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f7b895c8-2529-4e78-b2e7-091bd28a46e3 | pathogenesis and clinical features The infective larvae deposited in the skin by the bite of the vector develop at the site to adult worms .Adult worms are seen singly, in pairs , or in tangled masses in the subcutaneous tissues ocular manifestations range from photophobia to gradual blurring of vision , progressing to total blindness. Ref : panikers textbook of medical parasitology 8th edition page 222 | Microbiology | parasitology | River blindness is caused by -
A. Onchocerca
B. Loa loa
C. Ascaria
D. B. Malayi
| Onchocerca |
00e0dcac-97a3-4624-b07f-8cef1b672d5e | Idiopathic thrombocytopenic purpura -quantitative disorder of platelets caused by antibodies directed against platelet or megakaryocytic antigens -related to antibody-mediated immune destruction of platelets or their precursors. -The peripheral blood smear in ITP exhibits numerous large platelets, and the bone marrow shows a compensatory increase in megakaryocytes. - C/F Petechia Purpura Hemorrhagic bullae Gum bleeding Hematuria Melena *Thrombocytopenia may be observed in the other choices but is usually associated with other systemic signs and symptoms. | Pathology | Bleeding disorder | A 9-year-old girl develops widespread pinpoint skin hemorrhages. She recovered from a fl u-like illness 1 week earlier. Laboratory findings reveal a platelet count of 20,000/mL but no other abnormalities. Her bone marrow shows an increased number of megakaryocytes. The platelet count is normal after 2 months. Which of the following is the appropriate diagnosis?
A. Antiphospholipid antibody syndrome
B. Disseminated intravascular coagulation
C. Hemolytic-uremic syndrome
D. Idiopathic thrombocytopenic purpura
| Idiopathic thrombocytopenic purpura |
dd3c398f-01f1-4f50-94c5-b7991b721e08 | Society
A society is a body of individuals of species, generally seen as a community or group, that is outlined by the bounds of functional interdependence, comprising also possible characters or conditions such as cultural identity, social solidarity or eusociality.
Human societies are characterized by patterns of relationships between individuals that share a distinctive culture or institution.
The importance of society lies in the fact that it controls and regulates the behavior of the individual both by law and customs.
It can exert pressure on the individuals to conform to its norms.
In short, society is a vast network of relationships and compulsions that propel, direct and constrain man's individual efforts.
Sociology is the study of society and social behavior. | Social & Preventive Medicine | null | What is the definition of society –
A. System of social relationship between individuals
B. Social relationship between families
C. Interaction of individuals and people
D. Relationship of individual family and the country
| Social relationship between families |
06ddfdaf-d088-42fd-b6d0-224da90f2eac | The above image shows Mitral facies which are seen in Mitral stenosis. Mitral stenosis may present with rosy cheeks, whilst the rest of the face has a bluish tinge due to cyanosis. In severe Mitral stenosis low cardiac output state produces vasoconstriction, peripheral cyanosis is often seen in lips, tip of nose and cheeks. Occasionally along with these, malar flush is seen due to vasodilation (vascular stasis) in malar area. | Medicine | Murmurs | A 50 year old lady comes to your OPD. What is the most probable diagnosis ?
A. Aoic Stenosis
B. Aoic Regurgitation
C. Mitral Regurgitation
D. Mitral Stenosis
| Mitral Stenosis |
9fc8b8ee-4a3b-424c-b539-bd13f6be6d40 | DUCHENNE MUSCULAR DYSTROPHY (PSEUDO HYPERTROPHIC MUSCULAR DYSTROPHY)
Duchenne muscular dystrophy is the most common hereditary neuromuscular disease affecting all races and ethnic groups.
Inheritance: X linked recessive
Presentation occurs between ages 3 and 5
Pathogenesis
Duchenne muscular dystrophy is caused by a mutation in the gene responsible for producing dystrophin.
Dystrophin is `subsarcolemmal protein' localized to the inner surface of the sarcolemma of the muscle fibre.
Dystrophin is part of Dystrophin - Glycoprotein sarcolenzmal complex and this protein deficiency leads to secondary loss of sarcoglycans and dystroglycans resulting in weakness of sarcolemma, causing membrane tears and muscle fibre necrosis.
Clinical manifestations:
Gower's sign is positive
Pseudohypertrophy of the calf is seen (muscle is replaced by fat & connective tissue)
Loss of muscle strength is progressive.
Proximal muscles and neck flexors are involved more
Leg involvement is more severe than arm involvement.
Contractures of heel cords and iliotibial band occurs (by age of 6 years)
progressive scoliosis develops.
Complications:
Chest deformity (scoliosis): Impairs pulmonary function By age of 16 and 18 years patients are predisposed to serious pulmonary fatal infections.
Cardiac: Cardiomyopathy and CHF may be seen Cardiac cause of death is uncommon
Intellectual impairment: is common (IQ is one SD below the mean) | Pediatrics | null | Duchenne Muscular Dystrophy is a disease of –
A. Neuromuscular junction
B. Sarcolemmal proteins
C. Muscle contractile proteins
D. Disuse atrophy due to muscle weakness
| Sarcolemmal proteins |
45c49f9b-1952-45c9-aaa5-b81cec4a1699 | If the hea rate does not improve after 30 sec with bag-and-mask (or endotracheal) ventilation and remains below 100 beats/min, ventilation is continued and chest compression should be initiated over the lower third of the sternum at a rate of 90 compressions/min. The ratio of compressions to ventilation is 3 : 1 (90 compressions:30 breaths). If the hea rate remains <60 beats/min despite effective compressions and ventilation, administration of epinephrine should be considered.Ref: Nelson; 20th edition; Page no: 845 | Pediatrics | New born infants | The ratio of chest compressions to ventilation in a newborn is
A. 1:01
B. 2:01
C. 3:01
D. 4:01
| 3:01 |
3710bd21-b8b8-48a3-a6d7-bf0ef7126c6d | Ans. is 'a' i.e., Pericardial Effusion o Auenbruger 's sign is an epicardial bulging due to massive pericardial effusion.Auenbrugeer frsieno It represents bulging of the epigastrium that may be seen in case of severe pericardial effusion.o The auenbrugger s sign is seen in large pericardial effusion.o During a large pericardial effusion an epigastric bulge is present,o This represents large pericardial effusion extending subxiphoid.o Compression of this bulge may cause hemodynamic compromise and cardiac tamponade.Signs in pericardial effusion : -Sign PresentationFriedreich's sign-Sudden collapse inthe distended neck veins with diastole suggests pericardial tamponade.Pitres's sign-Anterior bidging of the lower sternum suggests pericardial effusion.Auenbrugger's sign-Protuberance/Bulging of the epigastrium suggests massive pericardial effusion (Sign on inspection).Sansom s sign-Percussible dullness in the left third intercostal space suggests large pericardial effusion.Greene's sign -Lateral displacement of the percussed cardiac border with expiration suggests a large pericardial effusions.Ebstein's sign A large pericardial effusion can blunt the percussible righ cardiomyopathic angle producing dullness along the lower right sternal border.Rotch's sign-Dullness at the right lower sternal border suggests large pericardial effusion.Moschcowitz s sign-In pericardial effusion, the transition on percussion from the lungs in the right heart border is abrupt.Ewart's sign-A large pericardial effusion produces egophony and bronchial breathing at the lower border of the left scapula.Ewart's second sign-A large pericardial effusion makes the first rib seen more prominent along the sternal border.Dressier 's sign-Is dullness to percussion of the lower one half of the sternum.The Dressier sound is aflat sound on percussion the lower half or two third of the sternum. In the absence of mitral stenosis, this finding 'should at once arouse suspicion of pericardial effusion '.Bamberger's sign-Dullness at the angle of the scapula that disappears when the patient leans forward is Bamberger s sign of pericardial effusion.Dullness at the left lower lung field is Ewart s sign ofpericardial effusion, while right-sided dullness is Conner s sign. Disappearance of Ewart s or Conner s signs when the patient sits up and leans forward is Bambeiger s sign of pericardial effusion. | Medicine | Pericardial Disease | Auenbrugger's sign is seen in -
A. Pericardial Effusion
B. Constrictive pericarditis
C. Aortic Regurgitation
D. Mitral Stenosis
| Pericardial Effusion |
b120e064-f3e0-422d-a127-e32216d9fdd2 | The main function of renal tubules is the concentration of urine and this can be measured by the specific gravity of urine. | Physiology | null | The most sensitive index for renal tubular function is
A. Specific gravity of urine
B. Blood urea
C. GFR
D. Creatinine clearance
| Specific gravity of urine |
c578e074-2063-40bd-bcb2-e46852c541f6 | in ileocaecal tuberculosis,.Ulcerative--commonest 60%. Circumferential transverse often multiple 'girdle' ulcers - with skip lesions. It i common in old, malnourished people. skip lesions are typical in the case of crohn&;s diseaseskip lesions are also observed in wet gangrene and necrotizing enterocolitis . ref:SRB&;s manual of surgery,ed 3,pg no 513 | Surgery | G.I.T | Skip lesions are seen in
A. Ulcerative colitis
B. Crohn's disease
C. Typhoid
D. Tuberculosis
| Crohn's disease |
58cf02fc-c186-41e4-bcca-ff8c8bcc53c1 | Ans. c (High priority or transferable cases) (Ref. Park Textbook of PSM 22nd/pg.741)TRIAGEIt consists of rapidly classifying the injured on the basis of the severities of their injuries and the likelihood of their survival with prompt medical intervention.Four colour coding# Red - High priority or transferable cases# Yellow - medium priority# Green - ambulatory patients# Black - dead or moribund patients. | Social & Preventive Medicine | Hospital waste, disaster management and occupational health | In TRIAGE system for disaster management, Red colour code indicates?
A. About to die patients
B. Uninjured patients
C. High priority or transferable cases
D. Dead or moribund cases
| High priority or transferable cases |
982bc630-53b0-4431-bc0c-24dfad256bed | The fundic branches of the stomach can be defined as a group of vessels that can arise either directly or indirectly from the following source aeries: the left inferior phrenic aery, the accessory left hepatic aery, the left gastric aery, the left middle suprarenal aery, the main trunk of the splenic aery Ref - BDC 6e vol2 pg277 | Anatomy | Abdomen and pelvis | Posterior gastric aery is a branch of
A. Splenic aery
B. Hepatic aery
C. Left Gastric aery
D. Right Hastric aery
| Splenic aery |
23787236-6241-44b3-b752-cfafe9180a86 | *Chalcosis refers to the specific changes produced by the alloy of copper in the eye. Ref: Khurana 7th/e p.452 | Ophthalmology | Ocular trauma | Chalcosis is seen with-
A. Pb
B. Cu
C. Fe
D. Hg
| Cu |
42a6f6e3-e758-433a-bc9e-0d42a9e08043 | Juvenile myoclonic epilepsy (JANZ syndrome) - Polygenetic inheritance, Strong family history - Onset: 10 -19 yrs. - Myoclonic Jerk (early morning) and prominent in morning after awakening. Consciousness is preserved unless severe - EEG: 4-6 Hz Polyspike pattern seen. - May develop GTCS in future and in 30% will also develop absence seizure in future Rx - Valproate (lifelong) | Medicine | Epilepsy and EEG | In juvenile myoclonic epilepsy (JME), which is the most common presentation?
A. GTCS during sleep
B. GTCS on awake state
C. Myoclonus
D. Absence seizures
| Myoclonus |
c61e1ba9-8e7f-44d4-bda5-0e04fe2d46f4 | (Safety and comparisons with other medicines) (43-Bennett & Brown) (61-62-GG)Pharmacokinetics - what the body does to the drag. This refers to movements of the drug in and alteration of the drug by the body; includes absorption, distribution, binding/localization/storage, biotransformation and excretion of the drug (1-KDT)* Post licensing (marketing) studies of safety and comparisons with other medicines (43-BB)Pharmacodynamics - What the drug does to the body. This includes physiological and biochemical effects of drugs and their mechanism of action at macromolecular/subcellular/ organ system levels.Post marketing detection of adverse reaction - several strategies exist to detect adverse reactions after marketing of a drug, but debate continues about the most efficient and effective method. Formal approaches for estimation of the magnitude of an adverse drug effect are the follow-up or "cohort" study of patients who are receiving a particular drug, the "case control" study where the potential for a drug to cause a particular disease is assessed, and meta-analysis of pre and post marketing (61-62-Goodman & Gillman's 10th) | Pharmacology | General Pharmacology | The aim of post marketing pharmacokinetics is
A. Efficacy of the drug
B. Dosage of the drug
C. Deals with alteration of the drug includes absorption, distribution, binding / storage
D. Safety and comparisions with other medicines
| Safety and comparisions with other medicines |
a6c2dd05-bbda-4de4-aef4-b02a19c6ddb1 | Ans. is 'b' i.e., Oxytocin Milk ejection reflexo Milk ejection is normally initiated by a neuroendocrine reflex.o The receptors involved are the touch receptors, which are plentiful in the breast-especially around the nipple,o Impulses generated in these receptors are relayed to the supraoptic and paraventricular nuclei,o Discharge of the neurons causes secretion of oxytocin from the posterior pituitary.o Oxytocin causes contraction of the myoepithelial cells, smooth muscle - like cells that line the ducts of the breast,o This squeezes the milk out of the alveoli of the lactating breast into the large ducts (sinuses) and thence out of the nipple ready to flow into the mouth of the waiting infant,o In lactating women, genital stimulation and emotional stimuli also produce oxytocin secretion, sometimes causing milk to spurt from the breasts. | Physiology | Pituitary | Efferent pathway for milk ej ection reflex -
A. Prolactin
B. Oxytocin
C. ACTH
D. Growth hormone
| Oxytocin |
02a8a7a8-223d-4fa2-8eb1-eb80307dbe73 | The diagnostic criteria of NCPF includes splenomegaly, normal liver function test, esophageal varices (90-95% cases), patent hepatic and poal veins and no evidence of cirrhosis on biopsy. Based on this criteria, the most probable diagnosis in this patient is Non cirrhotic poal fibrosis. Ref: Arun J. Sanyal, Vijay H. Shah (2005), Chapter 25, "Noncirrhotic Poal Hypeension and Poal Vein Thrombosis", In the book, "Poal Hypeension: Pathobiology, Evaluation and Treatment", USA, Pages 411-12 ; Harrison's Internal Medicine, 15th Edition, Page 1759 | Pediatrics | null | A 8 yr old boy presents with upper GI bleeding. On examination, he is found to have splenomegaly; there are no signs of ascites, or hepatomegaly; esophageal varices are found on upper GI endoscopy. Most likely diagnosis is:
A. Budd chiari syndrome
B. Cirrhosis
C. Veno-occlusive disease
D. Non cirrhotic poal fibrosis
| Non cirrhotic poal fibrosis |
f3f3db02-5a89-4d17-a1a7-d8c1f6921fdf | Carbonic anhydrase inhibitors(CAIs)are more likely to produce acidosis in patients of COPD,CRF and DM.They are contraindicated in COPD as they may precipitate respiratory acidosis. They are sulfonamides in structure,so should not be given in hypeensitive persons. | Pharmacology | Endocrinology | Carbonic anhydrase inhibitors should not be given in
A. Sulfonamide hypersensitivity
B. Glaucoma
C. High altitude sickness
D. Metabolic acidosis
| Sulfonamide hypersensitivity |
ab4f2185-9e5c-45b3-9877-e7330db26804 | Ans. (a) Frontalis Suspension surgery(Ref: Kanski 8/e, p. 45; Parsons 22/e, p. 464; Yanoff 4/e, p. 1273)Brow (frontalis) suspension is used for severe ptosis (> 4 mm) with very poor levator function (< 4 mm) in simple congenital ptosis or occurring due to 3rd nerve palsy, blepharophimosis syndrome and following unsatisfactory previous LPS resection. The tarsal plate is suspended from the frontalis muscle using a sling made of either fascia lata or silicone/prolene | Ophthalmology | Orbit | A 5-year-old boy presents with Severe ptosis associated with poor levator function. Which of the following will be the treatment?
A. Frontalis Suspension surgery
B. Levator resection
C. Mullerectomy
D. Fasnella servat operation
| Frontalis Suspension surgery |
cc326ba5-8dce-434d-a32f-e8b13fced49b | .DIVEICULAR DISEASE OF THE COLON * They are acquired herniations of colonic mucosa through circular muscles at the points where blood vessels penetrate (points of least resistance). * It is more commonly localised to sigmoid colon (90%) but occasionally seen in full length of the colon. Rectum is not affected. saint's triad (5%) includes *Diveiculitis *Hiatus hernia *Gallstones.Complications of diveiculitis * Perforation and pericolic abscess or peritonitis * Progressive stenosis and intestinal obstruction * Profuse colonic haemorrhage (17-20%) * Fistula formation (5%)--vesicocolic, vaginocolic, enterocolic, colocutaneous. ref:SRB&;s manual of surgery,ed 3,pg no 820 | Surgery | Urology | A complicated case of diveicular disease is defined as diveicula with?
A. Abdominal pain
B. Abscess and perforation
C. Constipation or diarrhea
D. Diveicular bleeding
| Abscess and perforation |
85bb7548-0b76-4294-b963-d9f3e6d7b2f5 | Voluntary health organisations of India: 1.Indian red cross 2.Hind kusht nivaran sangh 3.Indian council for child welfare 4.Tubercukosis association of India 5.Bharath sevak samaj 6.Central social welfare board 7.The Kasthurba memorial fund 8.Famaily planning association of India 9.All India womens conference 10.All India blind relief society 11.professional bodies 12.International agencies like CARE Parks textbook of preventive and social medicine.K Park. Edition 23.Pg no: 916 | Social & Preventive Medicine | Health care of community & international health | Which of the following is a voluntary organization -
A. TB association of India
B. Directrate of Health Service
C. Indian Medical Council
D. Council of Medical Research
| TB association of India |
ce726946-4c40-447b-ab9f-064b43256c69 | SA node is situated at the atriocaval junction in the upper pa of the sulcus terminalis B D CHAURASIA'S HUMAN ANATOMY UPPER LIMB THORAX-VOLUME 1 SIXTH EDITION Page no-262 | Anatomy | Thorax | SA Node is located at
A. Upper end crista terminalis
B. Lower end of crista terminalis
C. At opening of IVC
D. At ostium primum
| Upper end crista terminalis |
41204550-cd7c-4610-812b-e640d126e230 | Hypokalemia is a serious adverse effect of Amphotericin B hence treatment mandates the monitoring of serum K+levels. ADVERSE EFFECTS OF AMPHOTERICIN B: Infusion related reactions are most common adverse effects and require premedication with antihistaminics or glucocoicoids. Dose limiting toxicity is nephrotoxicity manifested by renal tubular acidosis, hypokalemia and hypomagnesemia. It is most common dose dependent adverse effect. It may also result in anemia (due to decreased erythropoietin). * Intrathecal administration may cause seizures and neurological damage. Liposomal AMB, colloidal dispersion (ABCD) and lipid complex (ABLC) are lipid preparations of amphotericin B. These formulations result in decreased accumulation of the drug in tissues like kidney, thus nephrotoxicity is decreased. Some formulations also show decreased incidence of infusion related reactions. However, these new preparations have similar efficacy and antifungal spectrum as possessed by conventional preparations. | Pharmacology | Anti-Fungal Drugs | Amphotericin B treatment mandates the monitoring of which of the following electrolytes:-
A. Ca2+
B. Na+
C. K+
D. Cl-
| K+ |
15ef7e48-1d2a-497f-9266-8b9428d0c759 | Anterior cruciate ligament prevents Posterior dislocation of femur on tibia Anterior displacement of tibia on femur Ref: Gray's Anatomy The Anatomical Basics of Clinical Practice 41 e pg 1394. | Anatomy | Lower limb | ACL prevents
A. Anterior displacement of fibula
B. Posterior displacement of tibia
C. Anterior displacement of femur
D. Posterior displacement of femur
| Posterior displacement of femur |
442fa731-65c1-461b-ab3c-368b35e26cfa | Disorders of Appetitive Phase (Sexual Desire Disorders)1. Hypoactive sexual desire disorder:This disorder is characterised by an absence of fantasies and desire for sexual activity which is not secondary to other sexual dysfunctions, such as premature ejaculation or dyspareunia.This disorder is many times more common in females (previously called as frigidity) and its prevalence increases with age. 2. Sexual aversion disorder and lack of sexual enjoyment disorder:In the sexual aversion disorder, there is an aversion to and avoidance of all sexual activity with a sexual paner. 3. Excessive sexual drive:Rarely, both men (Satyriasis) and women (Nymphomania) may complain of the excessive sexual drive as a problem. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 126 | Psychiatry | Sleep disorders and eating disorders | Excessive sexual desire in males is known as
A. Nymphomania
B. Satyriasis
C. Triabadism
D. Sadism
| Satyriasis |
0232a481-b59b-4f54-bc0b-a2b8b35469fa | The presentations of fat necrosis are protean and can closely mimic cancer as a painless palpable mass, skin thickening or retraction, or mammographic densities or calcifications. About half of affected women have a history of breast trauma or prior surgery.Duct ectasia too can mimic cancerDuct ectasia presents as a palpable periareolar mass that is often associated with thick, white nipple secretions and occasionally with skin retraction. Pain and erythema are uncommon. This disorder tends to occur in the fifth or sixth decade of life, usually in multiparous women. The principal significance of this disorder is that the irregular palpable mass mimics the clinical and radiographic appearance of invasive carcinomaRef: Robbins Pathology; 9th edition; Page no: 1047 | Pathology | Breast | Which of the following benign condition can mimic cancer in the breast?
A. Accessory Axillary Breast Tissue
B. Fat necrosis
C. Fibrocystic disease
D. Granulomatous Mastitis
| Fat necrosis |
8a55330d-4ca5-4177-bdbc-ea2cdff4d78b | Systemic lupus erythematosus (SLE) predominantly affects younger women, and so the question of lupus and pregnancy may arise frequently in clinical practice. Patients with SLE have an increased incidence of spontaneous aboion, fetal death in utero, and prematurity. The mother may experience an exacerbation in the activity of her disease in the third trimester or peripaum period, and it may be difficult to distinguish between active SLE and preeclampsia. Therapy of pregnant patients with SLE is problematic, and the generalist should consult the literature or a specialist when such a patient is encountered.Congenital malformations (choices B, C, and D) are not a complication of pregnancies in patients with SLE. Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 54. Connective-Tissue Disorders. In F.G. Cunningham, K.J. Leveno, S.L. Bloom, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e. | Gynaecology & Obstetrics | null | A patient with systemic lupus erythematosus very much wants to become pregnant. What should her physician tell her regarding pregnancy in lupus patients?
A. There is no increased risk to the baby.
B. There may be an increase in cardiovascular malformations
C. There may be an increase in nervous system malformations.
D. There may be an increase in spontaneous aboions and prematurity.
| There may be an increase in spontaneous aboions and prematurity. |
72db3d9b-bc82-44ad-bb37-cc24a9710be2 | Panretinal photocoagulation is used to prevent fuher neovascularization Ref:Comprehensive ophthalmology-AK Khurana 6th edition chapter-10 page no:250 Ref:Comprehensive ophthalmology-AK Khurana 6th edition chapter-10 page no:250 | Ophthalmology | Glaucoma | The laser procedure, most often used for treating iris neovascularization is -
A. Goniophotocoagulation
B. Laser trabeculoplasty
C. Panretinal photocoagulation (PRP)
D. Laser iridoplasty
| Panretinal photocoagulation (PRP) |
8e666d76-e390-42a4-8390-9fe031088129 | Ans. is 'b' i.e., Height for age Assessment of PEM* Weight for age = Acute* Height for age = Chronic* Weight for Height = Acute on chronicAge dependent factors* Weight# Height* Head circumference# Chest circumferenceAge independent factor* Mid arm circumference# Kanawati index* Me Laren's index# Quae stick* Shakir tape# Skin fold thickness* Rao & Singh# Dugdale* Jelleff's ration | Pediatrics | Nutrition, Food Security, and Health | Best marker for chronic PEM is -
A. Weight for age
B. Height for age
C. Weight for Height
D. Head circumference
| Height for age |
c0e5da66-c71e-40f0-8608-cb9a6d7fa65f | Ans. is 'b' i.e., Li o Spinal cord begins at foramen magnum and, in adults, ends at the lower border of LI. Structure Extends up to # Adult spinal cord # Infant spinal cord Lower border of L1 or upper border of L2 Upper border of L3 vertebrae # Filum terminate # Pia mater Tip of the coccyx # Dural sheath # Subdural space # Subarachnoid space S2 vertebra | Unknown | null | Spinal cord ends at lower border of which vertebra in adults -
A. L11
B. L1
C. L3
D. L5
| L1 |
a0c8b205-f560-4651-bba4-fe1a35ef1028 | Adenoid cystic carcinoma, which has a propensity for neural invasion, is the second most common malignancy in adults. Skip lesions along nerves are common and can lead to treatment failures because of the difficulty in treating the full extent of invasion. Adenoid cystic carcinomas have a high incidence of distant metastasis but display indolent growth. It is not uncommon for patients to experience lengthy survival despite the presence of disseminated disease." - Schwaz 8/e "Treatment consists of removal of the gross tumor with radiation therapy for the microscopic disease that is assumed to exist at the periphery of the tumor." | Surgery | Head and neck | Which among the following parotid tumor spreads through neural sheath
A. Mixed parotid tumour
B. Adenocystic ca
C. Sq cell ca
D. Oxyphillic lymphoma
| Adenocystic ca |
6dc5657c-a26c-4c7d-b249-93168eaf1020 | McCune-Albright syndrome (MAS) is classically manifested as a triad of irregular cafe au lait spots, fibrous dysplasia of long bones with cysts, and precocious pubey (sexual precocity). This is a sporadic disorder caused by somatic (postzygotic) activating mutations in the GSalpha subunit that links G protein-coupled receptors to intracellular signaling pathways. Precocious pubey may be central or incomplete. Other clinical manifestations include, Hypehyroidism Adrenal nodules with Cushing syndrome Acromegaly Hyperprolactinemia Hyperparathyroidism Hypophosphatemic hyperphosphaturic rickets Autonomous endogenous-functioning ovarian cysts (in girls) Must know: Causes of Precocious Pubeal Development: Central (GnRH-dependent) precocious pubey: Idiopathic Central nervous system abnormalities Acquired--abscess, chemotherapy, radiation, surgical trauma Congenital--arachnoid cyst, hydrocephalus, hypothalamic hamaoma, septo-optic dysplasia, suprasellar cyst Tumors--astrocytoma, craniopharyngioma, glioma Peripheral (GnRH-independent) precocious pubey: Congenital adrenal hyperplasia Adrenal tumors McCune-Albright syndrome Familial male-limited gonadotropin independent precocious pubey Gonadal tumors Exogenous estrogen--oral (contraceptive pills) or topical Ovarian cysts (females) HCG-secreting tumors (eg, hepatoblastomas, choriocarcinomas) (males) Ref: Styne D. (2011). Chapter 15. Pubey. In D.G. Gardner, D. Shoback (Eds), Greenspan's Basic & Clinical Endocrinology, 9e. | Pediatrics | null | Eight year girl presented by her mother with sexual precocity. She may have the following disorder:
A. Hypehyroidism
B. Addison's disease
C. McCune Albright syndrome
D. Neuroblastoma
| McCune Albright syndrome |
a0525d56-0bb6-442a-abb7-04215133bdbf | Ans. is 'c' i.e., Diverticulitis * Hinchey Classification is used to describe perforations of the colon due to diverticulitis.* The Hinchey classification - proposed by Hinchey et al. in 1979 classifies a colonic perforation due to diverticular disease.* The classification is I-IV:i) Hinchey I - localised abscess (para-colonic)ii) Hinchey II - pelvic abscessiii) Hinchey III - purulent peritonitis (the presence of pus in the abdominal cavity)iv) Hinchey IV - feculent peritonitis. (Intestinal perforation allowing feces into abdominal cavity)* The Hinchey classification is useful as it guides surgeons as to how conservative they can be in emergency surgery. Recent studies have shown with anything up to a Hinchey III, a laparoscopic wash-out is a safe procedure avoiding the need for a laparotomy and stoma formation. | Surgery | Small & Large Intestine | Hinchey classification is used for perforations of colon secondary to -
A. Trauma
B. Carcinoma
C. Diverticulitis
D. Inflammatory enteropathy
| Diverticulitis |
938853a3-4646-4f48-bc46-9e3e297e886d | Answer is A (Prothrombin time (PT)): An increased prothrombin time is the most frequently observed first laboratory test suggesting the possibility of hepatocellular failure. Early liver failure may be suspected based on isolated prolongation of the Prothrombin Time (PT). Patients with early hepatocellular failure may present with isolated prolongation of PT Prolonged PT is an early sensitive indicator of hepatic synthetic dysfunction due to the sho half life offactor VII (2-6 hours) vvhich the failing liver cannot maintain. APTT is prolonged after PT in Liver Disease. Albumin has a long half life of about 20 days and hence reduced albumin will manifest only after 20 days of onset of Reduced synthetic function of Liver. Increased aerial ammonia is also a sign of acute liver failure, however increased aerial ammonia is primarily vieved as an impoant factor in the development of hepatic encephalopathy. 'Patient with liver disease may have only a prolonged PT (normal APTT and thrombin time) reflecting a decrease in factor VII which is the. first to be reduced in liver disorders because of its sho half life of 2-6 hours' 'Factor Vila is an essential enzyme in the extrinsic pathway of coagulation. The pathway is evaluated by PT. Because factor VII has the shoest half life of the procoagulant proteins, patient with early liver disease may present with an isolated prolonged PT' - Hematology / Oncology Secrets / 82 `Increased Prothrombin Time has a high prognostic value, paicularly for patients with acute hepatocellular failure. An abnormal prothrombin lime with confirmed prolongation of more than 5-6 seconds above control is the single laboratory test that draws attention to the possibility of the development offlummant hepatic necrosis (acute hepato cellular failure) in the course of acute viral hepatitis. Such a prolonged prothrombin time often precedes by days the manifestations of liver failure' - Schiff's Disease of the Liver 1011/52 'Most coagulation factors are produced in the liver (except VWF) and development of liver disease may result in prolongation of both PT and APTT. However because factor VII (Extrinsic pathway; measured by PT) has the shoest half life amongst all vitamin K dependent factor. PT will be the first to be prolonged. Development of Liver disease will lead to deficiency offactor VII first and initial prolongation of only the Prothrombin Time. With fuher deterioration of liver function both the PT and APTT will be prolonged' - 'Clinical Anesthesia' by stoelting (Lippincott Williams) 2009/396 | Medicine | null | The first laboratory test that becomes abnormal in acute hepatocellular failure is:
A. Prothrombin time (PT)
B. APTT
C. Decreased Albumin
D. Increased Aerial Ammonia
| Prothrombin time (PT) |
8bb9df52-1dbe-49b1-b957-a30c97e17156 | Ans. A Meigs syndromeRef: CMDT 2019 page 323* The CXR shows presence of right sided pleural effusion along with history of ascites and a benign ovarian tumor. This a triad seen in Meigs syndrome.* Choice B is seen in post MI patients* Choice C leads to acute onset ascites and right upper quadrant pain* Choice D leads to obstructive jaundice and cachexia. | Physiology | Misc. | A 42-year-old woman with benign ovarian tumor presents with ascites and breathlessness. CXR is performed. The clinical diagnosis is?
A. Meigs syndrome
B. Dressier syndrome
C. Budd-Chiari syndrome
D. Cholangiocarcinoma
| Meigs syndrome |
832ec1a2-99db-4673-9c7b-5750d5ea2988 | Progesterone reduces muscle excitability by increasing calcium binding, thereby reducing free intracellular calcium. Oestrogen has the opposite effect and increases myometrial excitability.Refer page no 106 of Textbook of obstetrics, Sheila Balakrishnan, 2 nd edition. | Gynaecology & Obstetrics | General obstetrics | The sensitivity of uterine musculature is
A. Enhanced by progesterone
B. Enhanced by estrogen
C. Inhibited by estrogen
D. Enhanced by estrogen and Inhibited by progesterone
| Enhanced by estrogen and Inhibited by progesterone |
e2caf3e1-172d-4163-b42e-a9a75317bf70 | The most serious consequence of splenectomy is increased susceptibility to bacterial infections, paicularly those with capsules such as Streptococcus pneumoniae, Haemophilus influenzae, and some gram-negative enteric organisms. Patients under age 20 years are paicularly susceptible to overwhelming sepsis with S. pneumoniae. The case-fatality rate for pneumococcal sepsis in splenectomized patients is 50-80%. Ref: Henry P.H., Longo D.L. (2012). Chapter 59. Enlargement of Lymph Nodes and Spleen. 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. | Surgery | null | A patient with hypersplenism underwent splenectomy. The most probable oppounistic infection in this patient after the procedure is:
A. E. coli
B. Pneumococci
C. Meningococci
D. Staphylococci
| Pneumococci |
1eb901dd-422a-458b-ab13-f684e54ffb7d | Chronic inflammatory demyelinating polyneuropathy (CIDP):An acute-onset form of CIDP should be considered when GBS deteriorates >9 weeks after onset or relapses at least three times.This neuropathy shares many features with the common demyelinating form of GBS, including elevated CSF protein levels and the Edx findings of acquired demyelination.The CSF is usually acellular with an elevated protein level.Biopsy typically reveals little inflammation and onion-bulb changes (imbricated layers of attenuated Schwann cell processes surrounding an axon) that result from recurrent demyelination and remyelination.CIDP responds to glucocoicoids, whereas GBS does not. Ref: Amato A.A., Hauser S.L. (2012). Chapter 385. Guillain-Barre Syndrome and Other Immune-Mediated Neuropathies. 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. | Pathology | null | A female is admitted in the ICU with the symptoms of GBS. She is getting these symptoms for the third time during few weeks. Nerve biopsy reveals onion-bulb appearance. What can be the MOST probable diagnosis?
A. Amyloidotic neuropathy
B. Diabetic neuropathy
C. Chronic inflammatory demyelinating polyneuropathy
D. Leprotic neuropathy
| Chronic inflammatory demyelinating polyneuropathy |
829e715b-3435-4089-ac2a-783a5ced2b2b | Ans. is 'a' i.e., Coronal Both coronal and axial view are used, but coronal views are best to study paranasal sinus polyps. | ENT | null | Paranasal polyp CT view?
A. Corona!
B. Axial
C. Sagital
D. 3D
| Corona! |
72de85f4-4b75-4259-b069-9ce32c412dc0 | Ans. (c) Specular microscopeRef : Yanoff 3/d, p 83 | Ophthalmology | Cornea | Corneal endothelial counting is done by?
A. Tachymetry
B. Pachymetry
C. Specular microscope
D. Perimetry
| Specular microscope |
ee274298-b680-4aad-881f-c992d2c3daba | A percentile (or a centile) is a measure used in statistics indicating the value below which a given percentage of observations in a group of observations falls. There is no standard definition of percentile,. however all definitions yield similar results when the number of observations is very large and the probability distribution is continuous. In the limit, as the sample size approaches infinity, the 100pth percentile (0<p<1) approximates the inverse of the cumulative distribution function (CDF) thus formed, evaluated at p, as p approximates the CDF. This can be seen as a consequence of the Glivenko-Cantelli theorem. Ref : https://en.m.wikipedia.org/wiki/Percentile | Social & Preventive Medicine | Biostatistics | Percentiles divides the data into _____ equal pas
A. 100
B. 50
C. 10
D. 25
| 100 |
90811af8-fc0f-4b74-8630-63306c1e545f | The lateral border provides inseion to vastus lateralis in its upper one-third or half. The medial border provides inseion to the vastus medialis in its upper two-thirds or more. Ref : B D Chaurasia's Humsn Anatomy , seventh edition , volume 2 , pg, no. 22 | Anatomy | Lower limb | Lateral dislocation of patella is prevented by
A. Rectus femoris
B. Vastus medialis
C. Vastus lateralis
D. Vastus intermedius
| Vastus medialis |
6b70c2af-9a94-4ecf-a07a-42f7309d2e57 | Wilson’s disease is an autosomal recessive disorder.
Autosomal recessive disorders
1) Metabolic - Cystic fibrosis, Phenyl ketonuria, Galactosemia, Homocystinuria, Lysosomal
storage dis, al- antitrypsin deficiency, Wilson disease, Hemochromatosis, Glycogen storage disorders
2) Hematological - Sickle cell anemia, Thalassemias
3) Endocrine - Congenital adrenal hyperplasia (some variants), Albinism
4) Skeletal - EDS (some variants) Alkaptonuria
5) Nervous -Friedreich ataxia, Spinal muscular atrophy, Neurogenic muscular atrophies, Ataxia
Telegiectasia. | Pathology | null | Wilson’s disease is?
A. AR
B. AD
C. XR
D. XD
| AR |
2ab33225-2e29-4e94-96d1-c9a23ca34a99 | Ans. (a) GlandularRef. Bailey & Love 24th edp 1389 | Surgery | Anatomy (Urethra & Penis) | Most common type of hyppospadias is?
A. Glandular
B. Penile
C. Scrotal
D. Perineal
| Glandular |
307d375e-95d9-4907-8f09-0da8426a5b19 | IL-11 (oprelvekin) is approved for use in the setting of expected thrombocytopenia, but its effects on platelet counts are small, and it is associated with side effects such as headache, fever, malaise, syncope, cardiac arrhythmias, and fluid retention. | Pathology | All India exam | Which of the following therapy is known to stimulate progenitor megakaryocytes and used in Rx of Cancer Chemotherapy-Induced Thrombocytopenia?
A. IL-2
B. IL-6
C. IL-8
D. IL-11
| IL-11 |
0a765deb-0d9b-4b03-89a0-60cff2fe3491 | Sumoylation of histones is associated with Transcription repression Histone post-translational modifications & their role: Post-translational modifications Role Acetylation of histones H3 and H4 Activation or inactivation of gene transcription Acetylation of core histones Chromosomal assembly during DNA replication Phosphorylation of histone H1 Condensation of chromosomes during the replication cycle ADP-ribosylation of histone DNA repair Methylation of histone Activation and repression of gene transcription Mono-ubiquitylation Gene activation, repression, and heterochromatic gene silencing Sumoylation of histones Transcription repression | Biochemistry | Basics of DNA | Sumoylation of histones proteins is associated with
A. Activation of gene transcription
B. Condensation of chromosome
C. Transcription repression
D. Inactivation of gene transcription
| Transcription repression |
dd2f2b9e-4212-40ae-be89-33a582f19dc6 | Ans. is 'c' i.e., Permathrin Treatment of scabies in children* Topical permethrin (5% cream) is a safe and effective scabicide in children. It is recommended as a first-line therapy for patients older than 2 months of age. Because there are theoretical concerns regarding percutaneous absorption of permethrin in inf ants younger than 2 months of age, guidelines recommend 7% sulfur preparation instead of permethrin.* Gamma benzene hexachloride 1% lotion (lindane) is recommended as second-line therapy for scabies in children. But it should be used with caution in children younger than 2 years of age as systemic absorption in children can cause neurotoxicity. It should not be applied over face and scalp* Ivermectin is not approved for use in children younger than 5 years.* Crotamiton 10% cream is approved by the US Food and Drug Administration for treatment of scabies in adults, but there is very little research on its use in children.Note - permethrin is the DOC for scabies in infants older than 2 years, pregnant & nursing female. | Skin | Scabies | Treatment of choice for scabies in an infant < 6 months is?
A. BHC
B. Ivermactin
C. Permathrin
D. Crotomiton
| Permathrin |
f4ed60f6-a828-4619-9f96-ec96800a2c63 | Lipoid proteinosis is a rare, recessively inherited disorder, characterized by infiltration of the skin, oral cavity and larynx. Patients with this genodermatosis can usually be recognized instantly because of husky voice, inability to protrude tongue and thickened eyelids. | Ophthalmology | Diseases of orbit, Lids and lacrimal apparatus | Beaded margin of eyelid is seen in
A. Erythema granuloma annulare
B. Leprosy
C. Granuloma annulare
D. Lipoid proteinosis
| Lipoid proteinosis |
a1e40ee6-0933-41b9-ae9f-6e1b6d9c40b3 | Ans. is 'a' i.e., Mc Treatment of Open Fractures Gustilo's classification of open fractures : Type I Small clean puncture wound with/ without protruded bone spike. Low energy non-comminuted fracture(low energy trauma). Little soft tissue injury with no crushing. Type II More than 1 cm long wound. Moderate soft tissue damage and crushing. Low to moderate energy trauma with moderate comminution. Type III Large laceration, skin flap, crushing. IIIA: fractured bone can be adequately covered by soft tissue despite laceration. IIIB: extensive periosteal stripping and fracture cover is not possible without use of local or distant flaps. IIIC: associated aerial injury that needs to be repaired regardless of the amount of other soft tissue damage. | Surgery | null | Vascular repair to be done in which Gustilo Anderson type?
A. Inc
B. I
C. II
D. IlIb
| Inc |
b246ec5e-7cc1-4d1b-a147-a200ad497fb8 | A judicial magistrate is the optimal person to record a dying declaration, but before recording the statement the doctor should ceify that the person is conscious and his mental faculties are normal. This is called "compos mentis". Also know S.32 IEA deals with dying declaration Ref: Textbook of Forensic Medicine and Toxicology by Narayan Reddy, Edition 21, Page - 9. | Forensic Medicine | null | You have been directed by a class - I judicial magistrate to provide "Compos mentis". "Compos mentis" is associated with which of the following?
A. Exhumation of a buried body
B. Dowry death
C. Dying declaration
D. Death in police custody
| Dying declaration |
b842d077-444e-4aa2-99c9-c96b8c64a371 | Usually students tend to mark 17 as the answer. Phenylalanine gets conveed to Tyrosine by enzyme Phenylalanine Hydroxylase. Most Hydroxylases are Mono-oxygenases i.e. EC No. 1. In hydroxylation reactions, only one oxygen atom from the molecular oxygen is added because H was already present in the phenylalanine. So, change in molecular weight is by 16 and NOT 17. Extra Information: Phenylalanine is an essential amino acid and its only role in the body is to give rise to tyrosine. | Biochemistry | Phenylalanine and Tyrosine metabolism Detail | The difference in molecular weight between Phenylalanine & Tyrosine is by :
A. 17
B. 16
C. 64
D. 32
| 16 |
8e802c79-24b6-4114-a9f6-5dfa8f25ce30 | POLYENE ANTI BIOTICS The name polyene is derived from their highly double-bonded structure. Amphotericin B is described as the prototype. Amphotericin B (AMB): It is obtained from Streptomyces nodosus ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:757 | Pharmacology | Chemotherapy | Amphotericin-B is obtained from:
A. Streptomyces nodosus
B. Streptomyces pimprina
C. Streptomyces nousseri
D. Streptomyces fragilis
| Streptomyces nodosus |
f1dbe884-4b3b-4f22-9f86-ad7f6899a631 | Ans. C: Sore throat Sore throat (pharyngitis, laryngitis) is the most common post-operative complication of intubation It usually subsides within 2-3 days without any treatment | Anaesthesia | null | Which of the following is the most common postoperative complication related to intubation: March 2011
A. Malposition
B. Bleeding
C. Sore throat
D. Abductor Paralysis
| Sore throat |
d53ca9dc-791b-42a5-b7cc-1a40dd5ec013 | Toluidine Blue Toluidine blue is a basic metachromatic dye with high affinity for acidic tissue components, thereby staining tissues rich in DNA and RNAQ. Wide applications both as vital staining in living tissues and as a special stain used in vivo to identify dysplasia and carcinoma of the oral cavityQ. | Surgery | Oral cavity | Areas of carcinoma of oral mucosa can be identified by staining with:
A. 1% zinc chloride
B. 2% silver nitrate
C. Gentian violet
D. 2% toluidine blue
| 2% toluidine blue |
2001f33c-3395-4e3b-ab8c-ebad97bc1ae0 | (D) (Weight loss) (1992-95-H 18th)* Syndrome X is much more common in patients who are obese.Metabolic' syndrome (syndrome X) or Insulin resistance syndrome (805- Davidson 22nd)* DM type II* Hypertension* Dyslipidaemia * Over weight/obesity* Central adiposity is a key feature of the syndrome* Sedentary life style* Aging 50 years* Coronary heart disease* Lipodystrophy* Glucose intoleranceOther ossociated conditions1. Non alcoholic fatty liver disease2. Hyperuricemia3. Polycystic ovary syndrome4. Obstructive sleep apnea | Medicine | Endocrinology | Syndrome x not found in
A. DM II
B. Dyslipidemia
C. High triglycerides
D. Weight loss
| Weight loss |
39acc331-c2fb-402f-a71b-06f12d87595a | Fibroids are monoclonal and about 40% have chromosomal abnormalities that include translocations between chromosomes 12 and 14, deletions of chromosome 7, and trisomy of chromosome 12.Cellular, atypical, and large fibroids are most likely to show chromosomal abnormalities.Ref: Berek and Novak&;s Gynecology; 15th edition; Chapter 15 | Gynaecology & Obstetrics | Uterine fibroid | Trisomy of which chromosome is associated with uterine fibroids?
A. Trisomy 10
B. Trisomy 11
C. Trisomy 12
D. Trisomy 14
| Trisomy 12 |
f1dd9b27-cff8-4da2-b336-6326410b8094 | Ans. b (Posterior portion of psoas) (Ref. BDC anatomy Vol. II 3rd ed., 278)LUMBAR PLEXUS# The lumbar plexus lies in the posterior part of the substance of the PSOAS MAJOR muscle.# It is formed by the ventral rami of the upper 4 lumbar nerves.Its branches include:- Ilioinguinal nerve (L1)- Lateral cutaneous nerve of the thigh (L2, L3 dorsal divisions)- Lumbosacral trunk (L4, 5; ventral trunk)- Genitofemoral nerve (L1, L2, ventral divisions)- Obturator nerve (L2, 3, 4; dorsal divisions)- Femoral nerve (L2, 3, 4; dorsal divisions)- Iliohypogastric nerve (L1)Branches of the lumbar plexusNerveSegmentMuscleMotionSensationIliohypogastricT12 -L1# Inter oblique# External oblique# Transversus abdominusAnterior abdominal wall# Inferior abdominal wall# Upper lateral quadrant of buttockIlioinguinalL1Internal obliqueAnterior abdominal wall# Internal medial inguinal ligament# GenitaliaGenitofemoralL1-L2CremasterTesticular# Inferior medial inguinal ligament# Spermatic cordLateral femoral cutaneousL2-L3 # Anterior, lateral and posterior aspect of thighFemoral Nerve1. Anterior division L2-L4# Sartorius,# Pectineus# Medial aspect of lower thigh# Adduction of thigh# Anterior medial skin of thigh2. Posterior division Quadriceps# Knee extension# Patellar movement# Anterior thigh hip and kneeObturator nerve1. Anterior division L2-L4# Gracilis# Adductor longus# Adductor brevis# PectineusThigh adduction# Posterior medial thigh# Medial knee# Hip2. Posterior division # Adductor magnus# Obturator externusThigh adduction with lateral hip rotationKnee | Anatomy | Nerves of Abdomen | Lumbar plexus is situated in
A. Anterior portion of psoas
B. Posterior portion of psoas
C. Anterior portion of quadratus lumborum
D. Posterior portion of quadratus lumborum
| Posterior portion of psoas |
fb62e315-1bdb-4842-a245-767538fdd185 | Ans. is 'b' i.e., 2 * Guidelines recommeded for prevention of neonatal tetanus are:-1) Training of birth attendants to provide clean delivery. Clean delivery mainly concentrates on three things:i) Hand (of attendant)ii) Delivery surfaceiii) Cord3 cleans5 cleans7 cleans (proposed under RCH+III)Clean HandClean HandsClean HandsClean TowelClean waterClean delivery surfaceClean delivery surfaceClean delivery surfaceClean cord careClean cord cut/bladeClean cord tieClean cord stump (no applicant)Clean cord cut/bladeClean cord tieClean cord stump (no applicant)2) Administration of tetanus-toxoid to pregnant women. Two dose of tetanus toxoid (one at early pregnancy and 2nd one month later) is given in unimmunized pregnant women; whereas only one booster dose is given in immunized pregnant female.3) Administration of tetanus toxoid to all women of child bearing age in areas where incidence of neonatal tetanus is high and coverage of antenatal care is low.4) Administration of antitoxin to unprotected neonates within 6 hours of birth. | Medicine | Infection | WHO recommended tetanus toxoid dose/s to prevent maternal and neonatal tetanus for a pregnant woman whose previous immunization status is not known is/are -
A. 1
B. 2
C. 3
D. 4
| 2 |
a2baec8e-32ee-44a3-a36b-de399c141844 | The sodium- potassium pump uses the energy contained in ATP to maintain the sodium gradient across the membrane. The sodium gradient, in turn, is used to transport other substances across the membrane. For example, the NaCa exchanger uses the energy in the sodium gradient to help maintain the low intracellular calcium required for normal cell function. Although sodium enters the cell during an action potential, the quantity of sodium is so small that no significant change in intracellular sodium concentration occurs. Because the sodium transference is so low, the sodium equilibrium potential is not an important determinant of' the resting membrane potential. | Unknown | null | The sodium gradient across the nerve cell membrane IS:
A. A result of the Donnan equilibrium
B. Significantly changed during an action potential
C. Used as a source of energy for the transport of other ions
D. An important determinant of the resting membrane potential
| Used as a source of energy for the transport of other ions |
6c2fbed8-f300-451d-92ce-5ea00e9ad6af | “Hyperglycemia at the time of conception results in enhanced rates of spontaneous abortion and major congenital malformations. Hyperglycemia in later pregnancy increases the risk for macrosomia, hypocalcemia, polycythemia, respiratory difficulties, cardiomyopathy, and congestive heart failure.”
COGDT 10/e, p 316
Macrosomia:
Fetal macrosomia is defined by ACOG as fetal birth weight is > 4500 g.
Macrosomic fetuses have extensive fat deposits on the shoulder and trunk which is associated with increased incidence of shoulder dystocia.
Organ which is not affected in macrosomia is brain.
Control of postparandial blood sugar levels is very important for preventing macrosomia.
For diagnosing macrosomia: USG is performed every 4 weeks, starting at 20 weeks of gestation.
First sign of developing macrosomia is: increase in abdominal circumference more than other measurements.
Management : If wt of fetus is > 4.5 kg in diabetic mothers or > 5 kg in non diabetic mothers–section is recommended. | Gynaecology & Obstetrics | null | Late hyperglycemia in pregnancy is associated with:
A. Macrosomia
B. IUGR
C. Postmaturity
D. Congenital malformation
| Macrosomia |
046fd89c-04ff-493b-9441-e65adc6fd011 | Mitochondria are essential in controlling specific apoptosis pathways. The redistribution of cytochrome c, as well as apoptosis-inducing factor (AIF), from mitochondria during apoptosis leads to the activation of a cascade of intracellular proteases known as caspases. Ref: Beal M.F., Hauser S.L. (2012). Chapter 366. Biology of Neurologic Diseases. 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. | Pathology | null | Which of the following organelle plays a pivotal role in apoptotic pathways?
A. Endoplasmic reticulum
B. Golgi complex
C. Mitochondria
D. Nucleus
| Mitochondria |
5fee6b27-0716-4dab-9d5b-1e2016da9da7 | Ans. is 'c' i.e., Atherosclerosis Lipoprotein - (a) o Lp (a) is a lipoprotein similar to LDL in lipid and protein composition, but it contains an additional protein called apolipoprotein (a). o Elevated level of Lp (a) is associated with increased risk of atherosclerosis. o How does Lp (a) increase the risk of atherosclerosis ? In atherosclerosis, there is hypercoagulability and hypofibrinolysis due to associated inflammation (remind you-atherosclerosis is a chronic inflammatory condition). So there is consistent doposition of fibrin. Lp (a) has close homology to plasminogen and it competes with plosminogen for binding on the surface of endothelium. This result in reduced generation of plasmin from plasminogen --> Inhibition of endogenous fibrinolytic system. This enhances fuher fibrin deposition. In addition, Lp (a) is accumulated in atherosclerotic lesions. So, Lp (a) causes impaired cell surface fibrinolysis and progressive atherosclerosis. | Pathology | null | Raised serum level of lipoprotein-a is a predictor of -
A. Cirrhosis of liver
B. Rheumatic ahritis
C. Atherosclerosis
D. Cervical cancer
| Atherosclerosis |
a7874a0c-b107-42f6-9edd-72dc556b0d03 | Management: Orchidopexy, Ideal time: 6-12 months of age. (Best time is 6 months) Types of Orchiopexy 1. Fowler-Stephens orchidopexy 2. Microvascular testicular autotransplanatation (Best results) 3. Ladd and Gross orchidopexy 4. Ombridanne's orchidopexy 5. Placing testis in Daos pouch 6. Keetley-Torek orchidopexy Diagnostic Laparoscopy IOC for 'non-palpable' UDT. Vas and testicular aery is traced in Pelvis. Blind ended Vas doesn't conclude the absence of testis, whereas Blind ended testicular aery is a definitive investigation for an absence of testis. Laparoscopy is also useful in lap. Assisted orchidopexy | Surgery | Testis and scrotum | Best time for surgery of Undescended testis is:
A. Just after bih
B. 6 months of age
C. 12 months of age
D. 24 months of age
| 6 months of age |
78dae398-d167-44b7-b0cc-acf62218b6c9 | Following virus entry into a cell, the virus initiates replication and the viral nucleic acid interacts with specific microbial sensors (TLR3, TLR7, TLR 9, RIG-1, and MDA-5). This interaction triggers cellular production of IFN that is secreted from the infected cell.Jawetz 27e pg: 130 | Microbiology | Immunology | IFN-a and IFN-b are produced by the virus-infected cell due to the interaction of virus nucleic acid with which of the following?
A. C3 (third component of complement)
B. Defensins
C. TLR pathway
D. IL-12
| TLR pathway |
9710d1ea-5cf3-4dfe-bbd9-e135ae0dd4e5 | Ans.is 'a' i.e., 4-6 hours (Ref: Ananthanarayan, 9th/e, p. 202 and 8th/e, p. 198)* Incubation period of staphylococcal food poisoning is 1-6 hours.* Toxin can be detected by ELISA, Latex agglutination test and toxin gene detection by PCR. | Microbiology | Bacteria | Incubation period of staphylococcal food poisoning is:
A. 4-6 hrs
B. 6-12 hrs
C. 12-18 hrs
D. 18-24 hrs
| 4-6 hrs |
50994534-2a5b-44da-a34f-b03949407660 | The Corpus delicti (the body of offence or the essence of crime) means, the facts of any criminal offence, i.e., murder. The main pa of corpus delicti is the establishment of identity of the dead body, and identification of violence in a paicular way, at a paicular time and place, by the person or persons charged with a crime and none other. Ref: Essentials of Forensic Medicine and Toxicology by K S Narayan Reddy, 27th edition, Page 52. | Forensic Medicine | null | Which of the following is the meaning of 'Corpus delicti' in forensic medicine?
A. Essence of crime
B. Inquest into death
C. Postmoem examination
D. Death by asphyxia
| Essence of crime |
a3cd956c-7c5a-434d-9ccd-498e5e9f60b7 | Ans. is 'c' i.e., Grayo 100 Rad is equal to 1 gray or 1 rad is equal to 0[?]01 gray.Quantity measuredOld unitNew (SI) unit RadioactivityCurieBecquerel1 curie = 3[?]7 x 1010 Becquerel1 Becquerel = 2[?]7 x 10-11 curieRadiation exposureRoentgenColumb/cm Absorbed doseRadGray (Gy)100 rad = 1 Gray1 rad = 0[?]01 GrayDose equivalentRemSievert (Sv)100 Rem = 1 Sievert1 Rem = 0[?]01 Sievert | Radiology | Radiation Dose and Safety Considerations in Imaging | Unit of absorbed dose of radiation -
A. Curie
B. Roentgen
C. Gray
D. Becquerel
| Gray |
903533aa-5777-444f-ad98-b96197a6916e | Ans. is 'b' i.e., Lattissimus Dorsi o Lattissimus Dorsi is sometimes referred as the 'Climber's muscles' as it comes in visible action in climbing up the trees, so also in swimming and rowing.Special nameMuscleBoxers muscleSerratus anteriorTailer's muscleSartoriusRider's muscleAdductors of thighClimber's muscleLattissimus dorsiGuthrie's muscleWilson's muscleSphincter urethraeShawl muscleCowl muscleTrapeziusLaughing or Smiling muscleCoder's muscleZygomaticus majorCorrugator supercilliToynbee's muscleTensor tympaniThelle's muscleSuperficial transverse perinea | Anatomy | Thorax | Which of the following is Climber's muscle -
A. Serratus anterior
B. Lattissimus Dorsi
C. Rhomboidus major
D. Subscapu laris
| Lattissimus Dorsi |
0c74a0a9-c87a-42b4-9014-a769af34271c | Ans. is 'a' i.e., TT TT --4. Max. no. of CD4 - T cells (TH -1) 11, --II. Max. no. of CD8 - T cells | Microbiology | null | Subtype of leprosy with maximum number of TH -1 cells -
A. TT
B. BB
C. LL
D. Borderline leprosy
| TT |
ae354de0-1c44-4f8b-921e-0cd141bcad67 | - Enterococcus faecalis can- - Resist 6.5% NaCL - Resist 40% bile - Temperature of >55o C They are bile esculin positive. Bile esculin agar is used to culture. Black coloured colonies are seen. In gram staining, Spectacle like appearance is present | Microbiology | JIPMER 2019 | Which among the following is bile esculin positive and shows growth in 6.5% sodium chloride?
A. Streptococcus agalactiae
B. Streptococcus pneumoniae
C. Enterococcus faecalis
D. Streptococcus viridans
| Enterococcus faecalis |
cfe3ccd6-0a19-4427-b97c-fb1dde20f235 | Middle cerebral aery syndrome is a condition whereby the blood supply from the middle cerebral aery (MCA) is restricted, leading to a reduction of the function of the poions of the brain supplied by that vessel: the lateral aspects of frontal, temporal and parietal lobes, the corona radiata, globus pallidus, caudate and putamen. The MCA is the most common site for the occurrence of ischemic stroke. Depending upon the location and severity of the occlusion, signs and symptoms may vary within the population affected with MCA syndrome. More distal blockages tend to produce milder deficits due to more extensive branching of the aery and less ischemic response. In contrast, the most proximal occlusions result in widespread effects that can lead to significant cerebral edema, increased intracranial pressure, loss of consciousness and could even be fatal. In such occasions, mannitol (osmotic diuretic) or hypeonic saline are given to draw fluid out of the edematous cerebrum to minimise secondary injury. Hypeonic saline is better than mannitol, as mannitol being a diuretic will decrease the mean aerial pressure and since cerebral perfusion is mean aerial pressure minus intracranial pressure, mannitol will also cause a decrease in cerebral perfusion. Contralateral hemiparesis and hemisensory loss of the face, upper and lower extremities is the most common presentation of MCA syndrome. Lower extremity function is more spared than that of the faciobrachial region.The majority of the primary motor and somatosensory coices are supplied by the MCA and the coical homunculus can, therefore, be used to localize the defects more precisely. Middle cerebral aery lesions mostly affect the dominant hemisphere i.e. the left cerebral hemisphere Ref Harrison20th edition pg 2456 | Medicine | C.N.S | In a right-handed person, which of the following signs is not a characteristic feature of occlusion in the right middle cerebral aery?
A. Left hemoplegia with left UMN VII cranial nerve palsy
B. Left hemiplegia with aphasia
C. Left hemiplegia with right anosognosia
D. Left hemiplegia with left hemi-anaesthesia
| Left hemiplegia with aphasia |
d28b441f-c7f3-4bb9-bfbf-d1c4b3fa7f89 | Acute primary angle glaucoma: It occurs due to a sudden total angle closure leading to severe rise in intraocular pressure (IOP). Typically acute attack is characterized by sudden onset of very severe pain in the eye which radiates along the branches of 5th nerve. Nausea, vomiting and prostrations are frequently associated with pain. Ref: Comprehensive Ophthalmology by A K Khurana, 4th edition, Page 229. | Ophthalmology | null | A 56 year old female is brought to casualty with acute narrow angle glaucoma. She has severe pain in her eye and it spreads. The radiation of pain in acute narrow angle glaucoma is in the distribution of:
A. Ill nerve
B. V nerve
C. VII nerve
D. II nerve
| V nerve |
98b4a7e7-6536-4890-94ea-cf538dc84b13 | Ans. B: Vascular ED is essentially a vascular disease. It is often associated with other vascular diseases and conditions such as diabetes, hypeension, and coronary aery disease. Other conditions associated with ED include neurologic disorders, endocrinopathies, benign prostatic hyperplasia, and depression. Conditions associated with reduced nerve and endothelium function, such as aging, hypeension, smoking, hypercholesterolemia, and diabetes, alter the balance between contraction and relaxation factors. These conditions cause circulatory and structural changes in penile tissues, resulting in aerial insufficiency and defective smooth muscle relaxation. In some patients, sexual dysfunction may be the presenting symptom of these disorders. Additionally, ED is often an adverse effect of many commonly prescribed medications. Some psychotropic drugs and antihypeensive agents are associated with ED. | Psychiatry | null | Organic cause for erectile dysfunction is most commonly: March 2009
A. Psychological
B. Vascular
C. Neuronal
D. Hormonal
| Vascular |
a0393e45-f54e-48bb-a8d8-08345f4718eb | GAUCHER DISEASE: It is one of the most common lysosomal storage diseases There are 3 clinical subtypes delineated by the absence or presence and progression of neurologic manifestations: type 1 or the adult, nonneuronopathic form; type 2, the infantile or acute neuronopathic form; and type 3, the juvenile or subacute neuronopathic form. All are autosomal recessive traits. Clinical manifestations : Thrombocytopenia & its manifestation *Anemia & its manifestation * Hepatomegaly with or without elevated liver function test results *Splenomegaly *Bone pain. *Pulmonary involvement *Growth retardation Erlenmeyer flask deformity of the distal femur Gaucher disease should be considered in the differential diagnosis of patients with unexplained organomegaly, who bruise easily, have bone pain, or have a combination of these conditions The pathologic hallmark of Gaucher disease is the Gaucher cell in the reticuloendothelial system, paicularly in the bone marrow. Treatment: Enzyme replacement therapy. The efficacy of enzyme replacement therapy with mannose-terminated recombinant human acid b- glucosidase has definitively been demonstrated. Reference: Harpers illustrated biochemistry 30th edition | Biochemistry | Metabolism of carbohydrate | A 44 yr old female presented with bony pain.On general examination hepatospleenomegaly was observed.Biopsy from spleen shows crumpled tissue paper appearance.Which of the following product is likely to have accumulated?
A. Ganglioside
B. Glucocerebroside
C. Sphingomyelin
D. Sulfatides
| Glucocerebroside |
1410aca7-ce2b-4fbe-a72c-cd33248aa46c | Pseudouridine (abbreted by the Greek letter psi- Ps) is an isomer of the nucleoside uridine in which the uracil is attached a carbon-carbon instead of a nitrogen-carbon glycosidic bond. It is the most prevalent of the over one hundred different modified nucleosides found in RNA. Ps is found in all species and in many classes of RNA. Ref-Harpers illustrated biochemistry 30/e p649 | Biochemistry | Metabolism of nucleic acids | Pseudouridine found in
A. DNA
B. rRNA
C. mRNA
D. tRNA
| tRNA |
5d550c3a-15cb-41bb-91a7-7a7049163798 | Ans. is 'c' i.e., Bicuspid aoic valve o 98% of coarctation of aoa is Juxta-ductal (at the origin of ductus aeriosus just below the origin of subclan aery). o Bicuspid aoic valve is associated in more than 70% of patients. o It is also associated with : ----> PDA, VSD, ASD, TGA, Hypoplastic left hea o It is the most common CHD seen in Turner syndrome. | Pediatrics | null | Coarctation of aoa is most commonly associated with -
A. VSD
B. PDA
C. Bicuspid aoic valve
D. ASD
| Bicuspid aoic valve |
203afd37-df8f-49a0-a061-2941e561e1da | Ans. is 'd' i.e., Leprosy Basic laboratory services at PHCRoutine urine, stool and blood tests.Bleeding time, clotting time.Diagnosis of RTI/STDs with wet mounting, Grama stain, etc.Sputum testing for tuberculosis (if designated as a microscopy center under RNTCP).Blood smear examination for malarial parasite.Rapid tests for pregnancy.RPR test for Svphilis/YAWS surveillance.Rapid diagnostic tests for typhoid (Typhi Dot) and malaria.Raid test kit for faecal contamination of water.Estimation of chlorine level of water using orthotoludine reagent. | Social & Preventive Medicine | Community Healthcare | Basic laboratory service is not available at PHC for which disease -
A. TB
B. Malaria
C. Syphilis
D. Leprosy
| Leprosy |
ce55aefd-dab9-4f70-8e2d-8af45a0cecf0 | The tourniquet test is a pa of WHO case definition for dengue. It is a market for capillary fragility Procedure of Tourniquet test 1) Take the BP, example 120/80 2) Inflate cuff to midway between SBP and DBP (120+80/2)=100mm Hg and maintain for 5 minutes. 3) Reduce the cuff pressure and wait for 2 minutes 4) Count the petechiae below antecubital fossa. A positive test is >10 or more petechiae per square inch | Medicine | viral infection | Tourniquet test is used for monitoring patients with?
A. Infectious mononucleosis
B. Zika Virus infection
C. Dengue fever
D. Chikungunya
| Dengue fever |
eb30c543-d2d5-445f-b085-c634e8df6c55 | Ans. is 'a' i.e., Parotid salivary gland * Most common salivary gland tumor - Pleomorphic adenoma (mixed tumor).* Site of Pleomorphic adenoma - Parotid > Submandibular > minor salivary glands | Pathology | Neoplasia | Most common site of salivary gland tumor is?
A. Parotid salivary gland
B. Submandibular salivary gland
C. Sublingual gland
D. Submaxillary gland
| Parotid salivary gland |
adb4962b-4eb6-436e-a519-d1e4d60561ee | Fracture Proximal Humerus MC fracture in osteoporotic postmenopausal women Classification of fracture - Neer classification Complications - Axillary nerve injury, Shoulder stiffness & Malunion, AVN of the humeral head Treatment Undisplaced - Immobilization in a sling (Cuff & Collar or Triangular sling) x 4 weeksDisplaced & Unstable - Closed reduction & internal fixation with percutaneous pinning or nailing(Refer: Watson Jones Textbook of Ohopedics & Trauma, 6thedition, pg no: 536-538) | Orthopaedics | All India exam | Fracture of the proximal humerus in an elderly patient is best treated by?
A. K-wire fixation
B. Open reduction internal fixation
C. Cuff and sling only
D. Manual reduction and Slab application
| Open reduction internal fixation |
bea00585-e4ea-433b-9639-f5d94978270d | Ans is 'a' i.e., CO Poisoning Ohobaric Oxygen - 100% oxygen at atmospheric pressure. Ohobaric oxygen is used in CO poisoning. It reduces the half life of carboxyhemoglobin complex. About use of hyperbaric oxygen in CO poisoning. - Although hyperbaric oxygen therapy is often recommended for patients with coma, syncope, seizures, and cardiovascular instability, for those who do not respond to ohobaric oxygen therapy, recent data suggest that it is no more effective than ohobaric oxygen therapy - | Surgery | null | Ohobaric oxygen is used in:-
A. CO poisoning
B. Ventilation failure
C. Anerobic infection
D. Gangrene
| CO poisoning |
92f300a7-7421-47b5-a86c-8f69459a66d6 | Magnesium produce broncho dilatationRef:Harrison 17th ed Pg 1605 | Pharmacology | All India exam | Drug used for acute severe asthma is
A. MGS04
B. Cromolyn sodium
C. Anti leukotriene
D. Cyclosporine
| MGS04 |
8389f6b7-61b6-4c03-b83e-90f4af08f749 | Ans. is 'a' i.e., Diffuse esophageal spasm o Radiological appearances of diffuse esophageal spasm have been described as:Curling esophagusCorkscrew esophagus orPseudodiverticulosiso Diffuse esophageal spasm is a motor disorder of esophagus characterized by repetitive simultaneous non-peristal tic contractions.o Symptoms are substernal chest pain and/or dysphagiao Diagnosed by manometry | Surgery | Esophageal Motility Disorders | Cork screw esophagus is seen in -
A. Diffuse esophageal spasm
B. Achalasia cardia
C. CA esophagus
D. Globus hystericus
| Diffuse esophageal spasm |
750c0914-64f8-45e6-888a-b919a1cea08f | The Bhore committee in 1946 gave the concept of primary health center as a basic health unit to provide as close to the people as possible an intergrated curative and preventive health care to the rural population with emphasis on preventive and promotive aspects of health care (refer pgno:904 park 23rd edition) | Social & Preventive Medicine | Health care of community & international health | Highest level of integration in health service is?
A. PHC
B. Sub centre
C. CHC
D. Distric hospital
| PHC |
10aacb23-4436-4bfa-bef8-de629a1b847b | Gas gangrene (clostridial myonecrosis) is a necrotizing, gas-forming infection that begins in contaminated wounds and spreads rapidly to adjacent tissues. The disease can be fatal within hours of onset. Gas gangrene follows the deposition of C. perfringens into tissues under anaerobic conditions. Such conditions occur in areas of extensive necrosis (e.g., severe trauma, war-time injuries, and septic abortions). Clostridial myonecrosis is rare when the wound is subjected to prompt and thorough debridement of dead tissue. Damage to previously healthy muscle is mediated by a myotoxin. C. botulinum (choice A) secretes a preformed neurotoxin.Diagnosis: Gas gangrene, clostridial myonecrosis | Pathology | Infectious Disease | A 45-year-old construction worker suffers a penetrating wound of the left leg, which is cleaned and sutured. Three days later, the patient presents with sudden onset of severe pain at the site of injury. Physical examination shows darkening of the surrounding skin, hemorrhage, and cutaneous necrosis. The wound shows a thick serosanguinous discharge with gas bubbles and a fragrant odor. Which of the following is the most likely etiology of this patient's wound infection?
A. Clostridium botulinum
B. Clostridium perfringens
C. Staphylococcus aureus
D. Staphylococcus epidermidis
| Clostridium perfringens |
0c01a98d-699a-4354-9632-fabf3fe32813 | Methotrexate is an antimetabolite chemotherapeutic agent that binds to the enzyme dihydrofolate reductase, which is involved in the synthesis of purine nucleotides. This interferes with deoxyribonucleic acid (DNA) synthesis and disrupts cell multiplication. Methotrexate has long been known to be effective in the treatment of leukemias, lymphomas, and carcinomas of the head, neck, breast, ovary, and bladder. It has also been used as an immunosuppressive agent in the prevention of graft versus host disease and in the treatment of severe psoriasis and rheumatoid ahritis. The effectiveness of methotrexate on trophoblastic tissue has been well established and is derived from experience gained in using this agent in the treatment of hydatiform moles and choriocarcinomas. As used in the treatment of ectopic pregnancy, methotrexate is administered in a single or in multiple intramuscular (IM) injections. Treatment with methotrexate is an especially attractive option when the pregnancy is located on the cervix or ovary or in the interstitial or the cornual poion of the tube. Surgical treatment in these cases is often associated with increased risk of hemorrhage, often resulting in hysterectomy or oophorectomy. Indications Medical therapy for ectopic pregnancy involving methotrexate may be indicated in ceain patients. To determine acceptable candidates for methotrexate therapy, first establish the diagnosis by one of the following criteria: Abnormal doubling rate of the beta-human chorionic gonadotropin (b-HCG) level and ultrasonographic identification of a gestational sac outside of the uterus Abnormal doubling rate of the b-HCG level, an empty uterus, and menstrual aspiration with no chorionic villi A number of other factors must also be considered once the diagnosis is established, as follows: The patient must be hemodynamically stable, with no signs or symptoms of active bleeding or hemoperitoneum (must be met by every patient) The patient must be reliable, compliant, and able to return for follow-up care (must be met by every patient) The size of the gestation should not exceed 4cm at its greatest dimension (or exceed 3.5 cm with cardiac activity) on ultrasonographic measurement - Exceeding this size is a relative, but not absolute, contraindication to medical therapy Absence of fetal cardiac activity on ultrasonographic findings - The presence of fetal cardiac activity is a relative contraindication No evidence of tubal rupture - Evidence of tubal rupture is an absolute contraindication b-HCG level less than 5000 mIU/mL - Higher levels are a relative contraindication Methotrexate Treatment Protocols A number of accepted protocols with injected methotrexate exist for the treatment of ectopic pregnancy. Multiple-dose regimen Initial experience used multiple doses of methotrexate with leucovorin to minimize adverse effects. Leucovorin is folinic acid that is the end product of the reaction catalyzed by dihydrofolate reductase, the same enzyme inhibited by methotrexate. Normal dividing cells preferentially absorb leucovorin; hence, it decreases the action of methotrexate, thereby decreasing methotrexate's adverse systemic effects. This regimen involves administration of methotrexate as 1 mg/kg IM on days 0, 2, 4, and 6, followed by 4 doses of leucovorin as 0.1 mg/kg on days 1, 3, 5, and 7. Because of a higher incidence of adverse effects and the increased need for patient motivation and compliance, the multiple dosage regimen has fallen out of or in the United States. Single-dose regimen The more popular regimen today is the single-dose injection, which involves injection of methotrexate as 50 mg/m2 IM in a single injection or as a divided dose injected into each buttock. Studies comparing the multiple methotrexate dosage regimen with the single dosage regimen have demonstrated that the 2 methods have similar efficacy. With smaller dosing and fewer injections, fewer adverse effects are anticipated, and the use of leucovorin can be abandoned. The protocol for single-dose methotrexate is detailed below. Using this protocol, Stovall et al achieved a 96% success rate with a single injection of methotrexate. Day 0 Obtain b-HCG level, ultrasonography, and +/- dilatation and curettage. Day 1 Obtain levels of the following: b-HCG Liver function - Eg, aspaate aminotransferase (AST or serum glutamic-oxaloacetic transaminase ), alanine aminotransferase (ALT or serum glutamic-pyruvic transaminase ) Blood urea nitrogen (BUN) Creatinine Evidence of hepatic or renal compromise is a contraindication to methotrexate therapy. Blood type, Rh status, and antibody screening are also performed, and all Rh-negative patients are given Rh immunoglobulin REFERENCE: emedicine.medscape.com | Pharmacology | Chemotherapy | Which of the following parameters is not monitored in a patient on methotrexate therapy:
A. Liver function tests
B. Lung function test
C. Eye examination
D. Hemogramz
| Eye examination |
87ee3561-0361-47ce-a3e9-ce784b0f4848 | About 95 percentage of duodenal ulcers occur within 2 centimetres of the pylorus | Surgery | null | Which is the most common site for duodenal ulcer
A. Within 2 centimetres of pylorus
B. Second part of duodenum
C. Distal duodenum
D. Early part of jejunum.
| Within 2 centimetres of pylorus |
8be8cc74-06d4-4cae-a62f-8c0c3e75c2ef | Chromosome 1 is the longest chromosome. In a karyotype, chromosomes- arranged according to their length and banding features. Chromosomes 1 to 22 are arranged according to their length, in the descending order. Chromosome X is longer than the Y Chromosome. | Pediatrics | Types of Genetic Disorders | Which is the longest chromosome?
A. Chromosome 1
B. Chromosome 21
C. Chromosome 14
D. Chromosome X
| Chromosome 1 |
c502503b-bd6f-46d9-a188-098c3a6ad9c7 | Ans a) superior orbital fissureStructure passing through Superior orbital fissureMedialMiddleLateralInferior ophthalmic veinSympathetic nerves around internal carotid arteryNasociliary nerveOtulomotur nerveAbducent nerveSuperior ophthalmic veinlacrimal nerveFrontal nerveTrochlear nerveMnemonic- Inferior sympathyMnemonic- NOAMnemonic Superior LPTInferior orbital fissure* Zygomatic br of maxillary nerve* Infraorbital nerve and vessels* Rami of Pterygoid ganglion* Communicating vein b/w inferior ophthalmic & pterygoid plexus of veinsOptic canal* Optic nerve* Ophthalmic arteryInfraorbital canal- Infra orbital nerve & vessels | Anatomy | Cranial Nerves | Oculomotor nerve leaves cranium through:
A. superior orbital fissure
B. Inferior orbital fissure
C. Foramen magnum
D. Optic canal
| superior orbital fissure |
2d6e6d86-98d1-4e79-a5ff-ae3a3978a3c0 | Progressive multifocal leukoencephalopathy(PML) is characterized pathologically by multifocal areas of demyelination of varying size distributed throughout the brain but sparing the spinal cord and optic nerves. Characteristic microscopic feature: 1. Oligodendrocytes have enlarged, densely staining nuclei that contain viral inclusions formed by crystalline arrays of JC virus (JCV) paicles. 2. Astrocytes are enlarged and contain hyperchromatic, deformed, and bizarre nuclei and frequent mitotic figures. Clinical presentation: Visual deficits (45%), typically a homonymous hemianopia Mental impairment (38%) (dementia, confusion, personality change) Weakness, including hemi- or monoparesis Ataxia Ref: Roos K.L., Tyler K.L. (2012). Chapter 381. Meningitis, Encephalitis, Brain Abscess, and Empyema. 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. | Medicine | null | A 33 year old male presented with homonymous hemianopia. He also has ataxia and personality changes. Characteristic inclusions are seen in oligodendrocytes. What is the MOST probable diagnosis in this patient?
A. Progressive multifocal leukoencephalopathy
B. Cruetzfeld-Jacob disease
C. Japanese encephalitis
D. Poliomyelitis
| Progressive multifocal leukoencephalopathy |
c403aa56-c462-44e1-af85-3a42285d2252 | TypeA or Magills circuit is used in Spontaneous ventilation. Type D is used in controlled ventilation. TypeB and Type C are obselete nowadays | Anaesthesia | Anaesthetic equipments | Anaesthesia breathing circuit recommended for spontaneous breathing is
A. Mapleson A
B. Mapleson B
C. Mapleson C
D. Mapleson D
| Mapleson A |
9cd093d8-fc91-4d49-bcfb-8e37654b2f4a | As the volume of pancreatic secretion increases, its Cl- concentration falls and its HCO3- concentration increases.The magnitude of the exchange is inversely propoionate to the rate of flow.In cystic fibrosis where this exchange mechanism is lost, pancreatic secretions become dehydrated and thickenedREF: GANONG&;S REVIEW OF MEDICAL PHYSIOLOGY, TWENTY-THIRD EDITION, PAGE NO:435,436 | Physiology | G.I.T | Pancreatic juice becomes thick if it has impaired
A. Na secretion
B. Cl- secretion
C. Na+ H+ exchange
D. H+ secretion
| Cl- secretion |
55737765-73f5-4057-a726-0584f11dede2 | This is V-to-Y advancement. Commonly used for fingeips and extremities.Ref: Bailey and love, 27e, page: 641 | Surgery | All India exam | Name of the procedure
A. Z plasty
B. Rhomboid flap
C. V-Y advancement flap
D. Rotation flap
| V-Y advancement flap |
7d4c4bb3-bc13-4582-b7ed-2bf6be7e1fb7 | Ans. is 'b' i.e., Cysteine Taurine is synthesized from cysteine. Synthesis of other impoant amino acid is as follows :? Glutamate is synthesized from a-ketoglutarate by enzyme glutamate dehydrogenase. Glutamine is synthesized from glutamate by enzyme glutamine synthase. Alanine is synthesized from pyruvate by transamination. Aspaate is synthesized from oxaloacetate by transamination. Asparagine is synthesized from aspaate by enzyme asparagine synthase. Serine is synthesized from 3-phosphoglycerate (a glycolytic intermediate). It can also be synthesized from glycine as conversion of serine to glycine is reversible. Glycine is synthesized from (i) glyoxylate and glutamate or alanine; (ii) choline; and (iii) serine Proline is synthesized from glutamate Cysteine is synthesized from methionine and serine Tyrosine is synthesized from phenylalanine. | Biochemistry | null | Taurine seen in bile acid metabolism is synthesized from which amino acid ?
A. Serine
B. Cysteine
C. Methionine
D. Glycine
| Cysteine |
cd9ea2a3-48e6-40a5-83ff-525af9a5a4e0 | * Actions of glycopyrrolate are similar to atropine except for some differences,as given below.. * CNS-minimal CNS effects. * CVS-increased hea rate is to a lesser extent and for shoer duration than atropine,hence ,lodynamic sLao.ay when used as premedication. * Similar actions on RS,GIT,GUT and other smooth muscles and glands as atropine. * 2 times more potent rntisialogoguE than atropine. ref : kd tripathi 8th ed | Pharmacology | All India exam | why do GLYCOPYROLATE is used as pre-anesthetic medication ?
A. no central effect as it do not cross BBB
B. as it have few side efects
C. as it increases pharyngeal secreation
D. no post surgical complications
| no central effect as it do not cross BBB |
be55a778-57b1-428b-81aa-eadcc0f835cc | Ans. is 'c' i.e., Basal cell carcinoma Advanced basal cell carcinoma may ulcerate and extensive local invasion of bone or facial sinus may occur after many years of neglected or in unusually aggressive tumors, explaining the archaic designation rodent ulcer. | Pathology | null | Rodent ulcer is ?
A. Infectious ulcer
B. Hypersensitivity
C. Basal cell carcinoma
D. Squamaous cell carcinoma
| Basal cell carcinoma |
c1024fcc-7197-4554-848b-77100cd916c9 | CALCINEURIN INHIBITORS (Specific T-cell inhibitors) Cyclosporine Mech of action:- It inhibits T lymphocyte proliferation, IL-2 and other cytokine production as well as response of inducer T cells to IL-1. Cyclosporin binds with protein cyclophiin-A and inactivate calcineurin and the transcription of genes involved in synthesis of IL2 and T Cell activation. Cyclosporine is most active when administered before antigen exposure uses:- 1) Cyclosporin selectively suppresses cell- mediated immunity (CMI), prevents graft rejection reaction. It is routinely used in renal, hepatic, cardiac, bone marrow and other transplantations. For induction it is staed orally 12 hours before the transplant and continued for as long as needed. 2) it is a second line drug in autoimmune diseases, like severe rheumatoid ahritis, uveitis, bronchial asthma, inflammatory bowel disease, dermatomyositis, etc. and in psoriasis, especially to suppress acute exacerbations. Ref:- kd tripathi; pg num:-878,880,881 | Pharmacology | Immunomodulators | Select the drug which is used exclusively in organ transplantation and autoimmune diseases, but not in cancers:
A. Cyclophosphamide
B. Cyclosporine
C. Methotrexate
D. 6-Mercaptopurine
| Cyclosporine |
5113b363-cc89-49f9-b933-2d19da307f05 | Ans. (a) Erb's paralysisRef: Apley's orthopedics 9th ed./ 279-80Erb's paralysis- Erb's palsy or Erb-Duchenne palsy is a paralysis of the arm caused by injury to the upper group of the arm's main nerves, specifically the severing of the upper trunk C5-C6 nerves.Position of hand in Erb's paralysis: Adducted, Internally rotated, and pronatedKlumpke's paralysisKlumpke's Palsy involves the eighth cervical vertebra and the first thoracic vertebra (C8 and Tl).Position of hand: Elbow flexed, arm supinatedThere may be unilateral homer syndromeHorner syndromeSeen with Pancoast tumor and presents with Ptosis, Miosis, enopthalmos, anhydrosis, loss of ciliospinal reflex.Central cord syndromeSeen most often after a hyperextension injury in an individual with long-standing cervical spondylosis. It presents with features of cortico-spinal pathway. | Orthopaedics | Injuries Around Shoulder | Injury to cervical nerve C5, C6 causes:
A. Erb's paralysis
B. Klumpke paralysis
C. Horner syndrome
D. Central cord syndrome
| Erb's paralysis |
c68fc590-b588-4406-ab87-e017156f5472 | (A) Intusussception # Ultrasound Axial images of intussusception showed a doughnut pattern.> Hypoechoic external ring was formed by the everted returning limb of intussusceptum and, to a lesser degree, by the intussuscipiens.> Doughnut's center varied according to the scan level.> Scans obtained at the middle or at the base of the intussusception showed a characteristic hyperechoic crescent in all cases.> This crescent was formed by the mesentery enclosing the entering limb of the intussusceptum, which the authors have termed the Crescent-in-doughnut sign'.> On scans obtained at the apex of the intussusception, the center was hypoechoic owing to the entering limb of the intussusceptum and the absence of the mesentery.> Crescent-in-doughnut sign appears to be a characteristic feature of intussusception.> Contrast enema remains the gold standard, demonstrating the intussusception as an occluding mass prolapsing into the lurren, giving the "coiled spring" appearance (barium in the lumen of the intussusceptum and in the intraluminal space).> Main contraindication for an enema is a perforation. | Surgery | Miscellaneous | 'Doughnut' sign and 'Coiled spring' appearance are seen in
A. Intussusception
B. Meckel's diverticulum
C. Intestinal malrotation
D. Volvulus
| Intussusception |
7db0f85c-3610-4da8-ace7-87fd78e444b2 | Ans. is 'c' i.e., Giardia Diarrhea in immunocompromised child (AIDS) include bacterial (salmonella, compylobacter) ,protozoal (giardiasis, cryptosporidium), and viral (CMV, HSV) causes. | Pediatrics | null | Profuse watery diarrhea in an immuno compromised child is due to -
A. Cryptococcus
B. Amoeba
C. Giardia
D. Lactose intolerance
| Giardia |
6309e1e8-eff8-48f6-a9e8-4bce44338d1b | Ans. C: Adapalane Adapalene is an aromatic naphthoic acid derivative. Adapalene is stable in the presence of light and resistant to oxidation by benzoyl peroxide. Additionally, it differs from tretinoin/ retinoic acid in its affinity for various retinoic acid receptors. Moreover, adapalene is a very effective antiacne agent and shows low irritation potential, no sensitization, and no phototoxicity. Adapalene was approved for the topical treatment of acne in 1996 | Skin | null | Latest retinoid drug used in acne is: March 2005
A. Retinoic acid
B. Clindamycin
C. Adapalane
D. Azelaic acid
| Adapalane |
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