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a0a269b2-39d3-4952-ac4a-b94612a51731 | A. i.e. (Cochlear implant) (125- Maqbool 11th) (121- Dhingra 4th)COCHLEAR IMPLANT - is indicated in patients with bilateral severe sensorineural deafness who do not respond to amplified sound stimuli* Cochlear implants are more useful in post lingually deaf patients i.e. who lost their hearing after acquisition of language* Stapedectomy with prosthesis replacement is the treatment of choice for otosclerosis*** Pathway for extension of the infection from meninges to labyrinth - Cochlear aqueduct*** **Cochlear implants electrodes are most commonly placed at cochlea to directly stimulate the fibre of VIII. nerve | ENT | Ear | A 10 years boy presented with sensory neural deafness not benefited with hearing aid, Next treatment is
A. Cochlear implant
B. Fenestromy
C. Stapedectomy
D. Stapes fixation
| Cochlear implant |
84c6ab92-006a-40fd-8ec5-cef733fb56f0 | Cystic astrocytoma's are neoplasms of the CNS. They usually consist of a large, non-enhancing cyst on the wall of which is an enhancing tumor nodule. They are most commonly found within the substance of the cerebellar hemispheres of children and young adults. A Rathke's cleft cyst is a remnant of the embryologic Rathke's pouch. These are found within the sella turcica. | Surgery | Nervous System | A 15-year-old boy complains of right-sided weakness and gait impairment. A CT scan shows a large, non-enhancing cyst in the posterior cranial fossa, with an enhancing tumor nodule in the left cerebellum. What is the most likely diagnosis?
A. An arachnoid cyst
B. A cystic astrocytoma
C. Rathke's cleft cyst
D. Glioblastoma multiforme
| A cystic astrocytoma |
0fd7b0d0-2ea2-4af1-932a-d36901f0c2cc | Ans. is 'a' i.e., Emergence delirium Ketamine The primary site of action is in the coex and subcoical areas; not in the reticular activating system (site of action of barbiturates). It acts on NMDA receptors. Sho duration of action (10-15 minutes) is due to redistribution from brain and blood to other tissues of the body. Ketamine is different from most other anaesthetic induction agents in that it has significant analgesic action. Ketamine increases IOT and cerebral metabolism --> contraindicated in head injury. It causes sympathetic stimulation with elevation of HR, CO & BP --) contraindicated in hypeension and ischemic hea disease. It also raises IOT --> contraindicated in glaucoma. It relieves bronchospasm --> intravenous anaesthetic of choice in asthmatics (inhalation anaesthetic of choice in asthmatic is halothane). Injection is not painful (All other inducing agents cause pain on injection). It is i.v. anaesthetic of choice in children (Sevoflurane is inhalation agent of choice). Because it causes sympathetic stimulation it is intravenous anaesthetic of choice in patients with shock and hypovolumia. It has no muscle relaxant propey rather muscle tone is increased. Airway reflexes (pharyngeal and laryngeal) are not depressed --> intravenous anaesthetic of choice for emergency anaesthesia (no starvation is required). Ketamine produces emergence reaction during awakening from anaesthesia --> vivid dreaming, illusions, extracorporeal experiences, excitment, confusion, fear and euphoria --> contraindicated in psychiatric illness like schizophrenia. | Anaesthesia | null | Ketamine produces ?
A. Emergence delirium
B. Pain on injection
C. Bronchoconstriction
D. Depression of cardiovascular system
| Emergence delirium |
90b3f354-77a5-487c-ad11-1698f2a7bbee | Ans. is 'a' i.e., Ankle joints OA affects ceain joints, yet spares others. Commonly affected joints include the cervical and lumbosacral spine, hip, knee, and first metatarsal phalangeal joint (MTP). In the hands, the distal and proximal interphalangeal joints and the base of the thumb are often affected. Usually spared are the wrist, elbow, and ankle. Our joints were designed, in an evolutionary sense, for brachiating apes, animals that still walked on four limbs. We thus develop OA in joints that were ill designed for human tasks such as pincer grip (OA in the thumb base) and walking upright (OA in knees and hips). Some joints, like the ankles, may be spared because their aicular cailage may be uniquely resistant to loading stresses. | Surgery | null | Osteoahritis not seen in ?
A. Ankle joints
B. Knee joints
C. Hip joints
D. I stmetacarpophalangeal joint
| Ankle joints |
6ec7e218-c7ca-4232-836e-b7b0feddaefc | Ans. is 'a' i.e., Lactose Lactose (g) Cow's milk 4.4 Human milk 7.4 Proteins (g) 3.2 1.1 Fat (g) 4.1 3.4 Calcium (mg) 120 28 Iron (mg) 0.2 1.0 Water (g) 87 Energy (Kcal) 67 65 | Social & Preventive Medicine | null | Compared with cow's milk, mother's milk has more-
A. Lactose
B. Vitamin D
C. Proteins
D. Fat
| Lactose |
0aa64051-b76f-448a-aa96-ca40a043c2c6 | Ans. is 'a' i.e., Arnold chiari malformation Down-beat nystagmus are seen in cerebellar lesion and Arnold-chiary malformation | Ophthalmology | null | Down beat nystagmus is seen in?
A. Arnold chiari malformation
B. Brain stem damage
C. Pontine hemorrhage
D. Labyrinthine damage
| Arnold chiari malformation |
806ab85f-ad81-4119-80d5-d1914fee41ae | Ans. is 6c' i.e., Phenyl-isocyanateo Determination of amino acid sequence (sequence analysis) is performed by Edman degradation method on automatic mechines, called cyclic sequentors. Edman's reagent is phenyl-isothiocyanate, and forms a covalent bond to N- terminal of amino-acid. This can be identified.o Sanger's reagent (l-fluoro-2,4-dinitrobenzene) can be used in place of Edman's reagent. | Biochemistry | Proteins and Amino Acids | Edman's reagent is -
A. 2-4 dinitrophenol
B. 1 -fluoro-2, 4-dinitrobenzene
C. Phenyl-isocyanate
D. Cynogen bromide
| Phenyl-isocyanate |
094776a9-8ba4-4f25-b216-64304d58165b | Ans. b. Wayson's stain Farmer presents with the features of high fever, painful inguinal lymphadenopathy, vomiting and diarrhea and hypotension. This clinical picture is suggestive of Bubonic plague. Bubonic plague Bubonic plague symptoms can occur within two to six days of being infected by the bacteria Yersinia pestisdeg. If left untreated, symptoms, such as vomiting, abdominal pain, and diarrhea, can progress rapidly to septicemic plaguedeg. Approximately 10 to 20 percent of people with bubonic plague symptoms will also develop symptoms in the lungs. This is called pneumonic plague, and is often fataldeg. Plague Caused by bacteria Yersinia pestisdeg. Animal reservoir for Yersinia pestis: Rodentsdeg Vector: Rat flea (Xenopsylla cheopsisdeg) carries infection from rat to rat and rat to humans Characterized by rapid onset of fever and other systemic manifestations of Gram (-)ve bacterial infections. It is of Bubonic Plague Incubation period 2-7 daysdeg MC type of plague and almost always caused by bite of infected fleadeg. MC site of bubo- femoral, inguinal regiondeg >axillary, cervical. Distinguished from lymphadenitis by its rapid onset, its extreme tenderness, accompanying signs of toxemia and absence of cellulites or obvious ascending lymphadenitis DIC is common and may lead to gangrenedeg. Y. pestis can also be cultured from blood of most bubonic plague patientdeg. Septicemic Plague: Often present with GI symptoms, DIC, multiorgan failuredeg Incubation period 2-7 days Pneumonic Plague Most infectious, most fatal type of plague with incubation period of 1-3 daysdeg Primary pneumonia: Cyanosis is very prominent, with bloody mucoid sputumdeg Secondary pneumonia: Diffuse interstitial pneumonia, less infectious. Diagnosis Yersinia pestis is best demonstrated by polychromatic stains (Wayson, Wright-Giemsadeg). These polychromatic stains accurately highlight bipolar stainingdeg characteristics of these gram negative bacilli | Microbiology | null | Farmer presents with the features of high fever, painful inguinal lymphadenopathy, vomiting and diarrhea and 'Ivpotension. Which stain will help in the diagnosis
A. Neisser stain
B. Wayson's stain
C. Albe's stain
D. McFadyean's stain
| Wayson's stain |
38360e1d-5d6a-4427-945a-25daacdbc13e | Area of Cornea indented in Goldman Applanation tonometer for measuring IOP is 3.06mm. | Ophthalmology | null | Area of Cornea indented in Goldman Applanation tonometer for measuring IOP
A. 3.66mm
B. 3.6mm
C. 3.0mm
D. 3.06mm
| 3.06mm |
37f710ed-5b93-4a98-8232-6eed3b95a8e8 | Ans. is 'a' i.e., FNAC In any patient with a breast lump or other symptoms suggestive of carcinoma, diagnosis should be made by a combination of : 'Triple Assessment' : a. Clinical assessment b. Radiological imaging c. Tissue sampling for either cytological or histological examination. FNAC is more than often the first investigation for a tissue assessment. Bailey writes ? "FNAC is the least invasive technique for obtaining a cell diagnosis and is very accurate if both operator and cytologists are experienced. However false negatives do occur, mainly through sampling error, and invasive cancer cannot be distinguished from 'in situ' disease. A histological specimen taken by core biopsy allows a definitive preoperative diagnosis, differentiates between duct carcinoma in situ (DCIS) and invasive disease and also allows the tumor to be stained for receptor status. This is impoant before commencing neoadjuvant therapy." | Surgery | null | A 45 year old woman presents with a hard and mobile lump in the breast. Next investigation is -
A. FNAC
B. USG
C. Mammography
D. Excision biopsy
| FNAC |
e00fddd9-6e29-4595-b6d6-50621e789563 | Ans. is 'c' i.e., H+ Central chemoreceptors o These receptors are located in a chemosensitive area on the ventral surface of the medulla near the exit of the ninth and tenth cranial nerves. The primary stimulus for the central chemoreceptors is an increase in the hydrogen ion concentration. Stimulation of central chemoreceptors by increased hydrogen ion concentration leads to excitation of the respiratory neurons, thereby producing an increase in the rate and depth of respiration o Although the primary stimulus for central chemoreceptors is an increase in hydrogen ion concentration, in actual practice the physiological stimulus is an increase in PCO2. The reason is that hydrogen ions cannot cross the blood-brain barrier. Therefore, a change in the blood hydrogen ion concentration does not change the hydrogen ion concentration in the immediate vicinity of the chemosensitive neurons (i.e., in CSF and brain interstitial fluid). On the other hand, CO2 being lipid soluble can easily cross the blood-brain barrier. It enters the brain, where it is hydrated to give rise to H+ and HCO2 ions. Now these H+ directly stimulate the central chemoreceptors. o Thus, central chemoreceptors are directly stimulated by an increase in H+ concentration in CSF and brain interstitial tissue, which is brought about by the change in arterial PCO2 (PaCO2). o Change in CSF & Brain interstitial tissue - | H+ concentration (Primary direct stimulus) o Change in Blood - | PCO2 (Actual physiological stimulus). o Central chemoreceptors are not stimulated by hypoxia; rather like any other cells, they are depressed by hypoxia. | Physiology | Regulation of Respiration | Primary Regulator for central chemoreceptor -
A. PaCO2
B. PCO2
C. H+
D. O2
| H+ |
6a835aa8-6ce4-4237-b3b7-90c901697777 | Most common cause of Primary Amenorrhea = Gonadal dysgenesis/ovarian dysgenesis
2nd most common cause of Primary Amenorrhea = Mullerian agenesis (Mayer Rokitansky Kuster Hauser Syndrome)
“Mullerian agenesis is a relatively common cause of primary amenorrhea, more frequent than congenital androgen insensitivity and second only to gonadal dysgenesis”
3rd most common cause is testicular feminizing syndrome. | Gynaecology & Obstetrics | null | The commonest cause of primary Amenorrhoea is:
A. Genital tuberculosis
B. Ovarian dysgenesis
C. Mullerian duct anomalies
D. Hypothyroidism
| Ovarian dysgenesis |
efd7312d-6635-4163-9508-fc2785ac421f | Ans. is d, i.e. Classical cesarean section followed by hysterectomySince this female is multigravida with multiple fibroids in lower uterine segments - vaginal delivery is not possible as multiple fibroids are present in lower uterine segment. We will have to do cesarean - but LSCS is also not feasible due to fibroids in lower segment (a lot of bleeding will occur if we cut through fibroid). Hence classical cesarean section should be done. The treatment of multiple fibroids in a multipara is hysterectomy, so classical cesarean section should be followed by hysterectomy). | Gynaecology & Obstetrics | Operative Obs | An elderly multigravida female presents in labor. She has multiple fibroids in lower uterine segment. Management is:
A. Vaginal delivery
B. Trial of labor
C. LSCS
D. Classical cesarean followed by hysterectomy
| Classical cesarean followed by hysterectomy |
a0ac5899-caa4-479f-904c-70282a6f1255 | Microfalaria in culex is an example of cyclo-developmental transmission. In Culex mosquito, it undergoes only development. stages will change There is no multiplication taking place in it. TYPES OF BIOLOGICAL TRANSMISSION- Propogative transmission Cyclo-developmental Cyclo-propogative | Social & Preventive Medicine | Other Key Definitions & Concepts | Microfalaria in Culex depicts what kind of Biological transmission?
A. Cyclo-developmental
B. Cyclo-propagative
C. Developmental
D. Propagative
| Cyclo-developmental |
ea5e485a-1529-49c8-9d6e-331ab509dbb8 | Ref Robbins 9/e p87 IL-8, also known as neutrophil chemotactic factor, has two primary functions. It induces chemotaxis in target cells, primarily neutrophils but also other granulocytes, causing them to migrate toward the site of infection. IL-8 also stimulates phagocytosis once they have arrived. IL-8 is also known to be a potent promoter of angiogenesis. In target cells, IL-8 induces a series of physiological responses required for migration and phagocytosis, such as increases in intracellular Ca2+, exocytosis (e.g. histamine release), and the respiratory burst. IL-8 can be secreted by any cells with toll-like receptors that are involved in the innate immune response. Usually, it is the macrophages that see an antigen first, and thus are the first cells to release IL-8 to recruit other cells. Both monomer and homodimerforms of IL-8 have been repoed to be potent inducers of the chemokine receptors CXCR1 and CXCR2. The homodimer is more potent, but methylation of Leu25 can block the activity of homodimers. | Anatomy | General anatomy | Which of the following chemical mediator of inflammation is an example of a C-X-C or alpha chemokine
A. Lipoxin LXA4
B. Interleukin IL8
C. Interleukin IL 6
D. Monocyte chemo attractant protein MPC1
| Interleukin IL8 |
0e8fa3cf-c409-4f0a-8623-32daa1aeca56 | Ans. A: Prolonged duration of effect Epidural anaesthesia, a form of regional anaesthesia involving injection of drugs through a catheter placed into the epidural space. The injection can cause both a loss of sensation (anaesthesia) and a loss of pain (analgesia), by blocking the transmission of signals through nerves in or near the spinal cord The anaesthetist may use epidural analgesia in addition to general anaesthesia. This may reduce the patient's requirement for opioid analgesics. This is suitable for a wide variety of surgery, for example gynaecological surgery (e.g. hysterectomy), ohopaedic surgery (e.g. hip replacement), general surgery (e.g. laparotomy) and vascular surgery (e.g. open aoic aneurysm repair) which are longer duration surgeries. Other features of epidural anaesthesia: Expensive compared to spinal anaesthesia More incidence of intravascular injection (epidural space has venous plexus of Batson) More incidence of epidural hematoma Level of block can be changed by increasing the dose through the catheter | Anaesthesia | null | Epidural anaesthesia is preferred over spinal anaesthesia because: September 2006
A. Prolonged duration of effect
B. Cheaper
C. Less incidence of intravascular injection
D. Less incidence of epidural hematoma
| Prolonged duration of effect |
83b3d1eb-c31c-4045-9d0f-85378a4ba217 | Ans. is 'd' i.e., Alcoholo As the major middle portion of membrane (core of the membrane) is formed by hydrophobic region of phospholipids, this portion is impermeable to the usual water-soluble substances, such as ions, glucose and urea.o Conversely, fat-soluble substances, such as oxygen, carbon dioxide, and alcohol, can penetrate this portion of the membrane with ease.o Permeability coefficient and permeability of some important molecules in increasing order of frequency are Na+ < K+ < Cl- < Glucose < Tryptophan < Urea = Glycerol< Indole < H2O. | Physiology | Nervous System | Plasma membrane is freely permeable to -
A. Glucose
B. Urea
C. Glycerol
D. Alcohol
| Alcohol |
a847d0a6-6a8b-4829-82f0-456ac21691bf | Mifepristone is a progestin analogue and it blocks the effects of progesterone. It is used as a medical termination of pregnancy in the first trimester and as a post-coital contraceptive. While misoprostol, oxytocin and ergotamine are oxytocics and as uterine stimulants are used in the management of postpaum hemorrhage. Ref: Dutta textbook of Obstetrics 6th edition, Pages 175, 550, 411-22 | Gynaecology & Obstetrics | null | Which of the following drugs is not useful in the management of Postpaum Hemorrhage(PPH)?
A. Mifepristone
B. Misoprostol
C. Oxytocin
D. Ergotamine
| Mifepristone |
9789dcf5-540d-4cd0-8e7a-d13b9dfd31b4 | • Squamous cell carcinoma of scrotumQ, most commonly resulted from exposure to environmental carcinogens including chimney soot, tars, paraffin and petroleum products.
• Superficial inguinal lymph nodes are the first lymph nodes involved.
Risk Factors
• Most cases results from poor hygiene and chronic inflammation.
Diagnosis
• Diagnosis is established by biopsy of scrotal skin.
Treatment
• Wide excision with 2 cm margins should be performed for malignant tumors.
• Prognosis correlates with presence or absence of nodal involvement. | Surgery | null | The lymph nodes first involved in cancer of the skin of the scrotum are -
A. Superfical inguinal
B. External iliac
C. Para aortic
D. Gland of Cloquet
| Superfical inguinal |
7e6261a2-7fc3-4c85-ab54-63c5dab33faf | The treatment of patients with varices that have never bled is usually referred to as prophylactic therapy (eg, prophylactic sclerotherapy or prophylactic propranolol). By convention, procedures performed on patients who have bled previously are referred to as therapeutic (eg, therapeutic shunts). Prophylactic therapy is of value, since the moality rate of variceal bleeding is high (25%), the risk of bleeding in patients with varices is relatively high (30%), and varices can often be diagnosed before the initial episode of bleeding. Ref :Jarnagin W.R. (2010). Chapter 24. Liver & Poal Venous System. In G.M. Dohey (Ed), CURRENT Diagnosis & Treatment: Surgery, 13e. | Surgery | null | The primary therapy to prevent oesophageal varices is :
A. Surgical approaches
B. Sclerotherapy
C. TIPPS
D. Shunt operation
| Sclerotherapy |
16826f89-a0cc-41a1-bac5-5664c2d97345 | Ref:Textbook of pathology (Harsh mohan) 6th edition,page no.492 Overexposure to asbestos is associated with 3 types of lesions: asbestosis, pleural disease and ceain tumours. A. ASBESTOSIS. The gross pulmonary fibrosis caused by asbestos exposure and histologic demonstration of asbestos bodies on asbestos fibres is termed asbestosis. Grossly, the affected lungs are small and firm with cailage-like thickening of the pleura. The sectioned surface shows variable degree of pulmonary fibrosis, especially in the subpleural areas and in the bases of lungs . The advanced cases may show cystic changes. Histologically, the following changes are observed: 1. There is non-specific interstitial fibrosis. 2. There is presence of characteristic asbestos bodies in the involved areas . These are asbestos fibres coated with glycoprotein and haemosiderin and appear beaded or dumbbell-shaped. The coating stains positively for Prussian blue reaction. 3. There may be changes of emphysema in the pulmonary parenchyma between the areas of interstitial fibrosis. 4. The involvement of hilar lymph nodes in asbestosis is not as significant as in silicosis. B. PLEURAL DISEASE. Pleural disease in asbestos exposure may produce one of the following 3 types of lesions: 1. Pleural effusion. It develops in about 5% of asbestos workers and is usually serious type. Pleural effusion is generally accompanied by subpleural asbestosis. 2. Visceral pleural fibrosis. Quite often, asbestosis is associated with dense fibrous thickening of the visceral pleura encasing the lung. 3. Pleural plaques. Fibrocalcific pleural plaques are the most common lesions associated with asbestos exposure. Grossly, the lesions appear as circumscribed, flat, small (upto 1 cm in diameter), firm or hard, bilateral nodules. They are seen more often on the posterolateral pa of parietal pleura and on the pleural surface of the diaphragm. Microscopically, they consist of hyalinised collagenous tissue which may be calcified so that they are visible on chest X-ray. Asbestos bodies are generally not found within the plaques. C. TUMOURS. Asbestos exposure predisposes to a number of cancers, most impoantly bronchogenic carcinoma and malignant mesothelioma . A few others are: carcinomas of oesophagus, stomach, colon, kidneys and larynx and various lymphoid malignancies. 1. Bronchogenic carcinoma is the most common malignancy in asbestos workers. Its incidence is 5 times higher in non-smoker asbestos workers than the nonsmoker general population and 10 times higher in smoker asbestos workers than the other smokers. 2. Malignant mesothelioma is an uncommon tumour but association with asbestos exposure is present in 30 to 80% of cases with mesothelioma. The exposure need not be heavy because mesothelioma is known to develop in people living near asbestos plants or in wives of asbestos workers. | Pathology | Respiratory system | The followng does not occur with asbestosis -
A. Methaemoglobinemia
B. Pneumoconiosis
C. Pleural mesothelioma
D. Pleural calcification
| Methaemoglobinemia |
6683f089-c480-4c20-a8be-cc5bb8105d32 | Juvenile myoclonic epilepsy is a subtype of idiopathic generalized epilepsy with onset usually between 8 and 20 years of age. Myoclonic jerks, especially in the morning, are of variable intensity ranging from simple twitching ("flying saucer syndrome") to falls; consciousness is not impaired in it. It is precipitated by alcohol and sleep deprivation. Patients will have normal intelligence. The typical interictal EEG abnormality consists of a generalized 4- to 6-Hz spike or polyspike and slow-wave discharges lasting 1-20 seconds. Usually, 1-3 spikes precede each slow wave. Also know: In Generalized tonic clonic seizure EEG shows a normal background with generalized epileptiform discharges such as spike or polyspike wave complexes at 2.5 to 4 Hz. During absence seizures there is an abrupt onset of bilaterally synchronous and symmetrical 3 Hz spike-wave discharge, irrespective of whether typical absences are simple or complex. Ictal recordings from patients with typical temporal lobe epilepsy usually exhibit 5-7 Hz, rhythmic, sharp theta activity, maximal in the sphenoidal and the basal temporal electrodes on the side of seizure origin. Ref: A-Z of Neurological Practice: A Guide to Clinical Neurology By Andrew J. Larner, Alasdair J Coles, Neil J. Scolding, Roger A Barker, 2011, Page 368 ; Clinical Electroencephalography by Misra,2005, Page 188 | Pediatrics | null | An adolescent is brought to the emergency depament following an episode of myoclonic jerks at morning after waking up. His consciousness was not impaired. His EEG shows generalized 3-4 Hz spike and slow wave complexes. Most probable diagnosis is?
A. Generalized tonic clonic seizure
B. Absent seizure
C. Temporal lobe epilepsy
D. Juvenile myoclonic epilepsy
| Juvenile myoclonic epilepsy |
3607051a-f54b-4f28-b274-657ac23afdc4 | Build up of cummonemia which occurs in urea cycle disorder or advanced liver disease, inhibits TCA cycle by depleting alpha ketoglutarate. | Biochemistry | null | How does hyperammonemia inhibit TCA cycle?
A. By depleting alpha ketoglutarate
B. By depleting oxaloacetate
C. By increasing concentration of alpha ketoglutarate
D. By increasing concentration of oxaloacetate.
| By depleting alpha ketoglutarate |
6977c03b-e61d-4987-b682-05272eadd984 | Ans is 'c' i.e. Angle of mandible * An accessory salivary gland is ectopic salivary gland tissue with a salivary gland duct system. The most common location of accessory salivary gland tissue is an extra major salivary gland in front of the parotid gland.* Salivary gland heterotopia is where salivary gland acini cells are present in an abnormal location without any duct system. The most common location is the cervical lymph nodes.* Most common ectopic salivary gland tissue is Stafne bone cyst.* It presents as asymptomatic, clearly demarcated radiolucency of the angle of mouth, characteristically, below inferior dental neurovascular bundle. | Pathology | Head & Neck | Most common site of ectopic salivary gland is?
A. Cheek
B. Palate
C. Angle of mandible
D. Tongue
| Angle of mandible |
011cb59e-80e7-48fe-aeba-65cc0fef4c7b | The boy in question is obviously malnourished (Expected weight is 20-25 kg and expected height is 125-130 cm) A normal sigmoidoscopy rules out ulcerative colitis as it extends in a continuous fashion proximally from the rectum. A negative Mantoux test goes against active tuberculosis and a negative stool culture also rules out strongyloidiasis. Interpretation of Mantoux test: If the width of the induration is: >= 10 mm: Positive (tuberculin reactors) 6-9 mm: Equivocal/doubtful reaction <=5 mm: Negative reaction Hence, the obvious choice left is option '2', i.e. Crohn's disease. | Pediatrics | Disorders of Gastrointestinal System Including Diarrhea | An eight-year-old boy had abdominal pain, fever with bloody diarrhea for 18 months. His height is 100 cm and weight is 14.5 kg. Stool culture was negative for known entero-pathogens. The sigmoidoscopy was normal. During the same period child had an episode of renal colic and passed urinary gravel. The Mantoux test was 5 x 5 mm. The most probable diagnosis is:
A. Ulcerative colitis
B. Crohn's disease
C. Intestinal tuberculosis
D. Strongyloidiasis
| Crohn's disease |
fb4f5360-e332-4c05-8032-0131e2a53d1d | Turner's syndrome Phenotype is female Karyotype is 45,XO Sho stature,webbed neck underdeveloped uterus and vagina ovaries lack graffian follicles breasts are not developed,axillary and pubic hair is scanty or absent SHAW'S TEXTBOOK OF GYNAECOLOGY,pg no:111,115th edition | Gynaecology & Obstetrics | Sexuality and intersexuality | A 17-year-old girl with amenorrhea, atrophied breast, hypoplastic uterus :
A. Turner's syndrome
B. Gonadal dysgenesis
C. Androgen insensitivity syndrome
D. Klinefelter's syndrome
| Turner's syndrome |
ba30ef45-e12c-4c58-a301-185542b5668f | Latent infection by HSV-2 has been shown to occur primarily in the sacral ganglia, whereas HSV-1 latency has been demonstrated in trigeminal, superior cervical, and vagal nerve ganglia. Varicella- zoster virus remains latent in neural sensory ganglia. Ref:- Baveja textbook of Microbiology | Microbiology | Virology | Which of the following cell types are specific to a latent genital infection with HSV-2
A. Sacral ganglia
B. Neural sensory ganglia
C. Trigeminal ganglia
D. Vagal nerve ganglia
| Sacral ganglia |
8fa85800-48b2-4749-8f5f-653aaad7ed1a | D i.e. Persists till merges with discolouration of putrefaction | Forensic Medicine | null | If a body is left undisturbed, for how long does post moem staining persists :
A. Few hours
B. Few days
C. Few months
D. Persists till merges with discolouration of putrefaction
| Persists till merges with discolouration of putrefaction |
fe94a1f7-2fa1-416b-b5cd-a3f044b8057b | Cleft lip and cleft palate, also known as orofacial cleft, is a group of conditions that includes cleft lip (CL), cleft palate (CP), and both together (CLP).] A cleft lip contains an opening in the upper lip that may extend into the nose. The opening may be on one side, both sides, or in the middle. A cleft palate is when the roof of the mouth contains an opening into the nose. These disorders can result in feeding problems, speech problems, hearing problems, and frequent ear infections. Less than half the time the condition is associated with other disordersMultifacorial inheritance is the type of inheritance followed by traits that are determined by multiple factors both environmental and genetic. Environmental factors interact with many genes to generate a normally distributed susceptibiity.Some diseases for example myocardial infarction, congenital bih defects, cancer, diabetes, mental illnesses and Alzheimer diseases cause along with morbidity, premature moality in two out of three individuals during their lifetime. Many show clustering among families. However their inheritance pattern does not follow that of single gene disorders (Mendelian pattern of inheritance). These kind of diseases are thought to result from complex interactions between genetic and environmental factors, i.e. multifactorial inheritance pattern. | Pathology | General pathology | Multifactorial inheritance is most likely to play a role in
A. Cleft lip
B. Marfan's syndrome
C. Down's syndrome
D. Erythroblastosis fetalis
| Cleft lip |
0162b165-fe45-4660-a76b-9c9982150cd1 | Ans. (C) Streptomycin(Ref: Katzung 10/e p835 KDT 8/e p746)Streptomycin is an aminoglycoside and require dose adjustment in renal failure whereas doxycycline, rifampicin and cefoperazone are secreted in bile and do not require dose adjustment in renal failure. | Pharmacology | Chemotherapy: General Principles | Which of the followign drugs require dose adjustment in renal failure?
A. Cefoperazone
B. Doxycycline
C. Streptomycin
D. Rifampicin
| Streptomycin |
ce95c227-e06d-41b3-a47e-c9f125031d15 | The learning theory: Davidson (1967)
This theory advocates that non-nutritive sucking stems from an adaptive response.
The infant associates sucking with such pleasurable feelings as hunger. These events are recalled by sucking the suitable objects available, mainly thumb or finger. | Dental | null | The learning theory of digit sucking was proposed by
A. Davidson, 1967
B. Sears and Wise, 1982
C. Johnson and Larson, 1993
D. Sigmond Freud, 1905
| Davidson, 1967 |
8e6d5c3d-2b96-4f38-9c61-5629b28b3c0e | Superior mesenteric aery: - Aery of mid gut Origin - L1 veebrae level . Regional anatomy of SMA: - It is crossed anteriorly by the splenic vein & the neck of pancreas. Posterior to it is the renal vein, the uncinate process & the inferior pa of duodenum (3rd pa). - This D3 pa can be compressed b/w two aeries: - Anterior - SMA Posterior - Abdominal aoa SMA dilatation can lead to compression of 3rd pa of duodenum. | This is called as superior Mesenteric aery syndrome. | Anatomy | Small intestine and large intestine | Which aery dilatation causes compression of 3rd pa of duodenum
A. Superior mesenteric aery
B. Gastroduodenal aery
C. Inferior mesenteric aery
D. Celiac aery
| Superior mesenteric aery |
0ca68dd1-02ec-4201-bf11-a02b25742c7b | After laparotomy hyperophied muscle is cut along the whole length adequately until mucosa bulges out, then pyloromyotomy is done. in Heller&;s operation muscle of the cardiac are cut to allow passage of food ,and is done in achalasia cardia Truncal vagotomyis done by denervating the main branch which is supply in pylorus as in cases like peptic ulcerarltion Delorme&;s operation is done for repairing a external rectal prolapse Reference: SRB 5th edition page no. 821 & internet | Surgery | G.I.T | The surgery for hyperophic pyloric stenosis of infancy is
A. Ramstedt's operation
B. Truncal vagotomy
C. Heller's operation
D. Delorme's operataion
| Ramstedt's operation |
bea50b65-023e-4085-a4fc-52ea30549a39 | Testamentary capacity (testament = will) is the mental ability to make a valid will. Will denotes any testamentary document. The requirement for a valid will are as follows. A written and properly signed and witnessed document must exist. The testator must be a major and of sound disposing mind at the time of making the will. Force undue influence or dishonest representation of facts, should not have been applied by others. Ref: The Essentials of Forensic Medicine and Toxicology 29th Ed Page 431 | Forensic Medicine | null | Testamentary capacity is the ability to:
A. Give evidence in a cou of law
B. Enter into a contract
C. Make a will
D. Give consent
| Make a will |
7d897424-4c41-4d11-bcee-5ce9af5fbf25 | Keep in mind that:-
Treatment of uveitis in hypertensive uveitis (uveitic glaucoma) is topical steroid along with mydriatic-cycloplegics.
Treatment for reducing IOP in hypertensive uveitis (uveitic glaucoma) is antiglaucoma drugs (Timolol is the drug of choice). | Ophthalmology | null | Uveitis with raised intraocular tension is best managed by –
A. Timolol
B. Atropine
C. Pilocarpine
D. Steroid
| Steroid |
700bd2c7-24d1-459f-b3a7-97aef7d008aa | D i.e. Barbiturate All are causes of constricted pupils but in? Barbiturate poisoning the pupils are usually slightly constricted & react to light by alternate contraction & dilation and dilate during terminal asphyxiaQ | Forensic Medicine | null | Pin point pupil is seen in A/E :
A. Pontine haemorrhage
B. Organophosphorus poisoning
C. Opium poisoning
D. Barbiturate poisoning
| Barbiturate poisoning |
2f8c8ce5-26b8-414a-97e7-e741341be72e | Ans. C. SchizophreniaSchizophrenia is a disorder characterized by delusions, hallucinations, negative symptoms, aggressive behavior in clear consciousness. Altered sensorium is seen in organic conditions like delirium. | Psychiatry | Schizophrenia | A 32-year-old female is brought by his family with history of gradual onset of suspiciousness, muttering and smiling without clear reason, decreased socialization, and violent outbursts. Mental status examination revealed a blunt affect, thought insertion, impaired judgement and insight. The most likely diagnosis would be:
A. Delusional disorder
B. Depression
C. Schizophrenia
D. Anxiety disorder
| Schizophrenia |
2cbedaef-4449-4161-bc27-0f662e59d0a3 | Extra oral film taken in a case of maxillary fibrous dysplasia shows ground glass appearence. Intraoral film taken in this condition shows orange peel appearence. Fibrous dysplasia is an idiopathic skeletal disorder in which medullary bone is replaced by poorly organized structurally unsound fibro osseous tissue. Most commonly involved site is the posterior maxilla. In this condition, the normally radiolucent maxillary antrum may be paially or totally replaced by the radio-opaque lesion. | ENT | null | In which of the following condition is Ground glass appearance of maxillary sinus seen?
A. Maxillary Sinusitis
B. Maxillary Carcinoma
C. Maxillary polyp
D. Maxillary fibrous dysplasia
| Maxillary fibrous dysplasia |
b77253db-30c6-4d5f-a6a5-cebeb1b917ef | Coincidental malignancy in the upper respiratory tract with inveed papilloma is seen in 4%Malignant transformation of the tumor itself is seen in 8% | Microbiology | All India exam | Coincidental malignancy in the upper respiratory tract with inveed papillomas seen in
A. 0.10%
B. 2%
C. 4%
D. 5%
| 4% |
e55c89a1-7340-4aca-939e-fa278715fc87 | Ans. is 'a' i.e., Hyponasal voice Clinical features of antrochoanal polypo Unilateral Nasal blockage (more on expiration than on inspirationo Obstruction may become bilateral when polyp grows into nasopharynx and starts obstructing opposite choana.o Hyponasal voiceo Mucoid nasal dischargeo Conductive deafness due to eustachian tube dysfunction.o On examination polyp may not be visible on anterior rhinoscopy as it grows posteriorlyo On posterior rhinoscopy - smooth, greyish white, spherical mass is seen in choana. | ENT | Polyp | What is the type of voice in antrochoanal polyp-
A. Hyponasal voice
B. Hoarse voice
C. Low pitched voice
D. High pitched voice
| Hyponasal voice |
ba81aeb9-d666-470d-aadc-17913046da14 | Ans. is 'c' i.e. Krabbe's disease Deep white matter lesion along with the involvement of thalamus suggests Krabbe's disease.Krabbe's disease is a leukodystrophy.LeukodystrophyIt is a term commonly used to refer to demyelination disorders.They are mainly due to genetic defects in the formation and maintenance of myelin.They usually present in infants and children with increasing development delay, progressive dementia and neurological deficit.These disorders are inherited as autosomal recessive trait and are associated with lysosomal enzyme deficiencies.They include the following disorders:-Metachromatic leukodystrophyGloboid leukodystrophy (Krabbe's disease)Spongiform degeneration (Canavan's disease)T. scan of leukodystrophies:-C. T. scan of the leukodystrophies shows low density areas in the white matter which are bilateral but not necessary symmetric and becomes more extensive as the disease process progresses.Krabbe's diseaseIt occurs due to deficiency of the enzyme P-galactocerebroside.It presents in infancy with retardation and spasticity.CT scan appearance of Krabbe's diseaseB/L symmetrical hypodensities in both frontoparietal and occipital regions in the white matter zone.Both thalamus and basai ganglia are hyperdenseCerebellum unaffected, ventricles normal, septum midlineMetachromatic leukodystrophyIt is a common leukodystrophy which commences in infancy.It occurs due to deficiency of the enzyme Arylsulphatase A.C. T. shows diffuse symmetric attenuation of the cerebellar and cerebral white matter.Alexander's diseaseIt is one of the few leukodystrophies that occurs sporadically and is characterized histopathologically by the abundant presence of Rosenthal fibres in the affected brain.Definitive diagnosis thus depends on brain biopsy.It occurs due to mutation in glial fibrillary acidic protein (GFAP).C. T. scan demonstrates degeneration of the white matter most prominent in the frontal lobes.Canavan's diseaseIt occurs due to deficiency of the enzyme aspart acylase leading to accumulation of N-Acetyl aspartic acid in the brain.C. T. scan shows diffuse white matter degeneration primarily in the cerebral hemispheres with less involvement in the cerebellum and brainstem. | Pediatrics | Endocrinology | Deep white matter lesion with bilateral deep bright thalamic appearance is suggestive of
A. Alexander disease
B. Canavan's diseases
C. Krabbe's disease
D. Metachromatic leukodystrophy
| Krabbe's disease |
f36ec928-6f46-4017-b540-f962b8695aaf | (C) (< 1) (258 - Park 22nd)AEDES AEGYPTI INDEX: This is a house index and is defined as "the percentage of houses and their premises in a limited well-defined area, showing actual breading of Aedes - aegypti larvae"* This index should not be more than 1 percent in towns and seaports in endemic areas to ensure freedom from yellow fever.* Airports and seaports are kept free from the breeding of insect vectors over an area extending at least 400 meters** around their perimeters.* The "aedes aegypti index" is kept below 1 **YELLOW - FEVER* It is a exotic zoonotic disease in India.* Causative agent - Group B Arbovirus (Flavivirus fibricus) (Togavirus family)* Reservoir - Monkey in forest areas and Man in urban area.* Vector - Aedes aegypti* Incubation Period - Intrinsic 3-6 days, Extrinsic 8-12 days.* Immunity - One attack confers life long Immunity. Infants bom of immune mothers have antibodies up to 6 months of life.* Clinical features - Haemorrhagic fever (black vomit, epistaxis, malena) with severe hepatic and renal manifestations. Spectrum of disease varies from clinically indeterminate to severe cases.* Case fatality rate - May reach 80% in severe cases.* Period of communicability: Blood of patients is infective during the first 3 to 4 days of illness.* Vaccine - 17 D vaccine Live attenuaed, Freeze dried. Immunity apperrs on 7th day and lasts >35 years. Rapid immunization of population at risk is the most effective control strategy.* International certificate of vaccination - Valid 10 days after date of vaccination and extends up to 10 years. WHO recommends re-vaccination after 10 years.* All travellers (including infants) exposed to risk of yellow fever or passing through endemic zones of yellow fever must poses a valid International certificate of vaccination.* Quarantine - A traveller without a valid international certificate of vaccination' is placed on quarantine in a mosquito proof ward for 6 days. | Social & Preventive Medicine | Communicable Diseases | Adies aegpti index at airport -
A. 0
B. 1
C. <1
D. 2-Jan
| <1 |
952a1c0f-50b4-45ea-8906-f1297ca9e5a5 | The lens is suspended in the eye by zonules which are inseed on the anterior and equatorial lens capsule and attached to the ciliary body. REF IMG | Ophthalmology | Lens | Strongest attachment of Zonule is at -
A. Equator
B. Just anterior to equator
C. Posterior to equator
D. Posterior lobe
| Just anterior to equator |
4f1d5eaf-0429-41ee-8739-3b2de8c51a86 | Ans. is 'b' i.e., Bupivacaine o Bupivacaine is the most cardiotoxic LA (Ropivacaine is a newer bupivacaine congener with less tardio toxicity).Important facts about LAso Chlorprocaine is the shortest acting LA.o Dibucaine is the longest acting, most potent and most toxic LA.o Procaine & chlorprocaine are least potent LAs.o Bupivacaine is the most cardiotoxic L4 (Ropivacaine is a newer bupivacaine congener with less cardiotoxicityi)o Levobupivacaine (The S (-) enantiomer of bupivacaine) is less cardiotoxic and less prone to cause seizure.o Prilocaine and Benzocaine can cause Methaemoglobinemiao Lignocaine is the most commonly used LAo Bupivacaine has the highest local tissue irritancy:o Chlorprocaine is contraindicated in spinal anaesthesia as it can cause paraplegia due to presence of neurotoxic preservative sodium metabisulphite.o Procaine is the LA of choice in malignant hyperthermia. | Anaesthesia | Miscellaneous (Local and Regional Anesthesia) | Most cardiotoxic local anesthetic -
A. Procaine
B. Bupivacaine
C. Cocaine
D. Lidocaine
| Bupivacaine |
a3d1f5d2-0cfb-4e3d-9082-2f51a0bbee3b | A hernia through foramen Bochdalek (through the pleuroperitoneal canal) (95% left-sided, only 5% right sided) * It is a commonest congenital diaphragmatic hernia. * This is a developmental defective condition, due to a failure of fusion of pleuroperitoneal canal leaving a direct communication between pleura and peritoneum on left side. This allows herniation of contents of the abdomen into the left side thorax. * Common content is a colon. Occasionally small bowel, stomach is the contents. * 80% cases do not have a hernial sac. Only 20% cases have got sac. Ref: SRB&;s manual of surgery,3 rd ed, pg no 1078 | Surgery | G.I.T | Bochdalek hernia occurs through
A. Diaphragm
B. Lumbar triangle
C. Femoral region
D. obturator canal
| Diaphragm |
24bbce20-dd17-4294-ae1b-ed3d0b0b78b1 | Appendicitis is often characterized by acute inflammation and is indicated with both a positive psoas test and rebound pain over McBurney's point. McBurney's point lies 1 inch lateral to the midpoint of an imaginary line in the right lower quadrant, joining the anterior superior iliac spine and the umbilicus. In patients with appendicitis, rebound tenderness may be felt over McBurney's point after quick, deep compression of the left lower quadrant. An ectopic pregnancy would be associated with generalized abdominal pain instead of the localized pain felt over McBurney's point. Cholecystitis results from an inflammation of the gallbladder and would result in pain over the epigastric region shifting to the right hypochondriac region. Kidney stones result in referred pain to the lumbar or possibly inguinal regions. Perforation of the duodenum could result in pain to palpation of the abdomen, together with adynamic (paralytic) ileus, rigidity of the abdominal wall, and referral of pain to the shoulder. | Anatomy | Abdomen & Pelvis | A 37-year-old woman was admitted to the emergency department with high fever (39.5deg C), nausea, and vomiting. Physical examination revealed increased abdominal pain in the paraumbilical region, rebound tenderness over McBurney's point, and a positive psoas test. Blood tests showed marked leukocytosis. Which of the following is the most likely diagnosis?
A. Ectopic pregnancy
B. Appendicitis
C. Cholecystitis
D. Kidney stone
| Appendicitis |
ad5ef257-584b-4364-b381-fbb3ce491b7b | Ans. B: Propranolol Beta-blockers such as propranolol help control many of the symptoms of hypehyroidism. These drugs can slow a fast hea rate, reduce tremors, and control anxiety. Beta-blockers are paicularly useful for people with extreme hypehyroidism and for people with bothersome or dangerous symptoms that have not responded to other treatments. However, beta-blockers do not reduce excess thyroid hormone production. Therefore, other treatments are added to bring hormone production to normal levels. | Pharmacology | null | Drug used to treat tremors in hypehyroidism is: September 2008
A. Adrenaline
B. Propranolol
C. Noradrenaline
D. Dopamine
| Propranolol |
108331f6-cf19-4734-bf85-8f55133bbaf4 | Patients should be given a 3-4 month trial of therapy to show objective benefit. Omalizumab is usually given as a subcutaneous injection every 2-4 weeks and appears not to have significant side effects. Ref: Harrison's principle of internal medicine 17th edition, chapter 248. | Medicine | null | Omalizumab is administered by which route:
A. Inhalation
B. Intravenous
C. Intranasal
D. Subcutaneous
| Subcutaneous |
5e9a055f-4270-4bea-9c94-2bda29b097fd | Cystic blow out' is a type of biliary duct injury in cholecystectomy patient. According to Strasberg classification it falls into Type A injury. Ref: Complication in Surgery By Michael W. Mulholland, Gerard M. Dohe, 2nd Edition, Page 432 | Surgery | null | According to the Bismuth / Strasberg classification 'Cystic blow out' is classified as:
A. Type A
B. Type B
C. Type C
D. Type D
| Type A |
d4f1b7b4-d096-409d-98f2-abbba360b7ac | Infantile spasms:-
West syndrome
Onset : 3-8 months of life
Characterised by combination of salaam spells( sudden dropping of the head and flexion of arms), developmental retardation, hypsarrythmia on ECG.
Causes-
Hypoxic ischemic encephalopathy
Neurocutaneous syndromes
Perinatal infections
Hemorrhage
Injury
Metabolic disorders
Localized structural malformations
The spasms occur in clusters usually on waking
Drug therapy-
Intramuscular ACTH 40-60 unit per day may be given 4-6 weeks and tgen tapered off.
On the other hand oral prednisolone at 2 mg/ kg / day in divided doses may also be used.
These agents abolish spasms and may result in resolution of hypsarrythmia. | Pediatrics | null | The drug of choice in treatment of inflantile spasms is
A. Phenytoin
B. Phenobarbitone
C. Carbamazepin
D. ACTH
| ACTH |
73ecf307-eeaa-4540-b0b2-baaae085eb48 | Answer A. Decompression sicknessCutis marmorata is a dermal manifestation of decompression sickness. Initially, there is erythema accompanied by pruritus, and then the rash spreads irregularly and deepens in color. It develops a mottled appearance, with areas of pallor surrounded by cyanotic patches. During recompression, the rash resolves. | Medicine | Infection | This rash appeared 9 hours after a scuba dive. What is the diagnosis?
A. Decompression sickness
B. Jellyfish envenomation
C. Mycobacterium marinum infection
D. Phylum Porifera contact dermatitis
| Decompression sickness |
950da181-d785-4ae3-82ee-b5f65c69c546 | (c) Posterior dislocationExplanationSince the question mentions limitation of abduction, hence there is adduction deformity along with flexion and internal rotation deformity. Thus this is a case of Posterior dislocation of hip.Position of hipPattern of InjuryFlexion, adduction, internal rotationPure posterior dislocationLess flexion, less adduction (neutral or slight abduction), internal rotationPosterior fracture dislocation > central dislocationHyper abduction + Flexion + External rotationAnterior dislocationSome students remember an alternate format of the question 6b | Orthopaedics | Pelvis & Injuries | A patient with hip dislocation with limitation of Abduction at hip and flexion and internal rotation deformity at hip and shortening. Diagnosis is:
A. Central dislocation
B. Anterior dislocation
C. Posterior dislocation
D. Fracture dislocation
| Posterior dislocation |
db9f83fb-de1b-4945-ae67-72701a4729b1 | Reversible cell injury:-
→ Hypoxia is the most common cause of cell injury.
→ Oxygen is an important requirement of mitochondria, for the formation of ATP, therefore hypoxia will result in earliest involvement of mitochondria, resulting in decreased formation of ATP.
→ Important organelles affected are
Cell membranes (require ATP for functioning of Na+ - K+ pump)
Endoplasmic reticulum (require ATP for protein synthesis)
Nucleus.
→ Swelling of organelles like endoplasmic reticulum, results in decreased protein synthesis.
→ Bleb results due to outpouching from the cell membrane to accommodate more water.
→ Loss of microvilli.
→ Formation of cellular organelle like endoplasmic reticulum. These are composed of phospholipids.
→Myelin figures are intracellular whorls of laminated lipid material.
When these myelin figures are present in membrane-bound structure, containing lysosome enzymes, these are known as myeloid bodies. | Pathology | null | A 28 year old female patient with patches of burns and swelling of arm. Histopathological findings reveal swelling of endopasmic reticulum, blebs from cell membrane, loss of microvilli, presence of myeloid bodies and no changes in nucleus. Which type of injury is seen in this patient?
A. Irreversible cell injury
B. Autolysis
C. Pyroptosis
D. Reversible cell injury
| Reversible cell injury |
248e7391-5985-42ca-8499-994745731c16 | Ans. is 'c' i.e., Dengue fever o Break bone fever (Saddle back fever) is caused by dengue virus.Dengue fevero Dengue fever is caused by arboviruses (at least 4 serotypes have been recognized)o It is transmitted by Aedes (Aedes aegypti is the main vector).o The reservoir of infection is both man and mosquito,o The transmission cycle is Man-mosquito-mano Dengue fever occurs both epidemically and endemically. Epidemics starts in rainy season and are usually explosive.o Aedes mosquito becomes infective by feeding on a patient from the day before onset to the 5th day of illness.o Various manifestations of Dengue infectionClassical dengue fever - Also known as break bone feverIncubation period 2-7 days (3-10 days - Park)Onset is sudden with chills and fever. Fever is usually between 39degc and 40degc temperature returns to normal after 5-6 days or subside on about the 3rd day and rise again after 5-8 days after onset (saddle back fever).Rashes appear in 80% of cases during remission or during second febrile phase. The rash lasts for 2 hours to several days and may be followed by desquamation. Dengue Hemorrhagic fever (DHF) -It is a severe form of dengue fever caused by infection with more than one dengue virus.The severe illness is thought to be due to double infection with more than one dengue virus.Dengue hemorrhagic fever is believed to result from reinfection with a virus of different serotype ( due to enhancing antibodies)DHF usally occurs after sequential infection with any two of the four serotypes of dengue virus.Sequence of infection may be important; serotype 1 followed by serotype2 is more dangerous than serotype 4 followed by serotype 2.Criteria for clinical diagnosis of DHFClinical diagnosisFever -Acute onset, high continuous lasting 2-7 days.Hemorrhagic manifestationsPositive tourniquet testPetechiae. purpura, ecchymosisEpistaxis, gum bleedingHematemesis and/or melaenaEnlargement of liverLaboratory diagnosisThrombocytopenia (100, OOO/mnV or less)Haemoconcentration haematocrit -->> increased by 20 percent or more of base-line value.C) Dengue shock syndromeThe clinical diagnosis is based on:All the above criteria plusShock manifested by rapid and weak pulse with narrowing of the pulse pressure to 20mm Hg or less or hypotension with the presence of cold clammy skin and restlessness. | Microbiology | Arboviruses | Break bone fever is caused by -
A. Yellow fever
B. Japaneseencephlitis
C. Denguefever
D. KFD
| Denguefever |
15bda01d-c3e2-448c-b1d6-0819ebddce5d | Ans. is 'b' i.e., Type II Erythroblastosis fetalis and blood transfusion reactions are type II hypersensitivity reactions. | Microbiology | null | Erythroblastosis fetalis is an example of which type of hypersensitivity reaction ?
A. Type I
B. Type II
C. Type III
D. Type IV
| Type II |
16647d47-3bbb-477c-b17a-f077faa3ea1a | Ans. is 'a' i.e., Na+ Cl- synpo inhibitor | Pharmacology | null | Mechanism of action thiazide is ?
A. Na+Cl- sympo inhibitor
B. Na+K+ sympo inhibitor
C. Carbonic anhydrase inhibitor
D. Osmotic diuresis
| Na+Cl- sympo inhibitor |
044262fd-2814-4028-9137-9937be78db85 | Angiosarcoma of the liver is associated with exposure to →
1) Vinyl chloride,
2) Arsenic,
3) Thorotrast | Pathology | null | Angiosarcoma of the liver is associated with -
A. Nickel
B. Chromium
C. Cadmium
D. Arsenic
| Arsenic |
ca17edb2-233d-4c52-8774-8e71a1ce269b | Ans. (b) LaryngomalaciaRef: Dhittgra's ENT 6th ed./ 295LARYNGOMALACIA* The most common congenital disease of larynx is Laryngomalacia.* Laryngeal cartilages are extremely soft and flabby in a child with laryngomalacia.* Most common clinical presentation of laryngomalacia: Stridor* The stridor is mainly inspiratory and increases during supine position but decreases during prone position.* Laryngomalacia may involve all the cartilages but epiglottis and aryepiglottic folds are mainly involved.* IOC: Direct laryngoscopy.* The finding is Omega shaped epiglottis (long and tubular epiglottis with curled up tip).DIFFERENT SHAPE OF GLOTTIS AND CONDITIONSGLOTTIS SHAPECONDITION* Key hole shapedPhonasthenia* Omega shapedLaryngomalacia* Thumb signAcute epiglottitis* Steeple signCroup/ Laryngotracheobronchitis* Turban shapedLaryngeal TB | ENT | Larynx | Omega shaped epiglottis is seen in:
A. Epiglottitis
B. Laryngomalacia
C. Epiglottis CA
D. Tuberculosis
| Laryngomalacia |
6f1aa9e9-dfc1-49f5-aed3-10d008964815 | Ptosis is the drooping eyelid, may be seen in some clinical cases.
Oculomotor ptosis due to paralysis of the levator palpebrae (e.g., transtentorial herniation).
Oculosympathetic ptosis due to paralysis of the superior tarsal (Muller) muscle as seen in Horner syndrome. This is a very slight ptosis, or pseudoptosis (e.g., Pancoast tumor). | Anatomy | null | Ptosis may occur due to damage to:
A. Trochlear nerve
B. Oculomotor
C. Trigeminal nerve
D. Superior oblique muscle
| Oculomotor |
294a6a99-9437-4189-8c5c-9cd4379f0639 | RULE OF HAASE: This is a rough method of calculating the age of the fetus. The length of the fetus is measured from crown to heel in centimeter During the first 5 months of pregnancy, the square root of the length gives an approximate age of the fetus in months, eg: a fetus length is 16cm is 4 months. HAASE'S MODIFICATION OF MORRISON'S LAW: during the last 5 months, the length in centimeters divided by five gives the age of the fetus in months, eg: fetus of 35cm is 7months. REF: The Synopsis of Forensic Medicine and Toxicology by Dr. K.S.Narayan Reddy 29th edition page no: 51 | Forensic Medicine | Identification | Rule of Hasse is used to determine -
A. The age of fetus
B. Height of an adult
C. Race of a person
D. gender of fetus
| The age of fetus |
8af3b0e6-1e89-4ba9-8b8a-895fc8b59490 | Five basic mechanisms of transmembrane signaling are well understood. Each uses a different strategy to circumvent the barrier posed by the lipid bilayer of the plasma membrane. These strategies use: a lipid-soluble ligand that crosses the membrane and acts on an intracellular receptor. a transmembrane receptor protein whose intracellular enzymatic activity is allosterically regulated by a ligand that binds to a site on the protein's extracellular domain. a transmembrane receptor that binds and stimulates a protein tyrosine kinase. a ligand gated transmembrane ion channel that can be induced to open or close by the binding of a ligand. a transmembrane receptor protein that stimulates a GTP-binding signal transducer protein (G protein), which in turn modulates production of an intracellular second messenger. Known transmembrane signaling mechanisms:1: A lipid-soluble chemical signal crosses the plasma membrane and acts on an intracellular receptor (which may be an enzyme or a regulator of gene transcription); 2: the signal binds to the extracellular domain of a transmembrane protein, thereby activating an enzymatic activity of its cytoplasmic domain; 3: the signal binds to the extracellular domain of a transmembrane receptor bound to a separate protein tyrosine kinase, which it activates; 4: the signal binds to and directly regulates the opening of an ion channel; 5: the signal binds to a cell-s urface receptor linked to an effector enzyme by a G protein. (A, C, substrates; B, D, products; R, receptor; G, G protein; E, effector ; Y, tyrosine; P, phosphate.) Receptor Ligand Ligand gated receptor Insulin, EGF, PDGF, ANP Nuclear receptor Fenofibrate. Gemfibrizol G protein coupled receptor Catecholamine Enzymatic receptor | Pharmacology | DNB 2018 | According to signal transductions mechanism, GABA B is which type of receptor?
A. Ligand gated receptor
B. Nuclear receptor
C. G protein coupled receptor
D. Enzymatic receptor
| G protein coupled receptor |
d02a62d3-231a-4572-af84-a9f649fd0089 | Bleaching tetracycline-stained teeth is difficult, some clinicians advocate intentional endodontic therapy along with the use of an intracoronal nonvital bleaching technique to overcome this problem. Although the esthetic result appears much better than that obtained from external bleaching, this approach involves all the inherent risks otherwise associated with endodontic treatment. External bleaching techniques offer a safer alternative, although they may not be as rapid or effective.
Patients who have darkly stained teeth always should be informed that although porcelain (or composite) veneers can result in improved esthetics, they may not entirely eliminate or mask extremely dark stains. Because of the limited thickness of the veneers and the absolute necessity of incorporating intrinsic opacity, the realistic translucency or esthetic vitality of veneered teeth may never be comparable with that of natural, unaffected teeth. Full porcelain coverage with all-ceramic crowns may be indicated in some patients with severe discoloration because of the crown’s greater capacity to restore esthetic vitality.
Reference- Sturdevant 7th ed Pg-281 | Dental | null | A 26 year old female patient complains of discoloured teeth. Intra-oral examination reveals generalized intrinsic tetracycline stains. Which of the following is an effective and esthetic treatment in this case?
A. External bleaching
B. Intracoronal bleaching
C. Veneers
D. Full coverage crowns
| Full coverage crowns |
ec328264-b521-4fca-a119-07bd211c3394 | C i.e. Astrocytoma Posterior Fossa tumors in children Features Astrocytoma Ependymoma Medulloblastoma Cyst Formation Very cominonQ Common Rare CT scan IlypodenseQ Rare Isodense No Hyperdense Yes (15-40%) CSF seeding Transforaminal spread No Yes No Calcification -10% 40-50% 10-15% T2WI Hyper (intense) Hyper/Iso Iso T1 WI Iso/Hypo Iso/Hypo Iso/Hypo Postgadolinium (contrast) Nodule enhanceQ Mild Moderate | Radiology | null | In 7 year old posterior fossa mass with cyst formation, hypodense on CT, hyper intense on T2WI and showing post gadolinium nodule enhancement is
A. Medulloblastoma
B. Ependymoma
C. Astrocytoma
D. Cysticercous
| Astrocytoma |
113dc09d-4f71-44c2-a657-6f3b809cd712 | Ans. (a) Inhibits plasminogenRef Lippincott's Pharmacology 4/e, p 265 | Pharmacology | Antiplatelets and Fibrinolytics | Mechanism of action of tranexamic acid in controlling bleeding is?
A. Inhibits plasminogen
B. Promote platelet aggregation
C. Cause vasoconstriction
D. Promote fibrin synthesis
| Inhibits plasminogen |
52b3f3fd-763e-4929-9240-2c525b18cae4 | Refer kDT 6/e p 340 Drugs competing with acetylcholine at neuromuscular Junction are competitive or non depolarizing neuromuscular blockers. These drugs are used as muscle relaxants. In contrast to depolarising muscle relaxant, these do not cause initial fasciculations | Pharmacology | Autonomic nervous system | How would a drug that competes with acetylcholine for receptors at the motor end plate effect of skeletal muscle. it would be?
A. Produce uncontrolled muscles spasm
B. Cause of muscle to contract and unable to relax
C. Cause muscle to relax and be unable to contract
D. Make the muscle more excitable
| Cause muscle to relax and be unable to contract |
dda728fa-b94d-4c03-a625-8bdc411fead7 | It is important to ventilate in between chest compressions. A positive breath should follow every third chest compression(chest compression to ventilation ratio is 3:1).
In one minute, 90 chest compressions and 30 breaths are administered(120 events).
To obtain this, the chest should be compressed 3 times in 1.5 seconds leaving out approx. 0.5 second for ventilation. | Pediatrics | null | During neonatal resuscitation, the chest compression to ventilation ratio is
A. 15:01
B. 5:01
C. 10:01
D. 3:01
| 3:01 |
3c8506bc-197a-4662-84f7-9f9f9e67a604 | Ans. b (Ultrasound study) (Ref: Grainger, Diagnostic Radiology, 4th/pg.2213 & Rumac, Diagnostic Ultrasound, 2nd/ pg.1359)MOLAR PREGNANCY# Molar pregnancy includes:- complete and- partial molar pregnancy.# The greatest diagnostic accuracy is obtained from the characteristic ultrasonographic appearance of hydatidiform mole# The classic USG features of complete molar pregnancy are well known and include enlarged uterus containing echogenic tissue that expands endometrial canal ('snowstorm' appearance).# The USG feature of partial molar pregnancy overlap with other conditions (missed or incomplete abortion).# Gestational trophoblastic disease includes the tumor spectrum of H. mole, invasive mole and choriocarcinoma.# Although USG is used for initial diagnosis of GTD & to exclude normal pregnancy finding are nonspecific.Educational Point:Follow-Up Evaluation of Molar PregnancyClose and consistent follow-up for these women is imperative with the following aims:1. Prevent pregnancy for a minimum of 6 months using hormonal contraception.2. Monitor serum hCG levels every 2 weeks. Serial measurement of serum hCG is important to detect trophoblastic neoplasia, and even small amounts of trophoblastic tissue can be detected by the assay. These levels should progressively fall to an undetectable level.3. Chemotherapy is not indicated as long as these serum levels continue to regress.4. Once the hCG level falls to a normal level, test the patient monthly for 6 months; then follow-up is discontinued and pregnancy allowed. | Radiology | Obstetrics And Gynaecology | Molar pregnancy can be best diagnosed by:
A. Clinical history and examination
B. Ultrasound study
C. Laproscopy
D. CT Scan
| Ultrasound study |
352636fd-8735-4e3c-864f-18d0f0489cb1 | Ans. (A) Man biting rate(Ref: Park Text book of PSM 25th ed; pg. 342)Vector burden may be denoted by the term-anthrophilismMan biting rate (biting density): It is defined as the average incidence of anopheline bites per day per person. It is determined by standardized vector cache on human bait.Sporozoite rate: It is percentage of female anopheles with sporozoites in the salivary glandInoculation rate: The man-biting rate multiplied by the infective sporozoite rate is called as Inoculation rate.Human blood index: It is the proportion of freshly fed female anopheline mosquitoes whose stomach contains human blood. It indicates the degree of anthrophilism.Mosquito density: It is usually expressed as the number of mosquitoes per man-hour-catch.Points to RememberPre-eradication era malariometric indicators: Parameters are based on clinical diagnosis (Spleen rate, average enlargement spleen, parasite rate, parasite density index, Infant parasite rate and proportional case rate).Eradication era malariometric indicators: Parameter based on microscopic diagnosis of malaria.#Annual parasite incidence#Annual blood examination rate#Annual falciparum incidence#Slide positive rate#Slide falciparum rateVector indices are:-#Human blood index, sporozoite rate, mosquito density#Man biting rate and inoculation rateSome Important IndicatorSpleen rate: Endemically of malaria in a communityInfant parasite rate: The most sensitive index of recent transmission off malaria in a locality.Annual parasite rate: Sophisticated measure of malaria incidence and burden of disease in a community.Annual blood examination rate: Index of operational efficiency.Human blood index: Indicates the degree of anthrophilism. | Social & Preventive Medicine | Communicable Diseases | Indicator for vector burden on human malaria is:-
A. Man biting rate
B. Inoculation rate
C. Slide positive rate
D. Human blood index
| Man biting rate |
a7f40ce2-cd62-4dee-9201-a7d6162e4169 | Causes of High-Anion Gap Metabolic Acidosis *Lactic acidosis * Toxins *Ketoacidosis * Ethylene glycol Diabetic * Methanol Alcoholic * Salicylates Starvation * Propylene glycol *Pyroglutamic acid (5-oxoproline) *Renal failure (acute and chronic) reference : harrisons principles of internal medicine,19 E , page 318 | Medicine | Fluid and electrolytes | Increased osmolar gap is not seen in poisoning of-
A. Para-aldehyde
B. Acetones
C. Methanol
D. Ethylene glycol
| Para-aldehyde |
b0d8e08d-51dc-422a-ad70-a3e0595b4e7f | Ans. d (Opioid analgesic). (Ref. KD Tripathi, Pharmacology/6th. 453)# Tramadol is synthetic centrally acting opioid analgesic having modest affinity for ji receptors.# Unlike other opioids, it inhibits reuptake of NA and 5-HT and thus activates monoaminergic spinal inhibition of pain.# Its oral bioavailability is good and it has minimal hemodynamic effects and hence safer in patients with compromised CVS function.# It is indicated for medium intensity short lasting pain due to diagnostic procedures, injury, surgery, etc as well as for chronic cancer pain. | Pharmacology | C.N.S | Tramadol is
A. Antiflatulent
B. Antireflux drug
C. Beta-blocker
D. Opioid analgesic
| Opioid analgesic |
600b7a9a-5684-4712-be5e-d2f1e1469a19 | Dark ground/ Darkfield microscope
Very slender organisms such as spirochetes and filamentous organisms such as flagella are not visible under ordinary illumination.
The contrast in dark field microscopy gives an illusion of increased resolution so that these structures can be seen under the dark field microscope.
In darkfield microscopy, reflected light is used instead of the transmitted light used in the ordinary microscope.
Dark ground (dark field) microscopy is used for
- Flagella
- Spirochetes | Microbiology | null | Dark ground microscopy is used to see -
A. Refractile organisms
B. Flagella
C. Capsule
D. Fimbriae
| Flagella |
908a356a-e56c-42b4-9444-d8819462d716 | Ans. is 'd' i.e., Bromocriptine o Prolactin is under predominant inhibitory control of hypothalamus through prolactin releasing inhibitory hormone (PRIH). o PRIH is a dopamine that acts on pituitary lactotrope D, receptor. So, Dopaminergic agonists decrease plasma prolactin levels. These agonists are : Dopamine Cobergoline Bromocriptine Apomorphine Dopaminergic antagonists and DA depleters will increase prolactin level Dopaminergic antagonists are : Dopamine depleters are : o Chlorpromazine o Reserpine o Haloperidol o Methyl dopa o Metoclopramide | Pharmacology | null | Prolactin secretion is inhibited by -
A. Dopamine antagonist
B. GABA
C. Neurophysin
D. Bromocripitine
| Bromocripitine |
eb3110cb-5cc2-4938-86e6-3fe732f7ea0f | The parotid duct, also known as the Stensen's duct, crosses the masseter muscle transversely and extends to the oral cavity. The facial artery can be palpated in the groove anterior to the mandibular angle. The facial vein lies anterior to the artery, passing toward the angle of the lips, but does not ascend in close proximity to the masseter. All of the other vessels are located more deeply and cannot be palpated. | Anatomy | Head & Neck | A 32-year-old female patient asks you what is the soft, thin ridge of tissue that she can feel running forward across the masseter muscle toward her upper lip. You reassure her that is perfectly normal. Which of the following is the most likely structure she is feeling?
A. Facial artery
B. Maxillary artery
C. Parotid duct
D. Marginal mandibular branch of facial nerve
| Parotid duct |
2a289b3b-7a93-470f-8913-51b181f9202f | (Point mutation) (628-R) (227-426-Basicpathology> 8th)Sickle cell disease is an important hereditary hemoglobinopathy, a type of disease characterized by production of defective hemoglobins.Sickle cell disease is caused by a point mutation at the sixth position of the b-globin chain leading to the substitution of a valine residue for a glutamic acid residue.Sickle syndromes occurs in 3 different forms (394-HM 5th)1. As heterozygous state for HbS: Sickle cell trait (AS)2. As homozygous state for HbS: Sickle cell anaemia (SS)3. As double heterozygous states eg. Sickle p-thalassaemia Sickle-C-disease, sickle-D disease (SD)Frame-shift mutation - occurs when there is insertion or deletion of one or two base pairs in the DNA sequence eg. Cystic fibrosis | Pathology | Blood | Sickle cell disease is due to
A. Point mutation
B. From shift mutation
C. Nucleotide receptor blockage
D. Non sequence mutation
| Point mutation |
a5478124-ad38-4b92-bb45-e9e971cfad74 | (20 minute) (271- Ananthanarayan 8th, 30- Chakrahorthy 2nd)* Many bacteria reproduce by binary fission and the average time required for the population, or the biomass, to double is known as generation time or doubling time.GENERATION TIME* Lepra bacillus - 24 Days* Tuberculous bacillus - 20 hours* Coliform E.coli - 20 minute* Clostridium - 10 minute* Each bacterial colony in a solid medium consists of descendants of a single cell* An ordinary bacterium doubles every 20-30 minutes and by geometric progression in exponential phase of growth thus a single bacterium can theoretically give rise to 1021 progeny in 24 hours roughly a ton of dry weight of bacterial cells. | Microbiology | Bacteria | Generation time of E-coli is
A. 20 days
B. 20 minutes
C. 20 hours
D. 20 second
| 20 minutes |
be6f298d-f621-4772-8054-4d68e9edb1e7 | Primary cell cultures:These are normal cells freshly taken from the body and cultured. Common examples are monkey kidney,human embryonic kidney,human amnion and chick embryo cell cultures. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO:435 | Microbiology | Virology | Which of the following is primary cell line -
A. Chick embryo fibroblast
B. Hela cells
C. Vero cells
D. WI-38
| Chick embryo fibroblast |
7810ee8a-7bb6-4d25-bca9-af0c6d082f9d | Keratoconus (conical cornea) is a noninflammatory bilateral (85%) ecstatic condition of the cornea in its axial pa. It usually stas at pubey and progresses slowly. Keratoconus may be associated with :Ocular conditions e.g. ectopia lentis, congenital cataract, aniridia, retinitis pigmentosa, and vernal keratoconjunctivitis (VKC). Systemic conditions e.g., Marfan's syndrome, atopy, Down's syndrome, Ehlers-Danlossyndrome, osteogenesis imperfecta, and mitral valve prolapse. Treatment. Falling vision may not be corrected by glasses due to irregular astigmatism. Contact lenses (rigid gas permeable) usually improve the vision in early cases. In later stages penetrating keratoplasty may be required. Intacs, the intracorneal ring segments, are repoed to be useful in early cases. Keratoconus can occur in patients with vernal keratoconjunctivitis due to repeated rubbing of the eye. early complications: This constant damage to the cornea may cause severe complications, including shield ulcers and vernal plaques, keratoconus, corneal scarring, microbial keratitis, and limbal epithelial stem cell deficiency. As some of these complications occur during the first decade of life, they may result in amblyopia. Ref khurana 16th edition pg 256 Ref: Khurana; 4th ed; Pg 119 | Ophthalmology | Conjunctiva | Complication of vernal keratoconjunctivitis is
A. Cataract
B. Keratoconus
C. Retinal detachment
D. Vitreous hemorrhage
| Keratoconus |
ce45f9ff-74f7-4b6a-b7ba-a57f64fa3f4c | Ring vaccination is a strategy to inhibit the spread of disease by vaccinating only those who are most likely to be infected. | Social & Preventive Medicine | Epidemiology | 'Ring vaccination' is
A. Given by a ring shaped machine
B. Given to produce a ring lesion
C. Given around 100 yards of a case detected
D. Given around a mile of a case
| Given around 100 yards of a case detected |
7b968f6a-620d-4c95-957b-4b5595f7342b | Ans. C. Suicidal ideationIn 2003, th UK Medicine and Health Care products regulatory agency concluded that all SSNs, with the exception of fluoxetine, were contraindicated in the treatment of depression in young people due to increase in suicidal ideation and dubious efficacy. | Psychiatry | null | SSRIs should be carefully used in the young for the management of depression due to increase in?
A. Nihilism ideation
B. Guilt ideation
C. Suicidal ideation
D. Envious ideation
| Suicidal ideation |
b2b095ff-db8a-4e67-8b65-1936442ae192 | Ans. is 'b' i.e., Autoimmune disorders* Molecular mimicry is defined as the structural similarity between foreign antigens and self-antigens, because of which T cells and B cells directed against foreign antigens cross react with self antigens resulting in autoimmunity.* Molecular mimicry does not always demand a structural similarity between foreign antigens and self antigens. Sometimes electrostatic attraction between foreign antigen and MHC molecule can cause self antigen damage by immune response generated against foreign antigens.* Molecular mimicry is also possible between two recognized peptides that have similar antigenic surfaces in the absence of primary sequence homology. For example, specific single amino acid residues such as cysteine (creates di-sulfide bonds), arginine or lysine (form multiple hydrogen bonds), could be essential for T cell cross-reactivity.* Immunological tolerance is the ability to discriminate self-antigens from foreign antigens and to not produce antibodies against self-antigens* Loss of this immunological tolerance is generally considered as a initiation factor for autoimmunity* Immunological tolerance is generally established in foetus, soon after the pre-T cells leave the bone marrow and they reach the thymus* In thymus, any clone of T cell which binds only weekly to self-antigen i.e., MHC class I antigen is positively selected and is allowed to undergo maturation.* Any clone which binds avidly to one's own MHC class I molecules are negatively selected and apoptosis is induced. This is called as clonal deletion* For exposure to more antigens, this process is found to continue even in peripheral circulation. The clonal deletion analogue which happens in peripheral circulation is called as clonal anergy* B cell tolerance is mediated by VDJ rearrangements and somatic hypermutation* Failure of these immunological tolerance rules can result in autoimmunity | Biochemistry | Molecular Genetics | Molecular mimicry is an explanation for -
A. Immune tolerance
B. Autoimmune disorders
C. Hypersensitivity
D. Immunosuppression
| Autoimmune disorders |
f56138c5-13ef-4348-82c7-402bc01f0345 | Multiple sclerosis affects only axons in CNS (spinal cord and brain) that have myelin sheaths formed by oligodendrocytes. Optic nerve is considered to be pa of CNS, as it is derived from an outpouching of diencephalon. All other nervous structures are in the PNS and have their myelin sheaths formed by Schwan cells | Medicine | Demyelinating disorder | A 9-year-old boy is diagnosed with multiple sclerosis (MS). Which of the following nervous structures would most likely be affected by this disease?
A. Trigeminal ganglion
B. Superior cervical ganglion
C. Optic nerve
D. Facial nerve
| Optic nerve |
6421adc1-aa77-46df-813e-02bf2b50615f | Anthracyclines and actinomycin-D (dactinomycin) can cause severe radiation toxicity. This is known as radiation recall syndrome. | Pharmacology | null | A patient with cancer developed an extreme degree of radiation toxicity. Further history revealed that the dose adjustment of a particular drug was missed during the course of radiotherapy. Which of the following drugs required a dose adjustment during radiotherapy in order to prevent radiation toxicity
A. Vincristine
B. Dactinomycin
C. Cyclophosphamide
D. 6–Mercaptopurine
| Dactinomycin |
dce22fbf-f388-4ed4-983e-82be2d2b52fc | Ans. (b) CataractRef: Khurana 4/e, p. 146If the halos break it is due to cataract and if not it is due to angle closure glaucoma.Thus, the test is positive in diagnosing cataract. Glaucoma is not being diagnosed by this test. It is a diagnosis by exclusion. | Ophthalmology | Lens | Fincham test is used to diagnose
A. Open angle glaucoma
B. Cataract
C. Mucopurulent conjunctivitis
D. Acute angle closure glaucoma
| Cataract |
531d2db7-4f1e-49e0-984a-7c8a8a52cf7c | Although many intracranial tumors show calcification, oligodendroglioma shows calcification in 70-90% of cases. Ref : Robbins 8/e p1333 ( | Surgery | Head and neck | The CNS tumor present with calcification -
A. Oligodendroglioma
B. Astrocytoma
C. Medulloblastoma
D. Pheochromocytoma
| Oligodendroglioma |
b653276a-0820-4ec1-9109-95f8f05f49d5 | Reddy - “The rectum is the ideal place to record temperature except in cases of sodomy.
The temperature can also be recorded by making a small opening into the peritoneal cavity and inserting the thermometer in contact with the inferior surface of the liver.
The external auditory meatus or the nasal passages also can be used to record temperature ” | Forensic Medicine | null | The ideal place to record temperature in a dead body is from:
A. Axilla
B. Groin
C. Rectum
D. Mouth
| Rectum |
ec83896e-97a1-4c1d-801b-bb6c36334475 | Kostmann's syndrome (severe congenital neutropenia)
Kostmann's syndrome, an autosomal recessive disorder, is an inherited disorder of the bone marrow in which there is the arrest of maturation of neutrophils at promyelocyte stage.
There is congenital neutropenia and neutrophils are often completely absent in the blood at the time of diagnosis.
Because of neutropenia, these patients suffer from severe infections e.g., omphalitis (infection of the navel), Pneumonia, Skin abscesses, otitis media.
Kostmann's syndrome is believed to be caused due to defect in the receptor of granulocyte colony stimulating factor (GCSF) on neutrophils (granulocytes). The purpose of this receptor is the binding of the granulocyte to the cytokine (GCSF) in order to give the signal to the cell to mature and multiply.
Patients with Kostamann's syndrome produce GCSF but because of the defect in GCSF receptor the response of neutrophils to normal amounts of GCSF in the blood is reduced: However, they can respond if the amount of GCSF is increased → These patients will respond to a higher dose of GCSE | Pediatrics | null | Kostmann's syndrome–treatment is –
A. Anti–thymocyte globulin + cyclosporin
B. Anti–thymocyte globulin + cyclosporin + GM–CSF
C. G–CSF
D. GM–CSF
| G–CSF |
880295f1-d26d-4ffc-8617-6380598b637d | Prostaglandins helps to keep ductus aeriosus open. Indomethacin inhibits prostaglandins levels | So, closure of ductus aeriosus | DOC for PDA | Medicine | Valvular hea diseases | What is the impact on fetus in case of use of Indomethacin in utero in third trimester?
A. Patent ductus aeriosus
B. Early closure of ductus aeriosus
C. Ventricular septal defect
D. Atrial septal defect
| Early closure of ductus aeriosus |
1fe8c133-2971-495a-90fd-63e171f2dc2f | coverings on peripheral nerve from inner to outer are Endoneurium, Perineurium, EpineuriumINDERBIR SINGH&;S TEXTBOOK OF HUMAN HISTOLOGY PAGE NO:171 | Anatomy | General anatomy | Arrange coverings on peripheral nerve from inner to outer
A. Endoneurium, Epineurium, Perineurium
B. Endoneurium, Perineurium, Epineurium
C. Perineurium, Endoneurium, Epineurium
D. Epineurimn, Endoneuriu, Perineurium
| Endoneurium, Perineurium, Epineurium |
93eda98a-92ba-4049-91a7-50629b492068 | AERIAL BLOOD SUPPLY TO ESOPHAGUS: Cervical pa of esophagus Esophageal branches of inferior thyroid aery. Thoracic pa of esophagus PICA (posterior Inter costal aery) (Branch of descending Thoracic aoa) + Bronchial aeries. Abdominal pa of esophagus Left gastric aery (Branch of Celiac trunk) + Inferior phrenic aery (Branch Of abdominal aoa) | Anatomy | FMGE 2018 | Abdominal pa of esophagus is supplied by
A. Bronchial aery
B. Abdominal aoa
C. Right gastric aery and inferior phrenic aery
D. Left gastric aery and inferior phrenic aery
| Left gastric aery and inferior phrenic aery |
2950c951-c546-4362-993a-4d6ff9d02054 | All forms of Burkitt lymphoma are highly associated with translocation of MYC gene on chromosome 8 that lead to increased MYC protein levels. Mantle cell lymphomas have an (11;14) translocation involing the IgH locus on chromosome 14 and the cyclin D1 locus on chromosome 11 that leads to overexpression of cyclin D1. In follicular lymphoma there (14;18)translocation that juxtaposes the IGH locus on chromosome 14 and BCL2 locus on chromosome 18. In Anaplastic large cell lymphoma there is rearrangement of ALK. REFERENCE; ROBBINS AND COTRAN PATHOLOGIC BASIS OF DISEASE.SOUTH ASIA EDITION VOLUME 1.PAGE NO. 591,594,597,602 | Pathology | Haematology | Which one of the following lymphoma is associated with translocation of c-myc gene on chromosome 8?
A. Burkitt's lymphoma
B. Mantle cell lymphoma
C. Follicular lymphoma
D. Anaplastic large cell lymphoma
| Burkitt's lymphoma |
7d12b3fb-ce02-4ee7-9af1-01241a16b063 | Ans. C: Actinomycosis Actinomycosis is an infectious bacterial disease caused by Actinomyces species such as Actinomyces israelii or A. gerencseriae. It can also be caused by Propionibacterium propionicus, and the condition is likely to be polymicrobial. | Microbiology | null | Which of the following is not a fungal infection: September 2007
A. Blastomycosis
B. Cryptococcus
C. Actinomycosis
D. Histoplasmosis
| Actinomycosis |
9f9f768e-48b0-4ac2-9ff0-69c822263bab | (Cyclophosphamide) (320- CSDT 12th)* Haemorrhagic cystitis can develop in patients recieving cyclophosphamide or Ifosamide* Other drugs causing hemorrhagic cystitis- Carmustine- Chlorumbucil- Extended spectrum penicilline- Nitrogen mustard- Vincristine* Remember these following two very important points* Hemorrhagic cystitis due to cyclophosphamide is attributed to the presence of its metabolite ACROLEIN in urine* Hemorrhage cystitis due to cyclophosphamide can be prevented by I.V- injection of MESNA (Sodium- 2 mercaptoethane sulfonate) and adequate hydration* Haemorrhagic cystitis is also seen in patients who undergo Bone marrow transplantation (BMT)* In BMT setting1. Early onset haemorrhagic cystitis - due to drugs (cyclophosphamide)2. Late onset haemorrhagic cystitis - due to polyoma virus BKV or adenovirus type II | Surgery | Urinary Bladder | A female developing haemarrhagic cystitis, with following -- treatment
A. 5-FU
B. Methotrexate
C. Bleomycin
D. Cyclophosphamide
| Cyclophosphamide |
c620c8ae-796f-4873-b0ae-b8ad2237f9ef | Innocent murmurs Murmurs not associated with significant hemodynamic abnormalities. Aka functional/ normal or insignificant murmurs >30% of children have innocent murmur at some time in their lives; MC innocent murmur is a medium - pitched, vibratory or "musical," relatively sho systolic ejection murmur, best heard along left lower & mid-sternal border & has no significant radiation to the apex, base, or back. It is heard most frequently in children b/w 3 and 7 yr of age. Intensity of murmur often changes with respiration and position, may be attenuated in the sitting or prone position. | Pediatrics | Other hea diseases in children | The innocent murmur is best heard in children at:
A. Pulmonic area
B. Aoic area
C. Left lower mid-sternal border
D. Apex
| Left lower mid-sternal border |
e009a61b-b2a0-4205-ab95-b026ed0f47c3 | <p> Prevalence <1 per 10,000. Reference:Park&;s textbook of preventive and social medicine,K.Park,22nd edition,page no:288. <\p> | Social & Preventive Medicine | Communicable diseases | Elimination of leprosy is define as prevalence -
A. < 1 per 1000
B. < 1 per 10000
C. < 1 per 1 lakh
D. < 1 per 100
| < 1 per 10000 |
4f285c2b-a96c-4018-b19c-55f9211cf281 | Entropion is a condition in which the lower eyelid turns inward, rubbing against the eye. Entropion occurs most commonly as a result of aging. Infection and scarring inside the eyelid are other causes of entropion. | Physiology | All India exam | Entropion is
A. Inversion of eyelid
B. Inversion of eyelashes
C. Eversion of eyelid
D. Eversion of eyelashes
| Inversion of eyelid |
56970685-9bca-4906-ac69-17946cfbe640 | Type XXVIII is distributed in Basement membrane around Schwann cells Reference: Harper; 30th edition; Page no: 628 Table no: 50-1 | Biochemistry | miscellaneous | Basement membrane around Schwann cells contains which of the following collagen?
A. Type IV
B. Type X
C. Type XX
D. Type XXVIII
| Type XXVIII |
f805eb19-e79e-42c0-a894-b88a306519bd | Refer KDT 6/e p 236 It is an ergot alkaloid and is a Dopamine agonist Dopamine acts as prolactin inhibiting hormonal big the brain Agonism of Dopamine receptors by Bromocriptine is responsible for it's use in hyperprolactinemia | Pharmacology | Endocrinology | Which of the following is used in the treatment of hyperprolactinemia
A. Cimetidine
B. Methysergide
C. Bromocriptine
D. Ondansetron
| Bromocriptine |
a5d6e4fe-ee14-4802-9bc1-2bfa12af5c1f | Most Brain tumors are Hypodense on NCCT Hyperdense Brain tumors include Medulloblastoma, CNS Lymphoma, and Pineal Germinomas. NCCT showing a hyperdense lesion in 4th ventricle s/o Medulloblastoma. | Radiology | Neuroradiology | Which of the following lesion is hyperdense on CT?
A. Ependymoma
B. Medulloblastoma
C. Oligodendroglioma
D. Astrocytoma
| Medulloblastoma |
368a61b3-9969-4bc9-8e69-d85961b27e6d | Pneumocystis carini REF: Harrison's 17th ed chapter 182, CURRENT Medical Diagnosis & Treatment Chapter 31. HIV Infection & AIDS The host factors that predispose to the development of Pneumocystis pneumonia (PcP) include defects in cellular and humoral immunity. The risk of PcP among HIV-infected patients rises markedly when circulating CD4+ T cell counts fall below 200/[tL. Pneumocystis pneumonia is the most common oppounistic infection associated with AIDS. Pneumocystis pneumonia may be difficult to diagnose because the symptoms--fever, cough, and shoness of breath--are nonspecific. Other persons at risk for PcP are patients receiving immunosuppressive agents (paicularly glucocoicoids) for cancer and organ transplantation; those receiving biologic agents such as infliximab and etanercept for rheumatoid ahritis and inflammatory bowel disease; children with primary immunodeficiency diseases; and premature malnourished infants. | Surgery | null | A person having CD-4 count of 200 presents with difficulty of breathing. Most probable diagnosis is?
A. Tuberculosis
B. Histoplasmisis
C. Candidiasis
D. Pneumocystis carinii
| Pneumocystis carinii |
8228f497-b538-457c-a6ce-bb3afa8afff3 | A heterotopic pregnancy is more likely associated with any of the following: Conception achieved by Assisted reproductive techniques Persistent or rising hCG levels after dilatation and curettage for an induced or spontaneous aboion A uterine fundus larger than menstrual dates More than one corpus luteum Absent vaginal bleeding in the presence of signs and symptoms of an ectopic pregnancy Sonographic evidence of uterine and extrauterine pregnancy. | Gynaecology & Obstetrics | Ectopic Pregnancy (Hello ! Where are you ?) | Which of the following is associated with an increased incidence of heterotopic pregnancy?
A. Obesity
B. Multiparity
C. Prior cesarean delivery
D. Assisted reproductive technologies
| Assisted reproductive technologies |
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