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3f386916-305d-4cf6-8d13-ca9b97f2134a | C/o of Anogenital was- cause by HPV 6 HPV type Associated clinical conditions 1 (m/c) Deep plantar and palmar was 2 (m/c) Superficial plantar was 3 Plane was 4 Common was, plantar was 5 Epidermo dysplasia verruciformis 6 (m/c) Laryngeal was, Anogenital was 7 (m/c) Butcher wa Mnemonic: DSP- CELB | Dental | Viral infections | A patient has the pink papules and plaques over genital. What serotype of human papilloma virus (HPV) is the most likely cause?
A. HPV 1
B. HPV 2
C. HPV 5
D. HPV 6
| HPV 6 |
acde5f2f-3381-4f3b-badc-93860808a9c1 | Principles of chlorination:
The "chlorine demand" of the water should be estimated. The chlorine demand of the water is the difference between the amount of chlorine added to the water and the amount of residual chlorine remaining at the end of a specific period of contact at a given temperature and pH of the water.
The minimum recommended concentration of free chlorine is 0.5 mg/liter for one hour. The free residual chlorine provides a margin of safety against subsequent microbial contamination which may occur during storage and distribution.
Essentials of preventive and community dentistry
Soben Peter
5th edition | Dental | null | Residual chlorine of water should be:
A. 1 mg/ltr after 1 hr
B. 1 mg/ltr after ½ hr
C. 0.5 mg/ltr after 1 hr
D. 0.5 mg/ltr after ½ hr
| 0.5 mg/ltr after 1 hr |
b2528021-83db-4301-b893-182742bce5dd | (A) (Thyroid) (Internet)Fluoroscopy is used in assessment of all the hormones.Fluorescence spectroscopy aka fluorometry or spectrofluorometry, is a type of electromagnetic spectroscopy which analyzes fluoescence from a sample. It involves using a beam of light, usually ultraviolet light that excites the electrons in molecules of certain compounds and causes them to emit light; typically, but not necessarily, visible light. A complementary technique isabsorption spectroscopy.Although the RIA technique is extremely sensitive and extremely specific, requiring specialized equipment, it remains among the least expensive methods to perform such measurements. It requires special precaution and licensing, since radioactive substances are used. The unique ability of RIA to measure small molecules can nowadays be achieved in many cases by non-radioactive methods such as ELISA, where the antigen-antibody reaction is measured using colorimetric, such as absorbance, fluorescence intensity or polarization. This, combined with the usual sandwich configuration of ELISA requiring two domains of an analyte to be present to generate a signal, has led to many assays being developed for ELISA instead of RIA or for RIA assays to be replaced by ELISA. | Biochemistry | Endocrinology | luorescence is used in assessment of levels of which hormone commonly -
A. Thyroid
B. Steroid
C. Catecholamines
D. Leutenising releasing hormone
| Thyroid |
f69507d8-075b-4200-98d6-6ce96558eb73 | MANAGEMENT OF ESTABLISHED FREY'S SYNDROMEAntiperspirants, usually containing aluminium chloride;Denervation by tympanic neurectomy;The injection of botulinum toxin into the affected skin.PreventionTechniques described to prevent Frey's syndrome following parotidectomy. These include:Sternomastoid muscle flap;Temporalis fascial flap;Inseion of aificial membranes between the skin and the parotid bed.Ref: Bailey and love, page no: 795 | Surgery | Head and neck | How do you manage an established freys syndrome?
A. Facial nerve stimulation
B. Physiotherapy
C. Antidepressants
D. Tympanic neurectomy
| Tympanic neurectomy |
c9ac41f2-22b2-4791-be39-9332afa80cba | Typical symptoms of Urrets zavalia, after corneal transplant in keratoconus surgery. URRETS ZAVALIA SYNDROME * Fixed dilated pupil unresponsive to pilocarpine * Iris atrophy due to iris ischemia Multiple posterior synechiae * Seen in post corneal transplantation in Keratoconus * Elevated IOP a risk factor Use of mydriatics is also considered as a risk factor | Ophthalmology | Diseases of Cornea | Combination of fixed dilated pupil with iris atrophy and secondary glaucoma following penetrating keratoplasty is:
A. Benedicts syndrome
B. Possner Scholsman Syndrome
C. Urrets Zavalia Syndrome
D. Kauffman
| Urrets Zavalia Syndrome |
d65c226d-0a05-4486-a265-2a571dff2646 | Cotrimoxazole is Doc for Pneumocystis Pneumonia. | Microbiology | null | Drug of choice for Pneumocystis Pneumonia
A. Cotrimoxazole
B. Penicillin
C. Itraconazole
D. Ivermectin
| Cotrimoxazole |
12fd64bd-9aeb-4e00-80bd-fcb3d1c7711e | Most common type of shock in surgical practice is hypovolemic shock. HYPOVOLEMIC SHOCK Causes of hypovolemic shock: Blood lossQ(Trauma, bleeding) Loss of plasma due to extravascular fluid sequestration in burnsQ Loss of body sodium & water (diarrhea & vomitingQ) | Surgery | Shock | Most common type of shock in surgical practice:-
A. Cardiogenic
B. Hypovolemic
C. Neurogenic
D. Septic shock
| Hypovolemic |
cb56c94e-2a94-4c0a-a39b-9bbc5f100af4 | Following information suggest the diagnosis of dermatitis herpetiformis.
Extremely pruritic
Paulo - excoriation
Buttock involved
Antibodies against epidermal transglutaminase
IgA deposition in dermis | Dental | null | Extremely pruritic excoriation & papules on buttocks with autoantibodies against epidermal transglutaminase and IgA deposition in dermis on immunohistological examination of normal perilesional skin. Diagnosis is –
A. Pemphigus vulgaris
B. Pemphigoid
C. Linear IgA disease
D. Dermatitis herpetiformis
| Dermatitis herpetiformis |
97a82343-c65f-4228-9aa0-4cc3f16c87a8 | Ans. a (Internal iliac artery ligation). (Ref. Dutta, Obstetrics 4th/ 447, Williams, Obstertrics, 21st/620, 635)Traditionally, postpartum hemorrhage (PPH) has been defined as the loss of 500 mL of blood or more after completion of the third stage of labor. This is unreasonable, because nearly half of all women who are delivered vaginally shed that amount of blood or more when measured quantitatively. After the first 24 hours it is designated late postpartum hemorrhage.Scheme for the management of true PPH:# If uterus is flabby:- Massage uterus- IV methergin (Drug of choice) - MH 2006- Oxytocin- Bladder catheterization- Examine expelled placenta# Bleeding Unresponsive to Oxytocics: Following management should be initiated immediately:- Use bimanual uterine compression- Begin blood transfusions- Explore the uterine cavity manually for retained placental fragments or lacerations.- If still flabby, hot uterine douche and intrauterine packing and- If this fails, either hysterectomy or bilateral ligation of anterior division of internal iliac arteries (in exceptional cases as an alternative to hysterectomy). | Gynaecology & Obstetrics | Miscellaneous (Gynae) | Conservative surgical treatment of PPH includes
A. Internal iliac artery ligation
B. Intravenous methergin
C. Packing of uterus
D. Vaginal hysterectomy
| Internal iliac artery ligation |
6a94747c-e154-4e4d-ae31-961a081a4332 | Ans. B (Gadolinium enhanced MRI) Vestibular schwannoma (VS) - arise from inferior vestibular division of eight nerve as from the auditory division a. MRI with gadolinium is the current standard for screening for suspected vestibular schwannomas because of the high false negative rate associated with BSERA Treatment Under 65 years - small intracranial tumors (within the internal auditory canal) may be surgically removed through the transmastoid labyrinthine route a. Larges tumors (> 3 cm) are associated with increased incidence of hearing loss, dysequilibrium, headache facial numbness, and diplopia are removed a suboccipital craniotomy b. Huge ones can only be removed combined suboccipital and translabyrinthine approach Over age 65 with slowly growing tumors, observation is the proffered treatment. | ENT | null | A patient is suspected to have vestibular schwannoma the investigation of choice for its diagnosis is:
A. Contrast enhanced CT scan
B. Gadolinium enhanced MRI
C. SPECT
D. PET scan
| Gadolinium enhanced MRI |
6dcaddeb-f66b-4725-b36a-d7a759a510e0 | Due to ciliary muscle spasm, convexity of lens increases leading to blurred vision and pain due to spasm. | Ophthalmology | null | Sudden painful diminition of vision in
Anterior Uveitis is due to
A. Blood in Anterior chamber
B. Cells in Anterior chamber
C. Edema of Cornea
D. Ciliary muscle spasm
| Ciliary muscle spasm |
d7c47562-a86a-4800-875d-823dc7713237 | According to the Guidelines (given by Ministry of Health and family welfare for rape victim examination): Vaginal swab should be taken within 72hrs , after this time period chances of demonstration of sperm (which might be a potential evidence) are very less. | Forensic Medicine | Trace evidences | In case of rape victim vaginal swab is taken within?
A. 2 days
B. 3 days
C. 4 days
D. 7 days
| 3 days |
858b735d-393c-43e5-afff-21708d5ab677 | Chromosome 22q11.2 deletion syndrome encompasses a spectrum of disorders that result from a small deletion of band q11.2 on the long arm of chromosome 22. It is also called as Velocardiofacial syndrome or DiGeorge syndrome It is characterized by Dysmorphogenesis of the 3rd and 4th pharyngeal pouches resulting in following features: C: Cardiac anomaly/cono-truncal anomaly A:Abnormal facies T: Thymic hypoplasia/T cell abnormality C: Cleft palate H: Hypocalcemia 22: Chromosome 22 | Pathology | JIPMER 2017 | Which of the following is a manifestation of 22q11 mutation syndrome?
A. Hypercalcemia
B. Conotruncal abnormalities
C. Thymic hyperplasia
D. Dysmorphogenesis of the 1st and 2nd pharyngeal pouches
| Conotruncal abnormalities |
7362fd06-c3df-46d4-a540-a965d94044f9 | (A) Metronidazole # Metronidazole acts directly on the trophozoites of E. histolytica. Because of high concentration in liver extensively small amounts of drug (800 mg, TDS X 5-10 days) effective in Amoebic Liver Abscess. | Medicine | Miscellaneous | Drug of choice in amoebic liver abscess is
A. Metronidazole
B. Ciprofloxacin
C. Emetine
D. Chloroquine
| Metronidazole |
96ab155c-44b2-4954-9f83-46351c695ae5 | Gelatin was the substance originally used to gel culture media. However, gelatin is liquid at 35oC., the optimum temperature for many bacteria. In addition, some bacteria are capable of liquifying the gelatin, making it an unsuitable solidifying agent. Agar has neither of these drawbacks. Agar is preferred over gelatin, as it is bacteriologically ine, melts at 98degC and usually solidifies at 42degC. | Microbiology | General Microbiology Pa 1 (History, Microscopy, Stains and Structure and Physiology of Bacteria) | Robe Koch assistant advised him to use agar instead of gelatin for solidifying culture media for cultivation of bacteria because
A. Agar has more nutrients
B. Gelatin melts at 37oC
C. Gelatin is not easily available
D. Agar is cheaper
| Gelatin melts at 37oC |
a381488f-e5af-4b6b-806d-e79746c26755 | Isolation is defined as the period of communicability of infected person or animals from others in such places and such strict conditions as to prevent or limit the indirect transmission of the infectious agent from those infected to those who are susceptible or who may spread the agent to others (refer pgno:120 park 23 rd edition) | Social & Preventive Medicine | Epidemiology | Isolation period should be -
A. Minimum incubation period
B. Maximum incubation period
C. Period interval
D. Generation time
| Period interval |
a58706d7-15ec-4967-9531-fcce6589b277 | Ans. is 'b' i.e., Progressive supranuclear palsyHummingbird sign on brain MRI is a radiological sign of progressive supranuclear palsy. | Radiology | null | Hummingbird sign in brain MRI is seen in ?
A. Multiple sclerosis
B. Progressive supranuclear palsy
C. Parkinson's disease
D. Alzheimer disease
| Progressive supranuclear palsy |
8350460d-b64e-4d21-985f-a41e259d17a7 | Nevus anemicus presents as a single or multiple patches of hypopigmentation with ill-defined margins merging into normal skin present at bih or thereafter. Nevus anemicus presents as congenital hypopigmented patches with a well-defined border. They are asymptomatic and typically seen on the upper trunk, although they have also repoed on the face and extremities. The distribution of hair, formation of sweat, and skin sensation are unaffected by nevus anemicus (Ref: harrison.20th edition pg 1267 | Dental | Autoimmune skin disorders | Hypopigmented patches are seen in
A. Nevus ota
B. Nevus Ito
C. Nevus anemicus
D. Becker nevus
| Nevus anemicus |
70adf425-091e-4a76-86b5-6b040fdf5e72 | The liver of premature (preterm) neonate is functionally immature that leads to hypoglycemia, hyperbilirubinemia (jaundice) and poor detoxification of drugs.
Problems of preterm Premature babies
Birth asphyxia
Hypothermia
Feeding difficulties
Infections
Respiratory distress
ARDS (Hyaline membrane dis)
Hyperbilirubinemia
Apenia
Intraventricular haemorrhage
Hypocalcemia
Necrotising enterocolitis
Metabolic acidosis
Hypoglycemia
Hypoproteinemia
Note - Problems of preterm small for date babies include problems of both i.e. problems of preterm and problems of small for date. | Pediatrics | null | A premature infant is more likely than a full-term infant to –
A. Suffer from jaundice of hepatic origin
B. Maintain in normal body temperature in a cold environment
C. Excrete urine with a uniform specific gravity
D. Suffer from anaemia
| Suffer from jaundice of hepatic origin |
63f7212b-1ea6-463e-8107-7d33db8989f9 | Ans. B i.e. Nicotinic receptor proteinsMyasthenia gravisIt is an autoimmune neuromuscular disease leading to fluctuating muscle weakness and fatigability.It is an autoimmune disorder, in which weakness is caused by circulating antibodies that block acetylcholine receptors at the postsynaptic neuromuscular junction, inhibiting the excitatory effects of the neurotransmitter acetylcholine on nicotinic receptors throughout neuromuscular junctions.Myasthenia is treated medically with acetylcholinesterase inhibitors or immunosuppressants, and, in selected cases,thymectomy. | Pathology | null | In myasthenia gravis, antibodies are present against:September 2012
A. Muscarinic receptor proteins
B. Nicotinic receptor proteins
C. Protein actin
D. Protein myosin
| Nicotinic receptor proteins |
3191c068-3f1d-4f0e-a044-a395faa2501d | Mineral oils are used as chemical control against mosquito larvae. The mineral oil application to water is the oldest method to control mosquito. oils used are diesel oil, fuel oil, kerosene oil, and crude oils. Special mosquito larvicidal oils are also available. Oil kills larvae and pupae within a sho time after application. When applied on water oil spreads and forms a thin film, which cuts off the air supply to mosquito larvae and pupae. Since the life cycle of a mosquito is about 8 days, its customary to apply oil once in a week on all breeding places. Other anti-larval measures include source reduction, using Paris green, and synthetic insecticides. Biological control with larvivorous fishes like Gambusia and Lebister. Park's Textbook of Preventive and Social Medicine, 25th Edition, Pg 832 | Social & Preventive Medicine | Environment and health | Mineral oils are used in mosquito control measure as -
A. A personal protection method
B. Larvicide
C. Adulticide
D. Space spray
| Larvicide |
b8cd6e73-ffe3-4e2e-9278-ae04370bb5b7 | Congenital nephrotic syndrome is a very rare form of nephrotic syndrome. It occurs predominantly in families of Finnish origin and manifests sholy after bih. It is an inherited disorder. The condition is caused by a defect in the protein nephrin. Requires renal biopsy for diagnosis. | Pediatrics | null | A patient with congenital nephrotic syndrome requires which of the following procedures?
A. Live attenuated vaccines
B. Renal biopsy
C. Steroids in high doses
D. Low protein diet
| Renal biopsy |
13b01f2b-571f-4d7c-b120-c35f64f1d647 | Ans. (b) Specific protectionRef : K. Park 23rd ed. / 41, 370-73* Iodised salt is given in an area which has risk of developing goiter. This is a primary level of prevention done by specific protection.* Primordial prevention is done before the emergence of risk factor. | Social & Preventive Medicine | Concept of Health and Disease | Iodised salt is given in an area endemic to Goiter. Type of prevention:
A. Health promotion
B. Specific protection
C. Primordial prevention
D. Treatment
| Specific protection |
5184ba3a-2c28-4c94-a11d-9548ae8b822d | Types of Collagen in different tissues
Type I - Bone, skin
Type II - Hyaline and elastic Cartilage
Type III - Skin, ligament, blood vessels
Type IV - Basement membrane in various tissue
Type V - Blood vessel wall, Synovium, corneal stroma | Anatomy | null | Type of Collagen in Hyaline Cartilage is
A. Type I
B. Type II
C. Type III
D. Type IV
| Type II |
add97165-2e8e-40c7-81e0-471cadf7e98b | The synopsis of forensic medicine & toxicology ; Dr k.s.narayan reddy ;28th edition ; Pg.no. 110 & 111 . Flaying comes under avulsion .The shearing & grinding force by a weight ,such as lorry wheel passing over a limb ,may produce seperation of skin from underlying tissue (avulsion ) over a relatively large area .This is called "FLAYING" .The underlying muscles are crushed and the bones are fractured . | Forensic Medicine | Mechanical injuries | Flaying is seen in which type of laceration -
A. Tear
B. Avulsion
C. Split
D. Stretch
| Avulsion |
a9d2839a-731a-4614-aaf6-c93affc1cb04 | Ans. is 'd' i.e., Myoneural junction Vecuronium is a nondepolarizing (competitive) neuromuscular blocker. The site of action is the end plate of skeletal muscles (End plate is thickened poion of muscle membrane at neuromuscular junction). | Pharmacology | null | Site of action of vecuronium is -
A. Cerebrum
B. Reticular formation
C. Motor neurone
D. Myoneural junction
| Myoneural junction |
342d31de-583c-4769-80a5-9f323e690d0c | Intermediate Syndrome: This has been repoed in some patients and is characterized by weakness of the upper extremities and neck musculature, cranial nerve palsies and secondary respiratory arrest. It may occur between 24 and 96 hours after ingestion.Delayed Neuropathy: May sometimes occur 1-4 weeks after exposure. The symptoms occur distally and progress proximally. The neuropathy is usually mixed with the patients complaining paraesthesias and motor weakness.Krishan Vij textbook of forensic medicine and toxicology 5e pg:533 | Forensic Medicine | Special topics | The intermediate syndrome in organophosphorus poisoning refers to the occurence of which of the following?
A. Cholinergic syndrome with hypersecretion
B. Organophosphate induced polyneuropathy
C. Organophosphate induced delayed neuropathy
D. Motor cranial nerve palsies
| Organophosphate induced polyneuropathy |
f66a9478-28b0-4564-8694-90ea49833677 | Blood-gas paition coefficient, also known as Ostwald coefficient for blood-gas, is a term used in pharmacology to describe the solubility of inhaled general anesthetics in blood. The coefficient is defined as the ratio of the concentration in blood to the concentration in gas that is in contact with that blood when the paial pressure in both compaments is equal. It is inversely propoional to the induction rate. It determines the onset of induction and recovery. anesthetic blood gas solubility Nitrous oxide 0.47 Halothane 2.4 Isoflurane 1.4 Sevoflurane 0.65 Desflurane 0.45 Methoxyflurane 12 Enflurane 1.9 | Anaesthesia | General anaesthesia | Which of the following inhalational agents has the maximum blood gas solubility coefficient?
A. Isoflurane
B. Sevoflurane
C. Desflurane
D. Nitrous oxide
| Isoflurane |
59f6ea2f-1099-44c2-8502-c9a9a8b5f202 | Androgen insensitivity syndrome (AIS), formerly known as testicular feminization, is an X-linked recessive condition resulting in a failure of normal masculinization of the external genitalia in chromosomally male individuals. Adolescent patients have no pubic and axillary hair, with otherwise scanty body hair, and lack acne, although breasts are normal as a result of conversion of testosterone to estradiol. Mullerian agenesis is characterized by a failure of the mullerian ducts to develop, resulting in a missing uterus and fallopian tubes and variable malformations of the upper poion of the vagina. An individual with this condition is hormonally normal; that is, they will enter pubey with development of secondary sexual characteristics including thelarche and adrenarche (pubic hair). Gonadal dysgenesis is characterized by a progressive loss ofprimordial germ cells on the developing gonads of an embryo.The accompanying hormonal failure also prevents the development of secondary sex characteristicsin either sex, resulting in a sexually infantile female appearance and infeility. Failure to develop secondary sex characteristics (sexual infantilism) is typical in Turner's syndrome. | Gynaecology & Obstetrics | null | A female comes with normal breast development but scanty pubic hair. What is the most likely diagnosis ?
A. Turner's syndrome
B. Testicular feminizing syndrome
C. Mullerian agenesis
D. Gonadal dysgenesis
| Testicular feminizing syndrome |
9f160a97-e9ec-4e15-b1bf-d5df088e7c59 | * The findings of dyspnea, elevated JVP and pedal oedema are suggestive of right sided CHF * Parasternal heave and palpable S2 indicates pulmonary aery hypeension * This also explains why lungs are clear since pulmonary oedema is absent in PAH * Reduced RV compliance in RVH leads to elevated JVP and oedema in feet * The reason for dyspnea is less pulmonary flow due to PAH. Echo for mitral stenosis Useful for diagnosis as PAH is seen in long standing MS ELISA For HIV Useful for diagnosis of Group 1 PAH Urine and stool for Schistosoma Useful for diagnosis of Group 1 PAH WHO classification of PAH Group 1 Idiopathic PAH HIV Poal Hypeension (Schistosomiasis) Drugs Connective tissue disorders Pulmonary veno-occlusive disease Group 2 Pulmonary aery hypeension due to left hea disease Group 3 PAH due to lung disease like COPD, interstitial lung disease Group 4 PAH due to secondary thromboembolism with occlusion of proximal or distal pulmonary aeries Group 5 PAH due to Hematological disorders: Myeloproliferative disorders Systemic disorders: Sarcoidosis, Langerhans cell histiocytosis Metabolic disorders: glycogen storage disorders Miscellaneous: Tumor embolization | Medicine | Hypeension | A patient came with dyspnea, elevated JVP and edema in the feet. Lungs are clear. There is a parasternal heave and S2 is palpable in the pulmonary area. Which one of the following is LEAST helpful in determining etiology?
A. Echo for mitral stenosis
B. Anti-endomysial antibody estimation
C. ELISA for HIV
D. Urine/stool examination for Schistosoma ova
| Anti-endomysial antibody estimation |
145a9614-2362-4e17-8246-c927fdbbd6a7 | Factor XIII is also called as fibrin stabilizing factor. It is activated by thrombin. Activated factor XIII strengthens the fibrin reticulum. The fibrin monomer molecules are initially held together by weak non covalent hydrogen bonding, and the newly formed fibers are not cross linked with each other. Therefore as a result, the clot is weak and can be broken apa easily. The activated factor XIII acts as an enzyme to cause covalent bonds between more and more fibrin monomer molecules as well as multiple cross-linkages between adjacent fibrin fibers, adding strength to the fibrin mesh work. Ref: Competition Science Vision, Feb 2003, Pages 1628-9 ; Text Book of Medical Physiology By Guyton and Hall, 10th Edition, Page 422 | Physiology | null | Which of the following clotting factors helps in bridging the fibrin in a clot and stabilizes the clot?
A. Factor III
B. Factor V
C. Factor VIII
D. Factor XIII
| Factor XIII |
ba369469-747c-4009-aa72-25f1ca6cba6e | Ans. is 'a' i.e., Sublimation Defence mechanismo Narcissistic (Psychotic) :- Denial, disortion, projection.o Immature :- Blocking, introjection, passive-aggressive behavior, acting out, hypochondriasis, regression, schizoid fantasy, somatization.o Neurotic :- Controlling, Displacement, inhibition, extemalization, intellectualization, isolation, rationalization, dissociation, reaction formation, repression, sexualization, conversion, undoing, inhibition,o Mature :- Asceticism, suppression, altruism, sublimation, humor, anticipation. | Psychiatry | Cognitive Development | Mature defence mechanism is-
A. Sublimation
B. Denial
C. Projection
D. Distortion
| Sublimation |
7115e8cb-52ba-422d-897e-8f0c97913efd | Ans: a (Urinary VMA estimation)Ref: Vasudevan & Sreekumari, 6th edi., Pg. 207Vanillyl mandelic acid (VMA) in urineVMA is the main urinary metabolite of the norepinephrine pathway. Metanephrine is acted upon by mono amine oxidase to form(VMA). Normal level of excretion of VMA is 2-6 mg/24 hr.lt is increased in pheochromocytoma and in neuroblastoma.Patient is asked to refrain from intake of chocolate, coffee, banana, vanilla ice creams, citrus fruits (lime & orange). These items contain vanillin, which produces very high value of VMA in urine. Patient should not take aspirin or drugs containing phenol ring.Homovanillic acid (HVA) in urine: HVA is the main urinary metabolite of dopa and dopamine pathway It is increased in neuroblastoma, malignant pheochromocytoma and ganglioneuroma.It is useful to predict prognosis of neuroblastoma. Drugs increasing the value are -L-dopa, disulfiram and reserpine. | Biochemistry | Endocrinology | Best screening test for pheochromocytoma?
A. Urinary VMA estimation
B. Serum catecholamine estimation
C. Clonidine suppression test
D. Urinarymetanephrine
| Urinary VMA estimation |
68856c0c-5d8e-4177-abcf-4668132309f8 | Gama benzene hexachloride 1%lindane 12 -24 hrs a day/2hrs in children .used in caution in infants and children. Permethrin 5%cream -8-12 hrs at night. It act on the nerve cell membrane and disrupt sodium channel current . Used to treat scabies in pregnancy,lctation and infants more than 2 months of age. Benzoyl benzoate 25%emulsion left on body for 48hrs or 3 consecutive nights Crotamiton 10%lotion every night for 2days Malathion 0.5% liquid 6%precipitated sulphur daily night application for 3 days Oral Ivermectin 200ug/kg two doses at 10day interval GABA agonist and chloride channel opener. IADVL textbook of dermatology page 429 | Dental | Fungal infections, Scabies, Pediculosis | Oral medication used in the treatment of scabies.
A. Albendazole
B. Metronidazole
C. Ketoconazole
D. Ivermectin
| Ivermectin |
81ffcdab-6aeb-43f4-954e-8b88fa798992 | Aggrecan is the major proteoglycan component of cartilage. It is composed of several glycosaminoglycans (hyaluronic acid, chondroitin sulfate and keratin sulfate) and both link and core proteins. | Biochemistry | null | Aggrecan in
A. Receptor over platelets
B. A molecule present in osteoid tissue
C. Granules in leukocytes
D. Important component of cartilage
| Important component of cartilage |
42c090c7-9712-4ec7-bdaa-83b7cf1d7c68 | Posterior synechiae extending for 360 degrees around the pupil (seclusio pupillae), prevent the passage of aqueous from the posterior to the anterior chamber. This gives rise to forward bowing of the peripheral iris causing an 'iris bombe'. This may lead to elevation of IOP due to secondary angle closure by the peripheral iris. | Ophthalmology | All India exam | "Iris bombe" occurs due to
A. Adherent Glaucoma
B. Anterior Synechiae
C. Posterior Synechiae
D. Ring synechiae
| Ring synechiae |
164f1927-543d-497d-8a53-e4c4338d6fbe | Ans. is `b' i.e., Deficiency of late complements | Microbiology | null | Neisseria infection are associated with ?
A. Deficiency of early complements
B. Deficiency of late complements
C. There is no such association
D. Any deficiency can be associated
| Deficiency of late complements |
c45d997f-1106-4f92-b48f-57d911e76597 | Bacteria are the most common pathogens in acute skeletal infections.
The microbial spectrum is diverse in suppurative arthritis, but Staphylococcus aureus infection is most common.
Salmonella is the most common cause of osteomyelitis in children with sickle cell anemia. | Pediatrics | null | Septic arthritis in a 2-year-old child is often caused by –
A. Hemophilous influenzae
B. Staphylococcus aureus
C. Gonococi
D. Pneumococci
| Staphylococcus aureus |
fdbbe368-4a13-42e6-8619-2bf4d21f1377 | Ans. is 'c' ie PET scan (Ref: Harrison, 16/e, p2460)."MRI or CT scans are often unable to distinguish radiation necrosis from recurrent tumor, but PET or SPECT scans may demonstrate that glucose metabolism is increased in tumor tissue but decreased in radiation necrosis." - Harrison. | Radiology | Neoplasia | Which of the following techniques in the best for differentiating recurrence of brain tumour from radiation therapy induced necrosis?
A. MRI
B. Contrast enhanced MRI
C. PET scan
D. CT scan
| PET scan |
bc5c96c1-51cb-480e-bc5e-9e03874b5e2b | In this case, diagnosis can be made by excluding each option. This patient is least likely to have scabies, as it does not produce lesions on the face in adults. Atopic dermatitis is unlikely since he is giving a history of similar lesions only since 3 years. In atopic dermatitis lesions first appears in infancy and then continues into childhood and adulthood. By this time lesions become more and more lichenified. Uicaria is characterised by the presence of evanescent wheals due to edema of dermis, and it last only for 24- 48 hours. So the most appropriate diagnosis would be insect bite hypersensitivity. In this condition the characteristic lesions are itchy persistent papules with a central punctum, seen mainly on exposed pas of the body and aggrevated during rainy season. | Skin | null | A 27 yr old boy has itchy, excoriated papules on the forehead and exposed pas of the arms and legs for 3 years. The disease was most severe in the rainy season and improved completely in winter. What is the most likely diagnosis?
A. Scabies
B. Uicaria
C. Insect bite hypersensitivity
D. Atopic dermatitis
| Insect bite hypersensitivity |
9faa2bab-0557-4309-aaf8-cd4e50c71fb6 | This is confusing one because of the following statements of Park.
"The most important part of the filter is the sand bed" - Park
"The vital layer is the heart of the slow sand filter" - Park
Following statement may help in choosing the answer : -
"Vital layer is the layer that provides the effective purification in potable water treatment, the underlying sand layer providing the support medium for this biological treatment layer" - Water & Health 3rd/e 733.
Read the mechanism of action of slow sand filter and there will be no confusion.
Mechanism of action of slow sand filter
Slow sand filter work through the, formation of a gelatinous layer called vital layer or hypogeal layer or Schmutzdecke in the top few cm of sand layer.
This layer is formed in the first 10-20 days of operation.
The formation of vital layer is known as "Ripening of the filter".
This vital layer consists of bacteria, fungi, Protozoa, and a range of aquatic insect larvae.
As waste passes through vital layer, particles of foreign matter are trapped in the mucilaginous matrix and dissolved organic material is absorbed and metabolized by bacterial, fungi and protozoa → Vital layer has mechanical (physical) as well as biological action.
So, the vital layer acts as the heart of slow sand filter. | Social & Preventive Medicine | null | Most important layer of a slow sand filter is -
A. Vital layer
B. Sand bed
C. Filter system
D. Raw water
| Vital layer |
73eb9714-155b-431a-bfcc-27fcbd1f1372 | Patterned abrasion. Patterning of abrasions The patterning of abrasions is clearer than that of bruises because abrasions frequently take a fairly detailed impression of the shape of the object causing them and, once inflicted, do not extend or gravitate; therefore, they indicate precisely the area of application of force. An abrasion (or a graze) is a superficial injury involving only the outer layers of the skin and not penetrating the full thickness of the epidermis. Patterned Abrasions: Patterned abrasions occur when the force is applied at or around right angle to the surface of skin. The classical example of this is seen in traffic accidents when tyre of a motor car passes over the skin leaving the pattern when the skin has been squeezed into the grooves of the rubber tread. Pressure Abrasions (Imprint Abrasions): When the impact is veical to the skin surface, the epidermis gets crushed and pressure type of abrasions result and the imprint of the impacting object may be produced. These may be seen in manual strangulation (abrasions produced by fingernails) and in hanging, where the weave of the ligature material may be reproduced. | Surgery | null | A rickshaw is run over legs of a child making markings of tyre on the legs. Which type of injury is this?
A. Patterned abrasion
B. Imprint abrasion
C. Pressure bruise
D. Split lacerations
| Patterned abrasion |
1bb5263c-3b99-4729-aa24-8b7bcd98f8cb | Ans. is 'a' i.e., Tuberculosis Asherman's syndrome (AS) or Fritsch syndromeo It is a condition characterized by adhesions and/or fibrosis of the endometrium most often associated with dilation and curettage of the intrauterine cavity:o Intrauterine adhesions can also form after infection with tuberculosis or schistosomiasis,o The adhesions may cause amenorrhea (lack of menstrual periods). repeated miscarriages, and infertility:o Pain during menstruation and ovulation is also sometimes experiencedo The history of a pregnancy event followed by a D&C leading to secondary amenorrhea or hypomenorrhea is typicalo Hysteroscopy is ihe gold standard for diagnosis.o Imaging by sonohysterography or hysterosalpingography will reveal the extent of the scar formation.o Treatment involves surgery to cut and remove the adhesions or scar tissue (adhesiolysis). This can usually be done with hysteroscopy:o Progesterone challenge test is negative.Sites of genital TB% involvementTubes90-100%Uterus50-60%Ovaries20-30%Vagina & vulva1-2%o Menstrual problems occurring in TB patients:-Hypomenorrhea/Amenorrhea due to Asherman s syndrome.Polym enorrhea/Menorrhagia | Gynaecology & Obstetrics | Secondary Amenorrhea | Asher man n syndrome is secondary to -
A. Tuberculosis
B. Endometrial carcinoma
C. Endometriosis
D. Submucosal fibroid
| Tuberculosis |
e451b103-fbd5-4d6c-9b42-ef75de84c708 | Ans. is 'd' i.e., > 5 years * The available musclepower is redistributed either to equalize an unbalanced paralysis, or to use the motorpower for a more useful function.* It is not done before 5 years of age, asthe child has to be manageable enough tobe taught proper exercises.* More commonlyperformed tendon transfers are as follows:i) Transfer of extensor hallucis longus (EHL)from the distal phalanx of great toe tothe neck of the first metatarsal (modifiedjones operation). This is done to correctfirst metatarsal drop in case of tibialisanterior muscle weakness.ii) Transfer of peronius tertious and brevismuscles (evertors of the foot) to thedorsum of the foot. The transfer isrequired in a foot with dorsiflexor weakness.Evertors can be spared for moreuseful function of dorsiflexion of the foot.iii) Hamstring (knee flexors) transfer to thequadriceps muscle to support a weak knee extensor. | Orthopaedics | Management In Orthopedics | What is the age of tendon transfer in post polio residual paralysis -
A. <6 months
B. 1 year
C. 2 years
D. >5 years
| >5 years |
53334b71-2ac3-4243-b130-9e3454858867 | Ans. B: 6 monthsNational programme for prevention of nutritional blindness focuses onPromoting consumption of vitamin A rich foods by pregnant and lactating women and by children under 5 years of age.Administration of massive doses of vitamin A up to 5 years. First dose of 100,000 IU with measles vaccination at 9 months and subsequent doses of 200,000 IU each, every 6 months up to the age of 5 years should be given. | Social & Preventive Medicine | null | Vitamin A prophylaxis is given to children every:September 2007
A. 3 months
B. 6 months
C. 12 months
D. 18 months
| 6 months |
e4f17d59-6085-4aeb-83fc-420d92ba7a7c | Ans. is 'b' i.e., Increase in cell size without increase in number Hyperplasia Increase in cell number without increasing in size o Occurs due to proliferation of cells Occurs only in cell capable of division DNA content in nuclei is same as normal cells o Example of tissues --> Breast, endometrium, liver, kidney Hyperophy Increase in cell size without increase in number Occurs due to increased synthesis of structural proteins Can occur both in cells with limited capacity of division as well as cells capable of division. DNA content is more than normal cells. Examples of tissues Myocardium, skeletal muscles, Breast, endometium, liver, kidney. Why do some tissues undergo hyperophy, while others undergo hyperplasia ? o The cells that have limited capacity of proliferation (e.g., myocardial cells & skeletal muscle cells) can not increase their number, So they are not able to undergo hyperplasia. But these cells can increase in size in response to increased demand, So they can undergo hyperophy. o The cells capable of division (hepatocytes, renal tubular epithelial cells, smooth muscles of uterus) have both the propeies, i.e., to increase the number as well as the size. So, tissues containing these cells can undergo hyperophy or hyperplasia or both. o For example, both hyperplasia and hyperophy occur in endometrium of pregnant uterus. | Pathology | null | In comparison to hyperplasia, hyperophy involves?
A. Increase in cell size and number
B. Increase in cell size without increase in number
C. Increase in cell number without increasing in size
D. Increase in cell size and decrease in number
| Increase in cell size without increase in number |
bdcd5061-814c-4b16-b994-30f67f31c93e | At 10 months Sits up alone and indefinitely without suppo Pulls to a standing position Walks holding furniture Grabs objects with thumb and forefinger Pokes at things with forefingers Uncovers hidden toy Mama, dada sounds (repetitive consonant sounds) Responds to the sound of a name Plays Peek-a-boo Waves bye-bye Ref : Nelson 20th edition pg no : 67 | Pediatrics | Growth and development | This milestone is achieved by _________
A. 10 months
B. 12 months
C. 16 months
D. 18 months
| 10 months |
d49e9415-6a54-450a-84e2-0a5ec154dda0 | Most screening programmes for newborn hearing ability uses otoacoustic emission as the initial test. It this test fails then auditory brainstem response is used for screening. Otoacoustic emissions are low level sound emitted spontaneously by the cochlea on presentation of an auditory stimulus. Persons with normal hearing produce oatoacoustic emissions whereas those who have hearing loss of 30-40db HL or greater do not produce OAE. Auditory brainstem response testing is used with babies between the ages of bih and 5 months. It is the electrophysiological response to an acoustic stimulus and originates from the eight cranial nerve and auditory brain stem. It can be used to determine the degree of hearing loss at different audiometric frequencies. | ENT | null | Which of the following is used for initial screening of auditory function in a neonate?
A. Otoacoustic emission (OAE)
B. Auditory brainstem response (ABR)
C. Pure tone audiometry (PTA)
D. Free field audiometry
| Otoacoustic emission (OAE) |
7e8d316f-f50b-4e6e-83c0-00f89e66a079 | Ans. c. 2,00,000 U style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif; margin: 0 0 0 8px; text-indent: 0">'There was a previous recommendation by WHO on giving 2 lacs IU of Vitamin A to pregnant women immediately after delivery, which was withdrawn in 2011.' | Social & Preventive Medicine | Vitamins | The recommended oral dose of vitamin A in pregnant females is:
A. 50,000 U
B. 1,00,000 U
C. 2,00,000 U
D. 3,00,000 U
| 2,00,000 U |
a9c9b072-2d17-4b20-9939-5c82038457a2 | Niacin or nicotinic acid is vitamin. Niacin is conveed to its coenzyme forms NAD and NADPTreatment of hyperlipidemia:Niacin (at doses of 1.5 g/day or 100 times the Recommended Dietary Allowance or RDA) strongly inhibits lipolysis in adipose tissue--the primary producer of circulating free fatty acids. The liver normally uses these circulating fatty acids as a major precursor for triacylglycerol synthesis. Thus, niacin causes a decrease in liver triacylglycerol synthesis, which is required for very-low-density lipoprotein (VLDL, see p.231) production. Low-density lipoprotein (LDL, the cholesterolrich lipoprotein) is derived from VLDL in the plasma. Thus, both plasma tri acylglycerol (in VLDL) and cholesterol (in VLDL and LDL) are lowered. Therefore, niacin is paicularly useful in the treatment of Type IIb hyperlipoproteinemia, in which both VLDL and LDL are elevated. Ref: Lippincott, 5th edition, page no: 380 | Biochemistry | vitamins | Which vitamin is given in type 2B familial hyperlipidemia?
A. Thiamine
B. Riboflavin
C. Nicotinic acid
D. Panthothenic acid
| Nicotinic acid |
a0b35fd9-8a5b-4084-a81f-8b3f5d046834 | Ans. is'd'i.e., PyridoxineDoxylamineSedative H1 antihistamine with prominent anticholinergic activity. Marketed in combination with pyridoxine, it is specifically promoted in India for 'morning sickness' (vomiting of early pregnancy), although such use is not made in the UK and many other countries. | Pharmacology | null | Doxylamine used in management of nausea and vomiting is marketed with which vitamin ?
A. Thiamine
B. Riboflavin
C. Niacin
D. Pyridoxine
| Pyridoxine |
f486903d-6d29-4d02-a670-8e7c92c076bb | 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. Ref: Robbins 8th edition Chapter 3. | Pathology | null | Maximum tensile strength is recovered in wound area during what period after an injury?
A. 1 to 2 weeks
B. 3 to 4 weeks
C. 6 months
D. 1 year
| 3 to 4 weeks |
aeacc5a4-67b0-4ff1-8143-dc8c8d92b855 | Ref Robbins 8/e p 45 ,9/e p74 The acute inflammatory response rapidly delivers leuko- cytes and plasma proteins to sites of injury. Once there, leukocytes clear the invaders and begin the process of digesting and getting rid of necrotic tissues. Acute inflammation has two major components (Fig. 2-2): * Vascular changes: alterations in vessel caliber resulting in increased blood flow (vasodilation) and changes in the vessel wall that permit plasma proteins to leave the cir- culation (increased vascular permeability). In addition, endothelial cells are activated, resulting in increased adhesion of leukocytes and migration of the leukocytes through the vessel wall. * Cellular events: emigration of the leukocytes from the circulation and accumulation in the focus of injury (cel- lular recruitment), followed by activation of the leuko- cytes, enabling them to eliminate the offending agent. The principal leukocytes in acute inflammation are neu- trophils (polymorphonuclear leukocytes). Stimuli for Acute Inflammation Acute inflammatory reactions may be triggered by a variety of stimuli: * Infections (bacterial, viral, fungal, parasitic) are among the most common and medically impoant causes of inflammation. * Trauma (blunt and penetrating) and various physical and chemical agents (e.g., thermal injury, such as burns or frostbite; irradiation; toxicity from ceain environ- mental chemicals) injure host cells and elicit inflamma- tory reactions. * Tissue necrosis (from any cause), including ischemia (as in a myocardial infarct) and physical and chemical injury * Foreign bodies (splinters, di, sutures, crystal deposits * Immune reactions (also called hypersensitivity reactions) against environmental substances or against "self" tissues. Because the stimuli for these inflammatory responses often cannot be eliminated or avoided, such reactions tend to persist, with features of chronic inflam- mation. The term "immune-mediated inflammatory disease" is sometimes used to refer to this group of disorders. Although each of these stimuli may induce reactions with some distinctive characteristics, in general, all inflamma- tory reactions have the same basic features. In this section, we describe first how inflammatory stimuli are recognized by the host, then the typical reac- tions of acute inflammation and its morphologic features, and finally the chemical mediators responsible for these reactions. | Anatomy | General anatomy | Characteristic of acute inflammation is
A. Vasodilation and increase permeability
B. Vasoconstriction
C. Platelet aggregation
D. Infiltration by neutrophil
| Vasodilation and increase permeability |
0c9af557-7e33-4ba6-9d7a-4c99378ee12c | Answer is B (Pernicious Anemia) Deficiency of Intrinsic factor leads to a specific form of vitamin B12 deficiency megaloblastic anemia called `Pernicious Anemia'. Pernicious Anemia also known as Addison's Anemia is a megaloblastic anemia due to deficiency of intrinsic factor (secreted by parietal cells of gastric mucosa) that is essential for vitamic B12 absorption. Note: 'Intrinsic factor' was first described by castle & coworkers and hence intrinsic factor is also called Intrinsic factor of Castle. | Medicine | null | Deficiency of the 'intrinsic factor of Castle' causes:
A. Microcytic anemia
B. Pernicious anemia
C. Cooley's anemia
D. Aplastic anemia
| Pernicious anemia |
1df63d84-9e14-4ea8-9d64-c3082bb31060 | Some Complications of Alcohol Dependence Medical Complications Central Nervous System: i. Peripheral neuropathy ii. Delirium tremens iii. Rum fits (Alcohol withdrawal seizures) iv. Alcoholic hallucinosis v. Alcoholic jealousy vi. Wernicke-Korsakoff psychosis vii. Marchiaa-Bignami disease viii. Alcoholic dementia ix. Suicide x. Cerebellar degeneration xi. Central pontine myelinosis xii. Head injury and fractures. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 39 | Psychiatry | Substance abuse | Morbid jealousy is most often seen in patients taking
A. Alcohol
B. Amphetamine
C. LSD
D. Cannabis
| Alcohol |
b1713ee3-ce97-4d46-86ad-d8ba809b626e | ANSWER: (B) Papillary carcinomaREF: Sabiston 18th ed chapter 36, Schwartz 9th ed chapter 38Papillary carcinoma is the most common of the thyroid neoplasms and is usually associated with an excellent prognosis, particularly in female patients younger than 40 years. About 70% to 80% of patients in the United States in whom thyroid carcinoma is newly diagnosed have papillary carcinoma.Thyroid malignancy PapillarycarcinomaFollicularcarcinomaHurthle cell carcinomaMedullarycarcinomaAnaplasticcarcinomaLymphomaPrevalence80%10%3%5%1%<1%Cell typeFollicularFollicularFollicular,oxyphiliccellsParathyroid C cellswide variety of cell typesNon Hodgkin's B cell type | Surgery | Thyroid Malignancies | Most common subtype of thyroid cancer is?
A. Medullary carcinoma
B. Papillary carcinoma
C. Follicular carcinoma
D. Anaplastic carcinoma
| Papillary carcinoma |
c7644e3c-19eb-4cd4-8cee-a8e1cb38a730 | LEEP Repeat All India 2009 "Although CIN can be treated with a variety of techniques, the preferred treatment for CIN 2 and 3 has become LEE?" - Novak's Gynecology p582 Though the patient is 35 yrs old and has completed her family, still hysterectomy won't be treatment of choice as-"Hysterectomy is currently considered too radical .for treatment of CIN"Novak's Gynecology p.585 Following are some situations in which hysterectomy remains a valid and appropriate method of treatment for CIN Microinvasion CIN 3 at limits of conizution specimen in selected patients Poor compliance with follow-up Other gynecologic problems requiring hysterectomy, such as fibroids, prolapse, endometriosis, and pelvic inflammatory disease Cervical intraepithelial neoplasia(CIN) Invasive squamous cell cervical cancers are preceded by a long phase of preinvasive disease, collectively referred to as cervical intraepithelial neoplasia (CIN). Histopathologically a pa or the full thickness of cervical squamous epithelium is replaced by cells showing varying degree of dysplasia, with intact basement membrane. CIN may be suspected through cytological examination using the Pap smear test or through colposcopic examination. Cervical cytology is the most efficacious and cost-effective method for cancer screening. Final diagnosis of CIN is established by the histopathological examination of a cervical punch biopsy or excision specimen. Additionally, human papilloma virus (HPV) testing can be performed in order to better triage women with early cytologic changes. Cervical Cytology Screening (American College of Obstetricians and Gynecologists Guideline) Initial screening Age 21 or 3 y after vaginal sex Interval Every year Every 2-3 y after age 30 with 3 consecutive normals Discontinue No upper limit of age Comparison of Cytology Classification Systems (in simplified form) Bathesda CIN llysplasia Limit of histologic changes *LSIL CIN 1 Mild Basal 1/3rd of sq. epithelium HSIL ON 2 Moderate Basal 1/2 to 2/3rd CIN3 Severe Whole thickness except one or two superficial layers CIS Whole thickness LSIL - Low grade squamous intraepithelial lesion HSIL - High grade squamous intraepithelial lesion CIS - Carcinoma in situ *LSIL incorporates HPV changes (koilocytotic atypia) along with CIN I. Role of HPV HPV infection is found in approx. 90% cases of intraepithelial neoplasia. Type H&18 are most commonly associated. HPV-18 is more specific than HPV-16 for invasive tumors. In most women, the HPV infection clears in 9 to 15 months. Only a minority of women exposed to HPV develop persistent infection that may progress to CIN. Type-16 is the most common HPV type found in women with normal cytology. Treatment CIN 1 Spontaneous regression of CIN 1 is seen in 60% to 85% of cases, typically within 2yrs. So patients who have biopsy diagnoses of C1N 1 are kept under observation with: Pap testing performed at 6 and 12 months Or HPV DNA testing at 12 months After two negative test results or a single negative HPV DNA test, annual screening may be resumed. Women with persistent CIN 1 after 24 months should be treated with a local ablative method. CIN 2 and3 CIN 2&3 carries a much higher probability of progressing to invasive cancer. All CIN 2 and 3 lesions require t reatment. LEEP ( loop electrosurgical excision procedure) is the preferred treatment for CIN 2 and 3. Because all therapeutic modalities carry an inherent recurrence rate of upto 10%. cytologic follow-up at about 3-month intervals for 1 year is necessary. Cryotherapy Considered acceptable therapy when the following criteria are met: - Cervical intraepithelial neoplasia, grade 1 to 2 - Small lesion Ectocervical location only - Negative endocervical sample - No endocervical gland involvement on biopsy Laser Ablation It has been used effectively for the treatment of CIN .But because of the expense of the equipment as well as necessity for special training, laser ablation has fallen out of or. Laser has been widely replaced by LEEP. Laser Excisional Conization Rather than using laser for vaporization leading to ablation, it can be used to excise a conization specimen. The ease of LEEP conization has significantly reduced the indications of laser conization. Loop electrosurgical excision( LEEP) LEEP, variably known as simply loop excision or LLETZ (large loop excision of the transformation zone), is a valuable tool for the diagnosis and treatment of CIN. It uses low-voltage, high-frequency, thin wire loop electrodes to perform a targeted removal of a cervical lesion, an excision of the transformation zone, or a cervical conization. This technique can be used in the outpatient setting Cold knife conization (scalpel) Conization is both a diagnostic and therapeutic procedure and has the advantage over ablative therapies of providing tissue for fuher evaluation to rule out invasive cancer. Conization is indicated for CIN 2&3 in following conditions: - Limits of the lesion cannot be visualized with colposcopy. - The squat-no-columnar junction (SCE) is not seen at colposcopy. - Endocervical curettage (ECC) histologic findings are positive for CIN 2 or CIN 3. - There is a substantial lack of correlation between cytology, biopsy, and colposcopy results. - Microinvasion is suspected based on biopsy, colposcopy, or cytology results. - The colposcopist is unable to rule out invasive cancer. | Gynaecology & Obstetrics | null | A 35 yr old P 3+0 is observed to have CIN grade III on colposcopic biopsy. Best treatment will be
A. Cryosurgery
B. Conization
C. LEEP
D. Hysterectomy
| LEEP |
886ed752-2ad3-44bd-b92c-eabe78f57546 | Herpes Simplex Viruses Infection Laboratory Diagnosis 1. Light Microscopy - cells from the base of the lesion, or wiped from a mucous surface, or biopsy material, may reveal intranuclear inclusions (Lipschutz inclusion bodies). Infected cells may show ballooning and fusion. 2. Electron Microscopy - Electron microscopy is not a sensitive tool for the detection of HSV, except in the case of vesicle fluids which often contain 108 or more paicles per milliliter. However, like light microscopy, electron microscopy cannot distinguish between the different viruses. 3. Direct examination by antigen detection - cells from specimens is treated in ice-cold acetone. FITC is generally used for staining of fixed material. It is more sensitive and specific than light and electron microscopy (90% sensitive, 90% specific), but cannot match virus culture. In terms of cost and technical expeise, it is very much more demanding. Cytopathic effect of HSV in cell culture, note the ballooning of cells (Couesy of Linda Stannard, University of Cape Town, S.A.) and positive immunofluorescence test for HSV antigen in the epithelial cell (Virology Laboratory, Yale-New Haven Hospital) Ref: mayo clinic | Pathology | miscellaneous | Lipschutz inclusion bodies are seen in infects caused by-
A. Herpes virus
B. Vaccinia virus
C. Hepatitis-A virus
D. Hanta virus
| Herpes virus |
a063d271-5c8b-453d-9ef1-b81dc4304b56 | Ans. d. Anti-CCP (Ref: Harrison 19/e p2136, 18/e p2745; CMDT 09/727)Anti-CCP antibodies are the most specific blood test for the diagnosis of rheumatoid arthritis."Anti CCP antibodies are the most specific blood test for rheumatoid arthritis (specificity ~95%)."- CMDT 09/727"Anti-cyclic citrullinated peptide (anti-CCP) antibody testing is particularly useful in the diagnosis of rheumatoid arthritis,with high specificity, presence early in the disease process, and ability to identify patients who are likely to have severe disease and irreversible damage. Anti-CCP antibodies have not been found at a significant frequency in other diseases to date, and are more specific than rheumatoid factor for detecting rheumatoid arthritis."- Oxford Journal of Medicine\Rheumatoid ArthritisIt is a chronic systemic inflammatory disease of unknown cause characterized by persistent involvement of synovial membrane of multiple joints and variety of systemic manifestations.More common in femalesQRA is best diagnosed by Anti-CCP antibodiesQ.Pathology:Pathology is not limited to articular cartilage alone and arthritis is typically 'erosive'QThe potential of the synovia! inflammation to cause cartilage damage and bone erosions and subsequent changes in joint integrity is the hallmark of the diseaseQ.RA is most strongly associated with the Class IIQ MHC allele HLA DR4Qand related alleles.Characteristic Features:RA most often causes symmetric arthritis with characteristic involvement of certain specific joints such as the proximal interphalangeal and metacarpophalangeal jointsQ.DIP joints are typically sparedQAxial skeleton involvement is usually limited to upper cervical spineQExtra articular manifestations are seen in up to 40% of patientsQRheumatoid nodules are seen in approximately 20% of patientsQTypically the pleural fluid contains very low levels of glucoseQRA is associated with nurmocytic normochromic anemia of chronic diseaseQAnti CCP antibodies arc the most specific blood test for RA (specificity ~95%)Felty's syndrome is seen in association with RAFelty's syndrome consists of chronic rheumatoid arthritisQ, splenomegalyQ and neutropeniaQDiagnostic criteria for Rheumatoid arthritisMorning stiffness* Stiffness in and around joints lasting 1 hour before maximal improvement.* Constitutional features indicative of the inflammatory nature of disease such as morning stiffness "support the diagnosis"Arthritis* SymmetricalQ, involving same joint areas on both sides of body simultaneously* MultipleQ: It commonly involves three or more joint areas, predominantly of the joint areas in hand (peripheral)* * Typical picture of bilateral symmetrical inflammatory polyarthritis involving small and large joints in both upper and lower extremity with sparing of axial skeleton except the cervical spineQRheumatoid nodulesQ* Demonstration of subcutaneous nodules is helpful diagnostic featureSerum Rheumatoid factorQ* An IgM antibody directed against the Fc fragment of IgG is present in sera of >75% of patientsQ.RadiographicchangesQ* Juxta articular osteoporosisQ* Joint erosion with narrowing of joint spacesQ.Rheumatoid Factor and Rheumatoid Arthritis:Rheumatoid factor in RA belongs to the igM class0 (directed against Fc fragment of IgG)QIgM Rheumatoid factor is positive in about 75-80% of patients with RAPresence of RA factor is not specific for RAQPresence of Rheumatoid factor does not establish the diagnosis of RAQRheumatoid factor is only of prognostic significance because patients with high titers tend to have more severe and progressive disease with extra-articular manifestationsQ.Causes of False Positive Rheumatoid factor* SLE (Associated with a positive Coomb's test)* Sjogren syndrome* Chronic liver disease* Sarcoidosis* Interstitial pulmonary fibrosis* Infectious mononucleosis* Hepatitis B (Associated with HbsAg)* Tuberculosis* Leprosy* Syphilis (Associated with a positive VDRL)* Subacute bacterial endocarditis* Visceral Leishmaniasis* Schistosomiasis* MalariaTreatment:DMARD's include agents that appear to have the capacity to alter the course of Rheumatoid Arthritis.Methotrexate is the DMARD of choice.DMARDs (Disease Modifying Anti-Rheumatoid Drugs)1. MethotrexateQ2. Gold compoundsQ3. D-PenicillamineQ1. Anti-malarials e.g. ChloroquinesQ2. SulfasalazineQ | Medicine | Rheumatoid Arthritis | Which of the following antibodies is the most specific for the diagnosis of rheumatoid arthritis?
A. IgA
B. IgG
C. IgM
D. Anti-CCP
| Anti-CCP |
a7d66965-15fb-4922-84da-4d8cfa9e8e4f | FISCH classification is used for glomus tumours based on the extension into surrounding anatomic structures. Type A tumour - Tumour limited to the middle ear cleft (glomus tympanicum) Type B tumour - Tumour limited to the tympanomastoid area with no infralabyrinthine compament involvement Type C tumour - Tumour involving the infralabyrinthine compament of the temporal bone and extending into the petrous apex; Type C1 tumour - Tumor with limited involvement of the veical poion of the carotid canal; Type C2 tumour - Tumour invading the veical poion of the carotid canal; Type C3 tumour - Tumour invasion of the horizontal poion of the carotid canal Type D1 tumour - Tumour with an intracranial extension less than 2 cm in diameter; Type D2 tumour - Tumour with an intracranial extension greater than 2 cm in diameter | ENT | Ear | Glomus tumour invading the veical pa of the carotid canal. It is
A. Type B
B. Type C1
C. Type C2
D. Type C3
| Type C2 |
eefe8af2-a23a-4436-9da0-2646b2c79c44 | Ans. is 'b' i.e., Stop aspirin for 7 days and then do surgery "Aspirin should be stopped 1 week before elective surgery." - KDT Aspirin, even in small doses, irreversibly inhibits Thrombooxane A2 (TXA2) synthesis by platelets. Thus it interferes with platelet aggregation and increase the bleeding time. This effect lasts for a week, the turnover time of platelets. | Surgery | null | An elective surgery is to be done in a patient taking heavy doses of Aspirin. Management consists of :
A. Proceed with surgery
B. Stopping aspirin for 7 days and then do surgery
C. Preoperative platelet transfusion
D. Intra operative platelet transfusion
| Stopping aspirin for 7 days and then do surgery |
fef6e97a-cd41-48ac-a3e8-a9273fb9c97e | Prevalence criteria for determining the Xerophthalmia problem in a community: Criteria Prevalence Night blindness >1.0% Bitot's spots >0.5% Corneal xerosis / corneal ulceration / keratomalacia >0.01% Corneal ulcer >0.05% Serum retinol >5.0% | Social & Preventive Medicine | Vitamins and Nutritional Deficiencies | Xerophthalmia is considered a problem in a community if:-
A. Night blindness >1%
B. Bitot spots >1%
C. Corneal ulceration > 0.05%
D. Corneal ulcer >0.5%
| Night blindness >1% |
84658904-3855-47b5-9307-99efb9d90b0d | Nerve to Obturator internus supplies obturator internus and Gemellus superior.
Nerve to Quadratus femoris supplies Quadratus femoris and Gemellus inferior | Anatomy | null | Nerve supplying Gemellus inferior
A. Nerve to Obturator internus
B. Superior gluteal nerve
C. Inferior gluteal nerve
D. Nerve to Quadratus femoris
| Nerve to Quadratus femoris |
d5c9834e-7024-4229-9bc4-01a8b1944a42 | D i.e. Water related disease Scabies is water washed (category II) water related disease. | Skin | null | Scabies, an infection of the skin caused by Sarcoptes scabiet, is an example of:
A. Water borne disease
B. Water washed disease
C. Water based disease
D. Water related disease
| Water related disease |
1fefc27f-ddd6-4f6d-b2e9-35e828c30dc7 | Rhythmic respiration is initiated by a small group of synaptically coupled pacemaker cells in the pre-Botzinger complex (pre-BOTC) on either side of the medulla between the nucleus ambiguus and the lateral reticular nucleus. These neurons discharge rhythmically, and they produce rhythmic discharges in phrenic motor neurons that are abolished by sections between the pre-Botzinger complex and these motor neurons. They also contact the hypoglossal nuclei, and the tongue is involved in the regulation of airway resistance. Ref: Barrett K.E., Barman S.M., Boitano S., Brooks H.L. (2012). Chapter 36. Regulation of Respiration. In K.E. Barrett, S.M. Barman, S. Boitano, H.L. Brooks (Eds), Ganong's Review of Medical Physiology, 24e. | Physiology | null | The components of the respiratory control pattern generator is responsible for automatic respiration. Pacemaker regulating the rate of respiration is:
A. Pneumotaxic centre
B. Dorsal group of nucleus
C. Apneustic centre
D. Pre-Botzinger Complex
| Pre-Botzinger Complex |
6077d7db-8c4d-45fe-ac3b-d22b71909045 | Ans. b. Oguchi's disease Mizuo phenomenon is seen in Oguchi \ disease."In Oguchis disease the characteristic golden yellowish metallic sheen (color) of posterior pole (fundus) in light adapted state reverts to normal after prolonged dark adaptation, a phenomenon described by and named after Japanese ophthalmologist Mizuo Re-exposure to light results in the return of golden yellow metallic sheen.** Female carriers of X-linked (XL) retinitis pigmentosa may have normal fundi or show a golden metallic (tapetal) reflex at macula and/or small peripheral patches of hone spicule pigmentation. The inverse Mizuo phenomenon seen in XL-RP is characterized by appearance of golden sheen in dark (hut no golden sheen in light)."Oguchi's Disease* Oguchi's disease is a rare autosomal recessive trait characterized by congenital stationary night blindness and a unique morphological and functional abnormality of the retina.* Show Mizuo phenomenon^* Mizuo phenomenon: Fundus is golden yellow in light adapted state which becomes normal after prolonged dark adaptation. Reexposure to light results in the return of the metallic y ellow sheeny.* Rod function is absent after 30-minutes of dark adaptation but recovers to a near normal level after a long period of dark adaptation (i.e. -- normal rod thresholds reached only after 4 hours or longer instead of normal 30 minutes).Etiopathogenesis:* A null allele in genes for each of rhodopsin kinase and arrestin (proteins responsible for terminating phototransduction cascade) is responsible for Oguchi's disease.* Therefore, the persistent low level of light may desensitize the rods continually.* Mizuo phenomenon suggest an abnormality in rod pigment, rhodopsin.* Cone function is normal because cone adaptation, final cone thresholds and photopicERG response are normal.* Rod function is abnormal with delayed dark adaptation and scotopic ERG showing only a small electronegative response, even when the rod threshold have reached normal.Clinical Features:* Patients have non-progressive night blindness since young childhood writh normal day vision, but they often claim improvement of light sensitivities w hen they remain long in the dark environment* The fundus oculi presents a most peculiar appearance. | Ophthalmology | Retina | Mizuo phenomenon is seen in:
A. Fundus albipunctatus
B. Oguchi's disease
C. Fundus amaculateus
D. Choroidermia
| Oguchi's disease |
85576357-e227-41da-b188-1c4b1fd547a1 | CDKN2A is a complex locus that encodes three different tumor sup- pressors, p15/INK4b, p16/INK4a, and p14/ARF. Of these, loss of p16/INK4a is clearly implicated in human melanoma, and experimental evidence also suppos a role for loss of p14/ARF. As already mentioned, p16/ INK4a inhibits cyclin-dependent kinase 4 (CDK4) and cyclin-dependent kinase 6 (CDK6), thus reinforcing the ability of the RB tumor suppressor to block cells in the G1 phase of the cell cycle. By contrast, p14/ARF enhances the activity of the p53 tumor suppressor by inhibiting MDM2, an oncoprotein that stimulates p53 degradation. CDKN2A is mutated in approximately 10% of sporadic melanomas, and these mutations uniformly abolish the production of p16/INK4a and more variably affect p14/ ARF. However, it is suspected that these mutations are the tip of the "oncogenic iceberg" with respect to molec- ular lesions affecting the G1 checkpoint. For example, 30% to 70% of melanomas show loss of p16/INK4a expression though varied mechanisms, and other famil- ial and sporadic melanomas have mutations in CDK4 | Pathology | dermatology and infectious disease | Mutation seen in malignant melanoma is
A. N-MYC
B. RB gene
C. CDKN2A
D. p53
| CDKN2A |
1a74e837-e474-43df-9318-c8ebaa81f3dd | Sample registration system (SRS) SRS is taken once every 6 months It is a dual record data collection system of India Therefore, it is the most accurate data collection system of India | Social & Preventive Medicine | FMGE 2017 | Sample registration is done
A. Every 3 months
B. Every 6 months
C. Every 9 months
D. Every 12 months
| Every 6 months |
7f493cce-32bd-4e31-8c0d-b45b8823d4b1 | a-ADRENERGIC BLOCKERS Terazosin, Doxazosin These are long-acting congeners of prazosin with similar propeies but suitable for once daily dosing. advantages include * Does not impair carbohydrate metabolism; suitable for diabetics, but not if neuropathy is present, because postural hypotension is accentuated. * Has a small but ourable effect on lipid profile: lowers LDL cholesterol and triglycerides, increases HDL. * Affords symptomatic improvement in coexisting benign prostatic hyperophy. Ref:- kd tripathi; pg num:-564,565 | Pharmacology | Cardiovascular system | 68-year-old male with hypeension presents for annual examination. On review of systems he repos urinary hesitancy and nocturia. Your examination reveals a nontender but enlarged prostate without nodules. On review of his blood pressure logs and clinic readings he is averaging values of 150/80 mm Hg. Wof medication offer treatment of HTN and prostatic symptoms
A. Aliskiren
B. Propranolol
C. Furosemide
D. Terazosin
| Terazosin |
7e2209b8-36f2-46c0-b8d8-8d07063bdc21 | Ans. is 'd' i.e., Proteus Capsuleo Many bacteria secrete a viscid material around the cel! surface,o When this is organized into a sharply defined structure, it is known as capsule,o Capsules are protective and protect the bacteria from phagocytosis and from lytic enzymes.o Some bacteria loose their capsules on repeated subcultures.Cansulated oroanismso Pneumococcuso Yersiniao Bacillus anthraxo V. parahemolyticuso Bordetellao H. influenzaeo Meningococcio Fresh strains of staphylococci, streptococci and E coli.o CL perfringens and CL butyricumo Bacteroideso Klebsiellao Cryptococcus. | Microbiology | Bacteria | Which of the following is not capsulated -
A. Pneumococcus
B. Cryptococcus
C. Meningococcus
D. Proteus
| Proteus |
ac2f91a2-9631-4ad0-a31c-172c515e3615 | Ans. is 'b' i.e.. Osteoid forming tumor ceils [Ref: Apley's 9th/e p. 208}Histologic appearance of osteosarcomao It appears pale and extending through the cortex on gross cut section examination,o On histological sections it consists of malignant stromal tissue showing osteoid formation.o Osteoid bone formation by tumor cells is diagnostic of OGS. | Orthopaedics | Osteogenic Sarcoma | In osteogenic sarcoma predominant histological finding is -
A. Giant cells
B. Osteoid forming tumor cells
C. Fibroblastic proliferation
D. Chondroblasts
| Osteoid forming tumor cells |
0629e556-2426-4d1f-91aa-1807f146d7b7 | Inflammatory breast cancer is a pattern of invasive breast cancer in which the neoplastic cells infiltrate widely through the breast tissue. The cancer involves dermal lymphatics and therefore has a high incidence of systemic metastasis and a poor prognosis. If the lymphatics become blocked, then the area of skin may develop lymphedema and "peau d'orange" or orange peel appearance. The overlying skin in inflammatory breast cancer is usually swollen, red, and tender. Acute inflammation is a rare finding in breast cancer and may be associated with secondary infection or abscess. Chronic inflammation in breast cancer is a non-specific finding. In medullary breast cancer, a type of invasive ductal carcinoma, there are a large number of lymphocytes around the tumor and a desmoplastic reaction is often absent in the surrounding tissue. This type of cancer carries a somewhat better prognosis. Epidermal invasion by cancer cells is a poor prognostic indicator. Intraepidermal malignant cells are called Paget cells. Paget's disease of the nipple is a type of ductal carcinoma that arises in large ducts and spreads intraepidermal to the skin of the nipple and areola. There is usually an underlying ductal carcinoma. | Pathology | null | A 55-year-old female presents to the surgeon with breast symptoms. Her right breast is swollen, red and tender. The physician palpates a firm area in the breast and suspects inflammatory breast cancer. Which of the following best describes the histological changes observed in this disorder?
A. Acute inflammation in breast carcinoma
B. Chronic inflammation in breast carcinoma
C. Dermal lymphatic invasion by cancer cells
D. Epidermal invasion by cancer cells
| Dermal lymphatic invasion by cancer cells |
f6b9e281-b40f-4e89-b2ea-360b6c56d75a | Caroli's disease Clinical features : Symptoms include cholangitis (64%), poal hypeension (22%) and abdominal pain(18%) More common in males Septa containing poal veins protrude into the lumen of the ecstatic bile ducts (central dot sign) The main and often the only symptom of bacterial cholangitis secondary to caroli's disease is fever without abdominal pain and jaundice Frequent episodes of cholangitis indicates poor prognosis Most stones are pigmented in caroli's disease Ref: Sabiston 20th edition Pgno :1511 | Anatomy | G.I.T | Multiple intrahepatic bile duct dilation with bile lakes and concurrent sepsis is suggestive of
A. Caroli's disease
B. Watson Algali syndrome
C. Primary sclerosing cholangitis
D. Klatskin tumor
| Caroli's disease |
06477366-22f3-4ac1-9954-ee6899a28f7b | (D) Vitamin D # Vitamin D is a fat-soluble vitamin that acts as a steroid hormone.> Several hormones, including adrenal and gonadal steroid hormones, thyroid hormones, retinoid hormones, and vitamin D, bind with protein receptors inside the cell rather than in the cell membrane. Because these hormones are lipid soluble, they readily cross the cell membrane and interact with receptors in the cytoplasm or nucleus.> The activated hormone-receptor complex then binds with a specific regulatory (promoter) sequence of the DNA called the hormone response element, and in this manner either activates or represses transcription of specific genes and formation of messenger RNA (mRNA) | Biochemistry | Miscellaneous (Bio-Chemistry) | Vitamin that acts like a hormone
A. Vitamin K
B. Vitamin B1
C. Vitamin B12
D. Vitamin D
| Vitamin D |
faeb3ef8-076c-4156-96d2-4bb02c7f23c0 | Ans. is 'd' i.e., Dementia o Rivastigmine, Donepezil, Galantamine and tacrine all are central cholinesterase inhibitors and are used in senile dementia of Alzheimer's desease. | Psychiatry | Pharmacotherapy Management of Children and Adolescents | Rivastigmine & donepezil are drugs used predominantly in the management of -
A. Depression
B. Dissociation
C. Delusions
D. Dementia
| Dementia |
07afc237-6176-40bf-8759-1d9f4541c7cf | Zellweger syndrome is due to absence of peroxisomes in all most all tissues, as a result of which long chain fatty acids are not oxidized and accumulated in live and brain. So this syndrome is also called as cerebrohepatorenal syndrome. | Biochemistry | null | Zellweger syndrome is due to
A. Absence of peroxisome
B. Absence of cytochrome
C. Absence of COX
D. Absence of LOX
| Absence of peroxisome |
ed9de848-3ccb-43aa-8ac3-04201f269917 | Cetuximab, Bevacizumab, Sunitinib, Sorafenib acts as VEGF inhibitors inhibiting angiogenesis.Ref: Sharma and Sharma 3rd ed/pg 875 | Pharmacology | Immunomodulators | Which of the following is a VEGF inhibitor?
A. Bevacizumab
B. Omalizumab
C. Adalizumab
D. Abciximab
| Bevacizumab |
f15ae2c7-1544-4939-a275-a87b889956b7 | Viral interference
Interference in which infectionof a cell by one virus inhibits simultaneous or subsequent infection by another virus.
Most important mediator of interference is interferon.
Interference produced by destruction of cell receptors is seen with myxoviruses and enterovirus.
It is applied in the field in controlling poliomyelitis outbreaks by in controlling poliomyelitis outbreaks by introducing into the population, the live attenuated poliovirus vaccine. | Unknown | null | One virus particles prevents multiplication of 2nd virus. This phenomena is:
A. Viral interference
B. Mutation
C. Supervision
D. Permutation
| Viral interference |
e533be12-2db1-4855-8315-6695f6d22bed | in visual sensation first order neurons lies in the bipolar cell layer of retina. Reference: textbook of comprehensive Opthalmology by AK Khurana. | Ophthalmology | Neuro-ophthalmology | Which are first order neuron in optic pathway-
A. Bipolar cells
B. Ganglionic cells
C. Cells of lateral geniculate body
D. Astrocytes
| Bipolar cells |
086e848b-0cd0-434c-afe6-48a0b45d8461 | Ans. (a) Deavers retractorDeavers retractor* Used to retract liver without any damage to liver parenchyma.* Used during Cholecystectomy to retract liver.* Used during Pancreatico jejunostomy to retract Stomach* Used in places where a careful retraction without organ damage is needed.Other RetractorsThompson Self Retaining Liver Retractor* Thompson retractor has multiple arms which can be fixed to a rod which is attached to the Operating table.* Adjustable and Self retaining in nature.Balfours Abdominal Self Retaining retractor:* It's used to retract the lateral abdominal walls.* The third limb-used to retract the bladder downwards. Joll's self retaining Thyroid retractor:* Used during thyroidectomy to retract the platysma.* It's a self retaining retractor.Doyen's Mouth gag:* Used to open mouth during intra oral operations like glossectomy, Cleft palate operations and Ranula surgery.* Used to retract tissues during hernia surgery, Appendectomy etc,* Available in various sizes.Morris retractor:* Used to retract the abdominal wall in a wide manner.* It is the instrument of choice for retraction in left subcostal region because it avoids the risk of splenic injuryCzerny retractor:* Serves the same purpose of a Langenback retractor, but has another limb with a double hook with space in between.* Sutures can be made in the tissues between the gap of hooks.Volkmann's Retractor: (Cat Paw retractor)* Has multiple hooks on one limb* Used to retract the skin flaps and fascia during operations on the surface level- Eg. Sebaceous cyst, Lipoma and Dermoid cyst. | Surgery | Hernia | What is the name of this retractor?
A. Deavers
B. Langenbacks
C. Czerny
D. Thomson
| Deavers |
294fbabf-d326-4fae-9372-857bb5c197f9 | Tacrolimus (FK506)- structurally a macrolide antibiotic which is a newer immunosuppressant chemically different from cyclosporine, but having the same mechanism of action, and is -100 times more potent. It binds to a different cytoplasmic immunophilin protein labeled 'FKBP', but the subsequent steps are the same, i.e. inhibition of helper T cells calcineurin. Tacrolimus is administered orally as well as by i.v. infusion. Oral absorption is variable and decreased by food. It is metabolized by CYP3A4 Section 14 and excreted in bile with a longer tlh of 12 hour. Therapeutic application, clinical efficacy as well as toxicity profile are similar to cyclosporine. It is paicularly valuable in liver transplantation because its absorption is not dependent on bile. Because of more potent action, itis also suitable for suppressing acute rejection that has set in. Hypeension, hirsutism and gum hyperplasia are less marked than cyclosporine, but tacrolimus is more likely to precipitate diabetes, cause neurotoxicity, alopecia, and diarrhea. Dose-limiting toxicity is renal. ESSENTIALS of MEDICAL PHARMACOLOGY SIXTH EDITION -K. D TRIPATHI Page:853 T | Pharmacology | Immunomodulators | FK 506 is a type of:
A. Immunoglobulin antibody
B. Non-depolarizing muscle relaxant
C. Macrolide antibiotic
D. Opioid anaesthetic
| Macrolide antibiotic |
dbe9bdb3-1aff-476b-b03d-e5c460650cac | Puromycin is an aminonucleoside antibiotic, derived from the Streptomyces alboniger bacterium, that causes premature chain termination during translation taking place in the ribosome. Pa of the molecule resembles the 3&; end of the aminoacylated tRNA. It enters the A site and transfers to the growing chain, causing the formation of a puromycylated nascent chain and premature chain release. The exact mechanism of action is unknown at this time but the 3&; position contains an amide linkage instead of the normal ester linkage of tRNA. That makes the molecule much more resistant to hydrolysis and stops the ribosome.Puromycin is selective for either prokaryotes or eukaryotes.Also of note, puromycin is critical in mRNA display. In this reaction, a puromycin molecule is chemically attached to the end of an mRNA template, which is then translated into protein. The puromycin can then form a covalent link to the growing peptide chain allowing the mRNA to be physically linked to its translational product.Antibodies that recognize puromycylated nascent chains can also be used to purify newly synthesized polypeptides and to visualize the distribution of actively translating ribosomes by immunofluorescence.Ref: https://en.wikipedia.org/wiki/Puromycin | Biochemistry | Metabolism of nucleic acids | A potent inhibitor of protein synthesis that acts as an analogue of aminoacyl t-RNA is
A. Mitomycin C
B. Streptomycin
C. Nalidixic acid
D. Puromycin
| Puromycin |
0f8af4df-d387-423d-99cf-57f8b78e63aa | Aversion TherapyAversion therapy is used for the treatment of conditions which are pleasant but felt undesirable by the patient, e.g. alcohol dependence, transvestism, ego-dystonic homosexuality, other sexual detions. The underlying principle is the pairing of the pleasant stimulus (such as alcohol) with an unpleasant response (such as brief electrical stimulus), so that even in absence of unpleasant response (after the therapy is over), the pleasant stimulus becomes unpleasant by association. The unpleasant aversion can be produced by electric stimulus (low voltage), drugs (such as apomorphine and disulfiram) or even by fantasy (when it is called as cove sensitization). Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 215 | Psychiatry | Treatment in psychiatry | Along a pleasant stimulus, noxious stimuli are given in treatment of alcohol dependence or sexual disorder is which of the following type of behaviour therapy
A. Negative reinforcement
B. Aversion therapy
C. Punishment
D. Flooding
| Aversion therapy |
aca7a804-bdf9-4cfe-9861-49590b3117b7 | Ans. (A) Congenital(Ref: Apley's System of orthopedics and Fracture 9th Ed; Page No- 465-66)Presence of a hemivertebra- Congenital Scoliosis.Neurofibromatosis: It is associated with scoliosis. The scoliotic curve is typically 'short and sharp and is associated with skin lesions.Idiopathic: It usually resolves spontaneously, measurement of the rib-vertebra angles at the curve apex in the early stages of the deformity is a good prognostic factor.Neuromuscular: The typically paralytic curve is long, convex towards the side with weaker muscles (spinal, abdominal, or intercostal), and at first is mobile. An X-ray obtained with traction would show the extent to which the deformity is correctable. | Radiology | Miscellaneous | Which of the following is the etiological agent for the given case below:
A. Congenital
B. Neurofibromatosis
C. Degenerative arthritic
D. Idiopathic
| Congenital |
a2b2c180-2f07-482a-b2fe-b49fdfe409d6 | Osteochondritis of Navicular bone is known as Kohler's Disease. It results in avascular necrosis of Navicular bone. | Surgery | null | Avascular necrosis of which of the following bone result in Kohler's Disease?
A. Lunate bone
B. Femoral neck
C. Navicular Bone
D. Medial cuneiform bone
| Navicular Bone |
67e3c03b-bb69-4b6f-ad91-d13e742aa65b | Ans. is 'b' i.e., Tumour permeation between bony trabeculae at periphery Chondroma (enchondroma) Vs Chondrosarcoma o The term chondroma is used for benign neoplasm composed of cailage. It is of two types : - i) Enchondroma : - Cailage tumors occuring within the bone. ii) Periosteal chondroma : - Cailage tumors occuring on the surface of the bone. o Chondrosarcoma is the malignant tumor of cailage. Growth potential of chondroma is limited and mostly remain stable, but they have a potential to undergo malignant (sarcomatous) change to become chondrosarcoma. lnfact, enchondromas are considered to be a low grade chondrosarcoma. o A painful chondroid neoplasm in a large bone in an adult patient can be either enchondroma or chondrosarcoma o The differentiation between a low grade chondrosarcoma and an enchondroma can be difficult. o To make distinction between these two neoplasms, one has to make use of Cytological changes Myxoid quality of stroma Permeative characteristics Among these permeation, maifested as marrow spaces filled with the neoplasm and entrapment of preexisting bony trabeuculae is the most impoant sign of malignancy. | Pathology | null | A 50-year-old lady presented with a 3-month history of pain in the lower third of the right thigh. There was no local swelling; tenderness was present on deep pressure. Plain X-rays showed an ill-defined intra medullary lesion with blotchy calcification at the lower end of the right femoral diaphysis, possibly enchondroma or chondrosarcoma. Sections showed a cailaginous tumor. Which of the following histological features (if seen) would be most helpful to differentiate the two tumours?
A. Focal necrosis and lobulation
B. Tumor permeation between bone trabecuae at periphery
C. Extensive myxoid change
D. High cellularity
| Tumor permeation between bone trabecuae at periphery |
d706647c-7c3e-475d-a29d-1bb0ab85192f | Even in people with severe MR, there may be no signs or symptoms until the left ventricle fails, an abnormal hea rhythm develops (atrial fibrillation), or pulmonary hypeension occurs. Pulmonary hypeension occurs when the blood pressure in the pulmonary aery is increased Ref Davidson 23rd edition pg 455 | Medicine | C.V.S | Severe chronic MR is associated with -
A. H3
B. H4
C. Left atrial enlargement
D. Atrial fibrillation
| H3 |
20347f82-5020-45d5-b45f-58f76ee792b9 | Ans-Di.e., Renal agenesis Oligohydramnioso In this condition, liquor amnii is deficient in an amount to the extent of fewer than 200 ml at term,o Sonographically it is defined as when the max vertical pocket of liquor amnii is less than 2 cm or when the amniotic fluid index is less than 5 cm (< 10 centiles). With AFI < 8 cm (below 5th centile) or> 24 cm (above 95 centile) was considerd abnormal at gestational age. from 28-40 weeks.Etiologyo Fetal causesFetal chromosomal or structural anomaliesRenal AgenesisObstructed uropathySpontaneous rupture of membraneIntrauterine infectionsDrugs:- PG inhibitors, ACE inhibitorspostmaturity1UGRAmnion nodosum ( failure of secretion by the cells of the amnion covering the placenta)o Maternal causesHypertensive disordersUteroplacental insufficiencyDehydrationIdiopathic | Unknown | null | Oligohydramnios causes include -
A. DM
B. Oesophageal atresia
C. Rh isoimmunisation
D. Renal agenesis
| Renal agenesis |
5368f4ec-9139-4e05-a994-ba4e1d765d21 | Involutional melancholia refers to manic depressive disorder occuring during old age. Age of first presentation is 50 for women and 55 for men. Early symptoms include weight loss, insomnia, lack of interest in activities, poor concentration and low spirits. They also experience dejection, agitation, nihilistic delusions, hypochondriacal delusions and paranoid features.Ref: Abnormal Psychology By Page Mn page 279; Kaplan & Sadock's Comprehensive Textbook of Psychiatry, 9th edition page 1707. | Psychiatry | null | Which of the following disorder is characterised by intense nihilisim, somatization and agitation in old age?
A. Bipolar depression
B. Atypical depression
C. Somatized depression
D. Involutional melancholia
| Involutional melancholia |
cf6bdfe2-9691-4791-8870-d5af2e9ea5ff | Clonidine, apraclonidine, brimonidine are selective alpha 2 agonists. Guanfacine and guanabenz are central alpha 2 agonists. Isoxsuprine is a selective beta-2- receptor agonist used to relax uterus. From medical pharmacology Padmaja 4th edition page no 101 | Pharmacology | Autonomic nervous system | Which of the following is NOT an alpha-adrenoceptor agonist?
A. Clonidine
B. Methyldopa
C. Guanabenz
D. Isoxsuprine
| Isoxsuprine |
dbac00eb-e48c-4974-a207-1cfac899f2b0 | Ans. (a) 8-10 daysRef Sabiston 18th ed. 12134Scalp suture should be removed on 6th to 8th day. Given these options, 8-10 days is the best choice.Day of suture removal from different body areasBody areaSuture removal on* Scalp6-8 days* Face3-5 days* Chest, Abdomen8-10 days* Ear10-14 days* Extremities, back12 -14 days | Surgery | General Management of Wounds | Female patient with injury on her scalp, hair was shaved and sutures were put. On which day sutures should be removed?
A. 8-10 days
B. 2 weeks
C. 3 weeks
D. 1 month
| 8-10 days |
6ebd0378-843f-4198-9df8-b22a7c4c990a | Ans. is 'c' is insulin (Ref Dutta 6/e, p 288 (5/e, p. 304); Holland and Brews, 16/e, p. 107).Insulin is the only antidiabetic drug given in pregnancy to control increased blood sugar.Oral hypoglycemics are contraindicated in pregnancy because they cross placenta and have teratogenic effect on fetus.They cause fetal hypoglycemia and increase m fetal bilirubin.Moreover the increase demand in pregnancy cannot be met by oral hypoglycemics. | Gynaecology & Obstetrics | Pharmacology in Gynaecology | A lady with 8 wks pregnancy presented with random blood glucose of 177mg/dl. The treatment is :
A. Phenformin
B. Sulfonylurea
C. Insulin
D. Glipizide
| Insulin |
03a1d84e-7df7-4425-9544-5dcaf5adf222 | Benzodiazepines (Chlordiazepoxide,diazepam) are the preferred drugs due to long duration of action and can be gradually withdrawn later. Ref KD Tripati 8th ed. | Pharmacology | Central Nervous system | Preferred drug for alcohol withdrawal seizures is:
A. Diazepam
B. valproate
C. Phenobarbitone
D. Carbamazepine
| Diazepam |
d180322d-fa0c-4040-a92f-683fab03afdd | <p>standrad error of mean= standard detion/[?]n =1/[?]100 =1/10 =0.1 Parks textbook of preventive and social medicine.K Park. Edition 23.Pg no: 850 </p> | Social & Preventive Medicine | Biostatistics | Estimated mean Hemoglobin (Hb) of 100 women is 10g%. Standard detion is 1 gm%. Standard error of estimated will be -
A. 0.001
B. 1
C. 10
D. 0.1
| 0.1 |
65f10f1e-b37a-409a-a7d0-5e39cfd2a5fe | Psoriasis is a long-lasting autoimmune disease which is characterized by patches of abnormal skin.] These skin patches are typically red, itchy, and scaly. They may vary in severity from small and localized to complete body coverage. Injury to the skin can trigger psoriatic skin changes at that spot, which is known as the Koebner phenomenonType 1 has a positive family history, stas before the age of 40, and is associated with the human leukocyte antigen, HLA-Cw6. Conversely, type 2 does not show a family history, presents after age 40, and is not associated with HLA-Cw6. Type 1 accounts for about 75% of persons with psoriasis. | Pathology | General pathology | HLA associated with psoriasis
A. HLA-B27
B. HLA-DR4
C. HLA-CW6
D. HLA-B8
| HLA-CW6 |
d0385d28-2282-443a-9eb6-8aef120b39c2 | Poland's syndrome (unilateral congenital absence of pectoral muscles) causes unilateral hypertranslucency.
Asthma & acute bronchiolitis cause bilateral hypertranslucency. | Radiology | null | Which of the following is a cause of unilateral hyperlucent lung on chest radiography?
A. Poland syndrome
B. Asthma
C. Acute bronchiolitis
D. Pleural effusion
| Poland syndrome |
55b1ba9f-8247-4fb2-863e-d43347636895 | The seminal vesicles secrete a significant propoion of the fluid that ultimately becomes semen. Lipofuscin granules from dead epithelial cells give the secretion its yellowish color. About 50-70% of the seminal fluid in humans originates from the seminal vesicles, but is not expelled in the first ejaculate fractions which are dominated by spermatozoa and zinc-rich prostatic fluid.Ref: Ganong&;s review of medical physiology; 24th edition; page no:-419 | Physiology | Endocrinology | PGs in semen is secreted by
A. Prostate
B. Seminal vesicle
C. Sperms
D. Testes
| Seminal vesicle |
5fdd0dce-352f-4582-a600-d85f29fdb96e | All the above agents are synthetic analogues, except Interferon which is a glycoprotein produced by many types of mammalian cells. It has been shown to be useful in treatment of hepatitis, papillomaviruses, hairy-cell leukemia and AIDS-related Kaposi's sarcoma. Idoxuridine, as its name implies, is a synthetic pyrimidine analog, which inhibits viral DNA polymerase. Zidovudine and zalcitabine are also synthetic pyrimidine analogs but they inhibit reverse transcriptase and act as chain terminators. Ref: Baden L.R., Dolin R. (2012). Chapter 178. Antiviral Chemotherapy, Excluding Antiretroviral Drugs. 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. | Pharmacology | null | Which is a glycoprotein, produced by many mammalian cells, and used in the treatment of hepatitis, papillomaviruses, hairy-cell leukemia and AIDS-related Kaposi's sarcoma?
A. Interferon
B. Idoxuridine
C. Zidovudine
D. Zalcitabine
| Interferon |
106df13c-90d4-443a-94a8-a7b5a8c5e1c1 | Sarcoidosis Chronic multisystem disorder of unknown cause characterized by accumulation of TH 1 lymphocytes and mononuclear phagocyte in various tissuesof body.Non-caseating sarcoid Granuloma in affected organsLungs (90%)Lymph nodesSkinOthersInterstitial lung disease (fibrosis of lung parenchyma)Pleura is involved, in 1-5% cases unilateral pleural effusion Cavitation is rare B/L hilar lymphadenopathy is the hallmark of Sarcoidosis B/L parotid enlargement Erythema nodosum Lupus pernio (purple blue shiny swollen lesion on nose, cheeks, lips, ears)UveitisRenal hypercalcemia with or without hypercalciuriaAhritisPeripheral neuropathyCor-pulmonale(Refer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 2805-2813) | Pathology | All India exam | The most likely cause of bihilar lymphadenopathy is
A. Histoplasmosis
B. Tuberculosis
C. Sarcoidosis
D. Aspergillosis
| Sarcoidosis |
2d544ca3-1909-4ac0-bce9-a44031ab3837 | CLOZAPINE * Impoance * First SGA * TREATMENT FOR TREATMENT RESISTANT SCHIZOPHRENIA * TOC for TD * Anti suicidal * Psychosis in parkinsonian patients Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, 935 | Anatomy | Pharmacotherapy in psychiatry | antipsychotic which has anti suicidal propey is
A. clozapine
B. chlorpromazine
C. aripiprazole
D. amisulpride
| clozapine |
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