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2643d26f-638f-4d2c-ad5b-387ff1481556 | ANSWER: (C) ConstipationREF: KDT 6th edition page 457Tolerance is exhibited to all actions except meiosis and constipation | Pharmacology | Opioids | The effect of morphine which has least tolerance is?
A. Analgesia
B. Respiratory depression
C. Constipation
D. Bradycardia
| Constipation |
ae711017-66be-45f1-87f0-293e670c88b1 | Meralgia Paraesthetica results from compression neuropathy of the lateral cutaneous nerve of thigh. It is also called Bernhardt-Roth syndrome. This nerve can be compressed as it runs through the inguinal ligament, just medial to the Anterior superior Iliac spine. Pain, numbness, tingling and paresthesia localised to anterolateral aspect of thigh. Metabolic disorder most notably diabetes is identified as the potential cause of this condition. Ref: Apley's System of Ohopedics and Fractures 8th Edition, Page 252; Lippincott's Primary Care Ohopedics, 2008, Page 87. | Surgery | null | 'Meralgia paresthetica' is due to the compression of which off the follwoing nerves?
A. Medial cutaneous nerve of thigh
B. Lateral cutaneous nerve of thigh
C. Sural nerve
D. Femoral nerve
| Lateral cutaneous nerve of thigh |
af336b40-2603-4fb5-b889-3d26e32ad926 | Ans. is 'd' i.e., Na+-amino acid transport Transport mechanismExamplesSimple diffusionMovement of fats, oxygen, CO2 through lipid portion of membraneFacilitated diffusionMovement of glucose and some amino-acidsOsmosisMovement of water into and out of the cellPrimary active transportIons K+, Na+, Ca++, H+Secondary active transportGlucose or amino-acid into the cell along Na+ (Symport or cotransport) Ca+2, H+ out of the cell against Na+ (Antiport or countertransport) | Physiology | Transport Across Cell Membrane | Example of secondary active transport-
A. K+ transport
B. Water Transport
C. Transport of oxygen
D. Na+-amino acid transport
| Na+-amino acid transport |
4a7e2645-fa04-4e3a-9527-db58296dee3d | Yolk sac tumor only occurs as a pure tumor in young males (at about 3 years of age). In adults, yolk sac tumors are pa of mixed germ cell tumors. One characteristic feature of yolk sac tumor is Schiller-Duval bodies, which resemble endodermal sinuses. Schiller-Duval bodies have a capillary at the core and are surrounded by a visceral and a parietal layer (i.e., resemble primitive glomerulus). Ref: Wyatt C., Butterwoh IV J.F., Moos P.J., Mackey D.C., Brown T.G. (2008). Chapter 17. Pathology of the Male and Female Reproductive Tract and Breast. In C. Wyatt, J.F. Butterwoh IV, P.J. Moos, D.C. Mackey, T.G. Brown (Eds), Pathology: The Big Picture. | Gynaecology & Obstetrics | null | Microscopic examination of a specimen shows 'Schiller-Duval bodies'. This most probably will have:
A. Seminoma
B. Choriocarcinoma
C. Yolk sac tumor
D. Embryonal carcinoma
| Yolk sac tumor |
e11e0a84-54e0-4678-9060-26a198f5bce8 | Ventimask (venturi mask) is a fixed performance (high flow) oxygen delivery device.
Nasal cannula, non-rebreathing mask (Hudson mask) and simple mask are variable performance (low flow) devices. | Anaesthesia | null | Fixed performance device is –
A. Ventury mask
B. Nasal cannula
C. Simple mask
D. Non rebreathing mask
| Ventury mask |
8a0b0d9a-79c0-4f79-9880-e590026bad08 | Ans. A. Bodya. Vertebral bodies mainly develop from ventral sclerotome (VS) and thus hemivertebra is a defect of VS.b. Hemivertebra can lead to defects in the vertebral column - scoliosis.c. Posterior vertebral arches (PVA) contribute mainly to the lamina & spines. PVA are contributed by the dorsal sclerotome. | Anatomy | Thorax | Hemivertebra is a defect of:
A. Body
B. Transverse process
C. Spine
D. Posterior vertebral arches
| Body |
d518d93d-6d27-499d-bdd9-68814eeef581 | Biosynthesis of urea occurs in five steps.
1) Carbamoyl phosphate synthase-I (CPS-I), a mitochondrial enzyme, catalyzes the formation of carbamoyl phosphate by condensation of CO2 and ammonia.
Two molecules of ATP are required for the reaction. CPS-I is the rate-limiting enzyme of the urea cycle. It is an allosteric enzyme and allosterically activated by N-acetyl glutamate.
2) Ornithine transcarbamylase catalyzes the formation of citrulline from carbamoyl phosphate and ornithine.
3) Argininosuccinate synthase catalyzes the formation of argininosuccinate from citrulline and aspartate.
This reaction requires 1ATP, but 2 high energy phosphate bonds are consumed as ATP is converted to AMP + PPi.
The amino group of aspartate provides one of the two nitrogen atoms that appear in urea (The other one is provided by ammonia NH4).
4) Argininosuccinate lyase (argininosuccinase) catalyzes the cleavage of argininosuccinate into arginine and fumarate.
Fumarate enters in TCA cycle.
5) Arginase catalyzes the formation of urea from arginine by hydrolytic cleavage of arginine to yield urea and ornithine.
Ornithine is thus regenerated and can enter mitochondria to initiate another round of the urea cycle. | Biochemistry | null | Not a metabolic product of urea cycle-
A. Citrulline
B. Ornithine
C. Alanine
D. Arginine
| Alanine |
74cebd18-4025-4732-b117-fde9b4d81453 | "Allowable normal range of variation in observation, is conventionally taken between 3'd and 97th percentile curves" -Ghai
This female child has weight (50 th percentile) and height (75th percentile) in normal range of variation (3rd-97th percentile).
So, nothing should be done actively and the parent should be assured that weight and height of the child are within normal range. | Pediatrics | null | A mother comes with her 3 year old female child with complain of that child is not eating anything. Her weight is 11 kg (50th percentile) and height is 88 cm. (75th percentile). What should be done next –
A. Vitamin rich tonic to be given
B. Forceful eating
C. Nothing should be done actively and assure the parent
D. Complete investigation for UTI
| Nothing should be done actively and assure the parent |
ddcf5f2f-c9a2-4c2e-ba72-904e1c5e2b78 | Pelvic tuberculosis is an absolute contraindication for IUD inseion. Absolute contraindications for IUD Relative contraindications for IUD Suspected Pregnancy PID Vaginal Bleeding of undiagnosed etiology Ca Cervix,Uterus or Adnexa and other pelvic tumours Previous Ectopic Pregnancy Anaemia Menorrhagia History of PID since last pregnancy purulent cervical discharge Congenital uterine malformations Unmotivated person | Social & Preventive Medicine | Natural Methods, Barrier Methods, IUDs, OCPs | IUCD must not be used in a woman with-
A. Genital herpes with severe non-purulent discharge
B. Pelvic tuberculosis
C. AIDS on ARV therapy
D. Recto-vaginal fistula
| Pelvic tuberculosis |
92e6d38b-7f7b-480d-b81e-07533d8f24d8 | Ans. is 'b' i.e., II o Ten different mammalian Toll like receptors (TRRs) have been identified --> TLR 1 to 10. o TLRs are involved in responses to widely divergent types of molecules that are commonly expressed by microbial but not mammalian cells. TLR Microbial ligand molecules Peptidoglycan of Gram (+)ve bacteria zymosan of fungi GPI anchor of Trypanosomes Lipoarabinomannan of mycobacteria LPS (endotoxin) of Leptospira Lipoproteins of bacteria Double - stranded DNA of viruses LPS (endotoxin) of all other gram (-)ve bacteria HSF 00 of chlamydia Flagellin of bacteria CpG DNA of bacteria and protozoa Note ? o Bacterial endotoxin of all gram (-)ve organisms, bind to TLR-4, except Leptospira. o Endotoxin of leptospira binds to TLR-2. | Pathology | null | Which toll like receptors are involved in action of bacterial endotoxins -
A. I
B. II
C. III
D. V
| II |
0daffc3e-eb67-4a55-bb29-481fa7dc17ec | A mucocele is an epithelial lined,mucus containing sac completely filling the sinus and capable of expansion: Mucocele are most commonly formed in frontal sinus followed by Ethmoid,sphenoid and maxillary sinuses. Mucocele of frontal sinus presents as a swelking in the floor of frontal sinus above the inner canthus.Itbdisplaces the eyeball forward,downward and laterally. Ref Dhingra 6/e,p 198;Tuli 1/e,p 196. | ENT | Nose and paranasal sinuses | Mucocelr is commonly seen in sinus:
A. Frontal
B. Maxillary
C. Ethmoid
D. Sphenoid
| Frontal |
3d881fde-4a5a-4515-ab42-5ac796910ca9 | ANSWER: (B) MRIREF: Surgical management of pain by Kim Burchiel Page 658, Neurology by Jon Brillman 8f Scott Khan page 110EMG and nerve conduction studies are done to identity the site of entrapment. Imaging is done to rule out any occult fracture and MRI for visualization of entrapped nerve in the tunnel. MRI is the imaging investigation of choice as it demonstrated soft tissue like nerve, muscle and tendon. MRJ is sensitive for changes in compressed or entrapped nerves | Radiology | Brain Imaging: Anatomy, Trauma, and Tumors | Investigation of choice for Entrapment Neuropathy is?
A. CT
B. MRI
C. Clinical exam
D. SPECT
| MRI |
c60a5450-bafb-45ff-a9c7-c556fdb91c13 | Oral cholecystography (Graham Cole Test) Once considered the diagnostic test of choice for gallstones, oral cholecystography has been replaced by ultrasonography It involves oral administration of a Radiopaque compound that is absorbed, excreted by the liver, and passed into the gallbladder Successful visualisation of GB in oral cholecystography depends on Blood flow to liver Ability of the liver cells to excrete dye into the bile (functioning liver) Patency of hepatic and cystic duct system Ability of GB to concentrate to excreted dye (by absorbing water) Ref: schwaz's principle of surgery 10th edition Pgno : 1141 | Anatomy | G.I.T | Graham Cole test refers to
A. Oral cholecystography
B. Intravenous cholangiography
C. Pre operative cholangiography
D. Post operative cholangiography
| Oral cholecystography |
7013a79a-27e8-41e3-905e-3029db80aed1 | Ans. is 'c' i.e., Axons o Nodes of Ranvier are periodic gaps in the myelin sheath on the axon.o Neuron is the functional unit (basic unit of nervous tissue).o It is specialized for the function of reception, integration and transmission of information in the body,o The basic structure of neuron is best studied in a spinal motor neuron,o This cell has a 'cell body (soma)' with 5-7 small processes called 'dendrites'.o There is a long process called 'axon' that originate from "axon hillock (A thickned area of cell body from which axon originates)".o The first portion of the axon is called "initial segment".o In a motor neuron, the axon hillock and the initial segment of axon have the low est threshold for excitation0o Functionally speaking, the neuron can be divided into four zones : -Dendrides and Soma (cell body) - Receptor zoneAxon hillock of body & initial segment of axon - Generator area (Nerve impulse is generated) QAxon (main length) : - Transmitter zone (Transmits nerve impulse).The nerve terminals (Terminal knobs or buttons) : - Release zone (release neurotransmitters). | Physiology | Nerve Physiology | Node of Ranvier is seen in -
A. Cell body
B. Dendrites
C. Axons
D. Terminalbutons
| Axons |
b639153c-1ec5-444d-b310-fcf57350eef4 | The pancreatic islets receive innervation from both the sympathetic and parasympathetic nervous system. Stimulation of the parasympathetic system increases secretion of insulin from the B cells. Stimulation of the sympathetic system increases glucagon secretion from the A cells. Insulin is inhibited by sympathetic stimulation. Ref: Molina P.E. (2013). Chapter 7. Endocrine Pancreas. In P.E. Molina (Ed),Endocrine Physiology, 4e. | Physiology | null | Parasympathetic stimulation of nerves innervating the islets of the pancreas will:
A. Have no effect
B. Increase secretion of insulin from B cells
C. Decrease secretion of insulin from B cells
D. Increase secretion of glucagon from B cells
| Increase secretion of insulin from B cells |
cf44c8de-f1e9-458a-ba21-bad5587dda95 | Rhinophyma or potato tumour is a slow growing benign tumour due to hyperophy of the sebaceous glands of the tip of nose. | ENT | null | Rhinophyma is a slow growing tumour with the following pathology:
A. Hyperophy of the sebaceous glands
B. Hyperophy of sweat glands
C. Hyperplasia of endothelial cells
D. Hyperplasia of epithelial cells
| Hyperophy of the sebaceous glands |
1bfbb88b-7019-4a30-abdb-9127c9e177d8 | Best indicator of protein quality: DIAAS (Digestible indispensable amino acid scores) > PDCAAS (Protein digestibility-corrected amino acid score) >NPU (Net protein utilization). DIAAS =100 x . NPU = 100 x (Nitrogen retained by the body) / (Nitrogen intake) Other indicators: Amino acid score, Biological value, Protein efficiency ratio. Amino acid score = 100x (mg of amino acid per gm of test protein)/(mg of same amino acid per gm of reference protein) Also remember, protein quantity is measured by protein energy ratio = 100 x energy from protein / total energy in diet. | Social & Preventive Medicine | Proteins, Fats, Rich Sources | Best indicator of protein quality:-
A. DIAAS
B. Amino acid score
C. PDCAAS
D. Protein efficiency ratio
| DIAAS |
98c9b278-c141-4761-89ed-cc76e264d488 | AMNIOCENTESIS Amniocentesis is the most commonly performed procedure used to diagnose fetal aneuploidy and other genetic conditions. Indications Diagnosis of fetal genetic disorders Congenital infections Alloimmunization Assessment of fetal lung maturity Therapeutic for polyhydramnios The most common types of prenatal diagnostic tests are: Chromosomal Micro Array to assess copy-number gains or losses karyotype analysis to test for aneuploidy, Fluorescent In Situ Hybridization ( FISH ) to identify gain or loss of specific chromosomes or vchromosome regions It is ideally done at 16-18 weeks.Early amniocentesis can be done between 13-15 weeks. | Gynaecology & Obstetrics | Aboions, Spontaneous & Induced Emergency Contraception (Hey,whats the hurry !) | Amniocentesis for aneuploidy detection is best done at:
A. 10-11 weeks
B. 12-13 weeks
C. 16-18 weeks
D. 20-26 weeks
| 16-18 weeks |
3e1d3db7-0b85-4f99-b51e-e136d4653999 | Image shows patellar fracture. Tension band wiring is also used for: Patellar fracture Olecranon fracture Medial malleolus fracture Tension band wire are loop of wires passed around two bony fragments and then tightened to compress the fragments together. External fixation is done by using screws and is applicable to the tibia and pelvis. Indications of TBW: Fracture patella Fracture olecranon Fracture medial malleolus Fracture greater tuberosity Fracture greater trochanter | Orthopaedics | Fracture Management | What is the treatment modality for the following fracture?
A. Tension band wiring
B. External fixation
C. Plating
D. ORIF
| Tension band wiring |
2c6d0837-72f1-4dad-ab58-0ff17f3c37f2 | 3b FIGO STAGING OF ENDOMETRIAL CANCER STAGE I Cancer confined to corpus uteri IA --> Limited to endometrium IB --> < 1/2 myometrial thickness IC > 1/2 myometrial thickness STAGE II Tumour involves cervix but does not extend beyond uterus (la --> Cervical glandular involvement llb --> Cervical stromal involvement STAGE III Local and/or regional spread Ilia --> Uterine serosa, positive peritoneal washings Adnexal involvement Ilib -4 Vaginal involvement (lymph node absent) 111c --> Positive lymph node no pelvis and paraaoic lymph node STAGE IV Tumour widespread IVa - Bladder or bowel mucosa IVb --> Distant metastasis | Gynaecology & Obstetrics | null | Endometrial cancer involving 50% of endometrium, extending to vagina, lymph nodes negative with positive peritoneal cytology is staged as
A. 3a
B. 3b
C. 3c1
D. 3c2
| 3b |
d037a4fa-2923-473c-b4af-b0a545a54a14 | Ans. is 'a' i.e., Heparin Heparin It is a parenteral indirect thrombin inhibitor. It is a on uniform mixture of straight chain polysaccharides with molecular weight 10, 000 - 20, 000. It contains polymers of two sulfated disaccharide units D glucosamine L iduronic acid and D glucosamine D glucuronic acid. Heparin is the strongest organic acid present in the body. | Pharmacology | null | Mucopolysaccharide having anticoagulant action is?
A. Heparin
B. Phenindione
C. Rivoroxaban
D. Dabigatran
| Heparin |
59323b9a-1f31-42be-93d8-6b292c15a12b | Priapism: It is defined as a persistent painful erection lasting longer than 4 hours irrespective of any sexual stimulation & beyond reaching of orgasm. It is an emergency situation It is of two types: Ischemic priapism Non-ischemic priapism | Surgery | Urethra and penis | Cut off duration for diagnosis of Priaspism is:
A. 1 hour
B. 2 hours
C. 3 hours
D. 4 hours
| 4 hours |
8c19ab09-5f86-42b9-9fa8-58a0cdb55f4f | MC cause of benign biliary stricture is laparoscopic cholecystectomy (operative trauma). | Surgery | Bile duct | Most common cause of biliary stricture is:-
A. CBD stone
B. Trauma
C. Asiatic cholangitis
D. Congenital
| Trauma |
1ef10f1f-2c16-44cf-8493-0c845033795d | The CXR of Coal worker patient shows the presence of hyperinflation in lungs with a tubular appearance of the hea. Lungs appear relatively blacker with flattening of the diaphragm on both sides. The hea appears smaller as lungs are hyper-inflated. These findings are suggestive of emphysema. | Medicine | Interstitial Lung Disease | A 35-year-old coal worker presents with difficulty in breathing on exeion for last 2 years. CXR was performed. What does it show?
A. Emphysema
B. Reticulonodular infiltrates
C. Pulmonary fibrosis
D. Cardiac atrophy
| Emphysema |
0add4cae-029a-43d2-96a2-fa23d821347d | Ref. Foundations of Community medicine. Page. 393 | Unknown | null | Which of the following is not a direct route for transmission of communicable diseases?
A. Skin contact
B. Vertical
C. Droplet nuclei
D. Soil contact
| Droplet nuclei |
c805aedd-61ae-428f-96b4-9091eeed10cf | Coisol, growth hormone and catecholamines increase the blood sugar levels leading to impaired glucose tolerance or diabetes mellitus. whereas hypothyroidism is not associated with the blood sugar levels or diabetes mellitus | Medicine | Diabetes Mellitus | Which is not associated with diabetes mellitus?
A. Cushing syndrome
B. Acromegaly
C. Hypothyroidism
D. Phaeochromocytoma
| Hypothyroidism |
c2a87175-6a21-4a8a-aab4-228331f1ac63 | All inhalational agents increase ICT.
Amongst intravenous agents only ketamine increases ICT. Propofol, etomidate, and barbiturates (thiopentone, methexitone) decrease ICT.
Lidocaine decreases ICT. | Anaesthesia | null | Which of the following anaesthetic agents causes a rise in the Intracranial pressure –
A. Sevoflurane
B. Thiopentone sodium
C. Lignocaine
D. Propofol
| Sevoflurane |
f5a55dad-9c8f-4258-9946-431f3a9e5800 | Odds ratio = ad/bc Breast cancer cases Non-cases Used Ca supplements 75 (a) 25 (b) Did not use Ca supplements 25 (c) 75 (d) 100 100 Odds ratio = ad/bc = 75*75/25*25 = 9 | Social & Preventive Medicine | Case Control Study, Combined Designs | A study is looking at breast cancer of women compared cases with non-cases, and found that 75/100 cases used calcium supplements compared with 25/100 of the non-cases. Calculate Cross product ratio
A. 9
B. 6
C. 3
D. 12
| 9 |
cee6e5ca-4a68-48a6-bba4-cc627de60e54 | Abdominal wall defects Omphalocele- Intestine fails return to the intra-abdominal cavity- Covered by 2 layers* Amnion* Peritoneum- For Small defect - Protrusion of small amounts of bowel- For Large defect - Protrusion of small bowel along with liver- Associated with Trisomy 13, 18, 21- Associated with congenital malformations - CVS > Musculoskeletal system >Gastrointestinal system > Genito urinary system- MC cause of death - congenital malformations- Associated with BECKWITH - WEIDMAN SYNDROME (variant of Wilms tumour)* Hemi hyperophy* Macroglossia* Visceromegaly* Omphalocele* Hepatoblastoma- Poor prognosis (associated with congenital malformations) Gastroschisis- Splitting of abdominal wall from right side with herniation of bowel.- Bowel is exposed, not covered and becomes thickened,matted and edematous- Associated with Intestinal atresiaRisk factors- If mother has history of intake of* Alcohol* Smoking* Aspirin during first trimester* Ibuprofen* Pseudoephedrine- Age of mother - < 20 years age- Not associated with congenital anomalies - so good prognosis | Surgery | Hernia and abdominal wall | A male neonate is born with an omphalocele. This entity can be distinguished from gastroschisis, because in an omphalocele, the protrusion is:
A. Not covered by a sac
B. A defect in the abdominal musculature
C. Associated with Intestinal atresia
D. Associated with congenital malformations
| Associated with congenital malformations |
be321bac-8de5-4f38-a7a3-00dff7519a26 | d. Keratomalacia(Ref: Nelson's 20/e p 3 IB-320, Ghai B/e p 111-112)WHO classification of Vitamin A deficiency:IndicatorCategoryNight blindnessXNConjunctival xerosisX1ABitot's spotsX1BCorneal xerosisX2Corneal ulcerationX3AKeratomalaciaX3BXerophthalmia-related corneal scarsXS | Pediatrics | Nutrition | Stage X3B refers to the following in the classification of vitamin A deficiency:
A. Night blindness
B. Corneal xerosis
C. Conjunctival xerosis
D. Keratomalacia
| Keratomalacia |
5e2f71c2-ac05-4d30-a114-d3d9049736ae | Bacterial vaginosis Clue cells are seen in bacterial vaginosis -Clue cells are vaginal epithelial cells coated with coccobacillary organisms which have granular appearance and indistinct borders, on a wet mount prepared by mixing vaginal secretions with normal saline in a ratio of -1:1. Amsel criteria for the diagnosis of bacterial vaginosis Includes any three of the following four clinical abnormalities i) Objective signs of increased white homogenous vaginal discharge. ii) Vaginal discharge pH of >4.5 iii) Liberation of distinct .fishy odour (attributable to volatile amines such as trimethylamine) immediately after vaginal secretions are mixed with a 10% solution of KOH. iv) Microscopic demonstration of clue cells. | Gynaecology & Obstetrics | null | Clue cell is seen in aEUR'
A. Bacterial vaginosis
B. Candidial vaginosis
C. Chlamydiasis
D. Trichomonas
| Bacterial vaginosis |
6d73097d-03e6-47ab-85cf-0712d90bde54 | Ans. is 'a' i.e., 1 year o In fetus, ECF is much larger than ICF. o By the age of 1 year, ratio of ICF to the ECF volume approaches adult level. | Pediatrics | null | When ICF and ECF of child becomes equal to adult person -
A. 1 year
B. 2 year
C. 3 year
D. 4 year
| 1 year |
68afe46d-ff6c-4136-a9e1-5fc548ee19e8 | Ans. A. The exchange of nutrients and wastes between blood and tissueEach of the choices is a function of the microcirculation, but its most important function by far is to provide tissue with nutrients and remove the wastes. | Physiology | Heart, Circulation, and Blood | The most important function of the microcirculation is:
A. The exchange of nutrients and wastes between blood and tissue
B. The filtration of water through capillaries
C. The regulation of vascular resistance
D. The autoregulation of blood flow
| The exchange of nutrients and wastes between blood and tissue |
ee6a612d-ef0d-49b4-86c8-48325f11f9ac | Non aeritic AION Impoant Points on Visual Pathway Lesions 1. Optic nerve lesion I/l direct and c/ L consensual reflex gone Causes *Optic atrophy/ optic neuritis, Avulsion optic nerve 2. Middle Chiasmal syndrome/ Central Chiasmal lesion Saggital chiasma lesion Bitemporal hemianopia | Ophthalmology | Squint | Altitudnal Field Defects are seen in
A. Non Aeritic Ischemic Optic Neuropathy
B. Lateral Geniculate Body lesions
C. Optic nerve lesion
D. Optic Chiasma Lesion
| Non Aeritic Ischemic Optic Neuropathy |
89c14dd8-52cb-4533-b5a3-84860c168358 | Propoxyphene binds primarily to opioid receptors and produces analgesia and other CNS effects that are similar to those seen with morphine-like opioids. It is likely that at equianalgesic doses the incidence of side effects such as nausea, anorexia, constipation, abdominal pain, and drowsiness are similar to those of codeine. All other choices produce gastric ulceration. Ref: Yaksh T.L., Wallace M.S. (2011). Chapter 18. Opioids, Analgesia, and Pain Management. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e. | Pharmacology | null | What is the treatment for headache in a case of peptic ulcer disease?
A. Microline aspirin
B. Propoxyphene
C. Paracetamol
D. Oxyphenbutazone
| Propoxyphene |
439a1759-2aae-44f1-afa9-123e2c0e02fc | Stimulation of muscarinic receptors decreases BP. | Pharmacology | null | Which of the following is not an effect of cholinergic muscarinic receptor stimulation:
A. Sweating.
B. Bradycardia.
C. Urination.
D. Rise in BP.
| Rise in BP. |
d4c93a77-b1b7-4503-af29-edbdcd49c219 | Ans: d (Isolated hepatic failure)Ref: Various internet sitesBranched chain amino acids are used in hepatic encephalopathy to improve mental function and muscle control.They have been tried in burns, sepsis and trauma but without much success.Eg of branched chain amino acid -valine, leucine and isoleucine. | Pharmacology | Miscellaneous (Pharmacology) | Branched chain aminoacid is used in:
A. MODS
B. SIRS
C. Sepsis
D. Isolated hepatic failure
| Isolated hepatic failure |
b03c7bb7-6004-47e3-9302-52a8f0a6cf3b | Hydroxyurea REF: Harrison 17th ed chapter 106 Drugs used in chemotherapy of multiple myeloma are: Melphan Thalidomide Lenalidomide Cyclophosphamide Vincristine Doxorubicin (Adriamycin) and liposomal doxorubici | Surgery | null | A drug not effective in Multiple Myeloma is?
A. Boezomib
B. Hydroxyurea
C. Melphalan
D. Cylcophosphamide
| Hydroxyurea |
c5f14096-b705-43e2-b029-f80f6d9a262e | Pseudomyxoma Peritonei Mucinous ascites Caused by ruptured Appendiceal or Ovarian Adenocarcinoma MC primary cause - Appendix > ovary Incidence- male = female Usually seen in 4th - 5th decade Peritoneal cavity is filled with mucinous substances (JELLY like) creates pressure in abdomen compressing the bowel & simultaneously in Upright posture - Abdominal distension | Surgery | GIT | In pseudomyxoma peritonei, mucinous cyst-adenocarcinoma of which following organ is involved:
A. Pancreas
B. Kidney
C. Ovary
D. Abdominal testis
| Ovary |
9d9d74fc-8449-4ab2-bbea-31d5781e5d60 | Ans. is 'c' i.e., Bile duct obstruction Haptoglobin o Haptoglobin is a transpo glycoprotein which binds free hemoglobin in plasma and carries it to the reticuloendothelial system. It is synthesized in the liver. o A decrease in haptoglobin levels (with normal liver function) occurs when there is excess of hemoglobin in the plasma due to intravascular hemolysis ---> free hemoglobin in plasma bound to haptoglobin and this complex is rapidly cleared by mononuclear phagocytic system. o In biliary obstruction the serum haptoglobin level is increased and this may mask the decrease in serum haptoglobin due to hemolysis. | Pathology | null | Low serum haptoglobin in hemolysis is masked by ?
A. Pregnancy
B. Liver disease
C. Bile duct obstruction
D. Malnutrition
| Bile duct obstruction |
e6ac5271-14bf-4399-aa45-b758ed27a955 | Best investigation for bony metastasis is MRI. MRI has almost 100% sensitivity in detecting bony metastasis Investigation of choice for whole body screening for bony metastasis is Bone scan Intial investigation in symptomatic bone pain is Radiography CT is used in evaluation of focal abnormalities of bone scan and also for guided needle biopsy. | Radiology | Skeletal system | Investigation of choice in whole body imaging in metastasis is -
A. Magnetic Resonance Imaging
B. Radiography
C. Bone scan
D. CT Scan
| Bone scan |
604634a0-a333-4c54-8fb1-1da9616120c3 | Ans. is 'd' i.e., Botulinum toxin Treatment of Achalasia The aim of treatment is to be relieve the functional obstruction at the cardia The two main methods to achieve this are I) Forceful dilatation or 2) Esophageal myotomy (Heller's myotomy) with or without an antireflux procedure 1) Forceful dilatation (pneumatic dilatation) - The aim is to weaken or rupture the circular muscle fibres of the LES by forceful stretch. - Perforation and bleeding are potential complications 2) Extramucosal cardiomyotomy (Heller's myotomy) this involves surgical division of the muscle fibres of the lower esophageal sphincter. this procedure can be performed through a laparoscopic or thoracoscopic approach (Open surgical procedure i.e. Laparotomy or thoractomy can also be done, but the videoscopic procedure is better) - major complication is gastro-esophageal reflux. - paial fundoplication is done to prevent reflux "modified laparoscopic Heller myotomy is the operation of choice"- Sabiston Other methods of treatment Drugs Nitrates and calcium channel bockers can be used, but are ineffective for long term use. They can be used for transient relief of symptoms and in patients unfit for surgery and pneumatic dilatation. Botulinum toxin Botulinum toxin is given by endoscopic injection into the LES. It reduces LES pressure by blocking the cholinergic excitatory nerves in the sphincter. Its effect is only sho-lived and repeated injections have to be given. Used only in patients unfit for surgery and pneumatic dilatation. | Surgery | null | Treatment for achlasia associated with high rate of recurrence :
A. Pneumatic dilatation
B. Laproscopic myotomy
C. Open surgical myotomy
D. Botulinum toxin
| Botulinum toxin |
ba45eb6a-052d-4e23-af45-7a0ae683be56 | Protein / acid in duodenum is the most potent stimulus for secretion of secretin. | Physiology | null | Most potent stimulus for secretin secretion is
A. Distension of stomach
B. Bile in duodenum
C. Protein in duodenum
D. Fatty food in duodenum
| Protein in duodenum |
7661d34d-3cf7-4848-9c07-211e5460e3ff | Ans. B, 30 grays (Gy) in 10 fractionsWhole-brain radiotherapy (WB) to 30 grays (Gy) in 10 fractions - Standard treatment in patients with multiple brain metastases.Current study investigated the potential benefit of dose escalation beyond 30 Gy. | Radiology | null | Standard treatment of whole-brain radiotherapy (WB) for brain Metastasis :
A. 20 grays (Gy) in 10 fractions
B. 30 grays (Gy) in 10 fractions
C. 30 grays (Gy) in 5 fractions
D. 15 grays (Gy) in 10 fractions
| 30 grays (Gy) in 10 fractions |
1df59731-5911-4f76-84b0-af31326e3b96 | Lipid bilayer is asymmetric. Phosphatidylserine and phosphatidyl ethanolamine are located in the inner leaflet Lecithin and sphingomyelin are located in the outer leaflet. Flipping of phosphatidylserine to outer membrane is seen in apoptosis. This is the basis of annexin V assay | Biochemistry | Chemistry of Lipids | Which of the following phospholipid is associated with apoptosis?
A. Phosphatidylcholine
B. Dipalmitoyl Phosphatidylcholine
C. Phosphatidylserine
D. Phosphatidylinositol 4,5-bisphosphate
| Phosphatidylserine |
7cfa5fe7-ec5c-49e3-9e0e-de168a93eb92 | Malignant melanoma of the choroid is the most common primary intraocular tumor of adults usually between the age group 40-70 years. It is rare in blacks and is more common in whites. It arise from the neural crest derived pigment cells of the uvea as a solitary tumor and is usually unilateral. This tumor during the stage of extraocular extension burst through the sclera at limbus. This extraocular spread occur through the perivascular spaces of voex veins or ciliary vessels. Ref: Comprehensive Ophthalmology By AK Khurana, 4th Edition, Pages 162-5. | Ophthalmology | null | Which of the following malignancy is associated with invasion of Voex Vein?
A. Retinoblastoma
B. Malignant melanoma
C. Optic nerve gliomas
D. Medullo-epitheliomas
| Malignant melanoma |
470f8c6c-20e6-4251-9931-79116a602ced | Demonstration -Is a carefully planned presentation where idea is to show ' how to perform' a skill/procedure Two principles : 1. Seeing is believing 2. learning by doing | Social & Preventive Medicine | HC Methods, D-P Communication | A Female health worker has to teach women in Urban slum about ORS preparation. Best method will be
A. Lecture
B. Flipcha
C. Demonstration
D. Workshop
| Demonstration |
3bedb51a-0d6c-415e-ba51-63f285715532 | Side effects of inhalation anesthetics Halothane: Auto immune hepatitis Disrupts dual blood supply Respiratory depression Sevoflurane Produce Comp A (nephrotoxic) Day care surgery Inhalational induction agent of choice Pediatric population Isoflurane Coronary steel phenomenon Procaine Local anesthetic Used in cataract surgery | Anaesthesia | FMGE 2018 | Which of the following Inhalation anaesthesia agent is Hepatotoxic:
A. Sevoflurane
B. Isoflurane
C. Halothane
D. Procaine
| Halothane |
ad10cb42-e1a4-46c2-aae7-5117a6ed9c7d | Neurofibrillary tanglesThe build-up manifests in two ways:Plaques- deposits of the protein beta-amyloid that accumulate in the spaces between nerve cells Tangles - deposits of the protein tau that accumulate inside of nerve cellsBoth amyloid plaques and neurofibrillary tangles are clearly visible by microscopy in brains of those afflicted by AD.Plaques are dense, mostly insoluble deposits of amyloid - beta peptides and cellular material outside and around neurons.Senile neural plaques correlates (increases) with ageTangles (neurofibrillary tangles) are aggregates of the microtubule-associated protein tau which has become hyperphosphorylated and accumulate inside the cells themselves & are associated with severe dementiaLateral geniculate body is resistant to neurofibrillary tangles. | Psychiatry | null | Degenerated neurofilaments seen in patients with Alzheimer's disease are:
A. Hirano bodies
B. Lipofuscin granules
C. Neurofibrillary tangles
D. Amyloid plaques
| Neurofibrillary tangles |
95a15814-9dde-47b4-952a-c533b4c00180 | Chief or zymogen or peptic cells secrete pepsiongens.Parietal or oxyntic cells secrete HCl and intrinsic factor.These cells are located in the body of stomach, including the fundus.(Ref: Ganong&;s Review of medical physiology, 23 rd edition, page 431) | Physiology | G.I.T | Pepsinogen is secreted by
A. Parietal cells
B. Mucus cells
C. Chief cells
D. Oxyntic cells
| Chief cells |
d5c83c8d-2fad-4e4c-bb1a-5ddc9b848487 | Work done = load x displacement. In the context of lungs, load is analogous to pressure and displacement is volume expansion of lungs. Hence, work of breathing = DP X DV. Thus, work done can be calculated as area covered under the inspiratory curve in compliance diagram. Of the total inspiratory work, 65% work is elastic work or compliance work. Remaining 35% is non-elastic work - (28% is airway resistance work, 7% is tissue resistance work.) | Physiology | Respiratory System Pa 1 | In the work of breathing, tissue resistance contributes ___% fraction:
A. 7%
B. 14%
C. 28%
D. 65%
| 7% |
d73ffecb-2adb-4a85-b060-741f57d2d182 | Cryptitis The pathology in ulcerative colitis typically involves distoion of crypt architecture, inflammation of crypts (cryptitis), frank crypt abscess, and hemorrhage or inflammatory cells in the lamina propria. Pathology of ulcerative colitis. Macroscopic features Ulcerative colitis is a mucosal disease that usually involves the rectum and extends proximally to involve all or pa of the colon. The lesion is continuous and normal areas between the lesions (skip lesions) do not occur. With mild inflammation the mucosa is erythematous and has a fine granular surface that appears like sand paper. In severe cases mucosa is hemorrhagic. ulcerated and edematous. In long standing cases. inflammatory polyps (pseudopolyp) may be present as a result of epithelial regeneration. With many years of disease the mucosa becomes atrophic and featureless and entire colon becomes narrowed and shoened. Microscopic features :? The impoant pathological characteristic is that the process is limited to the mucosa and superficial submucosa with deeper layers unaffected except in fulminant disease. Two major features in ulcerative colitis suggests chronicity Distoion of the crypt architecture of the colon (cryptitits) - Crypts may be bifid and reduced in number often with a gap between crypt bases and musculoris mucosae. Diffuse predominantly mononuclear infiltrate in lanzina propria is universally present - Neutrophilic infiltration of epithelial layer produce collection of neutrophils in crypt (crypt abscess). | Pathology | null | Ulcerative colitis what is seen?
A. Cryptitis
B. Crypt loss
C. Crypt branching
D. Proliferating mucosa
| Cryptitis |
5d57e27e-f21f-4078-a981-d61e610bd320 | Ans. D i.e. Persists Parachute (forward) reflex When:This occurs from about 9 months of age and persists. What:If the baby is held in a position where he is dropped forward, he will outstretch his hands. This is one of the baby milestones that is protective for falling. | Pediatrics | null | Parachute reflex disappears by: March 2013 (c, f)
A. 1 year
B. 2 years
C. 3 years
D. Persists forever
| Persists forever |
bd33b12f-ac10-40a4-8f1a-13cf4d118e1a | .marjolin&;s ulcer is the name given to a malignancy ( usually a squamous cell carcinoma ) which arise in any long standing wound or a scar mostly scar of an old burn it grows slowly as it is avascular it is painless | Surgery | General surgery | Marjolin ulcer
A. Ca in marjolin's is squamous cell ca
B. Chronic venous insufficiency
C. Basal cell carcinoma
D. arise from base of the ulcer
| Ca in marjolin's is squamous cell ca |
53d0fd05-9fd6-4daf-a444-47303c37a667 | Ans. is'a'i.e., Fasciculus cuneatus and fasciculus gracilis(Ref: Guyton 12th/e p. 573)Posterior column (Dorsal column) (Fasciculus Gracilis and Fasciculus Cuneatus) carriesProprioception (Position of body or limb, position of joint)VibrationFine touch (two point discrimination, topognosis, stereognosis).Kinesthesia | Anatomy | null | Proprioception is carried by which fibers?
A. Fasciculus cuneatus and fasciculus gracilis
B. Anterior spinothalamic tract
C. Lateral spinothalamic tract
D. Spinocerebellar tract
| Fasciculus cuneatus and fasciculus gracilis |
392da5ca-e097-4dc4-a8e8-b55576c97d75 | Ans. b (Choanal atresia). (Ref. Diseases of ENT, PL Dhingra, 3rd ed., 78, 210, 510)# Persistant bucconasal membrane leads to choanal atresia.Choanal atresia# Is a autosomal recessive trait in which the posterior choanae unilaterally or bilaterally fail to develop properly.# Persistent bucconasal membrane is the basic etiology.# Occurs in 1 in 5,000 births; more common among girls (2:1)# Unilateral > bilateral atresia.# Because newborns are obligate nose breathers, bilateral atresia is immediately apparent as respiratory distress.# Characteristics is the history or failure to pass a rubber catheter or nasogastric tube into the pharynx.# Symptoms of choanal atresia include failure to thrive due to poor feeding and mucoid nasal discharge.# The presence of choanal atresia can be confirmed with visualization of retention material in the posterior part of the nose on a lateral radiograph with the patient in the supine position.# Anatomic characterization of the deformity with CT can be important for planning surgical procedures.# Surgical treatment methods for membranous atresia include puncture of the choanal membrane and placement of a stent for 6 weeks.# If bony atresia is present, the bony wall can be taken down transnasally with microsurgical techniques followed by placement of a stent.# When suboptimal resection for atresia or choanal stenosis occurs, transpalatal repair at 3-4 years age is advised.# The septum usually deviates to the affected side; however, more posterior examination shows atresia.# Transpalatal repair is being replaced by endoscopic techniques of repair of atresia in children and adults. | ENT | Nose and PNS | Persistent bucconasal membrane result in
A. Cleft lip
B. Choanal atresia
C. Cleft palate
D. T-O Fistula
| Choanal atresia |
0a8d08fb-bad1-4046-9ec6-62534715a204 | Ans. (A) Ceftriaxone(Ref: Harrison 19/e p767)Drug of choice for treatment of meningococcal meningitis is Penicillin G. But for empirical treatment we need to cover other likely organisms too. So, ceftriaxone is preferred that will also cover H. influenzae. Vancomycin is usually added to cover other organisms also. | Pharmacology | Chemotherapy: General Principles | Empirical treatment for meningococcal meningitis is:
A. Ceftriaxone
B. Cefotetan
C. Gentamicin
D. Cefoxitin
| Ceftriaxone |
e0d81130-bfb6-419a-b679-74f1a859bf0b | Ans. B. Adrenal medullaPheochromocytoma are a type of tumor of the adrenal glands that can release high levels of epinephrine and norepinephrine. As the name implies, the "ad-renal" glands are located near the "renal" area. Someone with a pheochromocytoma usually has three classic symptoms, headache, sweating, and heart palpitations (a fast heart beat) in association with markedly elevated blood pressure (hypertension). Other conditions that may accompany these classic symptoms are as follows:a. Anxiety,b. Nausea,c. Tremors,d. Weakness,e. Abdominal pain, andf. Weight loss. | Biochemistry | Endocrinology | Pheochromocytoma are tumours of:
A. Adrenal cortex
B. Adrenal medulla
C. Pancreas
D. Bone
| Adrenal medulla |
a85064ea-a586-4021-8880-493772698a71 | Ans. is 'd' i.e., Multipolar * All skeletal muscles are supplied by motor neurons which are multipolar neurons.* There are following types of neurons1) Unipolor neurons These neurons have one process, with different segments (of that one process) serving as dendrite (receptive surfaces) as well as axons (releasing terminals). It is found in invertebrates.2) Bipolar neurons These are neurons with a dendrite and an axon, e.g. bipolar cells of retina.3) Pseudounipolar neurons (subclass of bipolar neurons) The neuron develops, a single process splits into two, both of which functions as axons, - one going to skin or muscle and another to spinal cord, e.g. dorsal root ganglion.4) Multipolar neurons These have one axons and many dendrites, e.g. motor neuron, pyramidal cell of hippocampus and cerebellar purkinje cells. | Physiology | Nervous System | Rhomboid major is supplied by which type of neuron-
A. Unipolar
B. Pseudounipolar
C. Bipolar
D. Multipolar
| Multipolar |
eceae43d-d926-44b3-a3d9-b4e8184a6df7 | Low-calcium diets increase the risk of the incident stone formation. Low-calcium diets lead to the stone formation by reducing the amount of calcium to bind oxalate in the intestine- | urine oxalate levels. | Medicine | Kidney Stones & Renal Tubular Acidosis | A 35-year-old female presents with recurrent renal stone. What is not advised?
A. Increase water intake
B. Restrict protein
C. Restrict salt
D. Restrict calcium
| Restrict calcium |
8a034771-38cb-4cd8-a500-08dd26fce343 | The recovery of tensile strength results from the excess of collagen synthesis over collagen degradation during the first 2 months of healing, and, at later times, from structural modifications of collagen fibers (cross-linking, increased fiber size) after collagen synthesis ceases.
'Recovery of Tensile Strength: Fibrillar collagens (mostly type I collagen) form a major portion of the connective tissue in repair sites and are essential for the development of strength in healing wounds. Net collagen accumulation, however, depends not only on increased collagen synthesis but also on decreased degradation. When sutures are removed from an incisional surgical wound, usually at the end of the first week, wound strength is approximately 10% that of unwounded skin.
Wound strength increases rapidly over the next 4 weeks, slows down at approximately the third month after the original incision, and reaches a plateau at about 70% to 80% of the tensile strength of unwounded skin. Lower tensile strength in the healed wound area may persist for life. The recovery of tensile strength results from the excess of collagen synthesis over collagen degradation during the first 2 months of healing, and, at later times, from structural modifications of collagen fibers (cross-linking, increased fiber size) after collagen synthesis ceases.'- Robbins 8/e p105-106 | Pathology | null | The tensile strength of wound after laparoscopic cholecystectomy in a 30 years old woman depends upon:
A. Replacement of type 3 collagen
B. Macrophage aetivity/snvasion
C. Extensive crosslinking of tropocollagen
D. Granulation tissue
| Extensive crosslinking of tropocollagen |
06bbd2f9-2c3d-4fd6-afef-1b5830f43ff5 | The normal BPG in the blood keeps the O2-hemoglobin dissociation curve shifted slightly to the right all the time. In hypoxic conditions that last longer than a few hours, the quantity of BPG in the blood increases considerably, thus shifting the O2-hemoglobin dissociation curve even faher to the right. This shift causes O2 to be released to the tissues at as much as 10 mm Hg higher tissue O2 pressure than would be the case without this increased BPG. Therefore, under some conditions, the BPG mechanism can be impoant for adaptation to hypoxia, especially to hypoxia caused by poor tissue blood flow.Ref: Guyton and Hall textbook of medical physiology 13th edition. Page:532 | Physiology | Cardiovascular system | The major role of 2,3 DPG in RBC includes
A. Binding of O2
B. Release of O2
C. Acid base balance
D. Reversal of glycolysis
| Release of O2 |
cce8ac92-41f6-4ccf-a26d-0b215c93f624 | Ans. is 'a' i.e. Beta 2 microglobulin Dialysis-related amyloidosis (DRA) is a disorder caused by tissue deposition of beta2 microglobulin as amyloid fibrils.The clearance of beta2 microglobulin, a component of the major histocompatibility complex that is present on cell surfaces, normally occurs by glomerular filtration with subsequent reabsorption and catabolism in proximal tubules. Clearance therefore declines in patients with reduced kidney function, leading to plasma accumulation and slow tissue deposition.The tissue deposition of amyloid detected histologically occurs much earlier than any clinical or radiographic manifestations of the illness.In contrast to fragments of immunoglobulin light chains in primary amyloidosis and serum amyloid A in secondary amyloidosis, the amyloid protein in DRA is composed primarily of beta2- microglobulin.The amyloid found in the bone cysts and synovial tissue in patients with DRA is similar to other forms of amyloid in its staining properties with Congo red and in exhibiting apple-green birefringence under polarized light. It has been proposed that beta2- microglobulin has a high affinity for collagen, an effect that could explain the predominance of joint and bone diseaseClearance of beta2-microslobulinUnderlying the tissue deposition of beta2-microglobulin among patients with end-stage renal disease is the inability to adequately clear this substance, even with modem high flux hemodialysis and/or convective therapies. Bones and diseasesLess tendency to deposit in gastrointestinal organsRarely involvesp2 amyloid has preference for deposition in bones joints and synoviump2 amyloid has affinity for collagenCarpal tunnel syndromeScapulohumeral periarthritisEffusive arthropathySpondyloarthropathyBone diseasesColonStomachEsophagusSmall intestineCardiacPulmonarycutaneousTissue histologyIn contrast to fragments of immunoglobulin light chains in primary amyloidosis and serum amyloid A in secondary amyloidosis, the amyloid protein in DRA is composed primary of beta2-microglobulinThe amyloid found in the bone cysts and synovial tissue is similar to other forms of amyloid in its staining properties with Congo red and in exhibiting apple-green birefringence under polarized light - Biopsy remains the "gold standard" for the diagnosis of beta2- microglobulin amyloidosis. Despite this, the diagnosis of DRA is usually clinical and relies upon the combination of typical clinical features plus characteristic radiographic findings. Abdominal fat pad aspirates are not useful for the diagnosis of DRA.Type of AmyloidosisMajor Fibril proteinPrecursor proteinSystemic Amyloidosis Primary amyloidosisSecondary amyloidosisHemodialysis associated amyloidosisALAAAb2 microglobulinImmunoglobulin light chainSSAb2 microglobulinHereditary amyloidosis Familial Mediterranean feverFamilial amyloidotic neuropathiesSystemic senile amyloidosisAAATTRATTRSAATransthyretinTransthyretinLocalized amyloidosis Senile cerebral(Alzheimer's)Medullary ca thyroidIslet of LangerhansIsolated atrial amyloidosisAbAcalAIAPPAANIAPPCalcitoninIslet amyloid peptideAtrial natriuretic factor | Pathology | Histo Pathology | A lady on long term hemodialysis developed carpel tunnel syndrome. The cause was diagnosed to be amyloidosis by using a biopsy. What is the type of amyloid that is seen?
A. Beta 2 microglobulin
B. Amyloid light chain
C. ATTR
D. Serum amyloid associated protein
| Beta 2 microglobulin |
5ce8d49b-7ce5-4408-b923-3147bfc6eafc | Gadolinium is the most commonly used MR contrast agent. | Radiology | null | Contrast used for MRI –
A. Iodine
B. Gadolinium
C. Metvazamide
D. Pmnipaque
| Gadolinium |
0671b28e-5cb9-43ce-b4d2-3bc210e95a2e | Answer is A (Ataxia): In most patients ataxia of gait and stance is the first manifestation of the disease.- Clinical Neurology by Goetz 2"d/742 Friedreich's ataxia presents with progressive staggering gait, frequent falling and titubation- Harrison Note: The first pathological changes in Friendreich's Ataxia are thought to occur is dorsal root ganglia with loss of large sensory neurons. | Medicine | null | Earliest presentation of Friedrich's ataxia is?
A. Ataxia
B. Seizures
C. Optic atrophy
D. Stuttering
| Ataxia |
10dbcd2f-df37-4901-96ed-35486a392340 | Ans. is 'a' i.e., Postpartum state "The operation is done in the interval period, concurrent with the vaginal termination of pregnancy or 6 weeks following delivery. Should not be done within 6 weeks following delivery." | Unknown | null | Laproscopic tubal ligation contraindication -
A. Post partum state
B. Post MTP
C. Gynaecologic malignancies
D. 3 previous childbirth
| Post partum state |
62620647-6c10-462a-af18-c531291d8a0d | Ans. is 'c' i.e., Lens PrecursorDerivativesNeural ectodermSmooth muscle of the iris, opticle vesicle and cup, iris epithelium, ciliary epithelium, Part of the vitreous, Retina, Retinal pigment epithelium, fibres of the opric nerve.Surface ectodermConjunctiva] epithelium , Corneal epithelium. Lacrimal glands, Tarsal glands. Lens .MesodermExtraocular muscles, corneal stroma, sclera, iris. Vascular endothelium. Choroid, Part of the vitreous.Neural crestCorneal stroma, keratocytes and endothelium, Sclera, Trabecular meshwork endothelium. Iris stroma, Ciliary muscles, Choroidal stroma. Part of the vitreous, Uveal and conjunctival melanocytes. Meningeal sheaths of the optic nerve, Ciliary ganglion, Schwann cells, orbital bones, Orbital connective tissue, Connective tissue sheath and muscular layer of the ocular and orbital blood vessels. | Ophthalmology | Anatomy | which of the following is derived from surface ectoderm-
A. Iris
B. Sclera
C. Lens
D. Optic nerve
| Lens |
a847371a-b9f1-4edb-a9b9-4bec0653d804 | Golden "S" sign is a Reverse "S" sign seen on Frontal Chest Radiograph In patients with Bronchogenic Ca with Right Upper lobe collapse Lower convexity of the Reverse S is due to the mass Upper concavity of the "S" is due to Right UPPER LOBE atelectasis with the upward shifting of the horizontal fissure. | Radiology | Respiratory Radiology | Golden S is seen in
A. Left upper lobe collapse
B. Pleural Effusion
C. Left lower lobe collapse
D. Bronchogenic carcinoma
| Bronchogenic carcinoma |
ac6a6959-3139-431c-b49c-23b2a534bca9 | Answer is D (Coarctation of Aoa) Isolated upper extremity hypeension (200 / 140 mm Hg), together with absent/ diminished femoral pulses is a characteristic feature of coarctation of aoa. Although coarctation of aoa does not commonly present with seizures, these may be seen as a consequence of severe hypeension (BP = 200/140) or complications like intracranial haemorrhage (from Berry aneurysms which are more common in patients with coarctation. Coarctation of Aoa is the most likely diagnosis: Approach (Nelson/Hurst) The classic sign of coarctation of aoa is a disparity in pulsations and blood pressure in arms and legs. The femoral, popliteal, posterior tibial and dorsalis pedis pulses are weak (or absent in upto 40% of patients) in contrast to bounding pulses in the arms and carotid vessels. The blood pressure is the legs is lower than in the arms and 90% of patients with coarctation have hypeension in an upper extremity greater than 95" perecentile for age Age (yrs) 95th percentile (mm Hg) > 1 yrs 110 60 I -- 5 yrs 115 /75 6-10 yrs 125 /85 11 -- 18 yrs 140 /90 A blood pressure of 200 /140 mm Hg in a 10 year old boy suggests severe hypeension (95" percentile at 10 years -- 125/85) Severe hypeension may be seen as a consequence of persistant hypeension in an individual who has not undergone corrective surgery for coarctation, and this usually appears in the second or third decade of life (Hurst) Children with severe/malignant hypeension may develop headaches, seizures and stroke (haemorrhage from Berry aneurysms which are more common in patients with coarctation). Takayasu Aooaeritis may also present with severe hypeension and absent femoral pulses due to acquired midaoic coarctation but this is an uncommon presentation in Takavasu aooaeritis (and hence not the single best answer of choice) Takayasu aeritis (or non specific aooaeritis) is a chronic vasculitis disease of medium and large sized aeries with a strong predilection for aoic arch and its branches. This may lead to stenosis of the involved vessels and hence a picture of acquired coarctation. It may thus produce a clinical picture similar to that of coarctation with disparity in pulsations and blood pressure in arms & legs with hypeension depending on the site of the acquired stenosis. However, this condition is more common in women and most commonly affects the subclavican aery. Hence it more commonly presents with claudication, along with unequal and reduced pulses / BP in the upper extremity than the lower extremity. Also systemic symptoms are more common is Takayasu than in coarctation. Neveheless Takayasu aeritis may affect the Thoracic or Abdominal aoa and present with absent lower limb pulses and upper extremity hypeension like coarctation of aoa. Takayasu aeritis can be picked as the answer if Coarctation of aoa is not provided amongst the options | Medicine | null | A Ten year old boy presents to the pediatric emergency unit with seizures. Blood pressure in the upper extremity measured as 200/140 mm Hg. Femoral pulses were not palpable. The most likely diagnosis amongst the following is:
A. Takayasu Aooaeritis
B. Renal parenchymal disease
C. Grandmal seiures
D. Coarctation of Aoa
| Coarctation of Aoa |
da3737ee-4035-41c4-8fa9-bdc1ac3f35ee | Answer is D (Obstructive jaundice): The patient in question has high conjugated bilirubin levels (direct bilirubin > 50% of total bilirubin), along with alkaline phosphatase levels more than 6 times normal. The answer of choice therefore is obstructive jaundice. Approach: If direct conjugated bilirubin is greater than 15O of the total bilirubin, it is termed as direct bilirubinemia. | Medicine | null | A 30 year-old male has jaundice. Blood examination shows total serum bilirubin 28 mg%, direct bilirubin 16 mg % and alkaline phosphatase 184 KA units. The Diagnosis is :
A. Haemolytic jaundice
B. Viral hepatitis
C. Chronic active hepatitis
D. Obstructive jaundice
| Obstructive jaundice |
cff87108-acda-4a48-94dd-d1c9ddf0d7cb | Answer is C (Accidental exogenous Insulin administration): Normal / Reduced levels of C- peptide in the presence of increased insulin suggest a diagnosis of exogenous insulin administration as the cause of hypoglycemia. Approach to a patient with Hypoglycemia and Increased Insulin levels: Role of C- peptide Assay Normally Endogemous Insulin is secreted from (3-cells of pancreas in the form of Pro-insulin This proinsulin is then broken down to Insulin and C- peptide such that for each molecule of endogenous insulin, one molecule of C-peptide is produced. C-peptide levels are thus increased whenever endogenous insulin is increased e.g. Insulinomas, Sulfonylureas, Autoimmune processes and in cases of Insulin resistance (type II DM). | Medicine | null | A patient presents with symptoms of Hypoglycemia. Investigations reveal decreased blood glucose and increased Insulin levels. C-peptide assay is done which shows normal levels of C- peptide. The most likely diagnosis is:
A. Insulinoma
B. Accidental sulfonylurea ingestion
C. Accidental exogenous Insulin administration
D. Accidental Metformin ingestion
| Accidental exogenous Insulin administration |
da8bd45b-e1f3-41b9-96ea-ae837913c481 | Lateral rectus Palsy 1. Lesion of Abducens nerve 2. Abduction limitation due to paralysis of lateral rectus 3. Convergent squint and diplopia (horizontal) on long standing palsy. 4. Patient present with turn towards the side of affected muscle Associations Millard Gubler syndrome: Ipsilateral 6th nerve palsy with contralateral hemiplegia Mobius Syndrome O Expressionless face O Facial palsy O 6th and 7th cranial Nerve involved O Lateral rectus paralyzed O Missing fingers & Bone abnormalities O The muscle weakness also causes problems with feeding that become apparent in early infancy. O Hypotonia O Intelligence is normal O Cleft palate O Missing and misaligned teeth | Ophthalmology | Squint | A patient came with abduction limitation of right eye and horizontal diplopia. Which nerve can possibly be paralyzed
A. 2nd Nerve
B. 3rd Nerve
C. 4th Nerve
D. 6th Nerve
| 6th Nerve |
228bafe6-feeb-4a22-aee1-30a74d77f82f | Ans. is 'a' i.e., Staph Aureus o MC organism is staph aureus >> str. viridans >> pneumococcus. | Surgery | Miscellaneous (Salivary Gland) | Most common cause of acute parotitis -
A. S. Aureus
B. S. Pneumonia
C. Klebsiella
D. S.Viridans
| S. Aureus |
fb17cf14-861c-4af4-a01b-118ab4f4d017 | Larvae penetrate the intestine -MC sites of deposition in- CNS (60-90%)> Eye > muscle. in CNS - subarchanoid >parenchymal Option 1, 2, 3, 4 Cysticercosis: Caused by T. solium (Pork tapeworm) Potentially dangerous systemic disease. Neurocysticercosis (NCC) NCC: MC parasitic CNS infection of man and MC cause of adult onset epilepsy in world. MC site: Sub-arachnoid space followed by parenchyma. | Microbiology | Parasitology Pa 2 (Helminthology) | The most commonly affected tissues in neurocysticercosis is -
A. Brain
B. Eye
C. Muscles
D. Liver
| Brain |
69cfb017-9078-4e30-b6c4-69cafa632abb | Ans. b. Stewart-Hamilton equation (Ref: Ganong 23/e p513; Guyton 11/e p244)Stewrt-Hamilton equation is the basis for thermodilution method used in measurement of cardiac output by pulmonary catheter.Stewart Hamilton equationThe thermodilution technique has become the de-facto clinical standard for measuring cardiac output because of its ease of implementation and the long clinical experience using it in various settings.It is a variant of the indicator dilution methodQ, in which a known amount of a substance is injected into peripheral vein and its concentration change measured over time in serial arterial samples.As its name implies, the thermodilution method uses a thermal indicator, whereas other indicator dilution methods use various substances, such as indocyanine green dye.The fundamental physical basis for the indicator dilution method is given by the Stewart-Hamilton equationQ, named after the two investigators who were instrumental in the development of this technique. | Physiology | Circulation: Cardiac Output, Venous Return | Which scientific principle is the basis for thermodilution method used in measurement of cardiac output by pulmonary catheter?
A. Hagen-Poisseuile principle
B. Stewart-Hamilton equation
C. Bemouli's principle
D. Universal Gas Equation
| Stewart-Hamilton equation |
de8f938e-9794-4459-bf6f-0d7818667884 | Submandibular gland is a large salivary gland situated in the anterior pa of the digastric triangle. It is roughly J-shaped,being indented by the posterior border of the mylohyoid which divides into a larger pa superficial to the muscle,and a small pa lying deep to the muscle. Reference: B D Chaurasia's human anatomy; 5th edition, page.166. | Anatomy | Head and neck | Which of the following muscle lies between superficial and deep pas of submandibular salivary gland?
A. Hyoglossus
B. Styloglossus
C. Mylohyoid
D. Geniohyoid
| Mylohyoid |
7a837c27-fb28-48ce-bbe0-1eb06db11273 | Compliance is defined as the change in volume for a unit change in pressure. It measures the distensibility or, stretchability of lung The total compliance of both lungs together in the normal adult human averages about 200 milliliters of air per centimeter of water transpulmonary pressure. The compliance of the combined lungthorax system is almost exactly one half that of the lungs alone-- 110 milliliters of volume per centimeter of water pressure. Types of compliance measurements: Static compliance: This is the measurement made without taking into account the effect of the different phases of respiration. Dynamic compliance: Compliance measurement during the difference phases of respiratory. So it's a measure of static compliance (lungs and chest wall stiffness) plus airway resistance = impedance of lung Specific compliance = Compliance/FRC Reduced compliance is caused by: Increased fibrous tissue in the lung (pulmonary fibrosis) Decreased surfactant or increased surface tension Presence of air (pneumothorax), excess fluid (pleural effusion), or blood (hemothorax) in the intrapleural space Alveolar edema, which prevents the inflation of some alveoli Atelectasis (collapse) Increased pulmonary venous pressure a lung becomes engorged with blood An increased compliance occurs in pulmonary emphysema normal aging lung In both instances, an alteration in the elastic tissue in the lung is probably responsible. Aging cause changes in the structure of lung collagen and elastin rather than changes in the amount or propoion of the two molecules. In emphysema, the alveolar septal tissue that normally opposes lung expansion are destroyed. Increased compliance also occurs during an asthma, but the reason is unclear. | Physiology | Respiratory System | Compliance curve of the lung given below. Curve A signifies which of the followings:
A. Pulmonary fibrosis
B. Atelectasis
C. Emphysema
D. ARDS
| Emphysema |
8169afad-2086-4bde-b413-a4dea8d49321 | The Glossopharyngeal nerve is the nerve for both general sensation and taste sensation for the posterior 1/3rd of the tongue including the circumvallate papillaeNerve supply of tongueMotor supply: All the intrinsic muscles, except the palatoglossus are supplied by the hypoglossal nerve (The palatoglossus is supplied by the cranial pa of accessory nerve through the pharyngeal plexus)Sensory supply :- Anterior 2/3rd of the tongue - Lingual nerve is the nerve of general sensation and the chorda tympani is the nerve of taste for the anterior two-thirds of the tongue.- Posterior 1/3rd of tongue - The glossopharyngeal nerve is the nerve for both general sensation and taste sensation for the posterior 1/3rd of the tongue.The posterior most pa of the tongue is supplied by the vagus nerve through the internal laryngeal branch | Anatomy | null | Which of the following nerves carries taste sensation from posterior one-third of the tongue:
A. Facial nerve
B. Chorda tympani
C. Glossopharyngeal nerve
D. Vagus nerve
| Glossopharyngeal nerve |
2ee35b19-619b-4ea1-a997-5593a2cda11e | Basal cell carcinoma This is usually a slow-growing, locally-invasive, malignant tumour of pluripotential epithelial cells arising from basal epidermis and hair follicles; hence, it affects the pilo-sebaceous skin. EPIDEMIOLOGY The strongest predisposing factor to BCC is UVR. It occurs in the elderly or the middle-aged after excessive sun exposure, with 95% occurring between the ages of 40 and 80 years. The incidence of BCC rises with proximity to the equator, although 33% arise in pas of the body not usually sunexposed. Other predisposing factors include exposure to arsenical compounds, coal tar, aromatic hydrocarbons, ionising radiation and genetic skin cancer syndromes. White- skinned people are almost exclusively affected. BCC is more common in men than women. PATHOGENESIS BCCs have no apparent precursor lesions and their development is propoional to the initial dose of the carcinogen, but not duration of exposure. The most likely model of pathogenesis for BCCs involves mesodermal factors as intrinsic promoters coupled with an initiation step. BCCs metastasise extremely rarely. MACROSCOPIC BCC can be divided into localised (nodular; nodulocystic; cystic; pigmented and naevoid) and generalised (superficial: multifocal and superficial spreading; or infiltrative: morphoeic, ice pick and cicatrizing). Nodular and nodulocystic variants account for 90% of BCC. MICROSCOPIC Twenty-six histological subtypes have been described. The characteristic finding is of ovoid cells in nests with a single 'palisading' layer. It is only the outer layer of cells that actively divide, explaining why tumour growth rates are slower thantheir cell cycle speed would suggest, and why incompletely excised lesions are more aggressive. Morphoeic BCCs synthesize type 4 collagenase and so spread rapidly Ref: Bailey and love 27th edition Pgno : 604 | Surgery | Urology | Most common malignant lesion of the eyelid is
A. Squamous cell carcinoma
B. Basal cell carcinoma
C. Malignant melanoma
D. Adenocarcinoma
| Basal cell carcinoma |
db3c5c93-ebc6-47d3-887e-8061f01bbd9c | “Antibodies to double-stranded DNA and the Smith (Sm) antigen are virtually diagnostic of SLE" ---------- Robbins
Antinuclear antibodies in SLE
1) Generic antinuclear antibodies (ANA)
□ These are most common (93-100% of patients), thus are most sensitive antibodies for SLE (best screening test).
2) Anti-dsDNA and Anti-smith (Sm) antibodies
□ These are the most specific antibodies for SLE.
3) Antihistone antibodies
□ Particularly seen in drug-induced SLE.
4) Anti-RNP SS-A (Ro), SS-B (La)
□ These are seen in neonatal lupus with congenital heart block and in subacute cutaneous lupus. These antibodies are associated with decreased risk of lupus nephritis.
5) Other less common types of ANAs in SLE
□ Anti-U1 RNP
□ Anti-DNA topoisomerase (Scl-70)
□ Anticentromere
□ Anti-histidyl t-RNA synthase | Pathology | null | ANA seen in SLE is directed against?
A. dsDNA
B. mRNA
C. Nucleolus
D. Ribosomes
| dsDNA |
7cffb021-2110-41d1-963f-50936f881550 | This is an X-ray film showing multiple cannonball metastasis in the lung. The following neoplasms are most likely to spread to the lungs. Given the history it is likely to be a colorectal carcinoma. Melanoma Thyroid cancer Breast cancer Colorectal cancer Head and neck cancer Renal cell cancer Choriocarcinoma Testicular cancer Osteosarcoma Ewing sarcoma Wilms tumor Rhabdomyosarcoma Prostate cancer | Radiology | null | A 76 year old male with a history of dyspnoea on exeion was subjected to x-ray chest by the treating physician. The findings on the chest X-ray are given below. There is a history of fever with significant loss of weight and occasional bloody diarrhoea for the past 3 months. What is the most likely diagnosis?
A. Disseminated tuberculosis
B. Colon cancer with lung metastasis
C. Amebic liver abscess with rupture
D. Squamous cell carcinoma lung
| Colon cancer with lung metastasis |
1bb0f11e-a9d9-448e-a43c-f3a9483a93d5 | Individuals with Turner's syndrome are phenotypic females with primary amenorrhea, absent secondary sexual characteristics, sho stature, multiple congenital anomalies, and bilateral streak gonads. Characteristic Findings in Women with Turner Syndrome: Height 142-147cm Micrognathia Epicanthal folds Low-set ears Sensorineural hearing loss Otitis media leading to conductive loss High-arched palate Webbing of the neck Chest square and shield-like Lack of breast development Areolae widely spaced Coarctation of the aoa Sho fouh metacarpal Cubitus valgus Renal abnormalities Autoimmune disorders Autoimmune thyroiditis Diabetes mellitus Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 18. Anatomic Disorders. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e. | Gynaecology & Obstetrics | null | A 21 years female of 143 cm height present primary amenorrhea, absent breast, Cubitus valgus. Most probable diagnosis is?
A. Turner's syndrome
B. Mixed gonadal dysgenesis
C. Mayer Rokitansky kuster Hauser syndrome
D. Androgen insensitivity syndrome
| Turner's syndrome |
5bb4ab2c-e273-4826-94f8-4ace92150b77 | Ans. is 'b' i.e., Potassium chloride-1.5 gm Because of the improved effectiveness of reduced osmolarity ORS solution, WHO and UNICEF are recommending that countries manufacture and use the following formulation in place of the previously recommended ORS solution. | Pediatrics | null | WHO ORS contains -
A. Sodium chloride 2.5 g
B. Potassium chloride 1.5 g
C. Glucose 20g
D. Shift of water from ECF to ICF
| Potassium chloride 1.5 g |
1d59dd69-b8cc-4f7e-baaa-21447e735f49 | Ans. is 'a' i.e., 51 - 31 Elongation in DNA synthesiso Once the RNA primer has been synthesized at each of the replicating forks, a DNA polymerase III initiates the synthesis of new DNA strand by adding deoxyribonucleotides to the 31 end of RNA primer. Thus, both new strands are synthesized always in 51- 31 direction. Both the DNA strands are synthesized simultaneously, but in opposite direction.o During synthesis of RNA primer and synthesis of DNA strands, the nucleotides are added according to the sequence of base in the template strand, i.e. 'base pairing rule'. For example, an adenine nucleotide would enter at a thymine nucleotide.Elongation in transcriptiono The process of elongation proceeds after the formation of the first phosphodiester bond. After formation of approximately 10 phosphadiester bonds of new RNA, sigma (a) factor dissociates from the core enzyme. RNA polymerase utilize ribnucleotide triphosphate (ATP, GTP, CTP and UTP) for the formation of RNA.o RNA synthesis occurs in 51-3' direction (similar to DNA synthesis), i.e. genetic information is read in 31-51direction on template DNA and complementary base sequence is synthesized in 51-31 direction for RNA strand.o The selection of nucleotide is according to base-pairing rule, (e.g. U opposite to A and G opposite to C)o The process of elongation continues until a termiantion point is reached. | Biochemistry | DNA Replication | DNA replication and transcription occurs in which direction -
A. 51-31
B. 5l-51
C. 31 -51
D. 31 -31
| 51-31 |
4e292c52-99ef-4c2d-ac8d-e089ef9711e6 | Sympathetic Ophthalmitis* Bilateral granulomatous panuveitis after penetrating trauma with prolapsed of uvea* Injured eye - exciting eye; normal fellow- sympathizing eye* Causes: penetrating injury, intraocular surgeries, cyclophotocoagulation, cyclocryotherapy* Site of injury: involving CB, iris and lens capsule* Pathogenesis: Autoimmunity against uveal pigments * Dalen Fuchs Nodules - granulomas between Bruchs and RPE* Earliest Symptom: Loss of accommodation* Earliest Sign: Retrolental flare and cells, KPs at the back of cornea* Enucleation of the injured eye within 10 days only in eyes with a hopeless visual prognosis* Treatment: Topical and systemic steroids | Ophthalmology | Ocular Trauma | Sympathetic ophthalmitis is due to
A. Blunt trauma
B. Penetrating trauma
C. Chemical injury
D. Retained intra ocular Iron foreign body
| Penetrating trauma |
509d3a6b-c998-4898-b72b-59f4e308bbc0 | Ans. is 'c' i.e., Kleinhauser test Kleiheaur betke testo It is quantitative test which is used to calculate the approx volume of the fetal blood entering into the maternal circulation. Based on the principle of acid elution technique and is done by using citric acid phosphate buffer. Fetal red cells (dark refractile bodies) are calculated as per 50 low power fields. If there are 80fetal erythrocytes in 50 low power fields in maternal peripheral blood films, it is estimated as transplacental haemorrhage to the extent of 4 ml of fetal blood.o Though more accurate tests are flow cytometry and immunofluorescence.o Apt test (Singer alkali denaturation test) is another test by which is used to detect the presence of fetal blood in maternal blood. But it is qualitative test. It uses KOH as reagent and is based on alkali denaturation.o Bubble test (shake test) is a bedside test to detect the fetal lung maturity. | Gynaecology & Obstetrics | Pregnancy in Rh-negative Women | Best test to quantify' feto-maternal haemorrhage in Rh isoimmunisation is -
A. LPT
B. DCT
C. Kleinhauser test
D. Indirect coombs
| Kleinhauser test |
f84822b1-ddbb-4b46-9074-c924e5278583 | Collagen present in cailage are chemically distinct from those in most other tissues.They are described as type 2 collagen Inderbir Singh&;s textbook of human Histology Seventh edition Pg no 82 | Anatomy | General anatomy | Collagen found in hyaline cailage is
A. Type I
B. Type II
C. Type IV
D. Type V
| Type II |
8a281141-376a-436b-88ea-471b882711d7 | -DEVELOPMENT OF RESIDUAL COMPRESSIVE STRESSES
The fabrication of metal-ceramic and all-ceramic prostheses usually involves sintering the ceramic at high temperature or hot-pressing a veneering ceramic onto the metal or core ceramic. The process of cooling to room temperature offers the opportunity to take advantage of mismatches in coefficients of thermal contraction of adjacent materials in the ceramic structure.
-MINIMIZING THE NUMBER OF FIRING CYCLES
The purpose of porcelain firing procedures is to densely sinter the particles of powder together and produce a relatively smooth, glassy layer (glaze) on the surface. In some cases a stain layer is applied for shade adjustment or for characterization, such as stain lines or fine cracks.
-ION EXCHANGE
The technique of ion exchange is an effective method of introducing residual compressive stresses into the surface of a ceramic.
-THERMAL TEMPERING
Perhaps the most common method for strengthening glasses is by thermal tempering, which creates residual surface compressive stresses by rapidly cooling the surface of the object while it is hot and in the softened (molten) state. This rapid cooling produces a skin of rigid glass surrounding a soft (molten) core. As the molten core solidifies, it tends to shrink, but the outer skin remains rigid. The pull of the solidifying molten core, as it shrinks, creates residual tensile stresses in the core and residual compressive stresses within the outer surface.
Philips’ Dental Material, pg- 440, 441 | Dental | null | A 60 year old male patient complains of food lodgment in upper right back teeth region. Patient gives h/o RCT with 16 and extraction with 15. Ceramic crown and bridge was planned. Which of the following is not a method for strengthening this restoration?
A. Thermal tempering
B. Maximizing the number of firing cycles
C. Ion exchange
D. Development of residual compressive stresses
| Maximizing the number of firing cycles |
73efa318-a118-4e3e-8bad-3b2124250b99 | Pepsin production is a normal physiologic activity of the stomach that, in conditions of stress, may overwhelm the stomach's weakened defenses and result in gastric ulceration. Gastric acid production is another condition that may increase and cause acute ulceration. Fuhermore, these two factors may remain unchanged and still result in gastric ulcers if the gastric defenses are weakened by stress. All of the other choices represent normal defensive forces in the stomach. Increased bicarbonate transpo would protect the gastric epithelium from the potentially harmful acidity of the gastric contents. The adherent mucus is relatively alkaline, providing local protection to the superficial mucosa. Gastric epithelial cells can normally replicate rapidly, allowing mucosal defects to be rapidly repaired. Increasing the regenerative capacity of the epithelium would have a protective effect against ulceration. The gastric mucosa is richly supplied with blood, providing the epithelial cells with an ample supply of nutrients, oxygen, and bicarbonate to contend with the harsh gastric microenvironment. Stress ulcers are associated with compromised gastric blood flow, not increased flow. Ref: Mills J.C., Stappenbeck T.S., Bunnett N. (2010). Chapter 13. Gastrointestinal Disease. In S.J. McPhee, G.D. Hammer (Eds), Pathophysiology of Disease, 6e. | Physiology | null | A 35 year old female, hospitalized after a motor vehicle accident, develops acute gastric stress ulcers. Increases in which of the following normal physiological parameters may have contributed to this condition?
A. Bicarbonate transpo
B. Epithelial regenerative capacity
C. Mucosal blood flow
D. Pepsin production
| Pepsin production |
20bb0d70-4d3b-4d33-bf8f-e83625c4ab2c | organism-Guinea worm/medina worm/serpent worm habitat- subcutaneous nodules DH-humans IH- cyclops(lobsters, crabs shrimps) MOI-ingestion of drinking water containing cyclops infested with L3Larvae | Microbiology | Parasitology Pa 2 (Helminthology) | What is the intermediate host of the organism shown here?
A. Snail
B. Cyclops
C. Pig
D. Mosquito
| Cyclops |
dfaa4327-bc95-4b02-b2a3-93baed357088 | The main difference between an X-ray photon and a visible light photon lies in the energy of each photon. Xray photon has approximately 5000 times the energy of an ordinary light photon, allowing the Xray photon to pass through materials more readily than a regular light photon. Ref: Techniques in Microscopy for Biomedical Applications By Terje Dokland, Page 289 | Radiology | null | The major difference between X-Rays and Light is:
A. Energy
B. Mass
C. Speed
D. Type of wave
| Energy |
cf225b0b-9e41-4f41-9e6a-55d6bd10e2a7 | At T8 - IVC hiatus in central tendon through which IVC and few branches of Rt. phrenic nerve passes At T10 - Oesophageal opening is present through which passes: Esophagus Esophageal branch of left gastric aery Anterior and posterior vagal trunk At T12 - Aoic hiatus posterior to diaphragm formed by median arcuate ligament through which passes: Aoa Thoracic duct Azygous vein | Anatomy | Umblicial cord and diaphragm | Structure NOT passing through esophageal opening
A. Esophagus
B. Phrenic nerve
C. Vagus nerve
D. Gastric aery branches
| Phrenic nerve |
07d6a46a-d033-40a0-bfe1-c06f0d253580 | Ans. is 'a' i.e., Proteosome inhibitor Proteosome inhibitors o Transcription factor NFKB is associated by an inhibitor IKB. o IKB is degraded by proteosomes. o Inhibition of proteosome prevents degradation of IKB which inhibits the overactivity of NFKB. o Proteosome inhibitor (Baezomib) is used in multiple myeloma. | Pharmacology | null | Baezomib is -
A. Proteosome inhibitor
B. DNA methyl transferase inhibitor
C. Tyrosine kinase inhibitor
D. Histone deacylase inhibitor
| Proteosome inhibitor |
6bb1a391-2c8d-45aa-9f20-54b3d60248b5 | An enzyme activated by trypsin is phospholipase A2. This enzyme splits a fatty acid off lecithin, forming lysolecithin. Lysolecithin damages cell membrane. It has been hypothesized that in acute pancreatitis phospholipase A2 is activated in the pancreatic ducts, with the formation of lysolecithin from lecithin that is a normal constituent of bile. This cause disruption of pancreatic tissue and necrosis of surrounding fat. | Pathology | null | Destruction of fat in acute pancreatitis is due to -
A. Lipase and elastase
B. Lipase and trypsin
C. Secretin
D. Cholecystokinin and trypsin
| Lipase and trypsin |
7ff5e2d3-c3a2-4693-a8a7-131d1830dcab | Regulatory sequences in DNA are classified as cis- or trans-acting elements, depending on the mechanism of action. Cis-acting elements function only when located on the strand of DNA being regulated, relatively close to the regulated gene. The operator (0), the promoter (P), and the CAP binding site all are located just upstream from the regulated structural genes of the operon, and do not function if placed at other locations. The -galactosidase gene is one of the regulated structural genes of this operon. Trans-acting elements can function from long distances, and can even be on a different DNA molecule in the cell. The gene, which encodes the repressor protein, is an example of a trans-acting regulatory element. Because the gene encodes a diffusible product, it doesn't matter where it is placed relative to the regulated genes. Ref : Biochemistry by U. Satyanarayana 3rd edition Pgno : 567 | Biochemistry | All India exam | Which DNA segments in the lactose operon of E. coli is a trans-acting regulatory element?
A. B-galactosidase gene
B. Operator
C. Promoter
D. I gene
| I gene |
b377d5f1-5b0a-45ac-92c9-3fed3bc05958 | Multiple myeloma is a plasma cell neoplasm commonly associated with lytic bone lesions, hypercalcemia, renal failure, and acquired immune abnormalities. Clinical Features. The clinical features of multiple myeloma stem from (1) the effects of plasma cell growth in tissues, paicularly the bones (2) the production of excessive Igs, which often have abnormal physicochemical propeies; and (3)The suppression of normal humoral immunity. Bone resorption often leads to pathologic fractures and chronic pain. The attendant hypercalcemia can give rise to neurologic manifestations, such as confusion, weakness, lethargy, constipation, and polyuria, and contributes to renal dysfunction. Decreased production of normal Igs sets the stage for recurrent bacterial infections. Cellular immunity is relatively unaffected. Of great significance is renal insufficiency, which trails only infections as a cause of death. The pathogenesis of renal failure (Chapter 20), which occurs in up to 50% of patients, is multifactorial. However, the single most impoant factor seems to be Bence-Jones proteinuria, as the excreted light chains are toxic to renal tubular epithelial cells. Ceain light chains (paicularly those of the l6 and l3 families) are prone to cause amyloidosis of the AL type, which can exacerbate renal dysfunction and deposit in other tissues as well. | Pathology | FMGE 2019 | Comment on the diagnosis for an individual serum alkaline phosphatase normal, PTH normal, Vitamin D3 normal with elevated serum Calcium values?
A. Vitamin D intoxication
B. Hyperparathyroidism
C. Multiple myeloma
D. Nutritional rickets
| Multiple myeloma |
3141aace-abf3-4584-9881-498b0ae1b400 | Ans. B. Pulmonary angiographyAlthough pulmonary angiography is supposed to be the definitive and gold standard means of diagnosing PULMONARY EMBOLISM with the decreasing availability of pulmonary arteriography and increasing use of other non-invasive tests like spiral CT, the exact role of pulmonary arteriography is now less clear and there are only few indications for it, especially in absence of spiral CT or MRI. | Radiology | Respiratory System | "Gold standard" study for diagnosis of pulmonary embolic episode is:
A. Ventilation perfusion scan
B. Pulmonary angiography
C. Chest x-ray
D. Multi slice CT
| Pulmonary angiography |
2e5b6018-c5f4-44d9-aa1f-fc73ee0696d6 | This is a case of congenital adrenal hyperplasia due to deficiency of 21 - hydroxylase deficiency.
Because of the enzyme block ,there is increased formation of 17- hydroxyprogesterone, which is then shunted into the production of testosterone.
Levels of cortisol and aldosterone are reduced. | Pediatrics | null | A 3–month old male child with normal genitalia presents to the emergency department with severe dehydration, hyperkalemia and hyponatremia. The measurement blood levels of which of the following will be helpful?
A. 17–hydroxy progesterone
B. Renin
C. Cortisol
D. Aldosterone
| 17–hydroxy progesterone |
b65ca73f-bca9-45cc-9cb3-6a9934924ccb | MUCORMYCOSIS: Caused by - rhizopus , rhizomucor , cunninghamella Moulds with non septate hyphae The higher prevalence of mucormycosis in India turned out to be statistically significant (p < 0.0001) in comparison with all other countries Predisposing factors - Organ transplant recipients - Long term desferroxamine therapy - Immunosuppression due to steroids or cytotoxic drugs Hematological malignancy - Diabetics - Chronic renal failure Five forms Rhinocerebral (most common site) Pulmonary mucormycosis (2' most common) Cutaneous Gastrointestinal Disseminated Diagnosis: Microscopy and biopsy show organisms that appears as broad ribbon like usually non septate hyphae which branch at right angles | ENT | null | Mucormycosis of paranasal sinus is most common in
A. HIV
B. Diabetes
C. Those on immuno suppressants
D. Post surgical
| Diabetes |
afc45b91-f055-4779-8c39-27391adec243 | Pineal gland is present posterior to midbrain so if tumor is in pineal gland ,it may l/t dorsal mid brain syndrome as it would press on the midbrain from behind. * MCA(Middle Cerebral Aery) not a pa of Circle of Willis * PCA (Posterior Cerebral Aery) P1,P2 and 10-11 Post choroidal aeries P1 supplies- Midbrain P2 supplies -PCA Post choroidal aeries supplies -Pineal gland | Medicine | Raised ICP and Brain death | Which of the following supplies the pineal gland?
A. Posterior choroidal aeries
B. Tuberothalamic
C. Recurrent aery of Heubner
D. Lenticulostriate aery
| Posterior choroidal aeries |
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