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553e0c4a-95de-471f-8ef1-309e50b0d95a | Ans. is 'b' i.e., Declaration of Oslo (1970) | Social & Preventive Medicine | null | Therapeutic aboion was accepted by
A. Declaration of Genava (1948)
B. Declaration of Oslo (1970)
C. Declaration of Helsinki
D. Declaration of Tokyo
| Declaration of Oslo (1970) |
1e8102fa-8144-434e-a6cf-0f95c19ee207 | International Society of Pediatric Oncology-SIOP staging system is the post - chemotherapy based staging system used in Wilm'stumor. Protocol of SIOP consists of initial clinical staging by physical examination, radiologic examination and neoadjuvant chemotherapy. The tumor burden is reduced by preoperative chemotherapy, facilitating resection of the tumor and reducing the total amount of postoperative chemotherapy and radiotherapy. Ref: Pediatric Oncology (Surgical and Medical Aspects) By Devendra K. Gupta, Page 628 | Surgery | null | Which of the following is the Post - Chemotherapy based staging system used in Wilm's tumor?
A. National Wilm's Tumor Staging System (NWTSG)
B. International Society of Pediatric Oncology (SIOP)
C. AJCC TNM Staging
D. Chadwick Staging
| International Society of Pediatric Oncology (SIOP) |
8660b6e4-7672-4c69-acd5-44b024164f86 | Ans. is 'a' i.e., diarrhoea "Nausea, vomiting, diarrhea and abdominal pain are the most common untoward effects of colchicine". - Goodman & Gilman | Pharmacology | null | Most common adverse effect of colchicine -
A. Diarrhoea
B. Peptic ulcer
C. Dyspepsia
D. Pulmonary fibrosis
| Diarrhoea |
ffcefe74-7680-4979-a5f6-f232fafb96af | Among the given options soft tick transmits relapsing fever while the KFD, tularemia and Indian tick typhus are transmitted by hard ticks. Ref: Park Textbook of Preventive and Social Medicine, 19th Edition, Pages 622-23, 634-35 | Social & Preventive Medicine | null | Soft tick transmits:
A. Relapsing fever
B. KFD
C. Tularemia
D. Indian tick typhus
| Relapsing fever |
c3c9e2ee-ee5c-41af-b173-9b853ae83965 | Elevated levels of serum α-fetoprotein are found in 50 to 75% of patients with HCC.
False-positive results are encountered with yolk-sac tumors and many non-neoplastic conditions, including cirrhosis, massive liver necrosis, chronic hepatitis, normal pregnancy, fetal distress or death, and fetal neural tube defects such as anencephaly and spina bifida.
Concept
The staining for Glypican-3 is used to distinguish early hepatocellular carcinoma from a dysplastic nodule. Other tests cannot be used because the levels of serum α-fetoprotein are inconclusive in this condition. | Pathology | null | A chronic alcoholic has an elevated serum alpha fetoprotein levels. Which of the following neoplasms is most likely -
A. Prostatic adenocarcinoma
B. Multiple myeloma
C. Hepatocellular carcinoma
D. Glioblastoma multiforme
| Hepatocellular carcinoma |
db203ade-91f3-4351-9735-6fe9ffe3e0d5 | Mandibulectomy Marginal mandibulectomy Segmental mandibulectomy - Conservative mandibulectomy - Refers to paial excision of the superior poion of mandible in veical phase - Inner coical surface and a poion of underlying medullary cavity is excised - Preserve mandibular continuity - Indicated when tumor lies within I cm of the mandible or abuts the periosteum without evidence of direct bony invasion - Entire through and through segment of mandible is resected - Results in mandibular discontinuity - Require major reconstructive procedure for cosmetic and functional purposes - Indications: 1. Invasion of medullary space of mandible 2. Tumor fixation to occlusal surface of mandible in edentulous patients 3. Invasion of tumor into the mandible mandibular or mental foramen 4. Tumor fixed to the mandible. | Surgery | Oral cavity | An 80-year-old patient presents with a midline tumor of the lower jaw, involving the alveolar margin. He is edentulous. Treatment of choice is:
A. Hemimandibulectomy
B. Commando operation
C. Segmental mandibulectomy
D. Marginal mandibulectomy
| Segmental mandibulectomy |
b3a1acc9-9a3e-4dae-b4fc-20f9d9886918 | Chloroquine rarely cause hemolysis in patients with G6PD deficiency. Drugs initiate hemolysis and should be avoided: Dapsone Methylthioninium chloride (methylene blue) Phenazopyridine Primaquine Rasburicase Tolonium chloride (toluidine blue) Nitrofurantoin, sulfonamides Aspirin, nonsteroidal anti-inflammatory drugs Quinidine Naphthalene Attacks can also be associated with infections (such as pneumonia, viral hepatitis, and Salmonella) and diabetic ketoacidosis. Finally, foods such as a beans have been implicated. Ref: Linker C.A., Damon L.E., Damon L.E., Andreadis C. (2013). Chapter 13. Blood Disorders. In M.A. Papadakis, S.J. McPhee, M.W. Rabow, T.G. Berger (Eds), CURRENT Medical Diagnosis & Treatment 2014. | Pharmacology | null | Which drug can be given in G6PD deficiency?
A. Chloroquine
B. Probenecid
C. Aminopyrine
D. Primaquine
| Chloroquine |
2f5def1a-653f-41dd-a7d9-0ede0216c517 | Ans. D: Melanocyte Structure involved in protection against ultraviolet radiation is melanin produced by melanocytes and transferred to keratinocytes | Skin | null | Which of the following is responsible for protection from ultraviolet rays: September 2011
A. Stratum corneum
B. Langerhans cells
C. Apocrine sweat glands
D. Melanocyte
| Melanocyte |
9f96b87b-3c23-4bdc-aaec-c36bd71cb42a | Ans. is 'a' i.e., EpitympanumPrussak's space is a small space between the shrapnel's membrane/pars flaccida laterally. neck of malleus medially, sho process of malleus below and lateral process of malleus above.Prussak's space communicates with epitympanum through a posterior gap.Prussak's space is impoant because it is a site for pars flaccida acquired cholesteatoma formation. | Pathology | null | Prussak's space is seen in ?
A. Epitympanum
B. Hypotympanum
C. Mesotympanum
D. Ear Canal
| Epitympanum |
4c269ea2-4308-4fd9-82e9-c9c3101499fd | Ans. is 'b' i.e., IgG Virulence factors of staphylococcus aureuso Protein 'A' binds to Fc terminal of IgG (IgG 1,2 & 4 but not IgG3) and prevents opsonophagocytosis by PMNs . It is a B-cell mitogen. It is chemotactic, anti-complementory and antiphagocytico Heat stable nuclease (DNAase) is a characteristic feature of staph aureus.o Staphylococcus produces five cytolytic toxins, consisting of four hemolysins (alpha, beta, gamma and delta) and a leucocidin.o a - hemolysin is the most important hemolysin.o Beta - hemolysin is a sphingomyelinase. It exhibits a hot-cold phenomenon, the hemolysis being initiated at 37degC, but becoming evident only after chillingo Leucocidin is also called the Panton-valentine toxin.o Staphylococcal leucocidin and gamma lysin have been grouped as synergohymenotropic toxins.o Toxic shock syndrome toxin (TSST), exfoliative toxin and enterotoxins are superantigens which are potent activators of T lymphocytes and lead to an excessive and dysregulated immune response with release of cytokines IL-1, IL-2, TNF-a and IFN-g.o Enterotoxin is responsible for food poisoning, o Exfoliative (epidermolytic) toxin# Responsible for staphylococcal scalded skin syndrome (S.S.S.S.).# Severe form of SSSS is known as Ritter's disease in newborn and toxic epidermal necrolysis in older patients. Milder forms are pemphigus neonatorum and bullous impetigo.o Hyaluronidase is helpful in persistent skin infection. | Microbiology | Bacteria | Protein A of staphylococcus binds to -
A. IgA
B. IgG
C. IgD
D. IgE
| IgG |
f14c6f99-75ac-407b-b205-56cd86d0ba40 | Ans- A Waterhouse-Friderichsen Syndrome This uncommon but catastrophic syndrome is characterized by the following:An overwhelming bacterial infection, which is classically associated with Neisseria meningitidis septicemia but occasionally is caused by other highly virulent organisms, such as Pseudomonas species, pneumococci, Haemophilus influenzae, or staphylococciRapidly progressive hypotension leading to shockDisseminated intravascular coagulation with widespread purpura, particularly of the skinRapidly developing adrenocortical insufficiency associated with massive bilateral adrenal hemorrhage Whatever the basis, the adrenals are converted to sacs of clotted blood virtually obscuring all underlying detail. | Unknown | null | A 22-year old software engineer was brought in an unconscious state to the casualty. Clinical examination revealed features suggestive of shock, DIC and multisystem failure. CSF and petechial rashes yielded gram-negative diplococcic, which subsequently grew on modiefied Thayer-Martin medium. This isolation is known to be associated with-
A. Waterhouse-Fridericheen syndrome
B. Fitz-Hugh-Curtis syndrome
C. Job's syndrome
D. Toxic shock syndrome
| Waterhouse-Fridericheen syndrome |
71a3b35e-b1a1-4f90-9999-bbe9c8573179 | Pregnancy due to rape, danger to maternal health, receiving cytotoxic drugs (can cause fetal damage and risks of a born child with physical/mental abnormalities) and pregnancy due to contraceptive failure are indications for abortion under MTP act. | Forensic Medicine | null | In which of the following conditions, MTP can be indicated -a) Pregnancy caused by rapeb) Husband is willing but mother is not agreeingc) If maternal health is in dangerd) Pregnancy after contraceptive failuree) Pregnant women have received cytotoxic drugs
A. bce
B. bde
C. acde
D. abde
| acde |
066cdcf2-48a6-4dcd-a4c2-b5c351988a47 | Hair * Hair is derived from ectoderm, but dermal papilla is of mesoderm-derivation * Hair follicle is positioned at an angle; base of follicle typically within the subcutaneous fat Longitudinal anatomy * Infundibulum: upper poion of follicle extending from surface of epidermis to opening of sebaceous gland * Isthmus: middle poion extending from opening of sebaceous gland duct to inseion of arrector pili muscle (bulge), lined by outer root sheath (ORS), no inner root sheath (IRS) * Inferior segment or lower hair follicle: extending from base of isthmus to hair bulb; consists of matrix cells and envelops dermal papilla; lined by IRS; ORS present but not keratinized; widest diameter termed critical line of Auber (below this is where bulk of mitotic activity occurs); melanocytes in bulb provide melanosomes for hair color * Cross-sectional anatomy:- from outer to inner layer: * Glassy membrane - ORS - Henle's layer (IRS) - Huxley's layer (IRS) - cuticle (IRS) - hair shaft cuticle - coex --> Medulla. Ref:- Sima Jain; pg num:- 13,14 | Dental | miscellaneous | Huxley- Henley layers is a pa of
A. Nail
B. Skin
C. Hair
D. Sweat glands
| Hair |
2f06f6de-316d-421f-afca-ceee964275bd | ANSWER: (B) 46XXREF: Dutta 6th ed p. 201Repeat in December 2011See APPENDIX-63 for "COMPLETE AND PARTIAL HYDATIDIFORM MOLES" APPENDIX - 63Complete and Partial Hydatidiform Moles:FeaturePartial Hydatidiform MoleComplete Hydatidiform MoleKaryotype69XXY, Triploid, paternal and maternal origin46XX, Diploid, mostly paternal originImmunohistochemistryhCGWeakStrongPlacental alkaline phosphataseStrongWeakhPLvariableWeakPathology Fetus or amnion, fetal vessels Hydropic villiTrophoblastic proliferationPresentVariable, often focal FocalAbsentPronounced, generalizedVariable, often markedClinical Mole clinical diagnosisUterus large for datesMalignant sequelaeRareRare<5%Common30%-50%6%-36% | Gynaecology & Obstetrics | Choriocarcinoma | Karyotype of Complete mole is?
A. 46 XY
B. 46 XX
C. 69 XXX
D. 69 XXX
| 46 XX |
5130aa5a-bcce-439b-b4bb-13ffb7c06726 | Pulmonary infections may be caused by bacteria, fungi, viruses, or mycoplasma. Bacterial infections generally result in a polymorphonuclear (neutrophil) response. Bacterial infection of the lung (pneumonia) results in consolidation of the lung, which may be patchy or diffuse. Patchy consolidation of the lung is seen in bronchopneumonia (lobular pneumonia), while diffuse involvement of an entire lobe is seen in lobar pneumonia. Histologically, bronchopneumonia is characterized by multiple, suppurative neutrophil-rich exudates that fill the bronchi and bronchioles and spill over into the adjacent alveolar spaces. In contrast, lobar pneumonia is characterized by four distinct stages: congestion, red hepatization, gray hepatization, and resolution Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition. | Pathology | miscellaneous | Histologic examination of lung tissue reveals multiple suppurative, neutrophil-rich exudates that fill the bronchi and bronchioles and spill over into the adjacent alveolar spaces only. The majority of lung tissue is not involved in this inflammatory process. Hyaline membranes are not found. This histologic appearance best describes
A. Bronchiectasis
B. Bronchopneumonia
C. Lobar pneumonia
D. Interstitial pneumonitis
| Bronchopneumonia |
c64544b5-5877-4de6-ae41-48d33516787c | Most tissue adhesives or glue are cyanoacrylate polymers, such as n-butyl-2-cyanoacrylate (eg, Histoacryl®, PeriAcryl®) or 2-octyl cyanoacrylate (eg, Dermabond®, Surgiseal).
Cyanoacrylate tissue adhesives are liquid monomers that undergo an exothermic reaction on exposure to moisture (eg, on the skin surface), changing to polymers that form a strong tissue bond. When applied to a laceration, the polymer binds the wound edges together to allow normal healing of the underlying tissue.
Compared with wounds closed with sutures, the tensile strength of wounds closed by tissue adhesives is less at the time of initial application, but equalizes by one week post-repair.
Advantages:
Less painful application, and sometimes no need for local anesthetic injection
More rapid application and repair time
Cosmetically similar results at 12 months post-repair
Waterproof barrier
Antimicrobial properties
Better acceptance by patients
No need for suture removal or follow-up
Indications and contraindications:
For use of tissue adhesives the wound needs to be clean, dry with near perfect hemostasis and under no tension.
Complex stellate lesions or crush injuries should not be closed with tissue adhesives since good wound approximation is difficult to achieve.
Tissue adhesives are not recommended for lacerations of the hands, feet, or joints, since repetitive movements could cause the adhesive bond to break before sufficient tensile strength is achieved.
Tissue adhesives are not recommended for the oral mucosa or other mucosal surfaces or areas of high moisture such as the axillae and perineum.
Lacerations involving the hairline or vermilion border require more precision, and should be repaired with traditional sutures. | Surgery | null | Tissue suturing glue contains:
A. Cyanoacrylate
B. Ethanolamine oleate
C. Methacrylate
D. Polychloroprene
| Cyanoacrylate |
103afa52-5ca0-4c7a-9d53-6a72cb5258f1 | Of the Uterine Sarcomas Almost 50% of are Mixed and are called the Mixed Mesodermal tumors (Synonymously called Mixed mullerian tumors). These mixed tumors can be Homologous 25% Heterologous 20% Adencarcinomas in 5% cases. The other Uterine sarcomas are Leiomyosarcoma in 33% cases and Stromal sarcoma in 16% cases | Gynaecology & Obstetrics | Endometrial Carcinoma | A female patient has adenocarcinoma uterus along with sarcoma of uterus. It is known as -
A. Homologous sarcoma
B. Sarcoma uterus
C. Mixed mullerian carcinogenesis
D. Heterologous sarcoma
| Mixed mullerian carcinogenesis |
f834ae4a-4a15-4fc5-9dc6-e710da3082bd | Ans.B intestine X-Ray shows gas under the diaphragm suggests perforating injury . Most common organ damaged in Penetrating or stab injury : Liver Most common organ damaged in Perforating injury : Small Intestine Most common organ damaged in Blunt abdominal injury : Spleen Most common organ damaged in Seat belt injury : Mesentry Most common organ damaged in Blast injury : Head above water : TM Below water : GIT Most common organ damaged in Deceleration injury- Dudodenojejunal flexure | Unknown | null | A patient presented to you after an assault and penetrating knife injury to the abdomen. X-Ray shows gas under the diaphragm. Most common organ damaged in this case:
A. Spleen
B. Intestine
C. Liver
D. Lung
| Intestine |
0d181df4-adfa-4763-80b7-93357ace33e9 | Philedelphia chromosome positivity is a feature of adult CML. Juvenile CML is commonly seen in children between 1-2 years of age. It is characterised by enlarged lymphnodes, spleen and liver. Lab findings includes thrombocytopenia, leukocyte count lower than classic CML, and in increase in propoion of fetal hemoglobin. | Medicine | null | Which of the following is not a feature of juvenile CML?
A. Thrombocytopenia
B. Lymphadenopathy
C. Presence of Philedelphia chromosome
D. High HbF
| Presence of Philedelphia chromosome |
b5627a4b-657f-490d-a257-57a96133ef0d | Optic disc, 1.5 mm in size, is responsible for blind spot of Mariotte Rods and cones are sensory end organs of vision Rods are absent in the foveal region. Ganglion cell layer is thickest in the macular region. Foveola is the most sensitive pa of retina. It contains only cones and their nuclei covered by a thin internal limiting membrane. There are 3 types of cones Red (maximum number) 65% Green Blue (least number) Cones are packed and tight mosaic hexagonal cells Visual acuity depends upon the density of cone mosaic | Ophthalmology | Retina | Maximum cones are seen in
A. Limbus
B. Fovea centralis
C. Macula lutea
D. Blind spot
| Fovea centralis |
5a071f66-a8bd-4c19-a5cd-2d444485ab84 | Answer is A (Autonomic neuropathy): Hypoglycemic unawareness refers to a loss of warning symptoms that ale individuals to the presence of hypoglycemia and prompt them to eat and'abo the episode. Hypoglycemic unawareness can be attributed to two factors : Autonomic neuropathy Loss of catecholamine response to hypoglycemia : This means that patients with repeated attacks of hypoglycemia lose their capacity to release epinephrine and norepinephrine in response to hypoglycemia. (increase release of glucogon in response to hypoglycemia is lost very early in type I Diabetes Thus type I patients overeated with insulin may be unaware of critically low levels of blood glucose because of an adaptive blunting of their alarm systems owing to repeated episodes of hypoglycemia. | Medicine | null | Hypoglycemic unawareness that occurs in diabetic patients when transferred from oral hypoglycemics to insulin, is due to :
A. Autonomic neuropathy
B. Insulin resistance
C. Lipodystrophy
D. Somogi phenomenon
| Autonomic neuropathy |
5d402338-a012-4b3d-a209-f5da920a4b96 | • Folliculitis, carbuncles and furuncles are all types of localized (superficial) skin infections that fall under the category of boils.
• Hair follicles serve as portals for a number of bacteria, although S. aureus is the MC cause of localized folliculitis. | Surgery | null | A boil is due to staphylococcal infection of -
A. Hair follicle
B. Sweat gland
C. Subcutaneous tissue
D. Epidermis
| Hair follicle |
50977c8e-c06a-4ef1-b41d-ea1fe415fa75 | Specific Learning Disability (SLD) in youth is a neurodevelopmental disorderproduced by the interaction of heritable and environmental factors that influence the brain's ability to effeciently perceive or process verbal and non verbal information. It is characterised by persistent difficulty learning academic skills reading, written expression, that is inconsistent with the overall intellectual ability of a child. They find difficulty to keep up with their peers in ceain academic subjects. SLD is associated with an increased risk of comorbid disorders, including ADHD, Communication disorders, Conduct disorders and Depressive disorders. Ref: Synopsis of Psychiatry, 11e, pg 1181. | Psychiatry | Child psychiatry | A 14-year-old boy has difficulty in expressing himself in writing and makes frequent spelling mistakes, does not follow instructions and cannot wait for his turn while playing a game. He is likely to be suffering from
A. Mental retardation
B. Lack of interest in studies
C. Specific learning disability
D. Examination anxiety
| Specific learning disability |
4c29b96c-01ee-455f-a4b0-1170f6a9be26 | Ans. is 'b' i.e., CholeraInfections transmitted by bloodViralBacterialParasiteso HCVo Pseudomonaso Taxoplasmao HBVo Yersiniao Malariao HIVo Coagulase negative stapho Babesiao CMVo Borrefia burgdorferio Chagas dis.o HTL V - Type 1(Lyme dis) o Hepatitis G virus (GBV-C) o Parvovirus B-19 o Hepatitis A (rarely) o West Nile virus o Creutzfeld - Jakob dis. | Social & Preventive Medicine | Cholera | Which is not transmitted through blood -
A. Westnile
B. Cholera
C. Toxoplama
D. HBV
| Cholera |
8d932040-8924-4bae-b19b-d7b390f0cf81 | * kliehauer Betke test is the procedure of choice to assess the volume of the fetal maternal bleeding * It should be done as soon as possible (within 2hours) after delivery in women with suspected large feto maternal haemorrhage who need larger amounts of anti D * This method is based on the fact that an acid solution elutes the adult but not the fetal hemoglobin from the red cells. * Fetal erythrocytes appear in a smear stained dark red and surrounded by colourless ghosts that are adult erythrocytes without hemoglobin. * This test can detect as little as 0.2ml of fetal blood diluted in 5litres of maternal blood. * Following clinical scenarios are associated with large feto maternal bleeding: 1. Traumatic deliveries including cesarean 2. Manual removal of placenta 3. Still bihs and intrauterine deaths 4. Abdominal trauma during the third trimester 4. Twin pregnancies at delivery 5. unexplained hydrops fetalis Reference: Greentop guidelines no: 22 | Gynaecology & Obstetrics | Medical, surgical and gynaecological illness complicating pregnancy | A 29year old primigravida at 36weeks with Rh negative pregnancy came to labor room with complaints of bleeding per vaginum followed by abdominal trauma. Which of the following test is advised to estimate the size of fetomaternal haemorrhage?
A. Rosette test
B. Kliehaure acid elution test
C. Indirect coombs test
D. Middle cerebral aery peak systolic velocity
| Kliehaure acid elution test |
95b9e1f5-eca3-443a-81bf-9ab7c9845218 | Ans. A: 1-123 The radionuclides that are used in thyroid scans are two isotopes of iodine, 1-131 and 1-123, and an isotope of technetium known as 99m Tc. Technetium scanning is preferred for some diagnostic workups because it is relatively fast and does not require the patient to fast beforehand. Many prefer to reserve 1-131 for follow-up evaluations of cancer patients, and use 1-123 for thyroid uptake tests and routine thyroid scans. The reason for the distinction is the higher radiation burden of 1-131. | Radiology | null | Which of the following radio of Iodine is used for thyroid scan: September 2008
A. 1-123
B. 1-125
C. 1-127
D. 1-131
| 1-123 |
06133f6a-acde-4586-89df-16918c2f4742 | Ans. is'c'i.e., Anterior visceral spaceRef: Ballenger's Otorhinolaryngology: Heat and Neck Surgery 1//e by james Byron Snow, Phillip A. Wackym, John lacob Ballenger p. 1021, Cummings Otolaryngology- Head and Neck Surgery Sh/e, Ch. 14Suprahyoid neckThese spaces are :-Peritonsillar spaceSubmandibular 6 sublingual spacesPrestyloid parapharyngeal spaceMasticator spaceParotid space | ENT | null | Which of the following is not a suprahyoid space?
A. Masticator space
B. Peritonsillar space
C. Anterior visceral space
D. Parapharyngeal space
| Anterior visceral space |
b91295f2-73f4-480c-b601-d23a111fe730 | Ans: d (21 and 30) Ref: Vasudevan,4th ed, p. 108Insulin is a protein hormone with 2 polypeptide chains; the A chain with 21 amino acids and B chain with 30 amino acids.Insulin:T 1/2 of insulin is 5 minutes.Normal daily insulin secretion is 50 units.Tissues independant of insulin - RBC, brain, renal medullary cells, placenta.Amino acids stimulating insulin secretion - leucine and arginine.Pork insulin differs from human insulin by only one amino acid residue. | Biochemistry | Proteins and Amino Acids | Number of amino acids in A chain and B chain of insulin is:
A. 30, 21
B. 28, 32
C. 32, 28
D. 21, 30
| 21, 30 |
1ea53b2b-0c7d-425e-bed4-f76414e437e5 | Ref: Robbins Pathologic Basis of Disease, 8th edition, Pg: 183Explanation:T Cell-Mediated (Type IV) HypersensitivityThe cell-mediated type of hypersensitivity is initiated by antigen-activated (sensitized T lymphocytes, including CD4+ and CD8+ Tcells.Tubercle bacilli colonizing the lungs are persistent or nondegradable antigensThe perivascular infiltrate is dominated by macrophages over a period of 2 or 3 weeks.The activated macrophages often undergo a morphologic transformation into epithelium-like cells and are then referred to as epithelioid cells.A microscopic aggregation of epithelioid cells, usually surrounded by a collar of lymphocytes, is referred to as a granuloma.This pattern of inflammation, called granulomatous inflammation is typically associated with strong T-cell activation with cytokine production.M. tuberculosis enters macrophages by endocytosis mediated by several macrophage receptors: mannose receptors bind lipoarabino- mannan. a glvcolipid in the bacterial cell wall, and complement receptors bind opsonized mycobacteria.M. tuberculosis organisms replicate within the phagosome by blocking fusion of the phagosome and lysosomeAbout 3 weeks after infection, a T-helper 1 (TH1) response is mounted that activates macrophages to become bactericidal.Differentiation of TH1 cells depends on IL-12, which is produced by antigen-presenting cells that have encountered the mycobacteria.Mature TH1 cells, both in lymph nodes and in the lung, produce IFN-g.INF-g is the critical mediator that enables macrophages to contain the M. tuberculosis infection.IFN-g stimulates formation of the phagolysosome in infected macrophages, exposing the bacteria to an inhospitable acidic environment.Macrophages activated by IFN-y differentiate into the "epithelioid histiocytes" that characterize the granulomatous response, and may fuse to form giant cells.Activated macrophages also secrete TNF. which promotes recruitment of more monocytes. | Pathology | Cells and Tissues of Immune System | The macrophage to epitheliod conversion in Mycobacterium tuberculosis infection is mediated by:
A. TNF alpha
B. IFN-g
C. IL-4
D. TGF-Beia
| IFN-g |
ac2b2c6f-6c24-4117-a0b0-02c0241aec10 | Its tempting here to go for Hypothyroidism but that is usually associated with weight gain. However, pituitary tumors and craniopharyngiomas can cause increase in PRL and consequent galactorrhea , weight loss attributed then to the malignant process. Ref - Harrison 20e pg2673 | Medicine | All India exam | An 18-year-old girl presents with amenorrhoea, milk discharge, weight loss. Diagnosis is
A. Pituitary Cancer
B. Anorexia nervosa
C. Hypothyroidism
D. Hypothalamic cause
| Pituitary Cancer |
3807f643-9fdb-40df-8e36-dd34b1545d5f | CLAVIPECTORAL FASCIAStrong fascial sheet deep to clavicular head of pectoralis major muscle.Fills space between clavicle and pectoralis major.Extend:-Verically-clavicle above to axillary fascia below.Medially-first rib and costoclavicular ligament.Laterally- coracoid process and blends with coracoclavicular ligament.The thick upper pa of fascia extending from first rib near costochondral junction to the coracoid process is called costocoracoid ligament.Clavipectoral fascia encloses two muscles- subclavius and pectoralis major.Structures piercing:-1. Thoracoacromial aery 2. Apical group of axillary lymph nodes.3. Lateral pectoral nerve.4. Cephalic vein{Reference: Vishram Singh, pg no.43} | Anatomy | Upper limb | Clavipectoral fascia is derived from which ligament
A. Coracoacromial
B. Coracoclavicular
C. Costoclavicular
D. Costocoracoid
| Costocoracoid |
f655dcf3-02e0-4d13-befa-339772e466ce | Ans. is a i.e. FSHRef: Shaw 14th/ed, p41, Dutta Gynae 5th/ed, p82Ovarian cycle is initiated by FSHRemember: Following questions asked, previously on FSHFSHi. It is the hormone which initiates ovarian cycleii. In menopausal females- Since primordial follicles are decreased so levels of estrogen is decreased, so negative feedback on FSH is decreased, hence levels of FSH are increased and increased FSH levels are a sine qua non of menopause.iii. Human menopausal gonadotropin (HMG) is FSH and LH obtained from the urine of postmenopausal femalesiv. FSH levels can help in differentiating the causes of male infertility vizIn pretesticular cause of male infertility = FSH decreasesIn testicular cause = FSH levels increaseIn post testicular cause = FSH is normal | Gynaecology & Obstetrics | Physiology & Histology | The ovarian cycle is initiated by:
A. FSH
B. Estrogen
C. LH
D. Progesterone
| FSH |
27c4dfce-2bf3-4c5e-951c-8f947eda667a | Submandibular duct REF: Clinical surgery: Volume 9 Head and neck edited by Charles Rob, Rodney, Smith page 56 "The treatment of ranula constitutes a problem, owing to the technical difficulty of complete excision without damage to adjacent structures such as the submandibular duct" | Surgery | null | Structure damaged most commonly during Surgery on Ranula is?
A. Lingual Aery
B. Lingual Nerve
C. Submandibular duct
D. Sublingual duct
| Submandibular duct |
1e11b518-54c2-488f-9ead-f405ee1a2efe | Ans. is `b' i.e., Multiple impact injuries | Forensic Medicine | null | Puppe's rule deals with?
A. Chemical injuries
B. Multiple impact injuries
C. Sexual assault
D. Percentage of burns
| Multiple impact injuries |
ce5819fd-1e86-480a-8c90-240395fe21f1 | Carpal tunnel Contents - 1. 4 tendons of Flexor Digitorum Profundus (FDP) 2. 4 tendons of Flexor Digitorum Superficialis (FDS) 3. 4 tendons of Flexor Pollicis Longus (FPL) 4. Median nerve Structure passing anterior to carpal tunnel: 1. Ulnar nerve 2. Ulnar aery 3. Palmaris longus tendon. Structure embedded into flexor retinaculum Flexor carpi radialis tendon. | Anatomy | FMGE 2018 | NOT a content of carpal tunnel
A. Flexor pollicis longus
B. Flexor digitorum profundus
C. Ulnar nerve
D. Median nerve
| Ulnar nerve |
afcc1975-d4b8-43fd-a8d7-10473455f957 | b. P1 & P3(Ref: Nelson's 20/e p 1561, 3212, Ghai 8/e p 190-194)Monovalent OPVs (mOPVs) & bivalent OPV (bOPV) are 2.5-3 times more efficacious than trivalent OPVIn bivalent OPV, the type 2 component is removed | Pediatrics | Immunization | OPV Bivalent vaccine contain:
A. P1 & P2
B. PI & P3
C. P2 & P3
D. P1, P2 & P3
| PI & P3 |
c61d6422-b2f9-436a-9123-0ab8ba50ff77 | Zinc is required for the activity of > 300 enzymes, covering all six classes of enzymes. alcohol dehydrogenase; superoxide dismutase; transferases like RNA polymerase and aspaate transcarbamoylase; hydrolases like carboxypeptidase A and thermolysin; lyases like carbonic anhydrase and fructose-1,6-bisphosphate aldolase; isomerases like phosphomannose isomerase; and ligases like pyruvate carboxylase and aminoacyl-tRNA synthases | Pharmacology | All India exam | Which of the following enzymes does NOT contain Zn? (NOT RELATED)
A. Alcohol Dehydrogenase
B. Arginase
C. Alkaline Phosphatase
D. Carbonic Anhydrase
| Arginase |
51b5232f-876b-4b6e-8958-8c32f4b1d1fd | Patient must have underwent Laparoscopic Roux-en-Y gastric bypass 5 years ago Now presented with internal hernia- late complication of gastric bypass surgery Closure of hernia defects at the time of gastric bypass surgery reduces the incidence of symptomatic internal hernias in future. | Surgery | Robotics, Laparoscopy and Bariatric Surgery | A patient presents with vomiting and severe colicky abdominal pain. He underwent bariatric surgery 5 years ago. He is advised to undergo an emergency reoperation. Which of the following procedures did he most likely undergo 5 years ago?
A. Laparoscopic Roux-en-Y gastric bypass
B. Laparoscopic adjustable gastric banding
C. Sleeve gastrectomy
D. Biliopancreatic division
| Laparoscopic Roux-en-Y gastric bypass |
7742f99f-5e9e-49d5-a160-1aa3d993a4a4 | ANSWER: (B) RetinoblastomaREF: Decision Making in Radiation Oncology, Volume 2 by Jiade J. Lu page 1041Repeat from June 2008Reese-Ellsworth classification of Retinoblastoma:TypeDescriptionGroup I"Very favourable"ASolitary tumor, less than 4 dd in size, at or posterior to the equatorBMultiple tumors, none over 4 dd in size, all at or posterior to the equatorGroup II"Favourable"ASolitary tumor, 4-10 dd in size, at or posterior to the equatorBMultiple tumors, 4-10 dd in size, all posterior to the equatorGroup III"Doubtful"AAny lesion anterior to the equatorBSolitary tumors larger than 10 dd posterior to the equatorGroup IV"Unfavorable"AMultiple tumors, some larger than 10 ddBAny lesion extending to the ora serrataGroup V"Very unfavourable"AMassive tumors involving over half the retinaBVitreous seeding*dd= disc diameter (approximately 1.5 mm) | Ophthalmology | Intra Ocular Tumour | Reese-Ellsworth classification is used for?
A. Rhabdomyosarcoma
B. Retinoblastoma
C. Optic nerve sheath tumor
D. Meningioma
| Retinoblastoma |
50cbb188-7d62-40e1-bfca-b31cf71c5557 | Prophylaxis of neural tube defects require treatment with folic acid. Methotrexate toxicity can be prevented by 5'-formyltetrahydrofolate (folinic acid). Pernicious anemia requires the therapy with vitamin B12. Anemia associated with chronic renal failure is treated with erythropoietin. | Pharmacology | Hematology | Which of the following is an indication for the use of folinic acid?
A. Prophylaxis of neural tube defects in the offspring of women receiving anticonvulsant medications
B. Counteracting toxicity of high dose methotrexate therapy
C. Pernicious anemia
D. Anemia associated with renal failure
| Counteracting toxicity of high dose methotrexate therapy |
2aed5043-026a-4c5f-99a8-44de1610e0e4 | Ans. is 'c' i.e., Scaleneus anterior Scaleneus anterior muscle divides subclan aery into three pas :?A) First pa :This pa is medial (proximal) to scaleneus anterior. Branches from first pa are :?Veebral aeryInternal thoracic aeryThyrocervical trunk:Costocervical trunk (on left side only).B) Second pa :This pa lies posterior to scalenus anterior. It gives origin to Costocervical trunk on right side. Costocervical trunk gives following branches:Deep cervical aerysuperior intercostal aery.C) Third pa :This pa lies lateral (distal) to scalenus anterior. It gives dorsal scapular aery (sometimes dorsal scapular aery arises from transverse cervical aery, a branch of thyrocervical trunk). | Anatomy | null | Subclan aery is divided by which muscle ?
A. Pectoralis minor
B. Teres minor
C. Scaleneus anterior
D. Trapezius
| Scaleneus anterior |
98008e16-5448-4ec6-bb50-a86d7a5a1cd1 | National Institute of Social Defence has launched NICE project (National Initiative on Care for Elderly) in 2000. Ref: National Health Programmes in India, J.Kishore, 10th edition pg: 795 | Social & Preventive Medicine | null | NICE project is associated with:
A. Female literacy
B. Population control
C. Rural infrastructure
D. Care of elderly
| Care of elderly |
d17a2408-d240-411b-9193-c7ef57a14cd8 | Ans. is 'c' i.e., Cold extremities o Amongst the given options cold extremities is the best answer. o Prolongation of physiological jaundice is the earliest sign. | Pediatrics | null | Commonest feature of hypothyroidism in children is
A. Cataract
B. Recurrent seizures
C. Cold extremities
D. Laryngospasms
| Cold extremities |
c92e770d-f617-4ace-81f2-d9f714a644cd | Left medial sector contains segment III and IV Left lateral sector contains only one segment II Ref: Sabiston 20th edition Pgno : 1421-1422 | Surgery | G.I.T | Left medial sector contains segment
A. III, IV
B. II, III
C. I, II
D. I, IV
| III, IV |
6c0a6ec2-4847-4874-8737-61de579f48c1 | Postmaturity syndrome is the description of a clinical syndrome in which fetus experiences placental insufficiency and resultant growth restrictions.The classical syndrome describes a neonate with wrinkled ,peeling skin coated with meconium,overgrown nails ,well developed palm and sole creases ,reduced subcutaneous fat and a wizened old man appearance (refer pgno:218 sheila textbooks of obstetrics 2 nd edition) | Gynaecology & Obstetrics | Abnormal labor | Saffron coloured meconium is seen in:
A. Postmaturity
B. TB
C. Breech
D. Normal in appearance
| Postmaturity |
a937600a-0f2d-47a7-a689-e2792d77b580 | First change of improvement noted after iron therapy is decreased irritability followed by increased reticulocyte count. Reference: GHAI Essential pediatrics, 8th edition | Pediatrics | Hematology | First change of improvement noted after iron therapy is initiated
A. Decreased irritability
B. Reticulcytosis
C. Increase in serum iron levels
D. Replenishment of iron stores
| Decreased irritability |
09a40c4d-2b66-4ae6-acf6-443a34cb19ac | Debranching enzyme Has 2 catalytic sites in a single polypeptide chain. Glucan transferase and debranching enzyme are the two separate activities of the same enzyme. Glucan transferase 1,6-glycosidase transfers a trisaccharide unit from one branch to the other, exposing the 1 - 6 branch point. Breaks a (1- 6) bond, which is present at the staing of a branched-chain releasing glucose **Glucose-6-phosphatase also release free glucose but only in liver and not in muscle. | Biochemistry | Glycogen | Which of the following enzyme leads to release of free glucose from glycogen during glycogenolysis in muscle?
A. Glycogen phosphorylase
B. Glucose-1-phosphatase
C. Glucose-6-phosphatase
D. Debranching enzyme
| Debranching enzyme |
ec307ba8-8ac8-46d7-bcbd-d079a356295d | M. gypseum-numerous fusiform (spindle) shaped macroconida M. audouinii- racquet shaped macroconidia E. floccosum- club shaped macroconidia T. rubrum- arrangement of microconida has been described as "birds on a wire" where the pyriform (teardrop shaped) microconidia are attached to the hyphae at the narrow end | Microbiology | Mycology | Skin scrapings from a patient with tinea corporis were taken and cultured on SDA. Figure shows the LCB mount. Likely identity of the causative dermatophyte is-
A. Epidermophyton floccosum
B. Microsporum audouinii
C. Microsporum gypseum
D. Trichophyton rubrum
| Microsporum gypseum |
21bea5f2-11e6-47a5-95ac-25ba2c5b97c2 | Among the given options only ethyl alcohol is used. | Forensic Medicine | null | Best method of treatment of Methyl alcohol -
A. Calcium gluconate
B. Ethyl alcohol
C. Amphetamines
D. 1% Ammonia
| Ethyl alcohol |
d38cf328-624f-4732-86ce-0cf65abfed6e | Ans. (a) Proximal duodenum(Ref: Robbins 9th/pg 762)Curling ulcers-Ulcers occurring in the proximal duodenum and associated with severe burns or trauma | Pathology | G.I.T. | Most common site of curling's ulcer?
A. Proximal Duodenum
B. Esophagus
C. Distal duodenum
D. D. jujenum
| Proximal Duodenum |
8457564e-ce71-4f98-9817-f32509607540 | A i.e. Trachoma Vit A deficiency causes epithelial xerosisQ. Parenchymal xerosis is caused by widespread destructive interstitial conjunctivitis as seen in trachoma Q, diptheria, Steven Jonson Syndrome, pemphigus or pemphigoid conjunctivitis, thermal, chemical or radiational burns of conjunctiva Q and exposure of conjunctiva. | Ophthalmology | null | Parenchymatous xerosis of conjunctivitis is caused by
A. Trachoma
B. Vitamin A deficiency
C. Vernal catarrh
D. Phlyctenular keratoconjunctivitis
| Trachoma |
791736f2-e882-4183-9774-0fcf99347c85 | Ans. is 'a' i.e., Dicloxacillin Treatment of impetigo is either dicloxacillin or cephalexin can be given at a dose of 250 mg four times daily for 10 days. Topical mupirocin ointment is also effective. | Pharmacology | null | Treatment for impetigo ?
A. Dicloxacillin
B. Ciprofloxacin
C. Gentamycin
D. Amoxicillin and clavulanic acid
| Dicloxacillin |
8a2b9435-fb12-4769-b1af-71d73b30860e | Haemorrhage is the most frequent life-threatening complication of thyroidectomy. Around 1 in 50 patients will develop a haematoma, and in almost all cases this will develop in the first 24 hours. If an aerial bleed occurs, the tension in the central compament pressure can rise until it exceeds venous pressure. Venous oedema of the larynx can then develop and cause airway obstruction leading to death. If a haematoma develops, clinical staff should know to remove skin sutures in order to release some pressure and seek senior advice immediately. Endotracheal intubation should be used to secure the airway while the haematoma is evacuated and the bleeding point controlled.Ref: Bailey and Love, page no: 815 | Surgery | Endocrinology and breast | A patient operated for thyroid surgery for a thyroid swelling, later in the evening developed difficulty in breathing. There was swelling in the neck. The immediate management would be
A. Epinephrine injection
B. Tracheostomy
C. IV calcium gluconate
D. Open the wound sutures in the ward
| Open the wound sutures in the ward |
f32a8f30-6017-413b-b4a0-429d3d9bb990 | Ans. A. Average age at attainment/observed age at attainment x100Significant delays on screening is an indication for a detailed formal assessment of developmental status. By assessment, one can assign developmental quotient (DQ) for any developmental sphere. A DQ below 70 is taken as delay | Pediatrics | Growth, Development, and Behavior | Developmental Quotient is calculated as:
A. Average age at attainment / observed age at attainment x100
B. Observed age at attainment / average at attainment x100
C. Observed age at attainment x average age at attainment
D. Observed age at attainment / average age at attainment
| Average age at attainment / observed age at attainment x100 |
5ac17690-6ff3-4356-a170-e0b40d121f2b | Temporo-mandibular joint is weight-bearing joint though not covered by hyaline cartilage like sterno-clavicular joint. Clavicle ossifies at five weeks followed by mandible at six weeks. Absence of hyaline cartilage is because no cartilaginous precursor exists at that time. This does not mean that the joint is non-weight bearing, it is the early ossification which has made the joint free of hyaline cartilage. | Dental | null | Temperomandibular joint is:
A. Devoid of the synovial membrane.
B. Has no synovial fluid.
C. Has rudimentary synovial membrane.
D. The synovial membrane does not cover the articular surface.
| The synovial membrane does not cover the articular surface. |
1ce0cebc-4bff-4048-9ff5-089fc41793f1 | In a normal res ng condition, the blood leaving the lungs is 98% saturated with oxygen, and the blood returning to the lungs is 75% saturated with oxygen. With vigorous exercise, blood leaving the lungs is still 98% saturated, but blood returning is usually less than 75% saturated because more oxygen is unloaded from hemoglobin in exercising muscles | Pathology | All India exam | Which of the following ranges of haemoglobin O2 saturation from systemic venous to systemic aerial blood represents a normal resting condition?
A. 25 to 75%
B. 40 to 75%
C. 40 to 95%
D. 75 to 98%
| 75 to 98% |
34c5ccd3-df8e-4a86-be9c-17712f291854 | Koebner response or the isomorphic response, attributed to Heinrich Kobner, is the appearance of skin lesions on lines of trauma. The Koebner phenomenon may result from either a linear exposure or irritation. Pseudokoebner phenomenon-Conditions demonstrating linear lesions after a linear exposure to a causative agent include molluscum contagiosum, was and toxicodendron dermatitis (dermatitis caused by a genus of plants including poison ivy). Was and molluscum contagiosum lesions can be spread in linear patterns by self-scratching ("auto-inoculation"). Toxicodendron dermatitis lesions are often linear from brushing up against the plant. True koebner phenomenon-Causes of the Koebner phenomenon that are secondary to scratching rather than an infective or chemical cause include vitiligo, psoriasis, lichen planus, lichen nitidus, pityriasis rubra pilaris, and keratosis follicularis Ref Harrison 20th edition pg 2111 | Dental | All India exam | The pseudo-isomorphic phenomenon is seen in
A. Psoriasis
B. Lichen planus
C. Vitiligo
D. Molluscum contagiosum
| Molluscum contagiosum |
69b51c11-7ff8-4959-870f-ca733bf42ce8 | B i.e. FRAPFRAP (fluorescence recovery after photobleaching) primarily measures rate of lateral diffusion of lipids and it can be used to investigate diffusion of biological macromolecules (such as proteins etc) including lateral diffusion in the plane of membrane and movements into & out of nucleus.- FRET is used to visualize biochemistry of living cells such as to measure cAMP and activity of PKA.AFM (atomic force microscopy) is used to yield 3D contour map of membrane (surfaces) and visualize membrane proteins (eg microdomains or rafts etc) | Biochemistry | null | Movement of protein from nucleus to cytoplasm can be seen by
A. FISH
B. FRAP
C. Confocal microscopy
D. Electron microscopy
| FRAP |
cfd33a8e-0dbd-4199-b192-1073f4e849e9 | Fatty liver refers to the deposition of excess triglycerides in the liver cells. The balance between the factors causing fat deposition in liver versus factors causing removal of fat from liver determines the outcome.Causes of Fatty LiverA. Causes of fat deposition in liver1. Mobilization of NEFA from adipose tissue.2. Excess synthesis of fatty acid from glucose.B. Reduced removal of fat from liver3. Toxic injury to liver. Secretion of VLDL needs synthesis of apo B-100 and apo C.4. Decreased oxidation of fat by hepatic cells.An increase in factors (1) and (2) or a decrease in factors (3) and (4) will cause excessive accumulation, leading to fatty liver.Ref: DM Vasudevan - Textbook of Biochemistry, 6th edition, page no: 142 | Biochemistry | Metabolism of lipid | The Lipid which accumulates in fatty liver is
A. Trigylcerids
B. FFA
C. Lipoprotein
D. Cholesterol
| Trigylcerids |
7b3b3ac0-042c-4392-bcaf-7f6fe1774d40 | Allergic blepharoconjunctivitis is a side effect of beta blockers. Ref: Essentials of Medical Pharmacology By K D Tripathi, 4th Edition, Page 95 | Ophthalmology | null | A patient having glaucoma develops blepharoconjunctivitis after instilling some anti-glaucoma drug. Which of the following drug can be responsible for it:
A. Timolol
B. Latanosprost
C. Dipiverine
D. Pilocarpine
| Timolol |
529c5ba7-062e-4c95-b8de-a46daa6a87eb | Ans. is 'c' i.e., Goldman type III Projected stimuli in perimetry are usually white and of variable size and intensity. There are five different sizes on Goldmann scale designated by Roman numeral Ito V. The standard used in both manual and automated perimetry is Goldman III (0.05" and area of 4mm2). o Failure to recognize target size III necessitates testing with stimulus V Goldman scale Stimulus size (mm2) I '/4 II 1 III 4 IV 16 v 64 | Ophthalmology | null | Standard in perimetry ?
A. Goldman type I
B. Goldman type II
C. Goldman type III
D. Goldman type IV
| Goldman type III |
c1d57827-57f5-4711-bffc-256348da1eae | Ans. is 'a' i.e., Sho metacarpal in hands Hypothyroidism o Hypothyroidism results from deficient production of thyroid hormone or a defect in thyroid hormone receptor activity. o Hypothyroidism may be : - i) Congenital --> Present since bih ii) Acquired --> Symptoms appear after a period of apparently normal thyroid function. Hypothyroidism causes - i) Delayed bone growth (Bone age markedly delayed) ii) Delayed pubey & Alteration in upper and lower segment ratio (upper segment > lower segment) Hypothyroidism o Hypothyroidism results from deficient production of thyroid hormone or a defect in thyroid hormone receptor activity. o Hypothyroidism may be : - i) Congenital --> Present since bih ii) Acquired --> Symptoms appear after a period of apparently normal thyroid function. Hypothyroidism causes - i) Delayed bone growth (Bone age markedly delayed) ii) Delayed pubey & Alteration in upper and lower segment ratio (upper segment > lower segment) | Pediatrics | null | NOT a feature of hypothyroidism is ?
A. Sho metacarpals in hands
B. Delayed pubey
C. Delayed bone age
D. Altered upper and lower segment ratio
| Sho metacarpals in hands |
cb474535-6aaf-41fb-8cc9-e9c0c21e86a6 | Dowry death is defined under section 304 B *According to this if husband or his relative subjects the woman to cruelty or harassment in demand of dowry within 7 years of marriage,they shall be deemed to have caused her death *The punishment for such cases is improvement for not less than 7 years,but may be extended to life imprisonment OptionA :Section 304 A IPC:Causing death by negligence Option C:Section 174 Cr. P. C:Police inquest Option D:Section 176 Cr. P. C. Magistrate inquest Textbook of Forensic Medicine and toxicology 2nd edition pg333 | Forensic Medicine | Medical Jurisprudence | Dowry death is defined under section
A. 304A IPC
B. 304B
C. 174Cr. P. C
D. 176Cr. P. C
| 304B |
d6ece7a6-6a6b-4086-9c6a-f8e09391bbe3 | Renal transplantation is the preferred treatment for many patients with end stage renal disease (ESRD), because it provides a better quality of life for them than dialysis.
The most common causes of ESRD (in decreasing order) are:
Diabetes mellitus
Hypertension
Glomerulonephritis | Surgery | null | Renal transplantation is most commonly done in -
A. Chr. glomerulonephritis
B. Bilateral staghorn calculus
C. Horse shoe kidney
D. Oxalosis
| Chr. glomerulonephritis |
bafe9336-a7e4-4340-bf5d-5abf85243667 | Isoflurane causes least vasodialation and hence helps to moderate the cerebral blood flow. It reduces the ICT and hence is useful in neurosurgery. It is more potent than halothane and has rapid onset of action and induction. Reference 1. Quick Review of Pharmacology, By Dr J G Buch, Page 204 | Anaesthesia | null | Which inhalational agent is used in patients with raised intra cranial tension?
A. Enflurane
B. Isoflurane
C. Desflurane
D. Sevoflurane
| Isoflurane |
41c8d9b1-237b-4575-9403-fa2b807d0dda | Patch clamp: measures ionic currents through a single ion channel. It has four configurations: Voltage clamp: whole cell voltage clamp measures currents across cell membranes. In using this apparatus, two electrodes are inseed into the nerve fiber. One of these electrodes is used to measure the voltage of the membrane potential, and the other is used to conduct electrical current into or out of the nerve fiber. Iontophoresis: a technique of introducing ionic medicinal compounds into the body through the skin by applying a local electric current. | Physiology | Concepts in physiology | Which of the following is used to study current flow across a single channel:
A. Patch clamp
B. Voltage Clamp
C. Iontophoresis
D. Galvanometry
| Patch clamp |
f61d4dca-1b53-40f8-84be-1cb742d717b7 | Ophthalmologic examination should be conducted once the child is >10 yr of age and has had diabetes for 3 -5 year. Annual follow up should suggest. Reference: OP Ghai,essential paediatrics,8 th edition, page no 546 | Pediatrics | Endocrinology | In children with type IDM when is ophthalmologic evaluation indicated
A. At the time of diagnosis
B. After 1 year
C. After 2 years
D. After 5 years
| After 5 years |
21d74dc7-2925-48de-b68d-0cdeea41f325 | Ans. is 'c' i.e., Greater petrosal nerve o Secretomotor (parasympathetic) fibers to lacrimal gland travel through greater petrosal nerve.GangliaSensory rootSympathetic rootSecretomotor rootMotor rootDistributionCiliaryFrom nasociliary nervePlexus along ophthalmic artery-Edinger-Westphal nucleus - oculomotor nerve - nerve to inferior obliqueCiliaris musclesSphincter pupillaeOticBranch from auriculotemporal nervePlexus along middle meningeal arteryInferior salivatory nucleus- pharyngeal nerve- tympanic branch- tympanic plexus- lesser petrosal nerveBranch from nerve to medial pterygoidto parotid gland via auriculotemporal nerveTensor veii palatini and tensor tympani via nerve to medial pterygoid (unrelated)Pterygopalatine2 branches from maxillary' nerveDeep petrosal from plexus around internal carotid arteryLacrimatory nucleus nervus intermedins - facial nerve - geniculate ganglion- greater petrosal nerve+ deep petrosal nerve= nerve of the pterygoid canal-Mucous glands of the nose, paranasal sinuses, palate nasopharynxSome fibers pass through zygomatic nerve -zygomaticotemporal branch to the lacrimal nerve-Lacrimal glandSubmandibular2 branches from lingual nervefromplexus around facial arterySuperior salivatory nucleus-facial nerve - chorda tympani joins the lingual nerve-Submandibular, Sublingual and Anterior lingual glands | Unknown | null | Parasympathetic supply to lacrimal glands are passed through -
A. Lesser petorsal nerve
B. Chorda tympani
C. Greater petorsal nerve
D. Lingual nerve
| Greater petorsal nerve |
db97f656-85a4-4097-b35d-044e1cac663e | Ans, is 'a' i.e., Ethmoid polypSamter-s triado Samtef s triad is a medical condition consisting of asthma, aspirin sensitivity-, and nasal/ethmoidal polyposis. It occurs in middle age (twenties and thirties are the most common onset times) and may not include any allergies,o Most commonly the first symptom is rhinitis.o The disorder typically progeses to asthma, then polyposis, with aspirin sensitivity coming last,o The aspirin reaction can be severe, including an asthma attack, anaphylaxis, and urticaria in some cases. Patients typically react to other NSAIDS such as ibuprofen, although paracetamol is generally considered safe,o Anosmia (lack of smell) is also typical, as the inflammation reaches the olfactory- receptors in the nose. | ENT | Nose and PNS | Samter's triad is related to -
A. Ethmoid polyp
B. Nasopharyngial
C. Angiofibroma
D. Nasal glioma
| Ethmoid polyp |
c8d14b52-e2db-4eb4-bc6d-931743702710 | Ans. is 'a' i.e., Toxoplasmosis Neurological manifestations of H.I.V. AIDS dementia complex (HIV encephalopathy) is a result of direct effects of HIV on CNS (not an oppounistic disease). It is subcoical dementia. Most common cause of seizures --> Toxoplasma Most common cause of meningitis --> Cryptococcus M.C. cause of focal neurological deficit --> Toxoplasma Toxoplasmosis is the most common CNS infection in AIDS. CNS lymphoma and prograssive multifocal leukoencephalopathy may occur. | Medicine | null | The most common cause of seizures in a patient of AIDS is
A. Toxoplasmosis
B. Cryptococcal meningitis
C. Progressive multifocal leucoencephalopathy
D. CNS lymphoma
| Toxoplasmosis |
56e06587-92c2-448e-870b-c28fc78d5a6f | Ans. a. Met loss of muscle protein due to increased breakdown (Ref: Ganong 24/e p21)Increased levels of alanine in serum after fasting are primarily due to net loss of muscle protein due to increased breakdown."The quantity of carbohydrate normally stored in the entire body can supply the energy required for body functions for 10-12 hours. Therefore, except for the first few hours of starvation, the major effects are progressive depletion of tissue fat and protein. Fat depletion is steady and continues unabated until most of the fat stores in the body are gone. Proteins undergo three phases of depletion-rapid depletion of mobilizable proteins at first, then greatly slowed depletion (during this time increased fat breakdown leads to a state of ketosis), and finally, rapid depletion again shortly before death. The major aim of protein catabolism during a state of starvation is to provide the glucogenic amino acids (especially alanine and glutamine) that serve as substrates for gluconeogenesis in the liver." | Biochemistry | Amino Acid Metabolism | Increased levels of alanine in serum after fasting is primarily due to:
A. Net loss of muscle protein due to increased breakdown
B. Leakage from cells due to membrane damage
C. Renal dysfunction
D. Decreased rate of gluconeogenesis
| Net loss of muscle protein due to increased breakdown |
d03d9fd0-5c5f-4398-8cd6-aecbac14b09b | Pachymetry is used to measure thickness of cornea. | Ophthalmology | null | The thickness of the cornea is measured by using –
A. Schiotz tonometer
B. Keratometer
C. Pachymeter
D. Aesthesiometer
| Pachymeter |
3b7ddc8c-e912-4b50-ac48-237602b17ec5 | Substrate for gluconeogenesis are: -glucogenic amino acids, lactate, glycerol, propionyl CoA Glucose cannot be produced from fatty acidRef: DM Vasudevan, 7th edition, page no: 120 | Biochemistry | Metabolism of carbohydrate | Which is not a substrate for gluconeogenesis?
A. Alanine
B. Fatty acid
C. Pyruvate
D. Lactate
| Fatty acid |
a0e0bc57-9c23-4d0a-9169-89049e62afda | Ans. B. Moderate uterine contractionsThe partograph is a graphical presentation of the progress of labor, and of fetal and maternal condition during labor.It is the best tool to help you detect whether labor is progressing normally or abnormally, and to warn you as soon as possible if there are signs of fetal distress or if the mother's vital signs deviate from the normal range. Research studies have shown that maternal and fetal complications due to prolonged labor were less common when the progress of labor was monitored by the birth attendant using a partograph.Different shadings on the squares drawn on partograph indicate the strength & duration of uterine contractions: | Gynaecology & Obstetrics | Normal Labour | What does indicate in the following partograph indicators?
A. Mild uterine contractions
B. Moderate uterine contractions
C. Strong uterine contractions
D. Arrest of labor
| Moderate uterine contractions |
557547fc-eda8-4a30-9e03-c96b49f7fc5b | Ans. is 'c' i.e., Ferrous ions converted to ferric ions o Free radicals are generated through Fenton's reaction.o In this reaction iron is converted from its ferrous to ferric form and a free radical is generated,o The effect of these reactive species relevant to cells injury include;Lipid peroxidation of membranesOxidative modification of proteins and lesions in DMA. | Pathology | Mechanisms of Cell Injury | Fenton reaction leads to free radical generation when -
A. Radiant energy is absorbed by water
B. H202 is formed by myeloperoxidase
C. Ferrous ion converted to ferric ion
D. Nitric oxide is converted to peroxynitrite
| Ferrous ion converted to ferric ion |
ff76a738-7668-48ed-b8ef-2a4e83095d14 | Dose to be given = 10 mcg/min As, one ampoule (5 ml) is mixed with normal saline to make 500 ml volume, Means 500 ml of solution contains = 5*5 = 25 mg NTG = 25000 mcg NTG 25mg -----500ml 1mg----500/25 10mcg -10*10 -3-----0.2ml So, we need to infuse 0.2 ml/min of the solution As, 1 ml = 60 drops So, 0.2 ml = 60/1 * 0.2 = 12 drops So, we need to infuse 12 drops/min | Pharmacology | Pharmacokinetics | A 70 kg patient needs to be staed on nitroglycerine (NTG) infusion. A 5 ml ampoule contains 5 mg/ml NTG. One ampoule is added to normal saline and to make a total of 500 ml solution. Calculate the rate of infusion if NTG is required at a rate of 10 mcg/min. (1 micro drip = 60 drops/ml )
A. 12 drops/min
B. 14 drops/min
C. 15 drops/min
D. 16 drops/min
| 12 drops/min |
a93a10d2-fbfa-4c67-965e-b8ecbb52a277 | Methyl alcohol is oxidized by alcohol dehydrogenase into formic acid and formaldehyde. Formic acid by inhibiting cytochrome oxidase is toxic to neurons especially retinal ganglion cells. In methanol poisoning vision loss begins 12 hours or more after ingestion and progress to complete blindness with unreactive pupils and optic disc hyperemia. | Ophthalmology | null | Methyl alcohol causes blindness by affecting which of the following structures?
A. Retinal ganglion cells
B. Nerve fibers
C. Rods & Cones
D. Rods only
| Retinal ganglion cells |
d544a17b-a0a2-4e98-b42e-72f7878afc55 | Ans. is 4b' i.e., Posterior o Disease affects the posterior third of larynx more commonly than anterior part.o The parts affected in descending order of frequency are i) Interarytenoid fold, ii) Ventricular band, iii) Vocal cords,iv) Epiglottis.o Also see above explanation. | ENT | Larynx | Most common part of larynx involved in TB -
A. Anterior
B. Posterior
C. Middle
D. Anywhere
| Posterior |
d0405727-f3e3-482c-811c-ba26a9a94042 | Ans. is 'b' i.e., Hypokalemia o In Bartter's syndrome the B.P. is low to normal despite increased level of aldosterone.Pathogenesis of Bartter Syndrome|Defect in sodium chloride and potasium transportin the ascending loop of henle|Loss of sodium and chloride|Volume contraction|Stimulation of Renin angiotensin|Increased secretion of Aldosterone|Promotes sodium uptake and potassiumexcretion|Hypokalemia -(Polyuria & Nocturia)Increased prostaglandin E|Further activates the reninangiotensin axiso Classic Bartter *s syndrome presents during childhoodo Weakness and cramps occur secondary to hypokalemiaQo Polyuria and nocturia are common due to hypokalemiaQo Nephrocalcinosis (due to hvpercalciuria)Diagnosis of Bartter's Svndrome :o Hypo kalemiaQo Metabolic alkalosisQo Blood pressure is usually normalQo Urinary-potassium, calcium and sodium elevatedQ.o Serum renin, aldosterone and postaglandin E elevatedQ.o Renal function is typically normalQ.There are two types ofBartter syndromeAntenatalClassicBartter syndromeBartter syndromeo More severe o Presents in infancy o Polyhydramnios (associated) o Salt wasting o Severe dehydration Also know,Gitteman's Syndromeo Autosomal recessive traito Caused due to mutation in thiazide sensitive Na-Cl transporterQ.o Loss of activity of the thazide sensitive transporter increases tubular calcium reabsorption leading toclassic finding of hypoclaciuria in Gitleman's syndrome.o There is also decrease in Na+ reabsorptionQ leading to volume depletion and hypokalemia.Gitleman's syndrome is a close differential diagnosis of Barter's syndrome -SimilaritiesDifferenceso Hypokalemiao Hypomagnesemiao Metabolic acidosiso Hypocalciuriao Salt wasting o Elevated renin and aldosterone o Normal blood pressure It is usually diagnosed during adolescence or adulthood with fatigue, weakness, muscle cramps, nocturia. | Medicine | Fluid & Electrolyte | In Barter's Syndrome, what is seen-
A. Metabolic acidosis
B. Hypokalemia
C. Hyperkalemia
D. Decrease in urinary calcium
| Hypokalemia |
b1a6bae4-34de-4940-ab0a-77b23ded91b7 | Ans. b. Intussusception (Ref; Ghai 8/e p287; Sabiston 19/e p1851; Schwartz 9/e p1433-I434; Bailey 26/e 1184. 1187, 1193. 25/e p1191, 1196. 1198; Shackelford 7/e p1059-106)Most likely diagnosis in a 6 months old child, who woke up in night, crying with abdominal pain, which got relieved on passing red stool, is intussusception.'Intussusception refers to the telescoping of a proximal segment of intestine (intussusceptum) into a distal segment (intussuscipiens). This is a common cause of intestinal obstruction in children between 3 months and 6 years. Most cases occur in infants during the weaning period following introduction of a new food, vaccination or upper respiratory tract infection. The classic triad of abdominal pain, red current jelly stools (blood and mucus) and palpable mass is seen only in a small percentage of children. Ultrasound is the investigation of choice that confirms the diagnosis ('dough nut' sign) and provides information about presence of a mass as lead point. Early reduction either with saline (under ultrasound guidance), barium contrast (both diagnostic and therapeutic) or with air insufflation is advisable. Reduction with air is safer with lower recurrence rates. Failure of radiological reduction or suspected intestinal gangrene may necessitate surgery and resection.'- Ghai 8/e p287IntussusceptionTelescoping of one portion of the intestine into the other.Middle layer is isolated between two sharp bends and first to become gangrenousQ.Highest incidence between 4 and 10 monthsQ of ageApprox. 80-90% of cases occurs between 3 and 36 monthsQ.Mostly idiopathic in infants and toddlersQ (no clear etiology).MC type: IleocolicQEtiology and Predisposing Factors:Upper respiratory tract infections or gastroenteritisQ (adenovirus and rotavirus have been implicated) have been thought to be contributory to the development of 'idiopathic' intussusception. Hypertrophy of Peyer's patchesQ can be seen at surgery, but no single etiologic factor predominates.Approximately 5-10% of cases have a true pathologic lead point. The older the toddler, the more likely there will be a lead pointQ.MC lead point is Meckel's diverticulumQ.Other lead points include polyps, the appendix, intestinal duplication, foreign bodies, and tumors such as hamartomas associated with Peutz-Jeghers syndrome.Henoch-Schonlein purpura: Submucosal hemorrhage acts as a lead pointQ.Cystic fibrosis: Risk for recurrent intussusceptionQClinical Features:Typical history: Sudden, short-duration, cyclic crampy abdominal painQ.During these episodes the infant cries inconsolably with the knees drawn upQ.Between episodes the infant is asymptomaticQ.Vomiting is almost universalQ.Initially the passage of stools may be normal while later on blood mixed with mucus is evacuated- red currant jelly stool.An abdominal mass may be palpated- a sausage shaped abdominal massQ (increase in size and firmness during the paroxysm of pain)There may be an associated feeling of emptiness in the right iliac fossa (Sign of Dance)QOccult or gross blood in 60-90% of cases on rectal examinationQApex may be palpable or even protrude from anus in extensive ileocolic or colocoiic intussusceptionQDiagnosis:USG: Kidney-shaped mass in the longitudinal view or a target sign in the transverse viewHydrostatic reduction by contrast agent or air enema (preferred) is the diagnostic and therapeutic procedure of choiceQ.Successful reduction is confirmed by reflux of airQ (or barium) into the small bowel.Treatment:Hydrostatic reduction by contrast agent or air enema is the diagnostic and therapeutic procedure of choiceQ.The success rate with air or barium reduction should exceed 70%Q.Failure of reduction or the presence of peritonitis mandates operative interventionQ, which can be performed laparoscopically or by a standard approach.Definitive surgical procedure: Ileocolectomy with primary anastomosisQRecurrence:Recurrence after successful hydrostatic reduction is 5-10%, recurrence rate after operative reduction is 1-4%.Recurrence is usually managed by hydrostatic reductionQ.Third recurrenceQ is an indication for operative intervention to look for a lead point. | Surgery | Intestinal Obstruction | A 6 months old child woke up in night, crying with ahdominal pain, which got relieved on passing red stool. What is the most likely diagnosis?
A. Meckel's diverticulum
B. Intussusception
C. Malrotation
D. Intestinal obstruction
| Intussusception |
86a83376-6be9-4ac9-9d63-8f7c206bb5a6 | Moure`s sign- Absence of Laryngeal click or crepitusClassical sign in post-cricoid malignancy.Bocca`s sign - is also an absence of post-cricoid click or crackle in cricoid malignancy.Ref: Hazarika; 3rd ed; Pg 534 | ENT | Larynx | Moure's sign can be detected in
A. Nasopharyngeal carcinoma
B. Oropharyngeal carcinoma
C. Postcricoid carcinoma
D. Supraglottic carcinoma
| Postcricoid carcinoma |
2cedb88b-1300-40e0-8e93-e0e551abc71b | Hemorrhagic external otitis media: (Otitis externa hemorrhagia) is caused by influenza virus. Characterised by formation of haemorrhagic bullae on tympanic membrane. Clinical features: severe pain and blood stained discharge. Treatment: Analgesics + antibiotics. | ENT | null | Heamorrhagic external otitis media is caused by:
A. Influenza
B. Proteus
C. Staphylococcus
D. Streptococcus
| Influenza |
692da2d0-f12d-4565-b17f-8bc6bd55a0ab | Ans. (a)Passive cutaneous anaphylaxis-in vivo method for detection of antibodies.Antigen injection intradermally then same antigen with a dye injected IV - after 4 to 24 hours - wheal flare reaction occurs in intradermal site.Helps to detect IgG ab which is heterocytotropic, not for IgM which is homocytotropic. | Microbiology | Immunology | Passive cutaneous anaphylaxis detect:
A. Heterocytotropic ab
B. Wheal and flare reaction
C. Atopy
D. Cutaneous anaphylaxis
| Heterocytotropic ab |
8b48f911-385f-4c6b-ae2e-cf03474d1231 | Serous demilunes are cellular formations in the shape of a half-moon on some salivary glands. It is a feature of mixed (seromucinous)glands like submandibular salivary glands. Theseare the serous cells at the distal end of mucous tubuloalveolar secretory unit of ceain glands. Type of glands: Parotid - serous gland Sublingual (major)- mucinous gland Submandibular and Sublingual- mixed | Anatomy | Glands & Connective tissue | Serous Demilunes are present in large number in which gland
A. Parotid
B. Submandibular
C. Sublingual
D. Pituitary
| Submandibular |
7e89d38f-7a19-48b8-a170-ea432fed9886 | Light rays from distant objects do not require as much refraction (bending) as do light rays from objects close at hand. Therefore, a thinner lens with less curvature is required for viewing distant objects. The process of accommodation adjusts the thickness of the lens for near and far vision by contracting or relaxing the ciliary muscle that surrounds the lens of the eye; contraction of the ciliary muscle thickens the lens, and relaxation causes the lens to become thinner. | Physiology | Special Senses | A 25-year-old student with 20/20 vision looks up from his book to view his girlfriend sitting on the other side of the room. Which of the following is most likely to occur when the student changes his view from his book to his girlfriend?
A. Thicker lens, contraction of ciliary muscle
B. Thicker lens, relaxation of ciliary muscle
C. Thinner lens, contraction of ciliary muscle
D. Thinner lens, relaxation of ciliary muscle
| Thinner lens, relaxation of ciliary muscle |
0f6734fa-fb78-4dd3-84bb-9edff2f2f25c | Answer- B. VincristineAcute kidney injury (AKI) (ARF)CirrhosisNephrotic syndromeCardiac failureAnti cancer drugs | Medicine | null | Dilutional hyponatremia is seen in ?
A. Addison's disease
B. Vincristine
C. Diuretic therapy
D. Craniphyrangioma
| Vincristine |
efc0932a-558e-462a-bc93-75501d4d27b9 | This is a case of minimal change disease(MCD) On biopsy-no lesion is seen by light microscopy, negative for deposits by immunofluorescent microscopy -so it is also called nil lesion. On electron microscopy -effacement of foot processes suppoing Glomerular cells(podocytes) with weakening of slit pore membranes is seen. Ref:Harrison 20 th edition pg no. 2142 | Medicine | Kidney | A 7 year old boy presented with generalized edema. Urine examination revealed marked albuminuria. Serum biochemical examinations showed hypoalbuminaemia with hyperlipidemia. Kidney biopsy was undeaken. On light microscopic examination, the kidney appeared normal. Electron microscopic examination is most likely to reveal-
A. Fusion of foot processes of yhe glomerular epithelial cells
B. Rarefaction of glomerular basement membrane
C. Deposition of electron dense material in the basement membrane
D. Thin basement membrane
| Fusion of foot processes of yhe glomerular epithelial cells |
f6115abc-4025-4631-a2c1-e6d51f9b975f | METHOD OF REMOVAL OF ORGANS. Virchow's technique- Organs are removed one by one, Cranial cavity is exposed first, followed by thoracic,cervical and abdominal organs. Spinal cord is removed from the back. Rokitansky's technique- It involves in situ dissection in pa, combined with en block removal. Letulle's technique- Cervical, thoracic, abdominal and pelvic organs are removed en masses and dissected as organ block. Ghon's technique- Cervical,thoracic,abdominal and urogenital system are removed as organ blocks, Neurobal system is removed as another block. Ref: K.S.Narayan Reddy's Synopsis of Forensic Medicine and Toxicology, 29th edition, Chapter 5, Page - 63. | Forensic Medicine | Death and postmortem changes | Virchows method of organ removal is
A. Organs removed en masse
B. Organs removed one by one
C. In situ removal
D. Minimal invasive autopsy
| Organs removed one by one |
7060a37b-45b7-4939-a93c-933e3052f9a2 | The uvula would move toward the intact right side. This is because the intact levator veli palatini would be unopposed by the opposite, paralyzed left levator veli palatini. | Anatomy | Head & Neck | A 36-year-old woman is admitted to the hospital with severe head injuries after a car crash. During neurologic examination it is noted that her uvula is deviated to the right. Which of the following muscles is paralyzed?
A. Left levator veli palatini
B. Left tensor veli palatini
C. Right levator veli palatini
D. Right tensor veli palatini
| Left levator veli palatini |
4354102e-3a13-4cb4-933c-b3bd6f535f6c | Ans. is 'b' i.e. Hepatitis E (Ref. Dutta, 6/e, p 292 (5/e, p. 308), Robbins illustrated, 6/e, p. 862).Hepatitis E infection has a benign course in normal individuals just like hepatitis A but once it infects a pregnant female it shows its ugly face. It then causes fulminant hepatitis in a large % of pregnant females leading to hepatic coma and death. | Gynaecology & Obstetrics | Hepatic, Biliary, and Pancreatic Disorders | Savita is 35 years female with Gravida-2 and parity 1+0 is suffering from hepatic encephalopathy. Likely cause will be -
A. Hepatitis B
B. Hepatitis E
C. Hepatitis D
D. Hepatitis A
| Hepatitis E |
1a64f235-feb2-434f-9bed-4bff844c6aaa | sn RNA (small nuclear RNA) acts as Ribozyme. (RNA with enzymatic activity) It has splicing activity and is involved in mRNA processing. | Biochemistry | null | Which RNA has splicing activity
A. m RNA
B. mi RNA
C. r RNA
D. sn RNA
| sn RNA |
e33f9d6e-08d0-4781-baf9-a7a60aee4360 | Ref: Ananthnarayan R. Paniker CKJ. Textbook of Microbiology. 8th Edition. Hyderabad: Universities Press; 2009. Pg. 332Explanation:Haemophilus influenzae is an important cause of meningitis.The disease is more common in children between two months and three years of age. Infections are caused by the capsulated strains, type b accounting for most cases.CSF specimen from suspected children should be plated promptly on a suitable medium such as blood agar or chocolate agar and incubated in an environment of 5-10 per cent C()2 and high humidity.As this bacillus is very sensitive to low temperatures. CSF specimens should never be refrigerated before inoculation. | Microbiology | Culture media and method | Which specimen shouldn't be refrigerated before primary innoculation?
A. CSF
B. Urine
C. Sputum
D. Pus
| CSF |
ad8bb997-1951-4647-92b8-bbb8028f4908 | Ans. C: Increased renal blood flow GFR = Kf x Net filtration pressure Net filtration pressure represents the sum of the hydrostatic and colloid osmotic forces that either our/oppose filtration across glomerular capillaries Hydrostatic pressure inside the glomerular capillaries (PGC) - Promotes filtration Hydrostatic pressure in the bowman's capsule outside the capillaries (PB)-opposes filtration Colloid osmotic pressure of glomerular capillary plasma proteins-Opposes filtration Colloid osmotic pressure of Bowman's capsule proteins-promotes filtration - Afferent aeriolar constriction will reduce renal blood flow and reduce PGC, causing a reduction in GFR. - Efferent aeriolar constriction will reduce renal blood flow but increase PGC; these changes act in opposite directions with respect to GFR and the net effect on GFR is minimal. - A reduction in Kf will reduce GFR (contraction of mesangial cells and reducing the area available for filtration) - Any given vasoactive agent may have a spectrum of effects (on afferent/efferent aeriolar tone or Kf), making the net effect on GFR difficult to predict. Thus, angiotensin II, a major regulator of glomerular function, causes constriction of both afferent and efferent aerioles, as well as reducing Kf. The overall outcome for GFR depends on the relative magnitudes of these actions, which vary in different pathophysiological conditions. A high protein intake increase renal blood flow and GFR - Large increase in blood glucose levels in uncontrolled D increase renal blood flow and GFR. Kf: Glomerular ultrafiltration coefficient, PGC: mean hydrostatic pressure in glomerular capillaries | Physiology | null | Glomular filtration rate increases if: September 2005
A. Increased plasma oncotic pressure
B. Decreased glomerular hydrostatic pressure
C. Increased renal blood flow
D. Increased tubular hydrostatic pressure
| Increased renal blood flow |
bb636c46-8d5a-480b-b952-31cb9b07e973 | Viral infections are the most common infection post transplantation. These include infections by cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes simplex virus, and varicella zoster virus. CMV infections presents as fever, malaise, myalgia, ahralgia, and leukopenia. Organ involvement leads to pneumonitis; ulceration and hemorrhage in the stomach, duodenum, or colon; hepatitis; esophagitis; retinitis; encephalitis; or pancreatitis. Pyelonephritis, cholecystitis, intra-abdominal abscesses, and parotitis are caused by bacterial infections or GI perforation and not primarily by CMV infection. | Surgery | Transplantation | A 65-year-old woman undergoes a kidney transplant for CKD. 6 weeks after the transplant, she develops CMV infection characterized by fever, malaise, and myalgias. Which of the following is a potential sequela of CMV infection?
A. Intra-abdominal abscess
B. Pyelonephritis
C. Cholecystitis
D. GI ulcers & hemorrhage
| GI ulcers & hemorrhage |
ecdb51ff-9d91-4916-93f5-a3619643eeaa | Anterior lenticonus is seen in Alport's syndrome and posterior lenticonus is seen in Lowe's syndrome. | Ophthalmology | null | Anterior lenticonus is found in –
A. Lowe's syndrome
B. William's syndrome
C. Alport's syndrome
D. Down's syndrome
| Alport's syndrome |
775c3602-1ecb-4cb6-9c6c-940558a97fef | ref Harrison 18/e p3419 Procalcitonin is an acute phase reactant which is now useful for being a marker of sepsis Procalcitonin (PCT) is a biomarker that exhibits greater specificity than other proinflammatory markers (eg, cytokines) in identifying patients with sepsis and can beused in the diagnosis of bacterial infections | Anatomy | General anatomy | Procalcitonin is used as marker of
A. Cardiac dysfunction in acute coronary syndrome
B. Menstrual perodicity
C. Pituitary function
D. Sepsis
| Sepsis |
caffa993-a9de-4768-a96c-0db2e0b12576 | The synopsis of forensic medicine & toxicology - Dr k.s.narayan reddy ;28th edition; Pg no. 105 Also called crushing or friction abrasion. The are caused by crushing of superficial layer of epidermis & are associated with bruise of the surrounding area . occurs when movement of instrument is around 90deg to the skin .hanging ,strangulation ,teeth bite marks are examples . | Forensic Medicine | Mechanical injuries | In case of hanging neck ligature marks are example of -
A. Contusion
B. Pressure abrasion
C. Lacerration
D. Bruise
| Pressure abrasion |
f9fbafd4-304c-48a8-a0d1-2b099186c022 | Ans. is 'c' ie. Ureteral calculus The patient's clinical picture is typical of ureteric calculus.Colicky renal pain associated with hematuria is suggestive of ureteric stone although a clot from a bleeding renal tumor can cause the same type of pain.A ureteric calculus pain is almost invariably associated with hematuria.Leukocytes in urine can be seen with urolithiasis. | Surgery | Urolithiasis | A 23 year old male who is otherwise normal complains of mild pain in his right iliac fossa in a waveform pattern which increases during the night and he becomes exhausted and is admitted in the hospital. On examination there is mild hematuria. Urine examination reveals plenty of RBCs, 50WBCs/hpf. Urine pH is 5.5. Most likely diagnosis is:
A. Glomerulonephritis
B. Ca-Urinary bladder
C. Ureteral calculus
D. Cystitis
| Ureteral calculus |
b8e7a175-ee98-40bd-b8ce-80e5e9b84fc3 | Rapid institution of full nutritional support can cause "refeeding syndrome" in malnourished patients. The hall mark of this condition is hypophosphatemia. Phosphate is taken up by phosphate-depleted cells trying to metabolize the nutrition and levels of ATP fall precipitously. This leads to respiratory failure. Refeeding syndrome can be avoided by starting nutritional support at low levels and increasing slowly. The other substances listed are not associated with respiratory failure after starting nutritional support. | Surgery | Fluid & Electrolyte | A 67-year-old, 60-kg homeless man has been in the intensive care unit (ICU) for a week after an emergency laparotomy and sigmoid resection for perforated diverticulitis. His serum albumin is 1.1 g/dL. He was just weaned from mechanical ventilation. His colostomy is not functioning. You start total parenteral nutrition (TPN) to deliver 1800 kcal/24 h. Two days later, the patient is in respiratory distress and requires reintubation and mechanical ventilation. You should check the level of serum
A. Phosphate
B. Magnesium
C. Calcium
D. Selenium
| Phosphate |
50b227a6-853e-41be-afe9-302f63f46706 | The low surface tension when the alveoli are small is due to the presence in the fluid lining the alveoli of surfactant, a lipid surface-tension-lowering agent. If the surface tension is not kept low when the alveoli become smaller during expiration, they collapse in accordance with the law of Laplace. | Physiology | null | Surfactant lining the alveoli
A. Helps prevent alveolar collapse.
B. Is produced in alveolar type I cells and secreted into the alveolus.
C. Is increased in the lungs of heavy smokers.
D. Is a glycolipid complex.
| Helps prevent alveolar collapse. |
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