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7e34cbba-ede9-4a14-bfd5-7765a5c630bb
Symptoms of depression should be present for at least 2 weeks.
Psychiatry
null
Daily depressed mood for minimum ________ weeks is must to classify someone as suffering from major depression disease - A. 1 B. 2 C. 3 D. 4
2
b3c7e831-adad-462b-b5fa-c5435bdc27e0
Carbohydrate-rich diet will lead to increase in Acetyl CoA production, which will lead to synthesis of fats in body. These fats are endogenous fat, which are transpoed in the form of VLDL. ADDITIONAL EDGE: When exogenous fat (fat directly from diet) is taken then it is transpoed in the form of chylomicrons. Atkin's diet is a weight loss diet which is low in calorie and also low in carbohydrates. It was originally promoted by the physician Dr. Robe C. Atkins. For weight reduction, the amount of carbohydrates taken in the diet should be less as carbohydrate gets conveed to fats in the body, which is called endogenous fat.
Biochemistry
Lipoproteins
A person on fat free, carbohydrate-rich diet, continues to grow obese. Which lipoprotein is increased in this person's blood: A. LDL B. HDL C. VLDL D. Chylomicrons
VLDL
92e76a23-a7a9-4b09-9670-3d0c956aa292
Ans. (a) SemimembranousRef.: BDC 6th ed. vol. II / 83* Hamstring muscles are - Semimembranosus, semiten- dinosus, long head of biceps femoris and ischial head of adductor magnus.
Anatomy
Posterior Compartment of Thigh & Popliteal Fossa
The following is part of Hamstrings - A. Semimembranous B. Gracilis C. Short head of biceps femoris D. Sartorius
Semimembranous
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Sudden death, defined as death within 1 hour of onset of symptoms, is usually caused by cardiac disease in middle-aged and elderly patients, but in younger age groups noncardiac causes predominate. There is a bimodal distribution in the population, with the first peak before 6 months of age (sudden infant death syndrome). The most common coronary artery finding is extensive chronic coronary atherosclerosis, although acute syndromes do occur.
Medicine
C.V.S.
A 58-year-old man whom you have followed dies suddenly, spurring you into doing some research on sudden death. Which of the following is the most likely cause for this individual? A. extensive coronary atherosclerosis B. electrolyte disturbance C. pulmonary embolism D. acute stroke
extensive coronary atherosclerosis
2b815900-eb5e-4b39-b6e7-7d226deffadf
Ans. D: Endometriosis Indications for gynaecological laparoscopy include the following: Ovarian cysts and tumours. Removal of fibroids (Myomectomy).or destroying them (Myolysis) Infeility, lysis of adhesions. Infeility, checking the condition and patency of the fallopian tubes. Reproductive or tubal surgery Endometriosis Intraperitonal Haemorrhage Polycystic Ovaries Pelvic infection (Pelvic Inflammatory disease) Egg collection for assisted reproduction Sterilization (laparoscopic Sterilization) Severe period pain Diagnosis and treatment of some uterine anomalies Pelvic floor and vaginal prolapse Urinary incontinence
Gynaecology & Obstetrics
null
Laparoscopy is the diagnostic procedure of choice for: March 2008 A. Ca uterus B. Ca cervix C. Ca rectum D. Endometriosis
Endometriosis
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B. melitensis, which is the most common cause of symptomatic disease in humans and for which the main sources are sheep, goats, and camels. Overall, the presentation of brucellosis often fits one of three patterns: febrile illness that resembles typhoid but is less severe; fever and acute monoahritis, typically of the hip or knee, in a young child; and long-lasting fever, misery, and low-back or hip pain in an older man. Dual therapy with streptomycin and tetracyclines is the most effective treatment. Ref: Corbel M.J., Beeching N.J. (2012). Chapter 157. Brucellosis. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.
Microbiology
null
A farmer rearing sheep, presented with complaints of fever and weakness for the last one month. There is generalised lymphadenopathy. There was also associated hepatomegaly. Biopsy of liver showed non caseating granuloma. These are most likely due to infection with: A. Yersinia pestis B. Brucella Canis C. Francisella tularensis D. Brucella melitensis
Brucella melitensis
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Klebsiella Friedlander's bacilli H.Aegypticus Koch week's bacilli Salmonella typhi Ebe gaffky bacilli Corynebacterium Kleb- Loeffler bacilli
Microbiology
Systemic Bacteriology (Gram Positive Bacilli, Gram Negative Bacilli)
Which of the following bacteria is known as Ebe Gaffky bacillus A. Klebsiella B. H. Aegypticus C. Salmonella typhi D. Corynebacterium
Salmonella typhi
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Meconium ileus is a neonatal manifestation of cystic fibrosis (also known as fibrocystic disease of pancreas). In cystic fibrosis there is pancreatic enzyme deficiency and abnormal chloride secretion in the intestine that results in the production of viscous water- poor meconium. Meconium ileus results because of impaction of thick meconium in the ileum. Meconium ileus presents sholy after bih with progressive abdominal distension and failure to pass that meconium with intermittent bilious vomiting. Abdominal X- ray shows Dilated loops of small intestine Air fluid level do not form inspite of complete small intestine obstruction, because the enteric contents are viscous and thick. Small bubbles of gas become entrapped in the inspissated meconium in the distal ileum, where they produce a characteristic 'ground glass' appearance on radiograph. In complicated meconium ileus in which perforation has occurred, intraperitoneal eggshell calcification are noted. Ref: Bailey & Love 25/e, Page 1199; Schwaz 9/e, Page 1429.
Surgery
null
Which of the following condition is associated with meconium ileus? A. Fibrocystic disease of pancreas B. Liver aplasia C. Cirrhosis of liver D. Malnutrition
Fibrocystic disease of pancreas
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Transposons are called as Jumping genes as they can jump from one chromosome locus to another.
Biochemistry
null
Jumping genes are also known as A. Plasmids B. Oncogenes C. Transposons D. Introns
Transposons
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Mercurial tremors The hands are first affected. There will be tremors of the hands called Danbury tremors. It may progress to lips, tongue, arms, and legs. The tremors are moderately coarse and intentional to sta with and are interspersed by jerky movements. The advanced condition is called hatter's shake or glass blower's shake. ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 428
Anatomy
Poisoning
Danbury tremors seen in which chronic poisoning A. Arsenic B. Lead C. Mercury D. Zinc
Mercury
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Ans. is 'b' i.e. Bronchioles Different parts of the respiratory tracts have distinctive histological features :Clara cells are found in-bronchioles*Goblet cells are found in-Bronchi*Mucous gland are found in-Bronchi*Neuroendocrine cells-Bronchi*Mural cartilage-Bronchi*Part rich in secretory immuno globin-Bronchioles*Pores of Kahn-Alveoli*Contain macrophages in their lumens-Alveoli*Note that Squamous cells are never present in the normal lung,* when found they represent a metaplasia, (Squamous cell Ca is the most common type of lungs cancer even though the normal lungs contain no squamous mucosa).
Anatomy
Respiratory System (Histology)
Clara cells are found in : A. Trachea B. Bronchioles C. Alveoli D. Oesophagus
Bronchioles
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Break bone fever is caused by the dengue virus. REF:<\p>ANATHANARAYANAN MICROBIOLOGY NINTH EDITION PAGE.523
Microbiology
Virology
Break bone fever is cuased by - A. Variola B. Coxsackie C. Arbovirus D. Adenovirus
Arbovirus
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Response to iron therapy can be documented by an increase in reticulocytes 5-10 days after the initiation of iron therapy. The hemoglobin concentration increases by about 1 g/dL weekly until normal values are restored Replacement of intracellular iron enzymes Ref essential paediatrics op ghai 9e
Pediatrics
Hematology
The initial response to iron therapy in a child suffering from iron-deficiency anemia is A. Reticulocytosis B. Replacement of intracellular iron enzymes C. Initial bone marrow response D. Erythroid hyperplasia
Replacement of intracellular iron enzymes
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Amiodarone can lead to bluish discolouration of skin, also called as "Blue man syndrome".
Pharmacology
null
Which of the following drug can lead to given below condition A. Vancamycin B. Phenytoin C. Valproate D. Amiodarone
Amiodarone
b7b3ccaa-a55e-40ce-9bb5-85184c5dd8cf
In epilepsy caused by brain tumor, agent of choice is those drugs that do not induce hepatic microsomal enzyme system. Drugs such as : Levetiracetam Topiramate Lamotrigine Valproic acid Lacosamide.
Medicine
Epilepsy and EEG
Which drug is suitable for epilepsy related to a brain tumor? A. Levetiracetam B. Phenytoin C. Carbamazepine D. Phenobarbitone
Levetiracetam
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(A) Systemic lupus erythematosus # SLE:> Characteristic Malar (Butterfly) rash seen as fixed erythematous rash over the cheeks, & bridge of nose (photosensitive but scarring is absent) Patchy scalp hair loss is seen & Hair usually regrow in SLE (but not in DLE) Raynaud's phenomenon is present in 10%; Antibodies against double-stranded DNA (Anti ds DNA) & Anti Sm are most specific Where as Antinuclear antibody (Anti SS DNA) test is most sensitive; ANF (Antinuclear factor) is positive in 98% Treatment: Antimalarials (Chloroquine, Hydroxychloroquine) are used when skin & joint disease predominate; Steroids with Ccytotoxic immunosuppressants (Azathioprine, Cyclophosphamide, Methotrexate) may be required when NSAIDS & Antimalarials are insufficient to control symptoms 11 criteria for diagnosis of SLE are: Malar rash; Discoid rash; Photosensitivity; Oral ulcers; Arthritis; Serositis (pleuritis, pericarditis); Renal disorder; Neurological disorder (Seizures or Psychosis); Haematological disorder (Haemolytic anaemia, Leukopenia, Thrombocytopenia); Immunological disorder;Antinuclear antibody. SLE may cause Libman Sach's Verrucous type of endocarditis
Skin
Miscellaneous
Butterfly rash is seen in A. Systemic lupus erythematosus B. Erythema marginatum C. Lupus gulgaris D. Erythema nodosum
Systemic lupus erythematosus
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At the point where the afferent aeriole enters the glomerulus and the efferent aeriole leaves it, the tubule of the nephron touches the aerioles of the glomerulus from which it arose. At this location, which marks the sta of the distal convolution, there is a modified region of tubular epithelium called the macula densa. The macula densa is in close proximity to the JG cells. The lacis cells, the JG cells, and the macula densa constitute the juxtaglomerular apparatus.Ref: Barrett K.E., Barman S.M., Boitano S., Brooks H.L. (2012). Chapter 38. Regulation of Extracellular Fluid Composition & Volume. In K.E. Barrett, S.M. Barman, S. Boitano, H.L. Brooks (Eds), Ganong's Review of Medical Physiology, 24e.
Physiology
null
Juxtaglomerular apparatus lies in relation to the following structure and have secretory function: A. Proximal convoluted tubule B. Ascending loop of Henle C. Descending loop of Henle D. Glomerulus
Glomerulus
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Ans. B: Fungal Infection Kerion is severe form of tinea capitis, in which well-circumscribed pas of the scalp are transformed into a painful, boggy, inflamed, confluent mass with loosened hair (easy pluckability), purulent folliculitis, crusting, often with lymphadenopathy It is commonly due to a zoophilic dermatophyte (e.g., M.canis).
Skin
null
Kerion is: March 2009 A. Viral infection B. Fungal infection C. Bacterial infection D. Parasitic infection
Fungal infection
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HERNIATED DISC B/W COMPRESSED NERVE ROOT DERMATOME AFFECTED MUSCLES AFFECTED MOVEMENT WEAKNESS NERVE AND REFLEX INVOLVED C6 and C7 C7 C7 middle finger Triceps wrist extensors extension of forearm extension of wrist radial nerve | triceps jerk
Anatomy
Back region
Burning sensation in middle finger Triceps Reflex is weak Slip disc? A. C6-C7 B. C5-C6 C. C3-C4 D. C2-C3
C6-C7
b460a831-6fd1-4de7-acb9-6a337d44e908
Ear pain and drainage in an elderly diabetic patient must raise concern about malignant external otitis. The swelling and inflammation of the external auditory meatus strongly suggest this diagnosis. This infection usually occurs in older, poorly controlled diabetics and is almost always caused by P aeruginosa. It can invade contiguous structures including facial nerve or temporal bone and can even progress to meningitis. Streptococcus pneumoniae, H influenzae, and M catarrhalis frequently cause otitis media, but not external otitis. Candida albicans almost never affects the external ear.
Medicine
Infection
A 70-year-old patient with long-standing type 2 diabetes mellitus presents with complaints of pain in the left, ear with purulent drainage. On physical examination, the patient is afebrile. The pinna of the left ear is tender, and the external auditory canal is swollen and edematous. The white blood cell count is normal. Which of the following organisms is most likely to grow from the purulent drainage? A. Pseudomonas aeruginosa B. Streptococcus pneumoniae C. Candida albicans D. Haemophilus influenzae
Pseudomonas aeruginosa
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Nutrients in growth media must contain all the elements necessary for the biosynthesis of pathogenic microorganisms. This rule is especially true of media that are intended to have a selective (select for a specific group of bacteria) or differential (differentiate between a pathogenic and a normal or usual strain of a group) purpose. Bacteria and plants use photosynthetic energy to reduce carbon dioxide expending water. The organisms that can use CO2 as a sole source of carbon are termed autotrophs. Chemolithotrophs are organisms that use an inorganic substrate, such as hydrogen or thiosulfate, as a reductant and CO2 a carbon source. Heterotrophs require organic carbon for growth. Many organisms possess the ability to assimilate nitrate (NO.3) and nitrite (NO2) reductively by conveing these forms to ammonia (NH3). Dissimilation pathways are taken by microorganisms that use these ions as terminal electron acceptors in respiration. This process is known as denitrification, with the final product being nitrogen gas (N2). Fermentation is characterized by substrate phosphorylation, in which products such as glucose are involved for energy production. Autotrophs should not be confused with auxotrophs. Auxotrophs are strains that require a nutrient that is not required by the parental or prototype strain. They are usually derived from mutants with defective synthetic capabilities. Ref: Ananthanarayana textbook of microbiology 9th edition pgno: 45
Microbiology
general microbiology
Autotrophic requirements are A. CO2 as a carbon source B. NH3 as a nitrogen source C. CO2 and NH3 together D. Essential molecules that the bacteria are unable to synthesize
CO2 as a carbon source
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Ans. is 'b' i.e., Decreased affinity to receptors Down regulation is a mechanism in which a hormone decrease the number or affinity of its receptors in target tissues. Down-regulation may occur by decreasing the synthesis of new receptors, by increasing the degradation of existing receptors or by inactivating receptors. The purpose of down-regulation is to reduce the sensitivity of the target tissue when hormone levels are high for an extended period of time.
Physiology
null
Down regulation of hormone means ? A. Decreased secretion of hormone B. Decreased affinity to receptors C. Defective regulation in secretion D. Regulation by low concentration of hormone
Decreased affinity to receptors
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The name "blood-testis barrier" is misleading in that it is not a blood-organ barrier in a strict sense, but is formed between Seoli cells of the seminiferous tubule and as such isolates the fuher developed stages of germ cells from the blood. imageref-sciencedirect.com
Anatomy
Abdomen and pelvis
Blood-testis barrier is formed by A. Seoli cells B. Leydig cells C. Epididymis D. Vas deferens
Seoli cells
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Among the given options, peripheral neuropathy is least common, and occurs in less than 10% of cases.
Forensic Medicine
null
Least common complication of lead poisoning in adults - A. Abdominal colic B. Peripheral neuropathy C. Anemia D. Encephalopathy
Peripheral neuropathy
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Ref: Multiple sources, Guyton, 12th edition, Pages 487- 488. 502-503: Khurana, W F Ganong, Review of Medical Physiology, 23rd edition Explanation: Normal PO2 and PCO2 at various sites Atmosphere (sea level) (inspired air Alveoli Pulmonary vein Arterial blood Tissue Venous Pulmonary artery Etpurid Air pO2 160 149-160 100-105 95-100 100 40 40 40 120 pCO2 0.3 (Negligible) 0.3 (Negligible) 40 4O 40 46 45 45 27 *A11 values in 'mm Hg' Note: Expired air pCO2 - 27 (Ref: Guyton Table 39-1) Expired air pCO2 - 32 (Ref: Ganong Figure 34-15. Page 635. 24th edition)
Unknown
null
The partial pressure of CO2 is lowest in: A. Arterial blood B. End tidal air C. Expired air D. Venous blood
End tidal air
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Recurrent conjunctivitis, intense itching and ropy discharge in a 12 year old boy suggest the diagnosis of spring catarrh.
Ophthalmology
null
A 12 years old boy presents with recurrent attacks of conjunctivitis for the last 2 years with intense itching and ropy discharge. The diagnosis is – A. Vernal conjunctivitis B. Phlyctenular conjunctivitis C. Trachoma D. Viral conjunctivitis
Vernal conjunctivitis
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Ans. (a) Down syndrome.Notice the hypotonia with facial grimace and a wide gap between the first and second toe of the foot. The karyotype confirms it to be trisomy 21.Mnemonic for DOWN Syndrome is "CHILD HAS PROBLEM"* Cataracts/heart disease (Endocardial cushion defect)* Hypotonia/hyperthyroidism* Incur 5th finger/Increased gap between 1st and 2nd toes* Leukemia (risk x 2)/Lung problems* Duodenal atresia/Delayed development* Hirschsprung's disease/Hearing loss* Alzheimer's disease/Atlantoaxial instability* Short neck/Squint* Protruding tongue/Palmar crease* Round face/Rolling eye (nystagmus)* Oblique eye fissure/Occiput flat* Behavioral difficulties* Low nasal bridge/Language problem* Epicanthic fold/Ear folded* Mental retardation/MyoclonusImage source- style="font-family: Times New Roman, Times, serif">
Pathology
Cytogenetic Disorders
Comment on the diagnosis? A. Down syndrome B. Turner syndrome C. Prader-Willi syndrome D. Patau syndrome
Down syndrome
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Ans. is 'c' i.e. 60dB Intensity is the strength of sound which determines its loudness. It is usually measured in deeibeis (dB). o Following are intensities when a person is at a distance of one meter from sound source. Whisper 30dB Normal conversation 60dB Shout 90 dB Discomfo of ear 120dB Fain in ear 130 dB
Social & Preventive Medicine
null
Normal voice heard from 1 meter, intensity of sound reaching ear is A. 20 dB B. 40 dB C. 60 dB D. 80 dB
60 dB
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Ans. is 'a' i.e., Ketamine Dissociative anaesthesia is characterized by profound analgesia, immobility, amnesia with light sleep and feeling of dissociation from once own body and the surroundings Cataleptic state. Ketamine (phencyclidine) induces dissociative anaesthesia.
Anaesthesia
null
Dissociative anaesthesia is produced by - (PGI 99) A. Ketamine B. Etomidate C. Propofol D. Thiopentone
Ketamine
7b981ced-70b6-41ef-9d3c-b2531edc6b18
Ans: a (Tears) Ref: Harrison, 16th ed, p. 1079; 17th ed, p. 1144HIV is not usually found in tears. It is usually transmitted by semen, cervical secretion and blood.HIVClinical features1. Primary infectionIt is symptomatic in 70-80% of cases and usually occurs 2-4 weeks after exposure. The major clinical manifestations of primary infection are fever. The appearance of specific anti HIV antibodies in serum (Serocinversion) takes place at 3-12 weeks (median 8 weeks)Any HIV infected individual with CD4 T cell count less than 200/cu.mm has AIDS by definition.2. Asymptomatic infectionAsymptomatic infection is a period during which the individual remains well with no evidence of disease except for the possible presence of persistent generalized lymphadenopathy.3. Mildly symptomatic disease.It indicates some impairment of the cellular immune system. These diseases correspond to AIDS related complex conditions, but by definition are not AIDS defining.Acquired Immunodeficiency SyndromeIt is defined by the development of specified opportunistic infections tumors etc. e.g, esophageal candidiasis, cryptococcal meningitis.Correlation between CD 4 count and HIV associated diseases are given below.>500 cells/cu. mm 1. Acute primary infection2. Progressive generalized lymphadenopathy3. Recurrent vaginal candidiasis<200 cells/cu. mm1. Pneumocystis carinii pneumonia2. Mucocutaneous herpes simplex3. Cryptosporidium4. Microsporidium5. Esophageal candidiasis6. Miliary /extra pulmonary tuberculosis7. HIV associated wasting8. Peripheral neuropathy200-500cells/cu. mm1. Pulmonary tuberculosis2. Herpes zoster3. Oropharyngeal candidiasis4. Oral hairy leucoplakia5. Salmonellosis6. Kaposi's sarcoma7. HIV associated idiopathic thrombocytopenia8. Cervical intra epithelial neoplasia 1 and 29. Lymphoid interstitial pneumonitis<100 cells/cu. mm1. Cerebral toxoplasmosis2. Cryptococcal meningitis3. Primary CNS lymphoma4. Non -Hodgkin lymphoma5. HIV-associated dementia6. Progressive multi focal leukoencephalopathy.<50 cells/cu. mm1. CMV Retinitis/gastro intestinal disease2. Disseminated Mycobacterium avium intacellulareGuys, this is a quite exhaustive Table but it is very important for PG entrance examinations. Atleast study the diseases seen when the CD 4 count is less than 100 and less than 50.It is a spherical enveloped virus. Nucleocapsid has icosahedral structure. Virus contain external spikes formed by the 2 major envelop proteins-the external gp 120 and Transmembrane gp 41.Cellular target of HIV* CD4 Helper T cell* Monocyte, macrophage* Dendritic Langerhans cells* Few B cellsGenome is composed of two identical single stranded positive sense RNA copies.Main genes are:gag - determines the core and shell of virusenv - determines the synthesis of envelop glycoproteinPol - polymerase reverse transcriptaseOther genes are-tat, rev, jej, vif, vpu, vpx, vpr, LTR.Replication begins with the high affinity binding of gp 120 with CD 4 cells. After binding with CD 4. gp 120 undergoes conformational changes that facilitates the binding of co receptor. The major co receptor for HIV-1 are CCR-5 and CXCR -4. After fusion, HIV genome RNA is uncoated and internalized into target cell. The reverse transcriptase catalyze the reverse transcription of RNA to DNA. DNA so formed is integrated with host cell chromosome through the action of virus encoded enzyme integrase.There are three groups of HIV-1Group M--most commonGroup OGroup NThere are 9 subtypes of M group. Subtype A is most prevalent worldwide. Subtype C is most prevalent in India and China.Modes of transmissionSexual transmission--Most common mode of transmission worldwide is heterosexual transmission. Chance of infection from male to female is twice as from female to male. Anal intercourse has higher risk of transmission.Transmission by blood and blood productsMaternal -fetal transmission- Risk is 30%. It occurs most commonly in perinatal period.Transmission by other body fluids- Semen, cervical secretions.
Medicine
Infection
HIV is not seen in: A. Tears B. Cervical secretion C. Semen D. Blood
Tears
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Shunt surgery is preferred in Non cirrhotic poal fibrosis with: Symptomatic large splenomegaly Very low platelet count (<20,000) Stays far away from a good medical center where an upper GI bleed can be tackled Rare blood group Endoscopic variceal ligation is preferred as the treatment modality for UGI bleeding in NCPF. Beta blockers also can be given. In cirrhotic patients too EVL is the best treatment. Ref: Medicine Update 2012 Vol. 22.
Medicine
null
The shunt surgery to control variceal bleeding in noncirrhotic poal fibrosis is done, if: A. Very low platelet count B. Upper GI bleeding at the age of 30 C. If beta blockers contraindicated D. Associated with cirrhosis
Very low platelet count
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Ans. c. Lymphocytosis, low glucose, high protein (Ref: Harrison 19/e p1111, 18/e p3414)Presence of significant basal exudates, together with dilated ventricles (hydrocephalus) in a young female with prolonged history of fever and headache suggests a diagnosis of tubercular meningitis. Tubercular meningitis is characterized by lymphocytic pleocytosis (Pleocytosis is the presence of both neutrophils and lymphocytes in CSF), low glucose and high proteins within the CSF."The pathological hallmark of Tubercular Meningitis is predominant involvement of basal cisterns that are observed by the presence of basal inflammatory tissue exudate."CSF changes in Infection of CNSParameters (Normal values)Bacterial MeningitisTuberculous MeningitisViral MeningitisPressureRaisedQRaisedQRaisedQGross appearanceTurbidQClear (may clot)ClearQProtein (Normal: 20-50 mg/dL)HighQVery highQSlightly highQGlucose (40-70 mg/dL)Very LowQLowQNormalQChloride (116-122 mg/dL)LowQVery LowQNormalQCells < 5/mLNeutrophilsQPleocytosisQLymphocytosisQTubercular MeningitisClassic CSF Abnormalities in Tubercular Meningitis* Elevated opening pressure* Elevated protein concentration (Range of 1 to 5 g/L or 10 to 500 mg/dL)* Decreased glucose concentration (Range of 1.1 to 2.2 mmol/L or 20 to 40 mg/dL)* Lymphocytic pleocytosis (10-500 cells/mL)* Mononuclear cells (except early infection when PMN cells are seen)* Chloride level: usually reducedThe pathological hallmark of Tubercular Meningitis is predominant involvement of basal cisterns that are observed by the presence of basal inflammatory tissue exudate.Classical Radiological Features (CT/MRI) in Tubercular Meningitis* Basal exudates/Obliteration of Basal cisternsQ (Tubercular exudates are primarily located in the vicinity of basal cisterns that are obscured by presence of inflammatory tissue exudate.)* Subarachnoid space is involved by the exudate (i.e. subarachnoiditis is present)Q* Abnormal leptomeningeal enhancement (Usually most pronounced in the basal cisterns)* Involvement is mainly of the leptomeninges i.e. Pia- arachnoid: Duramater is usually sparedQ.* Hydrocephalus (Usually communicating although non-communicating may also be seen)* Ischemic/Vasculitic infarcts (Basal ganglia and/or Internal capsule)* Tuberculomas (Granulomas)* Calcification is commonly seen in the meninges at the base of the brain.* Ventriculitis may be seen, but it is not common
Medicine
C.N.S.
A 25-year-old lady presented with fever of one month duration, ataxia and headache. Brain imaging showed dilated ventricles with basal exudates. Which among the following is the most likely CSF finding? A. Lymphocytosis, low glucose, low protein B. Lymphocytosis, normal glucose, high protein C. Lymphocytosis, low glucose, high protein D. Polymorphonuclear pleocytosis, normal glucose, high protein
Lymphocytosis, low glucose, high protein
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Most commonly used scalpel blade for intraoral surgery – No. 15 The blade used primarily for making small stab incisions, such as for incising an abscess – No. 11 Blade commonly used for skin incisions – No. 10 blade The hooked blade commonly used for mucogingival procedures – No. 12 blade The blades commonly used in gingivectomy – No. 11 and 12 The blade used for incising periodontal abscess – No. 12
Surgery
null
Most commonly used scalpel blade for intraoral surgery is: A. No.15 B. No.11 C. No.12 D. No.10
No.15
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nef ( negative factor gene) down regulates viral replication. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO-572
Microbiology
Virology
Nef gene in HIV is for use- A. Enhancing the expression of genes B. Enhancing viral replication C. Decreasing viral replication D. Maturation
Decreasing viral replication
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Pleomorphic adenomas, or benign mixed tumors, are the most common neoplasms of the salivary glands. They represent approximately 60-70% of all parotid tumors and 90% of submandibular benign tumors. These neoplasms affect females more than males and are commonly seen in the third to sixth decades of life. It presents as an isolated swelling or mass in the submandibular gland with little associated pain. Ref: Butt F.Y. (2012). Chapter 18. Benign Diseases of the Salivary Glands. In A.K. Lalwani (Ed), CURRENT Diagnosis & Treatment in Otolaryngology--Head & Neck Surgery, 3e.
Surgery
null
Which among the following is the commonest type of parotid tumor? A. Pleomorphic tumor B. Wahin's tumor C. Adenoid cystic Ca D. Secondaries
Pleomorphic tumor
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Valine Isoleucine Methionine conves to Propionyl CoA & then conves to Succinyl CoA & enters the cycle.Ref: DM Vasudevan Textbook of Medical Biochemistry, 6th edition, page no: 221
Biochemistry
Respiratory chain
Which of the following enters the TCA cycle at succinyl - CoA? A. Tyrosine B. Methionine C. Tryptophan D. Histidine
Methionine
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The nasion is the point where the internasal and frontonasal sutures meet. It lies a little above the floor of the depression at the root of the nose, below the glabella. Nasion is termed as the central point of the frontonasal suture. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition.
Anatomy
Head and neck
Nasion lies at the junction of A. Frontonasal and internasal suture B. Frontonasal and interparietal suture C. Frontonasal and frontozygomatic suture D. Frontogomatic and internasal suture
Frontonasal and internasal suture
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Ans. is 'b' i.e. Vitamin B Nutritional optic atrophyo The exact mechanism by which nutritional deficits damage the optic nerve has not been elucidated. Although the etiology is likely multifactorial, most clinicians agree that in patients who abuse ethanol and tobacco, malnourish- ment is often present and undemutrition, rather than direct toxicity, is the principal cause of the visual loss. Specific deficiencies of vitamin B-12 (cyanocobalamin), thiamine (vitamin B-1), other B-complex vitamins (riboflavin, niacin, and pyridoxine), and folic acid, as well as reduced systemic levels of other proteins with sulfur-containing amino acids, may play a role.Causes of optic atrophyo Compressive - secondary to papilledema, tumor, bony growth (fibrous dysplasia, osteopetrosis), thyroid eye disease, chiasmal (pituitary etc), optic nerve sheath meningioma, disc drusen, increased intraocular pressure (glaucoma)o Vascular - arteritic and non-arteritic ischemic optic neuropathy, diabeteso Inflammatory - sarcoid, systemic lupus, Behcet's, demyelination (MS), etc.o Infectious - viral, bacterial, fungal infections - herpes, TB, bartonella, etc.o Toxic & nutritional - many medications such as ethambutol, amiodarone, methanol, vitamin deficiency etc.o Metabolic - diabeteso Neoplastic - lymphoma, leukemia, tumor, gliomao Genetic - Autosomal dominant optic atrophy (OPA1), Leber's hereditary optic atrophy, Leber's hereditary optic neuropathy, as a late complication of retinal degneration.o Radiation optic neuropathyo Traumatic optic neuropathy
Ophthalmology
Diseases of the Optic Nerve
Vitamin deficiency causing optic atrophy - A. Vitamin A B. Vitamin B C. Vitamin C D. Vitamin D
Vitamin B
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Ans. A. Wash mouth between two puffsRecommendations for correct inhaler technique: -a. Remove capb. Check does counter (if applicable)c. Hold inhaler upright and shake welld. Breathe out gently, away from the inhalere. Put mouthpiece between teeth without biting and close lips to form good sealf. Start to breathe in slowly through mouth and, at the same time, press down firmly on canisterg. Continue to breathe is slowly and deeph. Hold breath for about 5 seconds or as long as comfortablei. While holding breath, remove inhalerj. Breathe out gently, away from the inhalerk. If an extra does is needed, repeat stepsl. Replace capm. When the patient has finished taking all the dosages, then rinse the mouth with water and spit out the water. This is important especially in case of steroid inhaler.
Pharmacology
Miscellaneous (Pharmacology)
Which of the following instructions is not given if a second puff is required from this device? A. Wash mouth between two puffs B. Wait for one minute before taking the second puff C. Shake again D. Keep mouth piece dry
Wash mouth between two puffs
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Because of its relatively low radiodensity, calculus is better visualized on images made with reduced exposure.
Radiology
null
The structure marked with arrow is most likely: A. Pulp obliteration B. Reactionary dentin C. Calculus D. Plaque
Calculus
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Invasive lobular carcinoma consists of cells morphologically identical to the cells of LCIS. Two thirds of the cases are associated with adjacent LCIS. The cells invade individually into stroma and are often aligned in "single-file" strands or chains. This growth pattern correlates with the presence of mutations that abrogate the function of E-cadherin, a surface protein that contributes to the cohesion of normal breast epithelial cells. ref : Robbins Basic Pathology, 9E,page-711 REF of IMG :
Pathology
Breast
The histology of Lobular carcinoma of breast reveals- A. Single file pattern B. Pleomorphic cells in sheets C. Clustersl/lslands of cells with mucous lakes D. Solid syncytium like sheets
Single file pattern
a1d60a6a-0e17-46d7-8f00-8a3ec21e6c8b
For acidic drug poisoning like (barbiturates, salicylates and methotrexates) ,urinary alkinization agents are prescribed where as basic drug poisoning (morphine, amphetamine ,atropine etc) urinary acidification agents are prescribed. Refer Ltd 7/e p29
Anatomy
General anatomy
Alkalinization of urine is required for decreasing poisoning due to A. Barbiturates B. Amphitamines C. Alcohol D. Morphine
Barbiturates
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Eastern equine encephalitis (EEE) is a severe disease usually seen in the summer months when Aedes mosquitoes are prevalent. In 1996 and 1997, there were several outbreaks in the Northeast United States. Control of EEE is a function of mosquito eradication. Horses and humans are accidental hosts. While draining of swamps helps, other measures to eliminate mosquitoes such as spraying are the most effective.
Microbiology
Virology
Eastern equine encephalitis virus is associated with a high fatality rate. Control of the disease could be possible by eradication of A. Horses B. Birds C. Mosquitoes D. Fleas
Mosquitoes
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Answer is B (Esophageal rupture): Most cases of acute mediastinitis are due to esophageal perforation or occur after median sternotomy for cardiac surgery- Harrison Acute Mediastinitis Chronic Mediastinitis 1. 2. Esophageal rupture Q Median sternotomy for cardiac surgery 1. 2. 3. Tuberculosis / Histoplasmosis (most cases) Q Sarcoidosis, silicosis Q Other fungal diseases
Medicine
null
Most common cause of Mediastinitis is: A. Tracheal rupture B. Esophageal rupture C. Drugs D. Idiopathic
Esophageal rupture
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Ans is 'c' i.e. Smad 7 o Smad 7 gene delivery prevents cachexia.o Smad-3y melanocortin - 4 receptor (MC4R) and APEH (acylpeptide hydrolase) genes have been implicated in causation of cancer cachexia.
Pathology
Nature of Gene Abnormalities
Which of the following is not a cachetic gene? A. APEH B. MC4R C. Smad7 D. Smad3
Smad7
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Ans. is 'a' i.e., Brucellosis o Tests for detection of brucellosis in herds of cattle.Rapid plate agglutination testRose bengal card testo Tests to detect antibodies in milk.Milk ring testWhey agglutination test
Microbiology
Bacteria
Milk ring test is seen in- A. Brucellosis B. Bacteroides C. Tuberculosis D. Salmonellosis
Brucellosis
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Multiple pathological fractures, high calcium, low phosphate and high alkaline phosphatase suggest the diagnosis of hyperparathyroidism.
Orthopaedics
null
A 50-year-old man presented with multiple pathological fractures. His serum calcium was 11.5 mg/dl and phosphate was 2.5 mg/dl. Alkaline phosphatase was 940 I.U./dl. The most probable diagnosis is - A. Osteoporosis B. Osteomalacia C. Multiple myeloma D. Hyperparathyroidism
Hyperparathyroidism
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Omenn syndrome is an autosomal recessive form of severe combined immunodeficiency (SCID) characterized by erythroderma (skin redness), desquamation (peeling skin), alopecia (hair loss), chronic diarrhea, failure to thrive, lymphadenopathy (enlarged lymph nodes ), eosinophilia, hepatosplenomegaly , and elevated serum Ref Harrison20th edition pg 1278
Dental
miscellaneous
Omenn syndrome is A. Squamous cell carcinoma B. Chronic mucocutaneous candidiasis C. IgA deficiency D. SCID
SCID
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Cisatracurium is preferred over atracurium as it does not release histamine. Onset of action is same for both atracurium and cisatracurium. Cis-atracurium has longer duration of action.
Anaesthesia
Muscle relaxants
Cis atracurium is preferred over atracurium due to advantage of A. Rapid onset B. Sho duration of action C. No histamine release D. Less cardiodepressant
No histamine release
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Ulcer serpens is a characteristic ulcer caused by pneumococci, it has a tendency to creep over cornea in a serpiginous fashion. Greyish white/ yellowish disc like lesion near centre of cornea, opacity is greater at the edges than at the centre paicularly well marked in one direction. Violent iritis is present and there may be a definite hypopyon which vary in size from hour to hour. Ref: Parson's diseases of eye, 21st edn, page:199
Ophthalmology
null
Ulcer serpens is caused by: A. Pneumococci B. Pseudomonas C. Staph aureus D. Fusarium
Pneumococci
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Sensory root by the auriculotemporal nerve. Sympathetic root is by the sympathetic plexus around middle meningeal aery. Secretomotor root is by the lesser petrosal nerve from the tympanic branch of cranial nerve IX. Motor root is by a branch from nerve to medial pterygoid. Ref BDC volume3,6th edition pg 311
Anatomy
Head and neck
Preganglionic parasympathetic fibres to parotid gland relay at A. Geniculate ganglion B. Otic ganglion C. Sub mandibular ganglion D. Stellate ganglion
Otic ganglion
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Ref: Ananthnarayan R. Paniker CKJ. Textbook of Microbiology. 8th Edition. Hyderabad: Universities Press: 2009. Pg. 389.Explanation:Mycoplasma pneumoniae causes primary atypical pneumoniaEaton (1944) was the first to isolate the causative agent of the disease in hamsters and cotton rats.He was able to transmit the infection later to chick embryos by amniotic inoculation.Because it was filterable, it was considered to be a virus (Eaton agent), but was subsequently shown to be a mycoplasma and named M pneumoniae.
Microbiology
Bacteria
Which is Eaton agent? A. Mycoplasma B. H.influenza C. Klebsiella D. Chlamydia
Mycoplasma
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B. MRP2(Ref: Nelson's 20/e p 1931, 1938)In Dubin Johnson syndrome, ABCC2 gene is affected, that codes for MRP2 protein. Absent function of multiple drug-resistant protein 2 (MRP2), an adenosine triphosphate-dependent canalicular transporter, is the responsible defect, that leads to defective conjugated bilirubin excretion.
Pediatrics
Gastro Intestinal System
Gene encoding which protein is defective in Dubin Johnson syndrome? A. JAG1 B. MRP2 C. ATP7A D. ATP 7B
MRP2
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Van Nuy's prognostic index (VNPI) was designed for DCIS patients, to determine which patients do not required radiotherapy after tumour resection. Size of tumour Width of margins Age of patient Grade Microcalcification (mnemonic: - micro SWAG)
Surgery
Breast
Van-Nuys classification does not include which of the following? A. Patients age B. Size of tumor C. Presence of microcalcification D. Her-2-neu receptor status
Her-2-neu receptor status
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Monoclonal mouse IgG1 antibody against human CD20 Rituximab has been approved by the FDA for the treatment of various lymphoid malignancies, including B-cell non-Hodgkin's lymphoma and B-cell chronic lymphocytic leukaemia also used in treatment of ebola . Ref Harrison20th edition pg 1078
Medicine
Infection
Chimeric human / murine monoclonal antibody'are - A. Adalimumab B. Rituximab C. Muromonab D. Trastuzumab
Rituximab
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All are disinfectants but ethylene oxide is used for sterilizing hea-lung machines ,respiratory sutures ,dental equipments books and clothings. it is unsuitable for fumigating rooms because of its explosive propey. it has been successfully used to sterilise a wide range of materials such as glass metal and paper surfaces clothing plastics soils some foods and tobacco REF:Ananthanarayan & Panicker's Textbook of Microbiology 8th edition pg no:37
Microbiology
general microbiology
Agent used for sterilization - A. Ethylene oxide B. Ionizing radiation C. 2% gluteraldehyde D. Formaldehyde with low pressure steam
Ethylene oxide
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Orexin-containing cell bodies are found exclusively in the lateral hypothalamus (LH), perifornical area (PFA), and dorsomedial hypothalamus (DMH) while orexin-containing fibers and terminals are widely distributed in almost all of the brain regions. Ref: Ganong's Review of Medical Physiology, 22nd Edition, Page 238; New Frontiers in Respiratory Control: XIth Annual Oxford Conference on Modeling ... By Ikuo Homma, 2010, Page 244.
Physiology
null
The cell bodies of orexinergic neurons are present in: A. Locus ceruleus B. Dorsal raphe C. Lateral hypothalamic area D. Hippocampus
Lateral hypothalamic area
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Ans. C: Radial nerve injury Cock-up splint is used for radial nerve palsy (extensors of wrist and metacarpophalangeal joints paralyzed) Splints in Ohopaedics: Aeroplane splint: Brachial plexus injury Von Rosen splint: Congenital dislocation of hip/ DDH Knuckle bender splint: Ulnar nerve injury
Surgery
null
Cock-up splint is used for: September 2011 A. Axillary nerve injury B. Ulnar nerve injury C. Radial nerve injury D. Median nerve injury
Radial nerve injury
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Ans. (a) Catalase positivity Pyoderma (Impetigo Superficial infection of the skin, caused primarily by Group A Streptococci and Staphylococci Usual site of infection are face (paicularly around nose and mouth) and the legs Diagnosis is based on the culture and staining of indeginous lesion. Gram positive cocci if catalase positive, than it is most likely to be Staphylococci and if catalase negative than it is Streptococci
Microbiology
null
A 5-year-old child presents with pustular lesions on the lower legs. The culture from the lesion showed hemolytic colonies on blood agar which were Gram-positive cocci. Provisional diagnosis of Group A streptococcal pyoderma can be done by? A. Catalase positivity B. Optochin sensitivity C. Bile solubility D. Bacitracin sensitivity
Catalase positivity
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Ans. C. Congenital adrenal hypoplasiaExplanationDAX1 mutation is seen in congenital adrenal hypoplasia.DAX1 (dosage-sensitive sex reversal, adrenal hypoplasia critical region, on chromosome X, gene 1) is a nuclear receptor protein encoded by the NROBlgene.DAX1 plays an important role in the normal development of several hormone-producing tissues.The adrenal glands,The pituitary gland andHypothalamusThe testes and ovariesMutations in this gene result in both X-linked congenital adrenal hypoplasia and hypogonadotropic hypogonadism
Pathology
Endocrine
DAX 1 gene Mutation is associated with A. Cushing's disease B. Hashimoto's disease C. Congenital adrenal hypoplaisa D. Addison's disease
Congenital adrenal hypoplaisa
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Fracture temporal bone (more commonly longitudinal) extending to external canal: tympanic membrane is frequently torn and inner ear is spared.Blood or CSF in external and middle ear.Damage to ossicle (most frequent being incudo-stapedial joint) resulting in more severe and permanent conductive deafness.Aseptic necrosis of long process of incus can lead to late conductive deafness. Tympanic membrane is normal and mobile: In hemotympanum - tympanic membrane will appear red/blue (due to presence of blood pigments) so it is ruled out. ... Logan Tumer1Oth/ed p441 Otosclerosis and EAC sclerosis do not occur in case of head injury and hence they are ruled out
ENT
null
Post head injury, the patient had conductive deafness and on examination, tympanic membrane was normal and mobile. Likely diagnosis is: A. Distoion of ossicular chain B. Hemotympanum C. EAC sclerosis D. Otosclerosis
Distoion of ossicular chain
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Ans. B Peripheral gangliaRef: Gray's, 41st ed. pg. 231, 303Lower motor neuron (LMN): It consists of-* Anterior horn cells or homologous cells in brainstem* Anterior spinal nerve root* Peripheral nerve
Anatomy
Neuroanatomy
Which of the following is not a part of lower motor neuron? A. Anterior nerve root B. Peripheral ganglia C. Peripheral nerve D. Anterior horn cells
Peripheral ganglia
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Ans. is 'c' i.e., DM o Diabetes mellitus is the most common cause of Renal failure.
Medicine
Chronic Kidney Disease and Uremia
Most common cause of CRF in adults is - A. TB B. HTN C. DM D. Scleroderma
DM
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Howell-Jolly bodies are spherical or ovoid eccentrically located granules in stroma of erythrocytes in stained preparations. These represent nuclear remnants and these occur most frequently after: 1. Splenectomy 2. Megaloblastic anemia 3. Severe hemolytic anemia
Pathology
Blood disorder
A 40 years old male had undergone splenectomy 20 years ago. Peripheral blood smear examination would show the presence of: A. Dohle bodies B. Hypersegmented neutrophils C. Spherocytes D. Howell-Jolly bodies
Howell-Jolly bodies
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Ans. is 'b' i.e., Study of social problems which cause disease in population o Social Pathology: Is the study of social problems which undermine the social, psychological or economical health of the populations; it is used to describe relationship between disease and social conditions. o Social pathology is uncovered by 'Social surveys'.
Social & Preventive Medicine
null
Social pathology is- A. Change in disease pattern due to change in lifestyle B. Study of social problems which cause disease in population C. Conflicts arising from new oppounities in transitional societies D. Study of human relationships and behaviour
Study of social problems which cause disease in population
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+ - Total + a (46) b (10) 56 - c (34) d (40) 74 Sensitivity = x 100 = 46/80 x 100 = 0.575 Specificity = x 100 = 40/50 x100 = 0.80 LR+ = = 0.575/ (1-0.80) = 2.875 LR- = = 1-0.575 / 0.80 = 0.531
Social & Preventive Medicine
Sensitivity, Specificity, PPV, NPV
A total of 130 patients were screened for Disc prolapse by CT scan and confirmation of the disease was made by discectomy operation. Out of 56 patient who screened positive in CT-scan, 46 were confirmed for disease in operation. Rest 74 patient who were screened negative in CT scan, only 40 patient were confirmed negative for the disease in operation. Calculate the Positive and Negative likelihood ratio. A. 2.875 and 0.531 B. 6.07 and 1.12 C. 1.12 and 6.07 D. 0.531 and 2.875
2.875 and 0.531
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The image shows a reticular net-like appearance called as livedo reticularis- mottled reticulated vascular pattern that appears as a lace-like purplish discoloration of the skin. The discoloration is caused by swelling of the venules owing to obstruction of capillaries by small blood clots.
Medicine
Vasculitis
A patient with hypeension presents with following skin lesions. What is the diagnosis? A. Livedo reticularis B. Drug-induced rash C. Anaphylactoid purpura D. Erythromelalgia
Livedo reticularis
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Ans. is 'c' i.e., Isoflurane Anaesthetic agents of choice for vaous conditions Day care : Ischemic hea disease : Congenital hea disease Left to right shunt : Right to left shunt : CHF : Shock To produce delibrate hypotenion Epilepsy : For electroconvulsive therapy : Thyrotoxicosis : Cardiac surgery : Neurosurgery : Propofol Etomidate Isoflurane Ketamine Ketamine Ketamine Isoflurane Thiopentone Methohexitone Thiopentone Isoflurane Isoflurane
Anaesthesia
null
Inhalational agent of choice for neurosurgery ? A. Halothane B. Enflurane C. Isoflurane D. N20
Isoflurane
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Anti hypeensive agents like thiazides and -blockers can cause impotence. It is maximum with thiazides among anti-hypeensive drugs and is thought to be due to volume depletion.
Pharmacology
Endocrinology
Thiazides can cause A. Hyperkalemic paralysis B. Hypouricemia C. Hypolipidemia D. Impotence
Impotence
cc4c70f2-1ddb-41b1-b274-e90d3ada0773
Robbins basic pathology 9th edition page no 34 Endothelial cell contraction leading to ntercellular gaps in postcapillary venules is the most common cause of increased vascular permeability. Endothelial injury occurs rapidly after the binding of histamine, bradykinin, leukotiens, and many other mediators to specific receptors.
Pathology
General pathology
Increased permeability in acute inflammation is due to - A. Histamine B. IL-2 C. TGF-b D. FGF
Histamine
ff039078-23b8-420d-8d61-3d882970727a
Central clearing: Tinea Central Crusting: Leishmaniasis Central Scarring: Lupus vulgaris.
Dental
null
"Central clearing" is seen with A. Leishmaniasis B. Lupus vulgaris C. Tinea D. Histoplasmosis
Tinea
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Rests of Serres (Dental lamina) OKC Lateral periodontal cyst Glandular odontogenic cyst Gingival cyst of infants and adults
Pathology
null
Cyst which develops from Rests of Serres is: A. Residual cyst B. Odontogenic keratocyst C. Dentigerous cyst D. Radicular cyst
Odontogenic keratocyst
b6bcde84-2467-4a92-a83c-8cebf448b17a
The most common cause of sudden cardiac arrest is ischemic heart disease. The risk of sudden death is increased with worsening atherosclerotic coronary arterial narrowing. However, the first event with an acute coronary syndrome is typically an arrhythmia, and this is why resuscitation, including defibrillation, can be successful, and survivors may have no ECG or enzyme changes to suggest myocardial infarction has occurred. Inflammation with infarction or infection takes days to develop. Sudden valvular incompetence from papillary muscle rupture, or wall rupture, may complicate an infarction 3 to 7 days following the initial event.
Pathology
C.V.S
A study of persons receiving emergent medical services is conducted. It is observed that 5% of persons with sudden cardiac arrest who receive cardiopulmonary resuscitation survive. Which of the following is the most likely mechanism for cardiac arrest in these survivors? A. Arrhythmia B. Infarction C. Inflammation D. Valve failure
Arrhythmia
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.standardised moality ratio is the ratio of total number of deaths that occur in the study group to the number of deaths that would have been expected to occur if that study group had experienced the death rates of a standardised population.it gives a measure of the likely excess risk o moality due to the occupation.it is used to compare the death rates of two countries. ref:park&;s textbook,ed 22,pg no 57
Social & Preventive Medicine
Epidemiology
Death rates of two countries are best compared by - A. Crude death rate B. Propoional crude death rate C. Standardized moality rate D. Age specific death rate
Standardized moality rate
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Cornea The cornea is the first and most powerful refracting surface of the eye. Light passes through the transparent cornea on its way to the retina. It has a greater curvature than the rest of the eyeball and a refractive power of approximately 44 dioptres.
Ophthalmology
Cornea
According to biophysics, in which pa of eye does maximum refraction occur? A. Cornea B. Aqueous humor C. Centre of the lens D. Periphery of the lens
Cornea
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Disease Repeat Fragile X syndrome CGG Friedreich's Ataxia GAA Myotonic dystrophy CTG Spinobulbar muscular atrophy (Kennedy disease), Spinocerebellar ataxia, Huntington's disease CAG
Biochemistry
Genetic Disorders
Which of the following trinucleotide repeat disorder and the repeat is wrongly paired? A. Kennedy disease - CAG B. Friedreich's Ataxia - CGG C. Myotonic dystrophy - CTG D. Huntington's chorea - CAG
Friedreich's Ataxia - CGG
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TRANSFORMATION: it is the transfer of genetic information through the agency of free DNA REF:Ananthanarayan and Panicker's Textbook ofMicrobiology 8thEdition pg no:63
Microbiology
general microbiology
The mechanism of genetic transfer where a phage serves as a vehicle is - A. Transformation B. Translation C. Conjugation D. Lysogeny
Transformation
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Dieulafoy's lesion Large (1- to 3-mm) submucosal aery that protrudes through the mucosa. It is not associated with a peptic ulcer. It can lead to massive bleeding. Usually is located in the gastric fundus, within 6 cm of the GE junction. Ref: Sleisenger and Fordtran's, E-9, P-299.
Medicine
null
The usual location of dieulafoy's lesion is in the: A. Fundus of the stomach B. Body of the stomach C. Pylorus of the stomach D. First pa of the duodenum
Fundus of the stomach
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Mucormycosis can affect the upper respiratory, pulmonary, cutaneous, gastrointestinal, and central nervous systems. The clinical manifestation of the condition is headache with nasal discharge and sinus pain. Infection quickly spreads from the sinuses to contiguous structures. Ocular involvement manifests as proptosis, periorbital edema, ophthalmoplegia, or vision loss. Angioinvasion by hyphae leads to a black necrotic eschar on the palate or nasal mucosa. Infection spreading from the ethmoid sinus to the frontal lobe can cause obtundation. Mucormycosis in immunocompromised patients typically occurs with spore inhalation or through skin lacerations. Hyperglycemia, usually with related metabolic acidosis, is the most common underlying condition associated with mucormycosis. Rhinocerebral mucormycosis is rapidly fatal and should be suspected in high-risk patients presenting with sinusitis, paicularly those with diabetes and metabolic acidosis. Altered mental status that persists after metabolic abnormalities are corrected suggests possible central nervous system (CNS) infection. Diagnosis is based on histopathology with culture confirmation Treatment requires prompt and aggressive surgical debridement and antifungal therapy with amphotericin B ref - pubmed.com
Medicine
Endocrinology
A 40-year old diabetic patient presents with proptosis of one eye and black eschar over palate. The likely organism is: A. Pseudomonas B. Candida C. E. coli D. Mucor
Mucor
b152c872-cccf-4b80-8e4d-7b5feee8e583
From superior to inferior (important structure on X-ray sholder) :- Clavicle : Acromian : Coracoid : Superior margin of humeral head : greater tubercle : anatomical neck : surgical neck.
Radiology
null
In normal X–ray of shoulder which is'superior most structure – A. Greater tubercle B. Surgical neck of humerus C. Coracoid process D. Head of humerus
Coracoid process
5fe2e075-3538-4309-baa9-c5dfd25f3af0
(B) Acute PID # Pelvic inflammatory disease (PID) is an inflammatory disorder of the uterus, fallopian tubes, and adjacent pelvic structures. Risk factors for PID include young age at first intercourse, multiple sexual partners, intrauterine device (IUD) insertion, and tobacco smoking. A delay in diagnosis or treatment can result in long-term sequelae such as tubal infertility.> Patients can present with a variety of symptoms, ranging from lower abdominal pain to dysuria. A direct correlation exists between the incidence of STDs and pelvic inflammatory disease (PID) in any given population.> Pain is present in more than 90% of documented cases and is by far the most common presenting symptom. Usually, pain is described as dull, aching, and constant; it begins a few days after the onset of the last menstrual period and tends to be accentuated by motion, exercise, or coitus. Pain from PID usually lasts less than 7 days; if pain lasts longer than 3 weeks, the likelihood that PID is the correct diagnosis declines substantially.> Abnormal vaginal discharge is present in approximately 75% of cases.> Unanticipated vaginal bleeding coexists in about 40% of cases.> Temperature higher than 38degC (30%), nausea, and vomiting manifest late in the clinical course of the disease.
Gynaecology & Obstetrics
Miscellaneous (Gynae)
A 24-vear-old lady with 24 hrs comes with complains of pain in the right iliac fossa, vomiting, central dyspareunia, rebound tenderness and with a temperature of 37degC. Pregnancy test negative. The probable diagnosis is A. Acute appendicitis B. Acute PID C. Ectopic Pregnancy D. Endometriosis
Acute PID
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Ref Harrison 19 th ed pg 1763 The use of a Swan-Ganz catheter permits measurement of PCWP and helps differentiate high-pressure (cardiogenic) from normal- pressure (noncardiogenic) causes of pulmonary edema. High altitude has been grouped together as one of the miscellaneous causes for ARDS reflecting pulmonary oedema with a normal PCWP
Medicine
C.V.S
Normal PCWP with pulmonary oedema is seen in A. Left atrial myxoma B. High altitude C. Pulmonary vein obstruction D. Pulmonary aery obstruction
High altitude
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CSF findings in tubercular meningitis includes: Elevated opening pressure High leukocyte count ( 1000/microl) predominantly lymphocytes Increased protein (100 - 800/mg/dl) Low glucose AFB seen on direct smear of CSF Culture of CSF is diagnostic and is the gold standard
Medicine
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Which of the following is not a CSF finding in tubercular meningitis? A. Low sugar B. Lymphocytic pleocytosis C. High protein D. Opening pressure is low
Opening pressure is low
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Ans. is 'c' i.e., Transduction (Ref: Ananthanarayan, 9th/e, p. 59 and 8th/e, p. 63, 67, 681)Acquiring antibiotic resistance by viral colony (bacteriophage) is by transduction.
Microbiology
General
Property of acquiring antibiotic resistance from viral colony is by: A. Transference B. Conjugation C. Transduction D. Mutation
Transduction
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It is a peripheral parasympathetic ganglion which relays secretomotor fibres to the parotid gland. Topographically, it is intimately related to the mandibular nerve, but functionally it is a part of the glossopharyngeal nerve. The sympathetic root is derived from the plexus on the middle meningeal artery. It contains postganglionic fibres arising in the superior cervical ganglion. The fibres pass through the otic ganglion  without relay and reach the parotid gland via the auriculotemporal nerve. They are vasomotor in function. The sensory root comes from the auriculotemporal nerve and is sensory to the parotid gland.
Anatomy
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The Otic Ganglion: A. Is in relation to maxillary nerve B. Receives preganglionic parasympathetic fibers, through the greater superficial petrosal nerve C. Sends postganglionic parasympathetic fibers to auriculotemporal nerve D. Is related to the tensor tympani
Sends postganglionic parasympathetic fibers to auriculotemporal nerve
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Major histocompatibility complex also called the human leucocyte antigen (HLA) is a 4 megabase region on chromosome 6. The region is densely packed with genes. The gene encodes two major proteins or antigens i.e., MHC I and MHC
Pathology
null
Gene for major histocompatibility complex is located on which chromosome? A. Chromosome 10 B. Chromosome 6 C. X chromosome D. Chromosome 13
Chromosome 6
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Daily water turnover (mL) in the gastrointestinal tract
Physiology
Gastrointestinal System
Which of the following is WRONG A. Secretion mL/Day Saliva 1500 B. Secretion mL/Day Stomach 2500 C. Secretion mL/Day Bile 700 D. Secretion mL/Day Pancreas 1500
Secretion mL/Day Bile 700
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D i.e. Abductor pollicis longus Bennett's Fracture dislocation is paial aicular fracture of 1st metacarpal baseQ with trapezium- metacarpal dislocation / subluxation(2. Maintenence of reduction is difficult d/t pull of abductor pollicis longusQ & adductor pollicis muscles. Thumb- Carpo - Meta Carpal (CMC) Fracture Dislocations The majority of thumb CMC joint injuries are fracture dislocationQ rather than pure dislocations. The majority of thumb metacarpal base fractures are intra - aicularQ. These intra- aicular fractrues are of two types- Bennett's Fracture Dislocation It is paial aicular fracture of 1,, metacarpal base with trapezium- metacarpal joint dislocationQ The displacement is driven primarily by abductor pollicis longusQ and adductor pollicis resulting inflexion, supination and proximal migration. It is paial aicular fractureQ of 1s, metacarpal base extending into CMC joint & is unstable. In which small volar- radial fragment of metacarpal aicular surface remains attached to the anterior oblique ligament, while the remainder of the metacarpal aicular surface and shaft is displaced proximally, radially and into adduction in response to the force of the adductor pollicis and abductor pollicis longusQ. Small triangular fragment has remained in contact with the medial half of the trapeziumQ while the remainder of the thumb has subluxated proxamilly Rolando's Fracture Dislocation It is complete aicular fracture of base of is metacarpal. It involves whole aicular surface with comminuted Tor Y intra aicular fracture. * There is disagreement regarding the primary stabilizing ligament in preventing dislocation of 1st CMC joint between deep anteror oblique & dorsoradial ligament. Although the deep anterior oblique was previously Considered the primary stabilizer , more recent research ours the dorsoradial ligament.
Surgery
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During fixation of Bennett's fracture, which muscle hinders it A. Extensor pollicis brevis B. Flexor pollicis brevis C. Flexor pollicis longus D. Abductor pollicis longus
Abductor pollicis longus
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Crescents are feature of RPGN. They are made up of parietal epithelial cells, fibrin and monocytcs / Macrophages.
Pathology
null
Crescents are derived from A. Mesangium + fibrin + macrophage B. Visceral epithelial cells + fibrin + macrophage C. Parietal epithelial cells + fibrin + macrophages D. Tubular epithelium + fibrin + macrophages
Parietal epithelial cells + fibrin + macrophages
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Four of the B vitamins are essential in the citric acid cycle and hence energy-yielding metabolism: (1) riboflavin, in the form of flavin adenine dinucleotide (FAD), a cofactor for succinate dehydrogenase; (2) niacin, in the form of nicotinamide adenine dinucleotide (NAD), the electron acceptor for isocitrate dehydrogenase, a-ketoglutarate dehydrogenase, and malate dehydrogenase; (3) thiamin (vitamin B1), as thiamin diphosphate, the coenzyme for decarboxylation in the a-ketoglutarate dehydrogenase reaction; and (4) pantothenic acid, as pa of coenzyme A, the cofactor attached to "active" carboxylic acid residues such as acetyl-CoA and succinyl-CoA Ref: Harper 28th edition, chapter 17.
Biochemistry
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Number of vitamins required in citric acid cycle is: A. 2 B. 3 C. 4 D. 5
4
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Spermicidal agents provide a physical barrier to sperm penetration and a chemical spermicidal action. Active ingredient is nonoxynol-9 or octoxynol-9. Spermicides must be deposited high in the vagina in contact with the cervix sholy before intercourse. Duration of maximal effectiveness is usually no more than 1 hour. Therefore, they must be reinseed before repeat intercourse.
Gynaecology & Obstetrics
FMGE 2019
Spermicidal cream which is used in contraceptives? A. Gossypol B. Nonoxynol-9 C. Cent chroman D. Clomiphene
Nonoxynol-9
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The sho gastric veins, four or five in number, drain the fundus and left pa of the greater curvature of the stomach, and pass between the two layers of the gastrosplenic ligament to end in the splenic vein or in one of its large tributaries. ref -
Anatomy
Abdomen and pelvis
Sho gastric vessels are present in which ligament A. Lienorenal B. Gastrophrenic C. Gastrosplenic D. Gastrocolic
Gastrosplenic
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The increasing oxygen saturation and the high aerial po2 causes the muscle of ductus to constrict and eventually closes the ductus aeriosus which eventually becomes ligamentum aeriosum.Anatomical closure of ductus aeriosus occurs within 10 to 25 days.Flow through ductus venosus disappears by the 7th day of postnatal life.
Pediatrics
All India exam
In full-term neonates, the ductus aeriosus closure is due to A. Cardiac output B. Prostaglandins C. Low pressure CO2 D. Low pressure O2
Low pressure O2
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Burkitt lymphoma (Appearance: Starry-sky pattern)
Unknown
null
Typical appearance of Tumour cells and Macrophages on Histological section indicate A. ALCL B. CLL C. Diffuse large B cell lymphoma D. Burkitt's lymphoma
Burkitt's lymphoma
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Ref: style="font-size: 1.04761904761905em; font-weight: bold; font-family: Times New Roman, Times, serif; margin: 0 0 0 8px; text-indent: 0; text-align: left">Explanation:Immunoglobulin A (IgA) nephropathy or Berger's diseaseIt is the most common form of primary glomerulonephritis in the worldIgA nephropathy is characterized by the accumulation in mesangial areas of immune complexes containing polymeric IgA1.The pathogenesis of this disease involves the deposition of polymeric and undergalactosylated IgAl in the mesangium.Quantitative and structural changes of IgA 1 play a key role in the development of the disease due to functional abnormalities of two IgA receptors: The Fc alpha R (CD89) expressed by blood myeloid cells and the transferrin receptor 1CD71) on mesangial cells. Abnormal IgA induce the release of soluble CD89 which is responsible for the formation of circulating IgA complexes.These complexes may be trapped by CD71 that is overexpressed on mesangial cells in IgA nephropathy patients allowing pathogenic IgA complex formation.
Pathology
Miscellaneous (Urinary Tract)
IgA nephropathy over expresses: A. CD 51 B. CD 61 C. CD 71 D. CD 81
CD 71
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A first degree tear involves the vaginal mucosa or perineal skin, but not the underlying tissue. In a second degree episiotomy, the underlying subcutaneous tissue is also involved, but not the rectal sphincter or rectal mucosa. In a third degree tear, the rectal sphincter is affected. A fouh-degree episiotomy involves a tear that extends into the rectal mucosa.
Pharmacology
All India exam
During the delivery, it is necessary to do an episiotomy. The tear extends through sphincter of the rectum, but the rectal mucosa is intact. How would you classify this type of perineal tear? NOT RELATED-GYN A. Ist Degree B. 2nd degree C. 3rd degree D. 4th degree
3rd degree
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(A) APLA CLINICAL FEATURES OF ANTIPHOSPHOLIPID ANTIBODY SYNDROMEManifestation%Venous Thrombosis and Related Consequences Deep vein thrombosis39Livedo reticularis24Pulmonary embolism14Superficial thrombophlebitis12Thrombosis in various other sites11Arterial Thrombosis and Related Consequences Stroke20Cardiac valve thickening/dysfunction and/or Libman- Sacks vegetations14Transient ischemic attack11Myocardial ischemia (infarction or angina) and coronary bypass thrombosis10Leg ulcers and/or digital gangrene9Arterial thrombosis in the extremities7Retinal artery thrombosis/amaurosis fugax7Ischemia of visceral organs or avascular necrosis of bone6Multi-infarct dementia3Manifestation%Neurologic Manifestations of Uncertain Etiology Migraine20Epilepsy7Chorea1Cerebellar ataxia1Transverse myelopathy0.5Renal Manifestations Due to Various Reasons(Renal Artery/Renal Vein/Glomerular Thrombosis,Fibrous Intima Hyperplasia)3Osteoarticular Manifestations Arthralgia39Arthritis27Obstetric Manifestations (Referred to the Number of Pregnancies) Preeclampsia10Eclampsia4Fetal Manifestations (Referred to the Number of Pregnancies) Early fetal loss (<10 weeks)35Late fetal loss (10 weeks)17Premature birth among the live births11Hematologic Manifestations Thrombocytopenia30Autoimmune hemolytic anemia10
Gynaecology & Obstetrics
Miscellaneous (Obs)
A lady presents with headache, recurrent abortions, and cavernous sinus thrombosis. The diagnosis is A. APLA B. Cervical incompetence C. Unexplained D. Pre eclampsia
APLA
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For frost-bite rewarming, the temperature should be: 40-44 degree C Gently rewarm frostbitten areas. Soak the frostbitten areas in warm water -- 104-111 degree F (40-44 DEGREE C). If a thermometer isn't available, test the water by placing an uninjured hand or elbow in it -- it should feel very warm -- not hot. Rewarming takes about 30 minutes. Stop the soaking when the skin becomes its normal colour or loses its numbness.
Surgery
NEET Jan 2020
For frost-bite rewarming, the temperature should be: A. 20? C B. 25? C C. 37? C D. 42? C
42? C
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Ans. is 'b' i.e., Hypochondrium from lumbar region
Anatomy
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Transpyloric plane separates ? A. Hypogastrium from lumbar region B. Hypochondrium from lumbar region C. Iliac fossa from lumbar region D. Umbilical region from lumbar region
Hypochondrium from lumbar region
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A prolonged BSP dye excretion test is diagnostic of Dubin Johnson syndrome BSP is a dye which is removed from circulation by the same mechanism as bilirubin.
Medicine
null
The test used to diagnose Dubin Johnson syndrome is- A. Bromsulphalein test (BSP) B. Scrum transaminases C. Hippuratc test D. Gamma glutamyl transferase level
Bromsulphalein test (BSP)