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d64a63bf-c476-4043-9b1c-05bf5e2628c1 | Glutaraldehyde, which has two reactive aldehyde groups, is 10 times more effective than formaldehyde and is less toxic. It denatures proteins and nucleic acids. Both proteins and nucleic acids contain essential -NH2 and -OH groups, which are the main sites of alkylation. In hospitals, it is used to sterilize respiratory therapy equipment, endoscopes, and hemodialysis equipment. Ref: Levinson W. (2012). Chapter 13. Sterilization & Disinfection. In W. Levinson (Ed), Review of Medical Microbiology & Immunology, 12e. | Microbiology | null | After an endoscopy a technician kept the instrument for sterilization. Which of the following agent is used for sterilization of fibre optic instruments?
A. Glutaraldehyde
B. Chlorine
C. Autoclave
D. Phenol
| Glutaraldehyde |
be10ec1b-8d6e-43a1-9043-7ab77343f3f2 | ref Harrison 18/e p2223_2225 , Robbins 7/e p202 Cytokines are the peptide mediators or intercellular messangers which regulate immunological, inflammation,reparative host response.they are produced by widely distributed cells like macrophages ,monocytes, lymphocytes, platelets,fibroblast, endothelium,stromal cells etc.. platelets is also the answer | Anatomy | General anatomy | Cytokinee are secreted in sepsis in and systemic inflammatory response syndrome (SIRS) by:
A. Neutrophils
B. Adrenal
C. Platelets
D. Collecting duct
| Neutrophils |
4f35422d-7907-4a4e-a2e3-43484a81dd9c | Kikuchi Fujimoto disease Or histiocytic necrotizing lymphadenitis It is Benign and self-limited disorder in young individuals characterized by regional cervical lymphadenopathy with tenderness Accompanied with mild fever and night sweats Diagnosed on the basis of an excisional biopsy of affected lymph nodes which shows fragmentation, necrosis and karyorrhexis, presenting with posterior cervical lymphadenopathy. | Pathology | Auto Immune Disorders Introduction | Necrotizing lymphadenitis is seen in:
A. Kimura disease
B. Kikuchi Fujimoto disease
C. Hodgkin disease
D. Castelman disease
| Kikuchi Fujimoto disease |
3ee93576-d484-4bff-9171-c3375cd5428a | Colostrum contains a high concentration of proteins as compared to normal milk.REF.PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE.Editon-21.Page no.-491 | Social & Preventive Medicine | obstetrics,pediatrics and geriatrics | Colostrums has in compared to normal milk -
A. Decreased K
B. Decreased Na
C. Increased proteins
D. Increased calories
| Increased proteins |
cef4da9b-e2e4-4f6e-a3f2-7f3b75916ee3 | Ans. is 'c' i.e. Extremity Rhabdomyosarcomas of the extremities have alveolar histology which is associated with aggressive tumor biology. Also know RMS is the most common malignant tumor of the soft tissues in infants and children. MC site is head & neck region Among head & neck, orbit is the most common site. | Surgery | null | The prognosis of rhabdomyosarcoma is likely to be poor if the site of the tumor is ?
A. Orbit
B. Paratesticular
C. Extremity
D. Urinary bladder
| Extremity |
13d1a16b-7679-4da4-9ee1-c2cc3a7ce60b | COMMON FRACTURES CLASSIFICATION FRACTURECLASSIFICATIONOpen fracturesGustilo & Anderson Supracondylar Humerus Galand ( based on displacement )Proximal Humerus Neer ( 4 pa fractures )Distal Radius Frykman , FermandezPelvis Young & Burgess, TileFemoral head Pipkin's classificationFemoral neck ( Pediatric )Delbet classificationFemoral neck ( Adult )Pauwel ( Based on fracture angle )Garden ( Based on displacement )Interochanteric Boyd & Griffin , Evans Femoral shaft Winquist & Hansen ( Based on degree of communition ) Tibial plateau SchatzkerPilon fracture Ruedi -AllgowerAnkle Lauge -Hansen , Danis- Weber Talar neck Hawkin Calcaneum Essex -Lopresti , Sanders ( Based on CT findings )Physeal injuries Salter - Harris Classification (Refer: Mohindra's Fundamentals of Ohopedics, 2nd edition, pg no. 125) | Orthopaedics | All India exam | Pipkin classification is used for
A. Acetabular fractures
B. Pelvis ring fracture
C. Femoral head fracture
D. Femoral shaft fracture
| Femoral head fracture |
9baf28d2-adec-4f9c-bdef-818da8763755 | Ans: d (Metacarpophalangeal joint)Ref: Maheshwari Ortho, 3rd ed, p. 252 & Harrison, 15thed, p. 1990 | Orthopaedics | Arthritis | Osteoarthritis does not affect:
A. Knee joint
B. Hip joint
C. Interphalangial joint
D. Metacarpophalangial joint
| Metacarpophalangial joint |
69138b67-5fda-4a5b-947e-95923bbc535f | Out of the given options, only mumps and toxoplasma cause aqueductal stenosis. Toxoplasma is not a virus. Hence, the answer is mumps. | Pediatrics | null | Most common viral cause of acquired aqueductal stenosis is ?
A. Rubella
B. Mumps
C. Toxoplasma
D. Enterovirus
| Mumps |
507a0ca8-f93b-4cbe-b970-efb650197231 | Ans. is d, i.e. Anovulatory infertilityPulsatile GnRH is used for:* Ovulation induction (in managing anovulatory infertility)* Delayed, puberty | Gynaecology & Obstetrics | Physiology & Histology | Pulsatile GnRH is used for managing:
A. Precocious puberty
B. Fibroid
C. DUB
D. Anovulatory infertility
| Anovulatory infertility |
32dd536f-b070-4428-af6e-b5925aaa9de6 | In hyperdynamic sepsis, the peripheral aeriolar tone and BP are low but the cardiac output is often high; therefore the vasoconstrictor noradrenaline (norepinephrine) is appropriate to restore BP, usually at the price of some reduction in cardiac output.In most cases, a vasoconstrictor such as noradrenaline (norepinephrine) is necessary to increase SVR and BP, while an inotrope (dobutamine) may be necessary to maintain cardiac output. In the later stages of severe sepsis, the essential problem is at the microcirculatory level. Oxygen uptake and utilisation are impaired due to failure of the regional distribution of flow and direct cellular toxicity despite adequate global oxygen delivery. Tissue oxygenation may be improved and aerobic metabolism sustained by reducing demand, i.e. metabolic rate. ref:Davidsson&;s principles and practices of medicine,ed 21,pg no 598 | Medicine | C.V.S | The regional aerial resistance of the mesentery and kidney vessels is reduced by
A. Dopamine
B. Dobutamine
C. Nor adrenaline
D. Isoprenaline
| Nor adrenaline |
0e7bbb2e-7820-4b9f-bf7c-4445a12a3292 | Mifepristone, also known as RU486, is an antiprogestin that has been used for treatment of leiomyomas. Mifepristone diminishes leiomyoma volume by approximately half and it is effective in improving symptoms. Other uses of mifepristone: For termination of early pregnancy For emergency postcoital contraception Endometriosis Cushing's syndrome Breast cancer Other neoplasms such as meningiomas that contain glucocoicoid or progesterone receptors Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 9. Pelvic Mass. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e. | Gynaecology & Obstetrics | null | Which of the following is an indication for using mifepristone?
A. Ectopic pregnancy
B. Fibroid uterus
C. Molar pregnancy
D. Habitual aboion
| Fibroid uterus |
c8398700-b266-44dd-a502-1460e95711c3 | Pale infarcts are typically seen in hea, kidney and spleen. Red infarcts principally occur in organs with dual blood supply such as lungs, or in those organs with extensive collateral circulation such as brain and small intestine. In both types of infarcts, infarcted area shows coagulative necrosis, but in red infarct there is bleeding into the necrotic area from adjacent aeries and veins. Reference: Essentials of Rubin's Pathology edited by Emanuel Rubin, 5th edition page 123. | Pathology | null | Which of the following organs does not show pale infarct?
A. Lung
B. Hea
C. Kidney
D. Spleen
| Lung |
b48da862-312f-4ae1-ba72-346d5c4c2e96 | Ref Robbins 8/e p171;9/e p172 Example of mitochondrial inheritance is leber's hereditary optic neuropathy.leigh's disease ,MELAS - Mitochondrial encephalopathy Lactic acid Stroke like syndrome Neuropathy , ataxia, retinitis, Kearns Sayre syndromes, chronic progressive external opthalmoplegia,Pearson syndrome M | Anatomy | General anatomy | Mitochondrial chromosomal abnormality leads to
A. Leber's hereditary optic neuropathy
B. Angelman syndrome
C. Prader villi syndrome
D. Myotonic dystrophy
| Leber's hereditary optic neuropathy |
0a3d446a-b19d-464f-b943-07d247aa5046 | Ans. is 'a' i.e., 5 weeks [Ref: Dutta's Obs 7th/ep. 68}TVS showso Gestational sac & yolk sac - 5th weeko Fetal pole & cardiac activity - 6th weeko Embryonic movements - 7th weeko Fetal gestational age is best determined by CRL between 7th to 12th weeks (variation +/- 5 days)o Doppler effect of ultrasound can pick up heart rate by 10lh week. | Gynaecology & Obstetrics | Diagnosis of Pregnancy | Gestational sac is seen by TVS at-
A. 5 weeks
B. 6 weeks
C. 7 weeks
D. 8 weeks
| 5 weeks |
24529115-b874-4602-bac8-c556ae3de80c | Ans. is 'd' i.e., Prevents fibrinolysis o Tranexamic acid binds to the lysine binding sites on plasminogen and prevents its combination with fibrin and thus prevents fibrinolysis. | Pharmacology | null | Mechanism of action of transexaminic acid is?
A. Decrease vascular permeability
B. Smooth muscle contraction
C. Activates Plasmin formation
D. Prevents fibrinolysis
| Prevents fibrinolysis |
74e740a7-f4e9-4b75-a190-3dc560b2f498 | (c) Supraspinatus and subscapularis- Rotator interval is a triangular portion of shoulder capsule which lies between supraspinatus and subscapularis tendon and coracohumeral ligament passes through it. | Orthopaedics | Injuries Around Shoulder | Rotator interval is between:
A. Supraspinatus and teres minor
B. Teres major and teres minor
C. Supraspinatus and subscapularis
D. Subscapularis and infraspinatus
| Supraspinatus and subscapularis |
23a04e1e-6ac1-4851-b0e0-2bc31c2f5840 | Rotigotine is a non-ergot dopamine agonist indicated for the treatment of Parkinson's disease (PD) and restless legs syndrome (RLS). It is formulated as a once-daily transdermal patch which provides a slow and constant supply of the drug over the course of 24 hours. However, it was withdrawn in 2008 because of crystal formation on the patches, affecting the bioavailability and efficacy of this drug. | Pharmacology | null | Which of the following drug is used as a Transcranial patch for Parkinson's disease
A. Levodopa
B. Rotigotine
C. Selegiline
D. Carbidopa
| Rotigotine |
29b6eb2c-71dd-4388-bddb-a19f3218a540 | HILL-SACH&;S lesion is most commonly seen in recurent shoulder dislocation. It is a posterolateral defect in the head of the humerus.This is produced due to the impact of posterolateral pa of the head of the humerus against the sharp anteraior margion of the glenoid rim. ref:textbook of ohopedics ,john ebnezar,4th edition page no:136 | Orthopaedics | Shoulder and arm injuries | Hill Sach&;s lesion is most commonly seen in
A. Recurrent shoulder dislocation
B. Posterior shoulder dislocation
C. Fracture neck of humerus
D. Anterior shoulder dislocation
| Recurrent shoulder dislocation |
455bd18a-8840-415f-b6ba-cdf2dc55df5d | Ans. is 'c' i.e., Null cells Null cells (Large granular lymphocytes or LGLIo Null cells are called so because they lack features of surface markers of both B and T lymphocytes. The account for 5 to 10% of peripheral blood lymphocytes.o They are also called "large granular lymphocytes (LGL)"as they contain large azurophilic cytoplasmic granules. They express CD 16 and CD56 markers. They proliferate in response to IL-2.o LGLs arise in both bone marrow and thymic microenvironment. In contrast to T-cells, they are not MHC restricted.o Various types of LGLs are:-1) Antibody dependent cytotoxic cells (ADCC)# These cells kill/lyse target cells which are sensitized with IgG.2) Natural killer cells (NK cells)# These cells possess cytotoxic activity against virus infected cells, tumor cells and transplanted foreign cells.# Cytotoxicity of NK cells is neither antibody dependent nor MHC restricted. Activity is nonimmune as it does not require antigenic stimulation.# NK-cells are positive for CD16 and CD56.# NK cells are usually negative for CD3, but a subset is positive for CD3 called NK/T-cells.# IL-2 acts as a growth factor for NK cells. NK cells activity is augmented by interferon. NK cells secrete peroforin (resembles comlement C9) which causes transmembrane pores through which cytotoxic factors (e.g. TNF-b) enters the cells and induce apoptosis.o Virus infected cells and tumor (cancer) cells are killed by NK cells and cytotoxic T-cells.3) Lymphokine activated killer (LAK) cells# These are NK cells which are activated by IL-2. These cells kill tumor cells more efficiently than unstimulated NK cells. | Microbiology | Immunology | Natural killer cell is -
A. MHC restricted
B. Antibody dependent
C. Null cells
D. B-lymphocytes
| Null cells |
faa5126d-1049-4f06-bf2a-ac2aae7f959f | The external laryngeal nerve lies in relation to superior thyroid aery. The recurrent laryngeal nerve lies close to inferior thyroid aery. | ENT | null | Most common nerve injured in ligation of superior thyroid aery:
A. Recurrent laryngeal nerve
B. Facial nerve
C. Mandibular nerve
D. External laryngeal nerve
| External laryngeal nerve |
d7fc3477-6c0e-4054-86e6-5a6532dc949a | Ans. is 'a' i.e., Brain o Duret - Bernard hemorrhage can be seen with severe compression of the midbrain and other brainstem areas during transtentorial herniation. | Medicine | C.N.S. | Duret hemorrhage seen in -
A. Brain
B. Kidney
C. Heart
D. Lung
| Brain |
60137255-30ef-4f50-ae6c-8adbef9ddf67 | According to previous editions of Park (21st/e) the minimum and maximum established values for life expectancy atbirth was 25 years and 85 years, respectively.
However, Now the minimum established value is 20 years and maximum value is the highest observed value during time series, i.e. the country which has the highest value is taken as reference for maximum value. For example themaximum life expectancy is observed in Japan (83.4 in 2011). Thus 83.4 years is taken as
upper (maximum limit).
That means minimum value is established at 20 years and maximum value is established at 83.4 years.
Human development index (HDI)
o HDI is a composite index combining indicators representing three dimensions –
(i). Longevity (life expectancy at birth)
(ii). Knowledge (Adult literacy rate and mean years ofschooling, i.e. Gross enrolement ratio)
(iii). Income (real GDP per capita in purchasing power parity in US dollars)
The HDI is an index used to rank countries by level of human development.
o According to HDI countries are divided -
(i). Developed countries (High HDI → ≥0.8) →USA, Canada, Norway
(ii). Developing countries (medium HDI → 0.5-0.79)→India
(iii). Underdeveloped countries (Low HDI → ≤0.5)→Seiera, Ethopia
Following information has been added in 22nd/e of Park
Components of human development index have changed. Now it includes expected years of schooling (insteadof adult literacy rate) and GNI per capita (instead of GDP per capita). | Unknown | null | Age limit for HDI?
A. 25 to 85 yrs
B. 25 to 50 yrs
C. 15 to 45 yrs
D. 50 to 75 yrs
| 25 to 85 yrs |
1085c041-d2db-41fc-ab3f-5ce4daaf78b1 | Ans. d. IgA and IgG2 deficiency Recurrent episodes of pyogenic infections by capsulated organisms are most commonly observed in patients with selective IgA deficiency and decreased IgA or IgG subclass levels (especially IgG2). "Specific Antibody Deficiency (SAD) patients generally present with recurrent upper and/or lower respiratory infections due to an encapsulated organisms (Streptococcus pneumonia, Haemophilus influenza, Branhamella catarrhalis, or Staphylococcus aureus). Frequent, recurrent episodes of otitis media are most commonly observed in patients with selective IgA deficiency and decreased IgA or IgG subclass levels (especially IgG2)." Specific Antibody Deficiency (SAD) Antibody deficiency against microbial polysaccharide antigens is a well-established clinical entity and has been referred to as either antigen specific antibody deficiency (ASAD) or specific antibody deficiency (SAD)Q Frequent, recurrent episodes of otitis media are most commonly observed in patients with selective IgA deficiency and decreased IgA or IgG subclass levels (especially IgG2) Q. Frequent nfections were repoed in 92% of patients with SAD (sinusitis, 77%; pneumonia, 42%; otitis media,25%; bronchitis, 28%). | Microbiology | null | In a 4-year old boy who has history of pyogenic infections by bacteria with polysaccharide-rich capsules, which of the following investigations should he done?
A. IgA deficiency
B. IgG 1 deficiency
C. IgG2 deficiency
D. IgA and IgG2 deficiency
| IgA and IgG2 deficiency |
c4cd0bcf-69dc-4a56-a44a-46ccf0ad0646 | Rhinophyma is a slow-growing benign tumor due to hypertrophy of sebaceous gland. | ENT | null | Rhinophyma is associated with-
A. Hypertrophy of the sebaceous glands
B. Hypertrophy of sweat glands
C. Hyperplasia of endothelial cells
D. Hyperplasia of epithelial cells
| Hypertrophy of the sebaceous glands |
8d028eef-4996-42d1-ab3c-b34ac7f53ec7 | New amphotericin B formulations: In an attempt to improve tolerability of i.v. infusion of AMB, reduce its toxicity and achieve targeted delivery, 3 new lipid formulations of AMB have been produced. (a) Amphotericin B lipid complex (ABLC): Contains 35% AMB incorporated in ribbon like paicles of dimyristoyl phospholipids. ( b ) Amphotericin B colloidal dispersion (ABCD). Disc shaped paicles containing 50% each of AMB and cholesteryl sulfate are prepared as aqueous dispersion (c) Lpi osomal amphotericin B (small unilamellar vesicles SUV): Consists of 10% AMB incorporated in uniform sized (60-80 nM) unilamellar liposomes made up of lecithin and other biodegradable phospholipids. The special features of these preparations are: * They, except ABCD, produce milder acute reaction (especially liposomal formulation) on i.v. infusion. * They can be used in patients not tolerating infusion oi conventional AMB formulation. * They have lower nephrotoxicity. * They cause minimal anaemia. * The liposomal preparation delivers AMB paicularh* to reticuloendothelial cells in liver and spleen-----especialh valuable for kala azar and in immunocompromised patients ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:758 | Pharmacology | Chemotherapy | Amphotericin B toxicity can be reduced by?
A. Incorporating it in liposomal complex
B. Combining with fluconazole
C. Combining with flucytosine
D. Injecting the drug with dextrose
| Incorporating it in liposomal complex |
e3dee44b-eadc-4bc7-8800-27d4ab477dfb | Ans. (a) MgSO4 Ref: Williams Obstetrics 25th Ed; Page No-730* To prevent convulsions; Administer IV MgSO4 and Continue IV MgSO4 for 24 hours after delivery.* Always avoid Nifedipine and b-blockers, because they cause severe maternal complication.Antihypertensive Drug Therapy Issues* Discontinue medications: This may be done in patients with mild-to-moderate HTN caused by the normal decrease in BP that occurs in pregnancy. Pharmacologic treatment in patients with diastolic BP <90mmHg or systolic BP <140mmHg does not improve either maternal or fetal outcome.* Maintain medications: It may be necessary in the case of patients with severe HTN. The drug of choice is methyl-dopa because less teratogenicity. Labetalol may be acceptable as alternatives. b-blocking agents side effects are intrauterine growth retardation (IUGR).* "Never use" medications: Angiotensin-converting enzyme inhibitors are mostly contraindicate in pregnancy, due to it is associated with some side effects; such as fetal hypocalvaria, renal failure, oligohydramnios, and death. Diuretics are contraindicated during pregnancy due to possible adverse fetal effects which are associated with the plasma volume reduction.* BP target range: Decreases of BP to normal valve in pregnancy may jeopardize Uteroplacental blood flow. Maintain diastolic values between 90 and 100mmHg.Management* Conservative outpatient management is appropriate with uncomplicated mild-to-moderate chronic HTN.# Stop drug therapy: Try to discontinuation of antihypertensive agents. Follow guideline outlined.# Serial sonograms and antenatal testing is appropriate after 30 weeks' gestation to monitor for increased risk of IUGR.# For early identification of superimposed preeclampsia; Serial BP and urine protein assessment are needed.# If the cervix is favorable; Induce labor at 39 weeks* Aggressive prompt delivery is indicated for chronic HTN with superimposed preeclampsia at any gestational age.# To prevent convulsions; Administer IV MgSO4 and Continue IV MgSO4 for 24 hours after delivery.# Try to keep diastolic BP between 90 and 100mmHg with IV hydralazine and/or labetalol.# If mother and fetus are stable; Attempt vaginal delivery with IV oxytocin infusion. | Gynaecology & Obstetrics | Pharmacotherapeutic in Obstetrics | In preterm labour which drug has Neuro-protective role?
A. MgSO4
B. Nifedipine
C. Ritoridine
D. Isoxsuprine
| MgSO4 |
c8745cac-94bb-4d0c-90aa-756df9973462 | Ans: d (Ciliary body contraction) Ref:Ganong, 22th ed, p. 154Accommodation is brought about by ciliary muscle contractionAccommodationThe process by which the curvature of the lens is increased is called accommodation.Mechanism: At rest the lens is under tension by lens ligaments & lens is pulled into a flattened state.When the gaze is directed towards a nearby object, ciliary muscle contracts. This decreases the distance between the edges of ciliary body & relaxes lens ligaments so that the lens attains a more convex shape. The change is maximum at the anterior surface of the lens (i.e., radius of curvature changes from 10 mm to 6 mm). The curvature of the posterior surface remains almost the same (i.e., 6 mm). This may add as many as 12 D to the refractive power of eye. | Ophthalmology | Elementary Optics | Accommodation is brought about by:
A. Dilation of iris
B. Dilation of pupil
C. Lens zonules made tense
D. Ciliary body contraction
| Ciliary body contraction |
0fe69853-983a-4e6b-931d-d552f7777928 | *Saccular aneurysm at size of >7mm and at top of basilar aery and at origin of posterior communicating aery are at greater risk of rupture . Ref Harrison20th edition pg 2445 | Medicine | C.N.S | A patient with suspected subarachnoid haemorrhage presents with blood isolated in the fouh ventricle on a CT scan. Aneurysmal rupture is likely to have resulted from
A. Posterior Inferior Cerebellar Aery Aneurysm
B. Anterior Communicating Aery Aneurysm
C. Posterior Communicating Aery Aneurysm
D. Basilar Aery Tip Aneurysm
| Posterior Communicating Aery Aneurysm |
e88c22c4-23f1-44e2-9f26-a430eaaf3f4e | Ans. is 'b' i.e., Headache Due to vasodilatation there may be tachycardia, palpitation, flushing, headache, dizziness and fainting may occur. Adverse effects Due to vasodilatation tachycardia, palpitation, flushing, headache, dizziness and fainting may occur. Rashes are common paicularly with pentaerythritol tetranitrate. Methemoglobinemia. Sildenafil causes dangerous potentiation of nitrate action (cGMP is increased by nitrates and its breakdown by phosphodiesterase is inhibited by sildenafil - marked accumulation of cGMP) - severe hypotension, MI and death may occur the only contraindications of nitrates use are hypotension or simultaneous use of sildenofil. | Pharmacology | null | Sublingual nitroglycerin for treatment of acutechest pain can cause ?
A. Hypeension
B. Headache
C. Bradycardia
D. Sexual dysfunction
| Headache |
5bbf4eaa-c62a-4031-ba1a-74c8ce49c6fb | Ans. is 'b' i.e., Age group 15-65 years Dependency ratio The propoion of persons above 65 years of age and children below 15 years of age are considered to be dependent on the economically productive age group (15-64 years). The ratio of combined age group 0-14 years plus 65 years and above to the 15-65 years age group is known as total dependency ratio. | Social & Preventive Medicine | null | Denominator in dependency ratio ?
A. Age group < 15 years
B. Age group 15-65 years
C. Age group > 65 years
D. < 15 years and > 65 yeas
| Age group 15-65 years |
3c64e4ad-8d9c-4fbc-9065-c5d1bed748ed | Capecitabine and 5-FU can cause hand and foot syndrome. Diarrhea is the most common adverse effect of 5-FU. 5-FU can also cause bone marrow suppression. Drugs commonly implicated are: Capecitabine 5-Fluorouracil Cytarabine Pemetrexed Doxorubicin | Pharmacology | Cytotoxic Anticancer Drugs | Hand and foot syndrome is an adverse effect of:
A. 5-Fluorouracil
B. Bleomycin
C. Etoposide
D. Actinomycin D
| 5-Fluorouracil |
5bd7c211-d519-4173-a982-1b501e1943a6 | PUVA is used to treat extensive psoriasis and psoriasis that has not responded to other therapies. PUVA stands for psoralens plus UVA. Psoralens are used orally followed by exposure of lesions to measured amount of a type of ultraviolet light-UVA. Sho term side effects of PUVA therapy include tanning, pruritus, nausea, headache and dizziness. Long term side effects include cataracts, lentigines, photoaging, squamous cell carcinoma and melanoma. Ref: Step by Step(r) Psoriasis Management By Khanna Neena, page 283. Manual of Dermatologic Therapeutics By Kenneth A. Arndt page 262. | Skin | null | Which of the following skin conditions is treated with PUVA therapy?
A. Psoriasis
B. Tinea versicolor
C. Lichen planus
D. Porphyria cutanea tarda
| Psoriasis |
ea3c1658-c844-4fb8-80ac-62973f93f2ed | 3 glycerol, 4 fatty acids , 2 phosphates Cardiolipin is a complex phospholipid, which can be antigenic. The structure is glycerol attached to two phosphatidic acids. Each phosphatidic acid contains one glycerol, 2 FA and one phosphate. So in total 3 glycerol, 4 fatty acids, 2 phosphates are present in cardiolipin. | Biochemistry | Chemistry of Lipids | Products of complete hydrolysis of cardiolipin are:
A. 3 glycerol, 4 fatty acids , 2 phosphates
B. 3 glycerol, 4 fatty acids , 1 phosphates
C. 3 glycerol, 3 fatty acids , 2 phosphates
D. 5 glycerol, 4 fatty acids , 2 phosphates
| 3 glycerol, 4 fatty acids , 2 phosphates |
b3c251fc-d600-49f0-b005-db8fc46c14cc | Ans. B. GLUT2GLUTTissue LocationFunctionGLUT 1Brain, Placenta, Kidney, RBCBasal Glucose UptakeGLUT 2Liver, Pancreas, IntestinePancreas-Insulin SecretionGLUT 3Brain (Neurons), PlacentaBasal Glucose UptakeGLUT 4Skeletal Muscle, Adipose Tissue, Cardiac MuscleInsulin stimulated uptake after mealsGLUT 5Small Intestine, TestisFructose TransportGLUT 6WBC, SpleenNot KnownGLUT 7Liver, Endoplasmic ReticulumGlucose transport in ER | Biochemistry | Carbohydrates | Glucose transporters present in the Beta cells of the Islets of Langerhans is:
A. GLUT1
B. GLUT2
C. GLUT3
D. GLUT4
| GLUT2 |
4921c86c-9682-4e1a-8d35-3edb40c45a57 | Refer Miller 7/ep781 Truncal rigidity caused by highly lipid soluble opioids like Fentanyl is supraspinal in origin. It is mainly caused by stimulation of mu receptors whereas kappa and delta receptors tend to reduce the rigidity | Pharmacology | Anesthesia | Muscular timidity caused by opioids is due to the agonist effect on which receptor
A. Mu
B. Kappa
C. Delta
D. Sigma
| Mu |
9e14a61e-9991-453a-a7fb-5b0d7251cea0 | Teratoma is most radio-opaque because of its calcifications (Ref: Radiology Review Manual by Wolfgang Dahne 6thEtd, 1010) | Radiology | All India exam | Maximum radiopaque shadow in ovary is seen in
A. Teratoma
B. Dysgerminoma
C. Mucinous cyst adenoma
D. Granulose cell tumour
| Teratoma |
266c3949-61fc-4dfd-98d4-dec06bc18bcd | <p> Lymphoedema Accumulation of fluid in extracellular and extravascular fluid compament , commonly in subcutaneous tissue. Classification: 1. Primary - without any identifiable disease. 2. Secondary- acquired due to definitive cause. Primary lymphoedema:- Affects commonly females. Common in lower limb and left side. It can be familial , syndromic ( Turners , Klinefelter&;s , Down&;s, Klipple Trenauy weber) It can be 1. Lymphoedema congenital : present at bih (<2yrs). Familial type is called Nonne- Milroy disease. 2. Lymphoedema praecox- present at pubey (2-35 years). Familial type is called Letessier- Meige&;s syndrome. 3. Lymphoedema tarda- present in adult life after 35 years. Complications: Skin thickening, abscess, maggot formation. Recurrent cellulitis Lymphangiosarcoma Recurrent streptococcal infection. Conservative treatment:- 1. Elevation of limb, exercise , weight reduction. 2. Static isometric activities like prolonged standing or weight lifting should be avoided. 3. Diuretics to reduce edema. 4. Daily wearing of below knee stockings. 5. Daily wearing of below knee stockings. 6. Intermittent pneumatic compression devices. 7. Antibiotics- flucloxacillin, erythromycin, long acting penicillin. 8. Skin care. 9. Complex decongestive therapy {Reference: SRB&;s manual of surgery, 5th edition , page no. 247} | Surgery | Vascular surgery | Antibiotic of choice for lymphedema is ?
A. Penicillin
B. Amikacin
C. Metronidazole
D. Ceftazidime
| Penicillin |
e4012dca-8632-44f1-b40d-a28dd7cf8fe7 | PERSONS WITH HIGH RISK OF CMV INFECTION : organ transplantation with malignant tumors who are recieving chemotherapy with hiv/aids viral excreation is icreased and prolonged diffuse interstitial pneumonia is common complication ref : ananthanaryana 9th ed | Microbiology | All India exam | a 40 yr old man underwent renal transplantation two months after transplantation he developed fever and features suggestive of bilateral diffuse interstitial pnuemonitis. what is causative agent ?
A. HSV
B. CMV
C. EBV
D. VZV
| CMV |
897920f2-ed35-4fbb-a5fc-bda825e39195 | Essentials of Diagnosis & Typical Features of Tuberous sclerosis: Facial angiofibromas or subungual fibromas. Often hypomelanotic macules, gingival fibromas. Retinal hamaomas. Coical tubers or subependymal glial nodules, often calcified. Renal angiomyolipomas. Seizures are the most common presenting symptom. Up to 20% of patients with infantile spasms (a serious epileptic syndrome) have tuberous sclerosis. Ninety-six percent of patients have one or more hypomelanotic macules, facial angiofibromas, ungual fibromas, or shagreen patches. Adenoma sebaceum, the facial skin hamaomas, may first appear in early childhood, often on the cheek, chin, and dry sites of the skin where acne is not usually seen. Mental retardation occurs in up to 50% of patients referred to teiary care centers; the incidence is probably much lower in randomly selected patients. Patients with seizures are more prone to mental retardation or learning disabilities. Diagnostic studies: More helpful is MRI or CT scanning; the latter can show the viually pathognomonic subependymal nodular calcifications and sometimes widened gyri or tubers and brain tumors. Contrast material may show the often classically located tumors near the interventricular foramen. Hypomyelinated lesions may be seen with MRI. Ref: Bernard T.J., Knupp K., Yang M.L., Kedia S., Levisohn P.M., Moe P.G. (2012). Chapter 25. Neurologic & Muscular Disorders. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e. | Pediatrics | null | A child presented to the emergency depament with seizures. On examination oval hypopigmented macules were noted on the trunk, along with sub-normal IQ. What is the probable diagnosis?
A. Neurofibromatosis
B. Sturge Weber
C. Tuberous sclerosis
D. Incontinentia Pigmenti
| Tuberous sclerosis |
63826197-0786-43c2-9c7e-5c4c471dc731 | CA rectum- MC site of large bowel malignancy- Usually seen in 5th - 6 decade- MC site of metastasis - Liver > lungs - Chemotherapy regimen- FOL FOX-IV* FOL - Folinic acid/ leucovorin* F- 5-FV (5-Flurouracil)* Ox- Oxaliplatin Clinical features- MC symptom - Bleeding PR- Early morning bloody diarrhea- Passage of bloody slime (no fecal matter) - Spurious diarrhea (every 2 to 3 hours, rectum is full with discharge from tumor, so patient passes like stool every 3 hours)- Tenesmus - Painful defecation with sensation of incomplete evacuation seen in lower pa of CA rectum- Back ache/ sciatica (sacral plexus involvement posteriorly)- Weight loss (liver metastasis) Investigations- Length of anal canal - 3cm- length of rectum - 14cm- For complete evaluation, the length of the instrument should be at least 17 cm Investigations Options available- PROCTOSCOPY- Sigmoidoscopy- Colonoscopy* Length of proctoscope - 10 cm* Rigid sigmoidoscope -25 cm* Flexible sigmoidoscope- 60cm* Colonoscope - 160 cm- Investigation of choice - Rigid sigmoidoscopy + biopsy- Colonoscopy is mandatory for adequate evaluation of whole colon and to rule out any synchronous polyp or synchronous malignancy* Synchronous- simultaneously* Metachronous- later after surgery- Viual colonoscopy (3D reconstruction colonoscopy using CT) * Advantage - can visualize outside of lumen also* Disadvantage - Biopsy of colon cannot be done- In head & neck malignancies & pelvic malignancies, overcrowding of nerves, blood vessels & soft tissues. So, IOC for staging of most of head and neck malignancy- MRI- For T- staging, investigation of choice- TRUS (Transrectal ultrasound)- Distantly lying nerve, lymph node, vessel cannot be differentiated as Sensitivity of ultrasound decrease if distance between probe & organ increase. - For lymph node staging, investigation of choice is - Endorectal MRI- Overall Best investigation for staging- MRI Treatment- Principle of treatment in CA Rectum* Stage I - Surgical resection* State II & III - Neoadjuvant chemoradiation followed by surgical resection (down stage the tumor & then surgery)* Stage IV - Neoadjuvant chemoradiation followed by palliation +- surgical excision - TOC- TOTAL MESORECTAL EXCISION* Given by Bill Heald* Significant length of bowel removal around the tumor* Removal of Surrounding tissues up to the plane between Mesorectum & Presacral Fascia known as HEALD'S HOLYPLANE - If CA rectum is located > 5 cm above Anal verge - Low Anterior Resection (LAR)- If CA rectum is located at or below 5 cm from anal verge - APR (Adomino Perineal resection) aka Mile's Procedure - In elderly patient >60 years with malignancy in sigmoid/ or proximal pa of rectum which is intraperitoneal - Haman's procedureHaman's procedure* Sigmoidectomy +Descending colostomy + Closure of rectal stump | Surgery | Rectum and anal canal | A 65yr old male patient presents with history of early morning bloody diarrhoea, Change in bowel habits, Intermittent Obstruction.Sometimes he had a feeling of incomplete evacuation and Tenesmus. There is no positive family history for any carcinoma.What will be the treatment of choice in this case:
A. Total mesorectal excision
B. Hamann's procedure
C. Anterior resection
D. Abdominoperineal resection
| Total mesorectal excision |
c7629450-a7e3-4aba-8dab-b56c15bc4592 | Ans. is 'b' i.e., Loss of negative charge on membrane o Sialoproteins in the glomerular capillary wall are negatively charged, and studies with anionically charged and cationically charged dextrans indicate that the negative charges repel negatively charged substances in blood, with the result that filtration of anionic substances 4 nm in diameter is less than half that of neutral substances of the same size.o This probably explains why albumin, with an effective molecular diameter of approximately 7 nm, normally has a glomerular concentration only 0.2% of its plasma concentration rather than the higher concentration that would be expected on the basis of diameter alone; circulating albumin is negatively charged,o In certain kidney diseases, the negative charges on the basement membrane are lost even before there are noticeable changes in kidney histology, a condition referred to as minimal change nephropathy,o As a result of this loss of negative charges on the basement membranes, some of the lower-molecular-weight proteins, especially albumin, are filtered and appear in the urine, a condition known as proteinuria or albuminuria. | Physiology | Diuretics, Kidney Diseases | The main cause of minimal change ds is:
A. Increase in pore size
B. Loss of negative charge on membrane
C. Loss of cells
D. Decreased circulation
| Loss of negative charge on membrane |
b9581080-6726-41da-95d7-a695d9bc071b | This is a case of Congenital Diaphragmatic (Bochdalek) Hernia. Herniation of abdominal contents into the pleural cavity (usually left). Caused by a failure of the pleuroperitoneal membrane to develop or fuse with other components of the diaphragm. Affected neonates usually present in the first few hours of life with respiratory distress that may be mild or so severe as to be incompatible with life. Symptoms : Difficulty in breathing (neo-natal emergency) O/E -Barrel-shaped chest, Scaphoid-shaped abdomen, and absence of breath sounds on the left side CXR -Air/fluid containing bowel in the left-side hemithorax | Anatomy | Umblicial cord and diaphragm | A mother is holding her newborn baby in the hospital bed just a few hours after giving bih. The mother becomes alarmed when her baby begins to have a difficulty in breathing and she rings for help. You arrive at the bedside and observe that the baby is in severe respiratory distress. A quick physical examination reveals that the baby has a barrel-shaped chest, a scaphoid-shaped abdomen, and absence of breath sounds on the left side. A chest radiograph reveals air/fluid containing bowel in the left-side hemithorax, no visible aerated lung on the left side, contralateral displacement of the hea and other mediastinal structures, compression of the contralateral lung, and reduced size of the abdomen. Which of the following is the most likely diagnosis?
A. Esophageal Hiatal hernia
B. Infantile Hyperophic Pyloric Stenosis
C. Tracheoesophageal fistula (TEF)
D. Congenital Diaphragmatic Hernia
| Congenital Diaphragmatic Hernia |
21766122-395b-426f-9408-64c57c145ed0 | In AIDS patients fungal infections by dimorphic fungi are more common. Of the following options all four other dimorphic fungi but the yeast stage with broad-based cells is seen only in blastomycosis histoplasma shows narrow base yeast cells. In coccidioidomycosis endospore, spherules are formed and in paracoccidioidomycosis, Mickey Mouse type of cells are seen. | Microbiology | JIPMER 2018 | A HIV positive patient presents with cough for 10 days. Sputum culture by SDA reveals broad budding yeast, diagnosis:
A. Histoplasma capsulatum
B. Blastomycosis
C. Coccidiodomycosis
D. Paracoccidiomycosis
| Blastomycosis |
bf2deb5e-004a-495e-9a3b-1ba8377ea6a2 | Ciliary body is called the dangerous area of eye Allergic theory is being postulated as the reaosn for calling it as dangerous area of eye. During trauma to eye when ciliary body is injured it exposes uveal pigments and excites plastic uveitis in the sound eye. | Ophthalmology | Ocular Embryology& Anatomy | Which of the following is known as the dangerous zone of the eye?
A. Sclera
B. Retina
C. Optic nerve
D. Ciliary body
| Ciliary body |
265980c2-f382-474b-ad45-7d2ea39c6936 | Skin rashes with presence of ketones and metabolic acidosis are all features of Multiple carboxylase deficiency. Phenylalanine hydroxylase deficiency- microcephaly, hypopigmentation, musty body odour Glucose 6 phosphatase deficiency- doll like facies | Pediatrics | Disorders of Amino acid Metabolism | A 6-month-baby presented with recurrent seizures and developmental delay. On examination there was alopecia and scaly skin rashes. Investigations revealed metabolic acidosis, elevated lactates & ketonuria. What could be the underlying enzyme deficiency?
A. Phenylalanine hydroxylase
B. Epimerase
C. Multiple carboxylase
D. Glucose 6 phosphatase
| Multiple carboxylase |
9b710500-45ff-46fc-ae81-3dd6ed29caea | The above symptoms suggests of TCA toxicity in a patient of depression and NaHCO3 remains as the main stay of treating TCA toxicity and metabolic acidosis associated with it. | Psychiatry | null | A patient diagnosed with depression on treatment came to emergency with altered sensorium seizures, palpitations and ECG showing sinus tachycardia. How do you treat this patient?
A. Aspirin + clopidogrel
B. IV Lorazepam
C. IV Sodium bicarbonate
D. IV Haloperidol
| IV Sodium bicarbonate |
655bef9d-6f6a-4113-9454-1d89fc61fcdc | Infection is acquired from pigs and other animal reservoirs or from human carriers. The infective form is the cyst, which is ingested in contaminated food or drink.excystment takes place in the small intestine and the liberated trophozoites reach the large intestine where they feed and multiply as lumen commensals. Infection is very often confined to the lumen and is asymptomatic. Clinical disease results only when the trophozoites burrow into the intestinal mucosa, set up colonies and initiate inflammatory reaction. This leads to mucosal ulcers and submucosal abscesses. resembling the lesions in amoebiasis. Clinically also, balantidiasis resembles amoebiasis, causing diarrhoea or frank dysentery with abdominal colic, tenesmus, nausea and vomiting. Occasionally there may occur intestinal perforation with peritonitis and rarely involvement of genital and urinary tracts TEXTBOOK OF MEDICAL PARASITOLOGY,CKJ PANIKER,6TH EDITION,PAGE NO111 | Microbiology | parasitology | Cyst form is found in -
A. Entamoeba fragilis
B. B.Coli
C. T. Vaginalis
D. T. Intestinalis
| B.Coli |
7127064c-afe7-4544-8703-455106284c54 | Kawasaki disease is an acute, febrile, multisystem disease of children. Although the disease is generally benign and self-limited, it is associated with coronary aery aneurysms in approximately 25% of cases.There is typical intimal proliferation and infiltration of the vessel wall with mononuclear cells. Beadlike aneurysms and thromboses may be seen along the aery. Other manifestations include pericarditis, myocarditis, myocardial ischemia and infarction, and cardiomegaly. High-dose IV g-globulin (2 g/kg as a single infusion over 10 h) together with aspirin (100 mg/kg per day for 14 days followed by 3-5 mg/kg per day for several weeks) have been shown to be effective in reducing the prevalence of coronary aery abnormalities when administered early in the course of the disease. Surgery may be necessary for Kawasaki disease patients who have giant coronary aery aneurysms or other coronary complications. Surgical treatment most commonly includes thromboendaerectomy, thrombus clearing, aneurysmal reconstruction, and coronary aery bypass grafting.Ref: Harrison&;s Principles of Internal Medicine; 19th edition; Chapter 385 The Vasculitis Syndromes; Page no: 2193 | Pediatrics | C.V.S | Which one of the following conditions is associated with Kawasaki&;s syndrome?
A. Acute rheumatic fever
B. Pulseless disease
C. Coronary aery aneurysm
D. Systemic lupus erythematosus
| Coronary aery aneurysm |
9ea68eb9-89ba-490c-99f5-18d0ed931072 | Chemotherapy in Carcinoma Breast: First generation regimen such as 6-monthly cycle of cyclophosphamide, methotrexate and 5-fluorouracil(CMF) will acheive a 25% reduction in the risk of relapse over a 10-12 year period. CMF is no longer considered adequate adjuvant chemotherapy. Modern regimens include an anthracycline (doxorubicin or epirubicin) and taxanes Effect of combining hormone and chemotherapy is additive although hormone therapy is staed after completion of chemotherapy to reduce side-effects. Most popular combinations were CMF & CAF (Cyclophosphamide, Adriamycin(Doxorubicin), and 5-flurouracil) In the united states, a combination of Adriamycin (doxorubicin) and cyclophosphide (AC) or Ac plus a taxane (docetaxel, paclitaxel) are likely to be used as polychemotherapy. For Her-2-positive breast cancer, adding trastuzumab to polychemotherapy is approved for use as a surgical adjuvant Anthracycline-containing combinations are significantly better than no treatment, single agent treatment or CMI Hormone Therapy in Breast carcinoma: Ovarian suppression or ablation: Bilateral oophorectomy Medically by LHRH agonist (Goserelin, Leuprolide) SERM: Tamoxifen & Raloxifen Aromatase inhibitors: Non-steroidal : Letrozole & Anastrozle Steroidal: Examestane Anti-estrogens: Fulvestrant Progestins: Megesterol & Medroxypregesterone acetate Ref: Sabiston 20th edition Pgno: 857 | Surgery | Endocrinology and breast | A 30 year old female presented with unilateral breast cancer associated with axillary lymph node enlargement. Modified radical mastectomy was done, fuher treatment plan will be:
A. Observation and follow up
B. Adriamycin based chemotherapy followed by tamoxifen depending on estrogen/progesterone receptor status
C. Adriamycin based chemotherapy only
D. Tamoxifen only
| Adriamycin based chemotherapy followed by tamoxifen depending on estrogen/progesterone receptor status |
9e3d3ec9-c4b9-40d1-8fc6-50333f8ec44a | Ans. b (Ultrasonography). (Ref. Grainger Radiology, 4th/2469; Refer Q. No. 17 of Radiology of MH'2002).RADIOLOGICAL PROCEDURE/ TOOLPRIME INDICATIONSIVP/IVU# Renal tuberculosis# Renal anomaliesOesophagography# TO fistula (Water-soluble contrast study)# Motility disorders (initial evaluation)# DysphagiaHysterosalpingography (Postmenstrual-preovulatoryperiod)# Infertility0# Congenital uterine anomalies# Tubal blockUrethrography# PU Valves (MCU)# VUR (MCU)# Trauma# StrictureUltrasound# Hydrocephalus in infants0# Thyroid nodule# Initial evaluation of Rotator cuff injury/ subacromial bursitis/ bicipital tendinitis0# Synovial cysts# Pleural/ Pericardial effusion0# First investigation done for Acute abdomen and obstructive jaundice0# Congenital Hypertrophic Pyloric Stenosis & Intussuception0# Gallstones0# Initial evaluation of focal liver lesions# Initial evaluation of blunt trauma abdomen (FAST protocol) 0# Free fluid in abdomen0# Cystic hygroma# Prostatic pathologies (TRUS)# Seminal vesicle pathologies (TRUS)# Staging of early rectal/pancreatic head malignancies (EUS)# Neuroectodermal pancreatic tumors-insulinoma & gastrinoma (EUS)# Scrotal pathologies# Developmental dysplasia of Hip0# Ectopic pregnancy (TVS) 0MRI# Investigation of choice for all brain tumors (CEMRI) 0# Chronic subarachnoid hemorrhage (MRI-FLAIR) 0# Sensitive most for ischemic stroke (DWMRI) 0# In perinatal asphyxia , neurological damage can be predicted by MRI# The best investigation for parameningeal rhabdomyosarcoma0# Best choice to radiologically evaluate a posterior fossa tumor0# Gadolinium enhanced MRI is investigation of choice for vestibular schwannoma.0# First investigation of choice for spinal cord tumor0# Investigation of choice for multiple sclerosis (all white matter diseases)0# Ideal test to detect bone metastasis to only spine. (For all other bones - metastasis : bone scan)0# Imaging of pancoast's tumor ( superior sulcus tumor )deg# Imaging of posterior mediastinal masses# Investigation of choice in traumatic paraplegia0# Investigation of choice for evaluation of suspected Perthes disease and acute osteomyelitis.0# In a 40 year old female patient on long term steroid therapy presents with recent onset of severe pain in the right hip. Imaging modality of choice for this patient is MRI.# Investigation of choice for a pregnant lady with upper abdominal mass# The most sensitive and specific investigation for renal artery stenosis.# Investigation of choice in aortic dissection0# Best diagnosis for dissecting aorta (aortic dissection).# MoyaMoya disease (MRA) | Radiology | Nervous System | Investigation of choice for diagnostic evaluation of hydrocephalus is a one month old child?
A. X-ray skull
B. Ultrasonography
C. CT scan
D. MRI
| Ultrasonography |
1c099a36-e339-4477-84ab-5fbce6ad51ab | Ref: Robbin's Pathology, 9th ed. pg. 324-325Cancers associated with radiation:* ALL, AML, CML* Thyroid cancer* Breast cancer* Lung cancer* Bladder, ovarian cancerCancers not seen with radiation:* CLL* Hodgkin's lymphoma* Prostate cancer, testis cancer and cervical cancer | Pathology | Hemodynamics | Which of the following leukemia almost never develops after radiation?
A. Acute myeloblastic leukemia
B. Chronic myeloid leukemia
C. Acute lymphoblastic leukemia
D. Chronic lymphocytic leukemia
| Chronic lymphocytic leukemia |
2531380d-f56b-446a-b9c8-a413b7a51f71 | Ans: a (ACTH in fetus) Ref: Ganong, 22nd ed, p. 451This also is a direct pick from self study MCQs (Chap 23 Q. 17)Mechanism responsible for onset of labour:| Circulatory estrogens due to increase in circulatory DHEAS.So |' gap junction - |' uterine contractions.| GRH by fetal hypothalamus - |' circulatory ACTH - | cortisol leading to maturation of respiratory system.(Thus in a sense fetus picks the time to be bom by | GRH & ACTH secretion) | Physiology | Endocrinology and Reproduction | Which of the following probably triggers the onset of labour?
A. ACTH in fetus
B. ACTH in mother
C. Oxytocin
D. Prostaglandin
| ACTH in fetus |
66368898-071e-4c01-bed8-935f06005929 | Ans is 'd' i.e. Hereditary spherocystosis Mean cell hemoglobin concentration (MCHC) is the average concentration of hemoglobin in a given volume of packed red blood cells, expressed in grams per deciliter. Normal value is 33-37 gm/dlMCHC is increased in hereditary spherocytosis, not because of increased hemoglobin, but due to decerase volume of spherocytes.MCHC is decreased in microcytic hypochromic anemia(iron deficiency anemia & anemia of chronic disease).MCHC remains normal in megaloblastic anemia. | Pathology | null | Increase in MCHC is associated with
A. Iron deficiency anemia
B. Megaloblastic anemia
C. Anemia of chronic disease
D. Hereditary spherocystosis
| Hereditary spherocystosis |
472bbab1-f249-4be0-989b-dcf546e51e7f | The child with biliary atresia will have hepatic dysfunction.
Sevoflurane, thiopentone and propofol are safe in liver disease.
Halothane is not contraindicated in pre-existing liver :-
"There is no compelling evidence associated with worsening of pre-existing liver disease".
─Morgan
"Pre-existing liver disease unrelated to halothane is not a contraindication to the use of halothane".
—Lee 13th/e 143
Though not a contraindication, halothane should be avoided in liver disease -
"Potentialy hepatotoxic drug should be avoided".
—Lee 55 | Anaesthesia | null | In a 2 months old infant undergoing surgery for biliary atresia, you would avoid one of the following anaesthetic –
A. Thiopentone
B. Halothane
C. Propofol
D. Sevoflurane
| Halothane |
26e3c0cd-5a21-4f71-b171-b4bf1d7dd318 | Parachute reflex is a reflex that if once appears, never disappears. | Pediatrics | Impoant Terminologies and Primitive Neonatal reflexes | A reflex that if once appears, never disappears is:
A. Moro's Reflex
B. Parachute reflex
C. Symmetric Tonic neck reflex
D. Asymmetric Tonic neck reflex
| Parachute reflex |
399e64ba-228d-458c-8d3b-fa0f80ca17e6 | The absent P wave indicates that the atrium is not depolarizing. Therefore, the pacemaker cannot be in the sinoatrial (SA) node. Because the QRS and T waves are normal, depolarization and repolarization of the ventricle must be proceeding in the normal sequence. This situation can occur if the pacemaker is located in the atrioventricular (AV) node. If the pacemaker were located in the bundle of His or in the Purkinje system, the ventricles would activate in an abnormal sequence (depending on the exact location of the pacemaker) and the QRS wave would have an abnormal configuration. Ventricular muscle does not have pacemaker propeies. | Physiology | ECG | A person's electrocardiogram (ECG) has no P wave, but has a normal QRS complex and a normal T wave. Therefore, his pacemaker is located in the
A. Sinoatrial (SA) node
B. Atrioventricular (AV) node
C. Bundle of His
D. Purkinje system
| Atrioventricular (AV) node |
331fc2a4-e458-4102-9fb7-fc57a6844171 | Ans. A. InspirationThe illustration shows a Pressure-volume curve of the lung during inspiration and expiration. | Physiology | Respiratory System | Identity '1' in the illustration depicting compliance of lungs:
A. Inspiration
B. Expiration
C. Inspiration Air filled
D. Expiration air filled
| Inspiration |
6408aa02-d2dc-4a4a-a2a4-36df98679935 | - One sided weakness indicates stroke. Stroke - IOC for stroke - NCCT - IOC for acute infarct / ischemic stroke is MRI (Diffusion weighted MRI) NCCT Hyperdense Hypodense / normal Haemorrhagic stroke Ischemic stroke / acute infarct - If MRI cannot be done and ischemic stroke is suspected: Sta thrombolytics. - BP should not be managed unless more than 180/110- ONLY aspirin is proven to be useful as an antiplatelet in the management of acute infarcts. | Radiology | CT SCAN | One side weakness, On NCCT No hemorrhage seen, BP is 160/100 what you should do as clinician?
A. Manage BP
B. Do Nothing
C. Thrombolytics
D. Aspirin plus Clopidogril
| Thrombolytics |
3ccd8240-0bb6-4d8e-8a79-a7d48fb80853 | Histologically most of the endometrial cancers are Adenocarcinomas Hence they are called endometriod adenocarcinoma About 10-15% are Papillary serous Clear cell Adenosquamous Pure squamous Ref : Shaw Gynecology 17e pg 434. | Gynaecology & Obstetrics | Gynaecological oncology | Most common histological subtype of cancer endometrium is :
A. Mucinous carcinoma
B. Clear cell carcinoma
C. Squamous cell carcinoma
D. Endometrioid adenocarcinoma
| Endometrioid adenocarcinoma |
3f1ddc6e-b3cc-45b3-8cec-9a30cab67553 | Ans. is 'c' i.e., RSV RSV does not posses hemagglutinin or neuraminidase. The viral envelope has two glycoproteins? i) G protein - By which virus attaches to cell surface ii) F- protein ( Fusion protein ) - which bring about fusion between viral and host cell membranes. It is also responsible for cell to cell fusion, which leads to characteristic syncytial formation. | Microbiology | null | Which myxovirus does not have hemagglutinin and neuraminidase but have membrane fusion protein -
A. Measles
B. Parainfluenza
C. RSV
D. Influenza
| RSV |
8a961904-97ab-4c31-8d70-a2e194b2208f | Ans. is 'c' i.e., Ingestion of foodFactors affecting BMR BMR (RMR) represents tissue metabolic activity. Hence BMR is affected by any factor which alters cellular metabolic activity and energy expenditure.i) Factors increasing BMR :- Early age (infancy and childhood), male sex, pregnancy, lactation, recent ingestion of food, (especially proteins), Cold or very hot (uncomfoable) environment, Fever, Hormones (thyroxine, catecholamines, growth hormone), muscular exercise (exeion), Smoking, Caffine, Stress and emotional hyperactivity, and person with tall thin built.ii) Factors decreasing BMR :- Advanced age (adult and old age), female sex, fasting, starvation, (up to 40% decrease in prolonged starvation), malnutrition, hot (comfoable) climate, obesity, sleep, and person with sho obese built. | Physiology | null | Which of the following increases BMR ?newe
A. Starvation
B. Obesity
C. Ingestion of food
D. Sleep
| Ingestion of food |
a7fe8261-2319-4cc1-ad38-9442e6c9f980 | D-xylose absorption test is used to check how well your intestines are absorbing a simple sugar called D-xylose. From the results of the test, your doctor can infer how well your body is absorbing nutrients. D-xylose is a simple sugar that occurs naturally in many plant foods. Ref Davidson edition23rd pg 822 | Medicine | G.I.T | The following is used for testing absorption in intestine -
A. Xylose
B. Sucrose
C. Fructose
D. Maltose
| Xylose |
11a3f6a4-0607-49ea-a972-44516d16c745 | Lymphoreticular system include lymphoid & reticular components, with clearly demarcated function. The lymphoid cells lymphocytes & plasma cells are primarly concerned with specific immune response. The phagocytic cells, forming pa of the reticuloendothelial system are primarly concerned with the scavenger functions Reff: Ananthanarayanan & Paniker's textbook of microbiology 9th edition pg: 128 | Microbiology | Immunology | Lymphoreticular system doesnot includes -
A. T-cells
B. B-cells
C. Platelets
D. Macropahges
| Platelets |
4b0d870c-db7c-472f-a6c7-fa7feeb883e2 | Generally, the genes are made up of DNA . Usually , DNA dependent RNA polymerase transfers the information of DNA to mRNA . But Retrovirus group , RNA acts as a template Based on this RNA , the enzyme , RNA dependent DNA polymerase or reverse transcriptase will make a new DNA strand. Reference : DM.VASUDEVAN.TEXTBOOK SEVENTH EDITION ; PAGE NO : 593. | Biochemistry | Metabolism of nucleic acids | Reverse transcription involves
A. RNA dependent DNA synthesis
B. DNA dependent RNA synthesis
C. DNA dependent DNA synthesis
D. RNA dependent RNA synthesis
| RNA dependent DNA synthesis |
aa3cb2b7-ea24-4415-8b82-888d83628e61 | Ans: d. Phosphatidyl-inositolPhospholipases hydrolyze the phosphodiester bonds of phosphoglycerides, with each enzyme cleaving the phospholipid at a specific site.Phospholipases release molecules that can serve as messengers (for example, DAG and IP3), or that are the substrates for synthesis of messengers (for example, arachidonic acid.Phospholipases are responsible not only for degrading phospholipids, but also for "remodeling" them. For example, phospholipases Al and A2 remove specific fatty acids from membrane-bound phospholipids; these can be replaced with alternative fatty acids using fatty acyl CoA transferase. | Biochemistry | null | Phospholipase A2 act on:
A. Phosphoglyceric acid
B. Phosphate
C. Ca+
D. Phosphatidyl-inositol
| Phosphatidyl-inositol |
ce90a42a-d2c0-4545-b1a0-7c3c638d7d34 | Hypotension is the most common cause of death in septic shock Cardiac output is decreased in septic shock, leading to hypotension Ref: Sabiston 20th edition Pgno :554 | Anatomy | General anatomy | The most impoant cause of the death in septic shock is-
A. Renal failure
B. Cardiac failure
C. Respiratory failure
D. DIC
| Cardiac failure |
ef3b03e4-a3ca-435b-ba9b-4ab5ab3c9c85 | Gastric ulcersTYPELOCATIONACID LEVELI60%Lesser curve at incisuraLow to normalII15%Gastric body with duodenal ulcerIncreasedIII20%Prepyloric IncreasedIVLess than 10%High on lesser curveNormalVAnywhereNormal, NSAID-inducedSome ulcers may appear on the greater curvature of the stomach,but the incidence is less than 5%Sabiston 20e pg: 1233 | Surgery | G.I.T | Increased gastric acid secretion occurs in
A. Type I gastric ulcer
B. Type III gastric ulcer
C. Type IV gastric ulcer
D. Type V gastric ulcer
| Type III gastric ulcer |
ab23ae6a-7291-47de-b49b-bd4fd084058f | Ref: Sharma & Sharma 3rd ed. P 783Adverse Drug reactions of Amphotericin B* The most common, most serious and long term side effect of amphotericin B is Nephrotoxicity (renal tubular necrosis)* This nephrotoxicity presents with hypokalemia, hypomagnesemia secondary to renal tubular acidosis, azotemia and even irreversible damage if the dose exceeds 5g.# In order to prevent the nephrotoxicity, prior hydration with 1L of normal saline is recommended.# Liposomal preparation has lesser risk of nephrotoxicity* Hypochromic normocytic anemia is common and thrombocytopenia and leukopenia although less common but has been noted.* Intrathecal administration: Arachnoiditis and seizure* Hepatic impairment and Jaundice* Infusion related toxicity (chills, tachypnea, fever, vomiting, hypotension, anaphylaxis) | Pharmacology | Anti Microbial | Most serious side effects of amphotericin B:
A. Hepatic damage
B. Renal damage
C. Cardiotoxicity
D. Hypochromic anemia
| Renal damage |
7103a1ec-9946-441c-8334-423d5a75f594 | Aerial thrombosis and related consequences in APLA syndrome: Stroke-20%, TIA-11 %, Myocardial ischemia-10% Amaurosis fugax-7% Ref: Harrisons principles of internal medicine, 18th edition, Page 2737 | Medicine | null | Most common aerial thrombosis related manifestations in antiphospholipid antibody syndrome is:
A. Stroke
B. Transient ischemic attacks
C. Myocardial ischemia
D. Amaurosis fugax
| Stroke |
61333696-341d-4d61-a70c-797ddae6727d | Ans. is 'd' i.e., 1.5 mg/L The recommended level of fluoride in drinking water in the country is accepted as 0.5 to 0.8 mg/ Liter. -Park o Maximum permissible limit is 1.5 mg/Lit. Guidelines of for drinking water Colour < 15 true colour units (TCU) Turbidity < 1 nephlometric turbidity units (NTU) Hardness < 100 - 300 mg/litre calcium ion o pH: 6.5-8.5 Total dissolved solids (TDS) < 600 mg/litre Chloride 200 - 600 mg/L H,S < 0.05 mg/L Iron < 0.3 mg/L Sodium < 200 mg/L Sulphate < 250 mg/L Zinc < 4 mg/L NH3 <1.50 mg/L Fluorine < 1.5 mg/L (0.5 - 0.8 mg/L : Optimum level) Nitrates < 50 mg/litre Nitrites < 3 mg/litre Gross alpha radiological activity < 0.1 Bq/litre Gross beta radiological activity < 1.0 Bq/litre Zero pathogenic microorganisms Zero infectious viruses Absence of pathogenic protozoa and infective stages of helminthes Dissolved 02 has indirect effect, level is not specified. | Social & Preventive Medicine | null | Fluoride level permissible in drinking water ?
A. < 0.5 mg/L
B. 0.5-0.8 mg/L
C. 1 mg/L
D. 1.5 mg/L
| 1.5 mg/L |
f0e5992e-79a7-4b0e-982d-cb35a55d9786 | Ans. (a) D.I.PRef: Maheshwari 5th ed. 1287* Rheumatoid arthritis characteristically causes swelling of small joints in the hand like the P.I.P, M.C.P and the wrist joint bilaterally.* Isolated D.I.P joint involvement is seen in psoriatic arthropathy.* D.I.P joint involvement is also seen with osteo-arthritis but the involvement is with pain at the base of thumb. Knee joint is the commonest joint involved in these patients. | Orthopaedics | Rheumatoid Arthritis | Joint NOT involved in Rheumatoid Arthritis:
A. D.I.P
B. P.I.P
C. M.C.
D. Wrist
| D.I.P |
826bf9d3-e73a-4566-b326-4e0304a061fd | Frederickson's classification of hyperlipoproteinemias Type III Lipoprotein fraction elevated: Broad beta VLDL Chylomicrons It is very rare. It is due to increased levels of LDL and IDL. Beta lipoprotein floats on ultra-centrifugation and a broad beta band is observed on electrophoresisRef: DM Vasudevan - Textbook of Biochemistry, 8th edition, page no: 299, Table 25.4 | Biochemistry | Metabolism of lipid | Which of the following types of hyperiglyceridemia is associated with an increase in chylomicron and VLDL remnants?
A. Type I
B. Type IIa
C. Type III
D. Type IV
| Type III |
0cd022b2-a8dd-41e9-93c7-bc80cd29213b | Lateral cricoarytenoid. The oblique and transverse arytenoids and thyroartenoid also adduct the vocal folds. The posterior cricoarytenoids abducts the vocal cords. The cricothyroid muscle raises the cricoid cartilage and tenses the vocal cords. | Anatomy | null | Which of the following muscles adducts the vocal cords?
A. Lateral cricoarytenoid.
B. Posterior cricoarytenoid.
C. Cricothyroid.
D. Vocalis.
| Lateral cricoarytenoid. |
d934265b-e659-47f4-b51e-3791bae825bc | Exclusive breastfeeding: The baby should be given only breast Milk and nothing else (not even water) for the first 6 months of life. Weaning should be started by 6 months of age with semisolid food, in addition to continuing breastfeeding.
The WHO recommends exclusive breastfeeding for the first six months of life and then breastfeeding up to two years or more. ___ Internet
Complementary feeding means giving the child other nutritious foods in addition to breast milk. Breastfeeding is sufficient food for the first 6 months. Thereafter, concentrated energy-dense complementary foods are essential in order to maintain an adequate velocity of growth for the infant. | Pediatrics | null | Exclusive breastfeeding is at least until –
A. 4 month
B. 6 month
C. 8 month
D. 10 month
| 6 month |
ac6a1fc1-a55e-4e36-a5b3-ce6e2504256d | Vitreous is composed of water, collagen and hyaluronic acid. Vitreous Humour. Vitreous humor is the fluid-like gel, composed of approximately 98-99% water with trace amounts of hyaluronic acid, glucose, anions, cations, ions, and collagen, located in the posterior chambers of the eyes Reference: khurana 6th edition pg 567 | Ophthalmology | Anatomy, Development and clinical examination | Hyaluronic acid is present in
A. Lens
B. Vitreous humour
C. Blood vessels
D. cornea
| Vitreous humour |
aa3af173-4296-4a04-84f4-6b67814329be | Ideal weight of the glucose taken for glucose tolerance test for children are 1.75gm/kg glucose . Obtain a fasting blood sugar level, then administer an oral glucose load (2 g/kg for children aged < 3 y, 1.75 g/kg for children aged 3-10 y , or 75 g for children aged >10 y). Check the blood glucose concentration again after 2 hours. A fasting whole-blood glucose level higher than 120 mg/dL (6.7 mmol/L) or a 2-hour value higher than 200 mg/dL (11 mmol/L) indicates diabetes. However, mild elevations may not indicate diabetes when the patient has no symptoms and no diabetes-related antibodies. Reference: GHAI Essential pediatrics, 8th edition | Pediatrics | Endocrinology | Oral glucose tolerance test in children is done with
A. 1.5 gm/kg glucose
B. 1.75 gm/kg glucose
C. 2 gm/kg glucose
D. 2.5 gm/kg glucose
| 1.75 gm/kg glucose |
64904a0b-7e9b-4020-9057-83d1321457b1 | This autosomal recessive disorder is characterized by ichthyosis (usually ichthyosis linearis circumflexa but occasionally the lamellar or congenital ichthyosiform erythroderma types), trichorrhexis invaginata and other hair shaft anomalies, and atopic diathesis. Mutations in the gene SPINK 5, which encodes a serine protease inhibitor, have been identified in patients with Netheon syndrome. causes: *Netheon syndrome is an autosomal recessive disorder associated with mutations in the SPINK5 gene, which encodes the serine protease inhibitor lympho-epithelial Kazal-type-related inhibitor (LEKTI). These mutations result in a dysfunctional protein that has a reduced capacity to inhibit serine proteases expressed in the skin. Potential endogenous targets of LEKTI include KLK5, KLK7 and KLK14. These enzymes are involved in various aspects of epidermal remodelling, including desquamation, PAR-2 activation and degradation of lipid hydrolases, suggesting a potential mechanism for the development of atopic manifestations characteristic of Netheon syndrome. *Disease severity is determined by the level of LEKTI expression and, consequently, serine protease activity. Complete SPINK5 gene deletions have been linked to severe cases, while mutations which induce alternate splicing or create premature stop codons may lead to varying levels of severit.Fuhermore, LEKTI-knockout mice exhibit a phenotype similar to Netheon syndrome in humans Ref Harrison 20th edition pg 1234 | Dental | miscellaneous | <img alt="" src=" />Which is not a feature of Netheon Syndrome
A. Autosomal dominant
B. Ichthyosis
C. Very sho hair
D. Erythroderma
| Autosomal dominant |
e334bea4-d412-459f-8c01-d8b391102dc9 | Idiopathic hirsutism is hrisutism in absence of any adrenal or ovarian tumor and normal serum levels of androgens. This is only 25 % of al the cases of hirsutism, and not the commonest! The most common cause of hyperandrogenism and hirsutism is PCOS. There are only two major criteria for the diagnosis of PCOS: anovulation and the presence of hyperandrogenism as established by clinical or laboratory means. Revised criteria (2 out of 3) 1. Oligo ovulation or anovulation 2. Clinical and/or biochemical signs of hyperandrogenism 3. Polycystic ovaries and exclusion of other etiologies (congenital adrenal hyperplasia, androgen-secreting tumors, Cushing's syndrome) From Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop These features alone are sufficient for the diagnosis in the absence of other pathologies accounting for hyperandrogenism (i.e., AOAH, or ovarian neoplasm, Cushing syndrome) or anovulation (i.e., hypogonadotropic or hypergonadotropic disorders, hyperprolactinemia, thyroid disease). Please note that presence of polycystic ovaries on USG is not necessary nor sufficient for diagnosis of PCOD | Gynaecology & Obstetrics | Polycystic Ovarian Syndrome | A young woman presents with delayed cycles and abnormal growth of hair on face. On USG ovaries are normal. What is the most probable diagnosis?
A. Idiopathic hirsutism
B. PCOD
C. Testestrone screting tumor
D. Adrenal hyperplasia
| PCOD |
62a89265-19b0-406a-8bfe-c73c6b46aa86 | Ans. D: Symptomatic Therapy for primary dysmenorrhoea consists of measure to relieve pain and to suppress ovulation if the woman desires contraception additionally Surgery is indicated if medical measures fail to provide relief and in women with secondary dysmenorrhoea to treat the underlying pelvic pathology | Gynaecology & Obstetrics | null | Treatment of choice in a young patient with primary dysmenorrhea is: March 2011
A. Presacral neurectomy
B. Dilatation
C. Hysterectomy
D. Symptomatic
| Symptomatic |
648264e4-195b-4d90-9cca-5de934d01e08 | Ans. B: Bronchus In adults, the metastatic lesions generally occur in the axial skeleton and other sites with residual red marrow, although the lesions may be found anywhere in the skeletal system. Common sites for metastases are the veebrae, pelvis, proximal pas of the femur, ribs, proximal pa of the humerus, and skull. Ceain carcinomas may have a predilection for paicular skeletal sites. For example, metastases to the bones of the hands and feet are rare, but 500/0 of hand metastases originate from lung neoplasms Primary tumors arising from the pelvis have a predilection for spread to the lumbosacral spine. | Pathology | null | Carcinoma, which has predilection for metastasis to hands and feet bones: March 2007
A. Prostate
B. Bronchus
C. Pelvis
D. Breast
| Bronchus |
01008fec-3ae8-4f2a-afcf-e496d8bcd61b | (Annular pancreas) (1120, 1198-LB) (1137-B & L 25th)Annular pancreas - in which a ring of pancreatic tissue from the head of the pancreas surrounds the descending duodenum X-ray shows a dilated stomach and proximal duodenum (double bubble sign) and little or no air in the rest of the small bowel.Congenital duodenal obstruction - causes of duodenal obstruction are atresia, mucosal web, annular pancreas, preduodenal portal vein and peritoneal bands {Ladd's bands) from malrotations - shows - "double bubble sign" (1316-CSDT 11th) | Surgery | Pancreas | "Double bubble sign" seen in
A. Annular pancreas
B. Ureterocele
C. Hypertrophic pyloric stenosis
D. Wilm's tumour
| Annular pancreas |
0241258d-0b31-4ba5-a06b-9461ac02a07a | Ans. is 'b' i.e., Haemophilus influenzae . The impoant clues in this question are ? The organism is gram negative coccobacilli. It grows only on chocolate agar and not on blood agar. Causing meningitis in children. . Haemophilus influenzae : - Gram negative Coccobacilli - Can not grow in blood agar because utilization of V factor (NAD or NADP) is limited by the presence of serum NADase. - Grows well on chocolate agar (blood agar which is heated up to 70-80degC) because, on heating extra X and V factors are liberated from the lysed red cells. - Is a common cause of meningitis in children. About other options - N. Meningitis . It occur as diplococci (not coccobacilli) . It can grow on blood agar. - Legionella pneumophilia . Does not cause meningitis. - Bramanhella catarrhalis . It occur as diplococci (not coccobacilli) . It can grow on blood agar. | Microbiology | null | A 2 years old child is brought to the emergency with history of fever and vomiting. On examination he has neck rigidity. The CSF examination shows polymorphs more that 2000/m1 protein 100 mg/dl and glucose 10mg/d1. The Gram stain shows the presence of Gram negative coccobacilli. The culture shows growth of bacteria only on chocolate agar and not on blood agar. The caustive agent is ?
A. Neisseria meningitides
B. Haemophilus influenzae
C. Branhamella catarrhalis
D. Legionella pneumophila
| Haemophilus influenzae |
6375395f-12ce-4cea-8472-1f9c378e37c6 | Ans. is 'd' i.e., Levator palpabrae superioris & muller muscleo The levator palpebrae superioris is the important upper eye lid retractor. Injury or weakness to this muscle leads to ptosis.o This muscle is supplied by occulomotor (3rd) nerve.o Deep part of the elevator muscle is the Muller's muscle, which is sympathetically innvervated.o In hyperthyroidism, sensitization of the Muller muscle leads to upper eyelid retraction and pseudoproptosis,o On the other hand, in Horner's syndrome loss of this muscle action leads to ptosis.o The capsulopalpebral fascia assists in lower eyelid retraction and coordinates with eyeball movement. It arises as an extension of the inferior rectus and inserts into the lower edge of the lower tarsus and the adjacent orbital septum. | Ophthalmology | Anatomy | Upper Lid Retractors include ?
A. Muller muscle and superior rectus
B. Levator palpabrae superioris and superior oblique
C. Superior oblique and superior rectus
D. Levator palpabrae superioris & muller muscle
| Levator palpabrae superioris & muller muscle |
566f1757-63ae-4380-9639-eba01bf19906 | Homocystinuria is autosomal recesive disorder.If one parent is affected and the other is normal,none of the children will be affected. | Pathology | null | What is the chance of having Homocystinuria if only one parent is affected and the other is normal?
A. 25%
B. 0%
C. 50%
D. 75%
| 0% |
cfee4081-6c1b-4211-8d6b-93881f154da2 | Fish mouth stenosis in RHD is manifestation of Chronic RHD involving mitral valve which is due to calcification and fibrosis bridging across valvular commissures. RHD is viually the only cause of mitral stenosis. Acute and chronic rheumatic hea disease. A) Acute rheumatic mitral valvulitis superimposed on chronic rheumatic hea disease. Small vegetations (verrucae) are visible along the line of closure of the mitral valve leaflet (arrows). Previous episodes of rheumatic valvulitis have caused fibrous thickening and fusion of the chordae tendineae. B) Microscopic appearance of an Aschoff body in a patient with acute rheumatic carditis. The myocardium exhibits a circumscribed nodule of mixed mononuclear inflammatory cells with associated necrosis; within the inflammation, large activated macrophages show prominent nucleoli, as well as chromatin condensed into long, wavy ribbons (caterpillar cells; arrows). C/D). Mitral stenosis with diffuse fibrous thickening and distoion of the valve leaflets and commissural fusion (arrows, C), and thickening of the chordae tendineae (D). Note neovascularization of anterior mitral leaflet (arrow, D). E). Surgically resected specimen of rheumatic aoic stenosis, demonstrating thickening and distoion of the cusps with commissural fusion. Comparison of the four major forms of vegetative endocarditis. The rheumatic fever phase of rheumatic hea disease (RHD) is marked by small, way vegetations along the lines of closure of the valve leaflets. Infective endocarditis (IE) is characterized by large, irregular masses on the valve cusps that can extend onto the chordae. Nonbacterial thrombotic endocarditis (NBTE) typically exhibits small, bland vegetations, usually attached at the line of closure. One or many may be present. Libman-Sacks endocarditis (LSE) has small or medium-sized vegetations on either or both sides of the valve leaflets. | Pathology | NEET 2019 | Fish mouth stenosis in rheumatic hea disease is due to which of the following mechanisms?
A. Calcification and fibrosis bridging across valvular commissures
B. Fibrinoid necrosis
C. Acute inflammation leading to valvular damage
D. Myxomatous degeneration of the valve
| Calcification and fibrosis bridging across valvular commissures |
cffefd7a-cdda-4fac-85e9-1f10de832592 | Functions of Vit A
Vitamin A is essential for -
I.Normal vision
Retinol is necessory for functioning of retina.
Regeneration of rhodopsin during dark light is vit A dependent --> vit A deficiency causes defective dark adaptation.
2. Anti-infective
Vitamin A is necessary for integrity of epithelial tissues that resist invasion by pathogens.
Vitamin A has some role in immune response.
3. Anticancer effect
Beta-carotene has antioxidant property —> by virtue of this action it reduces the incidence of lung, breast, oral, esophageal and bladder cancers.
4. Skeletal - growth
Vitamin A supports skeletal growth. | Pediatrics | null | Anti infective vitamin is –
A. Vitamin B6
B. Vitamin A
C. Vitamin D
D. Vitamin C
| Vitamin A |
4047c095-f550-4e89-bf0c-659ce3af0840 | Explanation:On ultrasound, the Hydatiform mole resembles a bunch of grapes ('cluster of grapes" or ''honeycombed uterus" or "snow-storm appearance) (See table below) Partial and Complete Hydatiform Mole PARTIAL MOLECOMPLETE MOLEFetus, Fetal vessels, PlacentaPresentAbsentKaryotype69 XXY (triploid)46 XXHydropic changesFocalMarkedMalignant potentialRare1 5-20%Ultrasound featuresFocal cystic spaces in placentaFetus and placenta are seenTransverse diameter of uterus increasesSnowstorm appearance | Radiology | Obstetrical Ultrasonography in the Second Trimester | Snowstorm appearance in Ultrasound is seen in:
A. Hydatiform mole
B. Twins
C. Hydronephrosis
D. Downs syndrome in fetus
| Hydatiform mole |
ac0d14a0-074e-4fdb-a149-c7cd2fe3d4fb | Ans. is 'a' i.e., Inhibition of Vitamin K epoxide reductase | Pharmacology | null | Warfarin acts by
A. Inhibition of Vitamin K epoxide reductase
B. Inhibition of gamma glutamyl carboxylase
C. Activation of Vitamin K epoxide reductase
D. Activation of gamma glutamyl carboxylase
| Inhibition of Vitamin K epoxide reductase |
3497fe30-1729-46a5-aae1-5c49ee87b87e | Ans. A. subtalarInversion and eversion refer to movements that tilt the sole of the foot away from (eversion) or towards (inversion) the midline of the body. This movement occurs at subtalar joint. Eversion is the movement of the sole of the foot away from the median plane. Inversion is the movement of the sole towards the median plane.Inversion of the foot is produced by tibialis anterior & tibialis posterior. Eversion of the foot is produced by Peroneus longus & brevis. | Anatomy | Lower Extremity | Eversion occurs at which joint:
A. Subtalar
B. Ankle
C. Metatarsophalangeal
D. Interphalangeal
| Subtalar |
ca3eccbb-6cf8-486f-b844-a69144eafefc | Ans. (d) 1064 nmRef: Khurana 6/e, p. 461Wavelength of laser is measured in nm and Nd:YAG Laser is 1064 nm. Nd:YAG Laser is used for posterior capsulotomy and peripheral iridotomy. | Ophthalmology | Lens | Wavelength of Nd: YAG laser
A. 1040 nm
B. 1040 mm
C. 1064 cm
D. 1064 nm
| 1064 nm |
68e3c6e9-528a-4f68-a94f-a13a64b4070c | Hfr Conjugation: F factor being a plasmid, is always Extra-chromosomal It may integrate with bacterial chromosome and behave as episome. Such donor cells are able to transfer chromosomal DNA to recipient cells with high frequency in comparison to F+ cells, therefore, named as Hfr cells (high frequency of recombination). During conjugation of Hfr cell with an F- cell, only few chromosomal genes along with only a pa of the F factor get transferred. Hence, F- recipient cells do not become F+ cells. | Microbiology | General Microbiology Pa 1 (History, Microscopy, Stains and Structure and Physiology of Bacteria) | F plasmid of high frequency recombination is
A. Extrachromosomal
B. Chromosomal
C. Mesosome
D. Ribosomes
| Extrachromosomal |
ee776b0c-5211-425b-8a8d-add3cbf35b8e | The tumor in the picture is a carcinoid. This neoplasm derives from the neuroendocrine cells of the intestinal epithelium and often retains the capacity to produce hormonal substances, such as serotonin, gastrin, somatostatin, etc. The architectural arrangement is variable, although trabecular and insular patterns are the most common. Carcinoid tumors may be found throughout the intestinal canal, as well as in the bronchial tree and other organs. Location and size are the most impoant predictor of their metastatic potential. Carcinoids of the appendix and cecum (the most frequent) only rarely metastasize to the liver. Carcinoids of the stomach, ileum and colon have a high metastatic propensity, especially if they are larger than 2 cm in main diameter. Neither architectural pattern nor cell pleomorphism is a good predictor of the malignant potential of carcinoid tumors. In general, this rule applies to most of endocrine tumors, in which histologic features and biologic behavior do not often correlate with one another. In other words, a tumor that shows relatively bland cells may undergo metastatic spread, while tumors with more anaplastic features may behave in a benign fashion. Hormonal production is common in carcinoids, but does not often lead to a clinical syndrome nor does it correlate with metastatic potential. | Pathology | null | This segment of jejunum shows a nodular lesion located in the submucosa. Upon histological examination, the tumor was composed of uniform round cells arranged in trabeculae, with a "salt-and-pepper" chromatin pattern. Electron microscopic studies revealed secretory granules, and immunohistochemical stains were positive for serotonin. Which of the following parameters correlates best with the metastatic potential of this tumor?
A. Architectural pattern
B. Cell pleomorphism
C. Hormonal production
D. Site and size
| Site and size |
5869cee3-fe75-4e5e-8f77-052a6a724546 | Arsenite and mercuric ions react with the - SH groups of lipoic acid and inhibit pyruvate dehydrogenase, as does a dietary deficiency of thiamin, allowing pyruvate to accumulate. Many alcoholics are thiamin-deficient (both because of a poor diet and also because alcohol inhibits thiamin absorption), and may develop potentially fatal pyruvic and lactic acidosis. Ref: Harper 28th edition, Chapter 17. | Biochemistry | null | Which of the following deficiency in alcoholics inhibit pyruvate dehydrogenase?
A. Thiamin
B. Niacin
C. Riboflavin
D. Ascorbic acid
| Thiamin |
193bb7c1-ba4e-4928-bcbf-9be0f7878eba | Most lung abscesses and all anaerobic abscesses involve the normal flora of the oropharynx. Septic embolic usually contain S. aureus. Factors that predispose to Gram-negative colonization of the oropharynx include hospitalization, debility, severe underlying diseases, alcoholism, diabetes, and advanced age. Impaired consciousness, neurologic disease, swallowing disorders, and nasogastric or endotracheal tubes all increase the likelihood of aspiration. | Medicine | Respiratory | An 83-year-old man with Parkinson's disease presents with low-grade fever and cough for several weeks. Lately, he has been experiencing more rigidity and difficulty with his walking. He is on a levodopa/carbidopa combination for treatment for the past 5 years. On examination, his gait is shuffling and slow. He has a tremor in his left hand at rest, and there is cogwheel rigidity of the forearm. There are crackles in the left lower lung field. CXR reveals a lung abscess in the left lower lobe. Which of the following is the most likely bacteriologic diagnosis for the lung abscess?
A. oropharyngeal flora
B. tuberculosis
C. Staphylococcus aureus
D. Pseudomonas aeruginosa
| oropharyngeal flora |
b2dbe8ac-5af8-4362-9f0f-a9cf94bfedba | Ans. (a) Atransferrinemia(Ref: Wintrobe's 12th/pg814)This patient with microcytic hypochromic anemia, has high ferritin level (800ng/ml) & increased transferrin percentage saturation (64%). The most possible diagnosis is Atransferrinemia.AtransferrinemiaIt is a rare congenital autosomal recessive condition with low transferrin level in the body.So whatever transferrin is left, is saturated.It presents with hypochromic microcytic anemia, decreased serum levels of iron, TIBC, and increased serum level of ferritin (as iron absorption is markedly increased but iron transfer to eryrthropoetic tissues are reduced)High transferrin saturation (64% in this case) & high ferritin level, excludes Iron deficiency Anemia (option B excluded)In DMT 1 mutation, transferrin saturation is low (hence option C excluded)High transferrin saturation excludes Anemia of chronic disease (option D) | Pathology | Misc. (R.B.C) | A patient with microcytic hypochromic anemia. Hb-9 g%, serum iron-20 microg/dl, ferritin level-800 ng/ml, transferrin percentage saturation is 64%. What is possible diagnosis?
A. Atransferrinemia
B. Iron deficiency anemia
C. DMT 1 mutation
D. Anemia of chronic disorder
| Atransferrinemia |
c3cbc758-268b-40a8-8e04-06ee4bad9483 | The Government of India has launched theNational Mental Health Programme(NMHP) in 1982, keeping in view the heavy burden of mental illness in the community, and the absolute inadequacy of mental health care infrastructure in the country to deal with it. Principal unit of Health administration in India is District under a collector. All National health programmes in India are implemented district wise. | Social & Preventive Medicine | Other NHPs | Functional unit for implementation of National Mental Health Programme is at which level?
A. District
B. Subcentre
C. PHC
D. State
| District |
d3e749dd-9d30-48f9-b050-46138d1376a7 | Ans. is 'b' i.e., Ectopic pregnancy* Empty endometrial cavity with an extrauterine single gestational sac with yolk sac in left adenexa. Both ovaries are normal. It is indicative of left adnexal, unruptured ectopic pregnancy. | Gynaecology & Obstetrics | Miscellaneous (Gynae) | Following ultrasound is showing-
A. Normal pregnancy
B. Ectopic pregnancy
C. H. mole
D. Ovarian cyst
| Ectopic pregnancy |
4dd139ec-8cdb-46c2-97d6-4a37f57701ad | Plain abdominal X ray showing a stent in the right and left ureter. Ureteric stents,also known as double J stents or retrograde ureteric stents, is a urological catheter that has two "J-shaped" (curled) ends, where one is anchored in the renal pelvis and the other inside the bladder. Stents are used for the free passage of urine from the kidney to the bladder, in adverse conditions such as postoperative urologic procedures, and previously to lithotripsy and ureteral obstructions. Indications Stents may be uses for a sho of long term period depending on the indication: * obstruction from urolithiasis * malignant obstruction (typically pelvic malignancies) * benign strictures * retroperitoneal fibrosis REF : DAVID SUTTON 9TH ED: | Radiology | All India exam | What is the structure seen in the given X-ray below?
A. Stent
B. Surgical clips
C. Foley catheter
D. Intravesical wire
| Stent |
5457999e-c4e3-4d59-ba60-94c81097022d | Limiting amino acid in various food stuffs Wheat-lysine (the most deficient) and threonine (second limiting amino acid) Rice-lysine Legumes-tryptophan or methionine (or cysteine) Maize-lysine and tryptophan Egg-none; the reference for absorbable protein | Biochemistry | null | Limiting amino acid in wheat are:
A. Lysine, arginine
B. Threonine, methionine
C. Lysine, threonine
D. Lysine, methionine
| Lysine, threonine |
70a64eaf-fc06-4396-ae85-abb7829b13c9 | C i.e. Nasal conjunctiva Goblet cells are the chief source of tear mucus Q. These occur throughout the conjunctiva, especially the plica semilunaris. | Ophthalmology | null | Maximum density of goblet cells is seen in:
A. Superior conjunctiva
B. Inferior conjunctiva
C. Nasal conjunctiva
D. Temporal conjunctiva
| Nasal conjunctiva |
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