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0f9a8d24-4638-4ceb-a452-ddd48f79a688 | Funding for the NPCB- The allocation of funds for the NPCB increased with the sta of the World Bank-financed Project in 1995. | Pathology | All India exam | Assessment and aiding for development of funds for the National Blindness Control Programme is done by
A. WHO
B. UNICEF
C. DANIDA
D. World Bank
| World Bank |
237a7e05-914e-4a2a-9217-d568c792678e | More significant hemoptysis can result from the proximity of the bronchial aery and vein to the air-way, with these vessels and the bronchus running together in what is often referred to as the bronchovascular bundle. Ref Harrison 19th edition pg 245-246 | Anatomy | Respiratory system | A young man with T.B presents with massive reccurere haemoptysis. For angiography treatment which vascular structure should be evaluated first
A. Pulmonary aery
B. Bronchial aery
C. Pulmonary vein
D. Superior vena cava
| Bronchial aery |
50ca064d-6a7a-42e1-b5e4-632504a8a77f | Ans. b. Mb Stage of the patient with carcinoma endometrium having >50% myometrial invasion and vaginal metastasis with involvement of pelvic and retroperitoneal lymph nodes is Mb. Stage Feature I Cancer confined to corpus uteri IA No or less than half myometrial invasion. IB Invasion equal to or more than half of the myometrium II Tumor invades cervical stroma but does not extend beyond the uterus. III Local and/or regional spread of the tumor IIIA Tumor invades the serosa of the corpus uteri and/or adnexa 111B Vaginal and/or parametrial involvement II1C1 Positive pelvic lymph nodes II1C2 Positive para-aoic lymph nodes with or without positive pelvic lymph nodes IV Spread beyond the pelvis IVA Tumor invasion of bladder and/or bowel mucosa. | Gynaecology & Obstetrics | null | A patient with carcinoma endometrium has >50% myometrial invasion and vaginal metastasis. Pelvic and retroperitoneal lymph nodesa are not involved. Peritoneal seedings are positive. The stage is:
A. Ma
B. Tub
C. HIC1
D. II1C2
| Tub |
05fbfca4-dcde-40b0-a8c3-560f4b00b408 | CTP scoring system ClassA: 5-6 points ClassB: 7-9 points ClassC: 10-15 points Ref: Sabiston 20th edition Pgno :1436 | Anatomy | G.I.T | According to Child - pugh staging Child's B is
A. 6-May
B. 9-Jul
C. 11-Oct
D. 12-Sep
| 9-Jul |
7f35c6c6-aeb5-423d-b287-b9ed367870e9 | Three most common caused of pain in the plantar aspect of the foot are plantar fasciitis, tarsal tunnel syndrome, and posterior tibial tendinopathy.
Plantar fasciitis is the most common cause; however, burning pain is characteristic of neural pain.
"If the patient describes the sensation as `burning "tingling ' or `numbness', the cause is peripheral nerve entrapment" __Neuromedicine | Orthopaedics | null | In a patient with a history of burning pain localized to the plantar aspect of the foot, the differential diagnosis must include -
A. Peripheral vascular disease
B. Tarsal coalation.
C. Tarsal tunnel syndrome
D. Planter fibromatosis
| Tarsal tunnel syndrome |
988e0696-e988-473f-9c26-39de493c8ba9 | Hirsutism M/C cause : PCOS Due to Hyperandrogenism Increase Androgen- increase Serum Testosterone & Andronstendione - decrease Sex hormone binding globulin- increase Free Androgen - Hirsutism Drugs for management of hirsutism OCP containing anti androgenic progesterones Spironolactone Cyproterone Acetate Other drugs- Flutamide Finasteride Ketoconazole Topical Eplornitihine Metformin GnRH Agonists | Gynaecology & Obstetrics | Polycystic Ovarian Syndrome | The most common cause of hirsutism:
A. Drug induced
B. PCOS
C. Endometriosis
D. Adenomyosis
| PCOS |
dd43d72c-1a78-4d51-b8c5-d376182cc99a | It is defined as ahritis of one or more joints with onset below 16 yr age and persisting for atleast 6 weeks Ref Ghai pediatrics eighth edition pg no 625 | Pediatrics | Musculoskeletal disorders | Diagnostic Criteria of JRA
A. Disease persisting 6 weeks or longer
B. Onset before age 16 years
C. Ahritis involving >5 joints
D. Polyaicular JRA ANA is +ve
| Disease persisting 6 weeks or longer |
83d7a565-3257-4e37-9049-eadfaf8df0d7 | Decreased brain perfusion may be generalized (global) or localized. Global ischemia results from generalized decreased blood flow, such as with shock, cardiac arrest, or hypoxic episodes (e.g., near drowning or carbon monoxide poisoning). Global hypoxia results in watershed (border zone) infarcts, which typically occur at the border of areas supplied by the anterior and middle cerebral aeries, and laminar necrosis, which is related to the sho, penetrating vessels originating from pial aeries. The Purkinje cells of the cerebellum and the pyramidal neurons of Sommer's sector in the hippocampus are paicularly sensitive to hypoxic episodes. Atherosclerosis, which predisposes to vascular thrombi and emboli, is related to regional ischemia. Hypeension damages parenchymal aeries and aerioles, producing small ischemic lesions (lacunar infarcts). Fat emboli, related to trauma of long bones, lodge in small capillaries to form petechiae. Venous sinus thrombosis is related to systemic dehydration, phlebitis, and sickle cell disease. Ref - Harrison's internal medicine 20e pg 1117, 2039-2040 | Medicine | C.N.S | Laminar necrosis and watershed infarcts are most suggestive of
A. Shock
B. Hypeension
C. Fat emboli
D. Vascular thrombosis
| Shock |
826d575c-08a9-4525-b667-473b5d7cd2f6 | Ans. is 'b' i.e., PhenylalanineTyrosine is synthesized from phenylalanine.In phenylalanine deficiency or in disorders in which phenylalanine cannot be conveed into tyrosine (phenylketonuria), tyrosine becomes an essential amino acid and should be supplemented from outside. | Biochemistry | null | If tyrosine level in blood is normal without external supplementation, deficiency of which of the following is ruled out ?
A. Tryptophan
B. Phenylalanine
C. Histidine
D. Isoleucine
| Phenylalanine |
627a133d-ec6b-4fb0-9310-bd5d55285efb | D. Biliary atresia(Ref: Nelson's 20/e p 1933)3 Enzymes reflect cholestasis: Alkaline phosphatase, 5'nucleotidase & Gamma glutamyl transpeptidase.About GGT in Cholestasis: (Normal value of GGT is 5-40IU/L)"GGT levels are commonly elevated to values more than 10 times normal in biliary atresia while in hepatic causes it is raised to about three times normal"Thus a value of 600IU/L in the patient in question reflects an elevation of more than ten times the normal value. The patient is thus likely suffering from 'biliary atresia'. | Pediatrics | Gastro Intestinal System | In neonatal cholestasis, if the serum gamma glutamyl- transpeptidase (GGT) is more than 600 IU/L the most likely diagnosis is:
A. Neonatal hepatitis
B. Choledochal cyst
C. Sclerosing cholangitis
D. Biliary atresia
| Biliary atresia |
3e48b698-7c19-467e-a3be-bceb3ccc4158 | Ans. is 'b' i.e., Inhibits spinal polysynaptic reflexes Centrally acting muscle relaxants selectively depress spinal and supraspinal polysynaptic reflexes involved in the regulation of muscle tone without significantly affecting monosynaptic mediated stretch reflex. | Pharmacology | null | Central muscle relaxants act by -
A. Decreased nerve conduction
B. Inhibits spinal polysynaptic reflexes
C. Block conduction across NM junction
D. CNS depression
| Inhibits spinal polysynaptic reflexes |
d1f6dd73-80e4-43c1-9b1f-3dbd52e582d4 | Carbamoyl Phosphate Synthase I Is the Pacemaker Enzyme of the Urea Cycle. Other enzymes are; Argininosuccinate Synthase. Argininosuccinate Lyase. Arginase.Ref: Harpers Illustrated Biochemistry, 30th edition, page no: 295 | Biochemistry | Metabolism of nucleic acids | Which of the following is not an enzyme of Urea biosynthesis?
A. Carbomoyl phosphate synthetase II
B. Ornithine transcarbamylase
C. Argininosuccinase
D. Arginase
| Carbomoyl phosphate synthetase II |
c76b06f3-d265-4d4a-a299-f25721d1c03a | The lungs and thoracic cage are both elastic structures. Hence they display a constant relationship between distending pressure and change in volume. The change in volume per unit change in pressure is called "compliance". The total compliance of both lungs together in the normal adult human being is about 0.2 L/cm water. That is, every time the transpulmonary pressure increases by 1 centimeter of water, the lung volume will expand 0.2 L (200 ml). Compliance is a measure of distensibility. Ref: Guyton 12th Ed. | Physiology | All India exam | Normal respiratory compliance is ?
A. 200 ml/cm water
B. 50 ml/cm water
C. 100 ml/cm water
D. 150 ml/cm water
| 200 ml/cm water |
8caf790f-1098-4597-ba5d-4b3b97d92c14 | At point C, Ventricular pressure becomes more than aortic pressure. Hence, aortic valve opens. | Physiology | null | Pressure-Volume loop of cardiac cycle is shown below. What does point C represent?
A. Mitral valve opens
B. Mitral valve closes
C. Aortic valve opens
D. Aortic valve closes
| Aortic valve opens |
1738c9f4-63c9-4f1a-b3be-12f52f1541e0 | A decrease in the diffusion distance will lead to an increase in DL. A decrease in capillary blood volume, surface area, cardiac output, and blood hemoglobin concentration will decrease DL. | Physiology | General physiology | Which of the following will not cause a low lung diffusing capacity(DL)?
A. Decreased diffusion distance
B. Decreased capillary blood volume
C. Decreased surface area
D. Decreased cardiac output
| Decreased diffusion distance |
6d97b397-a3a4-411a-b3e0-1f7b807e27ee | Ans: b (Biliary atresia) Ref: Nelson, 18th ed, p. 1712, Table 365-1; 17th ed, p. 1349, Table 349-1Most frequent indication of pediatric liver transplantation is extrahepatic biliary atresia after a failed portoenterostomy (Kasai) procedure.Causes of neonatal cholestasisIntrahepatic* Idiopathic-- Commonest cause* Infections-- TORCH, hepatitis, HIV, parvo B19, Reovirus, Bacterial infections esp E. coli.* Metabolic amino acid-- TyrosinemiaCHO-- Galactosemia, fructosemia, GSDIVLipid-- Neimann Pick, Gaucher, Wolman* Inherited-- a 1 antitrypsin deficiency, cystic fibrosis, neonatal iron storage disease.* Endocrine-- Hypopituitarism, hypothyroidism* Chromosomal-- Down / Edwards syndrome* Others-- Zellweger / Watson Alagille / Byler / neonatal lupus / histiocytosisExtra hepatic* EHB A (extra hepatic biliary atresia)* Choledochal cyst* Inspissated bile* Sclerosing cholangitis* Bile duct stenosis | Pediatrics | Gastro Intestinal System | Most common indication for pediatric liver transplant?
A. Wilson disease
B. Biliary atresia
C. Neonatal hepatitis
D. Cystic fibrosis
| Biliary atresia |
c54456eb-6e08-4bcf-a621-66b28979175c | Glucose-6-phosphate is required in the liver in order for this organ to supply the rest of the body with glucose that has been produced by hepatic gluconeogenesis or released from stored hepatic glycogen. A deficiency in glucose-6- phosphatase leads to the most common of the glycogen storage diseases, von Gierke's disease. This glycogen storage disease results from excess hepatic glucose-6-phosphate allosterically activating the beta form of glycogen synthase leading to increased incorporation of glucose into glycogen. Ref: Bender D.A., Mayes P.A. (2011). Chapter 20. Gluconeogenesis & the Control of Blood Glucose. 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 | Deficiencies in the enzyme glucose-6-phosphatase are likely to lead to which of the following?
A. Decreased glucagon production
B. Decreased Skeletal Muscle Glycogen Accumulation
C. Hyperglycemia
D. Increased hepatic glycogen accumulation
| Decreased Skeletal Muscle Glycogen Accumulation |
b5ef92f8-77d0-46b6-9d7d-a3f9747d22d9 | HIV has been isolated from blood, semen, vaginal secretions, saliva, tears, breast milk, CSF, amniotic fluid, and urine. It is an extremely fastidious virus that ordinarily is transmitted only after repeated admixture of body fluids. Blood and semen are by far the major transmission fluids. | Surgery | Transplantation | Human immunodeficiency virus (HIV) has been isolated from many body fluids. Which of the following is a major source of transmission?
A. Tears
B. Sweat
C. Semen
D. Urine
| Semen |
47258b4c-232e-4ff0-ae1b-313e0ea015c8 | A i.e. 193 - Corneal reshaping refractive procedures such as photorefractive keratectomy (PRK), laser assisted epithelial keratomileusis (LASEK), & laser assisted insitu keratomileusis (LASIK), used to correct refractive errors (myopia and hypermetropia), are ultraviolet-photoablation procedures using Excimer (also k/a argon fluoride/Ar-F- excimer) laser of ultraviolet (193 nm) wave lengthQ. Myopia is treated by ablating the central anterior corneal surface so that it becomes flatter; 10um ablation corrects 1D myopia. Hypermetropia is corrected by ablation of periphery so that the centre becomes steeper. Excimer laser (193 nm) corneal reshaping refractory surgery is of 2 types. In PRK the anterior surface of cornea is ablated by laser, which can correct myopia upto 6D, astigmatism upto 3D and low hypermetropia. The more popular other method is LASIK, in which superficial circular flap of epithelium & stroma is cut with microkeratome (an automated sharp blade), lifting up 120-150 pm thick hinged flap attached on one side. The stromal bed is laser ablated to desired extent ensuring minimal stromal bed thickness of 250 pm (to maintain stability & prevent iatrogenic ectasia). Following this the flap is repositioned without sutures; this can corret hypermetropia upto 4D, astigmatism upto 5D and myopia upto 12D. Modifications to minimize microkeratome related complications include use of 20% alcohol (30-40 seconds) to lift / clear thin epithelial flap (LASEK), use of special microkeratome to cut & separate a thin flap of epithelium & Bowman's layer (Epi - LASIK) and use of femto second laser to pre fashion the anterior flap to a desired size and depth without using a surgical blade Refractive Keratoplasty to modify refractive power of cornea may be done by: (i) radial keratotomy (radial incisions are made in cornea); (ii) arcuate keratotomy (arcuate shaped incisions in steeper or more myopic meridian to reduce astigmatism); (iii) Keratomileusis (tissue resected & modified in shape before replacement) and (iv) epikeratophakia, where donor corneal tissue is attached to the host cornea after removal of epithelium capsulectomy in an eye with a silicone intraocular lens implant is challenging because optical breakdown occurs in silicone at relatively low power, therefore damaging IOL even when the laser is focused posterior to implant. Procedure is even more difficult if capsule is in intimate contact with the implant. Use of corneal contact lens during laser capsulectomy result in steeper convergence & more sharply focused Nd YAG laser beam. - IOL made of PMMA and acrylic are less susceptible to optical breakdown than silicone lenses. Photodisruption (PD) - PD is a mechanical effect produced by highly focused laser (with high electromagnetic field strength), which can actually strip electrons from their nuclei, destroying chemical nature of material producing an entirely different physical state of matter called plasma. - In plasma, the orderly array of molecules is fractured into a random mixture of electron & protons in a process called optical break down, which is basically a miniature lightening bolt or thunderclap. Vapors formed by lightning bolt expands, quickly collapse and produce a miniature thunder clap. Acoustic shock waves produced from thunderclap cause most of the tissue damage. - PD optical breakdown requires electro magnetic fields so powerful they can be produced only by concentrating lasr energy into very brief periods, thereby giving each pulse an extremely high power. Infrared Nd: YAG laser (1064nm) with Q switching or mode locking pulsing is used for PD. Q switching is most commonly used, inexpansive and reliable but cant produce pulses as sho or powerful as mode locking. Whereas, mode locking are expansive and difficult to maintain but more powerful. - Nd: YAG laser is infrared, invisible, so aiming system (a red helium-neon / He-Ne laser) is necessary. However, the patient's eye cause the red aiming beam to bend more than Nd:YAG's infrared laser. Therefore, the focus of both rarely coincide precisely (chromatic aberration). Photodisruption with infrared Nd: YAG laser (1064nm) is used in performing posterior lens capsulectomyQ. Photocoagulation (PC) - In PC, laser light (mostly visible or sometimes infrared) is absorbed by the target tissue or by neighbouring tissue, generating heat that coagulates (denatures) proteins. - It is the most commonly used laser procedure performed during panretinal photocoagulation, argon laser trabeculoplasty, peripheral iridecotomy, and thermal destruction of choroidal neovascular membranes. It is used in treatment of various conditions. Anterior segment PC Posterior segment PC - lridoplasty - Proliferative DR - Iridotomy - Diabetic macular edema - Trabeculoplasty - Choroidal neovascularization - Cyclophoto secondary to age related macular coagulation degeneration - Retinal breaks - Retinal detachments - Types of laser that produce PC include Laser Wave length (nm) Argon Blue- Green 488 Argon-Green 514 Frequency doubled (2x) Nd-YAG (green) 532 Rhodamine 6G Organic tunable Dye laser (Yellow-Red) 570 to 630 Krypton-Red 647 Ruby - Red 694 Diode (near infrared) 810 - Increase in exposure time modestly increases the lesion's diameter and also extends damage deeper into target tissue (eg 10 fold ET doubles diameter). Whereas very brief exposure times (0.01-0.05 seconds), allow little time for heat to dissipate from the burn. Therefore a small area of intense burn is produced, resulting in perforation of delicate ocular structures like neural retina & Bruch's membrane. - An increase in power has strong influence on lesion diameter (doubling power doubles size) but creates more damage and can be painful. In most PC lasers, the energy is concentrated in the centre of beam, with less energy at edges. Therefore, use of excessive power during laser treatment of retina may result in inadveent retinal hole. Also the lower energy at periphery may produce permanent tissue damage even though it does not produce a visible reaction. This means the area of laser damage may extend beyond the area of immediately visible reaction. In sensitive areas such as macula, a small spot size (100pm) is preferred so as to minimize unnecessary adjacent damage. In contrast, larger spot size (200-500pm) is preferred for panretinal photocoagulation. - Laser contact lenses also increase spot size Laser contact lens Multiplication factor of increased spot size Goldman three mirror lens 1.08 Panfundoscopic lens 1.41 Mainster wide angle lens 1.47 Quadr Aspheric lens 1.92 If the spot size is increased, the power needs to be increased. However, because energy is concentrated in centre of beam, it is best to raise power only modestly (no more than two folds at a time) and to test burns to refine the power settings. Photoablation (PA) - PA breaks chemical bonds that hold tissue together, essentially vaporizing the tissue. Chemical bonds are broken by absorption of Photons without any external mechanical pressure. Therefore, the laser is able to remove tissue with more precision and with much less damage to surrounding tissue. - It is most recent light tissue interaction using argon-fluoride (Ar-F) excimer laser producing electro magnetic energy with a wave length of 193 nm (in the extreme ultraviolet). - Photoablation used for shaping cornea in refractive surgery and to treat corneal pathology such as corneal ulcers and scars. - Excimer laser removes --0.1 mm of corneal tissue with each pulse. Beam shaping optics are used to create even beam profile; however, these are ablated slowly & must be replaced periodically. - Irregularities in corneal stroma, presence of keratinocytes, & variable corneal collagen density (depending on altitude, atmospheric pressure, humidity, age and duration of procedure) may cause uneven ablation even when beam profile is uniform. | Ophthalmology | null | Which of the following reflects wavelength (nanometers) of Laser used for shaping cornea in refractive surgery:
A. 193
B. 451
C. 532
D. 1064
| 193 |
5cddb146-df5b-4d78-a16c-0086f662b230 | Biotin is a cofactor for carboxylase, so it can be used in the treatment of multiple carboxylase deficiency. Maple syrup urine disease- Thiamine Methylmalonic acidemia- Vitamin B12, L- carnitine, Metronidazole Phenylketonuria- Tetrahydrobiopterin | Pediatrics | Disorders of Amino acid Metabolism | Biotin may be used for treatment of which of the following conditions?
A. Maple syrup urine disease
B. Methylmalonic acidemia
C. Phenylketonuria
D. Multiple carboxylase deficiency
| Multiple carboxylase deficiency |
c4fb3d4c-62d8-437b-ac29-15b4dd5093df | * Chi-Square test offers a method of testing the significance of difference between the propoions. * Its advantage lies in the fact that it can also be used when more than two groups are to be compared. * By using this test, we can find out if the difference between two propoions or ratios has occurred by chance. The steps involved are- 1) Testing the null hypothesis. 2) Applying chi-square test. 3) Calculating the degree of freedom. 4) Comparing with probability tables. | Surgery | null | The significance of difference between propoions can also be tested by-
A. .'t' test
B. Chi square test
C. ANOVA
D. Correlation and regression
| Chi square test |
5d96ace8-2f21-466d-9368-8ee16b9716cf | Ans. a (Basal cell carcinoma). (Ref. Baily & Love, 25th/pg. 609)BASAL CELL CARCINOMA (BCC, rodent ulcer)# Basal cell carcinoma is the commonest form of skin cancer and typically affects individuals between the ages of 40 and 79 years; 50 percent are male.85 percent occur in the head and neck region.# Are thought to originate from pluripoten epithelial cells of the epidermis and hair follicles.# BCCs grow slowly, but locally invasive and penetrate deeper tissues -- hence the term rodent ulcer,# Metastasis is rare.# Typically these tumours have a nodular appearance with a pearly rolled edge (which is apparent on stretching the skin) and telangiectatic vessels.# Clinically types in order of frequency:- Nodular: 50-54%; (90% nodular/nodular cystic). Superficial : 9-11%;- Cystic: 4-8%; Pigmented: 6%; Morpheic : 2%.# Treatment:- Surgical excision -- the treatment of choice with cure rates between 85 and 95%.- Electrodessication and curettage -- commonly used for small superficial lesions (2--5 mm in diameter) gives cure rates between 85 and 100%.- Radiotherapy -- BCC is very radiosensitive and has an overall response of 92 % in selected patients. This is reserved for elderly patients who are not suitable for surgery or for specialised anatomical sites.- Moh's micrographic surgery (chemosurgery) --involving serial horizontal excision and mapping of the tumour. Usually reserved for recurrent lesions, tumours in difficult areas or those with indistinct borders (morphea-form).- Following complete excision it is unnecessary routinely to follow-up these patients unless they have a familial disposition for BCC formation (Gorlin's syndrome). | Surgery | Neoplasia | Most common tumor of eyelid is
A. Basal cell carcinoma
B. Keratoacanthoma
C. Melanoma
D. Squamous cell carcinoma
| Basal cell carcinoma |
7c9f6920-5687-4255-98b9-1aa652db9fd1 | Ans. is 'a' i.e., Regression of language and motor milestones Rett's syndromeo Age of onset is around 5 months.o Development may proceed normally until 1 yr of age, when regression of language and motor milestones become apparent.o This is the characteristic features, that they begin to loose their acquired skills, e.g., cognitive and head growth is normal during early period after which there is an arrest of growth,o Acquired microcephaly (Decleration of head growth due to significantly reduced brain weight).o Most children develop peculiar sighing respirations with intermittent periods of apnea that may be associated with cyanosis - Breath holding spells.o Autistic behavior is a typical finding in all patients - Impaired social interaction, language and communication.o Generalized tonic-clonic convulsions occur in the majorityo Feeding disorder and poor weight gain are commono Death occurs in adolescence or in the 3rd decadeo Cardiac arrhythmias may result in sudden, unexpected death. | Psychiatry | Mood Disorders | Rett's syndrome is characterized by -
A. Regression of language and motor milestones
B. Hyperactive child
C. Normal weight
D. Macrocephaly
| Regression of language and motor milestones |
883cedd9-849c-4418-b2fa-3046b86e3ba1 | Sodium cromoglicate stabilises the mast cell membrane, inhibiting release of vasoactive mediators. It is effective as a prophylactic agent in asthma and allergic rhinitis, but has no role in acute attacks. It is poorly absorbed and therefore ineffective in the management of food allergies DAVIDSON&;S 22 ND EDITION | Medicine | Immune system | Which of the following is treatment of Type I hypersensitivity
A. Histamine
B. IgA immunoglobulin
C. Sodium cromoglycate
D. Interleukin 5
| Sodium cromoglycate |
8ce7c547-9d58-4bfb-9a62-47de48218dec | Ans: B (Cervical lymphadenopathy) Ref: Diseases of the Ear, Nose and Throat by PL Dhingra. 5th edn .2010 page 265Explanation:Nasopharyngeal CarcinomaMost commonly seen in the Chinese populationBimodal age distributionRisk factors are burning of incense sticks, preserved salted fish and decreased intake of vitamin CTypes of Nasopharyngeal carcinoma Type I - squamous cell carcinoma Type II - non keratinizing carcinoma Type III - undifferentiated carcinomaPresents most commonly as cervical lymph node 160%)Most common region is posterior cervicalAlso presents as hearing loss, nasal block, epistaxis and cranial nerve palsy (most common VIN)Other cranial nerves which can be involved are II, III, IV, VI, V, IX, X XI, Homer's syndromeDiagnosis is with CT scan and MRI scansTreatment is with radiotherapy and chemotherapy (cisplatin +/- 5FU) | ENT | Pharynx | Most common presentation of nasopharyngeal carcinoma is: (JIPMER 2011 Repeat)
A. Epistaxis
B. Cervical lymphadenopathy
C. Nasal obstruction
D. Hearing loss
| Cervical lymphadenopathy |
76c4ccfc-f326-4098-9286-dfaa885137b0 | Ans: d (Measles) Ref: Park, 19th ed, p. 95The two vaccines which must be stored in the freezer compartment are:* Polio* Measles.Vaccines which must be stored in the cold part but never allowed to freeze are:* DPT* TT* DT* BCG* Diluents.Nothing is kept in the door!All vaccines with the letter T are kept in the cold part and not in the freezer. Remember that BCG is Bacille CalmetteGuerin.Cold chain:The "cold chain" is a system of storage and transport of vaccines at low temperature from the manufacturer to the actual vaccination site, at 4-8degC.Among the vaccines polio is most heat sensitive, requiring storage at minus 20degC.The cold chain equipment consists of the following.a) Walk in cold room (WIC) - located at regional level, meant to store vaccines up to 3 months and serve 4-5 districts.b) Deep freezers and ice lined refrigerators (ILR) - supplied to all districts and the WIC locations to store vaccines. Deep freezers are used for making ice packs and to store polio and measles vaccines.c) Small deep freezers and Ice lined refrigerators (ILR) - one set is provided to PHCs, urban family planning centres, and post partum centres.d) Cold boxes - supplied to all peripheral centres, mainly for the transportation of vaccines.e) Vaccine carriers - used to carry small quantities of vaccine (16-20) vials to out of reach sessions.f) Day carrier - used to carry small quantities of vaccine (6-8) vials to nearby sessions. | Social & Preventive Medicine | Miscellaneous | Which of the following is stored in freezer?
A. DT
B. IT
C. DPT
D. Measles
| Measles |
e78ccbfa-b7a6-40a3-954d-9b3cd46fae3e | Shoulder joint is the commonest joint to undergo dislocation.it occurs commonly in adults and rare in children. Anterior dislocation is common than posterior dislocation. Shoulder instability is term used when head of humerus is not stable within the glenoid. The instability may be uni or bidirectional. The instability can be in many directions-multi directional. A fall on out stretched hand with shoulder abducted and externally rotated is common mechanism of injury. Ref: Essential Ohopaedics, Maheswari & Mhaskar, 9th ed Page no: 89 | Orthopaedics | Shoulder and arm injuries | Most common joint to undergo recurrent dislocation is ?
A. Shoulder joint
B. Patella
C. Knee joint
D. Hip joint
| Shoulder joint |
62cc354b-1489-42f3-9929-59afd7283a38 | Carbon dioxide is not commonly regarded as an air pollutant it is a natural constituent of air. It does not take pa in any significant chemical reactions with other substances in the air However, it could increase global temperature enough to affect climate markedly | Social & Preventive Medicine | Environment and health | Among the following, which of the following is/are the greatest contributors to global warming as a consequence of human activities and life style ?
A. Carbon dioxide
B. Chlorofluorocarbons
C. Methane
D. Ozone
| Carbon dioxide |
b20ecc89-dbd2-4273-821c-499669049679 | Ans. is 'a' i.e., 30 mg Cetchroman (Saheli)o Ormeloxifene, research product of Central Drug Research Institute, Lucknow, India.o It is a potent non - steroidal compound with potent anti - estrogenic and weak estrogenic properties. It is taken orally (30 mg) twice a wreek for first three months then once a wreek.o It works primarily by preventing implantation of fertilized ovum. It does not inhibit ovulation,o It is avoided in PCOD, writh liver and kidney diseases and in tuberculosis. There may be a tendency of oligomenorrhoea.o The failure rate is 1 - 4/100 woman years of use. Failure rate is less with increased doses. It is devoid of any significant adverse metabolic effect.o This may also be used as a emergency contraceptive. | Pharmacology | Vitamin | Dose of centchroman is -
A. 30 mg
B. 60 mg
C. 120 mg
D. 240 mg
| 30 mg |
5afea53d-0275-4df0-a1cd-1b34194bd51b | Ans. is 'c' i.e., Subarachnoid haemorrhage Nimodipine selectively relaxes cerebral vasculature, approved for prevention and treatment of neurological deficit due to cerebral vasospasm following subarachnoid haemorrhage or ruptured congenital intracranial aneurism. | Pharmacology | null | The major clinical use of nimodipine is in ?
A. Hypeension
B. Angina pectoris
C. Subarachnoid haemorrhage
D. Raynaud's phenomenon
| Subarachnoid haemorrhage |
8f70c1be-1adf-4ce3-b7c4-fd47d22db38c | Pyeloplasty is performed to treat an uretero-pelvic junction obstruction if residual renal function is adequate There are different types of pyeloplasty depending on the surgical technique and patterns of incision used. These include the Y-V, Inveed &;U&;, and Dismembered types of pyeloplasty. The dismembered type of pyeloplasty (called an Anderson-Hynes pyeloplasty) is the most common type of pyeloplasty. This was described in relation to retrocaval ureter (now renamed as preureteric vena cava). Another technique of pyeloplasty is Culp&;s pyeloplasty, in this method a flap is rotated from dilated pelvis to decrease narrowing of ureter. A pyeloplasty can either be done by the robotic, open, or laparoscopic route. Reference: GHAI Essential pediatrics, 8th edition | Pediatrics | Urinary tract | A child presented with Intermittent episodes of left sided flank pain. Ultrasonography reveals large hydronephrosis with dilated renal pelvis and coical thinning with a normal ureter. Kidney differential function was observed to be 19% which of the following is the best management
A. Nephrectomy
B. Pyeloplasty
C. External drainage
D. Endopylostomy
| Pyeloplasty |
ed870930-496d-4db3-b783-9e3345e668e0 | Ans- A 10600 nm Ref- CO2 Lasers Definition: infrared lasers based on a gas mixture in which light is amplified by carbon dioxide molecules The CO2 laser (carbon dioxide laser) is a molecular gas laser based on a gas mixture as the gain medium, which contains carbon dioxide (CO2), helium (He), nitrogen (N2), and possibly some hydrogen (H2), water vapor and/or xenon (Xe). Such a laser is electrically pumped via a gas discharge, which can be operated with DC current, with AC current (e.g. 20-50 kHz) or in the radio frequency (RF) domain. Nitrogen molecules are excited by the discharge into a metastable vibrational level and transfer their excitation energy to the CO2 molecules when colliding with them. Helium serves to depopulate the lower laser level and to remove the heat. Other constituents such as hydrogen or water vapor can help (particularly in sealed-tube lasers) to reoxidize carbon monoxide (formed in the discharge) to carbon dioxide. Figure 1: Schematic setup of a sealed-tube carbon dioxide laser. The gas tube has Brewster windows and is water-cooled. CO2 lasers typically emit at a wavelength of 10.6 mm, but there are other lines in the region of 9-11 mm (particularly at 9.6 mm). In most cases, average powers are between some tens of watts and many kilowatts. The power conversion efficiency can be well above 10%, i.e., it is higher than for most gas lasers (due to a particularly favorable excitation pathway), also higher than for lamp-pumped solid-state lasers, but lower than for many diode-pumped lasers. - Laser Types The family of CO2 lasers is very diverse: For laser powers between a few watts and a several hundred watts, it is common to use sealed-tube or no-flow lasers, where the laser bore and gas supply are contained in a sealed tube. Such lasers are compact and rugged, and reach operation lifetimes of several thousands of hours. High-power diffusion-cooled slab lasers (not to be confused with solid-state slab lasers) have the gas in a gap between a pair of planar water-cooled RF electrodes. The excess heat is efficiently transferred to the electrodes by diffusion, if the electrode spacing is made small compared with the electrode width. Several kilowatts of output are possible. Fast axial flow lasers and fast transverse flow lasers are also suitable for multi-kilowatt continuous-wave output powers. The excess heat is removed by the fast-flowing gas mixture, which passes an external cooler before being used again in the discharge. Transverse excited atmosphere (TEA) lasers have a very high (about atmospheric) gas pressure. As the voltage required for a longitudinal discharge would be too high, transverse excitation is done with a series of electrodes along the tube. TEA lasers are operated in pulsed mode only, as the gas discharge would not be stable at high pressures. They often produce average output powers below 100 W, but can also be made for powers of tens of kilowatts (combined with high pulse repetition rates). There are gas dynamic CO2 lasers for multi-megawatt powers (e.g. for anti-missile weapons), where the energy is not provided by a gas discharge but by a chemical reaction in a kind of rocket engine. The concepts differ mainly in the technique of heat extraction, but also in the gas pressure and electrode geometry used. In low-power sealed-tube lasers (used e.g. for laser marking), waste heat is transported to the tube walls by diffusion or a slow gas flow. The beam quality can be very high. High-power CO2 lasers utilize a fast forced gas convection, which may be in the axial direction (i.e., along the beam direction) or in the transverse direction (for the highest powers). - Applications CO2 lasers are widely used for material processing, in particular for cutting plastic materials, wood, die boards, etc., exhibiting high absorption at 10.6 mm, and requiring moderate power levels of 20-200 W cutting and welding metals such as stainless steel, aluminum or copper, applying multi-kilowatt powers laser marking of various materials. Other applications include laser surgery (including ophthalmology) and range finding. CO2 lasers used for material processing (e.g. welding and cutting of metals, or laser marking) are in competition with solid-state lasers (particularly YAG lasers and fiber lasers) operating in the 1-mm wavelength regime. These shorter wavelengths have the advantages of more efficient absorption in a metallic workpiece, and the potential for beam delivery via fiber cables. (There are no optical fibers for high-power 10-mm laser beams.) The potentially smaller beam parameter product of 1-mm lasers can also be advantageous. However, the latter potential normally cannot be realized with high-power lamp-pumped lasers, and diode-pumped lasers tend to be more expensive. For these reasons, CO2 lasers are still widely used in the cutting and welding business, particularly for parts with a thickness greater than a few millimeters, and their sales make more than 10% of all global laser sales (as of 2013). This may to some extent change in the future due to the development of high-power thin-disk lasers and advanced fiber cables in combination with techniques which exploit the high beam quality of such lasers. Due to their high powers and high drive voltages, CO2 lasers raise serious issues of laser safety. However, their long operation wavelength makes them relatively eye-safe at low intensities. - Bibliography C. K. N. Patel, "Continuous-wave laser action on vibrational-rotational transitions of CO2", Phys. Rev. 136 (5A), A1187 (1964) C. K. N. Patel, "Interpretation of CO2 optical maser experiments", Phys. Rev. Lett. 12 (21), 588 (1964) A. Robinson and D. Johnson, "A carbon dioxide laser bibliography, 1964-1969", IEEE J. Quantum Electron. 6 (10), 590 (1970) P. T. Woods et al., "Stable single-frequency carbon dioxide lasers", J. Phys. E: Sci. Instrum. 9, 395 (1976) A. L. S. Smith and J. Mellis, "Operating efficiencies in pulsed carbon dioxide lasers", Appl. Phys. Lett. 41, 1037 (1982) K. M. Abramski et al., "Power scaling of large-area transverse radiofrequency discharge CO2 lasers", Appl. Phys. Lett. 54, 1833 (1989) O. Svelto, Principles of Lasers, Plenum Press, New York (1998) | Unknown | null | Wavelength of carbon dioxide laser is?
A. 10600 nm
B. 1082nm
C. 2940 nm
D. 1064 nm
| 10600 nm |
39fa893a-b05b-4b63-93aa-96777b6ea707 | d. Marfan syndromeA - ArachnodactylyB - Steinberg sign (thumb tip extends from palm of hand, in a closed fist)C - Walker-Murdoch sign (thumb & 5th finger overlap each other, when opposite wrist is gripped) | Pediatrics | Genetics And Genetic Disorders | What is the disease in which these hand abnormalities are seen?
A. Down syndrome
B. Osteogenesis imperfecta
C. Turner syndrome
D. Marfan syndrome
| Marfan syndrome |
04b8afe6-5aac-413e-9a63-ae5f38f33699 | Ans. is c, i.e. Intrinsic sphincter deficiency is an indicationLets see each option:TVT acts by increasing urethral coaptation, kinking the urethra with the rise in abdominal pressure and not by elevating bladder neck hence option a is incorrect.TVT is made from polypropylene (marlex) or polytetrafluoroethylene (Goretex) and not autologous sling material. Autologus sling material refers to natural sling materials made from rectus fascia or porcine dermis. These are less Antigenic; hence option b is incorrect.TVT is done in case of intrinsic sphincter deficiency, i.e. option c is correct.Success rate of sling procedure are over 80%, i.e option d is incorrect | Gynaecology & Obstetrics | Urinary Fistulas | Regarding the sling procedure for Urodynamic Stress Incontinence (USI):
A. Tension-free vaginal tape (TVT) elevates the bladder neck to a retropubic position
B. TVT is an autologous sling material
C. Intrinsic sphincter deficiency is an indication
D. Success rate of TVT is low than other retropubic procedures
| Intrinsic sphincter deficiency is an indication |
c49f3a23-fd55-4199-9907-5ba747e50eee | <p> Cervical incompetency is the one of the cause for recurrent 2nd trimester miscarriage(20%) Management of cervical incompetence is by two types of operations named after Shirodkar and McDonald Reference:DC Dutta&;s textbook of obstetrics,8th edition,page no:199 <\p> | Gynaecology & Obstetrics | General obstetrics | A gravida 3 female with H/o 2 previous 2nd trimester aboion presents at 22 weeks of gestation with funneling of cervix. Most appropriate management would be:
A. Administer dinoprostone and bed rest
B. Administer misoprostol and bed rest
C. Apply fothergill stretch
D. Apply McDonald stitch
| Apply McDonald stitch |
e4bf9b47-23c4-4c96-8a09-d9f5e5c71e8a | *Most common symptom of osteoporosis is back pain secondary to veebral compression fracture. *Dorso - lumbar spine is the most frequent site. <img alt="" src=" /> * Other common sites of fracture are lower end radius and fracture neck femur. *Osteoporotic fracture are : (1)Fracture veebrae (2)Colle's Fracture (3) Fracture neck (4) femur Ref: Maheshwari 6th/e p.308 | Anatomy | null | Most common site for the osteoporotic veebral Fracture is :
A. Dorsolumbar spine
B. Cervical spine
C. Lumbosacral spine
D. Dorsal spine
| Dorsolumbar spine |
887f7edd-d259-44b7-9fe6-50f4ccfb4193 | The refractive index of the lens coex is 1.386 while that of the lens core is 1.406. Refractive index of each component of the eye as an optical system Refracting medium Refractive index Air 1.000 Cornea 1.373 Aqueous humour 1.336 Lens(coex-core) 1.386 - 1.406 Vitreous humour 1.336 Ref: Parsons' Diseases of the Eye By Ramanjit Sihota & Radhika Tandon page 52. Theory And Practice Of Optics And Refraction By Khurana page 32. | Ophthalmology | null | Which of the following component of the eye has highest refractive index?
A. Anterior surface of the lens
B. Posterior surface of the lens
C. Centre of the lens
D. Cornea
| Centre of the lens |
a086b821-197f-431d-80fe-abc314980fb9 | (Internal fixation with plate & screw) (720-ApIey's 8th)* Unstable fracture of Tibial plateau - In younger patient, and more so those with a central depression of more than 5 mm, open reduction with elevation of the plateau and internal fixation with a buttress plate is preferred.* Stable fracture - depression is slight (less than 5 mm), if the patient is old and frail or osteoporotic the fracture is treated with closed reduction (Skeletal traction for 3-4 weeks and then hinged cast brace for another 6 weeks. | Orthopaedics | Injuries Around the Thigh & Knee | The immediate treatment of unstable tibial plateau fracture is:
A. Internal fixation with plate & screw
B. Internal fixation with nail
C. External fixator
D. Complete bed rest
| Internal fixation with plate & screw |
151ff40d-ba40-4739-a2a3-e1f9b4c7e86b | Post exposure prophylaxis(HDCV) requires 5 or 6 doses on 0,3,7,10,14,30&Optionally90. REF:<\p> ANATHANARAYANAN MICROBIOLOGY NINTH EDITION PAGE.531 | Microbiology | Virology | In rabies, human diploid cell culture vaccine for post-exposure vaccination is given on the following days -
A. 0, 7, 28 then booster dose in 90 days
B. 0, 7, 28 then booster dose in 2 days
C. 0, 3, 7, 14, 30 then booster dose in 90 days
D. 0, 3, 7 and booster dose in 90 days
| 0, 3, 7, 14, 30 then booster dose in 90 days |
019c1f6f-1d1f-4daa-a332-d9fcc3457084 | Ans. is 'a' i.e., Ulcer extends beyond the gastric wallo In malignant ulcers mucosal rugae stop far of the ulcers whereas in benign ulcers mucosal rugae projects outwards from the margins of the ulcer | Pathology | null | Malignant gastric ulcers are characterized by A/E ?
A. Malignant gastric ulcers are characterized by A/E ?
B. Mucosal rugae stop far of ulcers
C. Eccentric crater
D. Margins are raised
| Malignant gastric ulcers are characterized by A/E ? |
da65f910-e789-45b3-b72f-609980443b69 | ‘Dipstick Test’ is used for the rapid diagnosis of Plasmodium falciparum (Pf)
– Is a ‘rapid whole blood immuno-chromatographic test’
– Uses 2 antibodies specific for ‘Pf Histidine Rich Protein II Antigen’
– Is a ‘antigen capture assay’ – Colloidal gold is used in the test card
– Gives results in 3 – 5 minutes
– Specificity and negative predictive value is 99%
– Not as effective when parasite levels < 100 parasites/ml of blood
• Rapid tests for diagnosis of Pf:
– Dipstick test (Pf Histidine rich protein II – HRP II)
– Leishman stain
– Field’s stain
– Acridine orange. | Social & Preventive Medicine | null | ‘Dipstick Test’ for rapid diagnosis of Plasmodium falciparum is based on
A. Arginine-rich protein
B. Serine-rich protein
C. Tyrosine-rich protein
D. Histidine-rich protein
| Histidine-rich protein |
16bdfb21-a03c-40de-82d7-8a30da51fc46 | HYPONASALITY (RHINOLALIA CLAUSA) It is lack of nasal resonance for words which are resonated in the nasal cavity, e.g. m, n, ng. It is due to blockage of the nose or nasopharynx. Ref:- Dhingra; pg num:-315 | ENT | Larynx | In a child with hyperophied adenoids, the voice abnormality that is seen is
A. Hot potato voice
B. Staccato voice
C. Rhinolalia apea
D. Rhinolalia clausa
| Rhinolalia clausa |
03d44c5e-5e14-4540-b82d-b2eed2afc697 | CHALAZION CLAMP is used to fix the chalazion and achieve haemostasis during the incision and curettage operation CHALAZION SCOOP it is used to scoop out contents of the chalazion during incision and curettage. | Ophthalmology | Lacrimal Apparatus and Eyelid Disorders | These instruments are used for the surgery of
A. Ptosis
B. Chalazion
C. Ectropion
D. Entropion
| Chalazion |
0a65a75c-a6c3-4a13-bfc2-3d45f6d22ee8 | C i.e. Sturge -Weber Syndrome Vascular plaque (capillary malformation) over lateral aspect of forehead mainly involving ophthalmic (VI) and maxillary (V2) division of trigeminal nerve and sezuresQ suggest diagnosis of Sturge-Weber syndrome (encephalo-trigeminal angiomatosis). | Skin | null | A mother brought her child which has got a vascular plaque like lesion over the lateral aspect of forehead mainly involving ophthalmic and maxillary division of trigeminal nerve. Mother says that the lesion remains unchanged since bih. Also mother gives a history that the child is on valproate for seizure disorder. The probable diagnosis is
A. Tuberous sclerosis
B. Infantile hemangioma
C. Sturage weber syndrome
D. Incontinentia pigment
| Sturage weber syndrome |
64d15b30-c6d4-4a43-bd62-da14fc920dbf | Ans. (b) Alagille syndromeRef: Internet Sources* Alagille syndrome is an autosomal dominant genetic disorder affecting liver and heart commonly.* Bile duct paucity is the common manifestation which results in Cirrhosis and Liver failure | Surgery | Gall Bladder & Bile Ducts | Ductopenia seen in
A. Primary biliary cholangitis
B. Alagille syndrome
C. Caroli's disease
D. EHPVO
| Alagille syndrome |
18e07000-4fb4-444a-b3a7-b2c88079f2ff | An X-ray film of the abdomen is obtained 12-24 hours after birth, with baby being kept in an inverted position. | Pediatrics | null | X–ray detect congenital anorectal malformation at –
A. Immediately after birth
B. 24–48 hours
C. 48–72 hours
D. After 72 hours
| 24–48 hours |
cb95e94b-c11c-4e9a-b32d-33a645866f4d | Ans: a (Propranolol) Ref: Katzung, 10th ed, p. 160Beta blockers decrease heart rate, force of contraction and cardiac output, this leads to decrease in blood pressure.Drugs used in hypertension are:1) Diuretics - Low-dose thiazide diuretics are often used as first-line agents, alone or in combination with other antihypertensive drugs e.g., hydrochlorthiazide, chlorthalidone.2) ACE-inhibitors and angiotensin receptor blockers - ACE inhibitors decrease the production of angiotensin n, increase bradykinin levels, and reduce sympathetic nervous system activity. Angiotensin II receptor blockers provide selective blockade of AT1 receptors.3) Beta Blockers - a adrenergic receptor blockers lower blood pressure by decreasing cardiac output, due to a reduction of heart rate and contractility. Other actions include renin inhibition.4) Calcium Channel Blockers - Calcium channel antagonists reduce vascular resistance through L- channel blockade, which reduces intracellular calcium and blunts vasoconstriction.5) Aldosterone Antagonists - It may be a particularly effective agent in patients with low-renin essential hypertension, resistant hypertension, and primary aldosteronism.The newer agent, eplerenone, which is a selective aldosterone antagonist have lesser side effects than spironolactone.6) a adrenergic blockers - They lower blood pressure by decreasing peripheral vascular resistance.7) Sympatholytic Agents - Centrally acting a2 agonists lower blood pressure by inhibiting sympathetic outflow and thereby decreasing peripheral resistance e.g., clonidine.8) Direct vasodilators - These agents decrease peripheral resistance.Hydralazine is a potent direct vasodilator.S/e: lupus-like syndrome.Minoxidil is another vasodilator and is most frequently used in patients with renal insufficiency that is refractory to all other drugs.S/e: hypertrichosis and pericardial effusion.9) Adrenergic neuron-blocking agents-These drugs lower blood pressure by preventing normal physiological release of norepinephrine from postganglionic sympathetic neurons.E.g. Guanethidine, reserpine | Pharmacology | C.V.S | Which of the following anti hypertensives act by decreasing heart rate only?
A. Propranolol
B. Methyl dopa
C. Prazosin
D. Nitrate
| Propranolol |
37033126-c04e-452c-a27b-db940e5284c1 | Ans. is 'c' i.e., Suprachiasmatic nucleus | Physiology | null | Biological clock of brain is located in
A. Preoptic nucleus
B. Lateral nucleus
C. Suprachiasmatic nucleus
D. Supraoptic nucleus
| Suprachiasmatic nucleus |
d1f59e22-5cc2-49d9-8359-90f669d7addf | In Coronary Aery Disease (CAD) the cholesterol level (mg/dl) recommended is below 200. Desirable High risk of Hea disease Total cholesterol <200 > 240 HDL > 60 <40 LDL <100 >200 TG <150 | Biochemistry | Lipoproteins | In Coronary aery disease the cholesterol level (mg/dl) recommended is:
A. Below 200
B. < 220
C. < 250
D. < 280
| Below 200 |
c74b9949-54aa-46d8-b7c8-4c6486f468c5 | Ans. is `c' i.e., 16, 18 HPV DNA of oncogenic types (High risk) in HPV-16, 18, 31, 33 and 45 - associated with cervical cancer HPV-6 and 11 (Low risk HPV) - associated with precursor lesions of cervical cancer (CIN) and Condyloma Acuminatum. In patients with epidermodysplasia verruciformis, Squamous cell cancer develop frequently at sites infected with specific HPV types, including 5 and 8. E6 and E7genes of HPV are responsible for carcinogenicity. | Microbiology | null | Most common type of HPV associated with cervical cancer ?
A. 6, 11
B. 5, 8
C. 16, 18
D. 6, 8
| 16, 18 |
a5526a85-75bc-45d9-bad4-8121f2ad114d | Ans. is 'a' i.e., Elvitegravir New drugs in HIV infectiono Etravirine is recently approved NNRTI. This is second generation NNRTI and is effective against HIV resistant to first generation NNRTI (Efavirenz, Delaviridine. Nevirapine).Fusion inhibitors (Entry inhibitors)o Enfluvtritide binds to Gp41 subunit of HIV envelop protein and inhibits the fusion of viral and host cell membrane.o Maraviroc is a CCR5 Co-receptor antagonist and is only active against "CCR - 5 - tropic virus" which tends to predominate early in infection.Integrase inhibitorso Raltegravir and Elvitegravir act by inhibiting enzyme integrase. | Pharmacology | Anti-Viral | HIV integrase inhibitor is -
A. Elvitegravir
B. Abacavir
C. Maraviroc
D. Tenofovir
| Elvitegravir |
70444d12-6b6d-42f8-a5ea-fb654335206d | Vitamin D is really a hormone: Vitamin D is not strictly a vitamin since it can be synthesized in the skin, and under most conditions that is the major source of the vitamin. Only when sunlight exposure is inadequate is a dietary source required. ts main function is in the regulation of calcium absorption and homeostasis; most of its actions are mediated by way of nuclear receptors that regulate gene expression. It also has a role in regulating cell proliferation and differentiation. There is evidence that intakes considerably higher than are required to maintain calcium homeostasis reduce the risk of insulin resistance, obesity and the metabolic syndrome, as well as various cancers. Deficiency, leading to rickets in children and osteomalacia in adults. Ref: Bender D.A. (2011). Chapter 44. Micronutrients: Vitamins & Minerals. 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 derivative of fat soluble vitamin is functioning like a hormone?
A. A
B. D
C. E
D. K
| D |
a57c51f7-89c0-40d8-8e9c-23bbca700725 | Among given options only DPT Booster & OPV are given to child at 18 months of age in case of Delayed immunization. VACCINES & AGE LIMIT IN DELAYED IMMUNIZATION : Vaccine Age limit BCG, Hep B, Rotavirus, Pentavalent vaccine, fIPV, PCV till 1 yearof age. OPV, Measles, Vitamin A till 5yrs of age HiB till 6 years of age DPT till 7 years of age JE till 15 years of age TT till 16 years of age | Social & Preventive Medicine | National Immunization Schedule 2020-21 | Baby came for immunization for 1st time on 18 months. Which vaccine can be given:
A. Only Pentavalent vaccine
B. Only DPT booster and OPV
C. Pentavalent, OPV, DPT, Measles and mumps
D. Only BCG plus OPV
| Only DPT booster and OPV |
50fadc2d-4113-4d80-b51e-4e34e4e6cc3e | Irreversible cell injury is associated with loss of membrane integrity. This allows intracellular enzymes such as AST and ALT to leak into the serum. All other morphologic changes listed are associated with reversible cell injury, in which the cell membrane remains intact and the cells do not die. | Pathology | Cellular Pathology | An 11-year-old girl becomes infected with hepatitis A and experiences mild nausea for 1 week. On physical examination, she has minimal right upper quadrant tenderness and scleral icterus. Laboratory findings include a serum AST of 68 U/L, ALT of 75 U/L, and total bilirubin of 5.1 mg/dL. Her laboratory findings most likely result from which of the following changes in her hepatocytes?
A. Cell membrane defects
B. Lysosomal autophagy
C. Mitochondrial swelling
D. Nuclear chromatin clumping
| Cell membrane defects |
e42127bd-364f-4ad8-94a1-4ee4e4fea5f0 | Embryonically the gastrosplenic ligament is derived from the dorsal mesogastrium. The gastrosplenic ligament is a made of peritoneum that connects the greater curvature of stomach with the hilum of the spleen. It contains sho gastric vessels and left gastro-epiploic vessels. | Anatomy | null | The gastrosplenic ligament is derived from which of the following embryonic developmental structures?
A. Splenic aery
B. Splenic vein
C. Dorsal mesogastrium
D. Ventral mesogastrium
| Dorsal mesogastrium |
a3172b80-1486-4717-a0e9-9b7df5d63e67 | C. Rotor syndrome(Ref: Nelson's 20/e p 1937-1939)Disorders of bilirubin metabolismType of bilirubin elevatedDiseasesUnconjugated HyperbilirubinemiaCrigler-Najjar syndrome Types I and II (UDP GT gene mutation) Gilbert disease (UPD GT polymorphism)Conjugated HyperbilirubinemiaDubin-Johnson syndrome (multiple drug-resistant protein 2 mutation) Rotor syndrome (deficiency in organic anion uptake)Unlike Dubin-Johnson syndrome, in Rotor syndrome:Total urinary coproporphyrin excretion is elevated, with a relative increase in coproporphyrin I isomerGallbladder is normal by roentgenography and Liver cells contain no black pigment. | Pediatrics | Gastro Intestinal System | Which one of the following inherited conditions causes direct hyperbilirubinemia?
A. Gilbert syndrome
B. Type II Crigler-Najjar syndrome
C. Rotor syndrome
D. Type I Crigler-Najjar syndrome
| Rotor syndrome |
f80cc270-0f5d-41b8-8655-d5ad90d59497 | Hyperacute rejection is due to the presence in the recipient of preformed antibodies against HLA class I antigens expressed by the donor. Antibody mediated rejection generally occurs hours to days after transplantation. Kidney transplants are paicularly vulnerable to hyperacute graft rejection, whereas hea and liver transplants are relatively resistant. Bailey and love 27th edition Pg: 1535 | Surgery | General surgery | Transplantation of which one of "the following organs is most often associated with hyper-acute rejection?
A. Hea
B. Kidney
C. Lungs
D. Liver
| Kidney |
c8ded23f-eeae-45a1-a3dc-18292891cd0c | Causes of Metabolic Alkalosis I. Exogenous HCO3-loads A. Acute alkali administration B. Milk-alkali syndrome II. Effective ECFV contraction, normotension, K+ deficiency, and secondary hyperreninemic hyperaldosteronism A. Gastrointestinal origin 1. Vomiting 2. Gastric aspiration 3. Congenital chloridorrhea 4. Villous adenoma B. Renal origin 1. Diuretics 2. Posthypercapnic state 3. Hypercalcemia/hypoparathyroidism 4. Recovery from lactic acidosis or ketoacidosis 5. Nonreabsorbable anions including penicillin, carbenicillin 6. Mg2+ deficiency 7. K+ depletion 8. Bater's syndrome (loss of function mutations of transpoers and ion channels in TALH) 9. Gitelman's syndrome (loss of function mutation in Na+-Cl-cotranspoer in DCT) III. ECFV expansion, hypeension, K+ deficiency, and mineralocoicoid excess A. High renin 1. Renal aery stenosis 2. Accelerated hypeension 3. Renin-secreting tumor 4. Estrogen therapy B. Low renin 1. Primary aldosteronism a. Adenoma b. Hyperplasia c. Carcinoma 2. Adrenal enzyme defects a. 11b-Hydroxylase deficiency b. 17a-Hydroxylase deficiency 3. Cushing's syndrome or disease 4. Other a. Licorice b. Carbenoxolone c. Chewer's tobacco IV. Gain-of-function mutation of renal sodium channel with ECFV expansion, hypeension, K+ deficiency, and hyporeninemic-hypoaldosteronism A. Liddle's syndrome (Ref: Harrison's principles of internal medicine 19E, pg 321) | Medicine | Fluid and electrolytes | Metabolic alkalosis is associated -
A. Fanconi's anemia
B. Acetazolamide
C. Hypocalcemia
D. Triamterene
| Acetazolamide |
4d023533-72f9-4e50-ab5f-73585b4e1b22 | Ans. is 'a' i.e., Respiratory infection "During 2006, about 17% of underfive moality worldwide was due to diarrheal disease, about 19% due to acute respiratory infection, 4% due to measles and 8% due to malaria". | Social & Preventive Medicine | null | Most common cause of death in children <5 yrs age -
A. Respiratory infection
B. Diarrhoea
C. Prematurity
D. Accidents
| Respiratory infection |
c29680d9-2482-400b-89df-18ac52250a7a | Type 1 muscle fibres are present in slow muscle. They are red muscles because have greater capillary network. (REF: TEXTBOOK OF MEDICAL PHYSIOLOGY GEETHA N, PAGE NO - 44) | Physiology | General physiology | Type I muscle fibers are
A. Red
B. Anerobic
C. Large
D. Glycolytic
| Red |
67433bd8-1970-438b-b306-ba7a7a97279e | Ans. is 'a' i.e., Induces apoptosis when it engaged by fas ligand system | Pathology | null | CD - 95 in apoptosis; the death receptors initiated through -
A. Induces apoptosis when it engaged by fas ligand system
B. Cytochrom C binds to a protein Apoptosis activating (Apaf -1) factor - 1
C. Apoptosis may be initiated by caspase activation
D. Apoptosis mediated through DNA damage
| Induces apoptosis when it engaged by fas ligand system |
6468d23c-c28c-4833-ae7e-fcc987d6c96d | The only firm contraindication to wide excision and radiation (breast preservation, lumpectomy) as the primary surgical treatment for a newly discovered breast cancer is the inability to achieve an uninvolved surgical margin after excision of the tumor. A positive surgical margin requires, at least, reoperation with an attempt at re-excision of cancer. If the margin of removal is positive after attempts at re-excision, this is a strong reason to recommend mastectomy in preference to breast conservation. Tumor size is a relative contraindication when the cancer is so large in relation to the breast that excision to a clean surgical margin seems unreasonable. Other histologic findings, such as tumor grade or vascular invasion, are not strong reasons to recommend a mastectomy if the patient would prefer breast conservation. | Surgery | Breast | Which of the following pathologic findings is/are the strongest contraindication to breast preservation (lumpectomy with breast radiation) as primary treatment for a newly diagnosed breast cancer?
A. Grade 3, poorly differentiated, infiltrating ductal carcinoma
B. Extensive intraductal cancer around the invasive lesion
C. Tumor size less than 3 cm
D. Positive surgical margin for invasive cancer
| Positive surgical margin for invasive cancer |
13d593b8-1a2b-41c7-a185-3b9e7224ad31 | Ans. is 'c' i.e., Cyanocobalamin o Cobalt is a part of Cyanocobalamine | Medicine | Nutrition | Cobalt is a part of which vitamin -
A. Retinol
B. Pyrodoxine
C. Cyanocobalamin
D. Vitamin C
| Cyanocobalamin |
68e6ec14-c2f1-430d-9407-adab2bd6f7a1 | Ans. is 'a' i.e., Dubin johnson syndrome Breast milk jaundice - Decrease bilirubin uptake across hepathocyte membrane. Entero-hepatic recirculation. Leads to indirect hyperbilirubinemia. Crigler naj jar & Gilbe syndrome (deficiency of glucuronyl transferase) <Type I - Complete deficiency Type II - Paial deficiency Decrease conjugation leads to Indirect hyperbilirubinemia. Defect in hepatocyte secretion of conjugated bilirubin. Leads to direct hyperbilirubinemia | Pediatrics | null | Conjugated hyperbilirubinemia
A. Dubin johnson syndrome
B. Criggler naj jar syndrome
C. Breast milk jandice
D. Gilbe syndrome
| Dubin johnson syndrome |
029601b1-29de-46f4-8360-d0c85fc41ebd | There are some systemic diseases that are characterized by the formation of crescents. Systemic diseases such as Goodpasture's syndrome, SLE, Henoch-Schlein purpura come under type1 RPGN and they are associated with crescent formation. Alpo's syndrome is an x-linked dominant disorder and the light microscopy shows segmental proliferation of mesangial cells with increased mesangial matrix and occasional segmental sclerosis. Another prominent feature is the presence of lipid-laden foam cells in the interstitium. Ref: TEXTBOOK OF PATHOLOGY HARSH MOHAN 7th edition, pg no:654,655,665 | Pathology | Urinary tract | Which of these does not cause crescentic glomerulo nephritis -
A. Rapidly progressive glomerulonephritis
B. Alpo syndrome
C. Goodpasture syndrome
D. Henoch schonlein purpura
| Alpo syndrome |
6893b1e9-eaa8-4c07-851e-1fd10167dde4 | Most common type of vitiligo is vitiligo vulgaris. | Dental | null | Commonest type of vitiligo –
A. Vulgaris
B. Segmental
C. Acrofacial
D. Facial
| Vulgaris |
152a8c8f-11c8-4272-a5cb-316cdca5b939 | Refer kDT 7/e p 5116 Digoxin toxicity can induce literally every arrhythmia except for rapidly conducted atrial arrhythmias ( and ). The classic arrhythmias seen during digoxin toxicity include atrial tachycardia with a 2:1 conduction, bidirectional ventricular tachycardia and atrial fibrillation with a slow ventricular response. | Pharmacology | Cardiovascular system | Which of the following drug does not contribute to Digoxin toxicity
A. Hyperkalemia
B. Hypercalcemia
C. Renal failure
D. Hypomagnesamia
| Hyperkalemia |
69da6879-e942-4c72-a5aa-bff61bbd845b | Ans- (D) 91 days. Reference- Benefits The section 46 of the Act envisages following six social security benefits :- (a) Medical Benefit : Full medical care is provided to an Insured person and his family members from the day he enters insurable employment. There is no ceiling on expenditure on the treatment of an Insured Person or his family member. Medical care is also provided to retired and permanently disabled insured persons and their spouses on payment of a token annual premium of Rs.120/- . System of Treatment Scale of Medical Benefit Benefits to Retired IPs Administration of Medical Benefit in a State Domiciliary treatment Specialist consultation In-Patient treatment Imaging Services Artificial Limbs & Aids Special Provisions Reimbursement (b) Sickness Benefit(SB) : Sickness Benefit in the form of cash compensation at the rate of 70 per cent of wages is payable to insured workers during the periods of certified sickness for a maximum of 91 days in a year. In order to qualify for sickness benefit the insured worker is required to contribute for 78 days in a contribution period of 6 months. Extended Sickness Benefit(ESB) : SB extendable upto two years in the case of 34 malignant and long-term diseases at an enhanced rate of 80 per cent of wages. Enhanced Sickness Benefit : Enhanced Sickness Benefit equal to full wage is payable to insured persons undergoing sterilization for 7 days/14 days for male and female workers respectively. (c) Maternity Benefit (MB) : Maternity Benefit for confinement/pregnancy is payable for three months, which is extendable by further one month on medical advice at the rate of full wage subject to contribution for 70 days in the preceding year. (d) Disablement Benefit Temporary disablement benefit (TDB) : From day one of entering insurable employment & irrespective of having paid any contribution in case of employment injury. Temporary Disablement Benefit at the rate of 90% of wage is payable so long as disability continues. Permanent disablement benefit (PDB) : The benefit is paid at the rate of 90% of wage in the form of monthly payment depending upon the extent of loss of earning capacity as certified by a Medical Board (e) Dependants' Benefit(DB) : DB paid at the rate of 90% of wage in the form of monthly payment to the dependants of a deceased Insured person in cases where death occurs due to employment injury or occupational hazards. (f) Other Benefits : Funeral Expenses : An amount of Rs.10,000/- is payable to the dependents or to the person who performs last rites from day one of entering insurable employment. Confinement Expenses : An Insured Women or an I.P.in respect of his wife in case confinement occurs at a place where necessary medical facilities under ESI Scheme are not available. In addition, the scheme also provides some other need based benefits to insured workers. Vocational Rehabilitation :To permanently disabled Insured Person for undergoing VR Training at VRS. Physical Rehabilitation : In case of physical disablement due to employment injury. Old Age Medical Care :For Insured Person retiring on attaining the age of superannuation or under VRS/ERS and person having to leave service due to permanent disability insured person & spouse on payment of Rs. 120/- per annum. Rajiv Gandhi Shramik Kalyan Yojana : This scheme of Unemployment allowance was introduced w.e.f. 01-04-2005. An Insured Person who become unemployed after being insured three or more years, due to closure of factory/establishment, retrenchment or permanent invalidity are entitled to :- Unemployment Allowance equal to 50% of wage for a maximum period of upto one year. Medical care for self and family from ESI Hospitals/Dispensaries during the period IP receives unemployment allowance. Vocational Training provided for upgrading skills - Expenditure on fee/travelling allowance borne by ESIC. Incentive to employers in the Private Sector for providing regular employment to the persons with disability : Minimum wage limit for Physically Disabled Persons for availing ESIC Benefits is 25,000/-. Employerss' contribution is paid by the Central Government for 3 years. Benefits & Contributory Conditions : An interesting feature of the ESI Scheme is that the contributions are related to the paying capacity as a fixed percentage of the workers wages, whereas, they are provided social security benefits according to individual needs without distinction. Cash Benefits are disbursed by the Corporation through its Branch Offices (BOs) / Pay Offices (POs), subject to certain contributory conditions. | Unknown | null | Sickness benefit under ESI is available for a maximum period of ________ days in a year-
A. 30 days
B. 46 days
C. 56 days
D. 91 days
| 91 days |
cf226055-5d45-4361-9daf-260c037e9571 | Intracellular accumulation of immunoglobulins that can occur in plasma cells or RER forms large rounded , eosinophilic Russell bodies. Multiple aggregates of Russell bodies forms Mott cells. Dutcher bodies- single and usually large pale staining nuclear inclusions that are common in IgA myeloma. | Pathology | Plasma Cell Disorders and Multiple myeloma | Intracellular accumulation of which of the following forms Russell bodies ?
A. Immunoglobulins
B. Cholesterol
C. Phospholipids
D. Lipoproteins
| Immunoglobulins |
091040cd-9efd-4a07-9638-27851919b2cb | Answer is A (Basal ganglia): The putamen (basal ganglia) is the most common site of hypeensive haemorrhage' - Harrison 16th/2390 | Medicine | null | The most common intracranial site of hypeensive aemorrhage is:
A. Basal ganglia
B. Brainstem
C. Cerebellum
D. Hippocampus
| Basal ganglia |
6a37ea21-3ed8-4a72-9885-ef343594f09c | (Prostatic urethra) (411, 434. S. Das-clinical surgery 7th)* Most common cause of haematuria is cystitis**Bladder stone - Heamaturia is characterised by the passage of a few drops of bright-red blood at the end of micturition and is due to the stone abrading the vascular trigone-a fact that also accounts for the pain (1348-LB)* Blood appears at the beginning of the act (urethral) towards the end of the act (vesical) or is intimately mixed throught the process (prerenal, renal or vesical). S. Das* Painless, profuse and paroxysmal heamaturia is the main and only symptom of Papilloma* Common cause of isolated heamaturia includes - stones, neoplasms, TB, trauma, and prostatitis* * Urogenital neoplasms in patients with isolated painless heamaturia (non dysmorphic RJBCs) increases with age (251-H)* Best answers is urinary bladder (vesical) (1286 -B &L 25th) | Surgery | Miscellaneous | Terminal heamaturia occurs in
A. Urethra
B. Prostatic urethra
C. Kidney
D. Prolate
| Prostatic urethra |
14716527-0142-4f7d-83a0-cce0b2be23f3 | Schwannoma is a benign tumor arising from Schwann cells of cranial and spinal nerve roots. NF-1 is associated with an increased incidence of schwannomas of spinal nerve roots. MC schwannoma is vestibular schwannoma or acoustic neuroma arises from vestibular poion of 8th cranial nerve. Patients with NF-2 have an incidence of vestibular schwannomas that are frequently bilateral. | Medicine | Intracranial Space Occupying Lesion | Schwannoma of spinal nerve roots is seen in?
A. Neurofibromatosis 1
B. Neurofibromatosis 2
C. Turcot syndrome
D. Li - Fraumeni syndrome
| Neurofibromatosis 1 |
2c102093-2f7f-4c1c-9258-24cf0245c7a7 | (Carcinoma stomach) (557-Harsh Mohan 6th ,786-Robbin-Pathologic-Basis of disease 8th)Leather bottle appearance termed linitis plastica seen in gastric adenocarcinoma. Breast and lung cancers that metastasize to the stomach may also creat a linitis plastica- like appearanceSCIRRHOUS CARCINOMA (Linitis plastica) - the stomach wall is thickened due to extensive desmoplasia giving the appearance as 'leather-bottle stomach' or 'linitis plastica, The lumen of the stomach is reduced. There are no ulcer but rugae are prominent (mother-of-pearl in appearance)* Gastric carcinoma is most commonly located into region of gastric canal (prepyloric region)**_* Ulcerative carcinoma*** is the most common pattern* Most common complication of gastric cancer is haemorrhage (haematemesis or melaena)* Pre malignant changes in gastric mucosa(i) Hypo or achlorhydria in atrophic gastritis of gastric mucosa with intestinal metaplasia***(ii) Adenomatous (neoplastic) polyp of the stomach(iii) Chronic gastric ulcer (Ulcer-cancer) and its association with achlorhydria(iv) Stump carcinoma in patients who have undergone partial gastrectomy* Superficial spreading or 'early' gastric cancer-confined to the mucosa or sub mucosa (with or without lymph node metastasis) are associated with an excellent prognosis* Trossier's si2n - The metastasis through lymphatic spread presents as left supraclavicular lymphnode enlargement* The depth of invasion and the extent of nodal and distant metastasis at the time of diagnosis remain the most powerful prognostic indicators for gastric cancers (786- Robbins- Basis of disease 8th)* Most common cause of gastric outlet obstruction in India is - Carcinoma stomach*** Sister Mary Joseph nodule (Metastatic involvement of the para umbilical nodes*** is most commonly seen with stomach carcinoma)* Early gastric cancer. Defined as a primary lesion confined to the mucosa and submucosa with or without lymph node metastasis*** There is one dictum that "Anterior ulcer perforates & posterior ulcer bleeds"* Stomach reveal fat-laden cells in post gastrectomy**** Watermelon stomach is seen in Scleroderma* Blood group A is associated with(i) Carcinoma stomach, cervix, salivary gland & pancreas(ii) Pernicious anemia(iii) Thrombosis in OCP users | Pathology | G.I.T. | Linitis plastica is seen in
A. Carcinoma of liver
B. Carcinoma stomach
C. Carcinoma lung
D. Carcinoma esophagus
| Carcinoma stomach |
682367a0-2015-4ab4-9552-c18a3f7c09f0 | Ans. is 'a' i.e., 14 days prior to mensturation o The length of the secretory' phase is remarkably constant at about 14 d, and the variations seen in the length of the menstrual cycle are due for the most part to variations in the length of the proliferative phase. Thus ovulation occurs 14 days before the start of next menstruation. | Physiology | Sex Hormones | Ovulation in a women with 28 day cycle occurs at-
A. 14 days prior to mensturation
B. Just before LH surge
C. Just after corpus leuteal maturation
D. Due to progesterone rise
| 14 days prior to mensturation |
665d2c3f-41b7-48df-8f45-f673c1a6b1cd | Gestational trophoblastic diseases include : Hydatiform mole Invasive mole Placental site trophoblastic tumor Choriocarcinoma Ref: Dutta Obs 9e pg 180. | Gynaecology & Obstetrics | General obstetrics | Which of the following does not belong to gestational trophoblastic tumour
A. Chorioangioma
B. Placental site trophoblastic tumour
C. Choriocarcinoma
D. Hydatidiform mole
| Chorioangioma |
d8f53524-a488-40f2-88eb-3dc9614f70e3 | Ans. is 'c' i.e., Plerocercoid through fish meal | Social & Preventive Medicine | null | D.latum transmitted by ?
A. Cercaria through cyclops
B. Cercaria through fish meal
C. Plerocercoid through fish meal
D. Metacercaria in cyclops
| Plerocercoid through fish meal |
00baddb3-747f-4ec1-8da2-09a28934fb26 | Clozapine isn't available as depot of long-acting muscular injection. clozapine is a drug that is used for trreatment of TREATMENT RESISTANT SCHIZIOPHRENIA patients the main adverse effects of clozapine was AGRANULOCYTOSIS, MYOCARDITIS, SIALORRHEA, SEIZURES, PARALYTIC ILEUS Ref: Essentials of postgraduate psychiatry By JN Vyas 1st ed Pg: 410-412 | Psychiatry | Schizophrenia and other psychotic disorders | Which of the following antipsychotic isn't available as depot preparation for the treatment of psychosis?
A. Aripiprazole
B. Olanzapine
C. Clozapine
D. Haloperidol
| Clozapine |
4d920461-1eab-47fd-9171-a46ccc0abdff | Ans. is 'c' i.e., Nephrin Congenital nephrotic syndrome o Infant who develop nephrotic syndrome within the first 3 months of life are considered to have congenital nephrotic syndrome. o The most common cause of this syndrome is finnish-type congenital nephrotic syndrome, an autosomal recessive disorder. o Two most common genes involved are - i) NPHS1--> Coding for nephrin and results in finnish-type nephrotic syndrome. ii) NPHS2 --> Coding for Podocin and results in FSGS. | Pediatrics | null | The finnish type of congenital nephritic syndrome occurs due to gene mutation affecting the following protein -
A. Podocin
B. Alpha-actinin
C. Nephrin
D. CD2 activated protein
| Nephrin |
4822057d-b550-441d-b708-8af55327fbca | ANSWER: (C) Tibialis anteriorREF: Grays anatomy 40th ed chapter 83, Snell's 8th ed ch: 10Tibialis anterior is a superficial muscle and is therefore readily palpable lateral to the tibia. It arises from the lateral condyle and proximal half to two-thirds of the lateral surface of the tibial shaft; the adjoining anterior surface of the interosseous membrane; the deep surface of the deep fascia; and the intermuscular septum between itself and extensor digitorum longus.Muscles of the Anterior/Extensor Fascial Compartment of the LegMuscleOriginInsertionNerveSupplyNerveRootsActionTibialisanteriorLateral surface of shaft of tibia and interosseous membraneMedial cuneiform and base of first metatarsal boneDeepperonealnerveL4, 5Extends foot at ankle joint; inverts foot at subtalar and transverse tarsal joints; holds up medial longitudinal arch of footExtensordigitorurnlongusAnterior surface of shaft of fibulaExtensor expansion of lateral four toesDeepperonealnerve15; SIExtends toes; extends foot at ankle jointPeroneustertius(Fibuiaristertius)Anterior surface of shaft of fibulaBase of fifth metatarsal boneDeepperonealnerveL5; SIExtends foot at ankle joint; everts foot at subtalar and transverse tarsal jointsExtensorhallucislongusAnterior surface of shaft of fibula1 Base of distal phalanx of great toeDeepperonealnerveL5; SIExtends big toe; extends foot at ankle joint; inverts foot at subtalar and transverse tarsal jointsExtensordigitorurnbrevisCalcaneumBy four tendons into the proximal phalanx of big toe and long extensor tendons to second, third, and fourth toesDeepperonealnerveL5-S1Extends toes Muscles of the Lateral Fascial Compartment of the LegMuscleOriginInsertionNerveSupplyNerveRootsActionPeroneuslongusLateral surface of shaft of fibulaBase of first metatarsal and the medial cuneiformSuperficialperonealnerveL5; SI,2Plantar flexes foot at ankle joint; everts foot at subtalar and transverse tarsal joints; supports lateral longitudinal and transverse arches of footPeroneusbrevisLateral surface of shaft fibulaBase of fifth metatarsal boneSuperficialperonealnerveL5; SI,2Plantar flexes foot at ankle joint; everts foot at subtalar and transverse tarsal joint; supports lateral longitudinal arch of foot | Anatomy | Leg | Musde that originates from bone and interosseous membrane is?
A. Peroneus longus
B. Peroneus brevis
C. Tibialis anterior
D. Tibialis posterior
| Tibialis anterior |
40acb45a-17a3-47bf-aba3-7e4798fe1439 | Zone 2: Intermittent blood flow only during the peaks of pulmonary aerial pressure (Ppc) because the systolic pressure is then greater than the alveolar air pressure (PALV), but the diastolic pressure is less than the alveolar air pressure. | Physiology | Respiratory system | Type of blood flow seen in the apex of the lung is
A. No flow, P(ALV) > Ppc
B. Intermittent flow, P(ALV) < Ppc during diastole
C. Intermittent flow, P(ALV) < Ppc during systole
D. Continuous flow, P(ALV) < Ppc
| Intermittent flow, P(ALV) < Ppc during systole |
9ae9396f-c252-4e25-aa52-93d3b6ee9ba3 | Chylomicrons
Lipoprotein lipase deficiency (Type I hyperlipoproteinemia) results in increased level of chylomicrones. | Biochemistry | null | Which of the following is increased in lipoprotein lipase deficiency
A. VLDL
B. LDL
C. HDL
D. Chylomicrons
| Chylomicrons |
b1326ed6-920f-4233-9bb8-1a18a85ba270 | Synthesis of Heme The enzyme ALA synthase condenses glycine with succinyl CoA to form delta-aminolevulinic acid (ALA) (Chapter 21). It is the key enzyme of heme synthesis.Ref: DM Vasudevan - Textbook of Biochemistry, 6th edition, page no: 185 | Biochemistry | Metabolism of protein and amino acid | Which of the following amino acid is required for synthesis of hemoglobin?
A. Alanine
B. Glycine
C. Arginine
D. Histidine
| Glycine |
5603ad82-45ca-4521-94fa-020fed85fa12 | Ans. is 'd' i.e., 0-5 Specific death rates When analysis is planned to throw light on etiology, it is essential to use specific death rates. The specified death rate helps identify paicular 'at risk' group (s) for prevention. It also permits comparison between different causes within same population. The specific death rates may be ? a) Cause or disease specific, e.g. TB, cancer, accident. b) Related to specific groups - e.g. age specific, sex specific. | Social & Preventive Medicine | null | Total number of TB cases in a community of 6000 population 150. Number death due to TB are 30. What is the TB specific death rate (per 1000 population) ?
A. 20
B. 10
C. 5
D. 0-5
| 0-5 |
b4ad6fec-9445-48c5-a7ad-fea59fc0c972 | The thigh, is most frequentluy used as a donor site, but almost anywhere else can be used. Grafts are harvested using a skin graft knife or a power dermatome. | Surgery | null | Skin graft for facial wounds is taken from:
A. Medial aspect of thigh
B. Cubital fossa
C. Groin
D. Post auricular region
| Medial aspect of thigh |
c7e86739-b175-4abd-91dd-fd101a869ec6 | A bacterium can divide every 20 minutes and exponential growth is for 3 hours,
Thus, C = 1,
And r = 1 (it doubles every time)
n = 3 hours/20 minutes = 9 times
Thus P = C (1 + r)n = 1 (1 + 1)9 = 29 = 512 | Social & Preventive Medicine | null | A bacterium can divide every 20 minutes. Beginning with a single individual, how many bacteria will be there in the population if there is exponential growth for 3 hours?
A. 512
B. 440
C. 18
D. 1024
| 512 |
10f45014-6171-4d58-9246-c4ecc2500a62 | Scattering is directly propoional to the number of electrons available in the outer shell of the atom. option A : Carbon has 4 outer shell electrons option B : mercury has 2 outer shell electrons option C : H+ has 0 outer shell electrons option D : Ca++ has 0 outer shell electrons | Radiology | Fundamentals in Radiology | Maximum scattering in X-ray plate occurs in
A. Carbon
B. Mercury
C. H+
D. Ca++
| Carbon |
153a819f-3b16-435a-8e69-d13e2de09a5b | Ans. is 'b' i.e., NADH to NAD,Ethyl alcohol (ethanol) is readily absorbed from GIT and degraded by oxidation (oxidative process).Liver is the major site for ethanol oxidation.Excess alcohol intake leads to excessive production of NADH with a concomitant decrease in NAD+ which causes Hypoglycemia, Inhibition of p- oxidation of fatty acids and citric acid cycle, Increased lipogenesis, Accumulation of lipids, Lactic acidosis and hyperuricemia. | Biochemistry | null | Alcohol/ethanol induced fatty liver is caused by increased in ratio of?
A. NAD* to NADH
B. NADH to NAD'
C. NADPH to NADP*
D. NADP' to NADPH
| NADH to NAD' |
5d354476-ed36-48f5-9648-85c47b171228 | Dorsal digital expansion is a tendinous modification of extensor digitorum and receives attachment of lumbricals, interossei but not adductor pollicis. Lumbricals andinterossei- MCP Flexion & IP extension their attachments to dorsal digital Expansion | Anatomy | Upper limb : Miscellaneous | Which muscle does NOT contribute to dorsal digital expansion
A. Interossei
B. Lumbricals
C. Extensor digitorum
D. Adductor pollicis
| Adductor pollicis |
60e5498d-0b30-4d62-bb3a-65857d971c93 | Answer: c) Coumarin is antagonizing vitamin K reductase necessary for production of factors II, VII, IX and X* Vitamin K is necessary for production of factors II, VII, IX, and X. Coumarin will antagonize vitamin K reductase and can result in the bloody stool after poisoning* Irritation of bowels is possible, but it wouldn't cause bleeding.* DIC is not caused by coumarin based poisons. | Pathology | Blood | A 2-year-old boy is brought in by his mother because of the bloody stool after ingestion of unknown amount of rat poison (coumarin based). He is admitted and treated with fresh frozen plasma and vitamin K after his prothrombin time (PT) was found to be prolonged. What is the reason for bloody stool in this case?
A. Local irritation of bowels because of the ingestion of rodenticide
B. Coumarin is antagonizing vitamin K reductase necessary for production of factors VIII and IX
C. Coumarin is antagonizing vitamin K reductase necessary for production of factors II, VII, IX & X
D. Coumarin caused disseminated intravascular coagulation (DIC)
| Coumarin is antagonizing vitamin K reductase necessary for production of factors II, VII, IX & X |
a2f9b1be-1205-42b5-a2a4-b0265e03ea73 | From the history, it is clear that the patient is suffering from anterograde amnesia. Therefore the site of lesion is hippocampus. Hippocampus is the primary structure within temporal lobe involved in conversion of sho-term memory to long-term memory. Hippocampal cognitive map is inappropriately reactivated during a deja vu experience. Hippocampus doesnot store memory but only conves sho-term memory to long-term memory. Hence, hippocampal lesions cause only anterograde amnesia. Ref: Ganong's Review of Medical Physiology 25th edition Pgno: 285, 288 | Physiology | Nervous system | A 30 year old male, who met with a A, regained conscious after 36 hours. It was then discovered that the patient is unable to create new memories. The probable site of lesion for this symptom is
A. Amygdala
B. Neocoex
C. Hippocampus
D. Hypothalamus
| Hippocampus |
dfa78158-98e0-4600-b45a-86c85a1d4932 | Ans: a (Tinea incognito) Ref: Davidson, 20th ed, p. 1083Inadvertent topical steroid application leads to worsening of the signs (tinea incognito) Chronic infestation with louse results in a post inflammatory hyperpigmentation and thickening of the skin known as "vagabond disease".Tinea versicolorCaused by malazzesia furfur (mycelial stage) or Pityrosporum ovale (yeast form)KOH mount shows-sphagetti meat ball apperance. | Skin | Fungal Infection | Tinea seen after inadvertent treatment with topical steroid is:
A. Tinea incognito
B. Vagabond disease
C. Tinea versicolor
D. Tinea capitis
| Tinea incognito |
bf76e53c-acaa-478b-8973-96cff20a4466 | Type I
Type II
Positive Symptoms
Negative Symptoms
CT and MRI normal
CT and MRI shows enlarged ventricles
Good Prognosis
Bad Prognosis | Psychiatry | null | T.J.Crow
A. Coined the term "Dementia Praecox"
B. Gave 11 First rank symptoms
C. Divided Schizophrenia into 2 subtypes , Type I & Type II
D. Gave 4 'A's of Schizophrenia.
| Divided Schizophrenia into 2 subtypes , Type I & Type II |
5385a471-41b5-4566-bad5-6ee56b7841ef | Pityriasis rotunda - Pityriasis rotunda is described as a persistent, large, sharply defined circular patch of dry ichthyosiform scaling with no inflammatory changes. Variant of Ichthyosis Fixed, annular, scaling, dry-skin change More often seen in the African and Asian races Associated with neoplasia, paicularly Hepatocellular carcinoma. | Dental | Tumours of skin | Pityriasis rotunda is:
A. Fungal infection
B. Bacterial infection
C. Pityriasis affecting nail
D. Variant of Ichthyosis
| Variant of Ichthyosis |
848b5c6f-298c-4a96-9e1e-35480f9c0a3c | Pyruvate enters the Krebs cycle (Citric acid cycle or Tricarboxylic acid cycle) following its conversion to acetyl-CoA; the reaction is catalyzed by pyruvate dehydrogenase that links glycolysis to the citric acid cycle and produces one molecule of NADH. Ref: Janson L.W., Tischler M.E. (2012). Chapter 6. Carbohydrate Metabolism. In L.W. Janson, M.E. Tischler (Eds), The Big Picture: Medical Biochemistry. | Biochemistry | null | Kreb's cycle is the second metabolic pathway involved in the catabolism of carbohydrates into energy. First substrate of Kreb's cycle is:
A. Pyruvate
B. Glycine
C. HQ
D. Lipoprotein
| Pyruvate |
7099717f-249d-4617-b1d9-4680a79af5e7 | Ans. is 'd' i.e., Reverse of Valsalva's maneuver Muller's maneuvre : - A flexible endoscope is passed through the nose and the patient asked to inspire vigrously with nose and mouth completely closed. Look for collapse of the soft tissues at the level of base of tongue and just above the soft palate. Level of pharyngeal obstruction can be found. In Valsalva's maneuver the person expires vigrously with nose and mouth closed completely. So, Muller's maneuver is opposite to Valsalva's maneuver. | ENT | null | Muller's maneuver is ?
A. Forceful expiration against closed glottis
B. Forceful inspiration against closed glottis
C. Forceful expiration against open glottis
D. Reverse of Valsalva's maneuver
| Reverse of Valsalva's maneuver |
861a5317-24d9-465a-8534-1d3079e7985b | SUBLAMINA DENSA * Contains anchoring fibrils, anchoring plaques, elastic microfibrils (without elastin), and linkin . Anchoring Fibril :- * Primary constituent is type VII collagen; appears larger than anchoring filaments and emanates perpendicularly down from lamina densa into papillary dermis. * Connects lamina densa to anchoring plaques (type IV collagen) in dermal matrix . * Intercalation with banded collagen fibrils of papillary dermis: forms fan-shaped clumps. Ref:- Sima Jain; pg num:- 8 | Dental | Anatomy of skin | Collagen 7 is present in which layer of Basement membrane zone
A. Hemi-desmosomes
B. Salt split layer
C. Lamina Densa
D. Sublamina Densa
| Sublamina Densa |
fa061a03-0979-4abe-9f63-303c2259b509 | CREMASTER MUSCLE:- Consists of muscle fasciculi embedded in cremasteric fascia. The fasciculi form superficial loops from middle one-third of upper surface of inguinal ligament and deep loops from pubic tubercle, pubic crest, and conjoint tendon. Fully developed in males. In females only few fibres. Muscle along with the intervening connective tissue forms a sac-like cremasteric fascia around spermatic cord and testis. Nerve supply:- genital branch of genitofemoral nerve. Action: suspend the testis and elevate it. Cremasteric reflex:- Stroking the upper pa of the medial side of the thigh there is reflex contraction of the cremaster muscle, as is evidenced by elevation and retraction of the testis. In UMN lesions above segment, L1 reflex is lost. {Reference: BDC 9E} | Anatomy | Lower limb | The cremaster muscle is innervated by which of the following nerves
A. Genital branch of the genitofemoral nerve
B. Ilioinguinal
C. T12
D. Femoral
| Genital branch of the genitofemoral nerve |
b35383ea-bc7c-45c7-8def-8a8ebb5335db | The pivot shift test was positive for anterior cruciate deficiency. A pivot shift demonstrates a non-functioning ACL. Ref: Surgical Techniques for the Knee By Fred D. Cushner, W. Scott, Giles R. Scuderi, 2006 ; Apley's System of Ohopaedics and Fractures, 8th Edition, Pages 705, 708 | Surgery | null | The pivot test is for:
A. Anterior cruciate ligament
B. Posterior cruciate ligament
C. Medial meniscus
D. Lateral meniscus
| Anterior cruciate ligament |
d42371a8-a754-476a-bdf3-d6fdf8c7e323 | Methotrexate can lead to hepatotoxicity and therefore require regular liver function assessment. | Pharmacology | null | Which of the following DMARDs require liver function testing?
A. Methotrexate
B. Infliximab
C. Abatacept
D. Cyclophosphamide
| Methotrexate |
b063c890-b581-4951-bd11-6c4ebbe82702 | Systemic lupus erythematosus (SLE) is a multisystem autoimmunedisease of protean manifestations and variableclinical behavior. Clinically, it is an unpredictable, remittingand relapsing disease of acute or insidious onset thatmay involve viually any organ in the body; however, itaffects principally the skin, kidneys, serosal membranes,joints, and hea.Antibodies to doublestranded DNA (dsDNA) and the so-called Smith (Sm) antigen can be detected by ELISA or multiplex flow methods and are specific for SLE.Robbins Basic pathology,9th edition,pg no.127 | Pathology | Cardiovascular system | Antinuclear antibody specific for SLE is
A. Anti ds DNA
B. Anti nuclear antibodies
C. Anti centromere antibody
D. Anti histone Ab
| Anti ds DNA |
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