most likely show which of the following pathologic findings?
A. Caseating granulomas
B. Follicular hyperplasia
C. Nodular amyloidosis
D. Noncaseating granulomas
| Caseating granulomas |
ae1daee7-049a-4740-b7d2-4bc82b4aa1ed | c. Neuroblastoma(Ref: Nelson's 20/e p 2464-2466, Ghai 8/e 617-618)Neuroblastoma is the most common extracranial solid tumor in childrenLocalized Neuroblastoma can manifest as an asymptomatic mass or can cause symptoms because of the mass itself, including spinal cord compression, bowel obstruction & superior vena cava syndrome.Note: Both Neuroblastoma & Wilms' tumor can present as abdominal mass in children but Neuroblastoma is more common than Wilms' tumor, so it is the better answer to this question | Pediatrics | Childhood Tumors | Most common abdominal mass in children:
A. Hydronephrosis
B. Wilms' tumor
C. Neuroblastoma
D. Rhabdomyosarcoma
| Neuroblastoma |
32dbef97-470a-4371-9d8d-916aba690207 | (A) Cleaning hands with spirit before and after examiation of each patient > Introduction of easily accessible dispensers with an alcohol-based waterless handwashing antiseptic led to significantly higher handwashing rates among health care workers. | Social & Preventive Medicine | Miscellaneous | Healthworker-hand washing
A. Cleaning hands with spirit before and after examination of each patient
B. Visible blood stain on hand is washed with soap and water
C. Use of soap an Dettol only for hand washing before surgery
D. Hand rub cannot be used in place of hand washing
| Cleaning hands with spirit before and after examination of each patient |
d49fcebe-a343-4abc-a215-cff9e95e40ca | Shenton line is an imaginary curved line drawn along the inferior border of the superior pubic ramus (superior border of the obturator foramen) and along the inferomedial border of the neck of femur. Ref essentials of ohopaedic maheshwari and mhaskar 6/e p150 | Physiology | All India exam | Shenton line is seen in X-ray of
A. Knee
B. Shoulder
C. Elbow
D. Hip
| Hip |
a5a31bbf-a1e6-4d80-b54e-e73e26ba4c8a | Ans. is 'a' i.e., Pulmonary edema Pulmonary edema is due to Lt sided hea failure that results in increased back pressure in pulmonary circulation. Signs of CHF in infants Left sided failure Tachypnea Tachycardia Cough Wheezing Rales in chest Hoarse Cry Failure of either side Cardiac enlargement Gallop rhythm (S3) Peripheral cyanosis Small volume pulse Absence of weight gain Oliguria Pulmonary edema Edema of feet Right sided failure Hepatomegaly Facial edema Jugar venous engrogment Ascites may occur in older children. | Pediatrics | null | Which of the following is not a characteristic of right sided failure -
A. Pulmonary oedema
B. Ascites
C. Oliguria
D. Dependent
| Pulmonary oedema |
3d81e630-7f3d-4861-94d4-5e0e2723c73d | Indeterminate leprosy is characterized by: a. Solitary, hypo pigmentary patch over face in a child b. Scaling absent c. Atrophy present d. Patient from endemic area eg Bihar, Jharkhand, Chhattisgarh Differential diagnosis Pityriasis alba Intermediate leprosy Solitary, hypo pigmentary patch over face in a child + + Scaling + - H/O of Atopy + - H/o Atrophy - + Sensation Intact Impaired Histology Spongiosis Perifollicular paraneural lymphocytic infilterate Treatment Self limiting Paucibacillary- multi drug therapy | Dental | Mycobacterial Infections | An 8 years old boy from Bihar presents with a 6 months history of an ill defined, hypopigmented slightly atrophic macule on the face. The most likely diagnosis is:
A. Pityriasis alba
B. Indeterminate leprosy
C. Vitiligo
D. Calcium deficiency
| Indeterminate leprosy |
4cf89529-3e94-4f0f-a383-c68f9b66908f | Hashimoto&;s Thyroiditis Biopsy features of lymphocytic infiltrate along with huhle cell change in thyroid swelling is diagnostic of hashimoto&;s thyroiditis ref : robbins 10th ed | Pathology | All India exam | A 25yr old male with thyroid swelling Biopsy shows intense lymphocytic infiltration along with huhle cell change TSH increased
A. Hashimoto's thyroiditis
B. Grave's disease
C. follicular carcinoma
D. Medullary carcinoma thyroid
| Hashimoto's thyroiditis |
ac5e62fd-723e-465b-ba02-cc84adfa210a | Lineage specific B cell marker is CD 19. However on IHC the best marker is CD 20. CD 21 is the receptor for EBV | Unknown | null | The lineage specific marker for B cells is
A. CD 19
B. CD 20
C. CD 21
D. CD 22
| CD 19 |
8563e2f8-eb30-48b9-b00c-5423912e8e70 | Metaplasia Metaplasia is an adaptive change in which one adult (mature) cell type is replaced by another adult (mature) cell. In this differentiation is not lost, rather it changes from one lineage to another, i.e. stems cell differentiates along a new pathway. But, the resulting cells are fully mature and differentiated. It is reversible. There is no pleomorphism, and cell polarity as well as cell & nuclear size are not altered. Dysplasia Dysplasia means disordered (abnormal) growth ---> there is disordered differentiation and maturation. This generally consists of an expansion of immature cells, with a corresponding decrease in the number and location of mature cells there is loss of uniformity of individual cells. Dysplastic cells show following feature Loss of polarity Hyperchromatosis Increased nuclear cytoplasmic size ratio (normal 1:4 to 1:6). Pleomorphism Increased number of mitosis with normal pattern. Dysplasia is parially reversible, i.e. It is reversible in early stage and later on it is irreversible. Term Dysplasia is usually used, when these changes occur in epithelium. When dysplastic changes involve the entire thickness of epithelium, it is concidered as preinvasive lesion and is referred to as carcinoma in situ. Anaplasia Anaplasia means lack of differentiation. That means anaplastic cells resemble primitive appearing, unspecialized (undifferentiated) cells. o Anaplasia is seen only in malignancy. Anaplastic cell shows - Loss of polarity Hyperchromatasia Increased nuclear cytoplasmic cell ratio Pleomorphism Increased number of mitosis which is atypical Anaplasia is irreversible. | Pathology | null | Reversible loss of polarity with abnormality in size and shape of cells is known as -
A. Metaplasia
B. Dysplasia
C. Hyperplasia
D. Anaplasia
| Dysplasia |
ad067894-8a87-4b25-b8e2-19dff2d96652 | Dissociative amnesia is the most common type of dissociative disorder. | Psychiatry | Neurotic, Stress Related and Somatoform Disorders | The most common form of dissociative hysteria is:
A. Fugue
B. Amnesia
C. Multiple personality
D. Somnambulism
| Amnesia |
d69e0e55-7d2d-4ce6-bad4-6a8ebbb3cb42 | Ans. (a) NK cell(Ref: Wintrobe's clinical hematology - 12th ed, pg 300; Robbins 9th/pg 192; 8th/pg 188)Most lymphocytes in blood are small (<=10mm), while some are large, known as large granular lymphocytes (LGL), as they contain azurophilic granules in their cytoplasm.These cells are LGL type of natural killer (NK) cells. | Pathology | Immunity | Which is a large granular lymphocyte?
A. NK cell
B. B-lymphocyte
C. T-lymphocyte
D. Macrophage
| NK cell |
ae30ac4b-f517-42a9-9685-8dec94394f57 | question repeated In pathology, Schaumann bodies are calcium and protein inclusions inside of Langhans giant cells as pa of a granuloma. Many conditions can cause Schaumann bodies, including: Sarcoidosis, Hypersensitivity pneumonitis, and Berylliosis. uncommonly, Crohn's disease and tuberculosis. | Pathology | Respiratory system | Schaumann bodies are seen in -
A. Sarcoidosis
B. Chronic bronchitis
C. Asthma
D. Syphilis
| Sarcoidosis |
623b2f94-0277-4ccd-9cfd-68bd8a6085fa | Nucleus ambiguus consists of large motor neurons and is situated deep within the reticular formation. The emerging nerve fibers join the glossopharyngeal, vagus and cranial pa of the accessory nerve and are distributed to voluntary skeletal muscle. The neurons in the nucleus ambiguus innervate the ipsilateral laryngeal, pharyngeal, and tongue muscles involved in breathing and in maintaining the patency of the upper airway. Ref: Clinical Neuroanatomy By Richard S. Snell, 2010, Page 204. | Anatomy | null | Which of the following nucleus in brain is common to IX, X & XI cranial nerves?
A. Nucleus solitarius
B. Nucleus ambiguus
C. Dentate nucleus
D. Red nucleus
| Nucleus ambiguus |
61fcf97e-b743-43bf-a4ad-86dcc8985e74 | (D) HOCM# Physical findings of HCM are associated with the dynamic outflow obstruction that is often present with this disease.> Upon auscultation, the heart murmur will sound similar to the murmur of aortic stenosis.> However, a murmur due to HCM will increase in intensity with any maneuver that decreases the volume of blood in the left ventricle (such as standing abruptly or the strain phase of a Valsalva maneuver). Administration of amyl nitrite will also accentuate the murmur by decreasing venous return to the heart.> Classically, the murmur is also loudest at the left parasternal edge, 4th intercostal space, rather than in the aortic area.> If dynamic outflow obstruction exists, physical examination findings that can be elicited include the pulsus bisferiens and the double apical impulse with each ventricular contraction.> A double apical impulse may be recognized, particularly with the patient in the left lateral recumbent position. | Medicine | Miscellaneous | A double apical impulse is seen in
A. AS & AR
B. TR&TS
C. MI
D. HOCM
| HOCM |
60372da3-86a2-4148-aadd-dadd149a41dc | Ans. a. Propofol (Ref: Miller's Anesthesia 8/e p726; Lee 13/e p158-160; Morgan 3/e 173, 884)Propofol is used in day care surgery.'Any induction agents used in day-case anesthesia should ensure a smooth induction, good immediate recovery and a rapid return to street fitness. Propofol is now used widely as the primary induction agent, which has advantage of rapid recovery and low incidence of post-operative nausea and vomiting.'Preferable agents in Day Care AnaesthesiaMivacuriumQ (muscle relaxant of choice, shortest duration of action)SuccinylchoIineQ (for Ultra short period of profound muscle relaxation: Disadvantage: Post-operative myalgia)lsofluraneQ (volatile inhalational agent)AlfentanylQPropofolQ (inducing agent of choice)MidazolamQ (for initial anaxiolysis and sedation)Mnemonic: Manmohan Singh Is A Prime Minister | Anaesthesia | Miscellaneous General Anesthesia | Which of the following agent is used in day care surgery?
A. Propofol
B. Thiopentone
C. Ketamine
D. Diazepam
| Propofol |
131553a7-e03a-49c4-ac0e-c467fbe039a2 | Ans: c (Folic acid) Ref: Dutta, 6th ed, p. 104, 409Folic acid is supplemented in the first trimester to prevent neural tube defects.Folic acid supplementation:1. Normal pregnancy -0.5 mg in first trimester2. Pregnancy with history of NTD - folic acid 4mg daily, 1 month before conception continued for 12 weeks of pregnancy.Folic acid requirements - ICMR recommendations:1. Healthy adults -100 pg / day2. Pregnancy - 400 pg / day3. Lactation -150 pg /day4. Children -100 pg / dayBRIDGE:unmanifested deficiency of folic acid has been implicated as a cause of abruption placenta. | Gynaecology & Obstetrics | Miscellaneous (Gynae) | Which of the following can prevent neural tube defects in pregnancy?
A. Iron
B. Vit B12
C. Folic acid
D. Zinc
| Folic acid |
dbb6d2a3-741b-43c9-a17e-ba5b2d2ebbcc | Ans. is 'c' i.e., Focal nodular hyperplasia Liver parenchyma is primarily made up of two types of cells. i) Hepatocytes -> Perform excretory and synthetic function ii) Kupffer cells -> They have reticuloendothelial function Both these cells can be investigated with 99mTc labelled cells. Two types of radionucleide imaging procedure are used in liver Hepatocyte based imaging (IDA Imaging) - IDA compound are taken up by functioning hepatocytes, excreted unchanged in the bile and are not reabsorbed from the gut This propey of IDA compounds is used in imaging of liver and biliary tract. It will allow the imaging of functioning liver parenchyma and trace the flow of the bile, in the ducts, gall bladder and bowel - Its clinicals use are i) Assessment of regional liver function ii) Demonstration of bile leaks in liver trauma iii) Investigation of biliary obstruction iv) Choledochal cyst v) Demonstration of gall bladder function including cystic duct obstruction as a marker of acute cholecystitis. - Remember the question asked about the use of HIDA scan in acute cholecystitis. If the gall bladder is not demonstrated by 4 hrs it is a good indicator of acute cholecystitis due to mechanical or functional obstruction of cystic duct. vi) Differentiation of hepatocellular tumours. | Surgery | null | Which one of the following hepatic lesions can be diagnosed with high accuracy by using nuclear imaging ?
A. Hepatocellular Carcinoma
B. Hepatic Adenoma
C. Focal Nodular Hyperplasia
D. Cholangiocarcinoma
| Focal Nodular Hyperplasia |
8d67fe49-250d-42f5-8fc0-4d1b5e9fd530 | Muscle Action Pectoralis major Adducts and medial rotation of arm Pectoralis minor Stabilizes the scapula Subclavius anchors and depresses the scapula Serratus Anterior protracts the scapula laterally rotates the scapula overhead abduction | Anatomy | Upper limb bones and muscles (proximal region) & Scapular movements | Flexion, adduction and medial rotation of arm is done by which muscle
A. Serratus Anterior
B. Pectoralis major
C. Pectoralis minor
D. Subclavius
| Pectoralis major |
a445135c-63c6-4f7d-aa83-557cce127f02 | Ans.B Nicotinic acidLIPID-LOWERING AGENTSDrugEffect on LDLEffect on HDLEffect on triglyceridesSide effects/problemsHMG-CoA reductase Inhibitors(Lovastatin, Simvastatin) pravastatin, Atorvastatin)|||||Expensive, reversible LFT's MyositisNiacin|||||Red, flushed fate, which is by aspirin or long-term useBile acid resins(cholestyramine)||?Slightly |Patients hate it-tastes bad and causes GI discomfortCholesterol absorption blocker (ezetimibe)|| -Rare | LFTs"Fibrates" (gemfibrozil, clofibrate, bezafibrate, fenofibrate)|||||Myosistis, | LFTsFenofibrate: Another 2nd generation prodrug fibric acid derivative which has greater HDL-CH raising and greater LDL- CH lowering action than other fibrates: may be more appropriate as an adjunctive drug in subjects with raised LDL-CH levels in addition to raised TG levels. No rise in LDL-CH has been observed in patients with high TG levels. Its t 1/2 is 20 hr. Adverse effects are myalgia, hepatitis, rashes. Cholelithiasis and rhabdomyolysis are rare. Fenofibrate appears to be the most suitable fibrate for combining with statins, because statin metabolism is minimally affected and enhancement of statin myopathy risk is lower. Indications of fenofibrate are similar to that of gemfibrozil. Gemfibrozil is the drug of choice for patients with markedly raised TG levels, whether or not CH levels are also raised. Episodes of acute pancreatitis are prevented in patients with chylomicro naemia and severe hypertriglyceridaemia. It is mo*t effective in type III hyperlipoproteinaemia; also a first line drug in type IV and type V disease. | Unknown | null | In a patient with poor glycemic control, hypertriglyceridemia, low HDL, which of the following drug Rx would be best without the risk of myositis as its side effect?
A. Fibric acid derivatives
B. Nicotinic acid
C. Atorvastatin
D. Simvastatin
| Nicotinic acid |
01781155-df77-4ccc-ac81-ee350dd1ed2d | Most common cause of primary hyperparathyroidism is autonomous secretion of parathyroid hormone (PTH) by a parathyroid adenoma. Single adenoma (90%), multiple adenomas(4%), nodular hyperplasia(5%), carcinoma(1%). Reference : page 769 Davidson's Principles and practice of Medicine 22nd edition | Medicine | Endocrinology | Most common cause of primary hyperparathyroidism-
A. Iatrogenic
B. Medullary carcinoma thyroid
C. Parathyroid adenoma
D. Parathyroid hyperplasia
| Parathyroid adenoma |
600c6294-b6d3-42ed-bc10-318e605cd566 | (Retinoblastoma): Ref: 280-KH, 358-K, 397-PRETINOBLASTOMA - is the most common primary intraocular malignancy of childhood.* The retinoblastoma may be heritable (40%) or non heritable (60%)* The predisposing gene (RPE1) is at 13q14* Leukocoria (white papillary reflex) is the commonest (60%) presentation* Delation involving the long arm of chromosomes 22 (22ql 1) are most common microdeletions identified to date, VCF (Velo Cardio Facial) syndrome is the most common associated syndromeTreatments1. Small tumour - no more than 4 mm diameter and 2 mm thickness without vitreous or subretinal seeds - Trans papillary thermotherapy laser or cryotherapy2. Median size tumour(I) Brachytherapy - is indicated for tumours of no more than 12 mm diameter and 6 mm thickness (60Co or I125)(II) Chemotherapy - (Carboplatin, vincristine, etoposide) may be combined with cyclosporin(III) External beam radiotherapy - should be avoided, because high risk of complications, cataract formation, radiation retinopathy and cosmetic deformity and secondary malignancy.3. Large tumours (a) Chemotherapy (b) Enucleation4. Extra ocular extension - beyond the lamina cribosa is treated with chemotherapy after enucleation* Extension to the cut end of the optic nerve or extension through the sclera - chemotherapy and irradiation of the affected orbit5. Metastatic disease: - High dose chemotherapy Enucleation is the treatment of choice when the child is brought in clinical stage II or late stage I (when tumour is more than 100 mm in size or when optic nerve is involved) (270-KH) | Ophthalmology | Tumors | Which of the following is commonest primary intraocular tumour in childhood is
A. Neurofibromatosis
B. Retinoblastoma
C. Cavernous haemangioma
D. Melanotic melanoma
| Retinoblastoma |
36fe2959-43b2-4e8c-8aa6-3c42e2e84ef9 | Ans. is 'c' i.e., Increased intracellular Ca o The mechanism involves a sudden rise in intracellular calcium due to release of stored calcium in sarcoplasmic reticulum, stimulating contraction, rhabdomyolysis and a hypermetabolic state.o Tachycardia and not bradycardia, is a feature of malignant hyperthermia.MALIGN ANT HYPERTHERMIAo Malignant hyperthermia is a life-threatening medical emergency which is genetically determined. The condition occurs during or immediately after anaesthesia and may be precipitated by potent inhalational agents,o The mechanism involves a sudden rise in intracellular calcium due to release of stored calcium in sarcoplasmic reticulum stimulating contraction, rhabdomyolysis and a hypermetabolic state.Drugs causing malignant hyperthermia# Succinylcholine# Desflurane# Tricyclic antidepressants# Halothane# Cyclopropane# Phenothiazines# Isoflurane# Ether# Lignocaine# Enflurane# Methoxyflurane # Sevoflurane# MAO inhibitors o Succinylcholine is the most common cause of MHoAmongst inhalational agents halothane is the most common cause.o Combination of Sch and Halothane has a much higher incidence.Clinical featureso Masseter spasm - if a patient develops severe masseter spasm after suxamethonium, there is a significant possibility of malignant hyperthermia.o Tachycardia, arrhythmias and hypertension.o Hyperthermiao Rise in end-tidal CO2 - May rise to more than 100 mm Hg (normal is 32-42 mm Hg). It is the earliest and most sensitive indicator.o Hyperkalemia, metabolic acidosis, elevated creatininephosphokinase, muscle rigidity,o Increased myoglobin, renal failure.o Muscle biopsy contracture test (definitive diagnostic procedure) :- The muscle biopsy contracture test is the most sensitive and specific test. The Caffeine Halothane Contracture test (CHCT), a test performed on freshly biopsied muscle; is the "gold standard" for diagnosis of malignant hyperthermia. However, the test is available only at few centers in the world (only about 30 centers world wide) and it is very costly. The CHCT test should be considered for all those judged to be at significant risk for malignant hyperthermia, either through family history, or by elicitation of signs of an episode of malignant hyperthermia, or if there had been any previous uncharacterized adverse reaction to a general anesthetic.Managemento Stop all anaesthetics immediately,o Hyperventilation with 100% oxygeno Cooling of body by ice coolingo Correct acidosis and hyperkalemia,o Maintain urine output,o IV dantrolene is the drug of choiceo Procaine is the local anaesthetic of choice for malignant hyperthermia patients,o Propofol is the intravenous anaesthetic of choice for malignant hyperthermia patient | Anaesthesia | Depolarising Neuromuscular Blocking Agents | Malignant hyperthermia is caused due to which of the following mechanism?
A. Increased intracellular Na
B. Decreased intracellular chlorine
C. Increased intracellular Ca
D. Increased serum K
| Increased intracellular Ca |
2b9df3f4-5aeb-4ec2-b560-c75fcbc34fb4 | -Right Posterior cardinal veins contribute to inferior vena cava and common iliac veins. Left anterior and Left posterior cardinal veins regress - Superior vena cava and jugular veins develop from anterior cardinal veins. | Anatomy | Bronchopulmonary Segments, Embryonic veins | Posterior cardinal vein develops into:
A. Superior vena cava
B. Internal jugular vein
C. External jugular vein
D. Common iliac vein
| Common iliac vein |
2ec531ce-6b21-4ff1-a38d-c3adfb3a3d3c | Long-standing inflammatory conditions such as rheumatoid ahritis (RA) are associated with deposition of a form of amyloid known as AA (amyloid-associated protein), which may involve kidneys, hea, liver, skeletal muscle, and skin, for example. Amyloid deposition in the myocardium results in decreased compliance and impaired diastolic filling, i.e., restrictive cardiomyopathy. The myocardium has a rigid and waxy texture. This form of amyloid, as well as any other biochemical form, can be visualized on tissue section by staining with Congo red, which acquires a characteristic apple-green birefringence under polarized light. Constrictive pericarditis is due to any pathologic process that results in fibrous thickening of the pericardium, with resultant impaired compliance. Clinically, therefore, this condition manifests with a picture similar to restrictive cardiomyopathy because of impaired diastolic filling. Constrictive pericarditis is usually caused by previous episodes of acute pericarditis, especially hemorrhagic, suppurative, and caseous pericarditis. Dilated cardiomyopathy is characterized by massive ventricular dilatation and may be caused by genetic alterations, myocarditis, toxic insults (alcohol), metabolic disorders (hemochromatosis), etc. Most cases are idiopathic. The main pathophysiologic alteration is impaired contractility. You may be tempted to think that this patient is prone to developing hypersensitivity myocarditis, but this form of myocardial disease has been repoed after treatment with some antihypeensive agents,antibiotics, diuretics and not with coicosteroids or NSAIDs. Fuhermore, myocarditis manifests acutely with arrhythmias and hea failure, and chronically with dilated cardiomyopathy and congestive hea failure. Ref: Hoit B.D. (2011). Chapter 34. Restrictive, Obliterative, and Infiltrative Cardiomyopathies. In V. Fuster, R.A. Walsh, R.A. Harrington (Eds), Hurst's The Hea, 13e. | Medicine | null | A 52 year old woman has long standing rheumatoid ahritis (RA) and is being treated with coicosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs). Which of the following cardiac complications may arise in this clinical setting?
A. Constrictive pericarditis
B. Dilated cardiomyopathy
C. Hypersensitivity myocarditis
D. Restrictive cardiomyopathy
| Restrictive cardiomyopathy |
4fecaecb-f4fb-4e32-9ff4-438ccc96e14b | Bleeding time is prolonged in all the platelet disorders like ITP ,TTP and heparin and also prolonged in all types of coagulation disorders and DIC Where is it is normal in vascular diseases like vascular purpuras Reference: textbook of Pathology, 7th edition author Harsha Mohan, page number 317 | Pathology | Haematology | Bleeding time is not prolonged in-
A. Von Willebrand's disease
B. Christmas disease
C. Haemophilia
D. Polycythemia
| Polycythemia |
e47e7e6f-5ce1-4ed2-85ee-fab32e92a9a4 | Atropine is highly selective for muscarinic receptors. Its potency at nicotinic receptors is much lower, and actions at nonmuscarinic receptors are generally undetectable clinically.The effectiveness of antimuscarinic drugs varies with the tissue and with the source of agonist. In most tissues, antimuscarinic agents block exogenously administered cholinoceptor agonists more effectively than endogenously released acetylcholine.Tissues most sensitive to atropine are the salivary, bronchial, and sweat glands.Secretion of acid by the gastric parietal cells is the least sensitive. Katzung 13e pg: 122 | Pharmacology | Autonomic nervous system | The tissues most sensitive to atropine are
A. The salivary, bronchial and sweat glands
B. The gastric parietal cells
C. Smooth muscle and autonomic effectors
D. The hea
| The salivary, bronchial and sweat glands |
00aa7367-b008-4efc-adc3-395cc46f6537 | Ans. is 'a' i.e., Rheumato.id arthritis Scleritiso Scleritis is an uncommon disorder which is characterized by cellular infiltration, destruction of collagen and vascular remodelling. Scleritis is usually a bilateral disease and occurs most frequently in women. It is associated with connective tissue diseases in 50% of cases. Rheumatoid arthritis is the most common association . Other important causes are PAN, SLE, Ankylosing spondylitis, Wegener's granulomatosis, dermatomyositis, Reiter's syndrome, Non- specific arteritis, Polychondritis and Gout.Clinical features of Scleritiso Patients complain of moderate to severe pain which is deep and boring in character and often wakes thepatient early in the morning. Ocular pain radiates to the jaw and temple. It is associated with localised or diffuse redness, mild to severe photophobia and lacrimation. Occasionally there occurs diminution of vision.Complicationso Complications are common in necrotizing scleritis and include sclerosing keratitis, Keratolysis, Complicated cataract, Uveitis and secondary glaucoma. Rarely, scleritis may also cause retinal detachment and macular edema. These are due to spread of inflammation from sclera into the uveal tract. | Ophthalmology | Miscellaneous (Sclera) | Most common cause of scleritis -
A. Rheumatoid arthritis
B. SLE
C. Sjogren's Syndrome
D. Behcet's Disease
| Rheumatoid arthritis |
df5a4187-8358-415b-a0e1-a26978635007 | Ans. is 'a' i.e., Fatty acid synthesisUses of NADPH:* Reductive biosynthesis of lipids# Fatty acid synthesis# Cholesterol synthesis# Steroid hormone synthesis# Fatty acid elongation# Bileacid synthesis | Biochemistry | Carbohydrates | NADPH used in which pathway-
A. Fatty acid synthesis
B. Gluconeogenesis
C. Beta oxidation
D. Glycogenolysis
| Fatty acid synthesis |
557e987f-c745-4911-b42b-f281e69b4e1d | From the history and clinical findings,the patient is having chronic obstructive pulmonary disease-emphysematous type.it is characterised by hyperinflation of lungs with low set diaphragm.Breath sounds are typically quiet.Right hea failure and cor pulmonale can occur in severe cases,evident as bilateral pitting pedal edema. Ref:Harrison's medicine-18th edition,page no:2156;Davidson's medicine-22nd edition,page no:674. | Medicine | Respiratory system | A 60-year old male has a long 5tanding history of breathlessness lie has been a heavy smoker since the age of 20 years. Physical examination reveals an anxious male who is emaciated, puffing for breath but is not cyanosed. The chest is barrels shaped. An additional clinical finding would be -
A. Elevated domes of the diaphragm
B. Left ventricular hyperophy
C. Muffled hea sounds
D. Gynecomastia
| Muffled hea sounds |
94817898-83ed-4765-b6ed-89a2e61edac2 | Up to a half of all patients with colorectal cancer will develop liver metastases at some point and regular imaging of the liver (by ultrasound and CT scan) and measurement of carcinoembryonic antigen (CEA) is designed to diagnose this early, in order to allow curative metastectomy. Trials of the optimum follow-up pathway have suggested that CEA measurement alone can be as effective as regular imaging.Ref: Bailey and Love, 27e, page: 1266 | Surgery | G.I.T | Tumor marker for Ca colon for follow up
A. CEA
B. CA 125
C. CA 19-9
D. AFP
| CEA |
4924fce7-eb5f-455f-9078-c0e1f7338e09 | Loco parentis In an emergency involving children, when their parents or guardian are not available, consent can be taken from the person who is in charge of the child, eg. teacher or the principal of the residential school. They can give consent in the place of the parent. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 385 | Forensic Medicine | Medical Jurisprudence | If parents or guardian is not available consent can be taken from teacher or principal under
A. Therapeutic privilege
B. Emergency doctrine
C. Loco parentis
D. Therapeutic waiver
| Loco parentis |
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