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6c521d0e-36e2-4bca-9ea8-5e6b7c892e89 | Luteinizing hormone (LH) a gonadotropin of the anterior pituitary gland, acting with follicle-stimulating hormone to cause ovulation of mature follicles and secretion of estrogen by thecal and granulosa cells of the ovary; it is also concerned with corpus luteum formation. In the male, it stimulates development of the interstitial cells of the testes and their secretion of testosterone. Called also interstitial cell-stimulating hormone.LH peak is a positive feedback mechanism from estradiol. The levels keep rising through the follicular phase and when they reach an unknown threshold, this results in the peak of the LH. This effect is opposite from the usual negative feedback mechanism presented at lower levels. In other words, the mechanism(s) are not yet clear. The increase in LH production only lasts for 24 to 48 hours. This "LH surge" triggers ovulation, thereby not only releasing the egg from the follicle but also initiating the conversion of the residual follicle into a corpus luteum that, in turn, produces progesterone to prepare the endometrium for a possible implantation. Ref: Ganong&;s review of medical physiology; 24th edition; page no:-407 | Physiology | Endocrinology | Increased LH secretion just before ovulation is due to
A. Positive feed-back by progesterone
B. Positive feed-back by estrogen
C. Positive feed-back by FSH
D. Positive feed-bad by relaxin
| Positive feed-back by estrogen |
91927901-80be-47c6-a626-6b7e467b452d | Ans. is 'd' i.e., Cricopharyngeus of inferior constrictor Upper esophageal sphinctor* The upper esophageal sphincter surrounds the upper part of the esophagus.* It consists of skeletal muscle, but is not under voluntary control.* Opening of the upper esophageal sphincter is triggered by the swallowing reflex.* The primary muscle of the upper esophageal sphincter is the cricopharyngeal part of the inferior pharyngeal constrictor. | Anatomy | Thorax | Which muscle causes opening of the upper end of esophagus?
A. Epiglottis
B. Thyropharungeus
C. Stylopharyngeus
D. Cricopharyngeus of inferior constrictor
| Cricopharyngeus of inferior constrictor |
583d4688-0d95-443c-a6c7-316aa33d07a1 | Janani Suraksha Yojana (JSY)
• Launched on 12th April 2005
• It is a ‘modification of National Maternity Benefit Scheme
• Objectives of JSY: Reduction of maternal mortality and infant mortality (through institutional deliveries and care especially for poor women.) | Social & Preventive Medicine | null | Which of the following is the ego-expansion of JSY?
A. Janani Sampoorna Yojana
B. Janani Samridhi Yojana
C. Janani Swarojgar Yojana
D. Janani Surakshan Yojana
| Janani Surakshan Yojana |
b6ec6bf2-fa70-477e-af00-d6cefeb451d1 | Ans. is 'c' i.e., Alpha agonist Drug of choice for initial treatment of open angle glaucoma is either an topical b-blocker or topical PG analogue (latanoprost) It target IOT is not attained either change over to alternative drug or use both concurrently. In refractory cases (who are not responding to (3-blockers and PG analogues), topical a-agonist (Brimozidine) or topical carbonic anhydrase inhibitor (dorazolamide) is added. It target IOT is still not attained, laser trabeculoplasty is considered. | Ophthalmology | null | Drug used in refractory glaucoma ?
A. Systemic glucocoicoid
B. ACE inhibitor
C. Alpha agonist
D. Beta blocker
| Alpha agonist |
10572939-fdef-490b-89f1-88597f5c4c2d | Ans. is 'c' i.e., Hyperparathyroidism o You can solve the question just looking at calcium value. Amongst the given options only hyperparathyroidism causes hypercalcemia. The patient in question has an increased serum Ca', decreased serum phosphorus and increased values of alkaline phosphatase, all of which characterize hyperparathyroidism. | Pediatrics | null | A 10 year old boy has a fracture of femur. Biochemical evaluation revealed Hb 11.5 gm/dl and ESR 18 mm 1st hr. Serum calcium 12.8 mg/dL, serum phosphorus 2.3 mg/dL, alkaline phosphate 28 KA units and blood urea 32 mg/dL. Which of the following is the most probable diagnosis in his case-
A. Nutritional rickets
B. Renal rickets
C. Hyperparathyroidism
D. Skeletal dysplasia
| Hyperparathyroidism |
a9050e02-a2e1-4825-8ac0-b364fe620ed4 | Ans. c (Measles is more infectious than mumps). (Ref: Park PSM 22nd/pg. 58, 96)SECONDARY ATTACK RATE# It is defined as "the number of exposed persons developing the disease within the range of IP, following exposure to primary case"SAR =Number of exposed persons developing the disease within the range of IP------------------------------------------Total number of exposed/wsusceptible" contactsx 100# The primary case is excluded from both the numerator and denominator.# Case fatality rate is a measure of "killing power" of a disease. | Social & Preventive Medicine | Communicable Diseases | The secondary attack rate of measles is more than mumps. What is the conclusion?
A. Measles is more dangerous than mumps.
B. Mumps is more dangerous than measles.
C. Measles is more infectious than mumps.
D. Measles is more common than mumps.
| Measles is more infectious than mumps. |
a9d12f91-0803-443d-bc52-8b760c101d89 | Ans. (a) LungRef: Blumgart 5/e p 930-933* Secondary deposits in Pancreas is mc from Renal cell cancer (But on Postmortem studies- Lung cancer has been the topmost to produce secondary to pancreas) | Surgery | Pancreas | Most common primary leading to secondaries in pancreas:
A. Lung
B. Breast
C. Colon
D. Stomach
| Lung |
82e67ce7-d356-4bda-99fe-722a3702cb2c | .The external branch of the superior laryngeal nerve (EBSLN) is at risk of injury during thyroid operations when dissection of the superior pole and ligation of the superior thyroid vessels (STV) are carried out. From that perspective, EBSLN injury poses a threat to handicap all patients undergoing thyroid operations. ref Robbins 9/e pg 345 | Pathology | All India exam | Most common nerve injury associated with thyroid surgery
A. Right recurrent laryngeal
B. Left recurrent laryngeal
C. Right internal laryngeal
D. External branch of superior laryngeal nerve
| External branch of superior laryngeal nerve |
43181a37-7d03-4e58-8941-e4458592e6c4 | Ans. is 'd' i.e., 5HT3 antagonist Ondansetron* It is the prototype of a distinct class of antiemetic drugs developed to control cancer chemotherapy/radiotherapy induced vomiting, and later found to be highly effective in PONV and disease/drug associated vomiting as well.* It blocks the depolarizing action of 5-HT exerted through 5-HT3 receptors on vagal afferents in the g.i.t. as well as in NTS and CTZ.* Cytotoxic drugs/radiation produce nausea and vomiting by causing cellular damage release of mediators including 5-HT from intestinal mucosa activation of vagal afferents in the gut emetogenic impulses to the NTS and CTZ. Ondansetron blocks emetogenic impulses both at their peripheral origin and their central relay.* It does not block dopamine receptors.* Apomorphine or motion sickness induced vomiting is not suppressed.* A weak gastrokinetic action due to 5-HT3 blockade has been detected, but this is clinically insignificant.* A minor 5-HT4 antagonistic action has also been shown, but seems to have no clinical relevance. | Pharmacology | G.I.T | Mechanism of action on ondensetron -
A. RANK ligand inhibitor
B. MMDA antagonist
C. NK 1 receptor antagonist
D. 5 HT3 antagonist
| 5 HT3 antagonist |
4544645a-c1ad-4a6f-a5bc-fcc19cf66fb1 | Ref: KDT 6th ed. pg. 614* HMG-CoA Reductase Inhibitors (statins): This class of compound is the most efficacious and best tolerated hypolipidaemic drugs.* MOA: Competitively inhibit conversion of HMG-CoA to mevalonate by the enzyme HMG-CoA reductase.* Drugs (Statins): Lovastatin, Simvastatin, Pravstatin, Atorvastatin, Rosuvastatin* All statins are given at night except: Rosuvastatin, Atorvastain (can be given at anytime)* Major side effects of statins: Myopathy* Most potent statin: Pitavastain | Pharmacology | C.V.S | Mechanism of action of statins:
A. Inhibit HMG CoA synthase
B. Stimulate HMG CoA reductase
C. Inhibit HMG CoA reductase
D. Stimulate HMG CoA synthase
| Inhibit HMG CoA reductase |
9584b8ee-ad93-4fca-a417-3e9b64ade107 | Ans. is 'd' i.e., +1000 SubstanceHU unitsWaterDense cortical boneSoft tissueFatLung tissueAir0+ 1000 (+400 to + 1000)+ 40 to + 80- 60 to -100- 400 to -600- 1000 | Radiology | Ultrasonography, CT, and MRI | HU units value of bone -
A. 0
B. 40
C. -100
D. 1000
| 1000 |
1d985d2e-1df9-4f8d-8492-a6cff46879cf | The vagina is a muscular tube. The lining epithelium is stratified squamous. Underneath the epithelium is a layer of lamina propria, which is rich in elastic fibres, and does not have any glands. Under the lamina propria layer is a layer of smooth muscle, which has an inner circular and outer longitudinal layer. Finally, there is an adventitial layer, which merges with that of the bladder (anteriorly) and rectum (posteriorly). ref - BDC 6e vol2 pg | Anatomy | Abdomen and pelvis | What is histological appearance of vaginal mucosa ?
A. Stratified squamous
B. Glandular
C. Simple squamous
D. Cuboidal
| Stratified squamous |
674d900e-9652-4bf7-a2ce-8fb83201518b | prospective coho studies is one which the outcome has not yet occurred at the time the investigation begins.most prospective studies begin in the present and continue into future. ref:park&;s textbook,ed 22,pg no 73 | Social & Preventive Medicine | Epidemiology | The influence of maternal smoking and LBW incidence is studied. Detailed smoking history is taken at first AN visit and smoking history and bih weight were studied later. The type of study is-
A. Retrospective coho study
B. Cross sectinal study
C. Clinical trial
D. Prospective coho study
| Prospective coho study |
159ee683-407c-4cdd-9aea-5e1d38722f5d | Phrenic nerveThe pericardium is composed of two layers.The tough external layer, the fibrous pericardium. The parietal layer of serous pericardium is attached to its internal surface. The visceral layer of serous pericardium is fused to the hea.The fibrous and parietal pericardia are supplied by the phrenic nerve (C3-05). They are sensitive to pain.The visceral pericardium or epicardium is supplied by autonomic nerves, not sensitive to pain. | Anatomy | null | In a case of chest pain with pericarditis and pericardial effussion, pain is referred by?
A. Phrenic nerve
B. Superficial cardiac plexus
C. Deep cardiac plexus
D. Vagus nerve
| Phrenic nerve |
730aaf2d-aa82-485f-98e3-ccd8cc33359d | Anticholinergic effects of tricyclic antidepressants (TCAs) are most common. These effects result in dry mouth, constipation, urinary retention, blurred vision, and confusion. They are more common with teiary amine TCAs such as amitriptyline and imipramine than with the secondary amine TCAs desipramine and noriptyline. The potent alpha blocking propey of TCAs often results in ohostatic hypotension. H1 antagonism by the TCAs is associated with weight gain and sedation. The TCAs are class 1A antiarrhythmic agents and are arrhythmogenic at higher doses. Sexual effects are common, paicularly with highly serotonergic TCAs such as clomipramine. The TCAs have a prominent discontinuation syndrome characterized by cholinergic rebound and flulike symptoms. Ref: DeBattista C. (2012). Chapter 30. Antidepressant Agents. In B.G. Katzung, S.B. Masters, A.J. Trevor (Eds), Basic & Clinical Pharmacology, 12e. | Psychiatry | null | A 60 yrs old male comes to casualty with acute retention of urine since 12 hrs. On examination there was distended bladder. His wife gives a history of taking some drug by the patient since 2 days as he is suffering from depression. The most likely drug is:
A. CPZ
B. Amitriptyline
C. Haloperidol
D. Pimozide
| Amitriptyline |
d30749ac-d52c-4276-88f1-3b580c251ea7 | The intercostobrachial nerve is a lateral cutaneous branch of the second intercostal nerve that supplies sensation to the skin of the Axilla . It leaves the second intercostal space at the midaxillary line and subsequently pierces the serratus anterior muscle to enter the subcutaneous tissues of the axilla. The nerve may be injured during axillary surgery such as nodal clearance for breast cancer The anterior divisions of the second, third, fouh, fifth, and sixth thoracic nerves, and the small branch from the first thoracic, are confined to the walls of the thorax, and are named thoracic intercostal nerves respectively . They pass forward in the intercostal spaces below the intercostal vessels. At the back of the chest they lie between the pleura and the posterior intercostal membranes, but soon they run between the internal intercostals and the innermost intercostals then anteriorly they lie between the pleura and the internal intercostals . Ref - radiology assistant.com | Anatomy | Thorax | Root value of intercostobrachial nerve is
A. T1
B. T2
C. T3
D. T4
| T2 |
08714c1d-9144-44b1-9cc9-b02e89557280 | a. Infant of diabetic mother(Ref: Nelson's 20/e p 898-899)Large for date baby with hairy pinna suggests a diagnosis of Infant of diabetic mother. | Pediatrics | New Born Infants | What is the most probable diagnosis in this neonate shown below?
A. Infant of diabetic mother
B. Beckwith Wiedemann syndrome
C. Congenital hypothyroidism
D. IUCR baby
| Infant of diabetic mother |
69dd9296-87d9-42df-a7d9-ad33b598ac36 | Investigations for rectal carcinoma: For Diagnosis: Best diagnosed by sigmoidoscopy (rigid not flexible) and biopsy of tumour Barium enema For Staging: TRUS (transrectal ultrasonography) CT MRI TRUS (Transrectal Ultrasonography) The depth of the tumour invasion can be accurately determined by TRUS, but it cannot detect cancer metastasis in lymph nodes (though it can detect enlarged lymph nodes, but it cannot predict if- cancer infiltration is present or not). CT Scan CT scan is also helpful for cancer extension, but again CT scan also cannot tell clearly about node invasion by cancer cell. MRI Scan It has become the most useful investigation tool (specially with the use of transrectal coils) for rectal carcinoma. It can very well predict the invasion of tumour in rectum as well as lymph node invasion with high accuracy. Ref: Maingot's 11/e, Page 701. | Surgery | null | Which of the following is the investigation of choice for assessment of depth of penetration and perirectal node involvement in rectal cancer?
A. MRI scan
B. CT scan pelvis
C. Double contrast barium enema
D. Transrectal ultrasound
| MRI scan |
b8287635-071b-4829-a328-8078442ffc37 | In 1700s,TB was called "White Plague" due to the Paleness of Patients. Ref: Pg No: 317, IAPSM Textbook of Community Medicine | Social & Preventive Medicine | Communicable diseases | "White plague" is
A. Pneumonic Plague
B. Bubonic Plague
C. Tuberculosis
D. leprosy
| Tuberculosis |
6f35d15b-ad9d-4a47-a47c-ed87f916e5e9 | Ans. is "d" i.e., Ventricular depolarization Event of ECGCauseP-waveAtrial depolarizationQRS complexVentricular depolarizationTwaveVentricular repolarizationPR intervalRepresents time taken by impulse to travel from SA node to ventricle (Atrial depolarization and AV conduction)QT intervalDuration of full ventricular contraction (Ventricular depolarization + Repolarization) | Physiology | Heart: Normal Electrocardiogram | QRS complex is due to -
A. Ventricular repolarization
B. Atrial depolarization
C. Conduction through AV node
D. Ventricular depolarization
| Ventricular depolarization |
29ffcd3f-b4d6-4db2-9bf0-8c84d2421628 | The description given above is of an individual with Graves' disease. Hypersecretion of thyroid hormone because of stimulation of the TSH receptor by thyroid-stimulating immunoglobulins results in excessive movement of thyroglobulin from the colloid to the plasma. The presence of exophthalmos is thought to be pa of the autoimmune disorder in Graves' disease. It is postulated that the thyroid and orbital muscles may share a common antigen. Lymphocytic infiltration and inflammation of orbital muscle then produces the ophthalmopathy. Serum T4 is increased in Graves' disease. Because of excessive stimulation of the thyroid by the thyroid stimulating immunoglobulins, radioactive iodine uptake, which assesses iodine trapping, is increased. The increase in free T4 due to hypersecretion by the thyroid shifts the equilibrium between free and bound T4 toward an increase in thyroxine binding globulin (TBG)-bound hormone. Concomitantly, the concentration of unbound TBG falls. Hence, the radioactive T3 in the resin T3 uptake test would preferentially bind to the resin and resin uptake would be increased. Ref: Jaume J.C. (2011). Chapter 2. Endocrine Autoimmunity. In D.G. Gardner, D. Shoback (Eds), Greenspan's Basic & Clinical Endocrinology, 9e. | Medicine | null | A 48-year-old woman presents with complaints of moderate weight loss over the past 6 months, heat intolerance, palpitations, and fine tremors in the hands. Physical examination reveals the presence of a diffuse goiter and exophthalmos. Which of the following laboratory findings would be expected in this individual?
A. Decreased serum T4
B. Decreased radioactive iodine uptake
C. Decreased resin T3 uptake
D. Increased plasma concentration of thyroglobulin
| Increased plasma concentration of thyroglobulin |
fe0a1a4c-9a32-48a4-8f87-56f32a8316fa | Malarial parasite infecting human belongs to genus plasmodium. P.vivax, P.falciparum,P.malariae,p.ovale.They are protozoa causing malaria in man.In India P.vivax and P. Falciparum are very common.(refer pgno:54 baveja 3 rd edition) | Microbiology | parasitology | Causative agent of malaria -
A. Protozoa
B. Mosquito
C. Bacteria
D. Virus
| Protozoa |
da723774-0586-4760-b962-c5a9308de572 | Morbid (pathological) jealousy is seen in alcoholism. | Forensic Medicine | null | Morbid jealousy is diagnostic of-
A. Cocaine
B. Cannabis
C. Alcoholism
D. Tabacco Intoxication
| Alcoholism |
d054047c-6073-4be7-96cb-e6bdfb8a04db | Calabar Swelling: Localized angioedema and erythema usually on the extremities, characterized by fugitive, swollen lumps of subcutaneous tissue caused by a parasitic filarial worm (Loa loa) endemic to Central and West Africa.
The swollen areas migrate with the worm through the body at a speed of about 1 cm per minute and may become as large as a small egg. | Microbiology | null | Calabar swelling is produced by-
A. Onchocerca volvulus
B. Loa loa
C. Brugia malayi
D. Wuchereria bancrofti
| Loa loa |
59c99be2-a96b-4c90-9df1-da874789d53a | The Deep radial nerve courses between the two heads of the supinator and is located just medial and distal to the lateral epicondyle. It can be compressed by hyperophy of the supinator causing pain and weakness. The Median nerve passes into the forearm flexor compament. Superficial radial nerve courses down the lateral aspect of the posterior forearm and would not cause pain due to pressure applied to the posterior forearm. | Anatomy | Nerve Lesions | Following several days of 12-hour daily rehearsals of the symphony orchestra for a performance of a Wagnerian opera, the 52-year-old male conductor experienced such excruciating pain in the posterior aspect of his right forearm that he could no longer direct the musicians. When the maestro's forearm was palpated 2 cm distal to, and posteromedial to, the lateral epicondyle, the resulting excruciating pain caused the conductor to weep. Injections of steroids and rest were recommended to ease the pain. Which of the following injuries is most likely?
A. Compression of the median nerve by the pronator teres
B. Compression of the median nerve by the flexor digitorum superficialis
C. Compression of the superficial radial nerve by the brachioradialis
D. Compression of the deep radial nerve by the supinator
| Compression of the deep radial nerve by the supinator |
3332af92-2328-47c5-a573-d945c7aff8a2 | Ans. is 'a' i.e., Jaundice o "13% of breast fed infants develop unconjugated hyperlbilirubinemia in the 1st week of life. The breast fed infants have higher, bilirubin levels than formula fed infants." o It is due to inhibitory substances (Pregananediol and free fatty acids) in breast milk that interfere with bilirubin conjugation. | Pediatrics | null | Which of the following will occur in an exclusively breast fed baby -
A. Jaundice
B. Scurvy
C. Tetany
D. Eczema
| Jaundice |
8c78895c-77b9-448b-8f5a-bd04b51c3cd3 | There is a marked increase in levels of serum prolactin during gestation to over 10 times those values found in nonpregnant women. If this woman were not pregnant, the prolactin value could easily explain the amenorrhea and further evaluation of hyperprolactinemia would be necessary. The physiologic significance of increasing prolactin in pregnancy appears to involve preparation of the breasts for lactation. | Gynaecology & Obstetrics | Physiology & Histology | In the evaluation of a 26-year-old patient with 4 months of secondary amenorrhea, you order serum prolactin and b-hCG assays. The pregnancy test is positive, and the prolactin comes back at 100 ng/mL (normal <25 ng/mL in this assay). This patient requires
A. Routine obstetric care
B. Computed tomography (CT) scan of her sella turcica to rule out pituitary adenoma
C. Repeat measurements of serum prolactin to ensure that values do not increase over 300 ng/mL
D. Bromocriptine to suppress prolactin
| Routine obstetric care |
c001d8b1-01eb-493c-8dab-7ca53dbb61a1 | Chondromyxoid Fibroma Disease of adolescent Knee X-ray Sclerotic lesion around the coex in the tibia. . Small eccentric lytic lesion which lie parallel to the long axis of the bone. * Bone cyst with fracture will show a larger lesion and is mostly unilateral. * Osteitis Fibrosis cystica will present with multiple lesions and also has a history of abdominal groans, psychic moans and renal stones. * Osteosarcoma is a malignant lesion usually occurs above the joint. | Orthopaedics | Ohopedics Oncology | Knee with leg x- ray of an adolescent boy is shown. Probable diagnosis:
A. Chondromyxoid fibroma
B. Osteosarcoma
C. Bone cyst with fracture
D. Osteitis Fibrosis cystica
| Chondromyxoid fibroma |
2f5620d9-35cd-4539-92ac-d4e121c7ec9c | Ans. is 'c' i.e., CC14 Hepatocellular necrosis: - o Liver necrosis is a common manifestation of many liver diseases and it can present in various ways, o If severe it can cause liver failure. o In some cases however the necrosis is subclinical, revealed only by elevations of liver enzymes in serum, o Various diseases can cause different patterns of necrosis. These are -] Focal Necrosis - Randomly occurring necrosis of single cells or small clusters of cells. It can involve any area of the lobule All lobules are not involved. Characteristic features on biopsy are - Councilman bodies Areas of lysed liver cells surrounded by collection of kupffer cells and inflammatory cells. Causes of Focal necrosis - Viral hepatitis, Bacterial infections, Toxic damage Zonal necrosis - The characteristic of zonal necrosis is that identical regions of liver lobules are involved. All liver lobules are involved. The necrosis is divided according to the zone involved (Note: In focal necrosis any area of lobule and some lobules are involved.) Types of zonal necrosis Centrizonal necrosis (centrilobular) ->> Necrosis in the cells surrounding central hepatic vein, seen in - i) Cardiac failure or shock iii) Chloroform toxicity ii) Carbon tetrachloride toxicity (CC14) iv) Viral hepatitis Peripheral zonal necrosis (periportal) - Necrosis is seen in areas around the portal tracts, Seen in i) Eclampsia ii) Phosphorus poisoning Midzonal necrosis - Rare, seen in yellow fever Also know - o Submassive necrosis - Occurrence of liver cell necrosis that is not limited by lobular boundaries i.e., the necrosis extends beyond lobular boundaries. o Massive liver necrosis - In this large areas of liver cell undergo necrosis. Only small areas are left intact, o Massive and submassive fiver necrosis are clinically manifested as. # Acute fiver failure of variable severity # Serum enzyme levels are very high | Pathology | Liver | Centrilobular necrosis of liver may be seen with -
A. Phosphorus
B. Arsenic
C. CCI4
D. Ethanol
| CCI4 |
8c1ccc27-48e2-49c6-8297-49ee2c85da6b | Points to note
Concentration of ions
Na+ concentration higher in ECF
K+ concentration higher in ICF
Cl- concentration higher in ECF
K+ leak channels allow K+ to move from ICF to ECF
Na+ is prevented from entering the cell.
Thus diffusion is highest for K+, then Cl- and least for Na+, when the cell is at rest. | Physiology | null | Most diffusable ion in excitable tissue is -
A. Na+
B. K+
C. PO4-
D. Cl-
| K+ |
dba505bd-e815-431f-b8a9-38be67c5984f | TCA * MECHANISM This is an antidepressant with three rings. It acts by blocking the transpoers of neurotransmitters resulting in increased neurotransmitters in synapse DRUGS AMITRYPTILLINE IMIPRAMINE CLOMIPRAMINE DESIPRAMINE NORIPTILLINE DOXEPINE * USE AMITRYPTILLINE========PAIN WITH DEPRESSION IMIPRAMINE==========CHILDHOOD ENEURESIS CLOMIPRAMINE========OCD * SIDE EFFECTS ANTI HISTAMINERGIC==== sedation, weight gain ANTI MUSCURANIC=======dryness of mouth ANTI ADRENERGIC========hypotension, giddiness SWITCH TO MANIA when used in BIPOLAR DEPRESSION REf. kaplon and Sadock,synopsis of psychiatry, 11 th edition,pg no. 955 | Anatomy | General anatomy | which of the following tricyclic antidepressent used for peripheral neuropathy
A. amitriptilline
B. clomipramine
C. fluoxetine
D. imipramine
| amitriptilline |
bc4dbd7a-05b0-41be-a148-ca948a6cb6df | LITTLE'S AREA (Anterior inferior pa of nasal septum) - Usual site for epistaxis in children. Four Aeries anastomose here and form Kiesselbach's Plexus. Anterior ethmoidal aery(Ophthalmic aery) Sphenopalatine(Maxillary aery) Septal branch of superior labial(Facial aery) Greater palatine aery(Maxillary aery) Ref: Dhingra 7e pg 197. | ENT | Nose and paranasal sinuses | Which aery does not contribute to Little's area
A. Septal branch of facial aery
B. Anterior ethmoidal aery
C. Sphenopalantine aery
D. Posterior ethmoidal aery
| Posterior ethmoidal aery |
6dcdc387-af18-4fc8-90f2-1563f719b616 | Erythrophagocytosis (erythrophagia) is characteristic of typhoid ulcer. | Pathology | null | Erythrophagia and Mononuclear cell infiltration ulcers are seen in -
A. Necrotising colitis
B. Ulcerative colitis
C. Crohn's disease
D. Typhoid ulcers
| Typhoid ulcers |
72a38ed7-1043-4562-83c5-29e6f0ba7665 | Ans: cRef: Parikh, 6th ed, p. 9.10 and 5th ed, p. 748 | Forensic Medicine | Toxicology | Velvety appearance of stomach is seen in poisoning with:(1995)
A. Abrus precatorius
B. Barbiturates
C. Arsenic
D. lead
| Arsenic |
ccd23538-9f84-454d-b0bc-e72a434f73c5 | Answer is B (REAL Classification) In 1994, a group of hematopathologists, oncologists and molecular biologists came together (International Lymphoma Study Group) and introduced a new classification, called the 'Revised European-American Classification of Lymphoid Neoplasms (REAL). WHO has now reviewed and updated the real classification resulting in inclusion of additional rare entities. WHO Classification / Modified 'REAL' Classification I. Precursor B-cell Neoplasm Precursor-B lymphoblastic leukemia/lymphoma II. Peripheral B-Cell Neoplasms Chronic lymphocytic leukemia/small lymphocytic lymphoma B-cell prolymphocytic leukemia Lymphoplasmacytic lymphoma Splenic and nodal marginal zone lymphomas Extranodal marginal zone lymphomas Mantle cell lymphoma Follicular lymphoma Marginal zone lymphoma Hairy cell leukemia Plasmacytoma/plasma cell myeloma Diffuse large B-cell lymphoma Burkitt lymphoma III. Precursor T-Cell Neoplasms Precursor-T lymphoblastic leukemia/lymphoma iv Peripheral T-Cell and NK-Cell Neoplasms T-cell prolymphocytic leukemia Large granular lymphocytic leukemia Mycosis fungoides/Sezary syndrome Peripheral large cell lymphoma, unspecified Anaplastic large cell lymphoma Enteropathy-associated T-cell lymphoma Hepatosplenic y8 T-cell lymphoma Adult T-cell leukemia/lymphoma NK/T-cell lymphoma, nasal type NK cell leukemia V. Hodgkins LF mphoma - Classical subtypes - Nodular sclerosis - Mixed cellularity - Lymphocyte-rich - Lymphocyte depletion Lymphocyte predominance | Medicine | null | The classification proposed by the International Lymphoma Study Group for non-Hodgkin's lymphoma is known as:
A. Kiel classification
B. REAL classification
C. WHO classification
D. Rappapo classification
| REAL classification |
5db72c48-23b8-4f96-bfdf-8a1347a8741a | Normal intracranial pressures : - Newborns : < 5mm of Hg - Infants : 6-15 mm of Hg - Children : 10-15mm of Hg ICP is considered severely elevated, if raised above 40mm of Hg | Pediatrics | Raised intracranial tension | Normal intracranial pressure in a child is:
A. < 5mm of Hg
B. 50-80 mm of Hg
C. 10-15 mm of Hg
D. 20-30 mm of Hg
| 10-15 mm of Hg |
4b4e6c3f-af09-46ae-b491-f7b9fa01eaf5 | (B) EBV # Hairy leukoplakia is a distinctive oral lesion that is seen in immunocompromised patients.> Approximately 80% of patients with hairy leukoplakia have been infected with the human immunodeficiency virus (HIV); the presence of this lesion sometimes calls attention to the existence of the infection.> Hairy leukoplakia takes the form of white, confluent patches of fluffy ("hairy") hyperkeratotic thickenings, almost always situated on the lateral border of the tongue.> The distinctive microscopic appearance consists of hyperparakeratosis and acanthosis with "balloon cells" in the upper spinous layer. | Medicine | Miscellaneous | Cause of hairy leukoplakia which is characterised by severe discomfort on lateral part of the tongue
A. HIV
B. EBV
C. Herpes virus
D. HPV
| EBV |
a7a9ecc7-a7f8-4195-aa96-d9496aadb7f9 | Bone metastasis is a characteristic feature of prostatic cancer. The lesions are typically osteoblastic on x-ray, and the serum acid phosphatase level becomes elevated | Surgery | Prostate and seminal vesicles | Patient because of positive biopsy findings and negative workup undergoes a radical prostatectomy. The pathology repo reveals Gleason score 9/10 and involvement of several pelvic lymph nodes. Which is the most likely site for prostatic cancer metastasis?
A. Liver
B. Kidney
C. Lung
D. Bone
| Bone |
1ff13e2b-940e-4c3a-ad3d-92aab3f2007b | Ahus reaction Localized area of tissue necrosis resulting from acute immune complex vasculitis, usually elicited in the skin. "SHARP" S- Serum sickness, Schick test, SLE H- HS pneumonitis (Farmers lung), HSP A- Ahus reaction R- Reactive ahritis, RA, Raji assay P - PAN, PSGN | Pathology | General pathology | Ahus reaction is what type of hypersensitivity reaction
A. Localized immune complex
B. Ag- Ab reaction
C. Complement mediated
D. Ab mediated
| Localized immune complex |
7ed5d889-fd10-4080-9e91-5adb45a0b4df | PLATINUM COORDINATION COMPLEXES Cisplatin Mech of action:- It is hydrolysed intracellularly to produce a highly reactive moiety which causes cross linking of DNA. The oured site is N7 of guanine residue. Adverse effects:- It is a highly emetic drug. Antiemetics are routinely administered before infusing it. The most impoant toxicity is renal impairment which is dependent on total dose administered. Renal toxicity can be reduced by maintaining good hydration. Tinnitus,deafness, sensory neuropathy and hyperuricaemia are other problems. Ref:- kd tripathi; pg num:-861 | Pharmacology | Chemotherapy | The following anticancer drug has high emetogenic potential
A. Chlorambucil
B. Vincristine
C. 6-Mercaptopurine
D. Cisplatin
| Cisplatin |
d306ea3d-13dc-4985-8642-a60135919464 | Sprinolanctone is a potassium sparing diurectic It doesn't excrete potassium - increasing potassium levels in the blood ACE IN. also increases potassium levels in the blood Hence the combination is contraindicated Ref: KD Tripathi 8th ed | Pharmacology | Cardiovascular system | Spironolactone should not be given with
A. Chlohiazide
B. Beta blockers
C. ACE inhibitors
D. Amlodipine
| ACE inhibitors |
089ba3ff-4042-422a-bf5e-d21dde55852b | There is focal periostitis at the radial styloid. The radial styloid itself is normal. This is secondary to adjacent inflammation at the extensor pollicis brevis and abductor pollicis longus tendons (De Quervains tenosynovitis). The periosteal reaction of osteomyelitis is usually associated with abnormal underlying bone. The periosteal reaction of hyperophic osteoahropathy is more diffuse involving both the radius and ulna. New bone formation is not a feature of rheumatoid ahritis. | Radiology | Skeletal system | Based upon this PA ulnar detion view of the wrist, what is the MOST likely diagnosis?
A. Osteomyelitis
B. De Quervain tenosynovitis
C. Hyperophic osteoahropathy
D. Rheumatoid ahritis
| De Quervain tenosynovitis |
c84a0115-f9e0-421c-83b6-90d0c9e89a8c | ANSWER: (D) Restriction endonucleaseREF: Basic Genetics: Textbook and Activities by Ahmed Abouelmagd, Hussein M. Ageely page 117A palindromic sequence is a nucleic acid sequence {DNA or RNA) that is the same whether read 5' (five-prime) to 3' (three prime) on one strand or 5' to 3' on the complementary strand with which it forms a double helix.A restriction enzyme (or restriction endonuclease) is an enzyme that cuts DNA at specific recognition nucleotide sequences (with Type II restriction enzymes cutting double-stranded DNA) known as restriction sites. Such enzymes, found in bacteria and archaea, are thought to have evolved to provide a defense mechanism against invading viruses. Inside a bacterial host, the restriction enzymes selectively cut up foreign DNA in a process called restriction; host DNA is methylated by a modification enzyme (a methylase) to protect it from the restriction enzyme's activity. Collectively, these two processes form the restriction modification systemRestriction enzymes recognize a specific sequence of nucleotides and produce a double-stranded cut in the DNA. While recognition sequences vary betwreen 4 and 8 nucleotides, many of them are palindromic, wrhich correspond to nitrogenous base sequences that read the same backwards and forwards. In theory, there are two types of palindromic sequences that can be possible in DNA.The mirror-like palindrome is similar to those found in ordinary text, in which a sequence reads the same forward and backwards on a single strand of DNA strand, as in GTAATG.The inverted repeat palindrome is also a sequence that reads the same forward and backwards, but the forward and backward sequences are found in complementary DNA strands (i.e., of double-stranded DNA), as in GTATAC (GTATAC being complementary to CATATG). Inverted repeat palindromes are more common and have greater biological importance than mirror-like palindromes.Naturally occurring restriction endonucleases are categorized into four groups (Types I, II III, and IV) based on their composition and enzyme cofactor requirements, the nature of their target sequence, and the position of their DNA cleavage site relative to the target sequenceCategoryFunctionCofactors requiredCleavageType IMultifunctional protein with both restriction and DNA modify-cation (methylase) activityMg2+, ATP SAM (S- adenosylmethionine)Cleave DNA at non specific sites usually remote from recognition siteType IISingle function (restriction) en-zymes independent of methylaseOnly Mg2+Site specific 8t cleave writhin or at short specific distances from recognition siteType IIICombine restriction and DNA modification (methylase) activity in a single enzyme complex with different subunitsMg2+, SAM stimulates reaction but is not requiredCleave at sites a short distance from recognition siteHere are some restriction enzymes and the palindromic sequences which they recognizeEnzymeSourceRecognition SequenceCutEcoRlEscherichia coli5'GAATTC3'CTTAAG5---G AATTC---3'3---CTTAAG---5'BamH1Bacillus amylobquefaciens5'GGATCC3'CCTAGG5'---G GATCC---3'3'---CCTAG G---5'Taq1Thermus aquaticus5'TCGA3'AGCT5'---T CGA--3'3'---AGC T---5'Alul*Arthrobacter luteus5'AGCT3'TCGA5'---AG CT---3'3'---TC GA---5'* = blunt ends | Pathology | Genetics | An enzyme that recognizes a specific (palindromic) sequence and cuts within a DNA molecule is?
A. Exonuclease
B. Methylase
C. Modification enzyme
D. Restriction endonuclease
| Restriction endonuclease |
ccb42e2e-6dde-499b-a88c-bbffaffb3f45 | Ans. is 'a' i.e., Group specific antigen of Legionella serogroup-1 (LP1) o The examination of urine for legionella antigen by ELISA is a rapid and specific method for identifying L pneumophila,o However, disadvantage of urine antigen test is that it only detects Legionella pneumophila serogroup 1 (LP-1) and negative urinary antigen test does not exclude infection with Iegionellae other than L pneumophila serogroup-1.o Only culture can detect non-LPl strains (strains other than serogroup-1). | Microbiology | Bacteria | In pontaic fever, which antigen is seen in urine-
A. Group specific antigen of Legionella serogroup- 1 (LP 1)
B. Group specific antigen of L egionella serogroup- 1. (LP 2)
C. Group specific antigen of Legionella serogroup- 4 (LP 4)
D. Group specific antigen of Legionella serogroup- 6 (LP 6)
| Group specific antigen of Legionella serogroup- 1 (LP 1) |
0d3ab112-04b1-46f1-a055-f21105024fac | Ans. A i.e. Cutaneous T cell lymphoma Mycosis fungoides Mycosis fungoides is also known as: Cutaneous T cell lymphoma, Special features: - MC skin lymphoma, - Pautrier's microabscesses - Presents with diffuse erythroderma | Skin | null | Mycosis fungoides: March 2013
A. Cutaneous T cell lymphoma
B. Fungal infection
C. Bacterial infection
D. Cutaneous B cell lymphoma
| Cutaneous T cell lymphoma |
ff707c87-44b1-4954-bc9d-4dc42e4c4156 | Ans. (c) Uric AcidRef: Harper's Biochemistry, 30th edn. pg. 347-357Purines are metabolized by several enzymes:GUANINE* A nuclease frees the nucleotide* A nucleotidase creates guanosine* Purine nucleoside phosphorylase converts guanosine to guanine* Guanase converts guanine to xanthine* Xanthine oxidase (a form of xanthine oxidoreductase) catalyzes the oxidation of xanthine to uric acidADENINE* A nuclease frees the nucleotide# A nucleotidase creates adenosine, then adenosine deaminase creates inosine# Alternatively, AMP deaminase creates inosinic acid, then a nucleotidase creates inosine* Purine nucleoside phosphorylase acts upon inosine to create hypoxanthine* Xanthine oxidoreductase catalyzes the biotransformation of hypoxanthine to xanthine* Xanthine oxido-reductase acts upon xanthine to create uric acid | Biochemistry | Proteins and Amino Acids | The main catabolic product/products of purine nuleotides in humans is which one of the following:
A. Ammonia + CO2
B. Ammonia
C. Uric Acid
D. CO2 and Water
| Uric Acid |
010bd06f-977c-4fca-87e3-79f12c60b476 | Electron Beam is preferred for intraoperative Radiotherapy. The Intraoperative radiotherapy (IO) appears to be an ideal therapeutic strategy for pancreatic cancer, Having the advantage of enabling the delivery of high doses of radiation to areas that are at risk for microscopic disease, saving critical organs and reducing the possibility of inducing radiotoxicity. | Radiology | Radiotherapy Pa 1 | Intraoperative Radiotherapy for treating pancreatic carcinoma mainly uses
A. Alpha Rays
B. Gamma Rays
C. Electron Beam
D. Proton beam
| Electron Beam |
77465ac2-c387-4d9f-8000-9fdcbe7cfd48 | Ans: a. Live attenuated.. LIVE ATTENUATEDKILLED WHOLE ORGANISMTOXOID PROTEINSPOLYSACCHARIDEGLYCOCONJUGATERCOMBINANTBCG, Yellow fever, OPV, Measles, Mumps, Rubella,Typhoid, Varicella,Rotavirus, Cholera,Cold-adapted influenza,Rotavirus reassoants.ZostTyphoid, Cholera, Plague,Peussis, Influenza,Typhus, lPV, Rabies, JE,Tickborne encephalitis, HAVDiphtheria, Tetanus,Acellular peussis,Anthrax, InfluenzasubunitPneumococcus,Meningococcus,Hib, Typhoid(Vi)Hib, Pneumococ-cus,MenACWY(Meningococcus)HBV Lymedisease, CholeraToxin B, HPV | Social & Preventive Medicine | null | MMR (Measles, mumps, rubella) vaccine is an example of:
A. Live attenuated vaccine
B. Conjugated vaccine
C. Polysaccharide vaccine
D. Killed vaccine
| Live attenuated vaccine |
d8b296cd-c657-42fe-b98a-79ec0df3a16b | Normal vaginal flora is mostly aerobic with an average of six different species of bacteria, most common of which is hydrogen peroxide producing lactobacilli. Other commonly found aerobic bacteria found in the vagina are Diphtheroids, Streptococci, Staphylococcus epidermidis and Gardenella vaginalis. Most prevalent anaerobic bacteria which are detected are Peptococcus, Peptostreptococcus and Bacteroids. | Gynaecology & Obstetrics | null | Which is the most common aerobic bacteria found in vagina?
A. Lactobacilli
B. Gardnerella
C. Mobilincus
D. Clostridium
| Lactobacilli |
9cf11086-017c-45e0-8bbc-35c047b0bd42 | Percutaneous transluminal coronary angioplasty (PCTA or angioplasty) is a procedure that is commonly performed on people with hea disease. This procedure is done to open up the blood vessel to allow the blood to pass through more easily PTCA is a minimally invasive procedure to open up blocked coronary aeries, allowing blood to circulate unobstructed to the hea muscle. The indications for PTCA are: Persistent chest pain (angina) Blockage of only one or two coronary aeries Ref Davidson edition23rd pg 460 | Medicine | C.V.S | A 30 year old male presents with severe pain chest, breathlessness, hypotension and ECG shows ST elevation in V3, V4 V5 and V6 leads. He will be best treated with:
A. Streptokinase
B. t-PA
C. Heparin
D. PTCA
| PTCA |
49c7b1d2-df37-41f3-a237-4c3c530c0af3 | Ans. (d) Increase in testicular sizePlease refer explanation of question 40 | Pediatrics | Assessment of Growth | Which of the following-is the first sign of sexual maturity in boys?
A. Increase in height
B. Appearance of facial hair
C. Change in voice
D. Increase in testicular size
| Increase in testicular size |
046047eb-6357-4c40-b0b3-57f8331dbf2b | (A) 4 or more episodes per year# Rapid cycling:> Most people who meet criteria for bipolar disorder experience a number of episodes, on average 0.4 to 0.7 per year, lasting three to six months.> Rapid cycling, however, is a course specifier that may be applied to any of the above subtypes. It is defined as having four or more episodes per year and is found in a significant fraction of individuals with bipolar disorder. The definition of rapid cycling most frequently cited in the literature (including the DSM) is that of Dunner and Fieve: at least four major depressive, manic, hypomanic or mixed episodes are required to have occurred during a 12-month period.There are references that describe very rapid (ultra-rapid) or extremely rapid (ultra-ultra or ultradian) cycling. One definition of ultra-ultra rapid cycling is defining distinct shifts in mood within a 24-48-hour period. | Psychiatry | Miscellaneous | In mood disorder, rapid cyclers are defined as
A. 4 or more episodes per year
B. Mania occuring during summer
C. Mania consistent during lunar year
D. Depressive episodes during winter
| 4 or more episodes per year |
fc391435-5a01-4a13-adc4-8e6a0fdfda59 | Ans. (b) Anti-ds DNA antibodies(Ref: Harrison 18th/chapter 319)Anti dsDNA is specific for SLE, only in high titers;But still, anti ds DNA is the best marker for SLE because its prevalence in SLE is 70%;Whereas, Anti Sm antibody, which is specific for SLE, but is seen in only 25% patients with SLE | Pathology | Immunity | Best marker of SLE?
A. Anti Sm antibodies
B. Anti-ds DNA antibodies
C. Anti-Histone antibodies
D. Anti Ro (SS-A) antibodies
| Anti-ds DNA antibodies |
4fc68f11-c23a-4d61-b6f9-d28554f3c917 | Disease name Abbretion Enzyme Defective GaG(s) affected Symptoms Hurler syndrome MPS I a-l-Iduronidase Dermatan sulfate, Heparan sulfate Mental retardation, coarse facial features, hepatosplenomegaly, cloudy cornea Reference: Harper; 30th edition; Page no:639; Table: 50-8 | Biochemistry | Metabolism of carbohydrate | Enzyme deficiency in Hurler syndrome?
A. Iduronate sulfatase
B. a-l-Iduronidase
C. b-Galactosidase
D. Galactosamine 6-sulfatase
| a-l-Iduronidase |
b673b67f-7993-4431-b29b-d52dc2b2e115 | All ACE inhibitors are prodrugs except captopril and lisinopril. | Pharmacology | null | Which of the following is a prodrug ?
A. Lisinopril
B. Enalapril
C. Chlorpromazine
D. Dopamine
| Enalapril |
9a41dbe7-cfea-4a68-8cf8-8cef3725dcaf | Reyes syndrome characterised by mitochondrial injury and decreased synthesis of mitochondrial enzymes in liver. Which leads to rise in blood ammonia and accumulation of triglycerides within hepatocytes. TEXTBOOK OF PATHOLOGY HARSH MOHAN 6TH EDITION PAGE 602 | Pathology | G.I.T | Histological finding in Reye&;s syndrome is
A. Budding and branching of mitochondria
B. Swelling of endoplasmic reticulum
C. Para nuclear micro dense deposits
D. Glycogen depletion
| Glycogen depletion |
080e83b3-c4fe-4997-8c92-2f4210eb1d10 | Mucoepidermoid carcinomas are composed of variable mixtures of squamous cells, mucus-secreting cells, and intermediate cells. "The low-grade mucoepidermoid carcinoma is composed of largely mucin-secreting cells, whereas in high-grade tumors, the epidermoid cells predominate." They are the most common malignant tumors of the salivary glands. Treatment The primary t/t of all salivary malignancy is surgical excision: for parotid malignancies- Superficial parotidectomy with preservation of CN VII. Total parotidectomy with nerve preservation if deep lobe is involved. for other salivary gland - Enbloc removal of the involved gland Neck dissection for lymph nodes is done clinically palpable nodes for high grade malignancies Radiation therapy is used postoperatively for specific indications high grade histology presence of extraglandular disease perineural invasion direct invasion of regional structureregional metastasis | Surgery | Head and neck | Mucoepidermoid carcinoma arises form
A. Epithelium
B. Myoepithelium
C. Acinus
D. Mucin secreting and epidermal cells
| Mucin secreting and epidermal cells |
a46bde09-9c2d-46b8-91a4-f5e8cebb6b82 | The worm lie in the lung parenchyma and are surrounded by a fibrous capsule formed by host tissue.Inflammatory reaction to the worms and their eggs lead to granuloma formation,cystic dilatation of bronchi,abscesses and pneumonitis.Patient present with cough,chest pain and haemoptysis (refer pgno:131 baveja 3 rd edition) | Microbiology | parasitology | Parasites causing lung infestation are -
A. H. Nana
B. Paragonimus westermanii
C. Taenia saginata
D. E. granulosus
| Paragonimus westermanii |
70e567e7-90be-4211-9289-d4af8db8107c | ANOPHELES CULEX AEDES MANSONIA Boat shaped Small in clusters Single ; Cigar shaped Star shaped ; in clusters Rest parallel to water surface Rest at an angle to water surface Rest at an angle to water surface Attached to roots of Aquatic plants - Sits by making an angle of 45o with surface - Have straight body & spotted wings - Hunchback posture - Hunchback posture 3-5 Km 11 km 100 m Clean water. Hence known as Sophisticated mosquito Diy water - Nuisance mosquito Aificial collection of rain water. - Tiger mosquito Aquatic plants Malaria Lymphatic filariasis Japanese Encephalitis West nile fever Dengue Chikungunya Yellow fever Zika virus Rift valley fever Brugian filariasis | Social & Preventive Medicine | VBDs, Arboviral & Viral Infections, Surface Infections | Culex mosquito is a vector for:
A. Chikungunya fever
B. Dengue fever
C. Japanese encephalitis
D. Malaria
| Japanese encephalitis |
537070e2-b38a-4e20-84a5-6a0ac089f437 | Ans: c (Vancomycin)Ref: Harrison 16 ed pg. 821, KDT 6 ed. Pg.732Vancomycin is the drug of choice for MRS A. Quinupristin and dalfopristin are both streptogramin antibiotics that act on MRSA and VRSA. They are used mainly for VRSA.Drugs useful against MRSA:Vancomycin Cotrimoxazole Doxycycline Minocycline Fluroquinolones - ciprofloxacin, levofloxacin Linezolid Streptogramins Quinipristine DalfopristineInvestigational Drugs for MRSA:Oritavancin Tigecycline | Pharmacology | Anti Microbial | Drug of choice for multidrug resistant staphylococcus aureus is:
A. Clindamicin
B. Streptogramins
C. Vancomycin
D. Aztreonam
| Vancomycin |
a6106bbf-6619-4bff-9bd0-52adc9743a5b | Ans. B. Lamellar ichthyosisLamellar ichthyosis (LI)* Collodion baby at birth as the baby is covered by a thickened collodion-like membrane which is then shed* Scaling occurs over the whole body, including creases and bends* The scale in LI is typically large, dark brown or grey and firmly adherent* Drooping of lower eyelids (ectropion), palmoplantar keratoderma and scarring alopecia may be seen in severe cases.* Limitation of joint movement, flexion contractures, and digital sclerodactyly may result. Nails may be small but hair shaft, mucous membranes and teeth are not affected.* May be associated with a mutation in transglutaminase 1 gene. | Skin | Autoimmune Skin Disorders | A 2 year old born out of consanguineous marriage, had a history of the collodion membrane. He had large, thick, plate-like brown scaling generalized distribution; no erythroderma and ectropion. Which disease is it?
A. Ichthyosis vulgaris
B. Lamellar ichthyosis
C. X linked ichthyosis
D. Netherton syndrome
| Lamellar ichthyosis |
ec8b1d4b-64bf-4e3c-8458-24bfdcecd3f4 | Tolvaptan is a vasopressor receptor antagonist used to correct hyponatremia in the treatment of syndrome of inappropriate water excretion or SIADH :-
Syndrome of inappropriate secretion of ADH is caused due to excesive secretion of antiduretic hormone.
Antidiuertic hormone (ADH) or arginine vasopressin is synthesized by the hypothalamus.
Its major effect is to prevent diuresis by promoting reabsorption of water in the kidneys.
- ADH is the primary physiological determinant of the rate of free water excretion.
- Its major renal affect is to augument the water permeability of the leminal membranes of the cortical and medullary collecting tubules thereby promoting water reabsorption.
The antidiuretic effect of ADH is mediated by "V2 receptors".
Tolvaptan is V2 receptor antagonist
- It can be used to correct hyponatremia due to excesive water retnetion caused by increased ADH secretion.
Randomized double blind trials have shown that oral or intravenous vasopressin antagonists are more effective than placebo in raising the serum sodium of hyponatremic patients.
"Tolvaptan" and "conivaptan" but not lixivaptan are approved for use in the united states.
Vasopressor receptor antagonist
There are three receptor for vasopressin (ADH).
- The V1 a, Vlb and V2 receptors.
The V2 receptors primarily mediate the antidiuretic response while V1 a and Vlb primarily cause vasoconstriction and adrenocorticotropic hormone (ACTH) release.
V2 → Mediate antidiuretic response
VlaVlb → Cause vasoconstriction and adrenocorticotropic hormone (ACTH) release.
The vasopressin receptor antagonist tolavaptan produces a selective water diuresis (aquaresis) without affecting sodium and potassium excretion.
- The ensuing loss of electrolyte free water will tend to raise the serum sodium in patients with SIADH and may improve mental status in patients with serum sodium under 130 meq/L.
| Medicine | null | Tolvaptan is approved for use in-
A. High Na
B. High K
C. High Ca
D. Low Na
| Low Na |
3399ff3f-7028-4e39-b66b-677182676f09 | Ans. is 'd' i.e., Hea o The susceptibility of a tissue to hypoxia influences the likelihood of infarction. o Neurons are most sensitive to hypoxia (irreversible changes develop in 3-4 minutes) followed by myocardial cells (irrversible changes develop in 20-40 minutes). o Fibroblasts are amongst the most resistent cells to hypoxia. | Pathology | null | Organ most vulnerable to ischaemic due to shock?
A. Lungs
B. Adrenals
C. Kidney
D. Hea
| Hea |
2ec73e7d-7ab4-4724-8bc5-fb2213dd5217 | Ans. a (Lactose) (Ref OP Ghai 6th/ p. 158; 7th/p. 131, 134)After premature delivery, mother's milk is low in:# Calcium # Phosphates # LactoseADVANTAGES OF BREAST MILK# Docosahexanoic acid (DHA, W3, 2:3) present in breast milk helps in brain development.# Maximum synthesis of breast milk occurs at 12 months.# Has better calcium than cow milk for baby to absorb.# Iron in breast has 70% availablity. # Prevents against infections by:- Human milk contains bacterial and viral antibodies, including secretory IgA. They probably account for the lower incidence of diarrhea, otitis media, pneumonia, bacteremia, and meningitis during the 1st yr of life.e- Macrophages in human milk may synthesize complement, lysozyme, and lactoferrin.- Lactoferrin has an inhibitory effect on the growth of Escherichia coli in the intestine.- The lower pH of the stool of breast-fed infants is thought to contribute to the favorable intestinal flora of infants fed human milk vs. formula (i.e., more bifidobacteria and lactobacilli; fewer E. coli), which also helps protect against infections caused by some species of E. coli.- Human milk also contains bile salt-stimulated lipase, which kills Giardia lamblia and Entamoeba histolytica.DISADVANTAGES OF BREAST MILK# Breast milk is balanced, will supply all the necessary nutrients except, perhaps, fluoride and, after several months, vitamin D.# The iron content of human milk is somewhat low. However, most normal infants have sufficient iron stores for the first 6 mo of life. Moreover, human milk iron is well absorbed.# The vitamin K content of human milk also is low and may contribute to hemorrhagic disease of the newborn. Parenteral administration of 1 mg of vitamin K, at birth is recommended for all infants, edpecially for those who will be breast- fed.# Cytomegalovirus (CMV), human T-cell lymphotropic virus type 1, rubella virus, hepatitis B virus, and herpes simplex virus also have been demonstrated in breast milk. Of these, the presence of CMV is the most troublesome.Nutritive value of milk compared BuffaloCowGoatHuman1Fat (g)6.54.14.53.42Protein (g)4.33.23.31.13Lactose (g)5.14.44.67.1Q4Calcium (mg)210120170285Iron (mg)0.20.20.3--6Vitamin C (mg)12137Minerals (g)0.80.80.80.18Water (g)81.08786.888 | Pediatrics | Nutrition | After premature delivery, mother's milk is low in
A. Lactose
B. Fat
C. Protein
D. Sodium
| Lactose |
9a7f7050-8067-49b8-a7df-3ea1ba8be6d6 | Ans. D Nasal irrigation and removal of crusts - warm normal saline or an alkaline solution made by Soda bicarbonate 1 pa Sodium biborate 1 pa Sodium chloride 2 pas in 280 ml of water Initially irrigation are done 2 or 3 times a day but later every 2 or 3 days is sufficient 25 % glucose in glycerine - nose is painted this inhibits the growth of proteolytic organisms which are responsible for foul smell. | ENT | null | Alkaline douch solution of nose does not contain:
A. NaCI
B. Na biborate
C. NaHCO3
D. Glucose
| Glucose |
ed04d2ca-75c4-4457-91c9-2703ce978cec | Ans. is 'a' i.e., Edrophonium o Edrophonium is the shoest acting anti-ChE. o Why is it so, lets see : o When carbamates (other than edrophonium) and organophophates react with cholinesterase, they form covalent bond at esteratic site, which is considerably resistant to hydrolysis. o In contrast, edrophonium binds electrostatically and by hydrogen bonds at anionic site (not at esteratic site) of cholinesterase. The enzyme inhibitor complex does not involve a covalent bond and is correspondingly sho lived (2-10 minutes). o So edrophonium is also called as noncovalent inhibitor. | Pharmacology | null | Shoest acting anticholinesterase is -
A. Edrophonium
B. Pyridostigmine
C. Glycopyrrolate
D. Neostigmine
| Edrophonium |
4798c743-8cf8-4d88-af53-00a9f0f38233 | The question speaks of Dorsal scapular nerve on whose damage leads to winging of scapula. | Anatomy | null | Injury to the nerve originating from C5 in Brachial plexus leads to
A. Loss of abduction of the arm
B. Loss of abduction of arm
C. Loss of shrugging
D. Winging of scapula
| Winging of scapula |
86f8feb0-f026-4da8-b435-21e419b33520 | It is considered a hypersensitivity reaction to some exogenous allergen, such as grass pollens. VKC is thought to be an atopic allergic disorder in many cases, in which IgE-mediated mechanisms play an impoant role. Such patients may give personal or family history of other atopic diseases such as hay fever, asthma, or eczema and their peripheral blood shows eosinophilia and inceased serum IgE levels. Ref: A K KHURANA COMPREHENSIVE OPHTALMOLOGY,E4,page-74 | Ophthalmology | Conjunctiva | Spring catarrah is -
A. Type I hypersensitivity reaction
B. Type II hypersensitivity reaction
C. Type III hypersensitivity reaction
D. Type IV hypersensitivity reaction
| Type I hypersensitivity reaction |
ac085ab5-8ae3-4d2c-9866-f0021a4a16da | (B) Papillary type # Morphological variants of thyroid carcinoma and their approximate frequencies are: Papillary carcinoma 75-85% Follicular carcinoma 10-20% Medullary carcinoma 5% Anaplastic carcinoma < 5%> Histology type Incidence Papillary 80% Follicular 10% Medullary 5% Anaplastic 1 %> Papillary carcinoma thyroid: Commonest carcinoma of thyroid gland (80%) Commonest carcinoma in iodine sufficient area. More common in patients with previous exposure to radiation (past childhood) Commonest age 30-40 year. Multifocal (more common) Lymph node metastases more common (i.e., lymphatic spread) Distant metastasis uncommon commonest site - lung followed by bone, liver, brain. Prognosis excellent -10 years survival (95%) | Pathology | Misc. | Most common histological type of thyroid carcinoma is
A. Follicular type
B. Papillary type
C. Anaplastic type
D. Medullary type
| Papillary type |
d96514ac-dca9-4ac0-bd27-95e785f9ef9d | Ans: B i.e. Pyridoxine The main cause of pyridoxine deficiency is a lack of pyridoxine in the diet. Another cause of vitamin B6 deficiency is the use of the ATT medication isoniazid, and for this reason, it is usually replaced with vitamin B6 whilst using this drug. | Social & Preventive Medicine | null | Which vitamin deficiency may be observed in a patient on INH therapy: September 2012
A. Thiamine
B. Pyridoxine
C. Folic acid
D. Cyanocobalamin
| Pyridoxine |
3d08747d-9694-4d5c-84a1-8a3b41b03dbd | Ans. is 'c' i.e.. Megaloblastic anemia Findings of megaloblastic anemiaPeripheral bloodo Macrocytosis i.e., megaloblastic RBC - Due to nuclear1 cytoplasmic asynchrony,o Macrocytes lack central pallor of normal RBC.o Anisopoikilocytosis - Marked variation in shape and size,o Majority of RBCs appear as macroovalcytes.o Few tear drop cells.o Low reticulocyte counto Some nucleated RBCs may appear (normally, during maturation of RBC, nucleus disappears),o Hyper-segmented neutrophils - First manifestation of megaloblastic anemia.o Large megakaryocytes with multilobate nuclei.o Evidence of erythropoiesis: - Basophilic stippling, Cabott Ring, Howell-jolly bodies,o As DNA synthesis is impaired in all proliferating ceils, pancytopenia (anemia, leukopenia, thrombocytopenia) may occur.Bone marrowo Hypercellular due to proliferation of erythroid precursors replacing fat - Decreased ration of fat cells to hematopoietic elements (normal is 1 : 1).o Reversal of myeloid to erythroid ratio (normal is 2 to 3 : 1) due to proliferation of erythroid precursors,o Megaloblastic erythropoiesisOtherso t MCV due to macrocytosiso T MCH due to increased hemoglobin content.o Normal MCHC because hemoglobin content in the cell is increased proportiante to increase in the size of RBC. | Pathology | Iron Deficiency and Megaloblastic Anemia | Hypersegmented neutrophils are seen in -
A. Microcytic hypochronic anemia
B. Sideroblastic anemia
C. Megaloblastic anemia
D. Hemolytic anemia
| Megaloblastic anemia |
3aca2a61-46f1-4168-8bf3-a70ec5b2e199 | This is a case of filariasis (acute lymphadenitis) due to Wuchereria bancrofti. Microfilariae are found in blood, hydrocoele and other body fluids. 1 Wuchereria bancrofti Sheath, no nuclei in the tip of the tail 2 Brugia malayi Sheath, 2 distinct nuclei in the tip of the tail 3 Loa loa Sheath, nuclei extending to the tip of the tail 4 Onchocerca volvulus (skin) No sheath, no nuclei in the tip of the tail 5 Mansonella perstans No sheath, nuclei extending to the tip of the tail 6 Mansonella ozzardi No sheath, no nuclei in the tip of the tail 7 Mansonella streptocerca (skin) No sheath, nuclei extending to the tip of the hooked tail | Unknown | Integrated QBank | A 20-year-old male presented with high-grade fever, groin pain and a swollen scrotum for 1 week and are worsening progressively. On examination, Tender inguinal lymphadenopathy Scrotal swelling with hydrocoele Lymphatic streaking Blood samples are taken and a parasite infection is suspected. Which of the following is the most likely organism: -
A. <img style="max-width: 100%" src=" />
B. <img style="max-width: 100%" src=" />
C. <img style="max-width: 100%" src=" />
D. <img style="max-width: 100%" src=" />
| <img style="max-width: 100%" src=" /> |
fa86d16d-c0e7-4f0c-8b5b-4334a40e19be | <p> Manpower and planning. Reference:India health repo 2010,page no;132. <\p> | Social & Preventive Medicine | Health education & planning | Bajaj committee in 1986 proposed?
A. Multipurpose health worker
B. Manpower and planning
C. Rural Health Service
D. Integrated health services
| Manpower and planning |
7a64fd0e-3505-4017-a612-4124738978e1 | Retcam has been used to diagnose pediatric retinal disorders. It has a probe which is put over eye which captures the fundus photo. It can also do fluorescein angiography and is used for tele consultation too High Yield Facts *Factors responsible for ROP : Low GA is more impoant than LBW *WHO Vision 2020 program targets ROP as "avoidable disease" *Nd:Yag LASER is used in ROP Photocoagulation *30 Day Screening Strategy: ROP screening in NICU *Anti VEGF & Algae extracts: Experimentally evaluated for Rx *Lensectomy is done for cataract a/w ROP *Stage 5 ROP: Rx is Vitrectomy under poor prognosis *Retcam: Retinal wide field camera for diagnosis, training and angiography in Pediatric retinal anomalies | Ophthalmology | Diagnosis and Treatment of Retina | Instrument of choice for diagnosing pediatric retinal disorders
A. OCT
B. Fluorescein angiography
C. Slit lamp examination
D. Retcam
| Retcam |
85c50675-b971-457a-b2f4-e15e3a5383b1 | The presence of mucous duodenal (Brunner’s) glands in the submucosa is indicative of upper duodenum. These submucosal glands are absent in the jejunum, ileum and the entire large intestine. | Anatomy | null | Brunner's glands are seen in -
A. Jejunum
B. Upper duodenum
C. Lower duodenum
D. Appendix
| Upper duodenum |
c6d70c86-332a-42dc-b895-bbdabee2616e | Cadaveric spasm occurs immediately after death and affects voluntary muscles. | Forensic Medicine | null | Cadaveric spasm -a) Immediate after deathb) After 2 hours of deathc) Affects voluntary musclesd) Affects involuntary muscle
A. ac
B. bc
C. ad
D. b
| ac |
34975b3c-3521-4bfc-a8df-08f14d7e803a | Ref : harrisons-manual-of-medicine-16th-edition pg no: 622-623 TREATMENT Initial Therapy Initial goals are to: (1) quickly identify if patient is candidate for reperfusion therapy, (2) relieve pain, and (3) prevent/treat arrhythmias and mechanical complications. * Aspirin should be administered immediately (162-325 mg chewed at presentation, then 162-325 mg PO qd), unless pt is aspirin-intolerant. * Perform targeted history, exam, and ECG to identify STEMI (1 mmST elevation in two contiguous leads or new LBBB) and appropriateness of reperfusion therapy , which reduces infarct size, LV dysfunction, and moality. * Primary PCI is generally more effective than fibrinolysis and is preferred at experienced centers capable of performing procedure rapidly , especially when diagnosis is in doubt, cardiogenic shock is present, bleeding risk is increased, or if symptoms have been present for 3 h. * Proceed with IV fibrinolysis if PCI is not available or if logistics would delay PCI 1 h longer than fibrinolysis could be initiated (Fig. 123-1). Dooo- needle time should be 30 min for maximum benefit. Ensure absence of contraindications before administering fibrinolytic agent. Those treated within 1-3 h benefit most; can still be useful up to 12 h if chest pain is persistent or ST remains elevated in leads that have not developed new Q waves. Complications include bleeding, reperfusion arrhythmias, and, in case of streptokinase (SK), allergic reactions. Heparin should be initiated with fibrinolytic agents other than SK ; maintain aPTTT at 1.5-2.0 control (50-70 s). * If chest pain or ST elevation persists 90 min after fibrinolysis, consider referral for rescue PCI. Later coronary angiography after fibrinolysis generally reserved for pts with recurrent angina or positive stress test. The initial management of NSTEMI (non-Q MI) is different . In paicular, fibrinolytic therapy should not be administered. | Medicine | C.V.S | The treatment of acute myocardial infarction includes which of the following-
A. Aspirin
B. Heparin
C. Alteplase
D. Oral anticoagulants
| Aspirin |
7fa5f474-c88c-4ed6-916e-c57284e9a0e9 | Ans. is 'b' i.e., Infectious Mononucleosis Infectious mononucleosis Infectious mononucleosis : Is the most characteristic disease produced by Epstein Barr Virus Clinical features : o Most infections are asymptomatic. o Headache, Abdominal pain, chills also seen in few casees. o Fever, malaise, sore throat, (exudative pharyngitis), loss of appetite o Generalized lymphadenopathy : Posterior and anterior cervical LN are almost always enlarged. Splenomegaly is found in 50-75% cases while hepatomegaly is found only in 30% cases. o Maculopapular rash. Laboratory findings : a. Atypical Lymphocytosis : Comprising over 10% of total lymphocytes at some time in the illness. b. Paul Bunnel test is positive c. Monospot test is the screening test | Pediatrics | null | An 8 year old boy presented with fever and bilateral cervical lymphadenopathy with prior history of sore throat. There was no hepatomegaly. The peripheral blood smear shows > 20% lympho-plasmacytoid cells. The most likely diagnosis is -
A. Influenza
B. Tuberculosis
C. Infectious mononucleosis
D. Acute lymphoblastic leukemia
| Tuberculosis |
d6c85d1d-0ecb-4b19-83dd-34358d525c9f | Answer is D (Anemia of chronic Renal Failure) Anemias of chronic renal failure and chronic disease are associated with low or normal reticulocyte counts. Elevated reticulocyle count is a feature of hyperproliferative anemias including PNH, hereditary spherocytosis and anemia after blood loss. | Medicine | null | Reticulocytosis is NOT a feature of:
A. Paroxysmal nocturnal hemoglobinuria
B. Following acute bleeding
C. Hereditary spherocytosis
D. Anemia in CRF
| Anemia in CRF |
4c88274a-ce9c-408c-91f6-0a021d055d62 | - Feline esophagus is seen in both Eosinophilic Esophagitis>GERD. It is characteristic of Eosinophilic esophagitis so it serves as a better answer. - Eosinophilic Esophagitis: A barium swallow should be the first test obtained in the patient with dysphagia EE has a characterised finding often called the "Ringed esophagus" or the "feline esophagus" as the esophagus rings are felt to look like the strips on a housecat. The endoscopic appearance of EE is also characteristic and the appears as a series of rings. Feline Esophagus-BARIUM SWALLOW Normal Esophagus | Surgery | Esophagus | Feline esophagus is seen in:
A. Eosinophilic esophagitis
B. Radiation esophagitis
C. GERD
D. Carcinoma esophagus
| Eosinophilic esophagitis |
e4405a08-da20-4973-912c-844267b940d7 | LOCAL ANAESTHETICS MECHANISM OF ACTION The LAs block nerve conduction by decreasing the entry of Na+ ions during upstroke of action potential (AP). As the concentration of the LA is increased, the rate of rise of AP and maximum depolarization decreases causing slowing of conduction. Finally, local depolarization fails to reach the threshold potential and conduction block ensues. The LAs interact with a receptor situated within the voltage sensitive Na+ channel and raise the threshold of channel opening: Na+ permeability fails to increase in response to an impulse or stimulus. Impulse conduction is interrupted when the Na+ channels over a critical length of the fibre (2-3 nodes of Ranvier in case of myelinated fibres) are blocked. Ref:- kd tripathi; pg num:-361 | Pharmacology | Anesthesia | Local anesthetic action is a result of blockade of the movement of wof channels
A. Chloride
B. Sodium
C. Potassium
D. Calcium
| Sodium |
ae249d6e-5948-4bda-bd37-e4981451aba2 | Ans. is 'd' i.e., Erythema chronicum migrans - malignancyo "Erythema gvratum repens" is a rare and characteristic rash strongly associated with malignancy .It consists of wavy erythematous concentric bands that can be figurate, gyrate or annular.These bands are arranged in parallel rings and lined by a fine trailing edge of scale pattern described as "wood grained"Erythema g}'ration repens can expand as fast as l cm/day. It is extremely pruritic and can involve large areas of the body but tends to spare hands, face and feet.Malignancies associated with Erythema gyratum repens :Bronchial carcinomaEsophageal cancerBreast cancerLess commonly it may also be seen in patients with genitourinary, gastrointestinal and hematological malig- nancies.o Erythema chromic urn nigranso Erythema chronicum migrans is the cutaneous hallmark of "h me disease "o One or more large erythematous patches appear anywhere on the skin. The lesion expands centrifugally. Sometimes with central clearing giving rise to annular patches.Ervthema Annulare centrifugumo Erythema annulare centrifugum is characterized by non indurated annular patches with associated trailing scale inside the erythematous bordere.o The annular lesions most commonly affects the tranks, bullocks, thighs and legs while sparing the hands feets and face.o The etiology and pathogenesis are unknown.It is believed that erythema annulare centrifugum represents a continuous manifestation of a hypersensitivity reation to a myriad of underlying conditions including infection by dermatophytes bacteria and viruses, malignancy and immunological disorders.Necrotizing acral ervthema is associated with Hepatitis C virusCutaneous manifatations associated with Hepatitis C virusUrticariaErthema multiformeErthema nodosumMixed cryoglobulinemiaUrticarial vasculitisHenoch schnolein purpuraNecrolytic acral erythemaPorphyria cutanea tardaLichen planusPntrigoErythema marginatumo It is a characteristic cutaneous manifestation of rheumatic fever.o Erythema marginatum are rash present on the trunk and proximal part of extremities.Face is spared.Never pruritic, never indurated andNever tender | Medicine | Skin | Odd pair -
A. Erythema marginatum-rheumatic fever
B. Erythema gyrens ripens-malignancy
C. Necrotic acral erythema-HCV
D. Erythema chrcnieum migrans ->> malignancy
| Erythema chrcnieum migrans ->> malignancy |
e35296fd-32b6-49e5-a3c7-8615c618db13 | Henoch Schonlein Purpura is a small vessel vasculitis characterized by palpable purpura, ahralgia, gastrointestinal signs and symptoms and glomerulonephritis. Patients have a normal platelet count, other laboratory findings includes mild leukocytosis, occasional eosinophilia, normal serum complement and elevated IgA. Reference: Harrison's Principles of Internal Medicine 18th edition, chapter 326. | Medicine | null | Which of the following is not a characteristic finding in Henoch Schonlein Purpura?
A. Palpable purpura
B. Nephritis
C. Thrombocytopenia
D. Abdominal pain
| Thrombocytopenia |
53a1e252-785f-4720-b5df-bee628aa588d | c. Severe pneumonia with sepsis(Ref: Neonatal and Pediatric Respiratory Care 4/e By Brian K. Walsh p 564)Pneumonia, sepsis and aspiration are the most common cause of ARDS and ALI in children | Pediatrics | Respiratory System | Most common cause of ARDS in children is:
A. Aspiration
B. Injury
C. Severe pneumonia with sepsis
D. DIC
| Severe pneumonia with sepsis |
05625285-f8ba-4ab9-b7c7-5f1ec19b9da0 | Amoxicillin-clavulanic acid : The most frequently implicated antibiotic among cases of drug-induced liver injury. Reference: Harrisons Principles of Internal Medicine, 18th Edition, Page 2560 | Medicine | null | The most frequently implicated antibiotic among the causes of drug induced liver injury is:
A. Tetracycline
B. Amoxicillin-clavulanic acid
C. Erythromycin
D. Nalidixic acid
| Amoxicillin-clavulanic acid |
60f357fb-7cd1-4746-8a4e-558026bca2bc | park's textbook of preventive and social medicine 23rd edition. *non modifiable risk factors for CHD :age,sex,ethnicity, genetic factors. *modifiable risk factors: obesity,alcohol,physical activity, saturated fat, socio-economic status. | Social & Preventive Medicine | Non communicable diseases | Which of the following is a nonmodifiable risk factor for coronary hea disease?
A. Cigarette smoking
B. Elevated serum cholesterol
C. Alcoholism
D. Age
| Age |
9ba9ffba-d069-4f11-8b9e-1e6a637e39e1 | Problem Family: Is a family which lags behind rest of the community; underlying factors in most problem families are those of personality, relationships, backwardness, povey, illness, mental and social instability, character defects and marital disharmony. Standards of life are generally far below the accepted minimum Parents are unable to meet the physical and emotional needs of children Home life is utterly unsatisfactory Ref: Park 25th edition Pgno: 723 | Social & Preventive Medicine | Social science, Mental health & Genetics | Families which lags behind rest of community, is known as
A. Communal family
B. Elementary family
C. Problem Family
D. Broken Family
| Problem Family |
d5691789-8391-484e-9cbd-83d047dcf4dd | IgG 1 - 65%, IgG2- 23%. IgG3 -8% IgG4 - 4% | Physiology | Immunology | The serum concentration in which of the following human IgG subclasses is maximum?
A. IgG1
B. IgG2
C. IgG3
D. IgG4
| IgG1 |
a942906f-ed09-4b02-a88e-d246f207d122 | * The urine electrolytes are used to distinguish between A and diarrhea * UAG is an indirect measure of ammonium excretion * UAG = (Na + K) - Cl * UAG = ( 100 + 31 ) - 105 = 26 * A positive UAG suggest A because in the setting of diarrhea, ammonium chloride concentration in the urine would be high and the UAG would be negative. * A positive value suggests that the kidney is unable to adequately excrete ammonium, leading to a reduction in net acid excretion and thus metabolic acidosis. Hyperkalemia, acidemia is seen in type IV A Type IV A associated with Diabetes Mellitus | Medicine | Electrolyte Imbalance | 29 year old female with history of Sjogren's syndrome presents with a 2 day episode of watery diarrhea 2 days ago. Physical examination is unremarkable. Because of her history, the physician decides to check her urine electrolytes. Urine chemistry: K = 31, Na = 100, Cl = 105. Her current diagnosis is?
A. Renal tubular acidosis
B. Hypochloremic Metabolic alkalosis
C. Malignant hypeension
D. Respiratory alkalosis
| Renal tubular acidosis |
e0dd2825-0d58-4a03-bf57-cde3dd54c572 | In primi, the latent phase is often long (about 8 hours) during which effacement occurs; the cervical dilatation averaging only 0.35 cm/hr. In multi, the latent phase is sho (about 4 hours) and effacement and dilatation occur simultaneously. Latent phase is the preparatory phase of the uterus and the cervix before the actual onset of labor. A latent phase that exceeds 20 hours in primigravidae or 14 hours in multiparae is abnormal. The causes include--(1) unripe cervix (2) malposition and malpresentation (3) cephalopelvic dispropoion and (4) premature rupture of the membranes. Management: Expectant management is usually done unless there is any indication (for the fetus or the mother) for expediting the delivery. Rest and analgesic are usually given. When augmentation is decided, medical methods are preferred. Amniotomy is usually avoided. Prolonged latent phase is not an indication for cesarean delivery. Reference: D C Dutta's Textbook of Obstetrics 7th edition page no 403 | Gynaecology & Obstetrics | General obstetrics | Prolonged latent phase is seen in :
A. Placenta prae
B. Unripe cervix
C. Abruptio placenta
D. Excessive sedation
| Unripe cervix |
062c5fdc-ea77-45f5-b855-9e1e6e0f958f | A. It is a subacute inflammatory myopathy affecting adults, without rash, involvement of eye, family history of neuromuscular disease B. Dermatomyositis is identified by a rash preceding muscle weakness. C. Inclusion body myositis has an asymmetrical muscle involvement. D. Limb girdle muscular dystrophy and would have pediatric presentation and not in old age. Even if it LGMD patient survives by 60 years of age severe muscle wasting with contractures would have occurred. | Medicine | Guillian Barre syndrome & Alzheimer's disease | A 60-year-old female is having proximal muscle weakness with increased serum creatinine kinase. The probable diagnosis is:
A. Polymyositis
B. Dermatomyositis
C. Inclusion body myositis
D. Limb-girdle muscle dystrophy
| Polymyositis |
b96c2aa5-6b98-4330-9da7-697bfdaf18df | Hemolytic uremic syndrome
Hemolytic uremic syndrome is characterized by the triad of :
Anemia (microangiopathic hemolytic anemia).
Renal failure (microangiopathy of kidney involving glomerular capillaries and arterioles).
Thrombocytopenia (due to platelet consumption).
Hemolytic uremic syndrome is most common is children under 2 years of age.
It usually follows an episode of acute gastroenterities, often triggered by E coli.
The prodrome is usually of abdominal pain, diarrhoea and vomiting.
Shortly thereafter, signs and symptoms of acute hemolytic anemia, thrombocytopenia and acute renal failure ensue.
Sometimes neurological findings also occur. (But usually absent and differentiate HUS from TTP.)
Rarely HUS may follow respiratory tract infection.
Etiology
Gastrointestinal infection in infants with the following organism :
E coli, Shigella dysenteriae, Streptococouus pneumoniae
Hematological findings in a case of microangiopathic hemolytic anemia :
Presence of schistocytes (fragmented red cells). This is the hallmark of microangiopathic hemolytic anemia.
Neutrophil leukocytosis.
Thrombocytopenia.
Hemoglobinuria is mild to moderate with hemosiderinuria.
Blood urea and serum creatinine
Elevated serum LDH | Pathology | null | Hemolytic Uremic Syndrome is characterized by -a) Microangiopathic haemolytic anaemiab) ↓ed LDHc) Thrombocytopeniad) Renal failuree) Positive Coomb's test
A. abc
B. ad
C. acd
D. bde
| acd |
722b37ff-b8a8-4a81-adee-8b989862bbaa | Ans. is 'c' i.e., Congo Red "To differentiate amyloid from other hyaline deposits (eg. Collagen andfibrin), a variety of histochemical techniques are used, of which the most widely used is Congo Red " - Robbins 7th/e p. 259Staining for Amyloido Congo red : It is the most widely used specific stain for amyloid.o Iodine staining: It is used for unfixed specimen or histological section. Amyloid stains mahogany brown and if sulfuric acid is added, it turns violet.o Thioflavin 'T' and 'S' give secondary immunoflurescence with ultraviolet light. Thioflavin T is more useful for demonstrating juxtalomerular apparatus of the kidney,o Metachromatic stains like crystal violet and methyl violet give rose pink appearance,o Amyloid is PAS positive. | Pathology | Amyloidosis | Which one of the following stains is specific for Amyloid?
A. Periodic Acidschif (PAS)
B. Alzerian red
C. Congo red
D. Von -Kossa
| Congo red |
d3619749-4faf-4fb8-bf1f-2e91b073ddee | autoimmune haemolytic anaemia, transfusion reactions,idiopathic thrombocytopenic purpura,graves disease,myasthenia gravis are the examples of type 2 hypersensitivity.Harshmohan textbook of pathology 7th edition | Pathology | General pathology | Type II hypersensitivity -
A. Blood transfusion reaction
B. Ahus reaction
C. Hay Fever
D. Glomerulonephritis
| Blood transfusion reaction |
1ed7b8c9-d9d9-4d83-953c-a8e8751f62b9 | Ans: A i.e. Clostridium welchii Conditions and pathogens Established pathogens (clostridium) for gas gangrene (group) includes Cl. Perfringens/ welchii, Cl. septicum & Cl. Novyi Established pathogen (clostridium) for tetnaus include Cl. Tetani Established pathogens (clostridium) for food poisoning (group) includes Cl. Perfringens type A (gastroenteritis), Cl. Perfringens type C (necrotising enteritis) and Cl. Botulinum (botulism) Established pathogens (clostridium) for acute colitis include Cl. difficile | Microbiology | null | Gas gangrene is caused by: March 2012
A. Clostridium welchii
B. Clostridium tetani
C. Clostridium botulinum
D. Clostridium difficile
| Clostridium welchii |
8f1098e1-cdd8-457b-bc2c-7282e8f44191 | Most important reaction in biotransformation of xenobiotics is oxidation reaction. The most important enzyme for oxidation reactions is cytochrome P450. | Biochemistry | null | The main enzyme responsible for activation of xenobiotics is -
A. Cytochrome P-450
B. Glutathione S-transferase
C. NADPH cytochrome P-450-reductase
D. Glucuronyl transferase
| Cytochrome P-450 |
a3fd413e-d69e-40da-b800-5333af840d1b | Ans. is'a' i.e., P. glycoproteinATP-binding cassette transpoers (ABCtranspoers) are integral transmembrane proteins that utilize ATP as an energy source to translocate a variety of substrates across membranes.P-glycoprotein is an ATP-binding cassette (ABC) transpoer and is an impoant factor to limit membrane permeability in several tissues and/or elimination pathways into urine (rend tubles) and bile (liver). | Physiology | null | ABC transpoer ?
A. P. glycoprotein
B. Membrane sparing
C. Channel
D. Adenylyl cyclase
| P. glycoprotein |
bac89777-4154-495f-9879-73e50f62ea56 | (b) Scala media(Ref. Scott Brown, 8th ed., Vol 2, page 545)Endolymph is present in the membranous labyrinth, whereas perilymph is present in the bony labyrinth.Hence scala vestibuli, scala tympani and their interconnection helicotrema, which are parts of bony labyrinth, are filled with perilymph.Scala media, utricle, saccule and semicircular canals, which are parts of membranous labyrinth, are filled with endolymph. | ENT | Ear | Site where endolymph is seen:
A. Scala vestibuli
B. Scala media
C. Helicotrema
D. Scala tympani
| Scala media |
6fbdc56a-d6bd-47b2-86ad-650a2567a74e | Pitolisant (Tiprolisant) is a inverse agonist of H3 receptors approved for Narcolepsy. H3 receptors are presynaptic receptors and inverse agonist will lead to increased histamine release and promote wakefulness. | Pharmacology | null | Which of the following drug is an inverse agonist at H3 receptors used for Narcolepsy?
A. Dexmedetomidine
B. Pitolisant
C. Icatibont
D. Secukinumab
| Pitolisant |
a583bb96-e6fe-45cb-95f2-43cf7430f2c0 | Micrococci:Micrococci are gram-positive cocci which occur mostly in pairs, tetrads or irregular clusters. They are catalase and modified oxidase positive and aerobic. They are ordinarily non-pathogenic. The resemble Staphylococci, but in general, they are large in size and tetrads. The common laboratory test used to differentiate between micrococci and staphylococci is modified oxidase test.Ref: Ananthanarayan 9th edition, p206 | Microbiology | Bacteriology | How to differentiate between staphylococci and micrococci?
A. Catalase test
B. Modified Oxidase test
C. Gram staining
D. AFS
| Modified Oxidase test |
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