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326e84ff-b473-43ec-9f8d-3287a680c416 | Ans. is 'a' i.e., IgM * Ig M is a pentameric immunoglobulin with five, four - peptide subunits.* The subunits are joined together by J chain.Remember* J chain is found in IgA and IgM.Also know* I think the following information requires some specific mention here-# There may be confusion about the status of momomer and dimer when applied to antibody as each molecule of an antibody is a dimer of two identical heavy and light chains.# But, the terms monomer , dimer or pentamer are used in context to how many molecules of same class of antibody are bound together-i) IgG is not found to bound to other IgG - Monomerii) IgA is bound to another IgA - Dimeriii) IgM binds four other IgM - Pentamer | Microbiology | Immunology | Which of following antibody is pentameric -
A. IgM
B. IgG
C. IgA
D. IgD
| IgM |
d33d9183-5145-44a5-8bb8-908ea1944448 | Severe vitamin C deficiency causes scurvy. The usual age of onset is 6 to 18 months. Pseudoparalysis is commonly seen. Hemorrhages occur under the periosteum of long bones. Gum bleeds are common. Costochondral junctions become prominent and appears sharp and angular. Scorbutic rosary is attributed to the separation of epiphysis of ribs and backward displacement of sternum. Diagnosis is based on radiological features. Bone assumes a ground glass appearance with a pencil thin coex. Metaphyses demonstrates a zone of well calcified cailage referred to as white line of frenkel. Pelkan's spur is one of the radiological lines seen in scurvy. It is a bone spur from the lateral border of metaphysis. Epiphyseal centers of ossification are surrounded by a white ring called Weinberger's sign. Ref: Textbook of Ohopedics, 4th Edition By John Ebnezar, Page 539; O.P.Ghai, 6th Ed, Page 127. | Pediatrics | null | Pelkan's spur is seen in?
A. Rickets
B. Hypopituitarism
C. Scurvy
D. Hypothyroidism
| Scurvy |
084aa1d7-88f7-4945-b1f9-0f97f065f484 | Contents of axillaAxillary aery and its branchesAxillary vein and its tributariesInfraclavicular pa of brachial plexusFive groups of axillary lymph nodes and the associated lymphaticsThe long thoracic and intercostobrachial nerveAxillary fat and areolar tissue in which the other contents are embeddedLymph nodes of axilla are very impoant from pathological point of view because breast cancer in female spread to these lymph nodes readily. | Anatomy | null | Which of the following is NOT a content of the axilla:
A. Axillary vessels
B. Axillary tail of the breast
C. Roots of brachial plexus
D. Intercostobrachial nerve
| Roots of brachial plexus |
76d21c33-d9d2-4d54-9cd7-05f02415217a | Ans. is 'c' i.e., Cyst over the popliteal fossa Baker's Cvsto A Baker's cyst, also known as a popliteal cyst, is a benign swelling of the semimembranosus or more rarely some othersynovial bursa found behind the knee joint.o Diagnosis is by examination. A Baker's cyst is easier to see from behind with the patient standing with knees fully extended. It is most easily palpated (felt) with the knee partially flexed. Diagnosis is confirmed by ultrasonography, although if needed and there is no suspicion of a popliteal artery aneurysm then aspiration of synovial fluid from the cyst may be undertaken with care. An MRI image can reveal presence of a Baker's cysto Baker's cysts usually require no treatment unless they are symptomatico Surgical excision is reserved for cysts that cause a great amount of discomfort to the patient. | Surgery | Orthopedics | What is a Baker's Cyst -
A. Gluteal Abscess
B. Cyst on the posterior aspect of the thigh
C. Cyst over the popliteal fossa
D. Swelling of the bursa of semiteninosus and gracilis
| Cyst over the popliteal fossa |
4316633d-d026-4881-a698-fa68a4dbafae | The orbicularis oris muscle encircles the opening of the mouth and helps to bring the lips together to keep the mouth closed. Pursing of mouth is due to orbicularis oris inseed into lips and angle of mouth supplied by VII nerve.The muscles of facial expression are innervated by branches of the facial nerve (VII). After emerging from the stylomastoid foramen, the facial nerve lies within the substance of the parotid gland. Here, it gives off its five terminal branches: (1) The temporal branch courses up to the scalp to innervate the occipito frontalis and orbicularis oculi muscles. (2) The zygomatic branch courses across the cheek to innervate the orbicularis oculi muscle. (3) The buccal branch travels with the parotid duct and innervates the buccinator and orbicularis oris muscles, and also muscles that act on the nose and upper lip. (4) The mandibular branch innervates the orbicularis oris muscle and other muscles that act on the lower lip. (5) The cervical branch courses down to the neck and innervates the platysma muscle. Ref: Dhillon N. (2012). Chapter 1. Anatomy. In A.K. Lalwani (Ed), CURRENT Diagnosis & Treatment in Otolaryngology--Head & Neck Surgery, 3e. | Anatomy | null | Inability to suck on a straw may indicate lesion of which nerve?
A. II
B. V
C. VII
D. IX
| VII |
bedb4726-66bf-4dae-9d3b-3f4a94478520 | Durkheim's theory: first major contribution to the study of social and cultural influences on suicide was made by french sociologist Emile Durkheim. He divided suicides into three social categories- Egoistic, Altruistic amd Anomic. Ref: Synopsis of Psychiatry, 11e, pg 766. | Psychiatry | Cognitive development and defence mechanism | Emile Durkheim is linked with work on which condition is psychiatry
A. Suicide
B. Obsessive compulsive disorder
C. Anxiety disorder
D. Schizophrenia
| Suicide |
c4e4de70-9ced-4d80-80a8-4dd08b58b375 | Histological alterations characterizing blood vessels in malignant hypeension. ? Hyperplastic aeriosclerosis Fibrinoid necrosis of aerioles: Onion-skinning (concentrically arranged smooth muscle with collagen). | Pathology | Basic Concepts | In a specimen of kidney, fibrinoid necrosis is seen and onion peel appearance is also present. Most probable pathology is:
A. Hyaline degeneration
B. Hyperplastic aeriosclerosis
C. Glomerulosclerosis
D. Fibrillary glomerulonephritis
| Hyperplastic aeriosclerosis |
308b8f00-75b5-491b-9a84-ed68ece4dc46 | The sinoatrial (SA) node normally displays the highest intrinsic rate. All other pacemakers are referred to as subsidiary or latent pacemakers because they take over the function of initiating excitation of the hea only when the SA node is unable to generate impulses or when these impulses fail to propagate. There is a hierarchy of intrinsic rates of subsidiary pacemakers that have normal automaticity: atrial pacemakers have faster intrinsic rates than AV junctional pacemakers, and AV junctional pacemakers have faster rates than ventricular pacemakers. Ref: Chen P., Antzelevitch C. (2011). Chapter 38. Mechanisms of Cardiac Arrhythmias and Conduction Disturbances. In V. Fuster, R.A. Walsh, R.A. Harrington (Eds), Hurst's The Hea, 13e. | Physiology | null | SA node acts as a pacemaker of the hea because of the fact that it:
A. Is capable in generating impulses spontaneously
B. Has rich sympathetic innervations
C. Has poor cholinergic innervations
D. Generates impulses at the highest rate
| Generates impulses at the highest rate |
181d5cc0-a2b7-4302-a539-a966c913bee7 | Hepatitis A → Picorna Viridae (Single Stranded RNA)
Hepatitis B → Hepadna Viridae (Double stranded circular DNA)*
Hepatitic C → Flavivirus (single stranded RNA)
Hepatitis D → Incomplete RNA virus (causes infection only in presence of Hepatitis B virus)
Hepatitis E → Calcivirus (Single stranded RNA | Microbiology | null | Which of the following is Calcivirus-
A. Hepatitis E
B. Hepatitis B
C. Hepatitis C
D. Hepatitis A
| Hepatitis E |
c7fa5b72-9f2e-4eaa-a848-8063beac2f7f | Seminoma, the most common GCT in adults, does not occur before 5 years of age. seminoma is considered a postpubeal tumor. | Pathology | Pediatrics, environment and nutrition | Not seen in children is
A. Neuroblastoma
B. Retinoblastoma
C. Hepatoblastoma
D. Seminoma
| Seminoma |
a88e7708-0106-45eb-a8aa-0189856b0793 | Temozolomide is an alkylating agent that can be given orally. | Pharmacology | null | Which group of anticancer drugs temozolomide belong to :
A. Oral alkylating agent
B. Antitumor Antibiotic
C. Antimetabolite
D. Mitotic Spindle Inhibitor
| Oral alkylating agent |
7a031a5a-48f3-4cdd-854b-3aca92473144 | Traumatic paraplegia is caused by a lesion of the spinal cord which occurs after a trauma, e.g. veebral fracture causing a puncture to the spinal cord. Any injury of the spinal cord may result in a condition known as autonomic dysreflexia (AD).. Autonomic dysreflexia can cause systolic blood pressure readings to increase by 20-40 mmHg. , this condition couples dangerously high blood pressure with decreased hea rates.nefidipine can be used for high blood preassures Ref Harrison20th edition pg 2378 | Medicine | C.N.S | A patient with traumatic paraplegia due to injury of the thoracic cord of 'T3 level' is observed to have blood pressure f 210/120. What should be the initial management?
A. Subcutaneous LMWH
B. Steroids
C. Nifedipine
D. Normal saline / Dextrose
| Nifedipine |
cf5faa3c-4e8b-4cbd-a52b-0d5aeed4fd62 | Histologically, with the usual hematoxylin and eosin stain, calcium salts have a basophilic, amorphous granular, sometimes clumped appearance. They can be intracellular, extracellular, or in both locations. In the course of time, heterotopic bone may be formed in the focus of calcification. On occasion single necrotic cells may constitute seed crystals that become encrusted by the mineral deposits. The progressive acquisition of outer layers may create lamellated configurations, called psammoma bodies because of their resemblance to grains of sand. Some types of papillary cancers (e.g., thyroid) are apt to develop psammoma bodies. Ref: Robbins, 8th edition, Chapter 1. | Pathology | null | Psammoma bodies are found in which of the following organs?
A. Stomach
B. Hea
C. Lungs
D. Thyroid
| Thyroid |
dc5090a9-0718-41b0-b0af-d1cb3fb44f75 | Ans. is 'a' i.e.. Increase blood volume Preload (Degree of ventricular filling during diastole)o Cardiac preload is represented by volume of venous blood that distends the ventricle, i.e., venous return determines the preload. An increase in preload, i.e., increase in venous return results in a higher end-diastolic volumeQ (PreloadQ).o This results in stretching of myocardial fiber and this increase in length of myofibril increases the strength of cardiac contraction in accordance with the Frank-Starling law or Starling's law of the hearto According to Starling's lawr, greater the initial length of muscle fiber, greater is the force of contraction,o The initial length of muscle fiber (length of fiber at the initiation of contraction/systole) refers to length of the fiber at the end of the diastole, i.e., end-diastolic fiber length.o Thus, the factors which improve venous return increase the cardiac output by increasing end-diastolic ventricular volume and length, i.e.. preload,o Opposite is true for factors which decrease venous return.| Stroke volume| Stroke volumeFactors Increasing end-diastolic ventricular muscle fiber length (Factors increasing venous return or preload)Factors decreasing end-diastolic ventricular muscle fiber length (Factors decreasing venous return or preload)o Increased total blood volumeQo Decreased total blood volumeo Increased venous toneQo Decreased venous toneo Increased pumping action of skeletal muscleo Decreased pumping action of skeletal muscleso Increased negative intrathoracic pressureQ (e.g. inspiration)o Less negative or positive intrathoracic pressure (expiration)o Sitting or standingQ (venous pooling of blood)o Lying down from sitting or standing position o Sympathatic discharge causing decrease in venous capacitance by decreasing venous compliance | Physiology | Circulation: Cardiac Output, Venous Return | Preload is increased by -
A. Increased blood volume
B. Increased total peripheral resistance
C. Standing
D. Sitting
| Increased blood volume |
3d537990-81ce-473b-9a8d-f5098b32131c | Ans. is 'a' i.e., Atopic dermatitis Hanifin and Rajka criteria is for diagnosis of atopic dermatitis. Diagnostic criteria (Hanifin and Rajka) Based mainly on clinical experience Major criteria Family history of atopy Chronicity Pruritus Typical morphology and distribution Minor criteria Dry skin Chelitis Elevated edge Dennie's line/dennie morgan fold (infra orbital fold) White dermographism Peripheral eosinophillia Immediate (type i) hypersensivity Facial pallor, orbital darkening Food intolerance Conjunctivitis (recurrent), keratoconus, cataract Pityriasis alba Hand dermatitis Recurrent infections At least 3 major or 2 major plus 2 minor criteria are necessary for diagnosis | Skin | null | Hanifin & Rajke is the diagnostic criteria for
A. Atopic dermatitis
B. Contact dermatitis
C. Uicaria
D. Erythroderma
| Atopic dermatitis |
6350ebdb-0759-4056-bce0-bd35dc9f5943 | The revolver, which tends to have a low muzzle velocity of 150 m/s, is a sho barreled weapon with its ammunition held in a metal drum, which rotates each time the trigger is released.The muzzle velocity of pistols varies between 300 and 360 m/s.The rifle is a long-barreled shoulder weapon capable of firing bullets with velocities up to 1500 m/s. | Microbiology | All India exam | The muzzle velocity of given firearm is
A. 150 m/s
B. 300 m/s
C. 360 m/s
D. 1500 m/s
| 150 m/s |
4407a8cd-6210-4bb0-a016-085ab9eeb310 | Ans. is 'a' i.e., Minimum alveolar concentration Minimal alveolar concentration (MAC)* Most important measure of potency is minimal alveolar concentration (MAC). MAC is the lowest concentration of the anesthetic in pulmonary alveoli needed to produce immobility in response to a painful stimulus (surgical incision) in 50% individuals. Higher the MAC, less potent the anesthetic agent.* Methoxyflurane has minimum MAC (0.16%) - The most potent inhalational agent.* N2O has maximum MAC (105) - The least potent inhalational agent.* Order of potency in decreasing order (MAC in increasing order): -* Methoxyflurane (MAC = 0.16 %) > Trilene (MAC = 0.2%) > Halothane (MAC = 0.74%) > Chloroform (MAC = 0.8 %) > Isoflurane (MAC = 1.15 %) > Enflurane (MAC = 1.68%) > Ether (MAC = 1.92 %) > Sevoflurane (MAC = 2.0 %)> Desflurane (MAC = 6.0%) > Cyclopropane (MAC = 9.2%) > N20 (MAC 104%).Factor affecting MAC1. Age: - Young age increases and old age decreases MAC.2. Alcohol: - Chronic intoxication increases and acute intoxication decreases MAC.3. Temperature: - Both hypothermia and hyperthermia decrease MAC.4. Electrolyte: - Hypercalcemia, Hypermagnesemia & Hyponatremia decrease. Whereas hypernatremia increases MAC.5. Anemia : - Decrease MAC6. Hypoxia (pO2 < 40), and hypercarbia (pCO2 > 95) decrease MAC.7. Pregnancy: - Decreases MAC8. Drugs: -A. Decreasing MAC - Local anaesthetics (except cocaine) Opioids, Ketamine, Barbiturates, Benzodiazepines, Verapamil, Lithium, Sympatholytics (Methyldopa, reserpine, Clonidine, Dexmedetomidine), Chronic amphetamine use.B. Increasing MAC: - Acute amphetamine intake, Cocaine, ephedrine. | Anaesthesia | Fundamental Concepts | MAC stands for?
A. Minimum alveolar concentration
B. Minimal analgesic concentration
C. Minimal anesthetic concentration
D. Maximum alveolar concentration
| Minimum alveolar concentration |
ccb4670b-95d4-4b9c-879e-bd30a72c7e4f | Ans. is tb' i.e., Botulism Remember these important points about Botulismo Acute onset of weakness in muscles innervated by cranial nerve with prominent bulbar palsy (4D's) i.e. -# Diplopia# Dysphonia# Dysphagia# Dysarthriao Descending symmetrical weakness occurs often leading to weakness,o Sensory' abnormalities are absent because only motor and autonomic nerves affected.o Mental function not affected o Afebrileo Absent pupillaty reflexes | Medicine | Toxicology | Acute onset of blurred vision and absent pupillary response with rapidly progressive descending muscular weakness manifesting as quadriparesis in an afebrile 20 year old male with preserved sensorium is -
A. Porphyria
B. Botulism
C. Polio
D. Diphtheria
| Botulism |
eb92f25f-29ec-4931-b26b-e76816b33c70 | Cod liver oil But overall Richest source is Halibut liver oil Ref: Park 25th edition Pgno : 653 | Social & Preventive Medicine | Nutrition and health | Vitamin D is maximum in -
A. Milk
B. Fish fat
C. Eggs
D. Cod liver oil
| Cod liver oil |
075c6aab-1ef0-43c9-926f-7770b3ed4507 | Shock index = heartrate/systolic BP
Normal = 0.5–0.7
If it becomes 0.9–1.1 it indicates massive blood loss and need for intensive resuscitation. | Gynaecology & Obstetrics | null | A female presents with significant blood loss due to post-partum haemorrhage (PPH). What would be the shock index (HR/systolic BP)?
A. 0.3-0.5
B. 0.5-0.7
C. 0.7-0.9
D. 0.9-1.1
| 0.9-1.1 |
6a772c13-d3fa-4854-a2a2-b7aa1bc1f431 | * Phrenic nerve (C3,C4,C5)- It descends in front of scalenus anterior muscle . * Descends down to enters thorax where it lies between subclan vein(in front) and subclan aery lies behind it . * Fuher it descends in front of hilum of the lungs (whereas vagus nerve descends behind the hilum of lungs) * It is mixed nerve sensory and motor.(both motor and sensory to diaphragm) | Anatomy | Bronchopulmonary Segments, Embryonic veins | what is the root value of phrenic nerve?
A. C3,4,5
B. C2,3,4
C. C4,5,6
D. C5,6,7
| C3,4,5 |
3a2f6c05-c606-48c0-9e66-cef8629b45a7 | Ref: Rook's Textbook of DermatologyExplanation:Guttate psoriasis (Eruptive psoriasis)Presents as shower of small psoriatic lesions, appearing more or less generally over the body, particularly in children and young adults, after acute streptococcal infections.Guttate psoriasis is classically triggered by a bacterial infection, usually an upper respiratory tract infection.Guttate psoriasis will most resolve, but may turn chronic remitting and relapsing psoriasis vulgaris.Because of a streptococcal etiology, antibiotic therapy is warranted. | Skin | Psoriasis | Antibiotics are indicated in which type of psoriasis?
A. Guttate
B. Pustular
C. Chronic plaque psoriasis
D. Erythrodermic psoriasis.
| Guttate |
ae1fabce-4c79-470a-adac-4250080d5761 | Ans-BTzank smearo It is done for vesiculobullous disorders.o A small, early, uninfected lesion should ideally be selected. The roof of the blister is removed with scissors, and the base of the blister gently scraped with a blunt scalpel so as not to produce bleeding. The material obtained is spread thinly on a glass slide.o It shows acantholytic cells (rounded cells with a relatively large nucleus and a condensed cytoplasm) e g: pemphigus gp of disorders.o Multinucleated giant cells nad ballooning degeneration is a characteristic of herpes simplest, herpes zoster and varicella infection. | Unknown | null | A patient has Bullous Lesion; on Tzank smear -
A. Langerhans ceils are seen
B. Acantholysis
C. Leucocytosis
D. The absence of melanin pigment
| Acantholysis |
d6c0c080-55a0-49db-bfcb-acc26dfa26f8 | Vitamin C plays the role of a coenzyme in hydroxylation of proline and lysine while protocollagen is converted to collagen (i.e. post-translational modification). The hydroxylation reaction is catalysed by lysyl hydroxylase (for lysine) and prolyl hydroxylase (for proline). | Biochemistry | null | Which of the following enzymes require Vitamin C for their activity?
A. Procollagen proline hydroxylase
B. Procollagen amino peptidase
C. Procollagen carboxyl peptidase
D. Lysyl oxidase
| Procollagen proline hydroxylase |
ef888510-5f56-4297-8a12-28f3fc3b0371 | In Asthma FEV1(forced expiratory volume in 1 second), FVC(forced vital capacity, is the total volume exhaled), FEV1/FVC decreases. To daignose Asthma: Compatible clinical history plus either : 1)FEV1>12% increase following administration of a bronchodilator or glucocoicoids. 2)FEV1>15% decrease after 6min of exercise 3)>20% diurnal variation on >3days in a weeks on PEF(peak expiratory volume). Reference : Davison, 23rd Edition, page no : 569,555 | Medicine | Respiratory system | Reduced FEV 1, Normal FVC and FEV 1/FVC ratio less than 0.7 .which is reversible with bronchodilator s is consistent with
A. Bronchial Asthma
B. Hypersensitivity penumonitis
C. Sarcoidosis
D. Polyaeritis nodosa
| Bronchial Asthma |
1c6a56ac-46fd-451b-ac07-7a3364abb2e8 | Endometrial biopsy is best done on 21st - 23rd day of the cycle. Evidences of secretory activity of the endometrial glands in the second half of the cycle give not only the diagnosis of ovulation but can predict the functional integrity of the corpus luteum. Luteal Phase Defect- Lag of 2 to 4 days in observed/expected secretory changes. Recognized as cause of infeility. | Gynaecology & Obstetrics | Normal Menstruation, Abnormal Menstruation, Menopausal Physiology and forsight of conception | A patient married for 3 years, unable to conceive, has regular menstrual cyclesHusbands semen analysis is normal and so is his hormonal profile What is the right time in menstrual cycle to do endometrial biopsy for infeility:-
A. 12-14 days
B. 17-19 days
C. 20-22 days
D. 3-5 days
| 20-22 days |
786921b8-a941-4eb0-8c38-ebbf097c2bf9 | Patients with RPGN presents with features of glomerulonephritis such as hematuria, edema and hypeension in association with a rapidly progressive loss of renal function. When untreated these patients rapidly develop end stage renal disease and death can occur within weeks to months. Reference: Robbins Pathologic Basis of Disease, 6th Edition, Page 951 | Medicine | null | Which of the following is not a feature of RPGN?
A. Oliguria
B. Edema
C. Hypeension
D. Rapid recovery
| Rapid recovery |
28e8ae2f-b81b-4c7f-a9d8-f65ad9df49b8 | Community Health Centre (CHC)
Secondary level of health care.
Located for population of 1,20,000 in plains.
Located for population of 80,000 in hilly areas.
Staff at CHC : 46-52
Acts as referral unit for 4 PHCS.
Bed strength : 30 | Social & Preventive Medicine | null | Bed strength at CHC:
A. 6-Apr
B. 10
C. 30
D. 50
| 30 |
51af9d9e-1ad2-442b-9aa6-0b88d289a079 | Ans. is 'a' i.e., CYP3A4/5 Cyp 3 A 4/5 carryout biotransformation of largest number (nearly 50%) of drugs. | Pharmacology | null | Most common cytochrome associated with metabolism of drugs is ?
A. CYP3A4/5
B. CYP2D6
C. CYP2C8/9
D. CYP2Cl.9
| CYP3A4/5 |
1d20c2ee-2f93-4cf3-9ebb-3c5d8117abf6 | Mandibular 1st premolar resembles canine from buccal aspect and it has almost rudimentary lingual cusp which further makes it canine alike. | Dental | null | Which premolar resembles a canine
A. Maxillary 1st premolar
B. Mandibular 1st premolar
C. Maxillary 2nd premolar
D. Mandibular 2nd premolar
| Mandibular 1st premolar |
76bd3887-86fe-4529-a5e7-0c178a1d4ab8 | Ans. c (Cullen's sign) (Ref. Bailey and Love 26th/pg. 1203; box 71.4)Signs to elicit in appendicitisClinical signs of Acute Pancreatitis# Pointing sign# Cullen's sign# Rovsing's sign# Grey Turner's sign# Psoas sign# Fox sign# Obturator sign ACUTE APPENDICITIS# Acute appendicitis is relatively rare in infants, and becomes increasingly common in childhood and early adult life, reaching a peak incidence in the teens and early 20s.# The incidence of appendicitis is equal amongst males and females before puberty. In teenagers and young adults the male: female ratio increases to 3:2 at the age of 25 years; thereafter the greater incidence in males declines.# Aetiology- Some form of luminal obstruction by either a faecolith or stricture is found in the majority of cases.- The incidental finding of a faecolith is a relative indication for prophylactic appendicectomy.- Intestinal parasites, particularly Oxyuris vermicularis (syn. pinworm), can proliferate in the appendix and occlude the lumen.Clinical signs --Clinical examination{best for diagnosis)The diagnosis of appendicitis rests more on thorough clinical examination of the abdomen than on any aspect of the history or laboratory investigation.Cardinal features# unwell patient with low grade pyrexia, localised tenderness, guarding and rebound tenderness.The pointing sign# The patient is then asked to point to where the pain began and to where it moved.McBurney's tenderness# Muscle guarding over the point of maximum tenderness, classically McBurney point.Rebound tenderness# Palpation in LTF causes pain in RIFRovsing's sign# Deep palpation of the left iliac fossa may cause pain in the right iliac fossa.Psoas sign# Occasionally an inflamed appendix lies on the psoas muscle and the patient, often a young adult, will lie with the right hip flexed for pain relief.Obturator test(Zachary Cope)# Spasm of the obturator internus is sometimes demonstrable when hip is flexed and internally rotated. If inflamed appendix is in contact with obturator internus, this maneuvre will cause pain in hypogastrium.Cutaneous hyperaesthesia# Cutaneous hyperesthesia may be demo in the right iliac fossa, but is rarely of diagnostic value.Special features. according to ageInfants# Appendicitis is relatively rare in infants under 36 months of age.# diagnosis is often delayed and thus the incidence of perforation and post-op morbidity is considerably higher.# Diffuse peritonitis can develop rapidly due to the underdeveloped greater omentum.Children# It is rare to find a child with appendicitis who has not vomited.# Children with appendicitis usually have complete aversion to food.# In addition, they do not sleep and bowel sounds are completely absent in early stages.The elderly# Gangrene and perforation occur much more frequently in elderly patients.# Elderly patients with lax abdominal walls or obesity may harbour a gangrenous appendix with little evidence of it, and the clinical picture may simulate subacute intestinal obstruction.# These features with coincident medical conditions produce a much higher mortality for acute appendicitis in elderly.The obese# Obesity can obscure and diminish all the local signs of acute appendicitis.# Delay in diagnosis coupled with the technical difficulty of operating in the obese make it wiser to consider operating through a midline abdominal incision.Pregnancy# Appendicitis is the most common extrauterine acute abdominal condition in pregnancv with a frequency of from one in 1500 to one in 2000 pregnancies.# As pregnancy develops during the second and third trimesters, the caecum and appendix are progressively pushed to the right upper quadrant of the abdomen.# Foetal loss occurs in 3-5% of cases, increasing to 20% if perforation is found at operation. | Surgery | Vermiform Appendix | Which of the following clinical signs is not associated with acute appendicitis?
A. Pointing sign
B. Rovsing's sign
C. Cullen's sign
D. Obturator sign
| Cullen's sign |
3cc9c16b-2271-40ba-828c-d7b8de54f1cc | Rapid fluid administration is often the key to successful trauma resuscitation. Some of the important factors affecting the rate of fluid resuscitation include the diameter of the intravenous tubing, the size and length of the venous cannulae, the fluid viscosity, and the site of administration. According to Poiseuille's law, flow is proportional to the fourth power of the radius of a catheter and inversely proportional to its length. Therefore, the shorter a catheter and the larger its diameter, the faster one can infuse a solution through it. Central venous placement alone does not assure rapid flow. Importantly, the diameter of the intravenous tubing employed may be the rate-determining factor in fluid delivery: blood-infusion tubing allows twice the flow of standard intravenous tubing and should be used when rapid fluid resuscitation is needed. Any patient who is suspected of having a major abdominal injury should immediately have at least two short, large-bore (16-gauge or larger) intravenous cannulae placed in peripheral veins. Longer, smaller catheters, such as standard 18-gauge central venous catheters, may take more time to place and will have lower flow rates. Once fluid resuscitation is under way, one may elect to place an 8- or 9-French pulmonary artery catheter-introducer via a central venous approach for further volume administration, as well as for measurement of central venous pressure or for Swan-Ganz catheter insertion. Lower-extremity venous cannulae, placed by saphenous vein cutdown or percutaneously into the femoral veins, are no longer advised as primary access for patients with abdominal trauma, since possible disruption of iliac veins or the inferior vena cava will render volume infusion ineffective. Studies have demonstrated that the flow rate of cold whole blood is roughly two-thirds that of whole blood at room temperature. Diluting and warming the blood by "piggybacking" it into infusion lines that are delivering crystalloid will decrease the blood's viscosity, enhance flow, and minimize hypothermia. | Surgery | Trauma | Rapid fluid resuscitation of the hypovolemic patient after abdominal trauma is significantly enhanced by which of the following?
A. Placement of long 18-gauge subclavian vein catheters
B. Placement of percutaneous femoral vein catheters
C. Bilateral saphenous vein cutdowns
D. Placement of short, large-bore percutaneous peripheral intravenous catheters
| Placement of short, large-bore percutaneous peripheral intravenous catheters |
7b63f051-afa8-45e9-9e56-f0c1b56dac9e | A i.e. Borderline Personality DisorderSchizophrenia can easily be ruled out by absence of disorganized speech, disorganized behaviour (or catatonia), delusions, hallucinations, & negative symptoms (ex blunt affect) for more than 6 months & leading to social / occupational dysfunction. | Psychiatry | null | A 16 year old girl was brought to the psychiatric emergency after she slashed her wrist in an attempt to commit suicide. On enquiry her father revealed that she had made several such attempts of wrist slashing in the past, mostly in response to tril fights in her house. Fuher she had marked fluctuations in her mood with a pervasive pattern of unable interpersonal relationship. The most probable diagnosis is:
A. Borderline personality disorder
B. Major depression
C. Histrionic personality disorder
D. Adjustment disorder
| Borderline personality disorder |
6a1ea4bf-28e4-41b6-8a95-8e1ea2b97c68 | 8th AJCC(2017) TNM Classification of Pancreatic cancer Tis Carcinoma in situ T1 Tumor limited to pancreas upto 2 cm in greatest dimension T1a : Tumor <= 0.5 cm in greatest dimension T1B: Tumor > 0.5 cm but <= 1 cm in greatest dimension T1c : Tumor > 1 cm but <= 2 cm in greatest dimension T2 Tumor limited to pancreas > 2-4 cm in greatest dimension T3 Tumor > 4 cm in greatest dimension T4 Tumor involves Coeliac axis, superior mesenteric aery and / or common hepatic aery N1 Metastasis in 1-2 regional LN N2 Metatasis in 4 or more regional LN M1 Distant metatasis Stage 0 Stage IA Stage IB Stage IIA Stage IIB Stage III Stage IV Tis N0 M0 T1 N0 M0 T2 N0 M0 T1-T3 N1 Mo T1-T3 N2 M0T4 AnyN M0 T1-T3 N2 M0T4 Any N M0 Any T AnyN M1 Involvement of veins does not change the staging. Size of 2cm pancreatic cancer is under T1 according to TNM staging. | Surgery | Pancreas | According to AJCC 8th edition, staging of 2 cm size pancreatic cancer if it involves poal vein in:
A. T1
B. T2
C. T3
D. T4
| T1 |
571af714-578c-4f10-bfc8-a058f7fbed88 | All the ocular manifestations of Vitamin - A deficiency are collectively known as 'Xerophthalmia' (Dry Eye). - Xerophthalmia is most common in children aged 1-3 years. 'First clinical sign' of Vitamin - A deficiency: Conjunctival xerosis . 'First clinical symptom' of Vitamin - A deficiency: Night blindness. Conjunctival xerosis in Xerophtalmia - characteristic appearance of emerging like sand banks at receding tide. 'Bitot's Spots' are triangular, pearly-white or yellowish, foamy spots on bulbar conjunctiva, on either side of cornea ( temporal > nasal). | Social & Preventive Medicine | Vitamins and Nutritional Deficiencies | First clinical sign of Vitamin - A deficiency is:
A. Night blindness
B. Conjunctival xerosis
C. Bitot's spots
D. Keratomalacia
| Conjunctival xerosis |
e947a1fe-dc52-4f2e-bcc9-cdd095f7b6a4 | Ans. is 'b' i.e., Leukocyte adhesion deficiency | Surgery | null | Most common cause of umbilicus does not separate at age of 2 years
A. Raspbery tumour
B. Leukocyte adhesion deficiency
C. Patent urachus
D. Umblical granuloma
| Leukocyte adhesion deficiency |
91d11336-a972-45f0-8480-9dadf9f6d95c | Tumour necrosis factor, interferon, prostaglandins are mediators of inflammation. The protein MPO is a marker of azurophil granules. MPO reacts with H2O2, formed by the NADPH oxidase, and increases the toxic potential of this oxidant. Through oxidation of chloride, tyrosine, and nitrite, the H2O2-MPO system induces formation of hypochlorous acid (HOCl), other chlorination products, tyrosine radicals, and reactive nitrogen intermediates, all of which can attack the surface membrane of microorganisms. Ref: Borregaard N., Boxer L.A. (2010). Chapter 66. Disorders of Neutrophil Function. In J.T. Prchal, K. Kaushansky, M.A. Lichtman, T.J. Kipps, U. Seligsohn (Eds), Williams Hematology, 8e. | Pathology | null | Various factors are involved in inflammation. Which among the following is NOT a mediator of inflammation?
A. Tumour Necrosis Factor (TNF)
B. Interferon
C. Myeloperoxidase
D. Prostaglandins
| Myeloperoxidase |
00e3414c-8f67-4ea3-afd7-2e42af4f7eb2 | Microsomal 7 α hydroxylase (cholesterol 7 α hydroxylase) is the rate limiting enzyme of bile acid synthesis. This enzyme is expressed only in liver. | Biochemistry | null | Which of the following is the rate limiting enzyme of bile acid synthesis
A. Mitochondrial 17 α hydroxylase
B. Cytoplasmic 7 α hydroxylase
C. Microsomal 7 α hydroxylase
D. Mitochondrial 7 α hydroxylase.
| Microsomal 7 α hydroxylase |
63497dfb-a998-4137-9888-40d31588e79c | Posterior circulation TIA is suggested by the constellation of symptoms (vertigo, dysarthria, and diplopia and the transient episode of his symptoms. The basilar artery is formed by the two vertebral arteries and supplies the pons, the midbrain, and the cerebellum with vertebrobasilar TIAs, tinnitus, vertigo, diplopia, ataxia, hemiparesis, and bilateral visual impairment are common findings. This patient does not have occlusion of the middle cerebral artery since it results in cortical symptoms of motor and sensory loss on the contralateral side. This is also not hypertensive encephalopathy since it causes confusion, headache, nausea, vomiting, and focal neurologic signs. | Medicine | C.N.S. | A 63-year-old man presents to the emergency department because of transient symptoms of vertigo, slurred speech, diplopia, and paresthesia. He is symptom-free now, and clinical examination is entirely normal. His past medical history is significant for osteoarthritis, hypertension, and dyslipidemia. Which of the following is the most likely cause for symptoms?
A. posterior circulation transient ischemic attack (TIA)
B. anterior communicating artery aneurysm
C. hypertensive encephalopathy
D. pseudobulbar palsy
| posterior circulation transient ischemic attack (TIA) |
4312cb15-405b-48f9-8679-8b78e621ffea | Ans. is 'a' i.e., Paracetamol Important ototoxic drugso Aminoglycosideso Cisplatino Furosemideo Deferoxamineo Quinineo Chloroquineo Interferonso Eiythromycino Bleomycino Aspirin | Pharmacology | Adverse Drug Effect | Which of the following is not a ototoxic drug -
A. Paracetamol
B. Cisplatin
C. Quinine
D. Erythromycin
| Paracetamol |
a431f057-b176-402d-bc65-d944b828a9a0 | Component Function Acceptor stem Hydroxyl group of adenosyl nucleotide forms an ester bond with the carboxyl group of aminoacid. DHU arm (DiHydroUridine) or D arm Recognition by specific aminoacyl tRNA synthetase Anticodon arm Base pairs with the codon of mRNA TpsC arm (RiboThymidine, Pseudouridine (ps), Cytidine) Ribosomal recognition Variable loop Unique sequences that are specific for that paicular tRNA. | Biochemistry | Translation | Which of the following is NOT a component of t RNA?
A. D-loop
B. TpsC loop
C. Codon arm
D. Variable loop
| Codon arm |
bb3dcf10-7035-4856-ad8a-7ab2f82bed35 | Wolf Parkinson-While syndrome Marfan's syndrome Ideally, a patient with Marfan's syndrome contemplating pregnancy should have a preconceptional echocardiography to determine the diameter of the aoic root risk depends upon the diagmeter of aoic root. If it is greater than 4.0 cm, she is at significant risk for aoic dissection and she should be offered surgery. If the patient is in early pregnancy, she should be informed that termination of pregnancy is an option. Eisenmengher syndrome & Pulmonary hypeension Pulmonary vascular disease whether secondary to a reversed large left to right shunt such as VSD, Eisenmenger's syndrome or lung or connective tissue disease (e.g., scleroderma) or due to primary pulmonary hyeension is extremely dangerous in pregnancy and women known to have significant pulmonary vascular disease should be adviced from an early age to avoid pregnancy and be given appropriate contraceptive advice. Arias says "Pregnancy is deleterious to patients with primary pulmonary hypeension. The maternal moality is approximately 40% and the fetal outcome is also poor with frequent spontaneous aboions and fetal demises secondary to maternal deaths." According to Dutta, Absolute indications for termination of pregnancy are:? a) Primary pulmonary hypeension b) Eisenmengers syndrome c) Pulmonary veno-occlusive disease Relative indications are a) Parous woman with grade HI and grade IV cardiac lesions. b) Grade I or II with previous history of cardiac failure in early month or in between pregnancy. The termination should be done within 12 weeks by suction evacuation (MVA) or by conventional D & E. | Gynaecology & Obstetrics | null | Normal pregnancy can be continued in aEUR'
A. Primary pulmonary hypeension
B. Wolf-Parkinson-White syndrome
C. Eisenmenger syndrome
D. Marfan syndrome with dilated aoic root
| Wolf-Parkinson-White syndrome |
47414217-6264-4752-a1fb-86f6b30a1759 | Ans. is 'a' i.e., Autosomal recessiveAutosomal recessive disordersMetabolicHematologicalEndocrineSkeletalNarvouso Cystic fibrosiso Phenylketonuriao Galactosemiao Homocystinuriao Lysosomal storage diso a1-antitrypsin deficiencyo Wilson diseaseo Hemochromatosiso Glycogen storage disorderso Sickle cell anemiao Thalassemiaso Congenital adrenal hyperplasiao Albinismo EDS (some variants)o Alkaptonuriao Friedreich ataxiao Spinal muscular atrophyo Neurogenic muscular atrophies | Pathology | Obstructive Lung Diseases | Alpha 1 antitrypsin deficiency mechanism of transmission -
A. Autosomal recessive
B. Autosomal dominant
C. X linked recessive
D. X linked dominant
| Autosomal recessive |
f6648b1d-d7b0-43de-b8a5-e1685c6e47bc | Ans. (b) Monochorionic, DiamnioticRef: Dutta 8th ed. 233Division of zygote and types of TwinningDivision of Zygote on/ afterTypes of Twining72 hours/3 daysDichorionic, DiamnioticBetween 4-8 daysMonochorionic, DiamnioticBetween 8-12 daysMonochorionic, Monoamniotic> DaysSiamese, Conjoined TwinsAlso Know* Most common type of twinning is dizygotic twins: 69%* Monozygotic twins in: 31%* MC TYPE OF TWIN GESTATION: Diamniotic Monochorionic (70-75%)* Least common type of twin gestation: Conjoined twins (<1%)* Hellin rule is associated with multiple pregnancyas per which chance of twins is al in 80 pregnancies, triplets 1 in 802 and so on. It can result in complications;* Prematurity is the commonest fetal complication* Post partumhemorrhage is the commonest maternal complication. | Gynaecology & Obstetrics | Multiple Pregnancy | Division of zygote took place on 5th day after fertilization. What is the type of twinning:
A. Monochorionic, Monoamniotic
B. Monochorionic, Diamniotic
C. Dichorionic, Diamniotic
D. Dichorionic, Monoamniotic
| Monochorionic, Diamniotic |
4570a05c-2ab9-4e68-b89f-bbf64d0a30e1 | Ans. (d) Lines of developmentBlaschko's lines reflect cell migration during embryogenesis of the skin. Nevi cluster along these lines | Surgery | Plastic & Reconstructive Surgery | Lines of Blaschko represent:
A. Lines along lymphatics
B. Lines along blood vessels
C. Lines nerves
D. Lines of development
| Lines of development |
2990ca20-1284-47e7-a836-91651861ff58 | Ans. is 'b' i.e., Aganglionic colon i) Option 'a & c' are causes of small bowel obstruction not colonic obstruction ii) Most common cause of Intestinal obstruction in a neonate is Intestinal atresia - p. 1133, 1232 Nelson | Surgery | null | Commonest cause of colonic obstruction in neonates is -
A. Meconium ileus
B. Aganglionic colon
C. Heal atresia
D. Volvulusd) Hernia
| Aganglionic colon |
b88e1497-2b8e-4534-95d1-bcb90f363cdd | Under Vision 2020, to check visual acuity, teacher will refer school child to Vision Centre Vision 2020 Right to Sight Major aim - eliminate avoidable blindness by 2020. They are Global India 1. Cataract 1. Cataract 2. RE + Low vision 2. RE + Low vision 3. Childhood blindness 3. Childhood blindness 4. Trachoma 4. Trachoma 5. Onchocerciasis (not present in India) 5. Diabetic Retinopathy 6. Glaucoma 7. Corneal Blindness Number of Authorised bodies Population Norms 2 (APEX) 1/500 million 20 (Centre of Excellence) 1/50 million 200 (Training Centre) 1/5 million 2000 (Service Centre) 1/500000 20000 (Vision Centre) 1/50000 Rajendra prasad institute of Ophthalmic sciences, AIIMS, Delhi: Services offered at Vision centre - vision testing - PMOA Service centre - cataract surgery - ophthalmologist Training centre - Training - opthal depament of medical college | Social & Preventive Medicine | NCDs: CHD, HTN, DM, RF, Cancers, Obesity, Blindness | Under Vision 2020, to check visual acuity, teacher will refer school child to
A. Service centre
B. Training centre
C. Centre for excellence
D. Vision centre
| Vision centre |
45fc1a21-5962-42ec-afc1-97b33c99944e | Ans. is 'b' i.e., Leukotriene B4 and C5a o Chemoattractant:- C5a (most potent), IL-8, LTB4, PAF, bacterial products, Lymphokine, Kallikrein.o C5a is the most potent chemoattractant | Pathology | Chemical Mediators and Regulators of Inflammation | Chemoattractants among the following are?
A. Histamine
B. Leukotriene B4 and C5a
C. Leukotriene C4 and C3a
D. Bradykinin
| Leukotriene B4 and C5a |
7f6ecbfa-68cd-4aeb-8799-18a470fba3e8 | In humans, depolarization of the ventricular muscle stas at the left side of the interventricular septum and moves first to the right across the mid poion of the septum. The wave of depolarization then spreads down the septum to the apex of the hea. It then returns along the ventricular walls to the AV groove, proceeding from the endocardial to the epicardial surface. The last pas of the hea to be depolarized are the posterobasal poion of the left ventricle, the pulmonary conus, and the uppermost poion of the septum. | Physiology | null | In humans, where does depolarisation of cardiac ventricular muscle stas from?
A. Posterobasal pa of ventricle
B. Left side of inter ventricular septum
C. Uppermost pa of interventricular septum
D. Basal poion of ventricle
| Left side of inter ventricular septum |
cc49d868-220f-4d2a-8b8e-9d6af30226d3 | In starvation, there is excessive breakdown of fatty acids resulting in the formation of Acetyl CoA in the liver. They ensure the conversion of pyruvate to oxaloacetic acid. It acts as allosteric activator of the enzyme pyruvate carboxylase and inhibits pyruvate dehydrogenase of Glycolysis. | Biochemistry | Metabolism of carbohydrate | Gluconeogenesis enzyme stimulated in starvation
A. Carboxylase
B. Pyruvate dehydrogenase
C. Pyruvate kinase
D. Glucokinase
| Carboxylase |
aae6e5d7-180d-48a9-bc15-e457b7c7338a | According to Piaget Cognitive theory, the sequence of development has been categorized into 4 major stages.
• Sensorimotor stage (0 to 2 yrs)
• Pre-operational stage (2 to 6 yrs)
• Concrete operational stage (7 to 12 yrs)
• Formal operational stage (11 to 15 yrs) | Dental | null | Age group for concrete operational stage:
A. 0-2 yrs
B. 2-6 yrs
C. 7-12 yrs
D. 11-15 yrs
| 7-12 yrs |
a366691d-cfb4-4861-b9c6-298e54189296 | Ans. (a) Gluteus maximusRef: Gray's anatomy 39th ed. H433 | Anatomy | Osteology of Lower Extremity | Third tubercle of femur provides attachment to?
A. Gluteus maximus
B. Gluteus medius
C. Gluteus minimis
D. Piriformis
| Gluteus maximus |
d0e239f1-8cfa-4d0b-8334-6acb7a671c36 | Desending (efferent) fibers passing through genu of internal cpsule are corticonuclear fibers. | Anatomy | null | Genu of internal capsule carries -
A. Optic radiation
B. Corticospinal
C. Corticorubral tract
D. Corticonuclear tract
| Corticonuclear tract |
b90d8171-031a-4e53-9143-7c1b816c3d29 | Ans. is 'd' i.e., Folic acid Assessment of folate deficiencyo Following tests are used for assessment of folate deficiency.Blood levelNormal level in scrum is about 2-20 nanogram/mJ and about 200 micorgram.'ml of packed cells.Histidine load test or FIGLU excretion test :- Histidine is normally metabolized to formimino glutamic acid (FIGLU) from wrhich formimino group is removed by THF. Therefore in folate deficiency, FIGLU excretion is increased in urine.AICAR excretion In purine nucleotide synthesis the 2nd last step is the addition of C2 with the help of N10-formyl THF. This step is blocked in folate deficiency and the precursor, i.e., amino imidazole carboxamide ribosyl-5-phosphate (AICAR) accumulates and is excreted in urine.Peripheral blood picture Macrocytosis, tear drop cells, hvpersegmented neutrophils, anisopoikilocvtosis. | Biochemistry | Vitamins | FIGLU Test is used for deficiency of -
A. Vitamin B ,
B. Riboflavin
C. Niacin
D. Folic acid
| Folic acid |
608794b2-d8c4-47c8-9ed1-e47fc7f109a1 | Ref Robbins 9/e p250-255 Pathogenesis of CNS Involvement The pathogenesis of the neurologic manifestations in AIDS deserves special mention because, in addition to the lymphoid system, the nervous system is a major target of HIV infection. Macrophages and cells belonging to the monocyte-macrophage lineage (microglial cells) are the predominant cell types in the brain that are infected with HIV. The virus is most likely carried into the brain by infected monocytes (thus, brain HIV isolates are almost exclusively of the R5 type). The mechanism of HIV-induced damage of the brain, however, remains obscure. Because neurons are not infected by HIV, and the extent of neuro- pathologic changes is often less than might be expected from the severity of neurologic symptoms, most expes believe that the neurologic deficit is caused indirectly by viral products and soluble factors (e.g., cytokines such as TNF) produced by macrophages and microglial cells. In addition, injury from nitric oxide induced in neuronal cells by gp41 and direct damage of neurons by soluble HIV gp120 have been postulated. This all results in perivascular giant cells,vacuolisation | Anatomy | General anatomy | Which is not found in CNS in a case of AIDS
A. Perivascular giant cells
B. Vacuolization
C. Inclusion bodies
D. Microglial nodules
| Inclusion bodies |
ebd915c1-c672-4cbc-bf0b-1556d01917bb | Structural theory of mind (the id, ego and superego) was given by Sigmund freud. | Psychiatry | null | The term 'id' was coined by -
A. Freud
B. Skinner
C. Wayker
D. Blueler
| Freud |
cf018b40-d1ed-4924-a461-1f5ba09d387e | Babesia Microti is a parasitic blood-borne disease transmitted by deer tick (Ixodes scapularis) does not infect liver cells. Its clinical symptoms is similar to malaria, so diagnosis is really confusing. Under the microscope, the merozoite form of the microti lifecycle in red blood cells forms a cross-shaped structure, often referred to as a "Maltese cross", whereas malaria forms more of a diamond ring structure in red blood cells. Ref: Medical Microbiology By Jawetz, 24th Edition, Page 680; 'Clinical Hematology' By Turgeon, 4th Edition, Page 108; 'Blood Cells' By Bain, 3rd Edition, Page 137 | Microbiology | null | 'Maltese Cross' is a characteristic feature of:
A. Cryptococcus Neoformans
B. Babesia Microti
C. Blastomycosis
D. Penicillium Marneffei
| Babesia Microti |
3854a4e9-6dad-4fea-b771-de00f38b08b3 | Paronychia is inflammation around a finger or toenail. Paronychia is a nail disease that is an often tender bacterial or fungal infection of the hand or foot, where the nail and skin meet at the side or the base of a finger or toenail. The infection can sta suddenly (acute paronychia) or gradually (chronic paronychia) signs and symptoms: The skin typically presents as red, itchy, and hot, along with intense pain. Pus is usually present, along with gradual thickening and browning discoloration of the nail plate. Causes: *Acute paronychia is usually caused by bacteria. Paronychia is often treated with antibiotics, either topical or oral or both. Chronic paronychia is most often caused by a yeast infection of the soft tissues around the nail but can also be traced to a bacterial infection. If the infection is continuous, the cause is often fungal and needs antifungal cream or paint to be treated. Risk factors include repeatedly washing hands and trauma to the cuticle such as may occur from repeated nail biting. In the context of baending, it is known as bar rot. Prosector's paronychia is a primary inoculation of tuberculosis of the skin and nails, named after its association with prosectors, who prepare specimens for dissection. Paronychia around the entire nail is sometimes referred to as runaround paronychia. Painful paronychia in association with a scaly, erythematous, keratotic rash (papules and plaques) of the ears, nose, fingers, and toes may be indicative of acrokeratosis paraneoplastica, which is associated with squamous cell carcinoma of the larynx. Paronychia can occur with diabetes, drug-induced immunosuppression,or systemic diseases such as pemphigus. Treatment: When no pus is present, warm soaks for acute paronychia are reasonable, even though there is a lack of evidence to suppo its use.Antibiotics such as clindamycin or cephalexin are also often used, the first being more effective in areas where MRSA is common.If there are signs of an abscess (the presence of pus) drainage is recommended. Chronic paronychia is treated by avoiding whatever is causing it, a topical antifungal, and a topical steroid. In those who do not improve following these measures, oral antifungals and steroids may be used or the nail fold may be removed surgically Ref Harrison 20th edition pg 1234 | Dental | miscellaneous | 30 year old female presents with a painful, red, warm nail fold since last 7 days. Patient is applying various home remidies like turmeric powder , warm saline compressions with out any relief .The most probable diagnosis is
A. Ingrowing finger nail
B. Acute paronychia
C. Chronic paronychia
D. Onychomycosis
| Acute paronychia |
673029bc-50cd-43ed-92e9-decd5b755560 | Positive predictive value=true positive/(true positive+ false positive) 416/425 x 100= 98% Ref: Medical biostatistics, 1st edition pg: 201 | Social & Preventive Medicine | null | ECG was performed on a total of 700 subjects with complaints of acute chest pain. Of these, 520 patients had myocardial infarction. Calculate the positive predictive value of ECG is: MYOCARDIAL INFARCTION ECG PRESENT ABSENT TOTAL POSITIVE 416 9 425 NEGATIVE 104 171 275 TOTAL 520 180 700
A. 40%
B. 55%
C. 95%
D. 98%
| 98% |
69ee06c8-273d-4e90-bc28-3de8133a351d | an obsolete sign: in chronic appendicitis, pain and tenderness in the right iliac fossa on inflation of the colon with air. The definition information forBastedo sign is provided by Stedman&;s. | Surgery | G.I.T | Rectum is inflated with air, pain occurs in right iliac fossa. Which sign
A. Aaron sign
B. Battle sign
C. Bastedo sign
D. Meburney sign
| Bastedo sign |
755aea45-baf9-491d-9f6e-e972f6ab0af6 | Rules for VVM use in India Rules 1: If the inner square is lighter than the outer circle, the vaccine may be used (Vials 1, 2) Rules 2: If the inner square is the color as, or darker than, the outer circle, the vaccine must not be used (Vials 3, 4). | Social & Preventive Medicine | Cold Chain in India | Which of the following OPV ls are usable?
A. Only 1
B. Only 1, 2
C. Only 1, 2, 3
D. Only 3, 4
| Only 1, 2 |
598181a0-31fd-4d52-99e7-0d4a48339843 | Forensic taphonomy is the interdisciplinary study and interpretation of postmoem processes of human remains. Thanatology is the study that deals with death in all its aspects. Entomology is the study of the form and behaviour of insects. Myiasis is a condition caused by infestation of the body by fly maggots. Putrefaction is the process of gradual dissolution and liquefaction of the tissues. | Forensic Medicine | Thanatology | The Study of postmoem process of a dead body and their interpretation is
A. Thanatology
B. Putrefaction
C. Taphonomy
D. Entomology
| Taphonomy |
b53c338c-ee25-4e1e-a179-2128253d1803 | After spontaneous rupture, the pressure in the oesophagus rapidly increases and burst at its weakest point in lower one-third, sending a stream of material into the mediastinum and often into the pleural cavity. Thus pneumomediastinum is formed Reference: Bailey and Love edition: 24 page no: 996 | Surgery | G.I.T | In which one of the following conditions is gas under diaphragm not seen
A. Perforated duodenal ulcer
B. Typhoid perforation
C. After laparotomy
D. Spontaneous rupture of oesophagus
| Spontaneous rupture of oesophagus |
e7e36b78-6f70-45fc-b117-19c6915c41f7 | C represents NREM 3 phase which is characterized by presence of δ waves. NREM 3 is also called as "deep sleep". | Psychiatry | null | Which of the following phase is characterized by presence of δ waves?
A. A
B. B
C. C
D. D
| C |
5b1a1289-b252-4650-af9c-882567db9658 | Lingual dovetail is required for large preparations in maxillary canines.
It is prepared only after completion of proximal portion, because otherwise tooth structure needed for isthmus between proximal portion and dovetail might be removed when the proximal outline form is prepared.
Nisha Garg, Amit Garg. Textbook of Operative Dentistry. Edition 3. Page:337 | Dental | null | The modified class III preparation uses a dovetail on the lingual side in:
A. Maxillary canine
B. Mandibular canine
C. Mandibular central incisor
D. Mandibular lateral incisor
| Maxillary canine |
69378c11-c9f8-4ba0-996b-43d4a16f6f8f | Ans. is 'b' i.e., 5 months Age Milestone 3 Month Neck holding 5 Month Rolls over 6 Month Sit with support 8 Month Sit without support 9 Month Stand with support 12 Month Stand without support Walk with support 15 Month Walk alone, creep upstair | Unknown | null | The child rolls over by -
A. 3 months
B. 5 months
C. 7 months
D. 8 months
| 5 months |
d37b9109-671a-4456-b955-a2e4155b54b4 | Debranching enzyme is a Bifunctional enzyme with two activities Glucan transferase Amylo a-1,6-glucosidase breaks the alpha (1-6) glycosidic bond present at the branch point of glycogen in glycogen breakdown. Other Options: Glycogen synthetase transfer glucose from UDP-glucose to glycogenin. Glycogen branching enzyme (also known as amylo-a(1,4)-a(1,6) trans glycosylase) make glycogen branches by transferring the end of the chain onto an earlier pa a-1,6 glycosidic bond. Glucose-6-phosphatase dephosphorylates glucose-6-phosphate to free glucose. | Biochemistry | Glycogen | Which of the following is a debranching enzyme:
A. Glycogen synthetase
B. Glucose-6-phosphatase
C. Amylo alpha-1,6-glucosidase
D. Amylo (1,4)-(1,6) trans glycosylase
| Amylo alpha-1,6-glucosidase |
58d23dee-8bc2-4364-8afd-77e71e67e0ed | D. i.e. (Serotonin) (95 - 96- Ganong 22nd) (1081-82- A.K. Jain 3rd)* Dopamine, Norepinephrine, Epinephrine, Serotonin. Histamine are AMINES* Polypeptides are - Substance P*, other tachykinins, Vasopressin, oxytocin, CRH, TRH, GRH,Somatostatin, GnRH, Endothelins, /3-Endorphin*, Endomorphins Enkephalins*, Dynorphins,Cholecystokinin (CCK-4 and CCK-8). VIP, Neurotensin, Gastrin releasing peptide, Gastrin, Motilin,Secretin, Glucagon derivatives, Calcitonin gene related peptide - a, Neuropeptide y, Activins, Inhibins,Angiotensin II. FMRF amide, Galanin, ANP, BNP,* Substance P - is transmitter for afferent neurons that relay sensory information into the CNS and is though to be invoved in the transmission of nociceptive (pain producing) stimuli.* Enkephalins and Endorphins - role in regulating pain, in eating and drinking behaviour, in central regulation of the CVS, and in cell development | Physiology | Nervous System | Which of the following synaptic transmitter is NOT a peptide, polypeptide or protein
A. Substance P
B. Met-enkephalin
C. b-Endorphin
D. Serotonin
| Serotonin |
0ce9b02f-b484-4f2b-9a59-9d082beca557 | HEAT STRESS INDEX(HSI): HSI% Consequence of 8 hour exposure 0 No thermal strain 10-30 Mild-Moderate heat stress, Minimal impairement in work 40-60 Severe heat stress, Threat to health if not fit 70-90 Very severe heat stress, only few can sustain it 100 Maximum heat stress, only young fit acclimatized can sustain it >100 Varying degrees of stress due to hypehermia Ref: Park 25th edition Pgno: 784 | Social & Preventive Medicine | Environment and health | At which level of heat stress index it is not possible to work comfoably causing threat to health:
A. 20-40
B. 40-60
C. 60-80
D. 80-100
| 40-60 |
f27d0008-ecb3-4524-b5c9-734f0870df62 | Ans. is 'a' i.e., Acts as PPAR gamma agonist Rosiglitazone It is oral antidiabetic drug They are selective agonists for nuclear peroxisome proliferator activator receptor gamma (PPAR gamma) expressed in the fat and muscle cells. It enhances transcription of several insulin responsive genes. Reverse insulin resistance by enhancing GLUT 4 expression and translocation. | Pharmacology | null | Rosiglitazone mechanism of action is ?
A. Acts as PPAR gamma agonist
B. Inhibitor of alpha glucosidase
C. Acts as amylin analogue
D. Acts as dipeptidyl peptidase inhibitor
| Acts as PPAR gamma agonist |
72c5bae5-7b8a-4ed6-b835-368a8f5c9b7b | Features of dhatura poisoning: (All Datura plants contain tropane alkaloids such as scopolamine, hyoscyamine, and atropine) Dilatation of pupils Dryness of mouth Difficulty in speech Dysphagia Dilatation of cutaneous blood vessels Dry, hot skin Drunken gait Delirium Drowsiness Reference The Synopsis of FORENSIC MEDICINE and Toxicology 29th Edition | Forensic Medicine | Miscellaneous | A person was brought by police from the railway platform. He is talking irrelevant. He is having dry mouth with hot skin, dilated pupils, staggering gait and slurred speech. The most probable diagnosis is:
A. Alcohol intoxication
B. Carbamates poisoning
C. Organophosphorous poisoning
D. Dhatura poisoning
| Dhatura poisoning |
7fd11a8c-c207-453d-bbb8-7f756e5d8858 | Ans. B. Stratum spinosumStratum spinosum is also called as the prickle cell layer.* Stratum spinosum consists of intercellular attachments, also called desmosomes.* These desmosomes appear like spines on microscopy; hence, it is called as the prickle layer.* Their spiny (Latin, spinosum) appearance is due to the shrinking of the microfilaments between desmosomes that occurs when stained with H&E. | Skin | Anatomy of Skin | Which of the following layers of epidermis is known as "prickle layer"?
A. Stratum basale
B. Stratum spinosum
C. Stratum granulosum
D. Stratum corneum
| Stratum spinosum |
5b18a115-44eb-4877-b8fe-937b67ce0748 | Cellular energy can be stored in high-energy phosphate compounds, including adenosine triphosphate (ATP). This ubiquitous molecule is the energy storehouse of the body. On hydrolysis to adenosine diphosphate (ADP), it liberates energy directly to such processes as muscle contraction, active transpo, and the synthesis of many chemical compounds. Loss of another phosphate to form adenosine monophosphate (AMP) releases more energy.(REF: GANONG'S REVIEW OF MEDICAL PHYSIOLOGY -23rd EDITION. Page No-8) | Physiology | General physiology | Energy currency of the cell is
A. Nucleotide diphosphate
B. Nucleotide triphosphate
C. Deoxynucleotide diphosphate
D. Nuceotide monophosphate
| Nucleotide triphosphate |
ab9e09e9-f33e-42b1-9a3b-0f972a4dc197 | Most common cyanotic hea disease is tetrology of fallot encountered beyond the age of 1 yr constituting almost 75% of all blue patient. Ref : Ghai essential pediatrics,eighth edition, P.no:420 | Pediatrics | C.V.S | Commonest type of cong. cyanotic hea disease is
A. ASD
B. VSD
C. TOF
D. PDA
| TOF |
f031095d-b57a-4707-9543-65fb562033f8 | Ans. is 'b' i.e., Erythropoietin o Chronic kidney disease leads to normocyih normochronic anemiaThe kidney is the primary' site of erythropoietin production in the adult. Erythropoietin enhances the growth and differentiation of erythropoietin progenitors.With increasing renal dysfunction decreased level of erythropoietin are produced resulting in progressive anemia,o The primary therapeutic options for anemia of chronic kidney disease areo Red blood cell transfusionso Erythropoietin stimulating agentso Androgen (to a much lesser degree)o Erythropoietin administration is considered the mainstay of the treatment of anemia of chronic disease in renal failureThe administration of erythropoietin stimulating agent is particularly attractive because they have substantially reduced the need for red cell transfusion with an attendant decrease in and for risk for transfusion related complications.# The erythropoietin deficiency can be corrected by the exogenous administration of erythropoietin stimulating agentsTwo such agents available in the united statesEpoetin afla (recombinant human erythropoietin)Darbepoetin alfaEpoetin alfa (recombinant human erythropoietin E.P.O.)o Provides effective treatment for anemia in patients, when administered, once weekly Has become standard care.o However, one problem with epoeitin alfa is that the need for the weekly dose can place a considerable burden on both patients and healthcare staff.Darbepoetin alfao Another erythropoiesis stimulator i.e.darbepoeitin alfa can provide an alternative as it has three fold longer half life.o The dose of darbepoeitin can be scheduled once weekly or twice weekly or may be monthly.Peginasatideo It is a synthetic peptide that activates EPO receptor. Peginesatide stimulates erythroid colony growth, reticulocyte count and hematocriiRed blood cell transfusionso RBC transfusion are universally sussessful in raising hemoglobin levels.o Transfusions often can ameliorate the patient s symptoms and improve health related quality of life .o However they may be associated with significant complications that include transfusion transmitted infection, immunological sensif cation, iron overload syndromes volume overload! transfusion reactionsAndrogenso Prior to the availability of erythropoietin stimulating agents, androgens were used regularly in the treatment of anemia in dialyses patients. Androgens may increae endogenous erythorpoietin production sensitivity of erythroid progenitors and red blood cell sunivat. However the role of androgen was limited because of side effects which was virilisation, priapism, peliosis hepatic, liver function and risk of hepatocellular Ca | Medicine | Anemia and RBC Disorders | CRF with anemia best treatment -
A. Iron
B. Erythropoietin
C. Blood transfusion
D. Folic acid
| Erythropoietin |
d468ff20-68f4-4920-a838-f8662f5cf410 | The ilioinguinal nerve, which arises from the L1 spinal nerve, innervates the skin on the medial aspect of the thigh, scrotum (or labia majora), and the mons pubis. It has been injured in this patient. The genitofemoral nerve splits into two branches: The genital branch supplies the scrotum (or labia majora) whereas the femoral branch supplies the skin of the femoral triangle. The subcostal nerve has a lateral cutaneous branch that innervates skin in the upper gluteal region, in addition to distribution over the lower part of the anterior abdominal wall. The Iliohypogastric nerve innervates the skin over the iliac crest and the hypogastric region. Spinal nerve T9 supplies sensory innervation to the dermatome at the level of T9, above the level of the umbilicus. | Anatomy | Abdomen & Pelvis | A 32-year-old woman was admitted to the hospital with a complaint of pain over her umbilicus. Radiographic examination revealed acute appendicitis. The appendix was removed successfully in an emergency appendectomy. One week postoperatively the patient complained of paresthesia of the skin over the pubic region and the anterior portion of her perineum. Which of the following nerves was most likely injured during the appendectomy?
A. Genitofemoral
B. Ilioinguinal
C. Subcostal
D. Iliohypogastric
| Ilioinguinal |
ec2b5a31-2e03-4f9c-8484-2ca175c39ef7 | Unexpected visual loss, 3 weeks after cataract surgery with 'honey comb maculopathy' and 'flower petal' hyperfluorescence on Fluorescin Angiography is characteristic of Cystoid macular Edema. | Ophthalmology | null | A 70–year–old man presents with deterioration of vision 3 weeks after cataract extraction and IOL implantation. Slit lamp examination shows honeycomb maculopathy and Fluorescein angiography (FA) shows 'flower petal' hyperfluorescence. The most likely diagnosis is –
A. Age related macular degeneration (ARMD)
B. Central serous Retinopathy (CSR)
C. Macular Dystrophy
D. Cystoid Macular Edema
| Cystoid Macular Edema |
9207b0b6-dd6c-4916-b214-745cf557bb34 | Ans. is 'b' i.e., Medullary carcinoma thyroid o RET p ratoon cumene is a growth factor receptor (receptor tyrosine kinase)o The RET protein Is a receptor for the glial cell lined derived neurotrophic factor and structurally related proteins that promote cell survival during neural development. | Pathology | Thyroid and Parathyroid | RET gene mutation is associated with which malignancy -
A. Pheochromocytoma
B. Medullary carcinoma thyroid
C. Lymphoma
D. Renal cell carcinoma
| Medullary carcinoma thyroid |
96766226-079f-4ae7-a4a4-dc9f3df6022e | Glucose is maximumly reabsorbed in normal condition.Ref: Ganong&;s review of medical physiology; 24th edition; page no; 682 | Physiology | Renal physiology | Most reabsorption out of
A. Glucose
B. Urea
C. Na+
D. HCO3
| Glucose |
bfd177c1-04d8-47a7-8d3b-022294de55b9 | Wahin tumour/papillary cystadenoma lymphomatosum is viually restricted to parotid gland. Occur more commonly in male than female. | Surgery | null | The tumour exclusively found in parotid gland:
A. Wahin tumour
B. Adenocarcinoma
C. Pleomorphic adenoma
D. Acinar cell tumour
| Wahin tumour |
97a1e331-0c6a-4b42-9b6e-5a3bfe31ade9 | Presence of cervix distinguishes vaginal atresia from mullerian agenesis. | Gynaecology & Obstetrics | null | Which of the following finding on MR imaging distinguishes vaginal atresia from mullerian agenesis
A. Amount of upper vaginal dilatation
B. Presence of cervix
C. Length of atresia
D. Hymeneal ring
| Presence of cervix |
19ac491c-6223-4b01-a1f4-dc06455c6523 | Answer is C (Diffuse Proliferative Glomerutonephritis) Wire loop lesions are most charachteristic of diffuse proliferative glomerulonephritis (Class IV WHO) but may also be seen in focal proliferative glomerulonephritis (Class III WHO). Most characteristic of: Lupus Nephritis Class IV (Diffuse Lupus Nephritis) Also seen in: Lupus Nephritis Class III (Focal) > Lupus Nephritis Class V (Membranous) | Medicine | null | Wire loop lesions are often characteristic for the following class of lupus nephritis:
A. Mesangial proliferative glomerulonephritis(WHO class II)
B. Focal proliferative glomerulonephritis (WHO class III)
C. Diffuse proliferative glomerulonephritis (WHO class IV)
D. Membranous glomerulonephritis (WHO class V)
| Diffuse proliferative glomerulonephritis (WHO class IV) |
dd32ae13-9422-4315-ac6b-a4b4f8caae20 | - Ulnar nerve innervates 15 of 20 intrinsic muscles of hand.Hence, its injury results in wasting of intrinsic muscles of hand - Musculocutaneous, radial, ulnar & median nerves are all impoant to hand function. - Musculocutaneous and radial nerves allow forearm supination; the radial nerve alone innervates the extensor muscles. - Median nerve is the "eye of the hand" because of its extensive contribution to sensory perception; it also maintains most of the long flexors, the pronators of the forearm & thenar muscles. | Surgery | Miscellaneous | Wasting of the intrinsic muscles of the hand can be expected to be due to injury which nerve ?
A. Ulnar nerve
B. Radial nerve
C. Brachial nerve
D. Axillary nerve
| Ulnar nerve |
319b1b70-b7e3-4104-bbc6-d34c7b67398e | Hyaluronic acid is a sulphate free mucopolysaccharide. It is present in vitreous humor of the eye. It is also present in skin, synol fluid, umbilical cord, hemolytic streptococci and in rheumatic nodule. It occurs both free and salt like combination with proteins and forms ground substance of the mesenchyme, an integral gel like ground substance of connective tissue and other tissues. It is composed of repeating units of N acetyl glucosamine and D glucuronic acid. Functions: It acts as a cementing substance and contribution to tissue barriers which permits metabolites to pass through but resist penetration by bacteria and other infective agents. In joints it acts as a lubricant and shock absorbent. Ref: Textbook of Medical Biochemistry By M. N. Chatterjea, page 38. Textbook of Biochemistry for Dental/Nursing/Pharmacy Students By Chatterjea page 15 | Ophthalmology | null | Mucopolysaccharide hyaluronic acid is present in which among the following:
A. Vitreous humor
B. Cornea
C. Blood vessels
D. Lens
| Vitreous humor |
7437be19-31e0-4922-a64d-05046be19976 | Ans. B CT abdomenRef: Bailey and Love: 26th ed. page 1137* The clinical history of epigastric pain radiating to back points to pancreatic etiology. This patient may have developed pancreatic cancer. Sudden onset of diabetes in the elderly is also suggestive. The best imaging modality to image chronic pancreatitis or pancreatic malignancy is CT abdomen.* Choice A is ruled out as gas shadows of stomach obscure ultrasound view of pancreas.* Choice C is fluoroscopic intubation-infusion small- bowel examination which is used to evaluate for small bowel pathology while this patient has pancreatic lesion* Choice D is ruled out as it used for large bowel evaluation. | Physiology | Misc. | A 66-year-old man presents with a sudden onset of diabetes, anorexia, weight loss, epigastric pain with radiation to back. Next best investigation for this patient is?
A. Ultrasound of abdomen
B. CT abdomen
C. Enteroclysis
D. Triple contrast barium enema
| CT abdomen |
4a474ad3-aba0-4cd3-9cf2-dd2e24a5f7b5 | Chancre redux : Recurrence of the primary sore at its original site during the first two years of the disease (Relapsing stage of syphilis). Pseudochancre redux : Gummatous (teiary stage) recurrence at the site of the primary chancre. | Dental | Sexually Transmitted Infections | 'Chancre redux' is a clinical feature of:
A. Early relapsing syphilis
B. Late syphilis
C. Chancroid
D. Recurrent herpes simplex infection
| Early relapsing syphilis |
54c55702-d645-440a-abbc-006adf8b8cfe | Ans. is 'd' i.e., Drowning Gettler testo Gettler test is done for drowning. It estimates chloride content of blood from both sides of heart. Normally the chloride content is equal in the right and left chambers of the heart (600 mg/100 ml). In fresh water drowning due to hemodilution the chloride content is decreased and in salt water drowning due to hemoconcentration the chloride content is increased in left side of heart. A 25% difference in chloride is significant but the test is of doubtful value.o Limitations of gettler test:-1. No value in atypical drowning; congenital cardiac defects as shunts and patent foramen ovale; and if drowning medium contains same amount of chloride.2. There is progressive loss of Cl- from blood after death. Therefore the test has to be made within a reasonably short time after death. | Forensic Medicine | Biological Materials & Stains | Gettlers test is for -
A. Hanging
B. Strangulation
C. Bums
D. Drowning
| Drowning |
87eae977-e803-46a7-8ebf-9ff0e46f079d | Oxidative phosphorylation occurs in the mitochondria. The TCA cycle occurs in the mitochondrial matrix. The electron transpo chain occurs on the inner mitochondrial membrane. Anaerobic metabolism occurs in the cytoplasm of most cells. The mitochondria are the site of aerobic metabolism. The Golgi apparatus is responsible for packaging of material for intra- and extracellular use. The nucleolus is the site with in the nucleus of active transcription a gene to mRNA. Centrioles are cytoskeletal elements responsible for nuclear division during cell division. Ref: Bender D.A., Mayes P.A. (2011). Chapter 18. Glycolysis & the Oxidation of Pyruvate. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e. | Biochemistry | null | Which of the following organelles is the major site for anaerobic metabolism?
A. Centrioles
B. Mitochondria
C. Golgi apparatus
D. Cytoplasm
| Cytoplasm |
5c2d4711-a8a9-494b-8c16-3f0932e1588b | Level of hardness is expressed in terms of milliequivalents per litre where one milliequivalent is equal to 50mg calcium carbonate in one litre of water. The level of hardness of hard water is equal to 3-6mEq/L or 150-300 mg/L. CLASSIFICATION LEVEL OF HARDNESS (mEq./L) LEVEL OF HARDNESS (mg/L) soft water <1 <50 moderately hard 1-3 50-150 hard water 3-6 150-300 very hard >6 >300 Park's Textbook of Preventive and Social Medicine, 25th edition, Page No.787 | Social & Preventive Medicine | Environment and health | Soft water has hardness levels of -
A. <50
B. 100
C. 150
D. >200
| <50 |
52a17e17-ca9e-48f9-bdc4-a6aeff3e06a7 | Deficiency in CAH Glucocoicoid Mineralocoicoid Androgens 21 hydroxylase Reduced Reduced Increased 3 b hydroxyl-steroide dehydrogenase Reduced Reduced Increased 11 b hydroxylase Reduced Increased Increased 17 a hydroxylase Reduced Increased Decreased P450 oxidoreductase Reduced Increased Decreased | Medicine | Disorders of Adrenal Gland | Which of the following variant of CAH presents with mineralocoicoid deficiency?
A. 11b hydroxylase deficiency
B. 17a hydroxylase deficiency
C. P450 oxidoreductase dehydrogenase
D. 3b hydroxyl-steroid dehydrogenase
| 3b hydroxyl-steroid dehydrogenase |
4579a1f8-62a1-4537-856f-ffe695ce5542 | Ans: b (Bacillus stearothermophilus) Ref: Ananthanarayan, 7th ed,p. 78 Autoclaving: (Moist heat) (121degC X 15 min under 15 lb/sq.inch pressure) - dressings, gloves, glass syringes, culture media, suture materials except catgut. Sterilizing control is by bacillus stearo thermophilus. Hot air oven: (Dry heat) (160degCX 1 hr)-glasswares, glass syringes, oil, grease, liquid paraffin, dusting powder. Sterilization control is by spores of non toxigenic strains of Clostridium tetani. | Microbiology | General | Indicator used in autoclave is -
A. Clostridium tetani
B. Bacillus stearothermophilus
C. Bacillus pumilis
D. Bacillus subtilis Var Niger
| Bacillus stearothermophilus |
9d7a394f-36ee-49bd-b4cf-89155e5557bc | “Irritation of the auricular branches of the vagus in the external ear (by ear wax, syringe, etc.) may reflexly cause cough, vomiting, or even
death due to sudden cardiac inhibition.”
Auricular branch of the vagus nerve is also known as Arnold’s nerve or Alderman’s nerve.
Also Know
Similarly irritation of recurrent laryngeal nerve by enlarged lymph nodes in children may also produce a persistent cough. | ENT | null | The cough response caused while cleaning the ear canal is mediated by stimulation of-
A. The V cranial nerve
B. Innervation of external ear canal by C1 and C2
C. The X cranial nerve
D. Branches of the VII cranial nerve
| The X cranial nerve |
1d4df690-1700-4b66-8674-1a7b53fdca4c | SSRI * IMPOANCE Most widely prescribed antidepressant * MECHANISM Specifically acts on serotonin transpoers and increases serotonin in synapse. DRUGS FLUOXETINE FLUVOXAMINE DAPOXETINE CITALOPRAM ESCITALOPRAM ESCITALOPRAM SERALINE PAROXETINE USE FLUOXETINE=============CHILDHOOD DEPRESSION FLUVOXAMINE===========OCD DAPOXETINE==============PME ESCITALOPRAM===========HEA SAFE, PATHOLOGICAL EMOTIONS PAROXETINE=========SEDATING, PANIC DISORDER IMPULSE CONTROL DISORDERS PME PARAPHILIA Ref. kaplon and Sadock, synopsis of psychiatry, 11 th edition, 955 | Psychiatry | Pharmacotherapy in psychiatry | which of the following SSRI is hea safe
A. escitalopram
B. clomipramine
C. fluoxetine
D. amitriptilline
| escitalopram |
40a9c6c3-7798-4d54-9c70-45f3f4c4e01f | (c) The suprasellar cistern can be obliterated by a pituitary tumor. | Anatomy | Head & Neck | Choose the appropriate lettered structure in this MRI scan showing a transaxial section through the head. Which structure may be obliterated by a pituitary tumor?
A. A
B. B
C. C
D. D
| C |
6a8aca69-0485-470a-bbde-8f452a4b4674 | Ans. is 'c' i.e., Used to see genetic transmission Pedigreeo Provide graphic depiction of a family structure medical history'.o Person providing information is formed as pro band,o Special symbol is used for each designation,o Three generation pedigree should be made.o Closer the relationship of proband to the person, greater is change of shared genetic component. | Pediatrics | Genetics And Genetic Disorders | Pedigree Chart -
A. Used for growth monitoring.
B. To assess side effect during chemotherapy
C. Used to see genetic transmission.
D. To assess developmental delay in infant
| Used to see genetic transmission. |
cb346e41-7afd-4e14-8a96-779b317a8a5b | Oral isotretinoin duration of treatment varies according to dose but post-therapy relapse is minimized by treatment courses that amount to the total of 120-150 mg/kg Ref Harrison 20th edition pg 1233 | Dental | All India exam | The maximum dose of isotretinoin should not exceed
A. 30-60mg/kg
B. 60-90 mg/kg
C. 90-120 mg/kg
D. 120-150 mg/kg
| 120-150 mg/kg |
91ec5518-373b-4a7e-9246-d7a72ba7640c | The islets are then purified from the dispersed tissue by density-gradient centrifugation and can be delivered into the recepient liver (the preferred site for transplantation) by injection into the poal vein Ref: Bailey and love 27th edition Pgno :1552 | Anatomy | General anatomy | Site of transplantation in Islet cell transplant for Diabetes mellitus is
A. Skin
B. Injected into the poal vein
C. Liver
D. Pelvis
| Injected into the poal vein |
77586db1-ffb6-446d-aff1-796d79223559 | Answer is D (Obstructive jaundice): Direct bilirubinemia (conjugated birirubin > 15% of total bilirubin) along with high serum alkaline phosphatase (6-7 times normal) suggests the diagnosis of obstructive jaundice. AffirghnfeAre Total bilirubin (mg/di) 0.3 to 1.0 21.0 Direct bilirubin is 45% of total bilirubin Conjugated bilirubin (mg/d1) 0.1 to 0.3 9.6 Direct bilirubinemia Alkaline phosphatase 3-13 KAV 84 KA Alkaline phosphatase is raised by atleast six times:Significant rise Rise in conjugated bilirubin level may be seen Wth both, hepatocellular disease (Viral/ infective Hepatitis) and Obstructive jaundice hut association with significantly elevated ALP limits our diagnosis to obstructive damage. Rise in alkaline phosphatase levels Patient with parenchymal disease of liver i.e. hepatocellular disorders : may show increase in alkaline phosphatase levels but the increase is only slight to moderate and usually not more than two times normal Obstructive lesion: Striking increase in alkaline phosphatase is more suggestive of an obstructive lesion In the given question rise in alkaline phosphatase is about 6 to 7 times normal and thus is more in our of an obstructive cause. | Medicine | null | A young pt presents with jaundice. Total bilirubin is 21, direct is 9.6, alkphosis 84 KA units. Diagnosis is:
A. Hemolytic jaundice
B. Viral hepatitis
C. Chronic active hepatitis
D. Obstructive jaundice
| Obstructive jaundice |
56a69b5d-6782-4fd2-81a4-bba439c8fcd6 | Pregnancy is not a contraindication or precaution for Influenza trivalent vaccine. This vaccine is recommended for women who will be pregnant during influenza season. Influenza live attenuated vaccine is contra indicated. Must Know - Principle: Live-virus vaccines are contraindicated during pregnancy because of the possibility that vaccine virus replication will cause congenital infection or have other adverse effects on the foetus. MMR (measles, mumps and rubella virus vaccine) is contraindicated in pregnancy. It is a live attenuated vaccine. It is also contraindicated in gelatine or neomycin hypersensitivity and known severe immunodeficiency. Varicella vaccine is contraindicated in pregnancy. It is a live attenuated vaccine. It is also contraindicated in gelatine or neomycin hypersensitivity and known severe immunodeficiency. Hepatitis A is not contraindicated, but is has to be use with caution in pregnancy. Ref: Schuchat A., Jackson L.A. (2012). Chapter 122. Immunization Principles and Vaccine Use. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e. | Social & Preventive Medicine | null | Which of the following vaccines can be used in pregnancy in normal circumstances?
A. MMR vaccine
B. Varicella vaccine
C. Influenza trivalent vaccine
D. Hepatitis A vaccine
| Influenza trivalent vaccine |
4d31c7e1-c3c6-40a4-8b36-0bbbc598757c | Hyperacute rejection: type 2 HSR, happens over span of few minutes to hours. Eg: kidney transplant Acute rejection: Few weeks to months(< 6 months) Chronic rejection: After 6 months. Graft vs host disease (Runt Disease): Acute GVH: < 100 days Chronic GVH: > 100 days | Pathology | FMGE 2019 | Acute graft rejection occurs within?
A. Few minutes
B. Few hours
C. < 6 months
D. 6-12 months
| < 6 months |
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