id
stringlengths 36
36
| exp
stringlengths 41
22.5k
| subject_name
stringclasses 21
values | topic_name
stringlengths 3
135
⌀ | input
stringlengths 35
1.3k
| correct_answer
stringlengths 1
287
|
|---|---|---|---|---|---|
3a9aca62-731e-4c98-bf64-6c4b2e36ed11 | Gas cylinders are made from a steel alloy of molybdenum, which is resistant to corrosion.
Aluminum cylinders are also available in western countries. | Anaesthesia | null | For high pressure storage of compressed gases cylinders are made up of –
A. Molybdenum steel
B. Iron + Mo
C. Steel + Cu
D. Cast iron
| Molybdenum steel |
1efb6fb5-7097-4cb3-8bca-059f7bf70530 | Early morning awakening is seen in depression. It is a type of insomnia patients with depression have altered dexamethasone suppression test that is no suppression of steroid in blood after administration of dexamethasone usually the steroid is produced in normal individuals at 6 Am whereas the steroids in increased amount always keeps the brain active , ruminations and decreased sleep. Different patterns of insomnia include a) difficulty falling asleep versus b) middle or terminal insomnia (early morning awakening) Reference: Kaplon and sadock, 11 th edition, synopsis of psychiatry, 11 th edition, pg no.351 | Psychiatry | Mood disorders | Early morning awakening is a feature of
A. Psychosis
B. Anxiety neurosis
C. Depression
D. Mania
| Depression |
4f825679-94a2-4d8b-80a5-9418a437642c | Patients who respond to shoacting vasodilators at the time of cardiac catheterization (a fall in mean pulmonary aerial pressure >=10 mmHg and a final mean pressure <40 mmHg) should be treated with calcium channel blockers. Typically, these patients require high doses (e.g., nifedipine, 240 mg/d, or amlodipine, 20 mg/d). Patients may have dramatic reductions in pulmonary aery pressure and pulmonary vascular resistance associated with improved symptoms, regressionof RV hyperophy, and improved survival now documented to exceed 20 years. However, <20% of patients respond to calcium channel blockers in the long term. These drugs are not effective in patients who are not vasoreactive. ref:Harrison&;s principles of internal medicine,ed 18,pg no 2079 | Medicine | C.V.S | A person has headache & profuse sweating. On examination his B.P is 200/120 mm Hg. Which of the following shoud not be used
A. Nifedipine
B. Sodium nitroprusside
C. Phenoxybenozamine
D. Methyldopa
| Nifedipine |
5009b5eb-a425-4467-ab23-e71c92508ed3 | A compound that liberates 7 Kcal/n:ol or more on hydrolysis is called high energy compound, or a compound that on hydrolysis undergoes a large (. 7 kcal/mol) decrease in free energy (AG) under standard condition is called high energy compound, i.e., AG - 7 Kcal/mol. | Biochemistry | null | Maximum energy is liberated by hydrolysis of ?
A. Creatine phosphate
B. ATP
C. Phosphoenol pyruvate
D. Glucose-6-phosphate
| Phosphoenol pyruvate |
b9ca6ced-145f-4430-b124-e842a79e9bf6 | Mode of injuries in Lower Cervical Spine Fractures (C3 - C7)Mode of injuriesPattern of fractureVeical (Axial) compression Burst fracture (Veebral height is decreased in toto)Pure flexion Wedge compression fracture (Decreased anterior height of veebrae)Combined axial compression & flexion Teardrop fracture (Antero inferior fragment of the veebral body is sheared off)Distraction - Flexion /Flexion rotation (MC unstable spine injury)Unilateral or bilateral subluxation & dislocation Flexion sprains Jumped facetsFloating veebra Avulsion injury of spinous process Clay shoveler's fracture Axial compression extension type Second most common type Distraction extension injury Disruption of anterior ligamentous complex followed by posterior soft tissue complex (Refer: Rockwood and Green's Fractures in Adults, 7th edition,pg no: 1498,1413,1435,1485) | Pathology | All India exam | Unstable spine injury occurs in
A. Compression injury
B. Flexion-rotation injury
C. Extensor injury
D. Flexion injury
| Flexion-rotation injury |
7cb81d3b-a936-44d2-82ec-64beedad4f3b | Ans. b. 2 Lithium should be stopped 48 hours, i.e. 2 day before surgery due to its interaction with anesthetic agents. | Anaesthesia | null | Lithium potentiates the action of non-depolarizing muscle relaxants. How many days before administration of the muscle relaxant should lithium be stopped?
A. 1
B. 2
C. 3
D. 4
| 2 |
0d9a5df6-9bde-46ad-bf51-808de5d8fb28 | Ans. is 'd' i.e., Uncinate process Development of pancreasPancreas is developed from the two pancreatic buds.i) Dorsal pancreatic bud :- It is larger and most of the pancreas is derived from it i.e. most of the head, and whole neck, body & tail.ii) Ventral pancreatic bud :- It is smaller and forms lower pa of the head of pancreas including uncinate process.During 7th week of development, the ventral and dorsal pancreatic buds fuse to form a single pancreatic mass.After the fusion of ventral and dorsal pancreatic buds, their ducts develop cross communications. Final duct system is formed as below ?i) Main pancreatic duct (Duct of wirsung) is formed by the duct of ventral bud, distal pa of duct of dorsal bud and an oblique communication between the two. The main pancreatic duct join the bile duct to form hepatopancreatic ampulla that enters th 2nd pa of duodenum at major duodenal papilla.ii) Accessory pancreatic duct is formed by the proximal pa of the duct of dorsal bud. It opens into 2nd pa of duodenum at minor duodenal papilla, 2 cm proximal (cranial) to major duodenal papilla.Anomalies of pancreatic development may be:1. Annular pancreas :- Two components of the ventral bud fail to fuse and grow in oppsite direction arround the duodenum and meet the dorsal pancreatic duct.2. Pancreatic divisum (divided pancreas) :- Ventral and dorsal buds fail to fuse with each other. It is the most common congenital anomaly of pancreas.3. Inversion of pancreatic duct :- The main pancreatic duct is formed by the duct of dorsal bud, i.e. accessory duct is larger than the main duct and the main drainage of pancreas is through the minor duodenal papilla.4. Accessory pancreatic tissue :- May be found in ?i) Wall of stomach, duodenum, jejunum or ileum.ii) Meckel's diveiculum. | Anatomy | null | Ventral pancreatic duct give rise to ?
A. Body
B. Tail
C. Neck
D. Uncinate process
| Uncinate process |
4e466817-a7c4-432e-ba2d-2cda7cfaba3b | TALUS:- Second largest tarsal bone.Head, neck, and body. Tibia above and calcaneum below, Attachments:-Devoid of muscular attachment. Numerous ligaments attached to it because it takes pa in three joints- ankle, talocalcaneal, and talonavicular.Neck:- Capsular ligament of ankle joint.Dorsal talonavicular Interosseus talocalcanean and cervical ligament.Anterior talofibular ligament. Medial surface of body:- deep fibres of deltoid. Medial tubercle - superficial fibres of deltoid ligament. Groove on posterior surface lodges flexor hallucis tendon. Posterior talofibular ligament attached to posterior process.Plantar border: posterior talocalcanean ligament. {Reference: BDC 6E pg no. 30} | Anatomy | Lower limb | Following tarsal bone is devoid of muscular attachment
A. Talus
B. Navicular
C. Cuboid
D. Medial cuneiform
| Talus |
bf7d034f-02b8-4e8d-8ad5-5bde2a6ec1c7 | Ans. is 'a' i.e. Gaucher's diseaseRef: Harrison 17th/Ep 2455 & 16th/Ep 2319 (15th/e p2280)The t/t of choice for Gaucher's disease is enzyme replacement therapy. A recombinantly produced mannose terminated enzyme called Cerezyme is used in the t/t of Gaucher's diseaseAbout the t/t of other options.Treatment of Niemann Pick disease -There is no specific treatment of Niemann pick disease.The efficacy of hepatic or bone marrow transplantation has not been proven. Clinical trials using enzyme therapy are anticipated to begin soon.Treatment of Phenylketonuria -T/T of phenylketonuria is to limit dietary intake of phenylalanine to amounts that permit normal growth and development.We could not get the t/t for - Hunter syndromeImp, points about Gaucher's diseaseIt's an autosomal recessive disorder *It results from the defective activity of b-glucosidase*b-glucosidase cleaves glucosylceramide. the parent compound of many glycosphingolipids and glucolipid.Diagnosis is established by demonstrating decreased acid b-glucosidase activity (0 to 20% of normal) in nucleated cells. | Unknown | null | Enzyme replacement therapy is available for the treatment of the following disorder-
A. Gaucher' disease
B. Niemann-Pick disease
C. Hunter syndrome
D. Phenylketonuria
| Gaucher' disease |
8de51243-bf2b-47e4-88b2-3e4775497398 | Ref: Park&;s Textbook of Preventive and Social Medicine 25 th Ed Pgno : 417-418 | Social & Preventive Medicine | Non communicable diseases | Morbid obesity means BMI of
A. >30
B. >40
C. >35
D. >29
| >40 |
0ce59744-583b-4f30-a84e-beaf94c7826d | - SIDE EFFECTS OF THE DRUG - APLASTIC ANEMIA - AGRANULOCYTOSIS - Hyponatremia - Steven Johnson's syndrome - Liver enzyme elevation - It has teratogenic potential Ref.kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 935 | Anatomy | Pharmacotherapy in psychiatry | agranuloctosis is a side effect of
A. risperidone
B. clonazepam
C. olanzapine
D. carbamezepine
| carbamezepine |
4a3f9abe-ae9f-4ddd-b0e0-d6eae7353145 | Dubucaine is the most potent, most toxic , and longest acting local anesthetic Cinchocaine or dibucaine is an amide local anesthetic. Among the most potent and toxic of the long-acting local anesthetics, current use of cinchocaine is generally restricted to spinal and topical anesthesia. From KD Tripati 7th edition Page no 367 | Pharmacology | Anesthesia | The most potent and longest acting anaesthetic agent is:
A. Dibucaine
B. Tetracaine
C. Bupivacaine
D. Lignocaine
| Dibucaine |
d312fa54-2250-40b0-9f1b-482a626ad2b4 | Venous return is decreased in standing posture due to pooling of blood in lower extremities and is maximum in lying down position. Ref: Textbook of medical physiology by N Geetha, 2nd edition, page no. 170 | Physiology | Cardiovascular system | In a normal person which of the following occurs when he changes to supine position from standing
A. Cerebral perfusion increases
B. Hea rate settles to a higher level
C. Immediate increase in venous return
D. Decreased perfusion to the apex
| Immediate increase in venous return |
b0b5f425-d48c-49b2-987a-c068415d777d | Ans. A. Wilson's diseaseAbnormalities Is Wilson's Diseasea. Basal ganglia lesions are most often bilateral and symmetrical.b. The putamina shows striking increase in T2 signal intensity. This is present to a lesser degree in other deep gray matter structures.c. Thalamic lesions are often present but typically spare the dorsomedial nuclei.d. White matter tracts including the dentatothalamic, corticospinal, and pontocerebellar tracts are commonly involved.e. The claustrum may show high T2 signal intensity. The midbrain is bright on T2 weighted images with relative sparing of its deep nuclei giving rise to the so-called Panda sign. | Radiology | Nervous System | "Face of giant panda" sign on MRI brain is seen in:
A. Wilson's disease
B. Japanese encephalitis
C. Rasmussen's encephalitis
D. Wernicke's encephalopathy
| Wilson's disease |
a3511697-9a9b-4a9a-be18-d8b52bc29ff8 | TEXT BOOK OF PATHOLOGY HARSHMOHAN 6TH EDITION PG NO 16 Epithelial tumors are stained by pankeratin or cytokeratin (high or low MW) <\p> | Pathology | General pathology | A 67 year nude smoker presents with haemoptysis and cough. Bronchoscopic biopsy revealed un-differentiated tumour. The immunohistochemical marker that can be most helpful is-
A. Calretinin
B. Vimentin
C. Cytokeratin
D. GGt
| Cytokeratin |
06ee65b6-3ab1-47d5-b602-bf5d8226118a | Preoperative antibiotics ,povidine iodine solutions are used to prevent post operative infection. REF:khurana,pg no 197 | Ophthalmology | Lens | Which of the following is the most impoant factor in the prevention of the endophthalmitis in cataract surgery?
A. Preoperative preparation with povidone iodine
B. One week antibiotic therapy prior to surgery
C. Trimming of eyelashes
D. Use of intravitreal antibiotics
| Preoperative preparation with povidone iodine |
809f2da4-59d4-45a3-b914-f8e7c003fd07 | The effective dose of a CXR is 0.02 mSv. Radiation dose of a chest CT (8mSv)is 400 times more than a chest X-ray. TYPICAL EFFECTIVE DOSES Investigation Dose (mSv) PA view CXR 0.02 Skull AP/Lat 0.06 AP pelvis 0.7 AXR 0.7 Lumbar spine 1 CT brain 2 IVU 2.5 Barium meal 3 Bone scan 3 Barium enema 7 CT abdomen 10 Thallium scan 20 | Radiology | Introduction to Radiology | The effective dose of a Chest x-ray is ____________.
A. 0.02 mSv
B. 0.2 mSv
C. 0.05 mSv
D. 0.1 mSv
| 0.02 mSv |
6a1ade89-e6e7-4d2f-88d4-a027764cee09 | The patient should be nil per orally for
8 hours for solid food
6 hours for liquid and semisolid food
2 hours for clear liquid. | Anaesthesia | null | A 50 year old male is posted for elective laparoscopic cholecystectomy. No history of comorbidities. His surgery is scheduled at 2 PM on the day of surgery. Which of the following is against the ASA guidelines for preoperative fasting
A. Coffee at 5:30 AM
B. Orange juice at 7:30 AM
C. Pancakes at 10:00 AM
D. Water at 12:00 PM
| Pancakes at 10:00 AM |
a25bdf47-10b5-4eb3-8bfc-b51b91201a5f | (C) Peripheral neuropathy # Causes of postural syncope: In patients receiving antihypertensive or vasodilator drugs and those who are hypovolemic because of diuretics, excessive sweating, diarrhea, vomiting, hemorrhage, or adrenal insufficiency. | Medicine | Miscellaneous | Most common cause of postural hypotension is
A. Progressive cerebellar degeneration
B. Striatonigral degeneration
C. Peripheral neuropathy
D. Adrenal insufficiency
| Peripheral neuropathy |
fa5a23af-4492-430b-bbf4-3332a752783c | Case fatality rate is directly related to the killing power of the disease. It denotes the virulence of an organism. But utility of case fatality rate is limited to acute illnesses and is not of much value for chronic diseases. Ref: Park 21st edition, page 55. | Social & Preventive Medicine | null | Which of the following is the best parameter to predict virulence of acute infectious illness?
A. Incidence
B. Secondary attack rate
C. Case fatality rate
D. Crude death rate
| Case fatality rate |
e2ca5e1e-a86f-48ae-8842-912ce472c80c | Ans. is 'b' i.e., Clearance* Once a drug is absorbed and distributed among the tissues and body fluids, it is then eliminated mainly by the liver and kidneys. The amount of drug eliminated from the body per unit time is called rate of eliminations.* Elimination of a drug from the plasma is quantified in term of its clearance..* Rate of elimination# It is the amount of drug eliminated per unit time from the body.* Clearance# Elimination of a drug from the plasma is quantified in terms of its clearance.# The clearance of a drug is the theoretical volume of plasma from which the drug is completely removed in unit time.Clearance (CL) =Rate of elimination--------------Plasma concentration# Renal clearance is the volume of plasma that is totally cleared of a drug in 1 minute during passage throughkidney. Similarly, liver clearance is plasma volume that is totally cleared of a drug in 1 minute during passage through liver. | Physiology | Kidneys and Body Fluids | Volume of plasma from which a substance is completely removed by filteration/secretion in kidney is equal to-
A. Rate of elimination
B. Clearance
C. Volume of distribution
D. Bioavailability
| Clearance |
93564dac-2474-41a3-840a-6a56513f4b88 | The initial depolarisation is due to Na+ influx through rapidly opening Na+channels. The inactivation of Na+ channels contributes to rapid repolarization phase. Ca2+ influx through more slowly opening Ca2+ channels produces plateau phase, and depolarization is due to net K+ efflux through multiple types of K+ channels. Ref: Ganong&;s review of medical physiology; 23rd edition; pg:491. | Physiology | Nervous system | The myocardial contraction is stimulated by
A. Influx of Ca++ ions
B. Influx of Na ions
C. Efflux of K ions
D. Efflux of Na ions
| Influx of Na ions |
f42771ea-ad5e-44ea-b685-e308380b798a | (A) Venlafaxine # Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) are a class of antidepressant drugs used in the treatment of major depression and other mood disorders. They are sometimes also used to treat anxiety disorders, Obsessive-Compulsive Disorder (OCD), attention deficit hyperactivity disorder (ADHD), chronic rteuropathic pain, Fibromyalgia Syndrome (FMS), and for the relief of menopausal symptoms. SNRIs act upon, and increase, the levels of two neurotransmitters in the brain known to play an important part in mood: serotonin, and norepinephrine. These can be contrasted with the more widely-used selective serotonin reuptake inhibitors (SSRIs) which act upon serotonin alone.> Venlafaxine: The first and most commonly used SNRI. Reuptake effects of venlafaxine are dose-dependent. At low doses (<150 mg/day), it acts only on serotonergic transmission. At moderate doses (>150 mg/day), it acts on serotonergic and noradrenergic systems, whereas at high doses (>300 mg/day), it also affects dopaminergic neurotransmission.> Desvenlafaxine: The active metabolite of Venlafaxine. It is believed to work in a similar manner, though some evidence suggests lower response rates compared to venlafaxine and duloxetine.> Duloxetine: Duloxetine is contraindicated in patients with heavy alcohol use or chronic liver disease, as duloxetine can increase the levels of certain liver enzymes that can lead to acute hepatitis or other diseases in certain at risk patients. Currently, the risk of liver damage appears to be only for patients already at risk, unlike the antidepressant nefazodone, which, though rare, can spontaneously cause liver failure in healthy patients. Duloxetine is also approved for Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD), chronic musculoskeletal pain, including chronic osteoarthritis pain and chronic low back pain (as of October, 2010), and is one of the only three medicines approved by the FDA for Fibromyalgia.> Sibutramine: An SNRI, which, instead of being developed for the treatment of depression, was widely marketed as an appetite suppressant for weight loss purposes.> Bicifadine: By DOV Pharmaceutical, potently inhibits the reuptake of serotonin and norepinephrine (and dopamine to a lesser extent), but rather than being developed for the already-crowded antidepressant market, it is being researched as a non-optoid, non-NSAID analgesic. | Pharmacology | Miscellaneous (Pharmacology) | Selective Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) is
A. Venlafaxine
B. Reboxetine
C. Moclobemide
D. Bupropion
| Venlafaxine |
16b4c1c5-9a5f-460b-b773-c2f47633a749 | Ans: c (Esmolol)Ref: Katzung 9 ed, Table 10.2The elimination half life of esmolol is 10 min which is the shortest.Notes on beta blockersCardioselective beta blockers are metoprolol, atenolol, bisoprolol, esmolol, betaxolol, celiprolol, nebivololPropranolol has highest degree of membrane stabilizing action.Nadolol is longest acting beta blocker and esmolol is shortest acting. Propranolol has poor oral bioavailability.Pindolol andpenbutolol have approx 100% bioavailability.Carvedilol is a third generation non-selective beta blockershowing anti-oxidant property and alpha 1 receptorantagonism. Labetolol also has alpha 1 receptor blockingactivity.Propranolol and metoprolol are extensively metabolized inthe liver, with little unchanged drug appearing in the urine. | Pharmacology | A.N.S. | Shortest acting B-blocker is:
A. Nebivolol
B. Carteolol
C. Esmolol
D. Timolol
| Esmolol |
64813c94-eb3b-4c58-88ca-db54ed7c7ee5 | Ans. A: N-acetyl cysteine In paracetamol poisoning, depletion of hepatic and renal glutathione potentiates the toxicity whereas treatment with sulfhydryl compounds such as cysteamine, 1- methionine and N-acetyl cysteine (NAC) is beneficial Acetylcysteine/ N-acetylcysteine/ N-acetyl-L-cysteine/ NAC) It is used primarily as a mucolytic agent and in the management of paracetamol (acetaminophen) overdose. Other uses include sulfate repletion in conditions, such as autism, where cysteine and related sulfur amino acids may be depleted. Acetylcysteine is a derivative of cysteine; an acetyl group is attached to the nitrogen atom. It is used as a cough medicine because it breaks disulfide bonds in mucus and liquefies it, making it easier to cough up. It is also this action of breaking disulfide bonds that makes it useful in thinning the abnormally thick mucus in Cystic Fibrosis patients Intravenous acetylcysteine is indicated for the treatment of paracetamol (acetaminophen) overdose. When paracetamol is taken in large quantities, a minor metabolite called N-acetyl- p-benzoquinone imine (NAPQI ) accumulates within the body. It is normally conjugated by glutathione, but when taken in excess, the body's glutathione reserves are not sufficient to inactivate the toxic NAPQI. This metabolite is then free to react with key hepatic enzymes, therefore damaging hepatocytes. This may lead to severe liver damage and even death by fulminant liver failure. For this indication, acetylcysteine acts to augment the glutathione reserves in the body and, together with glutathione, directly bind to toxic metabolites. These actions serve to protect hepatocytes in the liver from NAPQI toxicity. Although both IV and oral acetylcysteine are equally effective for this indication, oral administration is poorly tolerated because high oral doses are required due to low oral bioavailability, because of its very unpleasant taste and odour, and because of adverse effects, paicularly nausea and vomiting. Inhaled acetylcysteine is indicated for mucolytic ("mucus-dissolving") therapy as an adjuvant in respiratory conditions with excessive and/or thick mucus production. | Pharmacology | null | Drug of choice in paracetamol overdose: March 2011
A. N-acetyl cysteine
B. Protamine
C. BAL
D. Magnesium hydroxide gel
| N-acetyl cysteine |
aecdb011-65f1-4111-816e-de960e52730d | Ans. is 'd' i.e., > 30 Classification of adults according to BMIClassificationBMIRisk of comorbiditiesUnderweight<18-50Low (but risk of other clinical problems increased)Normal range18-50-24-99AverageOverweight:>25-00 Pre-obese25-00-29-99IncreasedObese class I30-00-34-99ModerateObese class II35-00-39-99SevereObese class III>40 00Very severe | Social & Preventive Medicine | Non-Communicable Diseases | Obesity is defined as if BMI is -
A. >20
B. >50
C. > 40
D. >30
| >30 |
62685e47-0e29-4ba8-b45d-13c662879574 | Terminator Codons : There are three codons which do not code for any paicular aminoacid.They ae "nonsense codons".more correctly termed as PUNCTUATOR OR TERMINATOR CODONS. They mark end of protein synthesis.These three codons are UAA,UAG,and UGA. UGA is a stop codon ,but in special circumstances,it stands for seleno-cysteine. REF :DM VASUDEVAN TEXTBOOK:7th EDITION ;Page no ;599. | Biochemistry | Metabolism of nucleic acids | Stop codons are
A. UAA
B. UAG
C. UGA
D. UAC
| UAA |
e8162589-54ce-4f9e-826a-111705a4ad89 | Harrison's principles of internal medicine. *In PML oligodendrocytes have enlarged densely staining nuclei that contain viral inclusions formed by crystallinearrays of JC virus paicles. | Medicine | C.N.S | Progressive multifocal leukoencephaloPathy is caused-
A. Epstein-barr virus
B. Varicella-zoster virus
C. Cytomegalo Virus
D. JC Papovavirus
| JC Papovavirus |
47d6ae2c-57d6-4935-aa27-6ff98c9246ae | Ans. is 'c' i.e., TGF-b Proinflammatorv cytokines i) Major:- IL-1, TNF- alpha, IL-6 ii) Other:- IL-2, IL-4, IL-5, IL-6, IL-8, IL-11, IL-12, IL-15, IL-21, IL-23, IFN- gamma, GM-CSF Anti-inflammatory cytokines i) IL-4, IL-10, IL-13, and transforming growth factor b (TGF-b) | Pathology | Chemical Mediators and Regulators of Inflammation | Cytokine with predominant anti-inflammatory action is ?
A. Interleukin 6
B. GM-CSF
C. TGF-b
D. TNF-Alpha
| TGF-b |
e9a97840-5bad-4fd2-9ac2-99bcc42c0818 | Ans. is 'b' i.e., Increased b-oxidationStarvation is characterized by decreased insulin : glucagon ratio.This causes :?i) Increased lipolysis - More FFAs for ketogenesis.ii) Increased fi-oxidation - Increased ketogenosis.iii) Decreased oxaloacetate - Acetyl CoA is utilized in ketogenesis.Regulation of ketogenesisKetogenesis is regulated at three levels:?1) Factors regulating mobilization of fatty acids from adipose tissues (i.e. lipolysis):- Free fatty acids, the precursors of ketone bodies, arise from lipolysis of triglycerides in adipose tissue. Hence, factors which enhance lipolysis (e.g. glucagon) stimulate ketogensis by providing more free fatty acids. Conversely, factors that inhibit lipolysis (e.g. insulin) inbibit ketogenesis.2) Factors regulating b-oxidation of fatty acids:- After uptake by liver, FAAs are either (i) b-oxidized to CO, or ketone bodies, or (ii) esterified to triacylglycerol. Carnitine acetyl transferase-I (CAT-I) regulates the b-oxidation of fatty acid and therefore the production of staing materials of ketogenesis i.e. acetylCoA and acetoacetyl-CoA (The remainder of fatty acids which do not enter b-oxidation, are estesified). Activity of CAT-1 is high in starvation and diabetes leading to increased b-oxidation of fatty acids and increased ketogenesis. CAT-1 activity is low in well fed state, resulting in decreased 13-oxidation and ketogenesis. This regulation is governed by Malonyl CoA, which is an allosteric inhibitor of carnitine acetyl transferase-1: CAT-1 (or carnitine palmitoyl transferase-1: (CPT-1). Malonyl CoA is synthesized by acetyl CoA carboxylase. Activity of acetyl CoA carboxylase is high in well fed state due to increase in insulin/ glucagon ratio, which inturn results in increased formation of malonyl-CoA. Malonyl-CoA inhibits CAT-I (CPT-I) leading to decreased b-oxidation and ketogenesis. Hence, esterification of fatty acids is increased. Conversely, during starvation (and diabetes) insulin/glucagon ratio is decreased which results in decreased activity of acetyl CoA carboxylase and decreased production of malonyl-CoA, releasing the inhibition of CAT-I (CPT-I). This results in increase b-oxidation of fatty acids and ketogenesis.3) Factors regulating the oxidation of acetyl CoA:- The acetyl-CoA formed in b-oxidation is oxidized in the citric acid cycle, or it enters the ketogenesis to form ketone bodies. When oxaloacetate concentration is low, little acetyl-CoA enters the TCA cycle and ketogenesis is oured (first reaction of TCA cycle inolves oxaloacetate, where it combines with acetyl-CoA to form citrate). Concentration of oxalaceatate is lowered if carbohydrate is unavailable or improperly utilized, e.g. in fasting and in diabetes. | Biochemistry | null | In starvation, there is ketosis due to ?
A. Decreased acetyl CoA
B. Increased b-oxidation
C. Decreased lipolysis
D. Decreased fatty acid
| Increased b-oxidation |
4690f7b7-0e59-481a-80e3-e83d77cf0271 | (Atorpine) (147-Parson 20th)* Atorpine - is the most potent and has longest duration of action (for 7 days or more)* Homatropine - are less potent. It affects lasts for 4-5 days* Tropicamide - short acting, though effective for upto 3 hours.* Phenylephrine - a selective alpha - 1 - agonist, sympathomimetics. | Ophthalmology | Drugs | A powerful cycloplegia is:
A. Atropine
B. Tropicomide
C. Phenylephrine
D. Homatropine
| Atropine |
c5ece579-f5fd-4434-9977-5c8f075b87ff | Ans. b. C3bRef: Robbins and Cotran Pathologic Basis of Disease 9th Ed; Page No-132Complement: System of hepatically synthesized plasma proteins that play a role in innate immunity and inflammation. Membrane attack complex (MAC) defends against gram [?] bacteria.Function of the ComplementC3b--opsonization.C3a, C4a, C5a--anaphylaxis.C5a--neutrophil chemotaxis.C5b-9--cytolysis by MACMnemonicC3b binds bacteriaOpsonins--C3b and IgG are the two 1deg opsonins in bacterial defense; enhance phagocytosis. C3b also helps clear immune complexes.Inhibitors--decay-accelerating factor (DAF, also known as CD55) and C1 esterase inhibitor help prevent complement activation on self-cells (e.g. RBCs). | Pathology | Immunity | Which of the following is an opsonin?
A. C3a
B. C3b
C. C5a
D. C6
| C3b |
a56a74e3-b33f-479c-8d89-fa4d457e8032 | Ans. (c) 5g/dL(Ref: Harshmohan 5th pg 97)When total plasma proteins <5gm/dl (normal 6-8gm/dl) or albumin <2.5gm/dl (normal 3.5-5gm/dl) edema takes place | Pathology | Hemodynamics | Edema occurs when plasma protein level is below:
A. 8 g/Dl
B. 2 g/dL
C. 5 g/dL
D. 10 g/dL
| 5 g/dL |
2137c01b-3671-4d55-a5c6-568f2148aaa2 | Therapeutic drug monitoring is adjustment of dose of the drug according to its plasma concentration. It is required for A Aminoglycosides (e.g. gentamicin) Drug Digitalis Possessing Phenytoin (anti-epileptics) Low Lithium Therapeutic Tricyclic antidepressants Index Immunomodulators (e.g. cyclosporine) Range of 0.8-1.2 mEq/L is ored for treatment of acute manic or hypomanic patients. 0.6-1.0 mEq/l is considered adequate and safer for long term prophylaxis. | Pharmacology | Pharmacodynamics | Administration of which of the following drug requires therapeutic drug monitoring?
A. Lithium
B. Haloperidol
C. Diazepam
D. Acetazolamide
| Lithium |
2e377946-5ab4-469b-b3b0-36f912002ccf | Benzodiazepines are the drug of choice in alcohol withdrawal. If the question asks you to chose a specific benzodiazepine, the best choice would be chlordiazepoxide. | Psychiatry | null | In alcohol withdrawal, drug of choice is-
A. TEP
B. Chlormethazole
C. Chlordiazepoxide
D. Buspirone
| Chlordiazepoxide |
6cc76bf5-087c-44df-82eb-faa78068ba8f | Transketolase is an enzyme of both the pentose phosphate pathway in all organisms and the Calvin cycle of photosynthesis. It catalyzes two impoant reactions, which operate in opposite directions in these two pathways. In the first reaction of the non-oxidative pentose phosphate pathway, the cofactor thiamine diphosphate accepts a 2-carbon fragment from a 5-carbon ketose (D-xylulose-5-P), then transfers this fragment to a 5-carbon aldose (D-ribose-5-P) to form a 7-carbon ketose (sedoheptulose-7-P). The abstraction of two carbons from D-xylulose-5-P yields the 3-carbon aldose glyceraldehyde-3-P. In the Calvin cycle, transketolase catalyzes the reverse reaction, the conversion of sedoheptulose-7-P and glyceraldehyde-3-P to pentoses, the aldose D-ribose-5-P and the ketose D-xylulose-5-P.The second reaction catalyzed by transketolase in the pentose phosphate pathway involves the same thiamine diphosphate-mediated transfer of a 2-carbon fragment from D-xylulose-5-P to the aldose erythrose-4-phosphate, affording fructose 6-phosphate and glyceraldehyde-3-P. Again, in the Calvin cycle exactly the same reaction occurs, but in the opposite direction. Moreover, in the Calvin cycle, this is the first reaction catalyzed by transketolase, rather than the second. | Biochemistry | Enzymes | Erythrocyte transketolase activity is seen in which vitamin?
A. Riboflavin
B. Thiamine
C. Folic acid
D. Niacine
| Thiamine |
e5d050f5-c2f3-4151-83a9-80bda63b951f | Postpaum Mood Disorders Post paum blues Occur within first few days and resolve by 2 weeks (50-60 %) Due to sudden loss of progesterones. Characterised by mild mood swings, irritability, anxiety, decreased concentration, insomnia , tearfullness, crying spells85% of women for a sho time in the immediate postpaum period. Post paum Depression Occurs in first 3-6 months (10-15%) insomnia, anxiety, low self woh, unable to care for and bond with baby, Post paum Psychosis Within first 2-3 months (<1%) severe insomnia, rapid mood swings, anxiety, psychomotor restlessness, delusions and hallucinations | Gynaecology & Obstetrics | Puerperium | After 5 days of a normal vaginal delivery a woman is brought to the casualty at 11 pm by her husband with history of crying, loss of appetite, difficulty in sleeping, and feeling of low self esteem. Her general physical examination is un-remarkable and there are no worrisome findings from a pelvic examination. Which of the following is the best term to describe her symptoms postpaum?
A. Blues
B. Manic depression
C. Neurosis
D. Psychosis
| Blues |
2960c439-8937-45fa-a83e-7d5caa87aa6f | Tricuspid regurgitation Primary Rheumatic Endocarditis Myxomatous (TVP) Carcinoid Radiation Congenital (Ebstein's) Trauma Papillary muscle injury (post-MI) Secondary RV and tricuspid annular dilatation Multiple causes of RV enlargement(e.g., long-standing pulmonary HTN)Chronic RV apical pacing ( Harrison&;s principle of internal medicine,18th edition,pg no. 1930 ) | Medicine | C.V.S | The most common cause of tricuspid regurgitation is secondary to -
A. Rheumatoid hea disease
B. Dilatation of right ventricle
C. Coronary aery disease
D. Endocarditis due to intravenenous drug abuse
| Dilatation of right ventricle |
058bdd39-efbd-4da5-bb0a-806ca07e6b0d | Diagnosis in this case is acute thyroiditis. Acute thyroiditis is preceded by respirstory symptoms like sore throat and in young patient. | Surgery | Thyroid | A young patient has a midline, tender swelling in neck occurring after an attack of sore throat. The diagnosis is:
A. Acute thyroiditis
B. Thyroglossal cyst
C. Subacute thyroiditis
D. Toxic goiter
| Subacute thyroiditis |
9b4ca920-64c2-44cf-a5aa-57890447917d | Ans. is 'b' i.e., Cytochrome p450 o Cytochrome p450 enzymes are microsomal enzymes that are involved in phase I metabolism of many drugs,o Most of the drugs are metabolized by CYP 3 A4 isoform.Drug metabolizing enzymeso The drug metabolizing enzymes are divided into two types :MicrosomalThese are located on smooth endoplasmic reticulum primarily in liver, also in kidney, intestinal mucosa and lungs.Examples are monooxygenase, cytochrome P450, glucronyl transferase.They catalyze most of the oxidation, reduction, hydrolysis and glucuronide conjugation.They are inducible by drugs, diet and other agencies.Non microsomalThese are present in the cytoplasm and mitochondria of hepatic cells as well as in other tissues including plasma.Examples are flavoprotein oxidase, esterases, amidases and conjugases.They catalyze some oxidation and reduction, many hydrolysis and all conjugation except glucuronidation.They are not inducible but many show genetic polymorphism (acetyl transferase, pseudocholinesterase). | Pharmacology | Pharmacokinetics | Detoxification of drugs is controlled by -
A. Cytochrome
B. Cytochrome p450
C. Cytochrome C
D. Cytochrome A
| Cytochrome p450 |
00c88c9f-c94a-4ea2-933a-66c6a110ba8b | Pheochromocytoma must be operated on first.
These tumors are generally (>50%) bilateral. Total thyroidectomy is the treatment of choice for patients with MTC because of the high incidence of multicentricity, the more aggressive course, and the fact that 131I therapy usually is not effective.
Central compartment nodes frequently are involved early in the disease process, so that a bilateral central neck node dissection should be routinely performed.
In patients with palpable cervical nodes or involved central neck nodes, ipsilateral or bilateral, modified radical neck dissection is recommended.
The role of prophylactic lateral neck dissection is controversial.
However, in patients with tumors >1 cm, ipsilateral prophylactic modified radical neck dissection is recommended because >60% of these patients have nodal metastases.
If ipsilateral nodes are positive, a contralateral node dissection should be performed.
In the case of locally recurrent or metastatic disease, tumor debulking is advised not only to ameliorate symptoms of flushing and diarrhea, but also to decrease risk of death from recurrent central neck or mediastinal disease.
External beam radiotherapy is controversial, but is recommended for patients with unresectable residual or recurrent tumor.
There is no effective chemotherapy regimen.
Radiofrequency ablation done laparoscopically appears promising in the palliative treatment of liver metastases >1.5 cm.
In patients who have hypercalcemia at the time of thyroidectomy, only obviously enlarged parathyroid glands should be removed.
The other parathyroid glands should be preserved and marked in patients with normocalcemia, as only about 20% of patients with MEN2A develop HPT.
When a normal parathyroid cannot be maintained on a vascular pedicle, it should be removed, biopsied to confirm that it is a parathyroid, and then autotransplanted to the forearm of the nondominant arm.
Total thyroidectomy is indicated in RET mutation carriers once the mutation is confirmed.
The procedure should be performed before age of 5 years in MEN2A patients and before age 1 year old in MEN2B patients.
Central neck dissection can be avoided in children who are RET -positive and calcitonin-negative with a normal ultrasound examination.
When the calcitonin is increased or the ultrasound suggests a thyroid cancer, a prophylactic central neck dissection is indicated. | Surgery | null | Treatment of Medullary Carcinoma thyroid:
A. Surgery and Radiotheryapy
B. Radiotherapy and Chemotherapy
C. Surgery only
D. Radioiodine ablation
| Surgery only |
cda07779-bb95-4a26-ba20-525366b03439 | Ref Harrison 19 th ed pg 1577: 289e-1 Myxomas are the most common type of primary cardiac tumor in adults, accounting for one-third to one-half of all cases at postmoem examination, and about three-quaers of the tumors treated surgically. They occur at all ages, most commonly in the third through sixth decades, with a female predilection. Approximately 90% of myxomas are sporadic; the remainder are familial with autosomal dominant transmission. | Anatomy | General anatomy | Most common tumour of hea is
A. Myxoma
B. Rhabdomyosarcoma
C. Fibroma
D. Leiomyosarcoma
| Myxoma |
7b1cb8a8-57c5-4ba1-b5a7-a661b52b975f | In children with burns over 10% total body surface area and adults with burns over 15% total body surface area, consider the need for intravenous fluid resuscitation. | Microbiology | All India exam | Intravenous resuscitation is needed for any child with burn greater than
A. 10% total body surface area
B. 20% total body surface area
C. 25% total body surface area
D. 35% total body surface area
| 10% total body surface area |
3578a6c3-ec28-4357-8e7f-2faa7c748d02 | Gustafsons method is used in the estimation of age of an adult above 21 years depending on the physiologic age changes in each of the dental tissues. Transparency of root is the most reliable criteria among the Gustafsons method of identification. It is seen after 30years of age. Canal in the dentine is wide at first, it increases in size with age due to deposition of minerals. A s a result they become invisible & dentine becomes transparent. Ref:The Essentials of Forensic Medicine and Toxicology By Dr K S Narayan Reddy, Page 63 | Forensic Medicine | null | Which of the following is the most reliable criteria in Gustafson's method of identification?
A. Attrition
B. Cementum apposition
C. Transparency of root
D. Root resorption
| Transparency of root |
b4d25381-8264-455d-a078-419da742a828 | Carotid and aoic bodies have very high rates of blood flow. These receptors are primarily activated by a reduction in paial pressure of oxygen (PaO2), but they also respond to an increase in the paial pressure of carbon dioxide (PaCO2) That is chemo receptors regulating blood flow to brain are insensitive to PaO2 despite the fact that it controls O2 content Ref: Ganong's Review of Medical Physiology Twenty-Third Edition Page No: 562 | Physiology | Cardiovascular system | Blood flow to brain is not influenced by
A. PaC02
B. P02
C. Cerebral circulation
D. Systemic circulation
| P02 |
a653f2ba-4344-4f5d-935f-af27f0113cd6 | (C) Central retinal artery # Amaurosis fugax> It refers to a sudden, temporary and painless monocular visual loss occurring due to a transient failure of retinal circulation.> Its common causes are: carotid transient ischaemic attacks (TIA), embolization of retinal circulation, papilloedema, giant cell arteritis, Raynaud's disease, migraine, as a prodromal symptom of central retinal artery or carotid artery occlusion, hypertensive retinopathy, and venous stasis retinopathy.> An attack of amaurosis fugax is typically described by the patients as a curtain that descends from above or ascends from below to occupy the upper or lower halves of their visual fields.> The attack lasts for two to five minutes and resolves in the reverse pattern of progression, leaving no residual deficit.> Due to brief duration of the attack, it is rarely possible to observe the fundus.> When observed shortly after an attack, the fundus may either be normal or reveal signs of retinal ischemia such as retinal oedema and small superficial haemorrhages.> In some cases, retinal emboli in the form of white plugs (fibrin-platelet aggregates) may be seen.) | Medicine | Miscellaneous | Amaurosis fugax is caused by occlusion of
A. Facial artery
B. Occipital artery
C. Central retinal artery
D. Posterior auricular artery
| Central retinal artery |
93f2aab2-654e-40bc-a7c0-fa758db075ef | ref: Ganong&;s review of medical physiology; 24th edition; page no;347 Grave&;s disease an autoimmune disorder which leads to an overactive and enlarged thyroid gland. | Medicine | Endocrinology | The antibodies that are seen in Grave&;s disease are-
A. ANA
B. TSH receptor antibodies (TRAb)
C. Thyroid peroxidase antibodies
D. Anti-T3 antibodies
| TSH receptor antibodies (TRAb) |
ef9b3446-69d3-4992-952c-d2c0c015c3a8 | The most common type of congenital adrenal hyperplasia is deficiency of in boys--that becomes prominent as the child grows. There may also be decreased production of , low serum sodium concentrations (hyponatremia), and high serum <a href=" deficiency</a> accounts for 95% of all cases of CAH and is inherited in an autosomal recessive pattern. It is due to a mutation of the CYP21 gene. It can occur in a classical or nonclassical form. The incidence of the classical form of CAH is roughly 1:15 000, while that of the nonclassical form is approximately 1:100. Classical CAH can be fuher divided into a salt-wasting form (75%) and a simple virilizing form (25%). 21-Hydroxylase is necessary for the production of coisol and aldosterone. Lack of this enzyme shunts intermediate steroid precursors toward androgen production. Symptoms are related to excess androgens and, in the salt-wasting form of classical CAH, decreased aldosterone. Aldosterone is necessary for normal sodium retention and potassium secretion by the kidney. Reference: GHAI Essential pediatrics, 8th edition | Pediatrics | Genetic and genetic disorders | Adrenogenital syndrome is most commonly caused by?
A. 21 a hydroxilase deficiency
B. 17 a hydroxylase deficiency
C. 3 ss hydroxylase deficiency
D. Steroid sulfatase deficiency
| 21 a hydroxilase deficiency |
ed0be1e0-eae8-4d6b-80ed-1c6672fa6d4d | The platysma muscle is the most superficial muscle of the neck. Unlike most skeletal muscles, the platysma is located in the superficial fascia . The muscle extends superiorly from the inferior border of the mandible and inferiorly to the clavicle to the fascia of the anterior shoulder and thorax. The platysma muscle is a muscle of facial expression and therefore is innervated by the facial nerve (cervical branch of CN VII). Ref: Moon D.A., Foreman K.B., Albeine K.H. (2011). Chapter 25. Overview of the Neck. In D.A. Moon, K.B. Foreman, K.H. Albeine (Eds), The Big Picture: Gross Anatomy. | Anatomy | null | Nerve supply to platysma is:
A. Ansa cervicalis
B. Facial
C. Hypoglossal
D. Mandibular
| Facial |
cfa84812-8b13-4723-89db-854f1e2248de | Otoacoustic emissions (OAEs) are produced by the outer hair cells. Motility of outer hair cells, spontaneous or in response to sounds, is transmitted by the basilar membrane, ossicular chain to tympanic membrane, and can be picked up and measured by a sensitive microphone placed in the outer ear canal.Spontaneous OAEs are present in 70% of normal individuals. Evoked OAEs are produced in response of pure tones or clicks. Absence of OAEs indicates damage to outer hair cells as in ototoxicity. | ENT | Ear | Otoacoustic emissions are produced by:
A. Inner hair cells
B. Outer hair cells
C. Basilar membrane
D. Auditory nerve
| Outer hair cells |
a70ad672-2e87-4a0e-9f8c-9fead5f479df | Epigastric pain radiating to back suggests the diagnosis of acute pancreatitis. CECT is the investigation of choice for pancreatitis. | Radiology | null | A patient complains of epigastric pain, radiating to back off and on. The investigation of choice is –
A. MRI
B. CT scan
C. USG
D. Radio nucleotide scan
| CT scan |
b46ae4ef-80f0-43d6-8a3e-3187d0b5b7ad | Ans. B. Cervical dilatation > 3 cm. (Ref. Williams Obstetrics 22nd/ Ch. 17)CHARACTERISTICS OF NORMAL LABOR# The strict definition of labor-uterine contractions that bring about demonstrable effacement and dilatation of the cervix-docs not easily aid the clinician in determining when labor has actually begun, because this diagnosis is confirmed only retrospectively.# Several methods may be used to define its start - One quantifies onset as the clock time when painful contractions become regular. Unfortunately, uterine activity that causes discomfort, but that does not represent true labor, may develop at any time during pregnancy. A second method defines the onset of labor as beginning at the time of admission to the labor unit. Criteria at term require painful uterine contractions accompanied by one of the following:1) ruptured membranes,2) bloody "show",3) complete cervical effacement.FIRST STAGE OF LABOR - Friedman developed the concept of three functional divisions of labor:# Although the cervix dilates little during the preparatory division, the connective tissue components of the cervix change considerably. Sedation and conduction analgesia are capable of arresting this division of labor. The dilatational division, during which time dilatation proceeds at its most rapid rate, is unaffected by sedation or conduction analgesia. The pelvic division commences with the deceleration phase of cervical dilatation. The classical mechanisms of labor that involve the cardinal fetal movements of the cephalic presentation-engagement, flexion, descent, internal rotation, extension, and external rotation-take place principally during the pelvic division.- Two phases of cervical dilatation are defined.# The latent phase corresponds to the preparatory division and# The active phase to the dilatational division. Friedman subdivided the active phase into: the acceleration phase, the phase of maximum slope, and deceleration phase.Latent Phase:# The onset of latent labor, as defined by Friedman (1972), is the point at which the mother perceives regular contractions. The latent phase for most women ends at between 3 and 5 cm of dilatation.# Friedman and Sachtleben (1963) defined a prolonged latent phase as bein$ greater than 20 hours in the nullipara and 14 hours in the multipara. These are the 95th percentiles.# Factors that affect duration of the latent phase include:- excessive sedation or epidural analgesia;- unfavorable cervical condition, that is, thick, uneffaced, or undilated; and- false labor.Active Labor:# Cervical dilatation of 3 to 5 cm or more, in the presence of uterine contractions, can be taken to reliably represent the threshold for active labor.# Turning again to Friedman (1955), the mean duration of active-phase labor in nulliparas was 4.9 hours. Indeed, rates of cervical dilatation ranged from a minimum of 1.2 up to 6.8 cm/hr.# Friedman (1972) also found that multiparas progress somewhat faster in active-phase labor, with a minimum normal rate of 1.5 cm/hr.# Descent begins in the later stage of active dilatation, commencing at about 7 to 8 cm in nulliparas and becoming most rapid after 8 cm.# Active-labor phase abnormalities are quite common, reported in 25 percent of nulliparous and 15 percent of multigravidas.# Friedman (1972) subdivided active-phase problems into protraction and arrest disorders.- He defined protraction as a slow rate of cervical dilatation or descent, which for nulliparas was less than 1.2 cm dilatation per hour or less than 1 cm descent per hour. For multiparas, protraction was defined as less than 1.5 cm dilatation per hour or less than 2 cm descent per hour. He defined arrest as a complete cessation of dilatation or descent.- Arrest of dilatation was defined as 2 hours with no cervical change, and arrest of descent as 1 hour without fetal descentSECOND STAGE OF LABOR# This stage begins when cervical dilatation is complete and ends with fetal delivery.# The median duration is about 50 minutes for nulliparas and about 20 minutes for multiparas.DURATION OF LABOR# It is reported that the mean length of first- and second-stage labor was approximately 9 hours in nulliparous women without regional analgesia, and that the 95th percentile upper limit was 18.5 hours. Corresponding times for multiparous women were a mean of about 6 hours with a 95th percentile maximum of 13.5 hours. | Gynaecology & Obstetrics | Miscellaneous (Gynae) | Which among the following is definitive indicator for start of Active labour?
A. Rupture of membranes
B. Cervical dilatation > 3 cm
C. Leaking
D. Show
| Cervical dilatation > 3 cm |
042e5bf9-a2c7-47ba-b4fa-eed543634ee7 | Ref:Park's Textbook of Preventive and Social Medicine 25th Ed | Social & Preventive Medicine | Biostatistics | In a statistical study for calculating the effect of drug on patient's sugar level the test showed significant difference when in reality there was no difference
A. Alpha error
B. Beta error
C. Gamma error
D. Power of a test
| Alpha error |
70e6261b-7b83-435e-8246-fcbe1e22a892 | * Minimal change renal disease is the most common form of idiopathic nephrotic syndrome in children of age group 2 to 6 years. It accounts for around 85% of cases and are mostly steroid sensitive.* The finding in renal biopsy in light microscope is usually normal. Electron microscope shows effacement of epithelial foot process.* Other most commonly asked question in nephrotic syndrome is the indication for renal biopsy -# Age group less than 1 and more than 10 years# Steroid resistant nephrotic syndrome# Steroid dependent nephrotic syndrome# Nephritic onset nephrotic syndrome# Persistent hematuria and hypo complement levels more than 2 months# Before starting cyclosporine analog drugs. | Pediatrics | Urinary Tract | Effacement of foot process of nephron is seen in?
A. Minimal change disease
B. Focal segmental glomerulosclerosis
C. Acute glomerulonephritis
D. Membranous nephropathy
| Minimal change disease |
7f258666-0d9f-4945-afd6-f3f64788845a | Children and adolescents with high risk factors for caries, must be examined with bitewing radiography atleast once in 6-12 months, whereas for adults it is 6-18 months. | Dental | null | Recommended intervals for bitewing examination in high risk children is:
A. 6-12 months
B. 6-18 months
C. 12-18 months
D. 3-6 months
| 6-12 months |
afc5c9cd-e10c-4657-bd22-edee22c2b6f2 | In acute alcohol intoxication when patient goes to the stage of coma, the pupils are contracted but stimulation of the patient cause them to dilate with slow return. This is known as Mc Ewan Sign. Carbolic acid poisoning: Odour of breath, white patches on lips and mouth and carboluria. Carbon Monoxide poisoning: History of exposure to poisoning with gas, intermittent convulsions, cherry red colour of skin and carboxyhemoglobin in blood. Barbiturate poisoning: Shallow respiration, deep coma, no response to painful stimuli, deep reflexes are depressed, subnormal temperature, low blood pressure, dilated pupils. Ref: The Essentials of Forensic Medicine and Toxicology 29th Ed Page 511. | Forensic Medicine | null | In which of the following poisonings Mc Ewan Sign is seen?
A. Acute alcohol intoxication
B. Carbon Monoxide poisoning
C. Barbiturate poisoning
D. Carbolic acid poisoning
| Acute alcohol intoxication |
c1cbfa42-973a-4b23-88e0-3598dcdc9a21 | Familial cancers
these cancers may occur at higher frequency in certain families without a clearly defined pattern of transmission.
Virtually all the common types of cancers that occur sporadically have also been reported to occur in familial forms.
examples include carcinomas of
breast
brain
colon
melanoma
ovary
lymphomas
features that characterize familial cancers include early age at onset, tumors arising in two or more close relatives of the index case, and sometimes, multiple or bilateral tumors. | Surgery | null | Which of the following carcinoma is familial -
A. Breast
B. Prostate
C. Cervix
D. Vaginal
| Breast |
947dbbdd-b555-4771-b992-2ea472f289ea | Positively charged (cationic) amino acids are attracted to the negative electrode (the cathode), and negatively charged (anionic) amino acids are attracted to the positive electrode (the anode). An amino acid at its isoelectric point has no net charge, so it does not move. So at the physiological pH, amino acid with positive charge will move slowest towards the anode (positively charged electrode). Thus lysine will migrate slowest to the anode end. Electrophoresis uses differences in isoelectric points to separate mixtures of amino acids. A streak of the amino acid mixture is placed in the center of a layer of acrylamide gel or a piece of filter paper wet with a buffer solution. Two electrodes are placed in contact with the edges of the gel or paper, and a potential of several thousand volts is applied across the electrodes. Positively charged (cationic) amino acids are attracted to the negative electrode (the cathode), and negatively charged (anionic) amino acids are attracted to the positive electrode (the anode). An amino acid at its isoelectric point has no net charge, so it does not move. Amino acid classification:- Acidic Amino acids: These amino acids have two - COOH groups and one -Nil, group. At neutral pH their side chains are fully ionized containing a negatively charged carboxylate group (-COO). Eg. Aspaic acid (Aspaate) & Glutamic acid (Glutamate) Basic Amino Acids: They have one -COOH group and two -NH, groups. At neutral pH. their side chains are fully ionized and positively charged. Eg. Arginine, Lysine, Histidine Rest all amino acids are neutral amino acids. Ref: Test book of Biochemistry, By Chatterjee Shinde, 4th Edition, Page 59 | Biochemistry | null | Which of these amino acids will migrate slowest to the anode end at the physiological pH-?
A. Aspaic acid
B. Glycine
C. Valine
D. Lysine
| Lysine |
1f073249-6f1c-4598-b18e-d93a39162276 | CONGENITAL COXA VARA Clinical Presentation Painless limp in a child who has just staed walking Shoening-Limitation of abduction and internal rotation Radiological Reduced neck shaft angle (varus) Veical epiphysis plate Separate triangle of bone in infero-medial pa of metaphysis called as Fairbank's triangle Treatment depend upon HE angle if:- Angle 40o -60o = Observation >60o or if shoening is progressive = subtrochanteric osteotomy. Hilgenreiner's epiphyseal angle: angle between horizontal line joining center (triradiate cailage) of each hip (Hilgenreiner's line) and line parallel to physis; the normal angle is about 30 degrees. | Orthopaedics | Pediatric Ohopedics | Congenital coxa vara is treated by:
A. Fixation by SP Nail
B. Osteotomy
C. Bone grafting
D. Traction
| Osteotomy |
5e07444f-d61b-49bd-9c80-e862ee23feac | Since K+ permeability is greater than Na+ permeability, therefore, K+ channels maintain the RMP.(Ref: Textbook of physiology AK Jaun 5th edition Page no.35) | Physiology | General physiology | Resting membrane potential depends mainly on
A. K
B. Na
C. Cl
D. HCO3
| K |
625863cc-a96b-427c-85b8-43242e02cdd9 | Ans. is 'b' i.e., Complex II o During the transfer of electrons through the ETC, energy is produced. This energy is coupled to the formation of ATP molecules by phosphorylation of ADP by an enzyme F0F1, ATPase. The phosphorylation of ADP into ATP is coupled with oxidation of reducing equivalents, therefore the process is called oxidative phosphorylation,o There are three ATP synthesizing sites of electron transport chain : (i) Site I is between NAD and CoQ. i.e., Complex I; (ii) Site II is between CoQ and cytochrome C, i.e., Complex III; and (iii) Site III is between cytochrome C and oxygen, i.e., complex IV. These sites provide energy required to make ATP from ADP by an enzyme F0F1 ATPase.o The energy liberated of site I (complex I) is used to synthesize 1 ATP molecule, at site II (complex III) is used to synthesize 1 ATP molecule and at site III (Complex IV) is used to synthesize Vi ATP molecule. Thus, when 1 NADH molecule enters the respiratory chain, it produce 2.5 molecules of ATP. When 1 molecule of FADH2 enters the respiratory chain only 1.5 molecules of ATP are produced as site 1 of energy liberation is bypassed.Note : Previously it was assumed the NADH produces 3 ATPs and FAD generates 2 ATPs. Recent experiments show that these old values are overestimates and NADH produces 2.5 ATPs and FADH2 produces 1.5 ATPs. | Biochemistry | Respiratory Chain | Which complex of ETC is not associated with liberation of energy -
A. Complex 1
B. ComplexII
C. Complex III
D. ComplexIV
| ComplexII |
66bc1c49-f9d9-4866-b302-195f72580165 | Ans. (a) CRVORef: Parson's 22/e, p. 350Swollen optic disc or disc oedema - causesUnilateralPapillitis or optic neuritis involving the nerve head (sudden loss of vision with subsequent improvement young age)Anterior ischaemic optic neuropathy (sudden loss of vision usually without improvement old age)Orbital tumours (slowly progressive visual loss)Papillophlebitis or optic disc vasculitis (rapid loss of vision without improvement)Central retinal vein occlusionQ (may or may not be associated with profound visual impairment)Infiltrative disorders (impaired vision)Ocular hypotony (rapid loss of vision without improvement)Foster-Kennedy syndrome (true papilloedema in one eye with optic atrophy in the fellow eye)Pseudo Foster-Kennedy syndromePosterior uveitis and scleritisBilateralIncreased intracranial pressure: papilloedema (optic nerve function is typically normal)Hypertension (optic nerve function is typically normal)Diabetic papillopathy (mild-to-moderate impairment of vision)Cavernous sinus thrombosisCarotid-cavernous fistulaLeber hereditary optic neuropathy in the acute stageOther systemic diseases such as anaemia and hvpoxaemia | Ophthalmology | Neuro-Ophthalmology | Disc oedema is seen in:
A. CRVO
B. CRAO
C. BRVO
D. BRAO
| CRVO |
e7d361ed-6445-461b-b3e1-b45de1bd813d | The sympathetic trunk lies just lateral to the veebral bodies for the entire length of the veebral column. ... The sympathetic trunk permits preganglionic fibers of the sympathetic nervous system to ascend to spinal levels superior to T1 and descend to spinal levels inferior to L2/3 The superior end of it is continued upward through the carotid canal into the skull, and forms a plexus on the internal carotid aery ; the inferior pa travels in front of the coccyx, where it converges with the other trunk at a structure known as the ganglion impar . Along the length of the sympathetic trunk are sympathetic ganglia known as paraveebral ganglia . Image showing efferrent system of sympathetic trunk Ref - medscape.com | Anatomy | Thorax | Sympathetic trunk rests on
A. Body of veebra
B. Transverse process
C. Lamina of veebra
D. Pedicle of veebra
| Body of veebra |
22c07bb3-7b79-40f3-9111-48a7b671fc90 | Ans. is 'c' i.e., Increased glycolysisIncreased BMR is associated with hypermetabolic state which is characterized by :?A) Carbohydrate metablismi) | Glycolysisii) | Gluconeogenesisiii) | Glycogenesisiv) | GlycogenolysisB) Lipid metablismi) | Lipogenesisii) | Lipolysisiii) | Cholesterol Synthesisiv) | Triacylglycerol Synthesisv) | Lipoprotein degradationvi) | KetogenesisC) Protein metablismi) Increased protein degradationii) Decreased protein biosynthesis | Physiology | null | Increased BMR is associated with ?
A. Increased body fat store
B. Increased glycognenesis
C. Increased glycolysis
D. Increased lipogenesis
| Increased glycolysis |
9d9b308d-d5cf-4d24-abe0-cd4e33585077 | Ans. is 'c' i.e., Spurious Polycythemia o Gaisbock syndrome refers to spurious polycythemia or relative erythrocytosis due to decreased plasma volume. | Medicine | Polycythemia | Gaisbock syndrome is known as-
A. Primary familial polycytemia
B. High altitude Erythrocytosis
C. Spurious Polycythemia
D. Polycythemia vera
| Spurious Polycythemia |
16558b39-119c-4358-bc3d-dac6e795b32a | Ans. b (Morbilliform rash). (Ref Harrison's medicine 18,h/ch. 55)DRUG-INDUCED SKIN REACTIONSMaculopapular eruptions are seen in the classic childhood viral exanthems, including:1)rubeola (measles)a prodrome of Coryza, Cough, and Conjunctivitis followed by Koplik's spots on the buccal mucosa; the eruption begins behind the ears, at the hairline, and on the forehead and then spreads down the body, often becoming confluent;2)rubellathe eruption begins on the forehead and face and then spreads down the body; it resolves in the same order and is associated with retroauricular and suboccipital lymphadenopathy; and3)erythema infectiosum (fifth disease)erythema of the cheeks ("Slapped-cheek" appearance) is followed by a reticulated pattern on extremities; it is secondary to a parvovirus B19 infection, and an associated arthritis is seen in adults. | Skin | Drugs | Most common drug induced skin reaction:
A. Maculopapular rash
B. Morbilliform rash
C. Fixed Drug Eruption
D. Photosensitivity reaction
| Morbilliform rash |
06fc7a14-3cb6-47e4-a00b-76c0b55f7fa6 | The baby described in the question stem is most likely suffering from the early manifestations of congenital syphilis. As per the choices given VDRL is the test done to diagnose syphilis. Ref: Harrison's Principles of Internal Medicine, 16th Edition, Page 981; Skin Diseases & Sexually Transmitted Infections, Uday Khopkar - 6th Edition, Page 257; Nelson 17th ,COGDT 10th Edition, Page 667;CPDT 18th Edition, Page 56. | Skin | null | A preterm baby developed bullous lesion on the skin soon after bih. The X- ray shows periostitis. What should be the next investigation?
A. VDRL for mother & baby
B. ELISA for HIV
C. PCR for TB
D. Hepatitis surface antigen for mother
| VDRL for mother & baby |
9d52c475-7bae-48d0-9498-3b748c934ffc | Globular heart with plethoric lung fields - TGA
Globular heart with Oligemic lung fields - Tricuspid atresia, Ebstein's anomaly | Radiology | null | Globular heart with plethoric lung fields is seen in
A. TGA
B. TAPVC
C. Tricuspid atresia
D. Ebstein's anomaly
| TGA |
7cb3b72d-4afc-4935-bc6d-9465a112d273 | The clinical presentation points towards scurvy and it can be treated by supplementing the diet with citrus fruits which are rich source of vitamin C. | Biochemistry | null | 7 year old child presents with poor wound healing, Perifollicular hemorrhages and sharp and painful swellings at the costochondral junction of ribs. Which of the following treatments are recommended
A. Leafy vegetables in the diet
B. Animal products containing liver in the diet
C. Avoidance of eggs from diet
D. Oranges and amla in the diet
| Oranges and amla in the diet |
b7e9073a-6634-4030-85ba-6ca9e8c72585 | The most common causes ofneonatal meningitis is bacterialinfection of the blood, known as bacteremia (specifically group B streptococci (Streptococcus agalactiae), Escherichia coli, and Listeria monocytogenes). Reference: GHAI Essential pediatrics, 8th edition | Pediatrics | Central Nervous system | Neonatal meningitis is caused by
A. L.monocytogenes
B. Group 'B' Streptococcus
C. E.Coli
D. H. Influenza
| Group 'B' Streptococcus |
592858c7-4284-445c-9545-3a108d2bf455 | Ans. is 'b' i.e., Posterior to rectus muscle insertion o Thinnest portion of sclera - Posterior to insertions of rectus muscle.o Thickest portion of sclera - Posterior pole.o The thickness of the sclera varies according to location : -At the limbus, the sclera is 0[?]8 mm thick.Anterior to the rectus muscle insertions, it is 0[?]6 mm thick.Posterior to the rectus muscle insertions, it is 0[?]3 mm thick (Thinnest portion).At the equator, it is 0[?]5 to 0[?]8 mm thick.At the posterior pole, it is greatest than 1 mm thick. | Ophthalmology | Miscellaneous (Sclera) | Thinnest portion of sclera -
A. Anterior to rectus muscle insertion
B. Posterior to rectus muscle insertion
C. Posterior pole
D. Limbus
| Posterior to rectus muscle insertion |
3c548106-6660-4947-8706-1ae4e4abeb8e | Patient in this question is most likely suffering from Actinomycotic mycetoma caused by Nocardia and Actinomadura species. Disease begins as a papule or a nodule and slowly progress into multiple abcesses and sinus tracts ramifying deep into the tissue. Trimethoprim sulfamethoxazole or dapsone are effective in the treatment. | Microbiology | null | A 50 year old man presents to the clinic with multiple abcesses and discharging sinus present on his left foot. X-ray of the foot shows destructive changes in the underlying bone. Which of the following is the most likely causative organism?
A. Nocardia
B. Sporothrix schenkii
C. Histoplasmosis
D. Cryptospordiosis
| Nocardia |
43e2847a-4311-4f64-9355-6ec7c8117a58 | National family health survey-3 conducted in India during 2005-2006 provides detailed information of feility trends Reference: Park&;s textbook of preventive and social medicine; 23rd edition | Social & Preventive Medicine | Demography and family planning | NFHS - 3 is conducted during
A. 1995
B. 2000
C. 2005
D. 2010
| 2005 |
61f26001-d8a3-4893-9914-1b2f92877e0c | The colour of postmortem hypostasis in hydrogen sulphide poisoning is bluish green. It is an asphyxiant which inhibits cytochrome oxidase. | Forensic Medicine | null | Green blue postmortem discoloration is seen in which poisoning –
A. Cyanide
B. Carbon monoxide
C. Hydrogen sulphide
D. Phosphorous
| Hydrogen sulphide |
d5d0fa83-4381-4545-a339-8ee2528f8de9 | Ans. is 'a' i.e., B-eells o There are two main types of adaptive immunity:-1. Cell mediated (cellular) immunity.# Mediated by T-lymphocytes# Responsible for defense against intracellular microbes.2. Humoral immunity# Mediated by B-lymphocytes and antibodies.# Protects against extracellular microbes and their toxins. | Microbiology | Immunity | Cells involved in humoral immunity -
A. B-cells
B. T-cells
C. Helper cells
D. Dendritic cells
| B-cells |
022274f9-033d-4e64-94a1-27d60c5975b1 | The Michaelis-Menten equation illustrates in mathematical terms the relationship between initial reaction velocity vi and substrate concentration . Vi=Vmax /Km+ The Michaelis constant Km is the substrate concentration at which vi is half the maximal velocity (Vmax/2) attainable at a paicular concentration of the enzyme. Ref: Kennelly P.J., Rodwell V.W. (2011). Chapter 8. Enzymes: Kinetics. 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 | Hormone substrate concentration affects the velocity of enzymatic action. This is based upon the following:
A. Zimmermann reaction
B. Salkowski reaction
C. Michaelis menten equation
D. Liebermann-Burchard reaction
| Michaelis menten equation |
33bc1aa0-9f03-4e17-9ed1-0daf7553172a | Units of potency
Roentgen and coulomb per kilograme → Units of exposure. It is the amount to which a person is exposed.
Red and Gray → Units of absorbed dose. It is the amount which is absorbed per gram of tissue.
Rem and Sievert → Product of the absorbed dose and the modifying factor. Represent the degree of potention danger to health. | Social & Preventive Medicine | null | Unit of one of radiation absorbed is –
A. Grey
B. Roengten
C. Curie
D. Bequerrel
| Grey |
b79727dc-13d4-4398-9b2a-fc15e8bd693c | Cholangiography T-tube done after 7-10 days of cholecystectomy. | Surgery | Gallbladder | Cholangiography T-tube done after how many days of cholecystectomy:
A. 1-5 days
B. 7-10 days
C. 10-14 days
D. 15-20 days
| 7-10 days |
73d5f47e-a307-4bc5-ac1b-23be98469ac1 | Pancuronium rapid IV injection may cause rise in BP and tachycardia due to cabal blockade and NA release. Vecuronium has cardiovascular stability due to lack of histamine release and ganglionic action. Atracuronium hypo tension may occur due to histamine release. Pipecuronium transient hypotension and bradycardia may occur . Hence Vecuronium has cardiac stability. From K D Tripati 7th edition Page no 353 | Pharmacology | Anesthesia | Which of the following muscle relaxants is free of cardiovascular effects over the entire clinical dose range?
A. Pancuronium
B. Vecuronium
C. Atracurium
D. Pipecuronium
| Vecuronium |
f0b26dc6-0afc-4238-8389-d4ab28dbaadb | Ans. is 'c' i.e., GlutamineSynthesis of asparagine from aspaate is catalyzed by asparagine synthetase.Donor of amide group (containing nitrogen) in this reaction is glutamine. | Biochemistry | null | For conversion of asparatate to asparagine, nitrogen comes from ?
A. Alanine
B. Glutamate
C. Glutamine
D. Histidine
| Glutamine |
fbb92d97-163d-4751-a27c-be05f1fbf301 | Explanation: Glasgow Coma Scale for Head Injury | Medicine | null | The minimum possible score in “Glasgow coma scale’’ is
A. 3
B. 5
C. 1
D. 0
| 3 |
eec1e00c-626d-4c92-a9fb-f08cf29b6cb9 | Ans. is 'a' i.e., Less than 8 yrs Sarcoma botvroides (Embryonal rhabdomyosarcoma)o Special type of mixed mesodermal tumour commonly arising from cervix, rarely from vagina & uterus,o Usually arises before the age of 8 yrs.o Presents with blood stained watery vaginal discharge, anemia & cachexia,o Vaginal examination show-s pinkish grape like, polypoidal soft growth,o Diagnosis is done by histopathology.o Treatment options are intravenous VAC (vincristine, actinomycin-d, cyclophosphamide), local resection & radiation. | Gynaecology & Obstetrics | Vigina | Sarcoma botyroides in vagina is seen in which age-
A. Less than 8vrs
B. 8-16yrs
C. 16-24yrs
D. > 24yrs
| Less than 8vrs |
1a38a051-66c8-4b09-8318-27658d58706e | William Farr is often referred to as the father of modern epidemiological surveillance. Textbook on Public Health and Community Medicine pg: 14. | Social & Preventive Medicine | Concept of health and disease | The father of modern epidemiological surveillance is
A. William Farr
B. James Lind
C. Edwin Chadwick
D. Pettenkofer
| William Farr |
f5cffab7-493d-4ebc-9931-0c1a491af420 | <p>PSORIASIS:-Inflammatory skin disease.Genetic predisposition. Psoriasis susceptibility 1 (PSORS1) is the most impoant susceptibility locus. Clinical features:-1. Classic lesion-Well defined erythematous plaque with a silvery white scales.2. Size varies from pin point papules to plaques. Types:-1. Chronic plaque psoriasis/psoriasis vulgaris:- Most common type Erythematous scaly plaques with silvery white scales of various sizes distributed symmetrically on the extensor aspect of extremities 2. Eruptive psoriasis:- More commonly seen in children and young adults with a shower of small papules and plaques all over the trunk and limbs. lesions are of size 1-2 cm, associated with streptococcal infection 3. Flexural psoriasis:-Involvement of flexural areas-axillae,perineum ,groin and inflammatory folds. Scaling minimal or absent. 4. Sebo - psoriasis : Occurs in sebum rich areas.Predominantly on scalp,face,inframammary region, retroauricular regions Moist erythematous lesions with yellow greasy scales. {Reference: IADVL textbook of dermatology page 1032 | Dental | Papulosquamous disorders | Typical silvery scales of psoriasis are absent in -
A. Scalp
B. Knee
C. Groin
D. Elbow
| Groin |
222bf9c5-a4fd-48f4-9245-8440acccd1bb | Cost-benefit analysis, in which benefits are compared to cost of the program. The benefits are expressed in monetary termsThe main drawback with this technique is that benefits in the health field, as a result of a paicular programme, cannot always be expressed in monetary terms.Park 23e pg:871 | Social & Preventive Medicine | Health education & planning | Economic benefits of any programme are compared with the costs incurred in
A. Cost benefit analysis
B. Cost effective analysis
C. Cost accounting
D. Net work analysis
| Cost benefit analysis |
a2b6f330-dc4c-405d-9dad-fc0bf69c8667 | Hematological malignancies e.g., leukemias are the most common radiation induced cancers. | Pathology | null | Most common tumour due to radiation arises from -
A. Lung
B. Liver
C. Bone marrow
D. Breast
| Bone marrow |
9ede9f44-f1b1-454e-96d1-1cbbd14b2110 | The diagnostic evaluation of an infertile couple should be thorough and completed as rapidly as possible. The primary diagnostic steps in the workup of the infertile couple include (1) documentation of ovulation by measurement of basal body temperature (BBT) or mid-luteal phase serum progesterone; (2) semen analysis; (3) postcoital test; (4) hysterosalpingogram; and (5) endometrial biopsy. Women should record their BBT for evidence of ovulation. In addition, serial serum progesterone levels may be helpful to confirm ovulation. Serum progesterone values should be obtained 7 days after ovulation and may also be helpful in evaluating inadequate luteal phase. An endometrial biopsy may also provide valuable information regarding the status of the luteal phase. The biopsy is obtained 12 days after the thermogenic shift, or 2 to 3 days before the expected onset of menses, on about day 26 of a 28-day cycle. A postcoital test is an in vivo test that evaluates the interaction of sperm and cervical mucus. It is performed during the periovulatory period up to 12 h after coitus. The cervical mucus is obtained, and its quantity and quality as well as its interaction with the sperm are evaluated. The hysterosalpingogram is performed in the mid follicular phase in order to evaluate the fallopian tubes and the contour of the uterine cavity; it should not be done while the patient is menstruating or after ovulation has occurred. Although gonadotropin levels are not routinely evaluated, they should be obtained in the early follicular phase when testing is indicated, e.g., in cases where there is a history of oligoovulation. | Gynaecology & Obstetrics | Physiology & Histology | "Gonadotropin evaluation" For the evaluation, select the most appropriate day of a normal 28-day menstrual cycle for a woman with 5-day menstrual periods. (SELECT 1 DAY)
A. Day 3
B. Day 8
C. Day 14
D. Day 21
| Day 3 |
1249489a-ee80-42d8-a03e-4ae6f5a2f341 | The child in question has following problems.
Child is hyperactive
He does not listen to teachings
Difficulty in playing
Disturbs other students
All these are features of attention deficit hyperactivity disorder (ADHD). | Pediatrics | null | A 9-year-old child is restless. He is hyperactive and his teacher complaints that he does not listen to the teachings. Disturbs other students, he also shows less interest in playing. The likely diagnosis is –
A. Cerebral palsy
B. Attention deficit hyperactive child
C. Delinnurn
D. Mania
| Attention deficit hyperactive child |
e62924b6-baaa-4f0e-924e-5d8a64114e32 | ANSWER: (A) Reiter's syndromeREF: Harrison's 18th ed chapter 325This is a case of reiters syndrome or reactive arthritis with a classical triad of arthritis, conjunctivitis (gritty feeling in eyes) 8t urethritis.Important points about reactive arthritis:Reactive arthritis (ReA) refers to acute nonpurulent arthritis complicating an infection elsewhere in the body. In recent years, the term has been used primarily to refer to SpA following enteric or urogenital infectionsS. flexneri has most often been implicated in cases of ReAOther bacteria identified definitively as triggers of ReA include several Salmonella spp., Yersinia enterocolitica, Y. pseudotuberculosis, Campylobacter jejuni, and Chlamydia trachomatisCharacteristic skin lesions : circinate balanitis , keratoderma blennohemmorhagicumAbout bechet's disease rememberDiagnostic Criteria of Behchet's DiseaseRecurrent oral ulceration plus two of the following:Recurrent genital ulcerationEye lesionsSkin lesionsPathergy test | Ophthalmology | Adverse Ocular Effects of Systemic Drugs | After a leisure trip, a patient comes with gritty pain in eye, and joint pain. What is the most probable diagnosis?
A. Reiter s syndrome
B. Bachet s syndrome
C. Sarcoidosis
D. SLE
| Reiter s syndrome |
4704020e-b70a-4ae7-a275-31af299ff5c0 | Ans. is 'a' i.e., 7.2 mm PointDistance in Listing's Reduced EyeNodal Point7.2mm behind the anterior corneal surfaceAnterior Focal Point15.7 mm anterior to anterior corneal surfacePosterior Focal point24.13mm behind anterior corneal surfaceAnterior focal length17.2mmPosterior Focal length22.63mmUniform Refractive Index1.336 | Ophthalmology | Anatomy | Distance between nodal point and cornea in Listing's Reduced eye is-
A. 7.2mm
B. 9mm
C. 12mm
D. 15.3mm
| 7.2mm |
7696ad35-a329-4693-a72a-1f0f944c835d | Ans. is 'a' i.e., Suprachiasmatic nucleus o A person's circadian rhythm is an internal biological clock that regulates a variety of biological processes according to an approximate 24-hour periods. Several body functions show a circadian (24 hour) rhythmo These functions include feeding, drinking, locomotor activity, sleep, corticosteroid secretion, body temperature and melatonin secretion by the pineal. Most of these functions are regulated by the hypothalamus.o Suprachiasmatic nucleus of the hypothalamus is believed to contain the "biological clock", which regulates the circadian rhythms according to the light dark cycles. | Physiology | Thalamus, Hypothalamus and Basal Ganglia | Body clock is maintained by -
A. Suprachiasmatic nucleus
B. Supraoptic nucleus
C. Ventrolateral nucleus
D. Thalamus
| Suprachiasmatic nucleus |
d649f3a9-d472-48bd-9dae-47ed0f30327b | Ref: Textbook of forensic medicine and toxicology (V.V.Pillay)17th edition page no.389 The punishment for rape is prescribed in sec.376IPC with two subsection. Subsection 1:for rape described in Sec.375IPC imprisonment for at least seven years and liability to fine,unless victim is his own wife and is not less than twelve years of age, on which case the maximum sentence is two year of imprisonment, or fine or both. Subsection 2:Deal with custodial rape,institutional rape, rape of pregnant women or a women less than twelve year of ageage, or victim of gang rape.minimum duration of penalty is enuanced to ten years. Sec.375IPC is definition of rape Sec.312AIPC is causing his miscarriage Sec.304AIPC is causing death by rash and negligent act | Forensic Medicine | Sexual offences and infanticide | Punishment for Rape is under which section of IPC -
A. 375
B. 376
C. 312A
D. 304A
| 376 |
8681e6ec-8d85-4eba-bf07-1671d16fd4f1 | All the options mentioned in the question are risk factors for IVH. However, the single most impoant factor is prematurity with IVH being very uncommon in term babies IVH occur due to fragile, highly vascular collection of vessels near the lateral ventricle, known as germinal matrix | Pediatrics | IUGR and Feeding of Preterm Neonate | Which of the following is the most impoant risk factor in the aetiology of intraventricular haemorrhage (IVH) in neonates?
A. Coagulation disorder
B. Continuous Positive airway pressure
C. Pneumothorax
D. Extreme prematurity
| Extreme prematurity |
84ccb58c-537f-4d22-b258-ffc061e213c9 | Ans. is 'c' i.e., a2A o Dexmedetomidine is a centrally active selective a2A agonist.o Has been explained in previous sessions. | Pharmacology | A.N.S. | Dexmedetomidine acts on which receptor for its analgesic action -
A. 5HT2A
B. D2
C. a2A
D. D5
| a2A |
62b10b19-428b-47bb-ae9a-4b8047d86242 | Trans epithelial nasal potential difference Diagnosis of cystic fibrosis Sweat chloride testing The sweat test is the standard approach to diagnosis. The diagnosis is made by elevated sodium and chloride level in the sweat > 60 meoll. Two tests on different days are required .for accurate diagnosis. A normal sweat chloride dose not exclude the diagnosis. Genotyping and other tests such as measurement of nasal membrane potential difference, pancreatic .function should be done if there is high clinical suspicion of cystic fibrosis. Nasal potential difference Measurement of nasal transepithelial potential difference in vivo can be useful adjunct in the diagnosis of cystic fibrosis. Individuals with cystic fibrosis demonstrate a significantly more negative baseline nasal potential difference, with the topical application of amiloride there is loss of this potential difference. Nasal potential difference is a sensitive test of electrolyte transpo (CFTR) function that can be used to suppo or refute a diagnosis of cystic fibrosis. Genetic analysis Cystic .fibrosis is an autosomal recessive disorder. It is caused due to defect in CFTR (Cystic fibrosis transmembrane conductance regulator) protein. Cystic fibrosis is associated with large number of mutations. More than 1500 CFTR polymoiphisms are associated with cystic fibrosis syndrome. The most prevalent mutation of CFTR is the deletion of single phenylalanine residue at amino acid 4.508 This mutation is responsible for high incidence of cystic fibrosis in nohern European populations. Approximately 50% of individuals with CF who are of nohern European ancestry are homozygous for 4.508 and > 70% carry at least one 4.508 gene. The remainder of patients has an extensive array of mutation, none of which has prevalence of more than several percent. Testing for cystic .fibrosis mutation was not possible because of the large no. of mutations associated with the disease. Now days commercial laboratories test for 30-80 of the most common CFTR mutations. This testing identifies > 90% individuals who carry 2 CF mutations. No where it is mentioned in the texts that testing only for 4508 is enough for diagnosis. Detection of atleast 2 CF mutations are necessary for making the diagnosis of cystic fibrosis. The patient has features of cystic fibrosis but sweat chloride levels are normal. - To diagnose cystic .fibrosis in this patient, another laboratory evidence demonstrating CFTR dysfunction is required. This can be done by two methods:? - Demonstrating abnormal potential difference - Demonstrating abnormal CF mutations. But the diagnostic criteria for cystic fibrosis requires. - Demonstration of two CF mutations (demonstration of single abnormal F508 mutation is not enough) So we are left with abnormal nasal potential difference. - It is an established laboratory evidence for CFTR dysfunction and is accepted as a diagnostic criteria to establish the diagnosis of cystic fibrosis. Diagnostic criteria for cystic fibrosis Presence of typical clinical features (respiratory, G.LT, genitourinary) OR A history of CF in a sibling OR A positive newborn screening test PLUS Laboratory evidence for CFTR Dysfunction Two elevated sweat chloride concentrations obtained on separate days OR Identification of two CF mutations OR An abnormal nasal potential difference | Pediatrics | null | In a child with respiratory distress, failure to thrive. His sweat chloride leveles were estimated 35 meq/L and 41 meq/L. What is next best test to do cystic fibrosis for diagnosis aEUR'
A. Nasal transmembrane potential difference
B. DNA analysis AF 508 mutation
C. CT chest
D. 72 hour fecal fat estimation
| CT chest |
3ec18de7-5e18-4e04-a5c9-42a060daee36 | A/k as broken hea syndrome High degree of emotional stress Increase catecholamines Coronary aery vasospasm | Ischemic dilatedcardiomyopathy M/E: Acute stage a necrosis + contraction band necrosis - Histologically, acute cases may show microscopic areas of necrosis characterized by myocyte hypercontraction (contraction band necrosis); subacute and chronic cases may exhibit microscopic foci of granulation tissue and/or scar. - Elevated levels of catechols also increase hea rate and myocardial contractility, exacerbating ischemia caused by the vasospasm. The outcome of such vasospasm can be sudden cardiac death (usually caused by a fatal arrhythmia) or an ischemic dilated cardiomyopathy, so-called takotsubo | Pathology | NEET 2018 | Stunning of myocardium without any acute coronary syndrome is:-
A. Subendocardial infarction
B. Restrictive cardiomyopathy
C. Takotsubo cardiomyopathy
D. Transmural infarction
| Takotsubo cardiomyopathy |
1ad2c939-b8a6-42b7-bd50-e9d96b623a4a | Taking repeated samples from the same population will result in a difference in the results obtained between samples; this is called SAMPLING ERROR. It occurs because data was gathered between samples rather than from the entire population. Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 913 | Social & Preventive Medicine | Epidemiology | "Sampling error" occurs due to the variation in results-
A. Between one sample and another
B. Between the observations of two individuals
C. Due to the use of many instruments in the study
D. Due to the multiple readings taken on the same instrument
| Between one sample and another |
d326c818-0bf8-42fd-92a1-f6e0942fa1cf | This patient has life-threatening hyperkalemia as suggested by the ECG changes in association with documented hyperkalemia. Death can occur within minutes as a result of ventricular fibrillation, and immediate treatment is mandatory. Intravenous calcium is given to combat the membrane effects of the hyperkalemia, and measures to shift, potassium acutely into the cells must be instituted as well. IV regular insulin 10 units and (unless the patient is already hyperglycemic) IV glucose (usually 25 g) can lower the serum potassium level by 0.5 to 1.0 mEq/L. Nebulized albuterol is often used and is probably more effective than IV sodium bicarbonate. It is crucial to remember that measures to promote potassium loss from the body (Kayexalate, furosemide, or dialysis), although important in the long run, take hours to work. These measures will not promptly counteract the membrane irritability of hyperkalemia. IV normal saline will not lower the serum potassium level. | Medicine | Kidney | A 47-year-old HIV-positive man is brought to the emergency room because of weakness. The patient has HIV nephropathy and adrenal insufficiency. He takes trimethoprim-sulfamethoxazole for PCP prophylaxis and is on triple-agent antiretroviral treatment. He was recently started on spironolactone for ascites due to alcoholic liver disease. Physical examination reveals normal vital signs, but his muscles are diffusely weak. Frequent extrasystoles are noted. He has mild ascites and 1+ peripheral edema. Laboratory studies show a serum creatinine of 2.5 with a potassium value of 7.3 mEq/L. ECG shows peaking of the T-waves and QRS widening to 0.14. What is the most important immediate treatment?
A. Sodium polystyrene sulfonate (Kayexalate)
B. Acute hemodialysis
C. IV normal saline
D. IV calcium gluconate
| IV calcium gluconate |
ec5ec33d-aea1-47ea-85f9-81024eb62bbf | *Brolucizumab is a monoclonal antibody against VEGF. *It is recently approved for wet (neovascular) age related macular degeneration.* Istradefylline is adenosine A2 receptor antagonist. It is approved for off episodes in Parkinsonism* Lefamulin is a new antimicrobial that acts by inhibiting protein synthesis. It is approved for community acquired bacterial pneumonia. | Pharmacology | Targeted Anticancer Drugs and Immunosuppressants | Which of the following is a new drug recently approved for treatment of neovascular age related macular degeneration?
A. Brolucizumab
B. Istradefylline
C. Lefamulin
D. Upadacitinib
| Brolucizumab |
5c9c9e06-f787-4ad1-abed-6ffd7f20b57b | Ans. is `a' i.e., Pulmonary lobule o Pulmonary lobule is not a component of acinus, rather cluster of 3-5 terminal bronchioles with acinus form pulmonary lobule. Respiratory tract anatomy o Progressive branching of bronchi forms bronchioles. o Fuher branching of bronchioles leads to terminal bronchioles. o Terminal bronchiole emnate into respiratory bronchioles. o Respiratory bronchioles proceed into the alveolar ducts, wich immediately branch into alveolar sacs (alveoli). o The pa of lung distal to the terminal bronchiole is called acinus, i.e., respiratory bronchiole, alveolar duct and alveolar sac. o A cluster of three to five terminal bronchioles, each with its appended acinus, is usually referred to as pulmonary lobule. o So, pulmonary lobules include cluster of three to five terminal bronchioles with its respiratory bronchioles, alveolar ducts and alveolar sacs | Pathology | null | Which of the following is not component of acinus?
A. Pulmonary lobule
B. Respiratory bronchioles
C. Alveolar ducts
D. Alveolar sac
| Pulmonary lobule |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.