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3e9dcb9e-8c8d-4082-aab0-015d188ce291 | Loop diuretics increase prostaglandin production by stimulating Cycloxygenase enzyme (COX) and NSAIDs attenuate the diuretic action of these drugs. | Pharmacology | null | NSAIDs attenuate action of which of the following diuretics:
A. Carbonic anhydrase inhibitors
B. Loop diuretics
C. Thiazide diuretics
D. Spironolactone
| Loop diuretics |
98cd9dca-cfea-4856-915f-dd34ff981322 | Ans. is 'd' i.e., Mycoplasma . Unique among prokaryotes is the requirement of most mycoplasma for cholesterol and related sterols, which are incorporated in their surface membrane. | Microbiology | null | Which one of the following needs cholesterol and other lipids for growth -
A. Mycobacterium TB
B. Chlamydia
C. Hemophilus
D. Mycoplasma
| Mycoplasma |
18269b74-4837-43b7-96ed-d191f63e35d2 | Mosty likely diagnosis in this patient is aldosterone secreting tumor (adenoma) leading to primary hyperaldosteronism (Conn's Syndrome). Aldosterone excess will cause hypeension, hypokalemia, metabolic alkalosis and depressed renin. Aldosterone antagonists such as spironolactone or eplerenone can be used as medical therapy for Conn's syndrome. | Pharmacology | Kidney | A 30-year-old male, Rajinder presents to your office with fatigue, muscle weakness and headache. His blood pressure is 170/120 mm Hg and his hea rate is 100/min. Laboratory evaluation reveals hypokalemia, metabolic alkalosis and decreased plasma renin activity. On CT scan, a mass was noted on left suprarenal gland. Patient was prescribed a drug for few weeks and the symptoms subsided. Laboratory values and blood pressure returned to normal values. The likely drug given to this patient is?
A. Clonidine
B. Propanolol
C. Hydrochlorothiazide
D. Spironolactone
| Spironolactone |
b1bd2eff-fb59-40ec-9f35-c5dcef85b29e | Meig's syndrome is present with ovarian fibroma, ascites and right sided pleural effusion Any other ovarian tumor or a pedunculated fibroid causing ascites with pleural effusion is known as Pseudo Meig's syndrome Most common cause of Pseudo meig's syndrome is Brenner tumor. | Gynaecology & Obstetrics | Ovarian Tumors | Meig's syndrome is commonly associated with:
A. Teratoma
B. Brenner tumour
C. Fibroma
D. Theca cell tumour
| Fibroma |
f68e192e-0a3a-452e-8221-96e3fa7b0d19 | Ans. is 'd' i.e., Middle genicular branch of popliteal aery Oblique popliteal ligament It is an expansion from the tendon of semimembranosus attachment to intercondylar line of femur.It is closely related to popliteal aery and is pierced by middle genicular vessels and nerve and the terminal pa of the posterior division of the obturator nerve. | Anatomy | null | Oblique popliteal ligament is pierced by ?
A. Anterior branch of popliteal aery
B. Medial inferior genicular branch of popliteal aery
C. Medial superior genicular branch of popliteal aery
D. Middle genicular branch of popliteal aery
| Middle genicular branch of popliteal aery |
bb5dda5b-b7a0-48ab-8509-d74fcd374c53 | Ans. (A) Phosphodiesterase 4 inhibition(Ref: Katzung 11th/e p345; KDT 8th/e p245)Theophylline is used in bronchial asthma. Its mechanism of action is:Inhibition of phosphodiesterases particularly PDE-4.Antagonism of adenosine receptors.Enhancement of histone deacetylation. Acetylation of histone is required for activation of inflammatory gene transcription. By inhibiting this process, low-dose theophylline may restore responsiveness to corticosteroids. | Pharmacology | Asthma | Mechanism of action of theophylline in bronchial asthma is:
A. Phosphodiesterase 4 inhibition
B. Beta2 agonism
C. Anticholinergic action
D. Inhibition of mucociliary clearance
| Phosphodiesterase 4 inhibition |
bbe3d2fd-68f9-49fa-bca5-7b36c8ce091d | MicroRNA (abbreted miRNA) is a small non-coding RNA molecule (containing about 22 nucleotides) found in plants, animals, and some viruses, that functions in RNA silencing and post-transcriptional regulation of gene expression.miRNAs (microRNAs) are sho non-coding RNAs that regulate gene expression post-transcriptionally. They generally bind to the 3&;-UTR (untranslated region) of their target mRNAs and repress protein production by destabilizing the mRNA and translational silencing. | Biochemistry | Metabolism of nucleic acids | Normal role of Micro RNA is
A. Gene Regulation
B. RNA splicing
C. Initiation of translation
D. DNA conformational change
| Gene Regulation |
552901c4-38e6-4bb4-925b-0580c5cfb35e | Waldenstrom macroglobulinemia is a syndrome in which high levels of IgM lead to symptoms related to hyperviscosity of the blood. It occurs in older adults , most commonly associated with lymphoplasmacytic lymphoma. Smoldering myelomas an uncommon variant of multiple myeloma defined by a lack of symptoms and a high plasma M component. Primary effusion lymphoma presents as a malignant pleural or ascitic effusion in patients with advanced HIV and older adults. Mycosis fungoides is a slowly evolving cutaneous T cell lymphoma occuring in middle aged adult males. Reference; Robbins and Cotran Pathologic basis of disease.South Asia Edition volume 1.page no. 596,598 Harsh Mohan textbook of pathology, 7th edition.Pg no.359 | Pathology | Haematology | Malignant tumor associated with Waldenstrom macroglobulinemia includes -
A. Smoldering myeloma
B. Primary effusion lymphoma
C. Mycosis fungoides
D. Lymphoplasmacytic lymphoma
| Lymphoplasmacytic lymphoma |
64f2dcf2-c583-4649-8760-d3d9c94d5799 | ANCAs are not seen in Polyarteritis nodosa. | Pathology | null | Which of the following vasculitis is ANCA negative
A. Microscopic polyangitis
B. Churg straus syndrome
C. Granulomatosis with polyangitis
D. Polyarteritis nodosa
| Polyarteritis nodosa |
a8028fed-30e4-40ac-89d8-4b5c1d00cc7d | Ans: b (Macrophages) Ref: Robbins, p. 593In acute rheumatic fever, focal inflammatory lesions found in the heart are called Ashoff bodies. They consist of foci of swollen eosinophils, collagen surrounded by lymphocytes, but occasionally they contain plasma cells and plump macrophages. These plump macrophages are called Anitschkow cells.They are pathognonomic of rheumatic fever.Some other important cells:-LEcell- Neutrophil in SLETart cell- lymphocyte in SLELangerhan'scell- Ag presenting cells in epidermis (modified macrophages)Langhan's cell- Giant cells in granulomaGlitter cells- leucocytes in pyelonephritisGitter cells- microglia in CNSFlame cells- plasma cells in multiple myelomaFoam cells- lipid containing macrophages in leprosyHofbauer cells- placentaArmani Ebstein cells- Epithelial cells of PCT in DM | Pathology | C.V.S | Anitskov's cells are modified:
A. Neutrophils
B. Macrophages
C. Lymphocytes
D. Eosinophils
| Macrophages |
0b8e9ab7-513f-4fe2-a0e7-4d03a040980b | Hyperemia is an active process due to aeriolar dilatation and increased blood inflow, resulting in high blood volume at tissues. Basic Pathology, Robbins. Page no.: 75 | Pathology | General pathology | Increased blood volume in tissue is known as -
A. Hypermia
B. Edema
C. Congestion
D. Purpura
| Hypermia |
06292198-370a-455b-a7b3-add6d10997c3 | In knee joint osteoarthritis, medial joint space is affected earliest and causes asymmetrical joint space narrowing. This results in varus deformity (genu varus). | Orthopaedics | null | Deformity is most commonly seen in primary osteoarthritis of the knee joint -
A. Genu valgum
B. Germ recurratum
C. Genu varus
D. Procurvaturn.
| Genu varus |
bb80f176-b1c1-4af1-86ef-63f70ba96f77 | Ans: a (48 - 72 hrs) Ref: OP Ghai, 6th ed, p. 302Rise in reticulocyte count occurs by 48 - 72 hrs after start of Iron therapy.Course of events after starting iron therapy :1. Child becomes less irritable and appetite improves within 24 hrs2. Bone marrow response is observed within 48 hrs3. Rise in reticulocyte count by 2nd to 3rd day4. Elevation of hemoglobin occurs next which may take upto 2 months depending on the severity of anaemiaNote:Dosage for parentral iron (iron dextran)Iron (mg) = Wt (kg) x Hb deficit (gm/dl) x 4 | Medicine | Blood | First increase of reticulocyte count occurs after how many hours of iron therapy
A. 48 - 72 hrs
B. 24 hrs
C. 96 hrs
D. 6 hrs
| 48 - 72 hrs |
88aef4f8-4bb8-449a-be92-ad4b98a5d58d | The characteristic feature of LC is an infiltration by lymphocytes into the colonic epithelium. Collagenous colitis (CC) shares this feature but additionally shows a distinctive thickening of the subepithelial collagen table. LC and CC have been suggested to represent different phases of a single pathophysiologic process, with LC possibly being a precursor or earlier phase of CC; however, this has not been proven. REFERANCE. MEDSCAP.COM IMAGE REF: | Pathology | G.I.T | Lymphocytic colitis
A. Bloody diarrhea
B. Intra epithelial lymphocytes
C. Lymphocytes is stools
D. Through Ileoscopy look for payer's patches
| Intra epithelial lymphocytes |
f4691d8f-f6f6-4308-bea7-04e9f037f0e0 | D i.e. (RSV) - Most common cause of tree in bud (bronchiectasis) appearance is Mycobacterium tuberculosis (endobronchial). Most common specific cause of tree in bud appearance in HSL (bone marrow) transplant patients is CMV (30-70%) > RSV (18%) > M. tuberculosis (5-6%) > Pneumocystis > Invasive aspergillosis. Tree in Bud appearance 6 Months) - Pneumocystis - S.pneumoniae - CMV, Seasonal respiratory virus (RSV & para influenza viruses) - Pneumocystis - Toxoplasma " v:shapes="_x0000_s1031">Tree in bud appearance (or gloved finger appearance) is depiction of normally invisible branching course of intralobular bronchiole on HRCT. It indicates the endobronchial spread of disease lit bronchiolar luminal impaction with mucus, pus or fluid, bronchiolar wall thickening, peribronchiolar inflammation and dilatation of distal bronchioles. On HRCT, it appears as peripheral (within 5mm of pleural surface) small (2-4mm) centrilobular well defined nodules connected to linear branching opacities with more than one contiguous branching sites. | Radiology | null | A Bone marrow transplant receipient patient, developed chest infection. ON chest Xray Tree in Bud appearance is present. The cause of this is:
A. Klebsiella
B. Pneumocystis
C. TB
D. RSV
| RSV |
d40e57cb-723f-4c3e-939e-a3319f46ca1d | Ans. is 'd' i.e., Congenital adrenal hyperplasia | Pediatrics | null | A newborn baby presents with shock, hyperkalemia and hypoglycemia. What is the most likely diagnosis-
A. Septicemia
B. Inborn error of metabolism
C. Diabetes mellitus
D. Congenital adrenal hyperplasia
| Congenital adrenal hyperplasia |
bc9cdf4f-348a-4e10-9fc5-24b1670ac702 | Harrison's principles of internal medicine 17th edition. * The classical presentation in syringomyelia is a central cord syndrome consisting of a dissociated sensory loss and areflexic weakness in upper limbs | Medicine | C.N.S | Dissociated sensory loss is seen in
A. Syringomyelia
B. Vitamin B12 deficiency
C. Transverse myelitis
D. Pellagra
| Syringomyelia |
c25f62b0-06a9-4448-a574-474265af35d0 | Vitamin B12 deficiency leads to:- Megaloblastic anemia Pernicious anemia Sub-acute combined degeneration of spinal cord Peripheral neuropathy Infeility Atrophic glossitis. | Social & Preventive Medicine | Vitamins and Nutritional Deficiencies | Subacute combined degeneration of cord is due to deficiency of:-
A. Vitamin B1
B. Vitamin B6
C. Folic acid
D. Vitamin B12
| Vitamin B12 |
c7136fd7-c28f-4a4c-9f2c-58b27a00cfb7 | Ans. is 'd' i.e., b2-Agonist b-agonists in Asthmao Bronchi have b2-adrenergic receptors which cause bronchodilatation - So, the adrenergic drugs used in asthma are selective b2 agonists.o b2-agonists are the most effective bronchodilatorso b2-agonists have some other effects also on airways (other than bonrchodilatation), that are responsible for beneficial effects in asthma:Inhibition of release of mast cells mediators -mast cells stabilizing action.Inhibition of exudation and airway edema.Increased mucociliary clearanceDecreased cougho b2-agonists have no effect on inflammation - no antiinflammatory action. | Pharmacology | Asthma | Maximum effect of bronchodilatation in asthma is caused by -
A. Corticosteroids
B. Theophylline
C. Anticholinergic
D. Beta 2-Agonist
| Beta 2-Agonist |
1c4164ab-1264-4957-9479-b39a808a5e77 | <p>BCG Aim- To induce a benign,aificial primary infection which will stimulate an acquired resistance to possible subsequent infection with virulent tubercle bacilli, and thus reduce the morbidity and moality from primary tuberculosis among those most at risk. WHO recommends the &;Danish 1331&; strain for vaccine production. Stable for several weeks at ambient temperature in a tropical climate and for upto 1 year if kept away from direct light and stored in a cool environment below 10 deg celcius. Vaccine must be protected from light ( wrapped up in a double layer of red/ black cloth). Normal saline is recommended as diluent for reconstituting the vaccine as distilled water may cause irritation. Reconstituted vaccine may be used within 3 hours. Dosage-0.1 mg in 0.1 ml volume. The dose of newborn below 4 weeks is 0.05 ml. Administered intradermally using tuberculin syringe. Injected slightly above the inseion of left deltoid. If injected too high / too low adjacent lymph nodes may become involved and tender. The vaccine must not be contaminated with an antiseptic/detergent. If alcohol is used to swab the skin , it must be allowed to evaporate before the vaccine is given. Phenomenon after vaccination:/ 2-3 weeks after a correct intradermal injection of a potent vaccine, a papule develops at the site of vaccination. It increases slowly in size and reaches a a diameter of about 4-8 mm in 5 weeks. It then subsides or breaks into a shallow ulcer but usually seen covered by a crust. Healing occurs within 6-12weeks leaving a permanent,tiny, round scar (4-8 mm in diameter).This is a normal reaction. Normally the individual become mantoux postive after 8 weeks has elapsed. Adverse reactions: prolonged severe ulceration at the site of vaccination, suppurative lymphadenitis, osteomyelitis and disseminated BCG infection. Contraindications: BCG should not be given to patients with generalised eczema, infective dermatosis, hypogammaglobulinemia , those with history of deficient immunity, patients under immunosuppressive treatment and in pregnancy. {Reference: park&;s textbook of preventive and social medicine, 23rd edition, pg no.196}</p> | Social & Preventive Medicine | Communicable diseases | The diluent used for BCG is -
A. Distilled water
B. Normal saline
C. Dextrose solution
D. Ringer - lactate
| Normal saline |
f11f21b3-b3f1-4469-aa84-f01dd35630b5 | Ans. is'b' i.e., Long head of tricepsSupraglenoid tubercle of scapula : origin oflong head ofbiceps.Infraglenoid tubercle of scapula : origin of long head of triceps | Anatomy | null | Which of the following arises from infraglenoid tubercle -
A. Longheadofbiceps
B. Longheadoftriceps
C. Shoheadofbiceps
D. Coracobrachialis
| Longheadoftriceps |
9cd61149-cdc7-4b66-bdd0-153893c9e0c3 | lead aprons of thickness 0.5mm will reduce the intensity of scattered X rays over 90% and should be worn by all workers regularly exposed to X ray procedures. Radiation protection is the youngest bramch of hygiene and is called radiation hygiene. Parks textbook of preventive and social medicine.K Park. Edition 23.page no: 745 | Social & Preventive Medicine | Environment and health | Thickness of lead apron to prevent radiation -
A. 1 mm
B. 3 mm
C. 0.5mm
D. 7mm
| 0.5mm |
c50ee3f1-1621-4c3e-9219-49a611992c4a | Ans. d. End tidal capnography (Ref: Bethune, R. W. M., and Brechner, V. L. (1968). Detection of venous air embolism by carbon dioxide monitoring. Anesthesiology, 29, 178)Brechner and Bethune are associated with end-tidal capnography. | Anaesthesia | Breathing Systems | The names Brechner and Bethune are associated with which of the following devices?
A. Precordial Doppler
B. Transesophageal echocardiography
C. Plethysmography
D. End tidal capnography
| End tidal capnography |
53cca08c-6266-40a5-a83c-b40c1edb0fee | DOC FOR myasthenia gravis is pyridostigmine as it long acting than neostigmine.both are quaternanry coumpounds and so cant cross BBB Ref: KDT 6th ed pg 101-102 | Pharmacology | Autonomic nervous system | Why pyridostigmine is preferred in myasthenia gravis?
A. It doesn't cross BBB
B. Longer acting than neostigmine
C. It crosses BBB
D. Sho-acting than neostigmine
| Longer acting than neostigmine |
136a13b9-9600-474e-bb8c-ee6eaa25eeb4 | The most probable diagnosis is mucormycosis which is a fungal infection of the nose and paranasal sinuses. It is seen in those on immunosuppressive therapy or those with uncontrolled diabetics. It is associated with rapid destruction due to the affinity of the fungus to aeries causing endothelial damage and thrombosis. A typical finding is the presence of a black necrotic mass filling the nasal cavity and eroding the septum and hard palate. Ref: Textbook of diseases of ENT; PL Dhingra; 7th edition, pg no. 178 | ENT | Nose and paranasal sinuses | A black necrotic mass was seen in the nose of an elderly diabetic patient. The most probable diagnosis is?
A. Lupus vulgaris
B. Aspergillosis
C. Mucormycosis
D. Pseudomonas infection
| Mucormycosis |
99de7e6c-61b0-44de-91f2-49b83d78dee8 | Ans. B. Genital branch of the genitofemoral nerveCremasteric Reflexa. Contraction of the cremaster muscle is elicited by lightly stroking the skin on the medial aspect of the superior part of the thigh with an applicator stick or tongue depressor. The afferent limb is ilio-inguinal nerve supplies this area of skin. Cremaster muscle is innervated by the genital branch of the genitofemoral nerve, derived from the first and second lumbar spinal nerves. The rapid elevation of the testis on the same side is the cremasteric reflex.b. This reflex is extremely active in children; consequently, hyperactive cremasteric reflexes may simulate undescended testes. A hyperactive reflex can be abolished by having the child sit in a cross-legged, squatting position; if the testes are descended, they can then be palpated in the scrotum.c. It may represent a protective reflex, and the cremaster may also have a role in testicular thermoregulation. | Anatomy | Male Genital System | The efferent limb of the cremasteric reflex is provided the-
A. Femoral branch of the genitofemoral
B. Genital branch of the genitofemoral nerve
C. Ilioinguinal nerve
D. Pudendal nerve
| Genital branch of the genitofemoral nerve |
580a574a-9082-4031-9950-e99f733fb301 | Most abundant type of Ig = IgA > IgD > IgG, IgM & IgE Anti-infective factors present in breast milk are: IgA (ratio of IgA: IgG is 100:1) Lymphocytes Anti- streptococcal factor Lysosome Lactoferrin Living cells. | Social & Preventive Medicine | Paediatric Care in RCH: BW, BL, PEM, Breast Feeding | Most abundant immunoglobulin present in breast milk?
A. IgA
B. IgM
C. IgG
D. IgE
| IgA |
f0a8a5cd-841a-40d5-a463-617f1d516d3b | Ans. B: NRR Net reproduction rate measures the number of daughters a woman would have in her lifetime if she experiences prevailing age-specific feility and moality rates Net reproduction rate/NRR It is the average number of daughters that would be born to a female (or a group of females) if she passed through her lifetime conforming to the age-specific feility and moality rates of a given year. This rate is similar to the gross reproduction rate but takes into account that some females will die before completing their childbearing years. An NRR of one means that each generation of mothers is having exactly enough daughters to replace themselves in the population. The NRR is paicularly relevant where sex ratios at bih are significantly affected by the use of reproductive technologies, or where life expectancy is low Total feility rate/ TFR/ Feility rate/ Period total feility rate (PTFR)/ Total period feility rate (TPFR) It is the average number of children that would be born to a woman over her lifetime if (1) she were to experience the exact current age-specific feility rates (ASFRs) through her lifetime, and (2) she were to survive from bih through the end of her reproductive life. It is obtained by summing the single-year age-specific rates at a given time. | Social & Preventive Medicine | null | Moality rates are taken into account while calculating: March 2011
A. General feility rate
B. NRR
C. Total feility rate
D. Gross reproduction rate
| NRR |
ff1c5737-a640-43de-8d57-1dc75e3d27b4 | Rapidly dividing cells are generally more radio sensitive then slowly dividing cells, reflecting radiation induced inhibition of D.N.A. synthesis. | Pathology | null | During radiotherapy the Buccal Mucosa exhibits radiation reaction before skin due to -
A. Rapid cellular turn-over in bone
B. Slow cellular turn-over in blood vessel
C. Rapid cellular turn-over in skin
D. Rapid cellular turn-over in mucosa
| Rapid cellular turn-over in mucosa |
843fc85d-f360-47df-8ecb-2dd0168d1d7b | Ans. is 'c' i.e., Intravesical BCG Management of bladder cancer Cystoscopy and transurethral resection or biopsy - initially, any pt. with hematuria is examined by cystoscopy and any tumor seen is removed by transurethral resection (if possible) or biopsied. Fuher treatment decisions are made after tumor staging on histology. Such decisions are based on tumor stage (TNM), grade, size, multiplicity, and recurrence pattern. First see the staging (TNM) The primary bladder cancer is staged according to the depth of invasion into the bladder wall or beyond The urothelial basement membrane separates superficial bladder cancers into Ta (noninvasive) and T1 (invasive) tumors. The muscularis propria separates superficial disease from deeply (muscularis propria) invasive disease. Stage T2 and higher T stage tumors invade the muscularis propria, the true muscle of the bladder wall. If the tumor extends through the muscle to involve the full thickness of the bladder and into the serosa, it is classified as T3. If the tumor involves contiguous structures such as the prostate, the vagina, the uterus, or the pelvic sidewall, the tumor is classified as stage T4. | Surgery | null | A 55 year old male presented with painless terminal hematuria. Cystoscopic examination revealed a solitary papillary tumor. Histopathological examination of completely resected tumor is suggestive of grade transitional cell carcinoma with no muscle invasion. fuher management of this patient is best done by
A. Just follow up
B. Intravesical chemotherapy
C. Intravesical BCG
D. Cystectomy
| Intravesical BCG |
485b0fa3-952c-49ed-bb71-d414fdf4e4ad | Ans. is 'b' i.e. Aluminium Phosphate Aluminium phosphate is used as an adsorbent in DPT vaccine. Adsorption increases the immunological effectiveness of the vaccine | Social & Preventive Medicine | Communicable Diseases | Preservative added in DPT vaccine is :
A. Zinc phosphate
B. Aluminum phosphate
C. MgS04
D. ZnS04
| Aluminum phosphate |
37e8161a-efc3-46af-bbc7-c38ff9f44f8c | Ans. is 'd' i.e., Nerve of bell o Serratus anterior causes protraction of scapula,o It is supplied by long thoracic nerve (Nerve of Bell),o It forms medial boundary of axilla.Serratus anterioro Origin : Outer surface of upper 8 ribs by 8 digitations (multipennate muscles),o Insertion : Medial border of scapula and inferior angle.o Nerve supply : Long thoracic nerve (nerve of bell),o Actions : Action of serratus anterior are -Rotates the scapula so that glenoid cavity is raised upward & forward - Helps in Vertical over head abductionQ (in this action assisted by trapezius).Draws the scapula forward around the throeic wall so paraiysis leads to winging of scapula.QAlso used when arm is pushed forward in horizontal position as in forward punchQ (helped by Pectoralis minor in this action)Q.Steadies the scapula during wreight carrying.Helps in forced inspiration^ (Accessory muscle of inspiration).Because of greater pull exerted on the inferior angle, inferior angle passes laterally and forward and the glenoid cavity is raised upward & forward; in this action the muscle is assisted by trapezius. | Anatomy | Nerves of Upper Extremity | Serratus arterior is supplied by -
A. Thoracodorsal nerve
B. Axillary nerve
C. Musculocutaneous nerve
D. Nerve of bell
| Nerve of bell |
7bdf06c1-3e9f-4c58-97cb-4d26998ddf01 | Ans. is 'a' i.e., Thumb adduction Normally when a person is asked to grasp a book between the thumb and index finger, he will grasp the book firmly with thumb extended, taking full advantage of the adductor pollicis and the first dorsal interosseous muscles. If the ulnar nerve is injured the adductor pollicis will be paralysed and the patient will hold the book by using the flexor pollicislongus (supplied by median nerve) producing flexion at the interphalangeal joint. This becomes more pronounced if the examiner tries to pull the book out while the patient tries to hold it. This sign is known as `Froment's sign' or the 'book test'. | Surgery | null | Froment's sign is positive in cases of weakness of ?
A. Thumb adduction
B. Thumb abduction
C. Thumb flexion
D. Thumb extension
| Thumb adduction |
4bad66a3-5215-459b-9d8a-5ef1b69ca357 | Laboratory studies are impoant to confirm the diagnosis of myxedema coma. However, if the condition is suspected, treatment should be staed immediately without waiting for the results. Thyroid function tests TSH is elevated in most patients indicating a primary thyroid disorder Free T4 and free T3 levels are low A low or normal TSH level with low levels of free T4 and free T3 may indicate that the disorder is due to pituitary or hypothalamic dysfunction Ref - medscape.com | Medicine | Endocrinology | The laboratory test of choice to confirm myxoedema coma is -
A. Thyroid stimulating hormone (TSH)
B. Thyrotropine releasing hormone (TRH)
C. Tri-iodothyronine (T3)
D. Tetra iodothyronine (T4)
| Thyroid stimulating hormone (TSH) |
164990c5-7eb8-4a54-8f38-c025dd4e9e27 | Cutaneous sporotrichosis, caused by S. schenckii, begins at the site of inoculation, usually on an extremity or the face. The organism often is found on thorns of rose bushes. Ulceration is common and new lesions appear along paths of lymphatic channels. Extracutaneous sporotrichosis is seen primarily in bones and joints. There is no evidence to suggest that any portal of entry besides skin is important. | Microbiology | Mycology | Infection with Sporothrix schenckii (formerly Sporotrichum schenckii) is an occupational hazard for gardeners. The portal of entry for this organism is the
A. Lymphatic system
B. Respiratory tract
C. Skin
D. Mouth
| Skin |
5ef2e1e1-d023-4f4b-b9e5-db960a1c364f | Estrogen is a generic term for any of the estrus-producing compounds (female sex hormones), including estradiol, estriol, and estrone. Called also estrogenic hormone. In humans, the estrogens are formed in the ovary, adrenal coex, testis, and fetoplacental unit, and are responsible for female secondary sex characteristic development, and during the menstrual cycle, act on the female genitalia to produce an environment suitable for feilization, implantation, and nutrition of the early embryo.Ref: Ganong&;s review of medical physiology; 24th edition; page no: 405 | Physiology | Endocrinology | Secretion of estrogen is maximum at
A. Just before menopause
B. At pubey
C. At menstruation
D. Before ovulation
| Before ovulation |
475a9dff-859f-4831-8cb9-2a92cbfccd1e | Aberrant epiphysis: is not always present example: epiphysis at the head of first metacarpal and base of other metacarpalRef BD CHAURASIA S Handbook of General Anatomy Fouh edition Pg no 42 | Anatomy | General anatomy | Which of the following is aberrant epiphysis
A. Coracoid process
B. Greater tubercle of humerus
C. Base of 1" metacarpal
D. Base of 2nd metacarpal
| Base of 2nd metacarpal |
a29bf584-4dd6-4707-84d0-05ab91aee05a | Anorexia nervosa Anorexia nervosa is a eating disorder where the patient has decreased weight and altered body image and persistent desire to maintain thinness * Gender==== more common in females * Age=======adolescence * Comorbidity=== depression and social phobia * Duration====3 months * Criteria= * Intense fear of becoming fat * Restriction of food intake * Restricting type * Binge eating and purging type * Amenorrhea is not needed for diagnosis, previously amenorrhea is considered as a diagnostic criteria for diagnosis, in recent DSM 5 amenorrhea is considered for a diagnosis * Association= * OCD and depression * Decreased interest in sex * Complication * 7-14% moality * ECG changes * Hypokalemic alkalosis because of induced vomiting * Gastric dilation * Drugs * Cypro hepatidine * SSRI * Management * Admit in severe cases * Prevent vomiting by making restroom inaccessible for 2 hours after food intake * Avoid laxatives * Small frequent meals * Avoid refeeding syndrome Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 509 | Anatomy | Sleep disorders and eating disorders | disorder where amenorrhea was once needed for diagnosis was
A. anorexia nervosa
B. metabolic syndrome
C. bulimia nervosa
D. binge eating
| anorexia nervosa |
14bc7576-bd7b-4e8e-906c-d3d8695a9516 | Vitamin A: - Role 1) Vision 2) Reproduction & growth 3) Maintenance of epithelial cell 4) Stabilization of cellular and intra Cellular membrane 5) Synthesis of glycoprotein 6) Antioxidant 7) Skin & Bone Metabolism | Medicine | JIPMER 2017 | In Vitamin A deficiency, respiratory tract infection due to:
A. Keratinization of upper epithelial cells
B. Lack of antibody production
C. Dysfunction of epithelial layer
D. Defective chemotaxis
| Dysfunction of epithelial layer |
62645a33-cff9-42d3-9aef-29ddfad1cfd0 | Marginal mandibulectomy with removal of outer table is not recommended. Marginal mandibulectomy -- It include incontinuity excision of tumour with margin of the mandible and overlying gingival at least 1 cm thick mandible inferiorly. It is indicated in carcinoma close proximity to the lower gingival or extending onto the mandible without clinical or radiological mandibular involvement. It is also recommended in patients with minimal coical mandibular invasion | Surgery | null | An old man who is edentulous developed squamous cell carcinoma in buccal mucosa that has infiltrated to the alveolus. Following is not indicated in treatment
A. Radiotherapy
B. Segmental mandibulectomy
C. Marginal mandibulectomy involving removal of the outer table only
D. Marginal mandibulectomy involving removal of upper half of mandible
| Marginal mandibulectomy involving removal of the outer table only |
8eec27a6-cae8-4aa6-9a56-721850dbe6f6 | Ans. is 'a' i.e., Nasopharyngeal swab "Culture of nasopharyngeal secretion remains the gold stadard for diagnosis of whooping cough" | Pediatrics | null | A child with complaints of cough. Characteristic inspiratory whoop. Sample for investigation is ?
A. Nasopharyngeal swab
B. Tracheal aspiration
C. Cough plate culture
D. Sputum culture
| Nasopharyngeal swab |
e1d3cc6f-61b3-4cb3-9978-21231387c9ac | - placenta is a human anatomical waste that comes under category no 1. - category no 1 wastes are discarded in yellow colour plastic bag and should be treated by incineration. Reference: Park's textbook of preventive and social medicine, 23rd edition, pg no: 793,794 <\p> | Social & Preventive Medicine | Hospital waste and disaster management, Occupational health | In PHC how to dispose placenta -
A. Incineration
B. Microwaving
C. Autoclaving
D. Chemical treatment
| Incineration |
f968aea4-be9b-4740-b6a2-f04da6de5d38 | Serous cystadenoma and cystadenocarcinoma
Serous cystadenoma and cystadenocarcinoma are amongst the most common of cystic ovarian neoplasms, accounting about 50% of all ovarian tumours; of these, 60-70% are benign, 15% borderline and 20-25% are malignant. | Unknown | null | Mc benign epithelial ovarian tumor is
A. Serous cystadenoma
B. Mucinous cystadenoma
C. Brenner tumor
D. Ovarian fibroma
| Serous cystadenoma |
58d0bbf4-2153-475c-bf96-56dd0f0d95bc | A large infiltrative mass is present in the right kidney with extension of mass into the renal pelvic fat, the right renal vein and IVC. There is also retroperitoneal lymphadenopathy and splenomegaly. A. Non-Hodgkin's lymphoma can involve the kidney but is seen on presentation in only 5.8% of cases. Although it can involve the kidney as a single mass, renal lymphoma most commonly presents as multiple lymphomatous masses. Additionally, renal vein and IVC invasion would be distinctly unusual for lymphoma. B. Angiomyolipoma is a benign tumor of the kidney that is characterized by regions of macroscopic fat (seen in 95% of cases). No areas of fat density are seen in the images provided with this case. Additionally, renal vein and IVC invasion and lymphadenopathy would not be a characteristic of this benign tumor. C. Renal medullary carcinoma is an unusual tumor that almost always occurs in young patients with sickle cell trait. No cases have been repoed in patients with sickle cell disease. The tumor arises from the calyceal epithelium and grows in an infiltrative pattern. It is a very aggressive tumor with early metastases to lymph nodes and vascular invasion. D. Transitional cell carcinoma can fill the renal pelvis and diffusely infiltrate the kidney as in this case. However, transitional cell carcinomas typically affect older individuals and would be rare to affect someone of this age. Also, transitional cell carcinomas would not demonstrate vascular invasion as in this case. | Radiology | GIT and hepatobiliary system | What is the MOST likely diagnosis for this 25-year-old man with sickle cell trait?
A. Non-Hodgkin lymphoma
B. Angiomyolipoma
C. Renal medullary carcinoma
D. Transitional cell carcinoma
| Renal medullary carcinoma |
76a401f9-61da-426a-85a8-b03e7ebd7552 | Sub-center kit A contains :- (i) Iron (Ferrous sulphate) & folic acid; (ii) Zinc sulphate; (iii) Cotrimoxazole; (iv) Vitamin A; (v) ORS; and (vi) Gentian violet crystals.
Sub-center kit contains :- (i) Paracetamol; (ii) Dicyclomine hydrochloride; (iii) Albendazole; (iv) Methylergometrine; (v) Povidone iodine ointment; (vi) Chloramphenicol eye ointment; (vii) Rolled bandage; and (viii) Absorbent cotton wool. | Social & Preventive Medicine | null | Kit B given at subcentre –
A. Vit A
B. ORS
C. Paracetamol
D. Iron
| Paracetamol |
80351dcb-3f71-4433-b1b1-2a505f97e74b | Robbins basic pathology 9th edition page no 63 The collagens are composed of three seperate polypeptide chains braided into a ropelike triple helix. | Pathology | General pathology | Triple helix is found in
A. Cystine
B. Collagen
C. Pectin
D. DNA
| Collagen |
98c462da-4f5b-464c-b71c-d62415965b81 | Hypersensitivity vasculitis, which is usually represented histopathologically as leukocytoclastic vasculitis (LCV), is a term commonly used to denote a small-vessel vasculitis. There are many potential causes of hypersensitivity vasculitis; however, up to 50% of cases are idiopathic. Hypersensitivity vasculitis may present clinically as cutaneous disease only or it may be a cutaneous manifestation of systemic disease. The internal organs most commonly affected in hypersensitivity vasculitis are the joints, gastrointestinal tract, and kidneys. Hypersensitivity vasculitis may be acute and self-limited, recurrent, or chronic. Overall, hypersensitivity vasculitis has a orable prognosis, paicularly when no internal involvement is present . Hypersensitivity vasculitis tends to affect the skin and occasionally the kidney. The loss of integrity of the capillaries and post capillary venules results in extravasation of red blood cells, usually causing purpura and a burning or minimally pruritic sensation. Hypersensitivity vasculitis is thought to be mediated by immune complex deposition.In this form of vasculitis, circulating antigens in the body (produced by factors such as medications, infections, and neoplasms) induce antibody formation. These antibodies bind to the circulating antigen and create immune complexes, which then deposit within vessels, activating complement and inducing inflammatory mediators. Inflammatory mediators, adhesion molecules, and local factors may affect the endothelial cells and play a role in the manifestations of this disease. Additionally, autoantibodies, such as antineutrophil cytoplasmic antibody (ANCA), may be associated with disease manifestations. In ANCA-mediated vasculitis, intracellular proteins from neutrophils become expressed on the cell surface, leading to formation of antibodies (ANCA). These autoantibodies then bind neutrophils, subsequently leading to neutrophil adhesion to vessel walls and cellular activation. Ref - medscape.com | Medicine | Immune system | Hypersensitivity vasculitis involve
A. Capillary
B. Aerioles
C. Postcapillary venules
D. Medium sized aeries
| Postcapillary venules |
c4cef47f-ecca-44e5-ab65-c1e0ce2d4887 | The musculocutaneous nerve supplies the biceps brachii and brachialis, which are the flexors of the forearm at the elbow. The musculocutaneous nerve continues as the lateral antebrachial cutaneous nerve, which supplies sensation to the lateral side of the forearm (with the forearm in the anatomic position). The biceps brachii is the most powerful supinator muscle. Injury to this nerve would result in weakness of supination and forearm flexion and lateral forearm sensory loss. Injury to the radial nerve would result in weakened extension and a characteristic wrist drop. Injury to the median nerve causes paralysis of flexor digitorum superficialis and other flexors in the forearm and results in a characteristic flattening of the thenar eminence. The lateral cord of the brachial plexus gives origin both to the musculocutaneous and lateral pectoral nerves. There is no indication of pectoral paralysis or weakness. Injury to the lateral cord can result in weakened flexion and supination in the forearm, and weakened adduction and medial rotation of the arm. The lateral cutaneous nerve of the forearm is a branch of the musculocutaneous nerve and does not supply any motor innervation. Injury to the musculocutaneous nerve alone is unusual but can follow penetrating injuries. | Anatomy | Upper Extremity | A 32-year-old woman is admitted to the emergency department after an automobile collision. Radiographic examination reveals multiple fractures of the humerus. Flexion and supination of the forearm are severely weakened. She also has loss of sensation on the lateral surface of the forearm. Which of the following nerves has most likely been injured?
A. Radial
B. Musculocutaneous
C. Median
D. Lateral cord of brachial plexus
| Musculocutaneous |
e4514ffc-7062-41d2-8e92-fb11da5a7b31 | Ans is 'b' i.e. Ordinal Repeat from All India 07, AIIMS May 2005, Nov. 2003Statistical data can be of two types -Qualitative data -Quantitative dataQualitative DataIn such data there is no notion of magnitude or size of the variables as they cannot be measuredVariables can be categorized according to some characteristics or quality.eg: Sex, occupation marital status, education level, vaccinated or not vaccinated, acquired the disease or not, died or cured, grades in the class.The qualitative data can be placed on 2 scales -NominalOrdinal.Nominal scaleNominal scale data are divided into qualitative categories or groups, such as male / female, black / white, died / cured, attacked/not attacked, vaccinated/not vaccinate, urban/sub urban/ruralThere is no implication of order or ratio, means that the data cannot be placed in a meaningful order.Ordinal ScaleHere the data can be placed into categories that can be rank ordered (eg. students may be ranked 1st / 2nd / 3rd / 4th in their class or into grades A/B/C, the activity of an animal can be rated on a scale of 1 to 6, hardness scale for water etc.)However, there is no information about the size of the interval ie no conclusion can be drawn about whether the difference between the first and second students is the same as the difference between the second and third.Variables in the form of mild, moderate and severe (or very satisfied, satisfied and dissatisfied) are analyzed by ordinal scale as they can be arranged in a meaningful order but there is no information about the size of the interval between them.Quantitative dataThe quantitative data have a magnitude ie they can be measured.Eg. - height, weight, blood pressure, serum cholesterol level, temperature, number of children in a family etc.Quantitative data can be measured on 2 scalesIntervalRatio scalesInterval scaleInterval scale data are like ordinal data in that they can be placed in a meaningful order; in addition, they have meaningful intervals between items, which can be measured.eg: Temperature on the Celsius scale (the difference between 80 degand 70deg is the same as between 40 degand 30 degCHowever, interval scale data do not have an absolute zero, ratios of the scores are not meaningful ie 80deg C of Celsius temperature is not twice as hot as 40degC because 0degC does not indicate a complete absence of heat.Ratio ScaleA ratio scale has the same properties as an interval scale, however, because it has an absolute zero, meaningful ratio do exist.eg. weights, time, blood pressure, temperature on the Kelvin scale (not Celsius scale) On the Kelvin scale, zero degrees indicate an absolute absence of heat, just as a zero pulse indicates an absolute absence of heartbeat. Thus we can say that 400 K is twice as hot as 200 K.Dichotomous Scale is a type of nominal scale in which nominal data fall into only two groups eg black / white, died / cured, failed / passed. | Social & Preventive Medicine | Statistical Tests | In a study following interpretation are obtained: Satisfied, Very satisfied, Dissatisfied. Which type of scale is this?
A. Nominal
B. Ordinal
C. Interval
D. Ratio
| Ordinal |
f76e1d5b-1bf4-4ede-8e20-defeb65a3858 | Ans. is 'a' i.e., AnthropometryBeillion system is anthropometry. | Forensic Medicine | null | Beillon system is for -
A. Anthropometry
B. Dactylography
C. Dentition
D. Nuclear sexing
| Anthropometry |
0971d63c-0725-42b6-b279-39ba7a35a121 | Dependency ratio = (Propoion of ppl in < 15yrs of age + >65yrs of age) / Propoion of ppl in 15-64 yrs of age = 150+50/800 = 0.25 | Social & Preventive Medicine | Definition & Concepts | In a population having mid-year population of 1000, there are 150 children less than 15 years and 50 elderly more than 65 years of age. Calculate dependency ratio ?
A. 0.2
B. 200
C. 0.25
D. 250
| 0.25 |
a0fb931b-1727-4087-9387-27e55141c30e | Rushton Bodies Rushton Bodies or hyaline bodies of odontogenic cysts feature as eosinophilic, straight or curved, irregular or rounded structure within the epithelial lining of odontogenic cyst Rushton bodies occur almost exclusively within odontogenic cyst Ref: Shafers 6th edition Pgno : 268 | Surgery | Head and neck | What are the Rushton bodies ?
A. Hyaline bodies of odontogenic cyst
B. Refractile bodies of radicular cyst
C. Bodies seen in ameloblastomes
D. Hyaline bodies seen in dentigerous cysts
| Hyaline bodies of odontogenic cyst |
0a22bdab-b65a-48b8-bde8-e73a0ecf5d0b | The articular calcification chondrocalcinosis is typical for pseudogout or calcium pyrophosphate disease (CPPD). The most common joint involved is the knee, but the wrist, shoulder, ankle, elbow, and hand are also frequently involved. Definitive diagnosis depends on finding typical rhomboid-shaped crystals with weak-positive birefringence in the synovial fluid, but chondrocalcinosis in the correct setting allows a presumptive diagnosis. Numerous diseases are associated with CPPD, but the most common predisposing factor is advancing age. | Medicine | Immunology and Rheumatology | A 69-year-old man has had mild arthritis involving many joints for several years. Over 1 or 2 days, he develops severe pain and swelling of his knee. His x-ray reveals calcifications in his articular cartilage. Which of the following is the most likely diagnosis?
A. acute gout
B. RA
C. pseudogout
D. infectious arthritis
| pseudogout |
0c5e460a-0679-4f88-b03e-aaf72a8807fe | Ans. is 'a' i.e.. Avascular necrosis of femur headClinical features of AVNo In the earlier stages of AVN, the patient is asymptomatic, and by the time patient presents, the lesion is well advanced.o Common histories patient gives (Any of the following) : -i ) Dislocation of HipAlcoholismSteroid intake for any disorderNephrotic syndromeo Pain is a common complaint. Pain is felt in the grain and may radiate to knee,o Decreased range of motion especially internal rotation followed by abduction.o Sectoral sign or Differential rotation : - Internal rotation is possible in extended position of hip, but as seen as the hip is flexed to 90deg no internal rotation is possible. This is the characteristic sign of AVN.o Limp with antalgic gaito Trendelenberg's test positive. | Orthopaedics | Avascular Necrosis | Sectoral sign is positive in -
A. Avascular necrosis of femur head
B. Osteoarthritis of btp
C. Protrusio acetabuli
D. Slipped capita! femoral epiphyses
| Avascular necrosis of femur head |
9609cf12-50f3-47be-802e-01a5bb8b6045 | D i.e. Generates impulses at the highest rate | Physiology | null | S.A. node acts as a pacemaker of the hea because of the fact that it:
A. Is capable of generating impulses spontaneously
B. Has rich sympathetic innervations.
C. Has poor cholinergic innervations
D. Generates impulses at the highest rate.
| Generates impulses at the highest rate. |
7fc651c1-b816-4962-b2ee-db8f5afdea4f | The scala media is bordered by the basilar membrane and Reissner's membrane and contains a tectorial membrane. The apical border of hair cells has stereocilia that are embedded in the tectorial membrane. | Physiology | Special Senses | The stereocilia of hair cells are embedded in which membrane?
A. Basilar
B. Reissner's
C. Tectorial
D. Tympanic
| Tectorial |
46126fa1-4678-4fee-8bf4-2d8b691409c8 | In egg cholesterol content is 250 mg. REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION. PAGE NO - 611) | Social & Preventive Medicine | Nutrition and health | Food with maximum Cholesterol content -
A. Eggs
B. Coconut oil
C. Hydrogenated Fats
D. Ghee (Hydrogenated)
| Eggs |
bdf86283-3eca-4eca-ae7d-8142a93ee247 | Ans. A. Micturating cystographyVesicoureteric reflux refers to the retrograde flow of urine from bladder to ureters and pelvis at rest or during micturition.Pathogenic organisms that might be present in the bladder can gain access to the renal parenchyma initiating inflammation and renal scarring. Two techniques are commonly used to detect VUR. The radiocontrast MCU is commonly used since in addition to showing VUR it provides excellent anatomical details. Isotope radionuclide cystography is more sensitive for detecting VUR and causes less radiation exposure but provides less anatomical details. | Pediatrics | Gastro Intestinal System | Vesicoureteric reflux is diagnosed by:
A. Micturating cystography
B. X ray abdomen
C. CECT Abdomen
D. Intravenous pyelography
| Micturating cystography |
53d1857f-06d2-4da0-9d7f-88b4a976ac5d | Nutrition experiments with various levels of calorie and protein intake were carried out on five healthy young men. Three series of experiments with two persons each were undeaken for periods up to 14 days. The first pa of each experiment, with 1100 to 1500 kcal/day, was immediately followed by the second pa, with 3500 to 2300 kcal/day. The concentrations of insulin, free fatty acids, glucose and amino acids were determined in the morning, fasted blood. The nitrogen balance was also determined. When insufficient carbohydrate intake is coupled with normal and high protein content of the food, there is interindividually an initial drop in the insulin concentration. Regardless of the absolute insulin concentration, this drop causes an increase in the free fatty acids and the branched-chain amino acids, together with a decrease in the concentrations of alanine and glycine (threonine) in the blood and a negative nitrogen balance. The high concentrations of branched-chain amino acids and the low threonine concentrations might be involved as feedback regulators in the fuher regulation of the gluconeogenic metabolism. When carbohydrate calories are added to the diet, a simultaneous decrease in the free fatty acids and branched-chain amino acids and increase in the blood concentrations of insulin, alanine, glycine and threonine within 24 to 48 h are only observed with 3500 kcal/day and 0.8 to 1.4 g protein per kg body weight. A positive nitrogen balance, however, is only observed with 1.4 g protein per kg body weight, regardless of the relative changes in the insulin level, while the increase in alanine and decrease in branched-chain amino acids (valine) are greatest at 0.8 g protein per kg body weight and day. In spite of the high glucose level, the falling insulin level provokes counter-regulatory processes in which the low concentrations of branched-chain amino acids and the high threonine (alanine) concentrations may play a role. Ref: guyton and hall textbook of medical physiology 12 edition page number:610,611,612 | Physiology | Endocrinology | In a seriously ill patient, addition of amino acids in diet results in a positive nitrogen balance. The mechanism for this is
A. Increased Growth hormones secretion
B. Enhanced rate of gluconegenesis
C. Increased absorption of amino acids from diet
D. Increased secretion of Insulin
| Increased secretion of Insulin |
0746e4e2-9087-4f07-ac87-b93772287bdd | Ans. is 'a' i.e., Conduction block Adverse effects of CCBs Nausea, constipation and bradycardia are more common with verapamil. Verapamil can accentuate conduction defect-should be avoided in 2nd & 3rd degree block, in sick sinus syndrome and along with 13-blocker. Most common side effects of DHPs are palpitation, flushing, hypotension, headache, ankle edema, drowsiness and nausea. Nifedipine can paradoxically increase the frequency of angina in some patients. Nifedine can cause voiding difficulty in elderly (relaxant effect on bladder) and glucose intolerance (decreases insulin release). | Pharmacology | null | Patient on verapamil should not be given beta blocker as ?
A. Conduction block
B. Bronchospasm
C. Neurogenic shock
D. Anaphylaxis
| Conduction block |
eaee85a6-e45f-4481-b950-316d0ab248ce | Option 1 2 3 Cell wall antigens: Inner thick peptidoglycan layer (confers cell wall rigidity, induces inflammatory response and has thrombolytic activity) C-carbohydrate antigen: Present as middle layer and is group specific Outer layer of protein (M, T, R) and lipoteichoic acid (helps in adhesion) M protein - Major virulence factor of S pyogenes Option 4 Outer layer of lipoteichoic acid (helps in adhesion) | Microbiology | Systemic Bacteriology Pa 1 (Gram Positive Cocci, Gram Negative Cocci) | Virulence factor of group A beta hemolytic streptococci:-
A. Protein M
B. Protein T
C. Protein R
D. Lipotechoic acid
| Protein M |
5b97cefb-fe59-41ef-80ee-e06a263c451e | (b) Greater auricular nerve(Ref. Cummings, 6th ed., 1254)The nerve that supplies skin over the angle of mandible is Greater auricular Nerve. Sometimes during parotid surgeries, Greater auricular Nerve also gets injured along with the Auriculotemporal Nerve. In this situation with the aberrant regeneration of the Auriculotemporal Nerve, the parasympathetic fibres (of the auriculotemporal nerve) to salivary glands become aberrantly connected with the sympathetic cholinergic fibres to sweat glands of the skin overlying the parotid as well as overlying the angle of mandible (the territory of Greater auricular nerve). | ENT | Facial Nerve And Its Disorders | The nerve that supplies skin over the angle of mandible, if involved in parotid injuries forms a part of anatomical basis for gustatory sweating:
A. Auriculotemporal nerve
B. Greater auricular nerve
C. Zygomaticotemporal nerve
D. Buccal nerve
| Greater auricular nerve |
7f29b59e-f58b-45a8-94aa-0860def10e79 | Thelarche, Pubarche, Menarche In girls the sequence of development of pubey is (Mnemonic * BPH in males).deg B - Breast development (Thelarche)deg P - Pubic hair development (Pubarche)deg H - Height increases; peak grown velocitydeg attained - growth spu in males = Menstruation stas (Menarche)deg (Axillary hair develop after menstruation stas)deg Extra Edge : Tanners staging of Breast development - Stage Breast development Stage I Prepubeal state; No palpable breast -tissue with areola < 2 cms in diameter. Stage II Breast budding occurs with a visible and palpable mound of breast tissue. Areola enlarges Nipples begin to develop Stage III Fuher growth & elevation of entire breast Stage IV Projection of areola & papilla above the general breast contour in a secondary mound Stage V Mature breast Nipple pigmented Montgomery's gland visible Recession of areola to contour of breast. Breast size - Is no indication of breast maturity. Tanners staging of Pubic hair Development - Stage Pubic hair development Stage I No sexually stimulated pubic hair present. Some nonsexual hair may be present. Stage II Coarse, long crinky pubic hair along labia majora Stage III Coarse curly pubic hair extending til mons pubis Stage IV Adult pubic hair in thickness and texture but does not extend up to the inner aspect of thighs Stage V Pubic hair extend upto the thighs Also know : Sexual development in adolescent males 1st sign Testicular enlargementdeg Appearance of pubic hair and growth of axillary hairdeg Penile enlargementdeg Growth spudeg | Gynaecology & Obstetrics | null | The Sequence of development of pubey in girls is :
A. Thelarche, Pubarche, Menarche
B. Pubarche, Thelarche, Menarche
C. Pubarche, Menarche. Thelarche
D. Menarche, Thelarche, Pubarche
| Thelarche, Pubarche, Menarche |
59e2580e-9f09-418f-ba9c-5ed97a61d39a | Dislocation of the knee- *This rare injury results from severe violence to the knee so that all of its suppoing ligaments are torn. *It is a major damage to the joint, and is often associated with injury to the popliteal aery. *Treatment is by reduction followed by immobilization in a cylinder cast. Clinical evaluation : (vascular exam) -Measure Ankle-Brachial Index (ABI) if ABI >0.9 >>>> then monitor with serial examination if ABI <0.9 >>>> -If pulses are absent or diminished confirm that the knee joint is reduced or perform immediate reduction and reassessment - Immediate surgical exploration if pulses are still absent following reduction &;schema time >8 hours has amputation rates - If pulses present after reduction then measure ABI then consider observation vs. angiography Clinical evaluation : (vascular exam) -Priority is to rule out vascular injury on exam both before and after reduction serial examinations are mandatory. - Palpate the dorsalis pedis and posterior tibial pulses if pulses are present and normal , >> it does not indicate absence of aerial injury. Ref: Maheshwari 9th ed p.142 | Orthopaedics | Thigh, Knee,Leg,Foot & Ankle injuries | Commonest dangerous complication of posterior dislocation of knee is-
A. Popliteal aery injury
B. Sciatic nerve injury
C. Ischaemia of lower leg compament
D. Femoral aery injury
| Popliteal aery injury |
31b90bb4-4b63-4711-8176-47e2aaeb00e2 | Mandibular Actinomyces is a uncommon disease caused by Actinomyces israelli CERVICOFACIAL ACTINOMYCOSIS This is the most common and recognized presentation of the disease. Actinomyces species are commonly present in high concentrations in nsillar crypts and gingivodental . Many patients have a history of poor dentition, oral surgery or dental procedures. or trauma to the oral cavity. Chronic tonsillitis. mastoiditis. and otitis are also impoant risk factors for actinomycosis. ref : maheswari 9th ed | Orthopaedics | Skeletal infections | Most common site of Actinomycosis among the following
A. Rib
B. Tibia
C. Femur
D. Mandible
| Mandible |
f6361722-4032-43e6-80f4-012b03ce9568 | B i.e. Jamais Vu Deja vu feelings are defined as those in which unfamiliar situations feel 'strangely' familiar Q. It may occur as a normal phenomenon and is also associated with several forms of epilepsy and schizophrenia. Jamais vu are those feelings in which the familiar situations are perceived unfamiliar Q. Apa from schizophrenia it also occurs in epilepsy. Deja entendu is the illusion that what one is hearing was heard previouslyQ and deja pense in which a thought never enteained before is incorrectly regarded as repetition of a previous thought. | Psychiatry | null | Unfamiliarity of familiar things is seen in :
A. Deja vu
B. Jamais vu
C. Deja entendu
D. Deja pence
| Jamais vu |
1aef9cef-cd72-430a-9646-eecc6aceb797 | Bile acids can induce hyperproliferation of the intestinal mucosa a number of intracellular mechanisms Cholecystectomy, which alters the enterohepatic cycle of bile acids, has been associated with a moderately increased rise of proximal colon cancers It cannot be ruled out, however, that it is less the effect of the cholecystectomy than the impact of other, not yet identified factors in the lithogenic bile of such patients A number of cofactors have been identified that may enhance or neutralize the carcinogenic effects of bile acids, e.g., the amount of dietary fat, fibre or calcium Calcium, in fact, binds bile acids and this may reduce their negative impact Ref: Maingot 11th edition Pgno : 628 | Anatomy | G.I.T | Most common malignancy after cholecystectomy is of
A. Colon
B. Stomach
C. Pancreas
D. Ileum
| Colon |
0c5fa0ac-8bd7-43e3-a78c-219dfa4afb39 | .CONGENITAL HYPEROPHIC PYLORIC STENOSIS is hyperophy of musculature of pyloric antrum, especially the circular muscle fibres, causing primary failure of pylorus to relax. Duodenum is normal. Clinical features of congenital pyloric stenosis 1. Vomiting 2. VGP 3. Palpable mass 4. Constipation and dehydration Diagnosis is established by -- Clinical examination. -- U/S abdomen (very useful)--Doughnut sign. * Pyloric muscle 4 mm or more in thickness. * Length of pyloric canal > 1.8 cm. -- Barium meal shows obstruction. ref:SRB&;S manual of surgery,ed 3,pg no 752 | Surgery | G.I.T | "Doughnut" sign is seen in
A. Intussusception
B. Carcinoma colon
C. CHPS
D. Volvulus
| CHPS |
14b164c6-4bb8-486b-985c-3a1779b21da6 | Diastatic fracture or sutural fracture: Suture separation is called a diastatic fracture. Penetrating and performing fracture: They are fractures produced by penetrating objects like a bullet, pointed sharp weapon, sword or dagger. Fracture which is having an entry and an exit is called a performing fracture. Cut fracture Skull may be subjected to cut injuries when a heavy cutting weapon is used. The cut injury may enter the skull cavity and injure the brain. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 164 | Anatomy | Special topics | Sutural separation seen in
A. Diastatic fracture
B. Penetrating fracture
C. Cut fracture
D. Performing fracture
| Diastatic fracture |
198976b9-cac6-4c3d-b116-23672a8c2d83 | Ans. is 'a' i.e., < 5 gm/d Ranges of population nutrient intake goalsDietary factorGoal (% of total energyunless otherwise statedTotal fatSaturated fatty acidsPolyunsaturated fatty acids (PUFAs)15-30%< 15%6-10%n-6 Polyunsaturated fatty' acids (PUFAs)n-3 Polyunsaturated fatty acids (PUFAs)Trans fatty acidsMonounsaturated fatty acids (MUFAs)5-8%1-2%<1%by differenceTotal carbohydrateFree sugarsProteinCholesterolSodium chloride (sodium)Fruits and vegetablesTotal dietary fibreNon-starch polysaccharides (NSP)55-75%<10%10-15%<300 mg per day< 5g per day (< 2g per day)3 400g per dayFrom foodsFrom foods | Social & Preventive Medicine | Nutrition and Health | WHO recommended salt intake -
A. < 5 gm/d
B. < 6 gm/d
C. < 7 gm/d
D. < 8 gm/d
| < 5 gm/d |
ac4d743c-7fb9-4962-86f0-dfa7de61f6b9 | The patient suffers from sensorineural deafness, so fenestration and stapes mobilisation cannot be done. Such patients require heating aid or cochlear implant. Since hearing aid has not shown any benefit, cochlear implant will be indicated to provide hearing and develop speech and language. There is no conservative treatment. | ENT | Ear | A child aged 3 years presented with severe sensorineural deafness, he was prescribed hearing aids but showed no improvement. What is the next line of management?
A. Fenestration surgery
B. Stapes mobilisation
C. Cochlear implant
D. Conservative
| Cochlear implant |
cffa3d77-2b9f-4868-b457-7124468e3931 | D i.e. 10 yearsRef: Diagnostic Pathology: Bone, By G. Petur Nielsen, Andrew E Rosenberg, 2nd edition, pageExplanation:Post-radiation OsteosarcomaLatent period from radiation is long: Median 11 years.Rarely as little as 2 years.Latency inversely related to radiation dose.OsteosarcomaThe X-ray appearances are variable.Hazy osteolytic areas may alternate with unusually dense osteoblastic areas.The endosteal margin is poorly defined.Often the cortex is breached and the tumour extends into the adjacent tissues; when this happens, streaks of new bone appear, radiating outwards from the cortex - the so-called 'sunburst' effect.Where the tumour emerges from the cortex, reactive new bone forms at the angles of periosteal elevation (Codman's triangle).While both the sunburst appearance and Codman's triangle are typical of osteosarcoma, they may occasionally be seen in other rapidly growing tumours.Risk Factors for OsteosarcomaFamilial cases where the deletion of chromosome '13q14' inactivates the retinoblastoma gene is associated with a high risk of osteosarcoma development.Bone dysplasias, including Paget's disease, fibrous dysplasia, enchondromatosis, and hereditary multiple exostoses, increase the risk of osteosarcoma.Li-Fraumeni syndrome (germline TP53 mutation) is a predisposing factor for osteosarcoma development.Rothmund-Thomson syndrome (i.e., autosomal recessive association of congenital bone defects, hair and skin dysplasias, hypogonadism and cataracts) is associated with increased risk of this disease.Bone irradiation.Note:Characteristic histologic finding of osteosarcoma:Bone forming tumor (osteo = bone).Presence of osteoid.Characteristic radiologic features:Codman's triangle.Sunburst appearance. | Radiology | Radiotherapy | Time period between occurrence of osteosarcoma following radiation therapy:
A. 1 year
B. 3 years
C. 5 years
D. 10 years
| 10 years |
5a6aff84-04a8-4660-adae-cce498edd550 | Ans. is 'a' i.e., Neuro blastoma MC intra abdominal solid tumor in children.Derived from neural crest.90% present before 5 years of age.50% present before 2 years of age.MC soft tissue sarcoma in children < 15 years of age.Half present below 5 years.2/3 present below 10 years.o Wilm's tumor (Nephroblastoma)Most common malignant tumor of kidney.80% of tumor present below' 5 year of age.o PresentionAsymptomatic abdominal mass (M.C.).Haematuria (10-25%).Hypertension (25%).Abdominal pain (30%).Fever (20%). | Pediatrics | Neoplasms of the Kidney | Most common intra abdominal solid organ tumor in child is-
A. Neuroblastoma
B. Rhabdomyoblastoma
C. Wilm's tumor
D. Hypernephroma
| Neuroblastoma |
d0283414-b3dd-431d-8633-e5d5b6a88b88 | There are several paraneoplastic syndromes associated with bronchogenic carcinoma. This patient's symptoms of polyuria, nausea, vomiting, abdominal pain and altered mental status indicates a diagnosis of hypercalcemia occurring secondary to the release of PTHrP by squamous cell carcinoma of the lung. Small cell carcinoma of the lung is associated with hyponatremia due to the syndrome of inappropriate secretion of antidiuretic hormone or possibly ANP. These patients develop hyponatremia. Small cell carcinoma is also associated with the ectopic production of ACTH resulting in hypokalemia. Ref: Horn L, Pao W, Johnson D.H. (2012). Chapter 89. Neoplasms of the Lung. InLongo D.L., Fauci A.S., Kasper D.L., Hauser S.L., Jameson J, Loscalzo J (Eds),Harrison's Principles of Internal Medicine, 18e | Medicine | null | Ramesh a 40 yr old male patient presenting with polyuria, pain abdomen, nausea, vomiting, and altered sensorium was found to have bronchogenic carcinoma. Which of the following electrolyte abnormality can be seen in him?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcaemia
D. Hypercalcemia
| Hypercalcemia |
152acb11-43a6-45eb-8a25-cf42fdf931a3 | IgA is the predominat immunoglobulin produced in Peyer's patches. IgA producing lymphocytes are more abundant in these tissues than in lymph nodes or spleen. The direct secretion of secretory IgA onto mucosal epithelia represents the major effector mechanism of mucosa-associated lymphoid tissue (MALT). IgA is the main immunoglobulin in secretions such as milk, saliva, and tears and in secretion; of the respiratory, intestinal, and genital tracts. It protects mucous membranes from attack of bacteria and viruses. | Microbiology | null | Which of the immunoglobulins is present in the Peyer's patch?
A. IgM
B. IgG
C. IgA
D. IgD
| IgA |
48c9e81f-089b-4db4-a409-c4127d8c2ba3 | Abdominal colic in lead poisoning is called saturnine colic.It is usually noctural colic and is a late symptom of lead poisening. | Forensic Medicine | null | In which of the following poisoning abdominal colic is a presenting feature?
A. Arsenic poisoning
B. Cyanide poisoning
C. Mercuric poisoning
D. Lead poisoning
| Lead poisoning |
55773040-dd79-44ab-8f1a-ffe521c6f45f | Malaria has a worldwide distribution between 45degN and 40degS latitude, generally at altitudes below 1800 m. P vivax is the most widely distributed of the four species, and together with the uncommon P malariae, is found primarily in temperate and subtropical areas. P falciparum is the dominant organism of the tropics. P ovale is rare and found principally in Africa. Ref: Ray C.G., Ryan K.J. (2010). Chapter 50. Sporozoa. In C.G. Ray, K.J. Ryan (Eds), Sherris Medical Microbiology, 5e. | Microbiology | null | Which of the following is the commonest cause of malaria in the world?
A. P. vivax
B. P. ovale
C. P. falciparum
D. P. malariae
| P. vivax |
c8422709-ce1a-463e-9b03-661e09cc1d97 | Age changes at pubic symphysis The changes in the pubic symphysis are the best criteria to assess the age from third to fifth decade. The changes occurs on three components: dorsal surface, ventral surface, and margin. At the age of about 20 years, there is formation of horizontal ridges of bone on the aicular surface which first stas on the upper poion of the ventral surface and extends to the dorsal surface. This is called billowing. At about 25-35 years, the surface becomes granular and the ventral nd dorsal margins are well defined. A rim formation stas from the dorsal surface extends to the ventral surface. At about 35 -45 years, the upper and lower end will be raised and also the ventral margin by bony extension which is called lipping and the beaded rim development will be complete on all around the margins of the aicular surface. By 45-55 years, the beaded rim stas breaking. By 55-65 years the breakdown of the rim is more and by the end of seventh decade the breakdown of the rim will be complete. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr. PC IGNATIUS PAGE NO90 | Forensic Medicine | Identification | Best bone of the following to assess the age of a person between 20-50 years is
A. Skull
B. Ribs
C. Sternum
D. Pubic symphysis
| Pubic symphysis |
f6ac73d4-439c-4f69-ab20-748d6f0a4a5c | Ref: Apleys System of Orthopaedics and Fractures, 9th editionExplanation:HINGE FRACTUREBasilar fracture of skull.Involves middle cranial fossa and pituitary fossa.Divides the skull into anterior and posterior segments.Mechanism of injuryo Blow to chin, e.g. Boxingo Motor-cycle accident - Due to impact on the chin during the fall.JEFFERSON FRACTUREBurst fracture of Atlas I Cl vertebra).Lower incidence of spinal cord injury when compared to burst fractures of the other vertebrae.This is due to absence of vertebral body in Cl vertebra. | Orthopaedics | Spinal Injuries | Hinge fracture is seen in:
A. Wrist
B. Mandible
C. Basilar skull fracture
D. Cl vertebra fracture
| Basilar skull fracture |
fcdbb875-c7fa-46c0-b204-b24b579ca4c1 | Activated CD4+ helper T cell is the specific immune mechanism effective in TB.
It is a ‘cell-mediated' type of immunity (since it is intracellular). | Microbiology | null | In TB, immunity is provided by:
A. CD4+ cells
B. CD8+ cells
C. IgG
D. IgM
| CD4+ cells |
dd8b1ce8-3494-4843-9808-25eaedce1e46 | (c) Source: (Kasper, p. 1993) AS occurs in 1-6% of adults inheriting human lymphocyte antigen B27 (HLA-B27). However, the prevalence in B27-positive relatives of patients with AS is up to 30%. Men are three times more likely to be affected. | Medicine | Immunology and Rheumatology | A 22-year-old man has symptoms of low back pain and stiffness. After several months of mild symptoms, he notes more severe stiffness at night and hip pain. On physical examination, there is paravertebral muscle tenderness and limited flexion of the lumbar spine. Figure shows an x-ray of the lumbar spine. Which of the following is the most likely diagnosis?
A. Reiter syndrome
B. Marfan syndrome
C. ankylosing spondylitis (AS)
D. RA
| ankylosing spondylitis (AS) |
65323036-8156-43dd-b8b0-913d30ab6e78 | Dose adjustment is not required for Trovafloxacin, Moxifloxacin, Pefloxacin and Nalidixic acid for patient with decreased creatinine clearence. Trovafloxacin will cause liver damage and increase in liver enzymes. So it is contraindicated in patients with active liver disease. Ref: Sherwood L. Gorbach, John G. Balett, Neil R. Blacklo (2004), Chapter 26, "Quinolones", "Infectious Diesases", 3rd Edition, Lippincott Publications, USA, Page 253 ; Kalzung, 9th Edition, Page 779. | Pharmacology | null | Which drug does not need dose adjustment in a patient with creatinine clearance of
A. Ciprofloxacin
B. Sparfloxacin
C. Lomefloxacin
D. Trovafloxacin
| Trovafloxacin |
311ea464-f79d-4208-a70c-d5fd4c9f423d | The liver is the largest gland in the body and has a wide variety of functions (265-Snell 7th )
The liver is the largest gland in the body. (283-BDC-2)
Femer is the longest and the strongest bone of the body (16-B DC-2)
Skin is the largest organ of the body (278-K- Sembulingam physiology)
Skin is considered as the largest sense organ in the body it has many nerve endings, which are specialized to form cutaneous receptors (281-K. Sembulingam physiology 3rd ) | Anatomy | null | The largest organ of the body is
A. Liver
B. skin
C. Gluteus maximus
D. Femur
| skin |
56dd6228-7b4c-4072-8c13-fa92f78bcc20 | Ans. (d) Surgery + Radiotherapy* Role of Radiotherapy in Abdominal wall desmoids is still controversial.* But there are studies showing better results with RT combined with surgery, rather than surgery alone.* So let us opt for both | Surgery | Anal Canal | Treatment of choice of desmoids tumour is:
A. Surgery
B. Chemotherapy
C. Radiotherapy
D. Surgery + Radiotherapy
| Surgery + Radiotherapy |
d8c5ed04-3c5a-43a3-bab1-bf67f4c65737 | An optical isomer can be named by the spatial configuration of its atoms.The D/L system does this by relating the molecule to glyceraldehyde.Glyceraldehyde is chiral itself, and its two isomers are labeled D and L | Biochemistry | null | The L or D form of a sugar is determined by its relation to:
A. Fructose
B. Glycogen
C. Glyceraldehyde
D. Glucose
| Glyceraldehyde |
a73ad975-427f-41c9-9166-2e5699e10962 | Ans. is 'a' i.e., Elevated CML there will be rise in B1, level LDH level And decreased levels of ALP. | Medicine | null | Vitamin B level in chronic myeloid leukemia is
A. Elevated'
B. Decreased
C. Normal
D. Markedly
| Elevated' |
5930efe0-aabd-4031-add7-926dca85292b | Patient's excessive dependency on her boyfriend,indecisiveness, and fear of being alone are suggestive of dependent personality disorder. It is a cluster C PD .Additionally in this patient is uncomfoable when alone. | Psychiatry | Personality Disorders | A 27-year-old woman comes to psychiatrist complaining of sleep difficulty since her breakup a month ago. On exploring fuher she repos difficulty in work, decision making, socializing without his help. Since early age she has struggled with low self-confidence and fears of rejection and abandonment. She appears anxious and sad but brightens easily. Which of the following is the most likely diagnosis in this patient?
A. Acute stress disorder
B. Major depressive disorder
C. Borderline personality disorder
D. Dependent personality disorder
| Dependent personality disorder |
656534f0-7618-43c9-9843-e568777cf009 | The diencephalon is the pa of brain between the cerebrum and brainstem.The cavity within it is called third ventricleThe pas of diencephalon are:ThalamusMetathalamusEpithalamusSubthalamusHypothalamus(Ref: Vishram Singh textbook of clinical neuroanatomy Second Edition pg -123) | Anatomy | Brain | Diencephalon represents
A. Lateral ventricle
B. 3rd ventricle
C. 4th ventricle
D. Aquedct
| 3rd ventricle |
320c059c-e672-4c79-a074-41258ec4c6f3 | Ans. is 'a' i.e., .Aspergillus o Septate hyphae with acute branching-Aspergilluso Non septate hyphae with obtuse branching-Rhizopus/mucoro Septate hyphae with dichotomous branching into two equal divisons at a regular angle of 45deg are typical of Aspergillus.o Mucor and rhizopus are non-septate (aseptate) and penicillium has no hyphae (It is yeast like fungus). | Microbiology | Mycology | Acute angled septate hyphae are seen in -
A. Aspergillus
B. Mucor
C. PeniciIlium
D. Candida
| Aspergillus |
b7e1e909-d360-4232-b40b-be38e83eede4 | Past pointing and intentional tremors- Lesion of neo-cerebellum. Archicerebellum lesion-Truncal ataxia. Damage to Substantia nigra -Parkinsonism- Resting tremor is seen. | Medicine | Parkinsonism and other movement disorders | Comment on the site of damage for a patient exhibiting the following symptom?
A. Substantia Nigra
B. Neocerebellum
C. Archicerebellum
D. Ventromedial nucleus thalamus
| Neocerebellum |
68b0418d-0260-445b-9518-c07108f41b41 | T11-T12 Pain pathways during labour The pain of labour arises from - Contraction of myometrium, against the resistance of cervix and perineum - Progressive dilatation of the cervix and lower uterine segment - Stretching and compression of pelvic and perineal structures Pain during the, first stage of labour is mostly visceral pain resulting from uterine contractions and cervical dilatation. It is usually confined to the T11-T12 dermatomes during the latent phase but eventually involves the TIO-LI dermatomes as the labour enters the the active phase. The visceral afferent fibres responsible for labour pain travel with sympathetic nerve.fibres.first to the uterine and cervical plexes then through the hypogastric and aoic plexes before entering the spinal cord with the T10-L1 nerve roots. The onset of perineal pain at the end of fist stage signals the beginning of the fetal descent and the second stage of labour. Stretching and compression of pelvic and perineal structures intensify the pain. Sensory innervations of the perineum is provided by the pudendal nerve (S2-S4) so pain during the second stage of labour involves the T10-S4 dermatosomes. | Gynaecology & Obstetrics | null | Prelabour pains are mediated through
A. Tit-T12
B. T2-L3
C. S1-S3
D. L3-L4
| Tit-T12 |
95f18b18-97c9-47f5-a025-663bf2fd2926 | ANSWER: (B) Inhibits LipoxygenaseREF: Goodman and Gillman s 11th ed page 479LEUKOTRIENE-SYNTHESIS INHIBITORS:The formation of leukotrienes depends on lip oxygenation of arachidonic acid by 5-lipoxygenase. Zileuton is a potent and selective inhibitor of 5-lipoxygenase activity and thus blocks the formation of all 5-lipoxygenase products. Thus, in addition to inhibiting the formation of the cys-LTs, zileuton also inhibits the formation of leukotriene B4 (LTB4), a potent chemotactic autacoidf and other eicosanoids that depend on leukotriene A4 (LTA4) synthesis.Logically, the therapeutic effects of a 5-lipoxygenase inhibitor would include all those observed with the CysLT-receptor antagonists, as well as other effects that may result from inhibiting the formation of LTB4 and other 5-lipoxygenase products. | Pharmacology | Asthma | Mechanism of action of zeulton is?
A. Inhibits production of IgE
B. Inhibits Lipoxygenase
C. Inhibits Cyclooxygenase
D. Inhibits activity of mast cells
| Inhibits Lipoxygenase |
81c054b4-9eea-487b-938b-63090a7d8bdb | Ref Robbins 8/e p262;7/e p272; 9/e p267 Hamaomatous Polyps Hamaomatous polyps occur sporadically and as compo- nents of various genetically determined or acquired syn- dromes (Table 14-6). As described previously, hamaomas are disorganized, tumor-like growths composed of mature cell types normally present at the site at which the polyp develops. Hamaomatous polyposis syndromes are rare, but they are impoant to recognize because of associated intestinal and extraintestinal manifestations and the need to screen family members. Juvenile Polyps Juvenile polyps are the most common type of hamaoma- tous polyp. They may be sporadic or syndromic. In adults, the sporadic form sometimes is also referred to as an inflam- matory polyp, paicularly when dense inflammatory infil- trates are present. The vast majority of juvenile polyps occur in children younger than 5 years of age. Juvenile polyps characteristically are located in the rectum, and most manifest with rectal bleeding. In some cases, prolapse occurs and the polyp protrudes through the anal sphincter. Sporadic juvenile polyps are usually solitary but in persons with the autosomal dominant syndrome of juvenile pol- yposis the number varies from 3 to as many as 100. Colec- tomy may be required to limit the hemorrhage associated with polyp ulceration in juvenile polyposis. Dysplasia occurs in a small propoion of (mostly syndrome- associated) juvenile polyps, and the juvenile polyposis syn- drome is associated with increased risk for the development of colonic adenocarcinoma. hamaomatous polyps and mucocutaneous hyperpigA mentation that carries an increased risk of several malig- nancies, including cancers of the colon, pancreas, breast, lung, ovaries, uterus, and testes, as well as other unusual neoplasms. Germ line heterozygous loss-of-function muta- tions in the gene LKB1/STK11 are present in approximately half of the patients with the familial form of Peutz-Jeghers syndrome, as well as a subset of patients with the sporadic form. Intestinal polyps are most common in the small intestine, although they may also occur in the stomach and colon and, rarely, in the bladder and lungs. On gross evaluation, the polyps are large and pedunculated with a lobulated contour. Histologic examination demonstrates a characteristic arborizing network of connective tissue, smooth muscle, lamina propria, and glands lined by normal-appearing intestinal epithelium (Fig. 14-31, B | Anatomy | General anatomy | Hamaoma is
A. Proliferation of cells in foreign site
B. Proliferation of native cells in tissue
C. Malignant condition
D. Acquired condition
| Proliferation of native cells in tissue |
bf96b28c-55ca-4a13-b525-078a38df568e | Different type of such healthcare infection and their most common causative organism:- | Microbiology | null | Which of the following organism is most commonly associated with urinary tract infection in Healthcare facility?
A. Staphylococcus epidermidis
B. Staphylococcus aureus
C. klebsiella
D. Streptococcus
| klebsiella |
35e83147-a7c3-4a61-ac1a-b8d0d1d03b9d | Answer is A (Headache): The single most common paroxysmal symptom repoed in patients with pheochromocytoma is headache 'Most adult patients have paroxysmal symptoms, lasting minutes to hours, consisting of headache (80%), perspiration (70%), and palpitations (60%)' - Endocrine Tumors (PMPH-USA, 2003)/ 104 The three most commonly repoed paroxysmal symptoms in pheochromocytoma are Headache, Palpitations and Excessive or inappropriate sweating. Almost all patients will have one of three symptoms above and most will have at least two. The most common and predominant sign of Pheochromocytoma is Hypeension | Medicine | null | Most common paroxysmal symptom of pheochromocytoma:
A. Headache
B. Palpitation
C. Abdominal pain
D. Hypotension
| Headache |
3e8e74c5-f728-4452-b601-c703158772b8 | Ans. is 'c' i.e., Lymphatic spread Spread of carcinoma Commonly by lymphatics o Spread of sarcoma --> Commonly hematogenous | Pathology | null | Squamous cell carcinoma spreads commonly ?
A. Implantation
B. Hematogenous spread
C. Lymphatic spread
D. Trancoelomic spread
| Lymphatic spread |
bb847487-09d0-4064-a8a0-a1288f3bbd5e | Ans. D i.e. Surface ectoderm Embryology of eyeball Structures derived from mesoderm: Corneal stroma & endothelium, Only smooth muscles of iris, All muscles (EXCEPT iris muscle) Structures derived from surface ectoderm: Conjunctival epithelium, Lens Structures derived from neuroectoderm: Epithelium of iris & ciliary body, Muscles of iris (constrictor & dilator pupillae) | Ophthalmology | null | Lens develops from: September 2012
A. Neural crest
B. Mesoderm
C. Neuroectoderm
D. Surface ectoderm
| Surface ectoderm |
13e9f4d1-f198-41ea-80d1-ca2bee598431 | Ans. is 'b' i.e., Affective symptoms o Presence of depression (affective symptom) is a good prognostic factor.PROGNOSTIC FACTORS FOR SCHIZOPHRENIAGood Prognostic FactorsPoor Prognostic Factorsl. Acute or abrupt onset1. Insidious onset2. Onset > 35 years of age (late onset)2. Onset < 20 years of age (early onset )3. Presence of precipitating stressor3. Absence of stressor4. Good premorbid adjustment4. Poor premorbid adjustment5. Catatonic subtype (Paranoid subtype has an intermediate prognosis)5. Disorganized, simple, undifferentiated, or chronic catatonic subtypes6. Short duration (< 6 months)6. Chronic course (> 2 years)7. Presence of depression7. Absence of depression8. Predominance of positive symptoms8. Predominance of negative symptoms9. Family history of mood disorder9. Family history of schizophrenia10. First episode10. Past history of schizophrenia11. Pyknic (fat) physique11. Asthenic (thin) physique12. Female sex12. Male sex13. Married13. Single, divorcedGood social supportPoor social supportPresence of confusion, perplexity, or disorientation in the acute phaseFlat or blunted affect16. Proper treatment, good treatment compliance, and good response to treatment16. Absence of proper treatment or poor response to treatment17. Outpatient treatment17. Institutionalization (long term hospitalization)18. Normal cranial CT scan18. Evidence of ventricular enlargement on cranial CT scan | Psychiatry | Schizophreniform Disorder | Good prognosis in schizophrenia is indicated by -
A. Soft neurological signs
B. Affective symptoms
C. Emotional blunting
D. Insidious onset
| Affective symptoms |
0216aaf7-bd27-47de-9682-247a1c3c9da7 | Monoamniotic twins are at a great risk of developing cord accidents like entanglement which can lead to sudden fetal death. Therefore all monoamniotic twins have to be delivered by a Cesarean sections between 32-34 weeks , after ensuring lung maturation | Gynaecology & Obstetrics | Twin Pregnancy, Molar Pregnancy, Gestational Trophoblastic disease and contraception in special situations (Sour Grapes!) | In twin pregnancy, Vaginal delivery is contraindicated in
A. Monochorionic monoamniotic
B. First twin veex, 2nd breech
C. Second twin transverse
D. First twin Mentoanterior
| Monochorionic monoamniotic |
a518383c-c795-4986-bc38-70ea3d86f435 | The standard definition of TIA requires that all neurologic signs and symptoms resolve within 24 hours regardless of whether there is imaging evidence of new permanent brain injury. Stroke has occurred if the neurologic signs and symptoms last for >24 hours. | Medicine | Stroke and TIA | Duration of T.I.A (Transient Ischemic Attacks) is less than?
A. 12 hours
B. 24 hours
C. 48 hours
D. 36 hours
| 24 hours |
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