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0e8a0096-a5c6-40eb-a77d-ca1d07717ced | Ans. is 'd' i.e., 91 days Sickness benefit under ESI* The sickness benefit is payable for a maximum period of 91 days in any continuous period of 365 days.* The daily rate is 50% of the average daily wage.* Extended sickness benefit - In this, persons suffering from certain long term diseases are entitled to Extended sickness benefit in addition to 91 days.* The extended sickness benefit is payable for 309 days.* Diseases for which extended sickness benefit is payable. (In case where the insured person has been in continuous employment for 2 years). | Social & Preventive Medicine | Occupational Health | Sickness benefit under ESI is available for a period-
A. 30 days
B. 46 days
C. 57 days
D. 91 days
| 91 days |
1c3d5617-2e2d-4071-b693-6a2b1d7bb1c3 | Ans. is 'a' i.e., Piedraia hoae Piedra is an asymptomatic superficial fungal infection of the hair shaft also known as trichomycosis nodu- laris. Black piedra is caused by Piedraia hoae, whereas white piedra is caused by pathogenic species of the Trichosporon genus, namely Trichosporon asahii, Trichosporon ovoides, Trichosporon inkin, Trichosporon mucoides, Trichosporon asteroides, and Trichosporon cutaneum. | Skin | null | Black piedra is caused by ?
A. Piedraia hoae
B. Trichosporon asahi
C. Trichosporon ovoides
D. Trichosporon inkin
| Piedraia hoae |
daf0b8f9-21e9-4a81-95be-0803c77e186d | Ans. is 'b i.e., Organ of coiAfferent (sensory) neurons carry information form sense organs to CNS (brain & spinal cord).Hair cells (in organ of coi) are the sensory recepors which are also innervated by efferent neurons. | Physiology | null | Sense organ which is having efferent supply
A. Golgi tendon organ
B. Organ of coi
C. Retina
D. Taste bud
| Organ of coi |
bfc166ab-500e-43f6-99b1-509356d54f80 | Ans. is 'd' i.e., Dibucaineo Dibucaine is the longest acting local anaesthetico Chlorprocaine is the shortest acting local anaesthetico Decreasing order of duration : - Dibucaine > Bupivacine = Tetracaine = Ropivacaine =Etidocaine > Prilocaine = Lignocaine = Mepivacaine = Cocaine > Procaine > Chlorprocaine. | Anaesthesia | Miscellaneous (Local and Regional Anesthesia) | Local anaesthetic with prolonged action -
A. Procaine
B. Cocaine
C. Lidocaine
D. Dibucaine
| Dibucaine |
c4d6fa3b-a648-4c82-9e87-3c2aa24ea876 | The biochemical changes associated with shock result from tissue hypoperfusion, endocrine response to stress, and specific organ system failure. During shock, the sympathetic nervous system and adrenal medulla are stimulated to release catecholamines. Renin, angiotensin, antidiuretic hormone, adrenocorticotropin, and cortisol levels increase. Resultant changes include sodium and water retention and an increase in potassium excretion, protein catabolism, and gluconeogenesis. Potassium levels rise as a result of increased tissue release, anaerobic metabolism, and decreased renal perfusion. If renal function is maintained, potassium excretion is high and normal plasma potassium levels are restored. | Surgery | Trauma | The response to shock includes which of the following metabolic effects?
A. Increase in sodium and water excretion
B. Increase in renal perfusion
C. Decrease in cortisol levels
D. Hyperkalemia
| Hyperkalemia |
0a631a65-b2a8-417e-9fa8-25cbb3cea67f | Acute infection Persistent neutrophilia of 30,000-50,000 cells/ul, or greater is known as leukemoid reaction. It is a term used to distinguish this degree of neutrophilia from leukemia. In a leukemoid reaction, the circulating neutrophils are mature and not cion ally derived. leukemoid reaction is seen in ACUTE INFECTIONS in children. | Surgery | null | Leukemoid reaction is seen in:
A. Acute infection
B. Erythroleukemia
C. Myelomatosis
D. Hemorrhage
| Acute infection |
3dce9767-584e-490a-bcd7-1267ab5bed72 | Calcium may be deposited at sites of cell death, resulting in pathologic calcification. Initiation of intracellular calcification occurs in the mitochondria of dead or dying cells that accumulate calcium. | Pathology | Reversible Cell Injury | Intracellular calcification begins in which of the following organelles?
A. Mitochondria
B. Golgi body
C. Lysosomes
D. Nucleus
| Mitochondria |
d5a9e83b-dc17-46a3-9383-a9ead8de1d6c | Ans: c (Increase endolymph reabsorption)Ref: Dhingra E.N.T. 3rd/e p. 129 & 2nd/e p. 103One of the etiological factors for menier's disease is poor vascularity & poor absorption. Vasodilators improve vascularity and therby absorption. | ENT | Menier's Disease | Vasodilators in Meniers disease are useful because they:
A. Dilate tympanic vessels
B. Decrease endolymph secretion
C. Increase endo lymph reabsorption
D. Area of no use
| Increase endo lymph reabsorption |
33c88d4c-cc2e-4015-b07c-fb27af811f00 | Froment's sign: the patient is asked to grip a card firmly between thumbs and index fingers; normally this is done using the thumb adductors while the interphalangeal joint is held extended. In patients with ulnar nerve injury or palsy, because the adductor pollicis is weak, the patient grips the card only by acutely flexing the interphalangeal joint of the thumb using flexor pollicis longus which is supplied by the median nerve.(Refer: Mohindra's Fundamentals of Ohopedics, 2nd edition, pg no. 519) | Orthopaedics | All India exam | Froments test is used in
A. Ulnar nerve injury
B. Median nerve injury
C. Radial nerve injury
D. Axillary nerve injury
| Ulnar nerve injury |
413ebe85-1aca-40c2-a89f-8e6d69b883b9 | Ans. C. Purpura* Purpura is a primary skin lesion.* Purpura is a condition of red-or purple-discolored spots on the skin that do not blanch on applying pressure. The spots are caused by bleeding underneath the skin usually secondary to vasculitis or dietary deficiency of vitamin C.Other Options:Option a: Crusts (scabs): Crusts consist of dried serum and other exudates.Option b: Atrophy* Loss of tissue from one or more of the epidermis, dermis or subcutaneous tissues.* There may be fine wrinkling and increased translucency if the process is superficial.Option d: Induration: Dermal thickening that clinically presents as skin that feels thicker and firmer on palpation than normal.Primary Lesions of SkinPrimary lesions of the skin include:* Papule* Plaque* Wheal* Vesicle* Bulla* Nodule* Macule* Patch* Purpura* PustuleFor mnemonic lovers, the following mnemonic might help!"Predatory Poisonous Wasps Viciously Bit on the Nose of My Patient causing Purulent Pus" | Skin | Miscellaneous | Which of the following is a primary skin lesion?
A. Crust
B. Atrophy
C. Purpura
D. Induration
| Purpura |
da681051-eee3-46a2-b7b3-b9bdae16e717 | As early as the third week of gestation, primordial germ cells appear in the endoderm of yolk sac, and these migrate along the dorsal mesentry to the urogenital ridge by the eighth week Reference: Shaw's textbook of Gynaecology 15th edition page 27 | Gynaecology & Obstetrics | General obstetrics | Germ cells appear in yolk sac at :
A. 3 weeks
B. 6 weeks
C. 9 weeks
D. 5 weeks
| 3 weeks |
8615e8c6-d60b-4404-95b5-6cb18395796f | Halothane causes hepatitis .It can also cause arrhythmia by making adrenaline more adrenogenic, i.e , Adrenaline Shows more adrenogenic action when halothane is used. Hence it should not be used in conditions where adrenaline is high ,i.e, pheochromocytoma | Pharmacology | FMGE 2019 | Which of the following inhalational anaesthetic agent can cause hepatitis on repeated use?
A. Halothane
B. Isoflurane
C. Sevoflurane
D. Ether
| Halothane |
58e52b30-980e-4ffe-b626-52efb255ed4d | largest protozoal parasite of human Lives in large intestine Two stages- trophozoite and cyst (refer pgno:82 baveja 3 rd edition ) | Microbiology | parasitology | Which of the following organism is biggest -
A. Balantidium coli
B. Entamoeba coli
C. Escherichia coli
D. Entamoeba histolytica
| Balantidium coli |
00e8a051-7cc4-48f9-9e04-ea20af4ecb35 | B i.e. Phenytoin Phenytoin It acts to suppress the abnormal brain activity seen in seizure by reducing electrical conductance among brain cells by stabilizing the inactive state of voltage-gated sodium channels. Aside from seizures, it is an option in the treatment of trigeminal neuralgia in the event that carbamazepine or other first-line treatment seems inappropriate. It is sometimes considered a class lb antiarrhythmic. | Pharmacology | null | NOT of use in bipolar disorder: September 2012
A. Carbamazepine
B. Phenytoin
C. Sodium valproate
D. Lamotrigine
| Phenytoin |
c7b3b5b4-75eb-466c-9dce-673365965955 | Crowd and mob are related terms.
Crowd means a large number of persons gathered together. A crowd can be a crowd of random people doing different things or it may be people with one intent or purpose.
Mob is highly emotional crowd whose members have with one intent or purpose and are engaged in or are ready to engage in, violence against specific target: a person, a category of people or physical property. | Social & Preventive Medicine | null | An unstable and emotional temporary social group with a leader is known as –
A. A band
B. A crowd
C. A herd
D. A mob
| A mob |
64566e03-e83f-48fd-adda-ada1cb56c288 | By changing the injection site every day, the incidence of lipodystrophy can be reduced significantly. Ref: KD Tripathi 8th ed. | Pharmacology | Endocrinology | How to avoid lipodystrophy in diabetics?
A. Avoid insulin injection
B. Change injection sites
C. Give injection on same site
D. Give injection on alternate days
| Change injection sites |
e680ed3b-80ae-40d1-869e-6dd5bc6c7a1d | dRef: KDT, 5th ed, p. 725, 783, 770 & 4th ed, p. 781 | Pharmacology | Anti Microbial | Which is not an antiviral drug:
A. Vidarbine
B. Acyclovir
C. Zidovudine
D. Mitomycin
| Mitomycin |
a28d8d30-2766-445e-8c51-672337d6e6f0 | The clinical symptoms, examination with USG findings of thickened pyloric muscle (>3mm) and elongated pyloric canal (>15mm) reveal the diagnosis as CHPS- congenital hyperophic pyloric stenosis which has hyperophy of circular muscle as depicted in option A Hyperophy-Small spindle-shaped (uterine smooth muscle cells) from a normal uterus, compared with large plump cells (the gravid uterus), at the same magnification.A Normal kidney tubules with Early (reversible) ischemic injury showing surface blebs, increased eosinophilia of cytoplasm, and swelling of few cells. Atrophy-Normal brain parenchyma of a young adult compared with Atrophy of the brain. Note made is of loss of brain substance that narrows the gyri and widens the sulci. Apoptosis- The shown cell is reduced in size, contains brightly eosinophilic cytoplasm and a condensed nucleus. | Unknown | Integrated QBank | A 3 week old boy is brought to pediatrics emergency depament with projectile vomiting which is non bilious. On physical examination, firm, olive like mass is noted in the epigastric region post breastfeed and USG revealed thickened pyloric muscle. What is the most likely pathological finding if the pylorus muscle is biopsied?
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=" /> |
6ec5028e-43b6-4f77-975b-737123f541f0 | Now, Mitomycin is being increasingly used for this purpose and is proving more useful.
Mitomycin is an anticancer agent that has shown to decrease scar formation after E.N.T. surgery.
It is an anti fibroblastic agent and thus prevents the wound healing and subsequent synechiae formation.
It is useful in preventing synechiae formation in following operations :-
DCR
Sinus surgery | ENT | null | To prevent synechiae formation after nasal surgery, which one of the following packings is the most useful -
A. Mitomycin
B. Ribbon gauze
C. Ribbon gauze with liquid paraffin
D. Ribbon gauze steroids
| Mitomycin |
bb2da234-b6f2-4782-9156-99c748cf4b6e | Theophylline is metabolized mainly by CYP1A2 hepatic microsomal enzyme. Inhibitors of CYP1A2: Cimetidine Ciprofloxacin Erythromycin Others are: - Aemisinin Atazanavir Enoxacin Ethinyl estradiol Fluvoxamine Furafylline Galangin Mexiletene Tacrine Thiabendazole Zileuton All these drugs inhibit the metabolism of theophylline and therefore may result in its toxicity. Nausea is a common side effect; tachycardia and tremors are also seen. Monitoring of blood theophylline levels is required to minimize toxicity. | Unknown | Integrated QBank | A 75-year-old male patient is a known case of a pulmonary disease and is being treated with inhalational coicosteroids and daily theophylline.The patient was admitted to a hospital for urinary retention few days back and catheterization was done. However, the condition got complicated with urinary tract infection and the patient was put on an antibiotic for the same. Now the patient is presenting with symptoms such as nausea, vomiting, abdominal pain, headache and a fine hand tremor. The patient also appears to have tachycardia. According to the doctor, the symptoms may be due to increased serum levels of the drugs taken by the patient. Which of the following drug may be responsible for the patient's condition?
A. Amoxicillin
B. Ceftriaxone
C. Nitrofurantoin
D. Ciprofloxacin
| Ciprofloxacin |
6d379f1c-8d18-4de6-b19b-867c27c4a9b6 | Answer- D. PneumoniaMost commot cause of death in measles is pneumonia | Medicine | null | Most common cause of death in measles ?
A. Encephalitis
B. Meningitis
C. Dehydration
D. Pneumonia
| Pneumonia |
d241fa04-6033-4ffa-8aa0-999355e09d91 | Earliest but nonspecific symptom of Congenital Glaucoma is photophobia | Ophthalmology | null | Earliest symptom of Congenital Glaucoma
A. Lacrimation
B. Blepharospasm
C. photophobia
D. Diminision of vision
| photophobia |
edf059f4-ae92-4489-91e3-9f16e5c30372 | ANSWER: (B) AntianginalREF: KDT 6th edition page 522, 536, Katzung 12th edition page 205CLASSIFICATION OF ANTIANGINAL DRUGSNitrates:Short acting: Glyceryl trinitrate (GTN, Nitroglycerine)Long acting: Isosorbide dinitrate (short acting by sublingual route), Isosorbide mononitrate, Erythrityl tetranitrate, Pentaerythritol tetranitrateBeta Blockers; Propranolol, Metoprolol, Atenolol and others.Calcium channel blockers:Phenyl alkylamine: verapamilBenzothiazepin: DiltiazemDihydropyridines: Nifedipine, Felodipine, Amlodipine, Nitrendipine, Nimoil, Lacidipine, Lercanidipine, BenidipinePotassium channel openers; Nicorandi-Others; Dipyridamole,'Tiimetazidine, Ranolazine, OxyphednneRANOLAZINE This recently developed trimetazidine congener LC3-KAT inhibitor is a metabolic modifier approved by US-FDA in 2006 for treatment of chronic angina pectoris in patients who fail to respond to standard antianginal therapy. Approved for chronic angina (KDT 6th edition), Prophylaxis of angina (Katzung) with combination therapyMechanism of action: Ranalozone act by shifting fatty acid oxidation to carbhohydarate oxidation. By reducing late sodium current in myocardium which facilitates Calcium entry. This reduced calcium entry during ischemia provides cardioprotective action.Pharmacokinetics: Orally absorbed, Bioavailablity 30-50%Side effects: Weakness, postural hypotension, Prolongation QT interval, torsades de pointes. | Pharmacology | Anti-Anginal | Ranolazine is a?
A. Vasodilator
B. Antianginal
C. Antihypertensive
D. Antiarrhythmia
| Antianginal |
280d069b-ad71-460a-b0bc-4595827dc941 | The occurrence and magnitude of the incisura of the central aoic pressure were shown in 66 patients to depend on the functional state of the aoic valve. In normal subjects and children with congenital aoic stenosis (with thin flexible leaflets), the incisura ranged between 6 and 14 mm Hg. With aoic regurgitation, the incisura diminished as the severity of regurgitation increased. With calcific aoic stenosis, the incisura was smaller or absent. These observations imply a valve mechanism productive of the incisura. In vitro studies of human aoic valves confirmed these observations. Additional in vitro studies with high speed cinematography (2,000 frames/sec) of a stented normal porcine valve also showed that early diastolic stretch and recoil of the leaflets occurs. These results indicate that in the presence of a normal or diseased aoic valve the aoic incisura is produced primarily by valve distension or recoil, respectively. Distension and rebound of the aoic walls do not appear to contribute significantly in the presence of a normal or a diseased valve. Because acquired aoic valve disease affects the magnitude of the central aoic incisura, inspection of the incisura may be of ancillary valve in evaluating the pathologic state of the aoic valve. Ref Davidson 23rd edition pg 431 | Medicine | C.V.S | Incisura is absent in ?
A. Aoic valve replacement
B. Aoic stenosis
C. Cardiac tamponade
D. Hypovolumic shock
| Aoic stenosis |
f3f1ef55-8598-4df6-93b3-1ab2262025fd | Follicular lymphoma likely arises from germinal center B cells and is strongly associated with chromosomal translocations involving BCL2. Its hallmark is a (14;18) translocation that juxtaposes the IGH locus on chromosome 14 and the BCL2 locus on chromosome 18. The t(14;18) is seen in up to 90% of follicular lymphomas, and leads to overexpression of BCL2. BCL2 antagonizes apoptosis and promotes the survival of follicular lymphoma cells. Notably, while normal germinal centers contain numerous B cells undergoing apoptosis, follicular lymphoma is characteristically devoid of apoptotic cells. BCL 10 : associated with extra nodal marginal zone lymphoma The t(14;18)(q32;q21) and t(1;14) (p22;q32) translocations cause increased expression of intact MALT1 and BCL-10 protein respectively. This translocation is associated with gastric MALToma. Each of the three translocations has the same net effect, the constitutive activation of NF-kB, a transcription factor that promotes B-cell growth and survival. Antigen dependent activation of NF-kB in normal B and T cells. requires both BCL-10 and MLT, which work together in a pathway downstream of the B- and T-cell antigen receptors. Thus, H. pylori-induced inflammation may trigger NF-kB activation through the MLT/BCL-10 pathway in MALTomas that lack these translocations. Removal of this stimulus may explain why these tumors tend to respond to H. pylori eradication. In contrast, NF-kB is constitutively active in tumors bearing translocations involving MLT or BCL10, and H. pylori treatment is ineffective. BCL 6 : associated with diffuse large b cell lymphoma(DLBCL). DLBCL is most common subtype of non Hodgkin lymphoma globally. BCL 1 : also called cyclin D1 and is associated with Mantle Cell Lymphoma | Pathology | NEET 2019 | Which of the following is positive in Follicular lymphoma?
A. Bcl 2
B. Bcl 6
C. Bcl 1
D. Bcl 10
| Bcl 2 |
553ee2ab-c91a-4c8a-b7a7-bd53e0ec3670 | Hemorrhagic conjunctivitis is caused by picornaviruses (Enterovirus-70, coxsackievirus A24) and sometimes Adenovirus type11. Ref: Duker 2nd/e p.229 | Ophthalmology | Conjunctiva | Acute hemorrhagic conjunctivitis is seen with -
A. Adenovirus
B. Staphylococcal
C. Pneumococcus
D. Hemophilus
| Adenovirus |
07d58e75-c74b-4b0f-a10c-4924b8fb02cb | Ans. is 'a'i.e., 1% o The risk of lower segment scar - rupture is low (0[?]2-1[?]5%) and even if it does occur, maternal death is much less and the perinatal mortality is about 1 in 8.o Previous history of classical caesarean section or hysterotomy makes the woman vulnerable to unpredictable rupture of the uterus. This may occur either late during pregnancy or during labour and when it does, the maternal mortality is to the extent of 5% and the perinatal mortality to 75%. | Gynaecology & Obstetrics | Caesarean Section | Risk of scar rupture in previous LSCS with lower segment scar is -
A. 1%
B. 5%
C. 10%
D. 50%
| 1% |
c6c30862-8805-4cb5-b9f6-dc27a941f0a7 | The portion of liver on the left side of falciform ligament is left (anatomical) lobe of liver. And in Couinaud's functional segmentation of liver, the segment number 2, 3, 4a and 4b form the left liver lobe. | Anatomy | null | A surgeon excises a portion of liver of the left of the attachment of the falciform ligament. The segments that have been resected are -
A. Segment la and 4
B. Segment 1 and 4b
C. Segment 2 and 3
D. Segment 1 and 3
| Segment 2 and 3 |
b675a12c-103a-4aba-a3a6-f9709213c66e | Weight-for-age is not a parameter for the WHO classification of malnutrition. It has limited clinical significance as it does not differentiate between wasting and stunting. WHO Classification Parameter Moderate malnutrition Severe malnutrition Symmetrical edema no yes Weight/height (wasting) <-2SD to >-3SD (70 to 79% of expected) <-3SD (<70%) Height/age (Stunting) <-2SD to > -3SD (85 ot 89%) < -3SD (<85%) Ref: Nelson textbook of pediatrics 21st edition Chapter 57 | Pediatrics | Nutrition | Which of the following is not a parameter for the WHO classification of malnutrition:
A. Symmetrical edema
B. Weight for height
C. Weight for age
D. Height for age
| Weight for age |
b6a5d62d-61d3-4c59-a97c-c59e29a1f5ca | (Ref: KDT 6/e p464, 465) Pentazocine can cause dysphoric reactions (hallucinations) by stimulating the K receptors. | Anatomy | Other topics and Adverse effects | Which of the following opioid analgesic acts primarily through K opioid receptors?
A. Pentazocine
B. Methadone
C. Buprenorphine
D. Pethidine
| Pentazocine |
412ca983-9c2d-44d9-a0c9-e267a34917f8 | (A) Menkes disease # Deficiency or Lower-than-normal ceruloplasmin levels may indicate the following:> Wilson disease copper storage disease)> Menkes disease (Menkes kinky hair syndrome) (rare - UK incidence 1/100,000)> Overdose of Vitamin C> Copper deficiency> Aceruloplasminemia> Excess or Greater-than-normal ceruloplasmin levels may indicate or be noticed in: copper toxicity / zinc deficiency pregnancy oral contraceptive pill use lymphoma acute and chronic inflammation (it is an acute-phase reactant) rheumatoid arthritis Angina Alzheimer's disease Schizophrenia Obsessive-compulsive disorder | Psychiatry | Miscellaneous | Hypoceruloplasminimia is associated with which abnormality?
A. Menkes disease
B. Alzheimer's disease
C. Schizophrenia
D. Obsessive-compulsive disorder
| Menkes disease |
819bd3ae-4e3e-4a00-9abc-2f2e5d9b14bd | Ans. a (Babesia microti). (Ref. Harrison's, Principles of Internal Medicine, 16th ed., pg1232)Babesiosis (B. microti)# Babesiosis is a worldwide protozoan disease of animals that is transmitted by ticks; humans are infected incidentally and initially develop a nonspecific febrile illness that can lead to hemolytic anemia.# Babesia organisms enter RBCs and resemble malarial parasites morphologically, posing a diagnostic problem.# Ixodid (hard-bodied) ticks, in particular Ixodes scapularis (/. dammini) and I. ricinus, are the vectors of the parasite. Transfusions are another source of babesiosis.# The incubation period for B. microti infection is 1 to 4 weeks.# Immunosuppressed patients, splenectomized individuals, and the elderly have the most severe illness.# The clinical presentation varies widely and resembles malaria or rickettsiosis; symptoms and signs include a gradual onset of irregular fever, chills, sweating, muscle pain, and fatigue. Mild hepatosplenomegaly and mild hemolytic anemia may develop, but a rash is not present.# Giemsa-stained thick and thin blood films examined for small intraerythrocytic parasites. b. microti appears as a small ring form resembling P. falciparum.# Unlike infection with Plasmodium, however, Babesia does not cause the production of pigment in parasites, nor are schizonts or gametocytes formed.# A species-specific polymerase chain reaction test using the RNA gene has been used to show parasite persistence when the blood smear is negative.# Treatment of Babesiosis:OrganismAdultsBabesia microtiAtovaquone 750 mg bid PO plus azithromycin 600 mg/ d PO or clindamycin 1200 mg bid IV.Babesia divergens and other Babesia species, including MO-1,WA-1, and CA-1Quinine 650 mg tid PO plus clindamycin 1200 mg bid IV (or 600 mg tid PO) plus atovaquone 750 mg bid POo | Microbiology | Parasitology | Apart from plasmodium, which of the following can infect RBCs in "ring forms"?
A. Babesia microti
B. Tyrpanosomas
C. Schistosomia
D. Microfilaria
| Babesia microti |
33d775c8-dcc5-4b61-93fa-841c569fac55 | Iridocorneal endothelial (ICE) syndrome is characterized by abnormal corneal endothelium which causes :- Iris atrophy, Secondary angle closure glaucoma in association with characteristic peripheral anterior synechiae, Corneal edema.
Option 'c' may cause confusion here. You should keep in mind that in iridocorneal endothelial syndrome, collagen deposition occurs on the posterior surface of Descemet's membrane (not in the Descemet's membrane). | Ophthalmology | null | Iridocorneal endothelial syndrome is associated with –
A. Progressive atrophy of iris stroma
B. Bilateral stromal edema of iris & cornea
C. Deposition of collagen in Descemet's membrane
D. Deposition of glycosaminoglycan in Descemet's membrane
| Progressive atrophy of iris stroma |
f9780cb1-f622-4bfc-a6cc-4626abeba48b | Tinnitus is the perception of abnormal noise in the ear or head. It is usually attributed to a sensory loss; pulsatile tinnitus occurs with conductive hearing loss and is due to carotid pulsations becoming more apparent. | Surgery | Nervous System | An elderly man complains of ear pain. During evaluation, the physician asks if the patient has tinnitus. What is tinnitus?
A. A subjective sensation of noise in the head
B. A complication of chronic metal ingestion
C. An audible cardiac murmur
D. Dizziness with sounds
| A subjective sensation of noise in the head |
99dafc79-4384-4222-bb13-bdbf56f7d5be | IQ is defined by as the mental age divided by the chronological age multiplied by 100. In this case, a child of 6 years of age with an IQ of 50%, means that his mental age is that of a 3 year old child. At 3 years of age, a child can identify two colours. Ref: Essential paediatrics by OP Ghai, 6th edition, Page 543. | Pediatrics | null | A 6 year old child with IQ of 50. Which of the following can the child do?
A. Identify colours
B. Read a sentence
C. Ride a bicycle
D. Copy a triangle
| Identify colours |
946ee136-fa79-453b-85d5-160ed33bef66 | Indications for Blood Transfusion
To correct anemia due to blood loss and to combat postpartum hemorrhage
Patient with severe anemia seen in later months of pregnancy (beyond 36 weeks)
Refractory anemia: Anemia not responding to either oral or parenteral therapy in spite of correct treatment
Associated infection | Gynaecology & Obstetrics | null | Not an indication for blood transfusion
A. Moderate anemia at 24-30 weeks
B. Severe anemia at 36 weeks
C. Blood loss anemia
D. Refractory anemia
| Moderate anemia at 24-30 weeks |
6025f06f-f128-461f-a138-a489777e81a3 | HSV infection may be acquired in utero, during the birth process, or during the neonatal period.
Intrauterine and postpartum infections occur infrequently.
Most cases of neonatal herpes result from maternal infection and transmission, usually during passage through a contaminated infected birth canal of a mother with asymptomatic genital herpes. | Pediatrics | null | Trans-placental spread is least associated with?
A. HSV
B. Rubella
C. HBV
D. HIV
| HSV |
0dc38ea6-216b-4c27-9cb9-e28b3cd4cf74 | Ovulation-the discharge of a secondary oocyte from the Graafian follicle; in an adult woman, this normally occurs at intervals of about28 days and alternates between the two ovaries. As a rule, only one secondary oocyte is produced, but occasionally ovulation produces two or more; if more than one subsequently become feilized, the result may be multiple bihs, such as twinsEstrogen levels peak towards the end of the follicular phase. This causes a surge in levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). This lasts from 24 to 36 hours, and results in the rupture of the ovarian follicles, causing the oocyte to be released from the ovary the oviduct.Ref: Ganong&;s review of medical physiology; 24th edition | Physiology | Endocrinology | Ovum is released due to
A. FSH
B. LH
C. Prolactin
D. HCG
| LH |
ca367e87-de96-4cb7-a097-6be2a041feb1 | The cause of malignant hypehermia is unknown, but it is associated with inhalational anesthetic agents and succinylcholine. It may develop in an otherwise healthy person who has tolerated previous surgery without incident. It should be suspected in the presence of a history of unexplained fever, muscle or connective tissue disorder, or a positive family history (evidence suggests an autosomal dominant inheritance pattern). In addition to fever during anesthesia, the syndrome includes tachycardia, increased O2 consumption, increased CO2 production, increased serum K+ , myoglobinuria, and acidosis. Rigidity rather than relaxation following succinylcholine injection may be the first clue to its presence. Treatment of malignant hypehermia should include prompt conclusion of the operative procedure and cessation of anesthesia, hyperventilation with 100% O2 , and administration of intravenous dantrolene. The urine should be alkalinized to protect the kidneys from myoglobin precipitation. If reoperation is necessary, the physician should premedicate heavily, alkalinize the urine, and avoid depolarizing agents such as succinylcholine. Pretreatment for 24 hours with dantrolene is helpful; it is thought to act directly on muscle fiber to attenuate calcium release. | Anaesthesia | Miscellaneous | Sholy after the administration of an inhalational anesthetic and succinylcholine for intubation prior to an elective inguinal hernia repair in a 10-year-old boy, he becomes markedly febrile, displays a tachycardia of 160, and his urine changes color to a dark red. Which of the following is the most appropriate treatment at this time?
A. Complete the procedure but pretreat with dantrolene prior to future elective surgery.
B. Administer inhalational anesthetic agents.
C. Administer succinylcholine
D. Hyperventilate with 100% O2 .
| Hyperventilate with 100% O2 . |
5dd3a208-0a47-43af-ab7d-3830502df7d5 | Varenicline is a prescription medication used to treat smoking addiction. This medication is the first approved nicotinic receptor paial agonist. Specifically, varenicline is a paial agonist of the alpha4/beta2 subtype of the nicotinic acetylcholine receptor Ref Davidson 23rd edition pg 578 | Medicine | Respiratory system | Varenicline is used in
A. Pulmonary hemosiderosis
B. Sleep apnea
C. Anti-trypsin deficiency
D. Nicotine dependency
| Nicotine dependency |
5294b9e6-443e-447a-b789-fe44db1e5e21 | IVP in ureterocele usually shows a round filling defect, sometimes large, in the bladder corresponding to the ureterocele, and characteristic finding of duplication of the collecting system (ureteroceles are nearly always associated with ureteral duplication)
Ureterocele :
Is a cystic dilatation of the terminal ureter, and is obstructive because of a pinpoint ureteral orifice.
It is more common in females
Affected children often are discovered by prenatal sonography or during an investigation of UTI (IVP)
Treatment : o transurethral incision of ureterocele : effectively relieves the obstruction but it may result in V.U.R. necessitating ureteral reimplantation later, or
' open excision of ureterocele and reimplantation 'as primary management'. About other options
An isolated VUR or Duplication of ureter do not explain the filing defect in the bladder.
Sacrococcygeal Teratoma :
The most common presentation here is with an abnormal, obvious protruding mass from the sacral area. Out of the 4 varieties known, only Type IV which contributes 9.8 % ie entirely pre-sacral and not visible externally (90.8% tumors are visible externally).
Bladder and Rectum may be displaced anteriorly but a filling defect is not characteristic as in ureterocele.
Ureters may be partially obstructed resulting in hydro-ureter and hydronephrosis. | Pediatrics | null | A 6 year old girl presents with Recurrent E.coli infection in urine. Ultrasound of abdomen shows Hydroureter and Hydronephrosis. Micturating cysto – urethrogram shows filling defect in urinary bladder. The likely diagnosis is –
A. Sacrococcygeal Teratoma
B. Vesicoureteric Reflux – grade II
C. Duplication of Ureter
D. Ureterocele
| Ureterocele |
5ebc3bc6-5483-4f16-bdb5-6d95fcd15958 | Ans. is 'a' i.e. Infancy Campbell's Urology writes - "Definitive treatment of an undescended testis should take place between 6 and 12 months of age. Because spontaneous descent occurs in most boys by 3 months of age and uncommonly thereafter, earlier interventions should be considered in order to theoretically prevent the complication of cryptorchidism that may be manifested before 1 yr. of age". | Surgery | Miscellaneous (Testis & Scrotum) | Orchidopexy is done in cases of undescended testes at the age of
A. Infancy
B. 1-2 yrs
C. 5 yrs
D. Puberty
| Infancy |
291e3856-795c-4c4d-87ef-69cb12a74ab8 | Ventilator suppo with IPPV(intermittent positive pressure ventilation) is the treatment of choice.Assisted ventilation is required for several days until the chest wall stabilises.If ventilator suppo is required for more than 10 days,then tracheostomy is done to prevent laryngeal stenosis which can occur due to prolonged endotracheal intubation. Reference:SRB's manual of surgery,5th edition,page no:1116. | Surgery | Cardio thoracic surgery | A man is brought to casualty who met with A. He sustained multiple rib fractures with paradoxical movement of chest. Management is
A. Tracheostomy
B. Consult cardiothoracic surgeon
C. Strapping
D. Intermittent positive pressure ventilation
| Intermittent positive pressure ventilation |
3d8129c9-cd7f-4217-af03-7b1886672d09 | Ans. is 'b' i.e., Plasma Hook worms Ancylostoma duodenale - Old world hookworm Nector americanus - New world hook worm Habitat - Small intestine (Jejunum > duodenum > Ileum) Infective form - Filariform larva Mode of infection - Penetration of skin Plasma forms the main source of nourishment for hookworm, the red blood cells pass out from the worm practically unchanged into the lumen of host's intestine. | Microbiology | null | The hookworm thrives on ?
A. Whole blood
B. Plasma
C. Serum
D. RBC
| Plasma |
acd0169d-8539-46e3-a289-41fca0afcff4 | (a) Pathological doubt, Ref: Complete review of psychiatry by Dr. Prashant Agrawal, ed.,, 2018, ch- 7, pg. 164 Explanation: Variable % Obsessions (N=200) Contamination 45 Pathological doubt 42 Somatic 36 Need for symmetry 31 Aggressive 28 Sexual 26 Other 13 Multiple obsessions 60 Compulsions (N=200) Checking 63 Washing 50 Counting 36 Need to ask for confess 31 Symmetry and precision 28 Hoarding 18 Multiple compulsions 48 | Psychiatry | Mood Disorders | Most common symptom associated with adult OCD?
A. Pathological doubt
B. Need for symmetry
C. Sexual
D. Aggressive
| Pathological doubt |
45adff9e-d3b4-413b-abe3-bc8ffb51e1c5 | Ans. is 'a' i.e., Reactivating cholinesterase enzyme o Pralidoxime is most commonly used cholinesterase reactivater.OXIMESo Oximes 1 Pralidoxime 2-PAM, obidoxime and diacetyl-monoxime (DAM)J are used in organophosphatepoisoning.o Oximes acts by reactivating cholinesterase enzyme.o Mechanism of actionIn organophosphate poisoning esteratic site of cholinesterase is phosphorylated and anionic site is free.Phosphorylated cholinesterase reacts very slowly with water.However, if more reactive OH groups in the form of oximes are provided, reactivation occurs more than a million time faster.Oximes attach to anionic site and provide more reactive OH groups.Oximes are ineffective in Carbamates poisoning.Pralidoxime is contraindicated in carbamates poisoning, because not only it does not reactivate carbamylated enzyme, it has weak anti-chE activity of its own.Remembero Obidoxime is more potent than pralidoxime.o Pralidoxime and obidoxime are lipid insoluble, while diacetyl-monoxime (DAM) is lipid soluble so it can cross EBB and regenerate AChE in brain.o Atropine is used in both organophosphate and carbamate anticholinesterase poisoning. | Pharmacology | Cholinergic System | Pralidoxime acts by -
A. Reactivating cholinesterase enzyme
B. Promoting synthesis of cholinesterase
C. Promoting synthesis of acetylcholine
D. Direct action on cholinergic receptors
| Reactivating cholinesterase enzyme |
fab52be2-1236-4ac4-b40f-95a9b9fd37dd | Ans. c (Urothelial carcinoma). (Ref. Harrison's Medicine 17th ed. 555)# Urothelial malignancy classically shows polychronotropism & multicentricity.# In urothelial or transitional carcinoma of renal pelvis or ureter, the examination of urine for malignant cells is positive and even may indicate whether tumor is well or poorly differentiated.# There is evidence that those with poorly differentited tumors do better if they have a short course of radiotherapy before surgery.# It is hence useful to obtain cells from tumor/urine by sampling a brush or catheter passes up the ureter under radiological control. | Surgery | Urinary Tract | Malignant cells in urine cytology are most commonly seen in
A. Renal cell carcinoma
B. Prostate carcinoma
C. Urothelial carcinoma
D. Bladder carcinoma
| Urothelial carcinoma |
3a6e9e54-bf62-4045-98be-e492013c29ee | Ans. a (Anterior cruciate ligament tear) (Ref. Adam's orthopedics 11th/pg, 315-325)Knee Joint Injuries1Normal range of motion# Flexion: 135 degrees# Extension: 0 to 10 degrees above horizontal plane2Patellar apprehension test# Evaluates for patella subluxation3Anterior cruciate ligament (ACL) stability tests# Lachman test (most sensitive) - done with the knee flexed at 20deg.# Anterior drawer test- done with the knee flexed at 20deg.# Pivot shift test (Macintosh Test)4Posterior Cruciate Ligament (PCL) Tests# Knee posterior drawer test# PCL sulcus test# PCL sag test5Collateral ligament evaluation# Knee valgus stress test (Medial collateral ligament)# Knee varus stress test (Lateral collateral ligament)6Meniscus evaluation# McMurray's test# Apley's compression test and apley's distraction test# Bounce Test7Pivot test# Patient lies in lateral decubitus position,# Affected knee extended, affected tibia internally rotated, and examiner applies valgus stress to knee (push from lateral side) and tries to flex knee,# If clunk felt at 30 degrees knee flexion, the test is said positive test for ACL rupture. | Orthopaedics | Injuries Around the Thigh & Knee | Pivot shift test is positive with
A. Anterior cruciate ligament tear
B. Posterior cruciate ligament tear
C. Medial meniscus injury
D. Lateral meniscus injury
| Anterior cruciate ligament tear |
b512d30c-b34d-48fe-a7ac-bc6346f0b8b3 | Drugs used in nocturnal enuresis are imipramine and desmopressine. | Psychiatry | null | Antidepressant drug used in nocturnal eneuresis is -
A. Imipramine
B. Fluoxetine
C. Trazdone
D. Sertaline
| Imipramine |
f0548c9a-9604-49d4-9507-39c7b55820d3 | This patient is showing features of severe hypeension which is an indication for delivery. Induction of labour is the definitive treatment of choice which is most preferable. In order to prevent the onset of seizures magnesium sulfate prophylaxis should be given. Features of severe pre eclampsia are: BP > 160/110 >- 3 + proteinuria Presence of headache, visual disturbances, upper abdominal pain, oliguria and convulsion Elevated levels of serum creatinine, serum transaminase or presence of thrombocytopenia Fetal growth restriction Pulmonary edema Ref: Anantharaman P., Schmidt R.J., Holley J.L. (2009). Chapter 55. Pregnancy & Renal Disease. Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 34. | Gynaecology & Obstetrics | null | A pregnant lady at 32 weeks of gestation presents with a BP of 160/110 mmHg, proteinuria with retinal haemorrhage. What is the definitive treatment of choice in this patient?
A. Ritodrine
B. Nifedipine
C. Magnesium sulphates
D. Termination of pregnancy
| Termination of pregnancy |
3761d425-1996-4438-b8ee-dc77c1e16d81 | Ans. d (Acrocentric). (Ref. Cell & Molecular Biology by DeRobertis, 7th /pg. 348)CHROMOSOMES# The entire genetic information contained in the genes is packaged in the chromosomes. All the somatic cells of an individual organism contain the same number of chromosomes.# Genes are arranged linearly on the chromosomes and their positions on the normal chromosome in relation to other genes on same chromosome are fixed. This position is called locus.# Genes occupying the same locus on a pair of chromosomes are called alleles.Structure of chromosomes:# Chromosomes are long structures with a constriction at point along its length-called centromere.# The ends of the chromosomes are called telomeres. These give stability to the chromosome. In the absence of telomeres, chromosomes become unstable and tend to break until joined to a telomere. An enzyme telomerase maintains the length of the telomeric sequences. Cell aging is controlled by telomerase enzyme. (AI 2003)# It has the structure for the attachment of chromosome to the spindle fibers called the Kinetochore.Depending on the location of the centromere on the chromosome, they are classified as: Type of chromosomeComments1.MetacentricThe centromere is in the centre of the chromosome so that the chromosome has two equal arms.2.Sub-metacentricCentromeres are away from the center so that the arms are unequal in size (one arm shorter than other).3.TelocentricCentromere is at the extreme end of replicating chromosome, so that chromosome consists of only one arm.4.AcrocentricCentromere is almost at the tip (one end) of the chromosome, so that one arm is much longer than other. BANDING TECHNIQUES# Techniques using dyes such as quinacrine, or giemsa after trypsin or heat treatment are called banding techniques. The banding pattern is specific for each chromosome, and seen in both members of a pair.# Bands seen with quinacrine, a fluorescent dye, are called Q-bands.# Banding seen with giemsa stain is called G-banding (The most extensively used technique)# Mitotic cells are essential for chromosome studies. In human body, mitosis occurs in:- Bone marrow, Intestinal mucosa, Skin and Gonads.# However, biopsies are difficult to obtain and sufficient number of dividing cells are not available.# The blood lymphocytes can be stimulated to divide in culture (appropriate medium) and easy to obtain.# Small skin biopsies can be obtained and the fibroblasts grown in culture.# Lymphocyte culture: Treatment of peripheral blood lymphocytes with substances such as Phytohemagluttinin (PHA) or Concanavalin A (Con A) stimulates the T lymphocytes to transform into lymphoblasts and undergo 3-4 rounds of mitotic divisions.# Sources of human cells for cytogenetic studies (analysis of human karyotypes) are:- Fibroblasts- Amniotic cells- Cells of chorionic villi.For detailed studies on the human chromosome mitotic cells are arrested in metaphase.The metaphase chromosomes are in a highly condensed state. | Anatomy | General | Chromosome in which centromere is close to one end which result in short arm being very short is which type of chromosome?
A. Metacentric
B. Submetacentric
C. Telocentric
D. Acrocentic
| Acrocentic |
bafc4838-ff95-4fac-bf18-7522993b43cf | Robbins basic pathology 9th edition page no 218,Heading=Transmission patterns of single-gene disorders Disorders of autosomal dominant inheritance are manifested in the heterozygous state, so atleast one parent in an index case usually is affected, both males and females are affected, both males and females are affected, and both can transmit the condition | Pathology | General pathology | Male to male transmission is seen in -
A. Autosomal dominant diseases
B. Autosomal recessive
C. X-linked dominant
D. Mitochondrial disease
| Autosomal dominant diseases |
5783b99d-68d8-43db-8877-c1357e81888d | Ans: a (Concurrent) Ref: Park, 19th ed, p. 108Sterilization is the process of destroying all life including spores.Disinfection- is the killing of infectious agents outside the body by direct exposure to chemical or physical agents.Types of disinfection:a) Concurrent disinfection- It is the application of disinfective measures as soon as possible after the discharge of infectious material from the body of infected person, or after the soiling of articles with such infectious discharges, e.g.. disinfection of urine, faeces, vomit, contaminated linen, cloth hands, dressings, aprons, throughout the course of illness.b) Terminal disinfection- It is the application of disinfective measures after the patient has been removed by death or to hospitals or has ceased to be a source of infection. Terminal disinfection is now scarcely practiced; terminal cleaning is considered adequate, alongwith airing and sunning of rooms, furnitures.c) Precurrent or prophylactic disinfection- Disinfection of water by chlorine, pasteurization of milk and hand washing are examples. | Social & Preventive Medicine | Communicable Diseases | Sputum from one patient is disinfected immediately following expectoration, this is known as:
A. Concurrent
B. Pre current
C. Recurrent
D. Terminal
| Concurrent |
9d65ee9b-e380-4fa0-8108-195f071bf656 | Anti rabies serum is given in class III bites (Single or multiple transdermal bites or scratches, licks on broken skin, Contamination of mucous membranes with aalvia, exposure to bats)
It is found to prolong the incubation period.
Passive immunization in rabies may be given by :
Horse Anti-rabies serum : 40 IU/kg body wt (upto max 3000 units), infiltrated
in the wound, & the rest given IM
Human Rabies Immunoglobulin : (preferred) 20 IU/kg body wt infiltrated in the wound, & the rest given i.m. | Unknown | null | Dose of Rabies immunoglobulin is?
A. 10 IU/Kg body weight
B. 15 IU/kg body weight
C. 20 IU/kg body weight
D. 25 IU/kg body weight
| 20 IU/kg body weight |
ac378e3c-74c8-48d7-ac19-bce3885d4312 | Ans. (a) AsbestosisRef: Harrison 19th ed. /1689* Working with asbestos is the most common risk factor for mesothelioma.* Indeed, the relationship between asbestos and mesothelioma is so strong that many consider mesothelioma a "signal" or "sentinel" tumor.* In rare cases, mesothelioma has also been associated with irradiation of the chest or abdomen, intrapleural thorium dioxide (thorotrast) as a contrast medium, and inhalation of other fibrous silicates, such as erionite. | Medicine | Pneumoconiosis | Mesothelioma is most commonly caused by?
A. Asbestosis
B. Silicosis
C. Anthracosis
D. Coal workers pneumoconiosis
| Asbestosis |
9f8dcde7-4ab4-4390-8ecc-387c17e340ce | Ans. C. Urticaria pigmentosa* It is urticaria pigmentosa.* It is cutaneous mastocytosis presenting with pigmented lesions.* On rubbing the lesions mast cells degranulate releasing histamine.* This produces the wheal and flare of the lesion. It is known as Darier's sign.Epidermal acantholysis in mid epidermis with "dilapidated or crumbling brick wall" appearance. Darier's disease is associated with ATP2A2 defect | Skin | Miscellaneous | A 5 yr. old male child has multiple hyperpigmented macules over the trunk. On rubbing the lesion with rounded end of pen, he developed urticarial wheal, confined to border of lesion, most likely diagnosis is:
A. Fixed drug eruption
B. Lichen planus
C. Urticaria pigmentosa
D. Urticarial vasculitis
| Urticaria pigmentosa |
b0dbf3bb-0859-4668-82ef-9d12ec3333b6 | In syringing (done to remove impacted wax) pinna is pulled upwards and backwards and a stream of water from the ear syringe is directed along the posterosuperior wall of the meatus. | ENT | null | Direction of water jet while doing syringing of ear should be:
A. Anteroinferior
B. Posterosuperior
C. Anterosuperior
D. Posteroinferior
| Posterosuperior |
f826865f-34c8-4391-a264-bfca803ad408 | Hormone Supply Stored in CellSteroids and 1,25(OH)2-D3NoneCatecholamines and PTHHoursInsulin DaysT3 and T4WeeksRef: Harper; 30th edition; Pg:515 | Biochemistry | Structure and function of protein | Among the given hormones which are stored the longest in a cell
A. Insulin
B. T3
C. PTH
D. Testosterone
| T3 |
f1d1ed18-131e-4d84-ae73-40c6007f2b84 | Ans. D. Mongoloid slant of palpable fissureMandibulofacial dysostosis is also known as Franceschetti-Klein syndrome or Treacher-Collins syndrome.Important features are as under:MicrognathiaColobomas of lower eyelidSunken cheek bonesBlind fistulas between the angles of mouth and earsDeformed pinnasAtypical hair growth extending towards cheekReceding chinLarge mouthFacial cleftsDeafnessAnti-mongoloid palpable fissureHypoplasia of mid face and zygomatic bone | Pediatrics | Genetics And Genetic Disorders | Not a feature of Treacher-Collins syndrome:
A. Deafness
B. Colobomas of lower eyelid
C. Hypoplasia of zygomatic bone
D. Mongoloid slant of palpable fissure
| Mongoloid slant of palpable fissure |
f9e0dd56-435f-4f22-aae9-ee8dea11f162 | Ans. C. ObesityBinge eating disorder (BED) is characterized by insatiable cravings that can occur any time day or night, usually secretive, and filled with shame.There are no comPensatory mechanisms associated with the binge to get rid of calories, so individulas with BED are more likely to be overweight or obese, while patients with bulimia nervosa may be underweight, normal weight. | Psychiatry | null | Binge eating disorder is characterized by ?
A. Normal weight
B. Weight loss
C. Obesity
D. Self induced vomiting
| Obesity |
b8930b48-32e6-4700-9951-bd12426ad066 | (Ref: Robbins 8/e p662)
Anemia of chronic disease- Impaired red cell production associated with any chronic diseases that would be infectious/inflammatory/neoplastic.
Chronic diseases produce a cytokine “IL-6” that increases the production of hepcidin from liver. Hepcidin inhibits ferroportin function in macrophages and reduces the transfer of iron from storage pool to developing erythroid precursors in bone marrow.
So the patient develop anemia irrespective of increased amount of iron in macrophages.
Laboratory findings- Increased ferritin (storage iron), Low serum iron and reduced total iron binding capacity.
Whereas in iron deficiency anemia, the patient will have decreased ferritin, lowserum iron and high iron binding capacity. | Unknown | null | Anemia of chronic disease is characterised by
A. Increased sideroblast
B. Increased TIBC
C. Increased bone marrow iron
D. Increased protoporphyrin
| Increased bone marrow iron |
df81c571-eab0-42e3-9d0e-0663e4b772bc | Ans. is 'd' i.e., Subcutaneous epinephrine o Brittle asthma is a type of asthma distinguishable from other forms by recurrent, severe attacks.o There are two subtypes divided by symptoms: Type 1 and Type 2, depending on the stability of the patient's maximum speed of expiration, or peak expiratory flow rate (PEFR).o Brittle asthma is one of the "unstable" subtypes of "difficult asthma", a term used to characterize the less than 5% of asthma cases that do not respond to maximal inhaled treatment, including high doses of corticosteroids combined with additional therapies such as long-acting beta-2 agonists.o Oxford Textbook of Medicine distinguishes type 1 brittle asthma by# "persistent daily chaotic variability in peak flow (usually greater than 40 per cent diurnal variation in PEFR more than 50 per cent of the time)",o While type 2 is identified by# "sporadic sudden falls in PEFR against a background of usually well-controlled asthma with normal or near normal lung function".o In both types, patients are subject to recurrent, severe attacks.o Individuals with type 1 suffer chronic attacks in spite of ongoing medical therapy, while those with type 2 experience sudden, acute and even potentially life-threatening attacks even though otherwise their asthma seems well managed. | Medicine | Asthma | Drug of choice for treatment of type 2 Brittle Asthma is -
A. b-adrenergic agonist
B. Inhaled corticosteroids
C. Antileukotrines DM
D. Subcutaneous epinephrine
| Subcutaneous epinephrine |
163ec7af-ce59-46da-afb3-4429b44ae682 | Presence of pansystolic murmur of mitral regurgitation in a patient with ASD suggests the presence of ostium primum defect with cleft mitral leaflet or a floppy mitral valve with mitral valve prolapse. ECG shows right axis detion in ASD, and extreme left axis detion in ostium primum ASD. Clinical presentation of ostium primum is similar to ostium secundum except that there may be a mitral systolic murmur due to MR and ECG shows left axis detion. Ref: Pediatrics: A Concise Text By SK Kabra, RN Srivastava, 2010, Page 135 | Pediatrics | null | A patient with ASD has the murmur similar to mitral regurgitation and left axis detion of 40 degrees. He is likely having:
A. TGA
B. Ostium secondum
C. Ostium primum
D. Floppy mitral valve
| Floppy mitral valve |
545927bc-c9c0-48c5-98a4-855a6e901674 | Ans. is 'c' i.e., Cardiac muscle* GLUT4 transporters mediate insulin dependent glucose uptake in skeletal muscle, cardiac muscle and adipose tissue | Biochemistry | Carbohydrates | GLUT 4 is present in -
A. Endothelium
B. Liver
C. Cardiac muscle
D. Lens
| Cardiac muscle |
e06652e3-5225-4e8b-ace7-cf5b9a12a29e | CTPA is the first-line diagnostic test. It has the advantage of visualising the distribution and extent of the emboli or highlighting an alternative diagnosis, such as consolidation, pneumothorax or aoic dissection. The sensitivity of CT scanning may be increased by simultaneous visualisation of the femoraland popliteal veins, although this is not widely practised. As the contrast media may be nephrotoxic, care should be taken in patients with renal impairment, and CTPA avoided in those with a history of allergy to iodinated contrast media. In these cases, either V/Q scanning or ventilation/perfusion single photon emission computed tomography (V/Q SPECT) may be considered Ref Davidson edition23rd pg 620 | Medicine | Respiratory system | Which is the best test to detect pulmonary embolism
A. D dimer assay
B. MRI
C. Ventilation Perfusion scan
D. CT with IV contrast
| CT with IV contrast |
eadf0100-f37f-4bd3-af71-f15226951a7c | Ans. is 'd' i.e., Left ventricular failureRight sided hea failureo Most common cause of right sided hea failure is left sided hea failure, i.e. right hea failure occurs as a consequence of left hea failure because left hea failure increases pressure in pulmonary circulation that produces an increased burden on the right side of the hea.o Left sided hea failure --> is pulmonary circulation pressure T burden to right atrium and ventricle -4 right sided hea failure.o Isolated right-sided hea failure most often occurs with chronic severe pulmonary hypeension and thus is called Cor-pulmonale.o Dilatation and hyperopy are confined to right atrium and ventricle.o The major morphological and clinical effects of pure right sided hea failure differ from those of left-sided hea failure because pulmonary congestion is minimal, while there is increased pressure and congestion in systemic veins and poal venous system. That results in ?l. Peripheral edema of dependent poion, especially ankle (pedal) and pretibial edema is a hallmark of right sided hea failure. Generalized massive edema may occur --> An asarca.Hepatic enlargement with centrilobular necrosis that may progress to cirrhosis --> Cardiac cirrhosis.Congestive splenomegaly.Pleural effusion (in contrast to left sided hea failure where pulmonary edema occurs).Pericardial effusion.Ascitieso Pulmonary edema is associated with LVF whereas pleural effusion is associated with RVF. | Pathology | null | Commonest cause of right ventricular failure is ?
A. Corpulmonale
B. Pulmonary involvement
C. Endomyocardial fibrosis
D. Left ventricular failure
| Left ventricular failure |
a8638e28-2393-4823-9101-da47173a14e9 | Loratidine is a second generation anti-histamine which has lesser sedation and cholinergic side effects. | Pharmacology | null | Which of the following anti-histaminie has very less cholinergic side effects?
A. Promethazine
B. Chlorpheniramine
C. Hydroxyzine
D. Loratidine
| Loratidine |
e94ea92f-3d1b-4f02-949c-e37f05e38d4f | Subclan steal syndrome refers to steno-occlusive disease of the proximal subclan aery with retrograde flow in the ipsilateral veebral aery and associated cerebral ischaemic symptoms.CausesClinical presentationIpsilateral upper limbNeurological, radiationCongenital Weak or absent pulseDecreased blood pressure (>20 mmHg)Arm claudication (rare due to collateral perfusion)DizzinessVeigoSyncopeAtaxiaVisual changesDysahriaWeaknessSensory disturbancesRadiographic featuresUltrasoundCT angiographyMR angiographyRetrograde flow in ipsilateral veebral aeryEarly changes prior to reversal of flow: decreased velocity, biphasic flow (in veebral aery)Changes can be augmented with arm exercise or inflation of BP cuff above systolic pressureProximal subclan aery usually can't be seen well enough to assessDistal subclan aery shows parvus-tardus waveform and monophasic waveformSubclan aery stenosis or occlusion easily identifiedDelayed enhancement of ipsilateral veebral aeryDirection of flow in veebral aery cannot be determinedOther intracranial or extracranial cerebral vascular lesions can be identifiedSubclan aery stenosis or occlusion easily identifiedDelayed enhancement of ipsilateral veebral aeryRetrograde direction of flow in ipsilateral veebral aeryOther intracranial or extracranial cerebral vascular lesions can also be identifiedTreatmentEndovascular: angioplasty & stent inseionSurgical: bypass surgery | Pathology | All India exam | Subclan steal syndrome is due to
A. Blockage of first pa of subclan aery
B. Blockage of second pa of subclan aery
C. Blockage of third pa of subclan aery
D. Thrombosis of subclan vein
| Blockage of second pa of subclan aery |
4123ffcc-6830-456b-8b4e-669fac15fae4 | A foreign body in trachea may move up and down the trachea between the carnia and the undersurface of vocal cords causing "audible slap" and "palpatory thud&;.Symptoms and signs of foreign bodies at different levelsSite of foreign bodiesSymptoms and signsLarynxChoking, Cyanosis, Complete obstruction leading to death* Paial obstruction: stridor, hoarseness, cough, respiratory difficultyTrachea* Choking, stridor, wheeze, cough, palpatory thud, audible slap* Cough, wheeze and diminished air entry to lung forms a "triad"Bronchi Respiratory distress with swelling of the foreign body* Lung collapse, emphysema, pneumonitis, bronchiectasis or lung abscess are late featuresRef: Hazarika; 3rd ed; Pg 651 | ENT | Larynx | Palpatory thud, an audible snap is seen in
A. Tracheal foreign body
B. Bronchial foreign body
C. Laryngeal foreign body
D. Foreign body in ear
| Tracheal foreign body |
d1a4d2e7-43f2-4634-b991-f4938c88cebb | Voclosporin is an immunomodulatory drug which inhibits the enzyme calcineurin. The chemical structure of voclosporin is similar to cyclosporine with a difference in one amino acid, leading to superior calcineurin inhibition and less variability in plasma concentration.
The LUMINATE (Lux Uveitis Multicenter Investigation of a New Approach to Treatment) clinical development programme was initiated in 2007 by Lux Biosciences Inc to assess the safety and efficacy of Voclosporin for the treatment, maintenance, and control of all form of non-infectious uveitis.
The aim of the LUMINATE programme was to ensure that voclosporin would become the first Corticosteroid-sparing agent to be approved by the US Food and Drug Administration for non-infectious uveitis. | Ophthalmology | null | A drug used in LUMINATE programme for non-infectious uveitis is –
A. Cyclosporine
B. Voclosporin
C. Methotrexate
D. Infliximab
| Voclosporin |
00b3f0c1-994f-4eb2-9caa-e37dd57c19c9 | Pudendal nerve block : Pudendal nerve arises from S2,3,4. Doesn't relieve the pain of labor Cause perineal analgesia and relaxation Ref: Dutta Obs 9e pg 480. | Gynaecology & Obstetrics | General obstetrics | The nerve root blocked in pudendal block is
A. L 1,2,3
B. L 2,3
C. S 2,3,4
D. S 4
| S 2,3,4 |
3c372938-0d3a-43c0-a2ae-4e6d55a8f27f | In adults, this is diagnostic, but in children, transillumination is also seen in an indirect inguinal hernia. As epididymal cyst may transilluminate but is posterior to the testis. | Surgery | Urethra & Penis | A 46-year-old man has a swelling in the scrotum. It shows clear transillumination anterior to the testis when a light is applied to the scrotum in a dark room. This physical exam is most consistent with?
A. Cyst of the epididymis
B. Torsion of testis
C. Hydrocele
D. Direct inguinal hernia
| Hydrocele |
5f0259bf-60fb-4e72-bcc5-c6ade1450ca2 | Acceptable noise levels Expressed in dB (A), sound pressure levels conforming to weighting curve (A) Environment Place Acceptable noise level dB(A) Residential Bed room 25 Living room 40 Commercial Office 35-45 Conference 40-45 Restaurants 40-45 Industrial Work shop 40-60 Laboratory 40-50 Educational Class room 30-40 Library 35-40 Hospitals Wards 20-35 Ref: Park 25th edition Pgno : 779 | Social & Preventive Medicine | Environment and health | Acceptable noise levels in bed room
A. 40dB
B. 35dB
C. 20dB
D. 25dB
| 25dB |
ffeaeb27-74d4-417b-9262-36f9602bccd9 | * ALCAFTADINE is a H1 receptor antagonist, and can be used for allergic conjunctivitis* The trial done for alcaftadine used 0.25% solution.* The trial states: "When Alcaftadine was tested against placebo and olopatadine, only Alcaftadine 0.25% was shown to have a clinically significant reduction in conjunctival redness scores 7 and 15 minutes after administration' | Pharmacology | Endocrinology | Alcaftadine trial used this concentration of drug:
A. 5%
B. 1%
C. 0.25%
D. 2.50%
| 0.25% |
5ff22325-030e-4251-bb0c-37db2955f9e5 | Ref. Robbins Pathology. 9th edition. Page. 148
Anti-Mullerian Hormone (AMH) / Mullerian Inhibiting Factor (MIF); Mullerian-inhibiting Hormone (MIH) / Mullerian-inhibiting Substance (MIS).
AMH - Downstream genes regulated by SRY pathway
SRY - Gene in “Sex determining region” - short arm of Y chromosome - Testis determining factor. | Unknown | null | Which chromosome is responsible for the production of MIF?
A. Chromosome 16
B. Chromosome 22
C. X Chromosome
D. Y Chromosome
| Y Chromosome |
546f2b32-9f5d-4d45-a06a-7197fe34e45f | Ans-CRef: Diseases of Ear, Nose & Thr oat. by Dhingra 5th edition. Chapter on diseases of pharynxExplanation:Waideyer's ringIt is formed by aggregated collections of lymphoid tissues distributed in the pharyngeal mucosa.It is formed by:AdenoidsPalatine tonsilsLingual tonsilsTubal tonsils in the fossa of RossenmullerLateral pharyngeal bandsNodules in the posterior pharyngeal wall | Unknown | null | Which of the following does not form Waldeyer's ring?
A. Palatine Tonsils
B. Adenoids
C. jugulodigastric node
D. Lateral pharyngeal bands
| jugulodigastric node |
9dd660ae-436a-45b0-bb9e-9bc9cc72ac80 | Ans. (c) ArginineRef: Harper's Biochemistry 30th edn. 1314, 660-61 | Biochemistry | Amino Acid Metabolism | Smooth muscle relaxant nitric oxide is synthesized from:
A. Methionine
B. Cyseine
C. Arginine
D. Ornithine
| Arginine |
7bebb540-b5ea-4b48-b037-cf6dab19b1c8 | Answer is A (Plasma Exchange Therapy): Plasma Exchange Therapy is the treatment of choice for TTP Pentad of Fever, Microangiopathic Hemolytic Anemia, Thrombocytopenia (platelets count = 20,000), Renal Failure (I'verum creatinine) and Neurological dysfunction (altered consciousness) together with normal tests of coagulation (normal PT and aPTT) confirms a diagnosis of Thrombotic Thrombocytopenic Purpura. Plasma Exchange .forms the mainstay of treatment of TTP. 'Plasma Exchange remains the mainstay of treatment of TTP' | Medicine | null | A person presents with fever and altered consciousness. Investigations reveal anemia with fragmented red blood cells, platelet count of 20,000/mm', serum creatinine of 3.0 mg % and normal PT and aPTT. Which of the following is the most appropriate treatment for the patient:
A. Plasma Exchange Therapy
B. Coicosteroids and Intravenous
C. Immunoglobulins
D. Anticoagulation with Heparin
| Plasma Exchange Therapy |
f0981937-0e4a-437c-8ed9-39b4d6d6569f | A i.e. Chicken pox - In patients with vesico-bullous lesions and oral ulcer (mucosal involvement), the diagnosis is pemphigus vulgaris and the bed side diagnostic Tzank test from floor of bullae shows acantholysis with numerous acantholytic keratinocyte cellsQ. In Tzank smear diagnostic multinucleated giant cells with ballooning degeneration is seen in herpes simplex, herpes zoster and varicella zoster (chicken pox) virusQ. | Skin | null | In Tzank smear multinucleated cells are seen in:
A. Chicken pox
B. Psoriasis
C. Molluscum contagiosum
D. Pemphigus vulgaris
| Chicken pox |
b6d0045b-4033-4eac-840a-cd4470cf9a52 | Type 2 Brittle asthma, are symptom-free patients developing sudden onset acute attack of asthma requiring mechanical ventilation or even death. These patients should ideally keep an auto-injector of epinephrine. Type 1 Brittle asthma is characterized by >40% variation in P.E.F.R for >50% of the time. It is managed with L.A.B.A + high dose inhaled coicosteroids and oral steroids. Long-term continuous subcutaneous infusion of P2 agonists like terbutaline is also given. | Medicine | COPD and Asthma | Drug of choice for the treatment of type 2 Brittle Asthma is?
A. b-adrenergic agonist
B. Inhaled coicosteroids
C. Antileukotrines DM
D. Subcutaneous epinephrine
| Subcutaneous epinephrine |
b804d1e5-b8c5-455e-8f72-874cc56c25d2 | Functional sensitivities for three generations of TSH assays: First generation: Functional sensitivity is 1-2 IU/mL Second generation: Functional sensitivity is 0.1-0.2 IU/mL Third generation: Functional sensitivity is 0.01-0.02 IU/mL Among the options more appropriate is 0.04 IU/mL Ref: Aicle: Evolution of TSH Assays: A Third Generation Viewpoint | Biochemistry | null | The minimum level of TSH that can he detected by TSH assay of the third generation thyroid function tests is which of the following?
A. 0.4 lU/ml
B. 0.04 IU/ml
C. 0.004 lU/ml
D. 4 IU/ml
| 0.04 IU/ml |
a47e16f8-68ab-4c56-89fd-a1c9dd7aad7b | Olf patients along with lytic circumscribed punched our X- rays appearance suggests multiple myeloma. Multiple myeloma most often presents as multifocal destructive bone tumours composed of plasma cells throughout the skeletal system.(ref Robbins 9/e p599,7/679) | Anatomy | Haematology | A 70yr old male has a pathological fracture of femur. The lesion appears a lytic on X- rays film with a circumscribed punched out appearance .The curetting from fracture site is most likely to show which of the following?
A. Diminshed and thinned trabecular bone
B. Sheets of atypical plasma cells
C. Metaplastic prostatic adenocarcinoma
D. Malignant cells forming osteoid bone
| Sheets of atypical plasma cells |
0396fe06-5dce-4bc8-a248-41f78be325ec | HPV infection of squamous cells Produces wrinkled nuclei surrounded by a clear halo. This is called koilocytosis. Whether it is indicative of a low or a high grade lesion in the cervix requires tissue documentation. This is usually obtained with a colposcopic biopsy. | Gynaecology & Obstetrics | Cervical Carcinoma | A cervical Pap smear repo stating that "koilocytic atypia is present" indicates the:-
A. Presence of high-grade cervical intraepithelial neoplasia
B. Cytologic effect of herpesvirus type 2
C. Cytologic effect of human papillomavirus
D. Presence of chlamydial infection
| Cytologic effect of human papillomavirus |
2aef15be-1714-4a48-8a08-cf84e05bfdee | Ans. c. Heat stroke (Ref: Reddy 33/e p319; Parikh 6/e p381)Sweating is not present in Heat stroke."Heat stroke (hyperpyrexia, sunstroke, systemic hyperthermia): This is attributed to an impaired functioning of the heat regulating mechanism caused by failure of cutaneous circulation and sweating. It is due to prolong exposure to he sun's infrared rays, and/or to hot atmosphere. "Heat stroke (Heat hyperpyrexia/Sun stroke/ Thermic Fever)Heat cramps (Miner's cramps/ Stoker's cramp/ Firemen's cramp)Heat exhaustion (Heat collapse/Heat syncope/Heat prostration)* It is due to failure of heat regulating mechanismQ* Caused by failure of cutaneous circulation & sweatingQ.* Occurs due to exposure to heat in open & humid environmentQ.* All signs of shock are present* There is sudden collapse with loss of consciousness.* Dry skin, hot flushes with absence of sweatingQ* These are painful spasm of voluntary muscles, which follow strenuous work in a hot atmosphere.* Caused by toss of water & salt in profuse sweatingQ.* Collapse without any elevation of body temperature.* Occurs due to exposure to high temperature in closed environment* Precipitated by muscular exercise & unsuitable clothing.* There is extreme exhaustion with peripheral vascular collapse with scanty sweatingQ | Forensic Medicine | Injuries | Sweating is not present in:
A. Heat syncope
B. Heat cramp
C. Heat stroke
D. Heat fatigue
| Heat stroke |
47228bcf-cf77-4a20-b1aa-7a491d26851d | NEPHROTIC SYNDROME:- Characterised by massive proteinuria, hypoalbuminemua and edema, hyperlipidemia is often associated. Some patients show hematuria and hypeension. Heavy proteinuria( more than 1g/metre square/day) is the underlying abnormality leading to hypoalbuminemia ( serum albumin below 2.5g/dl). The resultant fall in plasma oncotic pressure leads to interstitial edema and hypovolemia. This stimulates the renin angiotensin aldosterone axis and ADH secretion that enhances sodium and water retention. Hypoalbuminemia also induces hepatic synthesis of beta lipoproteins resulting in hypercholesterolemia. Main cause of nephrotic syndrome in children is associated with minimal change disease. Other causes include amyloidosis, vasculitis, SLE, postinfectious glomerulonephritis, and hepatitis B nephropathy. Steroid sensitive nephrotic syndrome:- MCNS accounts for 80% cases of nephrotic syndrome. Electron microscopy shows non specific obliteration of epithelial foot processes. Immunofluorescence studies shows deposits of occassional mesangial IgM. Lab findings- urine examination shows heavy proteinuria. Hyaline and granular casts are present. Serum albumin is low. Hypercholesterolemia impa a milky appearance to plasma. Blood urea and creatinine values within normal range. Blood levels if IgG low and IgM elevated. Low serum calcium level. Steroid resistant nephrotic stndrome:- Homozygous or complete heterozygous mutations in genes encoding podocyte proteins, including podocin(NPHS2), nephrin(NPHS1) and wilms tumor(WT1) genes. Reference: GHAI essential Paediatrics | Pediatrics | Urinary tract | Nephrotic syndrome in children is caused by
A. Minimal change disease
B. RPGN
C. MPGN
D. FSGS
| Minimal change disease |
1102427c-62b4-4cc6-8059-24b664b2550e | Ans. is 'c' i.e., Filariasis o Filariasis is transmitted by all four genera of mosquitoes including Anopheles, Aedes, Culex and Mansonoides. | Social & Preventive Medicine | null | Given three genera of mosquitoes (('ulex, Anopheles and Aedes) act as vectors for which of the following diseases world w ide -
A. Malaria
B. Dengue
C. Filariasis
D. Yellow Fever
| Filariasis |
895d8a6c-69c9-4ee1-8757-546226f971e5 | In AML with the t(15;17),acute promyelocytic leukemia (M3 stage) ,auer rods present (most common stage associated with DIC) t(8,21) AML With maturation stage (M2 stage) t(16,16) associated with best prognosis. Presence of "FAGGOT CELLS" is a characterstic feature of AML M3 (acute promyelocytic leukemia) Faggot cells are cluster of auer rods (shown in image below) All-trans retinoic acid (ATRA)- induce the neoplastic promyelocytes to differentiate into neutrophils rapidly. | Pathology | Acute Myelogenous Leukemia | Chromosomal translocation characteristic in acute promyelocytic leukemia is:
A. t ( 15; 17)
B. t ( 22; 9)
C. t ( 21; 17)
D. t ( 8; 21)
| t ( 15; 17) |
6bd41a77-1b70-4dd4-80b0-be366aded9c3 | Ans. C. SIADHHypervolemic hyponatremia -- Both sodium & water content increase: Increase in sodium content leads to hypervolemia and water content to hyponatremia. Total body water and sodium are regulated independently* Cirrhosis of the liver* Congestive heart failure* Nephrotic syndrome in the kidneys* Massive edema of any causeEuvolemic hyponatremia -- there is no volume expansion in the body, no edema, but hyponatremia occurs* States of severe pain or nausea* In the setting of trauma or other damage to the brain* SIADH (and its many causes)* Hypothyroidism* Glucocorticoid (steroid) deficiencyHypovolemic hyponatremia -- THE hypovolemia (extracellular volume loss) is due to total body sodium loss. The hyponatremia is caused by a relatively smaller loss in total body water.* Any cause of hypovolemia such as prolonged vomiting, decreased oral intake, severe diarrhea* Diuretic use (due to the diuretic causing a volume depleted state and thence ADH release, and not a direct result of diuretic-induced urine sodium loss)* Addison's disease and congenital adrenal hyperplasia in which the adrenal glands do not produce sufficient steroid hormones (combined glucocorticoid and mineralocorticoid deficiency) | Medicine | Endocrinology | Euvolemic hyponatremia is seen in:
A. Adrenocortical failure
B. Burns
C. SIADH
D. Cirrhosis
| SIADH |
d15f7cba-283c-4014-96b5-cdb6a4e53f55 | Timolol is a non selective Beta blocker and can precipitate acute attacks of asthma in a susceptible individual blockade of Beta 2 receptors. Betaxolol is a cardioselective Beta blocker and is less likely to cause this adverse side effect Refer kDT 6/e p 139 | Pharmacology | Autonomic nervous system | A patient came to casualty for acute bronchial asthma after treatment for glaucoma. The probable drug may be
A. Timolol
B. Betoxalol
C. Lantanoprost
D. Anticholinesterase
| Timolol |
6ee8cd57-fbd5-4120-b0af-9aa94fb4c832 | Ans. D. AcyclovirOseltamivir is neuraminidase inhibitor which can be given for both influenzas A and B. Amantadine is drug which inhibit the uncoating of influenza A virus RNA. Ribavirin has a broad spectrum antiviral activity which inhibit the synthesis of viral RNA. Acyclovir mainly inhibit the viral DNA and its drug of choice for herpes simplex infection. | Pharmacology | Anti Microbial | Which of the following drug is not used in influenza?
A. Oseltamivir
B. Amantadine
C. Ribavirin
D. Acyclovir
| Acyclovir |
4710e7fb-fd64-45f7-8812-cc7a3b5f16e4 | Indirect ophthalmoscopy can be used to examine the entire retina, even out to its extreme periphery, the ora serrata. This is possible for two reasons. Optical distoions caused by looking through the peripheral lens and cornea interfere very little with the indirect ophthalmoscopic examination compared with the direct ophthalmoscope. In addition, the adjunct technique of scleral depression can be used. Ref : Chang D.F. (2011). Chapter 2. Ophthalmologic Examination. In P. Riordan-Eva, E.T. Cunningham, Jr. (Eds), Vaughan & Asbury's General Ophthalmology, 18e. | Ophthalmology | null | Periphery of retina is best visualized with :
A. Direct ophthalmoscopy
B. Indirect ophthalmoscopy
C. Retinoscopy
D. USG
| Indirect ophthalmoscopy |
e0f9b9fd-db34-4c61-8f96-3714356d3158 | It is a Fibrous band arising from C7, which inserts on 1st thoracic rib. | Surgery | null | Cervical rib arises from:
A. C6
B. C7
C. C8
D. T
| C8 |
47af1ea4-82c5-46fa-bc25-7c3ce2f14af8 | Left-Right movement of skull occurs at Atlanto - axial joint.
Up - down movement of skull occurs at Atlanto - occipital joint. | Orthopaedics | null | Left-Right movement of skull occurs at
A. C2 - C3
B. Atlanto - occipital joint
C. Atlanto - axial joint
D. C4 - C5
| Atlanto - axial joint |
faf7f665-d0c5-48e9-a718-f4c1483e5d38 | B i.e. When the headache is followed by paial paralysis of 3rd nerve without any scotoma Ophthalmoplegic migrane is characterized by recurrent episodes of migraine like headache accompanied mostly by recurrent, ipsilateral and transient paresis of 3rd (most common), 6th (rare) and/ or 4th (rarest) cranial nervesQ. It is more common in childhood & typically stas before the age of 10 years. | Ophthalmology | null | Ophthalmoplegic migraine means
A. When headache is followed by complete paralysis of the IlIrd and VIth nerve on the same side as the hemicrania
B. When the headache is followed by paial paralysis of the IIIrd nerve on the same side as the hemicrania without any scotoma
C. Headache is associated with IIIrd, IVth and VIth nerve paralysis
D. Headache associated with optic neuritis
| When the headache is followed by paial paralysis of the IIIrd nerve on the same side as the hemicrania without any scotoma |
66511959-4ba2-4dfb-a253-822c7ce684d2 | Ans. a. Follicular carcinoma (Ref: Robbins 9/e p1097, 8/e p1123; Schwartz 9/e p1364, 1357; Sabiston 19/e p901-902; Bailey 26/e 765, 25/e p775)FBI AC cannot detect follicular carcinoma.'The hallmark of all follicular adenomas is the presence of an intact, well-formed capsule encircling the tumor. Careful evaluation of the integrity of the capsule is therefore critical in distinguishing follicular adenomas from follicular carcinomas, which demonstrate capsular and/or vascular invasion. This cannot be done by cytology of aspirate alone obtained by a fine needle. - Robbins 8/e p1123Limitations of FNAC in Thyroid DiseasesNot able to distinguish follicular adenoma from follicular carcinomaQNot able to distinguish Hurthle cell adenoma from Hurthle cell carcinomaQUseless in Reidel's thyroiditisQ (Biopsy is preferred)QFNAC is less reliable in patients who have history of head and neck irradiation or family history of thyroid cancer due to higher likelihood of multifocal lesions and occult cancerQFollicular carcinoma of ThyroidFTC account for 10% of thyroid cancersOccurs more commonly in iodine-deficient areasQ.More common in women with mean age of 50 yearsGenes implicated in FCT: p53Q, PTENQ, RasQ , PAX8/PPAR1Pathology:Usually solitary lesion surrounded by capsuleQ.Histologically, follicles are present, but the lumen may be devoid of colloidQ.Malignancy is defined by the presence of capsular and vascular invasionQ.Tumor infiltration and invasion, as well as tumor thrombus within the middle thyroid or jugular veins, may be apparent at operation.Clinical Features:Usually present as solitary thyroid nodules, occasionally with a history of rapid size increase, and long-standing goiterQ.Pain is uncommon, unless hemorrhage into the nodule has occurred.Cervical lymphadenopathy is uncommon at initial presentation (about 5%)Preoperative clinical diagnosis of cancer is difficult unless distant metastases are present.Large follicular tumors (> 4 cm) in older men are more likely to be malignantQ.MC site of metastasis is bone (Osteolytic metastasis with pulsating secondaries in flat bones)QDiagnosis:FNAC is unable to distinguish benign follicular lesions from follicular carcinomasQ.Intraoperative frozen-section examination usually is not helpful, but should be performed when there is evidence of capsular or vascular invasion, or when adjacent lymphadenopathy is present.Treatment:Follicular lesion: HemithyroidectomyQ (80% of these patients will have benign adenomas)Thyroid cancer: Total thyroidectomyQTotal thyroidectomy in older patients with follicular lesions > 4 cm because of the higher risk of cancer in this setting (50%)Q.Prophylactic nodal dissection is unwarrantedQ because nodal involvement is infrequentPrognosis:The cumulative mortality: 15% at 10 years and 30% at 20 years.Most important prognostic factor: Age and distant metastasis.Poor long-term prognosis* Age >50 yearsQ* Tumor size > 4 cmQ * Higher tumor gradeQ* Marked vascular invasionQ* Extrathyroidal invasionQ* Distant metastasesQ | Surgery | Thyroid Malignancies | FNAC cannot detect which of the following?
A. Follicular carcinoma
B. Papillary carcinoma
C. Colloid goiter
D. Hashimoto's thyroiditis
| Follicular carcinoma |
b006bb32-d600-4a03-86ec-474c2f4123e4 | Ablation bypass tract offers a permanent cure of supraventricular tachycardias. The advantage of radio-frequency catheter ablation has viually eliminated the need for surgery Ref Harrison 20th edition pg 1567 | Anatomy | General anatomy | Radio-frequency ablation is done for
A. Ventricular tachycardia
B. PSVT
C. WPW
D. Atrial tachycardia
| WPW |
afbb9828-ce13-467a-bdd6-768d5b4d8691 | Undoing is a neurotic defense mechanism where an act is done to nullify a previous act. | Psychiatry | null | A person brings gifts for her wife next day after having fight with her. This is an example of
A. Reaction formation
B. Aim inhibition
C. Undoing
D. Suppression
| Undoing |
ba1e4de0-be97-4807-8760-753e3b0ca5f2 | *Lisch nodules are the most common type of ocular involvement in NF-1. These nodules are melanocytic hamaomas, usually clear yellow to brown that appear as well- defined, dome-shaped elevations projecting from the surface of the iris. Ref: Harrison 18th/e p.2964 | Ophthalmology | Miscellaneous | Lisch nodule seen in-
A. Sympathetic ophthalmitis
B. Neurofibromatosis
C. Chronic iridocyclitis
D. Trachoma
| Neurofibromatosis |
91b75df8-05c3-454a-9d60-6e892fc3f88d | Presence of thyroid nodule along with palpable cervical lymph nodes and amyloid histologically is clearly indicative of Medullary Carcinoma Thyroid, as explained before. Ref : Bailey 25/e p797 | Anatomy | Endocrinology and breast | Needle biopsy of solitary thyroid nodule in a young woman with palpable cervical lymph nodes on the same sides demonstrates amyloid in the stroma of lesion. Likely diagnosis is
A. Medullary carcinoma thyroid
B. Follicular carcinoma thyroid
C. Thyroid adenoma
D. Multinodular goitre
| Medullary carcinoma thyroid |
b1375587-d8f5-45c4-9846-c5aeefd46ab7 | Ans, is 'b' i.e., 3 year AgeMilestone2 MonthSocial smile3 MonthRecognise mother6 MonthStmger anxiety9 Monthwave bye - bye12 MonthComes when called15 MonthJargon18 MonthsCopies parents task2 yearAsk for food, drink, shows toys3 yearKnow full name & gender4 yearPlays in group.5 yearHelps in household task, decrease & undresses | Pediatrics | Developmental-Behavioral Screening and Surveillance | Child knows his/her sex by age of-
A. 2 year
B. 3 year
C. 4 year
D. 5 year
| 3 year |
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