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6f0b2cc4-de54-4d80-8aa6-e9dc3acc4bb0 | Patient is developing tingling sensation (peripheral neuropathy) which is a side effect of Isoniazid (INH) a first line antitubercular drug. INH is extensively metabolized in liver; most impoant pathway being N-acetylation by NAT2. The acetylated metabolite is excreted in urine. The rate of INH acetylation shows genetic variation. There are either: Fast acetylators: (30-40% of Indians) t1/2 of INH 1 hr. Slow acetylators: (60-70% of Indians) t1/2 of INH 3 hr. Slow acetylators will not be able to metabolize the drug quickly and there will be accumulation of isoniazid. Isoniazid inhibits pyridoxal phosphokinase enzyme and hence causes peripheral neuritis, paraesthesias, numbness etc. Pyridoxine given prophylactically (10mg/day) prevents this neurotoxicity. On the other hand, fast acetylators are more prone to develop. | Pharmacology | AIIMS 2017 | A patient on anti-tubercular drug therapy developed tingling sensation on lower limb. Which of the following drug should be used for the treatment?
A. Thiamine
B. Folic acid
C. Pyridoxine
D. Vitamin B-12
| Pyridoxine |
e0f9e4af-3c3f-49d3-a19a-f8b884951de6 | Ans: D. 30:2(Ref AHA 2015 CPR Guidelines " wp-content/uploads/2015/10/2015-AHA!Guidclinet.-Hilivhtv-En,cgish ficIf.)Ratio of chest compressions to rescue breath in all adults (Even with 1 or 2 rescuers) = 30:2. | Anaesthesia | null | What is the ratio of chest compressions and breaths when a lone person is giving cardiopulmonary resuscitation?
A. 10:01
B. 15:01
C. 30:01:00
D. 30:02:00
| 30:02:00 |
e14c42e1-754e-40a6-9b50-5d27b40e5a7d | Answer- A. 1 Fc and 2 Fab fragmentsHydrolysis of IgG with papain will lead to the formation of 1 Fc and 2 Fab fragments. Papain hydrolyzes IgG at the hinge region, which lyses IgG into one constant Fc region and two Fab fragments.When studying the Ig molecule structure, it was identified experimentally thot an antibody molecule, such as IgG, can be split into two fragments by the proteolytic enzyme, papain. When this happens, the peptide bonds in the hinge region are broken.The antigen-binding activity is associated with one of these fragments, the Fab poion- The second fragment is the Fc poion that is involved in the placental transfer, complement fixation, attachment to various cells, and other biologic activities. | Microbiology | null | Hydrolysis of IgG with papain will lead to formation of following fragments:
A. 1 Fc and 2 Fab fragments
B. 2 Fc and 1 Fab fragment
C. 1 variable chain and 1 constant chain
D. 1 Fab and 1 hypervariable region
| 1 Fc and 2 Fab fragments |
8be32dbe-9a46-4a8a-8c08-ff89c3e78c3d | Ans. D: CoisoneFetal adrenals shows hyperophy of the reticular zone (fetal zone), which is the site of synthesis of oestriol precursor, coisol and dehydroepiandrosterone.After 12 weeks of gestation, the activity of 3 p-hydroxysteroid dehydrogenase (HSD3B) decreases in fetal adrenal and sulfokinase activity increases.At that time (during the mid-gestation, 12 to 22 weeks) the major steroid products are DHEA and DHEA Sulfate (DHEA-S).During the mid-gestation (12 to 22 weeks), the aromatase activity and sulfokinase activity increases. So Placenta itself utilizes fetal DHEA and DHEA-S as substrate for estrone and estradiol as precursors. | Gynaecology & Obstetrics | null | Fetal adrenals release which hormone predominantly:March 2009, September 2010
A. Oestrogen
B. Testosterone
C. Aldosterone
D. Coisone
| Coisone |
8e64201e-6d6b-4187-98df-bb12e0945c78 | Ans: A. Hurler's syndrome(Ref Nelson 20/e p739)Likely diagnosis = Hurler's syndrome.Hurler's syndrome:Type 1 mucopolysacharidoses.AR disorder.Characterized by alpha L-iduronidase deficiency resulting in accumulation of dermatan > heparin-sulfate.Clinical features:Presents with Goesque gargoyle facies:Coarse and heavy face.Enlarged head - Due to hydrocephalus caused by meningeal deposits.Low forehead & ears.Eyes wide set.Wide nosePoorly formed & widespread teeth.Open mouth, enlarged tongue & eveed lips.Hepatosplenomegaly.Sho neck.Thoracolumbur kyphosis.Gibbus deformity with motor delays.Flexion contracture of joints.Sho stature.Genu valgum.Fiat feet.Broad-sho hand, radially curved little finger.Carpal tunnel syndrome in children. | Pediatrics | null | A male child with coarse facial features, macroglossia, thick lips presents with copious mucous discharge from nose at 10 months of age. The child was absolutely normal at bih. On examination he was found to have enlarged Liver and Spleen. Diagnosis is:
A. Hurler's syndrome
B. Beckwith-Weidman syndrome
C. Hypothyroidism
D. Proteus syndrome
| Hurler's syndrome |
ff15f943-5815-44a6-a8cf-5513f692fde6 | Patient presenting at 22 weeks with:
Funnelling of cervix on ultrasound examination and history of second trimester abortions indicating cervical incompetence as the cause of preterm labor. In this case Mc Donald stitch will be the ideal treatment as it will prevent preterm labor. | Gynaecology & Obstetrics | null | G3 with previous second trimester abortion presents with 22 week of gestation, abdominal pain, USG shows funneling of internal os. What is the ideal management?
A. Dinoprost and bed rest
B. Misoprost and bed rest
C. Fothergills stitch
D. Mc Donald stitch
| Mc Donald stitch |
b3554a03-5d0e-42ef-8033-6b3062193ae1 | The patient (a 4 years girl) in the question is presenting with mild respiratory distress due to multiple Juvenile papillomatosis of larynx.
The management in such a case is microlarygoscopic surgery using CO2 laser to ablate the lesion.
Steroids and antibiotics have no role.
Tracheostomy is reserved for those patients who have severe respiratory distress. | ENT | null | Kamla 4 yrs of age presented in emergency with mild respiratory "stress. On laryngoscopy she was diagnosed to have multiple juvenile papilomatosis of the larynx. Next line of management is -
A. Tracheostomy
B. Microlaryngoscopy
C. Steroid
D. Antibiotics
| Microlaryngoscopy |
77455482-e309-477c-a662-c2d26da66b19 | Ans: D. Glycogenin(Ref Harper 30/c p 181)Glycogenin:An enzyme involved in glucose conversion to glycogen.Acts as a primer - By polymerizing first few glucose molecules a enzymes take over.Involved in glycogen synthesis pathway rather than glycogenolysis. | Biochemistry | null | Which of these is not a cofactor for glycogen phosphorylase, an impoant enzyme of the glycogenolysis pathway?
A. Calmodulin
B. c-AMP
C. Protein Kinase A
D. Glycogenin
| Glycogenin |
1cf99105-7487-4c44-8c8b-8f8caa90225c | A number of chemotherapeutic drugs have been used either systemically or directly (surgically administered medical management - SAM under sonographic or laparoscopic guidance) for the medical management of ectopic pregnancy.
Drugs commonly used for medical management: | Gynaecology & Obstetrics | null | Which of the following drug is not used for medical management of ectopic pregnancy:
A. Potassium Chloride
B. Methotrexate
C. Actinomycin D
D. Misoprostol
| Misoprostol |
592c91f5-5a59-44d3-b19b-08d036762a1b | Answer:. d. Acquired factor VIII inhibitors (Wintrobes p1442-144-.'74;Harrison19/ep734-735, 740, 18/e p982).The clinical presentation in a young female of recurrent joint pains with petechial hemorrhage is suggestive of an autoimmune disease.A female patient is unlike to have hemophilia, as it is an X-linked disorder. However, she can have autoantibodies against factor VIII. | Pathology | null | A 22-year-old female gives the history of recurrent joint pains. She has now developed petechial hemorrhages. She is most likely to have:
A. Megakaryocytic thrombocytopenia
B. Amegakaryocytic thrombocytopenia
C. Platelet function defects
D. Acquired factor VIII inhibitors
| Acquired factor VIII inhibitors |
5587f082-44da-4a6e-9c8a-d1ee7760bf60 | Management of Rh negative females depends on whether the female is immunized/ nonimmunized. The question which says- what should be done in case of the paitent with 28 weeks pregnancy if ∆ OD lies at the top of Zone 3. | Gynaecology & Obstetrics | null | At 28 weeks gestation, amniocentesis reveals a AOD 450 of 0.20 which is at the top of third zone of the liley curve. The most appropriate management of such a case is:
A. Immediate delivery
B. Intrauterine transfusion
C. Repeat Amniocentesis after 1 week
D. Plasmapheresis
| Intrauterine transfusion |
d29bcd44-fb81-4521-8d9d-9f2e0bfd9a87 | Ans: B. 4x incision length (Rel. Bailey 27/e p1041, 26/e p965, 25/e p234)According to Jenkins' rule, optimal ratio of suture length to wound length = 4:1.If less length used than ratio a suture bites are too far apa or too tight.Converse applies if more length than ratio used." | Surgery | null | After a midline laparotomy, you have been asked to suture the incision. What length of suture material will you choose?
A. 2x incision length
B. 4x incision length
C. 6x incision length
D. 8x incision length
| 4x incision length |
86c24b0d-be4b-477d-8683-af6094c476d6 | Four classes of Haemorrhagic Shock (According to the ATLS course ) Class Parameter I II III IV Blood loss (%) 0-15% 15-30% 30-40% >40% CNS Slightly anxious Mildly anxious Anxious or confused Confused or lethargic Pulse (Beats/min) < 100 >100 >120 >140 Blood pressure Normal Normal Decreased Decreased Pulse pressure Normal Decreased Decreased Decreased Respiratory rate 14-20/min 20-30 / min 30-40/min > 35/ min Urine (mL/hr) >30 20-30 5-15 Negligible Fluid Crystalloid Crystalloid Crystalloid + Blood Crystalloid + blood Base deficit 0 to -2 mEq/L -2 to -6 mEq/L -6 to -10mEq/L -10mEq/L or less | Surgery | AIIMS 2018 | Class 3 hemorrhagic shock refers to:
A. Blood loss less than 15 %
B. Blood loss between 15 % - 30%
C. Blood loss between 30% - 40%
D. Blood loss more than 40%
| Blood loss between 30% - 40% |
139372ab-2365-445d-a053-e978dc9ca6af | Initial assessment, also termed the primary survey, follows the mnemonic ABCDE: Airway and cervical spine protection, Breathing, Circulation, Disability or neurologic condition, Exposure and environmental control. | Surgery | AIIMS 2017 | In a school bus accident, which of the following victim you will attend first?
A. A child with Airway obstruction
B. A child with shock
C. A child with flail chest
D. A child with Severe head injury
| A child with Airway obstruction |
2dbbf01a-5a68-40c9-a24f-fd4af9d314e8 | Ans. c. >10 per 1,00,000 population (Ref: Park 23/e p165, 22/e pl56)WHO defines highly endemic areas where incidence of meningococcal meningitis as number of cases per 1,00,000 population is >10 cases. | Social & Preventive Medicine | null | According to WHO definition, what is the criteria for considering a high endemic area for meningococcal meningitis?
A. <2 per 1,00,000 population
B. 2-10 per 1,00,000 population
C. >10 per 1,00,000 population
D. >100 per 1,00,000 population
| >10 per 1,00,000 population |
893ad532-01e8-421e-ac71-d5e8dfb882e5 | Clinical features of wilson disease in children
Acute or chronic liver disease o KF ring
Psychiatric disturbances o Hemolytic anemia
Neurological --> Rigidity, tremer, Parkinsonism, cerebellar ataxia. o Fanconi syndrome | Pediatrics | null | Which is not a feature of wilson\'s disease in a child –
A. Fanconi syndrome
B. Sensory changes
C. Hemolytic anemia
D. Chronic active hepatitis
| Sensory changes |
2c4e0c71-ef7f-4f02-a2d3-a7a8860fe37e | "Compression of the lung results in pulmonary hypoplasia involving both lungs, with the ipsilateral lung being the most affected. In addition to the abnormal airway development, the pulmonary vasculature is distinctly abnormal in that the medial muscular thickness of the arterioles is excessive and extremely sensitive to the multiple local and systemic factors lcnown to trigger vasospasm. Thus, the two main factors that affect morbidity and mortality are pulmonary hypoplasia and pulmonary hypertension."-Sabiston 18th/e p2073 | Pediatrics | null | Most important prognostic factor in congenital diaphragmatic hernia –
A. Pulmonary hypertension
B. Size of hernia
C. Timing of surgery
D. Gestational age
| Pulmonary hypertension |
376472be-1031-446f-abbd-f35a14669d7f | Apexification
Definition
“Apexification is defined as chemically induced root formation by calcium hydroxide or CMCP in nonvital immature, blunderbuss canals of young permanent teeth.”
APEXIFICATION
It is a method of inducing apical closure by formation of mineralized tissue in the apical region of a nonvital permanent tooth with an incompletely formed root apex.
It is defined as a method to induce development of the root apex of an immature pulpless tooth by formation of osteocementum/bone-like tissue (Cohen).
Apexification is a method of inducing apical closure through the formation of mineralized tissue in the apical pulp region of a nonvital tooth with an incompletely formed root and an open apex (Morse et al. 1990). | Dental | null | 8 year-old child had fractured his maxillary central incisor
10-months ago. The pulp shows no response. There is no periapical lesion in the radiograph. The treatment of choice is:
A. Ca(OH)2 pulp capping
B. Formocresol pulpotomy
C. Conventional root canal treatment
D. Complete debridement and apexification
| Complete debridement and apexification |
db180b6d-8b4e-487e-a47d-7c554c8dad2e | When the powder and liquid are mixed, the surface of powder particles are attacked by the acid, releasing zinc, magnesium and tin ions. These ions bind to the polymer chain via the carboxyl groups. They also react with carboxyl groups of adjacent polyacid chains to form cross-linked salts. Structure of set cement the hardened cement consists of an amorphous gel matrix of zinc polyacrylate in which unreacted powder particles are dispersed.
Key concept:-
Zinc polycarboxylate cement was the first dental cement to exhibit chemical bonding to teeth, marking an improvement over the mechanical bonding of zinc phosphate cement. Zinc polycarboxylate cement is not used for restorative purposes because the cement is opaque.
Ref: Phillips Ed 12th P: 318 | Dental | null | Which of the following show chemical bond with enamel (calcified tissues)?
A. Composites
B. Direct filling resins
C. Polycarboxylate cements
D. BIS-GMA resins in pit and fissure sealants
| Polycarboxylate cements |
25ad5741-fdb7-49d7-b985-aa021e70a967 | STORAGE TEMPRATURES: LABEL WHERE TO KEEP TEMPRATURE Keep frozen Inside freezer -20 degree celsius Keep cold Inside refrigerator; outside freezer 2-8 degree celsius Keep cool Outside refrigerator 8-15 degree Celsius(in USA); 8-25 degree Celsius (in India) | Pharmacology | AIIMS 2018 | 'Store in a cool place' is written on a drug label. It means drug should be stored at a temperature of:
A. -2 degree Celsius
B. 0 degree Celsius
C. 2-8 degree Celsius
D. 8-15 degree Celsius
| 8-15 degree Celsius |
08fc1a87-43dd-42aa-97ba-3510c4944fdb | Ans: B(Ref: Robbins 9/e p544)Triphenyltetrazolium chloride (TTC) stain:Impas a brick-red color to intact, non-infracted myocardium where dehydrogenase enzymes are preserved.Acute Ml - Early morphologic recognition:Infarct preceding death by 2 to 3 hours:Highlighting area of necrosis by immersion of tissue slices in a solution of triphenyltetrazolium chloride.Gross histochemical stain impas brick-red color to intact, non-infarcted myocardium where lactate dehydrogenase activity is preserved.Dehydrogenases leaks out damaged membranes of dead cells.Hence, an infarct appears as an unstained pale zone.By 12 to 24 hours after infarction:MI identified grossly as a reddish-blue area of discoloration.Caused by stagnated, trapped blood.By 2 days to 10 days:Infarct becomes progressively more sharply defined, yellow-tan & soft.By 10 days to 2 weeks:Rimmed by a hyperemic zone of highly vascularised granulation tissue.Over succeeding weeks:Fibrous scar | Pathology | null | During autopsy of a patient died due to suspected myocardial infarction, the hea was stained with triphenyltetrazolium tetrachloride dye. What will be the color of the ble myocardium?
A. White
B. Red
C. Blue
D. Dark Brown
| Red |
361849c8-ca2f-4200-89c4-8642afe7a273 | 26 - Dental X-ray Equipment
27 - Resin-Based Filling Materials (Direct filling materials)
28 - Endodontic Files and Reamers (Hand Use)
30 - Dental Zinc Oxide Eugenol and Zinc Oxide Non-Eugenol Cements
31 - Exposure time designation for timers of dental X-ray machines
32 - Orthodontic Wires
33 - Dental Terminology / Vocabulary | Dental | null | ADA specification for orthodontic wires is
A. 32
B. 30
C. 27
D. 25
| 32 |
01c2e93f-70e6-417c-b779-c037ee975bff | Answer- C (Prevention of calcium influx)-The release of the synaptic vesicles from the presynaptic terminal is inhibited by the prevention of Ca2+ influx. | Physiology | null | Release of synaptic vesicle from presynaptic terminal is inhibited by
A. Inhibition of conduction of nerve impulse
B. Prevention of sodium influx
C. Prevention of calcium influx
D. Prevention of depolarization of nerve terminal
| Prevention of calcium influx |
ce41e98c-3f43-4c6a-9dbb-74c77dc10584 | Ans: B. Primary yolk sac(Ref Gray's. 41/e p169, 40/e p167, 173, 186-189; Langmuir S 13/e p45,'Pe p54-55)Extra-embryonic mesoderm is derived from primary yolk sac.Formed by delamination of yolk sae cells - later by migration of cells through primitive streak during gastrulation. | Anatomy | null | Extra-embryonic mesoderm is derived from:
A. Epiblast
B. Primary yolk sac
C. Secondary yolk sac
D. Hypoblast
| Primary yolk sac |
34c40855-d9e8-48a6-aedd-c214e19de1fd | Ans.C. Middle1st: largest; lateral side of index finger2nd and 3rd: both attach to either side of 3rd (middle) finger4th: medial side of 4th (ring) finger | Anatomy | null | Finger with two dorsal interossei attached?
A. Little
B. Index
C. Middle
D. Ring
| Middle |
4982eef9-e03f-4b52-af7d-e0e2f588358e | Answer: c. Continue valproate and serial drug monitoring in blood (Ref Harrison I9/e p2544, 18/e p3269)Continue valproate with serial drug monitoring in the blood of the 4-month old patient having history of juvenile myoclonic epilepsy. | Medicine | null | A 29-year-old, 4 months pregnant primigravida has history of juvenile myoclonic epilepsy. She has been regularly taking sodium valproate and now presents requesting for an opinion for a change in her anti-epileptic treatment. What would you sugeets her?
A. Immediately taper off valproate and sta lamotrigine
B. Switch to carbamazepine
C. Continue valproate and serial drug monitoring in blood
D. Add lamotrigine to valproate
| Continue valproate and serial drug monitoring in blood |
af165621-880c-4bde-9256-f9283df3344e | The flow of the flux and hence the solder can be limited by the use of an antiflux, which should be applied to the surface before the flux is applied.
Zinc oxides in alcohol, rouge (iron oxide) in chloroform, whiting (calcium carbonate) in alcohol and graphite suspension are the commonly used antifluxes.
Key comment :
The boric acid/borax acts as flux. | Dental | null | Which of the following is not used as an antiflux?
A. Graphite
B. Boric acid
C. Iron oxide
D. Calcium carbonate with alcohol
| Boric acid |
838f8aa6-e9c7-4e24-ae4b-d430371f9e27 | Ans. d. Bilateral gonadectomyHistory of primary amenorrhea, karyotype of 45X0 & infantile uterus is suggestive of Turner's syndrome. Approximately 5% of women with Turner's syndrome have a karyotype with Y chromosome (45X/46XY). It is impoant to identify' a Y chromosome because affected individuals are at significant risk of gonadoblastoma (20 to 30%). Therefore, prophylactic gonadectomy should be performed. | Gynaecology & Obstetrics | null | An 18 years old girl presents with primary amenorrhea. On evaluation, she was having a karyotype of 45X0 and infantile uterus. What should he done next?
A. H to induce pubey
B. Vaginoplasty
C. Clitoroplasty
D. Bilateral gonadectomy
| Bilateral gonadectomy |
77e009e5-3114-4561-a767-b0e6940ef658 | Muscles of tongue develop from occipital myotomes, so the cranial nerve XII (hypoglossal nerve) supplies all intrinsic and three extrinsic muscles. Only palatoglossus is supplied by cranial root of accessory through pharyngeal plexus and is developed from mesoderm of sixth arch. | Anatomy | null | Palatoglossus develops from:
A. Occipital myotomes
B. Lingual swelling of first arch
C. Third arch
D. Mesoderm of sixth arch
| Mesoderm of sixth arch |
caf724b6-82da-46cf-8d55-ed16513faf46 | Answer- D. Pancost tumorMRI: An at uncovering the extent to which a tumor has invaded other structures | Medicine | null | In which of the following tumor MRI is better than CT Scan..
A. Brochogenic Carcinoma
B. SCC of lung
C. Mesothelioma
D. Pancost tumor
| Pancost tumor |
7e7eb34c-f362-459d-8bf5-7c485e460260 | Wormian bones, also known as intra sutural bones, are extra bone pieces that occur within a suture in the cranium. These are irregular isolated bones that appear in addition to the usual centers of ossification of the cranium. An isolated wormian bone at the lambda is referred as an Inca bone or Goethe's ossicle. Inca bones are also named as interparietal bones as they lie in between the two limbs of the lambdoid suture of the parietal bones.
Wormian bones are a marker for some diseases and important in the primary diagnosis of brittle bone disease: osteogenesis imperfecta.
Wormian bones may also be seen in:
Pycnodysostosis
Osteogenesis imperfecta
Rickets "Kinky-hair: Menke's syndrome
Cleidocranial dysostosis
Hypoparathyroidism and hypophosphatasia
Otopalatodigital syndrome
Primary acro-osteolysis
Down syndrome | Anatomy | null | Inca bone or Goethe's ossicles is a sutural bone present in?
A. Bregma
B. Lambda
C. Pterion
D. Asterion
| Lambda |
425262d7-1238-4195-a713-1cb8befefd2d | It is seen in Systemic Sclerosis (Scleroderma). Limited form of scleroderma known as CREST syndrome is characterised by presence of anti-centromere antibodies positive and generalized form shows anti-topoisomerase antibodies Anti-histone antibodies are positive in drug-induced lupus. Anti-SS-A (RO) antibodies and anti-SS-B(LA) antibodies are positive in Sjogren's Syndrome. Most specific in SLE: anti ds-DNA and Anti-Smith antibodies | Pathology | AIIMS 2018 | Anti-centromere antibodies are seen in which of the following conditions?
A. Drug-induced lupus
B. SLE
C. Sjogren syndrome
D. Scleroderma
| Scleroderma |
4391391c-04bb-4ca1-abba-9f4b3a6c2a81 | Non- Healing Ulcer, 2x3 cm, no palpable lymphadenopathy concludes to stage Ib of Ca Vulva. Staging of Ca vulva Stage I Limited to vulva IA IB Size - < 2 cm, Invasion - < 1 mm Size - < 2 cm, Invasion - > 1 mm Stage II Adiacent organ femoral LN involvement Lower 1/3rdvagina Lower 1/3rdof urethra, anus Stage III Inguinal femoral LN involvement IIIAi Aii One LN - > 5mm One or Two LN - < 5m IIIBi Bii Two LN - > 5mm More than 3 LN - < 5mm III C LN involvement ?, with extra capsular spread Stage IV IV Ai Aii Upper urethra, upper vagina, rectal involvement Growth stuck to pelvic bone Fixed or ulcerated LN IV B Distant metastasis Pelvic LN Treatment: Stage IA- Wide excision Stage I & II- Radical vulvectomy with sentinal LN biopsy If negative- Radical vulvectomy alone If positive- Radical vulvectomy + LN removal Stage III & IV- Chemoradiation with resection | Gynaecology & Obstetrics | AIIMS 2018 | A 76 - year - old female presented with non - healing ulcer on labia majora for 6 months measuring 2 x 3 cm with no palpable lymphadenopathy. Biopsy shows Squamous cell carcinoma. Management of this patient includes?
A. Radical vulvectomy with sentinal LN biopsy
B. Wide excision
C. Simple vulvectomy
D. Chemoradiation with resection
| Radical vulvectomy with sentinal LN biopsy |
a9eacca0-36c6-4171-996c-d7c4d75f42df | Undescended test (UDT) Palpable UDT Inguinal Exploration Non- Palpable UDT Diagnostic Laparoscopy | Surgery | AIIMS 2019 | A 4 years old child was brought to the hospital with right impalpable testsis. During diagnostic laparoscopy for undescended testis, there are blind testicular vessels. What should be done next?
A. Abdominal exploration
B. Nothing is to be done
C. Inguinal exploration
D. Scrotal exploration
| Nothing is to be done |
9b33051b-e39d-4342-acd7-8bc45abdf2d6 | Ans. a. Wearing clothes of opposite sexIt is a person whose personality is dominated by the desire to be identified with the opposite sex It is usuallyfound in males who obtain sexual pleasure by wearingfemale dress. | Forensic Medicine | null | A person of eonism derives pleasure from.
A. Wearing clothes of opposite sex
B. Fondling female body pas
C. Rubbing genitalia against body of other person
D. Seeing the opposite paner nude
| Wearing clothes of opposite sex |
461c8a4f-a185-459a-879b-c3d15b2a4682 | Growth of the nasomaxillary complex:
The nasomaxillary complex consists of the bones and cartilages of the nose and maxilla. Growth of the nasomaxillary complex occurs by primary growth, secondary displacement and surface remodelling.
The maxilla displaces downward and forward due to sutural growth at its posterior margins, while surface resorptive changes lead to deepening of its facial surface. Drift is brought about by deposition on one side and resorption on the opposite side of the same cortical plate. The classical example of cortical drift is provided by growth of the facial surface of the maxilla. | Dental | null | Normal growth of maxilla occurs by
A. Displacement and drift
B. Drift only
C. Apposition
D. Replacement resorption
| Displacement and drift |
2cf2c4e4-e50a-494e-9894-50ed2d50df63 | Ans: C. Odds ratio/Relative riskThe strength of association between the risk factor and disease is measured by the Odds ratio/Relative risk.The estimation of disease risk associated with exposure is obtained by an index known as relative risk (RR) or risk ratio, which is defined as the ratio between the incidence of disease among exposed persons and incidence among non-exposed.Odds ratio (Cross product ratio):From a case-control study, we can derive what is known as the odds ratio (OR) which is a measure of the strength of the association between risk factor and outcome.Odds ratio is closely related to relative risk. | Social & Preventive Medicine | null | The strength of association between the risk factor and disease is measured by
A. Attributable risk
B. Absolute risk of the variable
C. Odds ratio/Relative risk
D. P-value
| Odds ratio/Relative risk |
7a163b43-2355-4789-aa99-a116c1a3ca00 | Aplastic anemia and leucopenia are rare complications of carbamazepine therapy. So, the patients receiving carbamazepine must have periodic hematological laboratory investigations. | Pathology | null | Carbamazepine has been utilized to successfully diminish attacks in trigeminal neuralgia. During this therapy, which of the following is indicated?
A. Clinical observation only
B. Clinical observation and complete blood and platelet counts prior to and at frequent intervals during therapy
C. No monitoring
D. Complete blood investigation, only if adverse symptoms arise
| Clinical observation and complete blood and platelet counts prior to and at frequent intervals during therapy |
99f0588d-fd2b-405a-ac4e-5615d0533fff | Ans. D (Superior Laryngeal nerve)* Vagus, RLN involvement leads to hoarseness of the voice* SLN divide into internal and external laryngeal* External laryngeal nerve supplies only one muscle- cricothyroid - tensor* Internal laryngeal nerve- safety nerve of larynx- prevents aspiration and supplies supraglottic pa of larynx. | ENT | null | Patient underwent surgery at the lateral pa of the skull. Postoperatively patient had aspirations without voice change
A. Vagus
B. RLN
C. Glossopharyngeal
D. SLN
| SLN |
b5245692-7504-44d2-8cf9-af7148c567dc | Ligamentum flavum pass b/w the laminae of adjacent veebrae. They consist of predominantly elastic tissue form pa of the posterior surface of the veebral canal. Function: Resist separation of the laminae in flexion & assist in extension back to anatomical position. . | Anatomy | AIIMS 2018 | Ligamentum flavum consists of which fibres:-
A. Type-I collagen
B. Type-II collagen
C. Reticular
D. Elastic
| Elastic |
014ba2fe-d596-4265-bf46-616641ea4a9f | Ans: C. Cordocentesis(Ref Williams 24/e p300; (Thai 8/e p341-344)Recommended test - Cordocentesis.As patient is presenting at 18 weeks - Quick method diagnosing thalassemia antenatally needed.Note:Legal age of aboion is only till 20 weeks.Fetal blood karyotyping accomplished within 24 to 48 hours.Significantly quicker than (7- to 10-day turnaround time with amniocentesis or CVS). | Gynaecology & Obstetrics | null | A G3P2, pregnant comes to your clinic at 18 weeks of gestation for genetic counselling. She has a history of two kids born with thalassemia major. Which test would you recommend now?
A. Amniocentesis
B. Chorionic villus sampling
C. Cordocentesis
D. Non-invasive prenatal testing
| Cordocentesis |
38c0c9e6-009c-4ef1-a3ae-2e3aacd715e7 | Black foot disease is caused by arsenic poisoning since it causes thrombosis of vessels and may cause peripheral gangrene. Mnemonic Arsenic poisoning A - Anemia / Aldrich Mee's line / Arsenophagist (Tolerate upto 300mg ) R - Rain drop pigmentation / Reinsch test / Red velvety mucosa S - Sub endocardial hemorrhages / Sensory neuropathy E - Eruptions N - NAA I - Imbibition of arsenic ( Arsenic imbibed from surrounding soils after death ) / before treated iron oxide C - Cumulative poison / Cholera like symptom / Chelation for treatment | Forensic Medicine | AIIMS 2017 | Black foot is seen in which poisoning?
A. Arsenic
B. Lead
C. Mercury
D. Phosphorus
| Arsenic |
d2198d20-fa7b-4abd-a3f6-d849ee0973fb | Ans: C: Venous air embolismRef Millers anesthesia &h ed-, pg. 2170.Diagnosis standard of care is precordial doppler (left or right parastemal, between 2nd and 3rd ribs) + ETC02 monitoring although this is not the most sensitive test - TEE is most sensitive.Pulmonary aery pressure will rise, and CO2 will fall alter VAE. | Anaesthesia | null | A patient is undergoing MRND for laryngeal malignancy; while dissecting the venous tributaries the surgeon elevated the internal jugular vein for ligation. Suddenly the patients EtCO2 dropped from 3g mmHg to 12 mmHg and the patient developed hypotension along with cardiac arrhythmia. Which of the following is most likely cause??
A. Sympathetic overactivity
B. Vagal stimulation
C. Venous air embolism
D. Carotid body stimulation
| Venous air embolism |
6fb3845d-5d6a-4867-850f-ec9cc51976be | The ratio of upper anterior facial height and lower anterior facial height ratio is 45:55. It decreases with age.
N-Sn occupying 45% and Sn-Gn 55% of the total height. | Dental | null | Ratio of upper anterior facial height to lower anterior facial height is:
A. 55:45:00
B. 60:40:00
C. 40:60
D. 45:55:00
| 45:55:00 |
74af945a-56c6-4b18-935d-388c29f19a56 | Both the serum creatinine and serum urea are abnormal in this neonate. They may be normal for an adult, but for an 8 day old infant they are elevated.
First the serum creatinine level
The serum creatinine level is high at birth reflecting the maternal value but it falls rapidly to 0.4 mg/dl by the end of the first week.
According to Nelson, creatinine level in various age groups are
Cord blood ______ > 0.6 —1.2 mg/di
New born _______ > 0.3 — 1.0 mg/dl
Infant ______ > 0.2 - 0.4 mg/di
Child ______ > 0.3 - 0.7 mg/di
Adolescent ______ > 0.5 — 1.0 mg/di
Do not get confused by the creatinine level of the newborn i.e., 0.3 — 1.0 mg/dl.
This high level reflects the maternal value and it comes down to 0.2 to 0.4 mg/dl by 5th day
So, Creatinine level of 0.6 mg/dl is abnormally high in an 8 day old infant.
Now, the serum urea level
The serum urea level in cord blood is 21-40 mg/dl, but it falls rapidly to 3-12 mg/dl by the 4th or 5th day.
So urea level of 30 mg/dl is abnormally high in an 8 day old infant.
According to Nelson Serum urea level in various age group
Cord blood ______ > 21-40 ing/dl
Premature ______ > 3-25 mg/dl
Newborn ______ > 3-12 mg/dl
Infant/child _____ > 5-18 ing/d1
Now, the capillary refill time
Capillary refill time is also prolonged here (N ---> < 3 seconds)
Prolonged capillary refill time indicates loss offluid and indicates shock, heart failure, Sympathetic stimulation
In acute renal failure due to fluid loss cappillary refill time is increased
All these findings plus characteristic h/o vomiting, poor feeding and loose stools confirms the diagnosis of acute renal failure (acute tubular necrosis)
Electrolyte abnormalities in ARF ---> 1) Hyponatremia, 2) Hyperkalemia, 3) Loss of Bicarbonate
About other options
In other three options serum urea and creatinine level will be normal. | Pediatrics | null | An 8–day old breast–fed baby presents with vomiting, poor feeding and loose stools. On examination the heart rate is 190/minute, blood pressure 50/30 mmHg, respiratory rate 72 breaths/minute and capillary refill time of 4 seconds. Investigations show hemoglobin level of 15 g/dl. Na 120 mEq/l, K 6.8 mEq/l, Cl 81 meq/l, bicarbonate 15 mEq/l, urea 30 mg/dl and creatinine 0.6 mg/dl. the most likely diagnosis is –
A. Congenital adrenal hyperplasia
B. Acute tubular necrosis
C. Congenital hypertrophic pyloric stenosis
D. Galactosemia
| Acute tubular necrosis |
ade05b67-b4f5-433b-8433-d74e009763cd | Ans. A.MgSo4Antenatal magnesium sulfate for both tocolysis and fetal neuroprotection in premature rupture of the membranes before 32 weeks' gestation. Other tocolytic drugs:Ritodrine, salbutamol and magnesium sulphate are tocolytic drugs used to terminate preterm labour and delivery.Other tocolytic drugs are isoxsuprine, indomethacin, calcium channel blockers, glyceryl trinitrate, atosiban and glyceryl trinitrate. | Gynaecology & Obstetrics | null | Which of the following can be used to delay preterm contractions of uterus with best neurological outcome for the fetus?
A. Mgso4
B. Nifidipine
C. Ritodrine
D. Isoxprine
| Mgso4 |
66445905-f680-4952-8f35-71253c0c525d | Ans: C. HGP deficiency(Ref: Nelson 20/e p746-747)Lesch-Nyhan syndrome:Complete HGP deficiency characterized by hyperuricemia, self-mutilative behavior, choreoathetosis, spasticity & mental retardation.HP gene:Located on X chromosome.Affected males - Hemizygous for mutant gene.Carrier females - Asymptomatic.Paial HP deficiency:Kelley!Seegmiller syndrome associated with hyperuricemia without CNS manifestations.Hyperuricemia - Due to urate overproduction a Causing uric acid crystalluria, nephrolithiasis, obstructive uropathy & gouty ahritis.Early diagnosis and appropriate therapy with allopurinol can prevent or eliminate all the problems attributable to hyperuricemia without affecting behavioral or neurologic abnormalities. | Pediatrics | null | A child presented at 2 years of age with delayed motor development, mental retardation and finger biting. He was normal at bih. He subsequently develops cerebral palsy ahritis and dies due to renal failure at age of 25 years. What is the likely enzyme deficiency implicated?
A. Hexosaminidase deficiency
B. Adenosine deaminase deficiency
C. HGP deficiency
D. Ornithine transcarbamoylase deficiency
| HGP deficiency |
357eebd0-e51d-46c8-8cc4-0fff4a79387b | Ans: A. Tympanometry(Ref Dhingra 7/e p62-63, 6/e p59)Assessment of eustachian tube function:Tympanometry & Politzer test.Tympanometry better than Politzer test.Tympanometry:Positive & negative pressures created in external ear canal.Patient swallows repeatedly.Normal tubal function:Ability of tube to equilibrate positive & negative pressures to ambient pressure.Done both in patients with perforated or intact tympanic membrane. | ENT | null | Eustachian tube function is best assessed by:
A. Tympanometry
B. VEMP
C. Rhinomanometry
D. Politzer test
| Tympanometry |
5b612728-c228-4423-8fd8-fde0ff1d3f68 | Infant safe Infant risk Working mothers Have not taken 100 days folic acid Malpresentation during bih Preclampsia in pregnancy | Gynaecology & Obstetrics | AIIMS 2019 | Criteria for infant at risk?
A. Working mothers
B. Have not taken 100 days folic acid
C. Preclampsia is pregnancy
D. Malpresentation during bih
| Preclampsia is pregnancy |
1ff979ad-8930-4ea2-9176-9975e626b233 | Ans: A. Niacin(Ref: Harper 30/e p547, 556)Niacin:Not strictly a vitamin.Can be synthesized in body from essential amino acid tryptophan.Two compounds, nicotinic acid & nicotinamide - Similar biologic activity of niacin.Metabolic function is as the nicotinamide ring of coenzymes NAD & NADP in oxidation-reduction reactions. | Biochemistry | null | Which of the following vitamin is synthesized in vivo, in the body by humans?
A. Niacin
B. Pantothenic acid
C. Cyanocobalamin
D. Folic acid
| Niacin |
5c578aa4-a6fd-4de5-b0f6-adb926564122 | Answer- A. IPC 201Embalming without issuing death ceiJicate is punishable under section IPC 201.'ln a medico legal case, condueting embalming before autopsy invites liabilities, under section 201 IPC (causing disappearance of evidence of offence, or giving false information to screen offender). | Forensic Medicine | null | Embalming without issuing death ceificate is punishable under section:
A. IPC 201
B. IPC 297
C. IPC 299
D. IPC 498
| IPC 201 |
13e7b27f-6f0c-4366-955b-16836ed6f6cd | Ans. d. Lithium heparin Lithium heparin is the anticoagulant used for electrolyte estimation.Lithium-heparin is the preferred anticoagulant for hematology in non-mammalians because EDTA causes in vitro hemolysis in some amphibian, reptile, and fish species; moreover, plasma harvested from blood anticoagulated with lithium-heparin can be used for routine chemistry/electrolyte analysis, which is especially advantageous with small sample volumes."Commonly used anticoagulants are heparin, EDTA, oxalates, citrate and fluoride. Of these, lithium heparin is best suited for most of the biochemical estimations. All other anticoagulants the/ate calcium and hence unsuitable for calcium estimation. The possibility of enzyme inhibition especially creatine kinase, ALP, ACP, amylase and LDH are observed with several of these anticoagulants. Oxalates are unsuitable for estimation of sodium and potassium also."- | Pathology | null | Which of the following anticoagulant is used for electrolyte estimation?
A. EDTA
B. Citrate
C. Sodium fluoride
D. Lithium heparin
| Lithium heparin |
78cde0de-1205-4bcb-a646-992a909fd268 | Ans. a. 36Neonatal moality rate=Number of deaths of children under 28 years of age in a year (neonatal deaths) x 1000/ Total live bihs in the same year450 x 1000/ 12450= 36 per 1000 live bihs | Social & Preventive Medicine | null | Calculate the neonatal moality rate for a population according to the data of 2012. Number of neonatal deaths- 450, number of stillbihs-212, total number of live bihs-12,450.
A. 36
B. 15
C. 90
D. 56
| 36 |
20f29076-98f9-479b-a77b-96fae28d5689 | Answer- C (Tuberous sclerosis)Tuberous sclerosis complex (TSC) is a rare multisystem autosomal dominant genetic disease that causes non-cancerous tumours.A combination of symptoms may include seizures, intellectual disability, developmental delay, behavioral problems, skin abnormalities, lung disease, and kidney disease.Three types of brain tumours are associated with TSC:Giant cell astrocytomaCoical tubersSubependymal nodulesPeople with TSC are frequently also diagnosed psychiatric disorders: autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), anxiety disorder and depressive disorder.TSC patients have benign tumors of the kidneys called angiomyolipomas causing hematuria. | Surgery | null | A 48 years old female presents with seizure, recurrent gross hematuria and left flank abdominal pain. Abdominal CT reveals left perinephric hematoma with 3 cm angiomyolipoma along with multiple right renal angiomyolipoma measuring 1.5 to 6.5 cm. What would be the most probable diagnosis?
A. VHL syndrome
B. Autosomal dominant polycystic kidney disease
C. Tuberous sclerosis
D. Hereditary angiolipoma
| Tuberous sclerosis |
57ddda15-6303-4ef9-a63c-8274551717ca | Ans. A. Characterized by sudden increase in urine volume with decrease in urine osmolality independent of circulating vasopressin levels. * Also referred as "Vasopressin Escape".* Characterized by sudden increase in urine volume with decrease in urine osmolality independent of circulating vasopressin levels. | Physiology | null | Which of the following rightly describes the mechanism of "Pressor Escape" in SIADH?
A. Characterized by sudden increase in urine volume with decrease in urine osmolality independent of circulating vasopressin levels.
B. Characterized by sudden increase in urine volume with decrease in urine osmolality dependent of circulating vasopressin levels.
C. Characterized by sudden decrease in urine volume with increase in urine osmolality independent of circulating vasopressin levels.
D. Characterized by sudden decrease in urine volume with increase in urine osmolality dependent of circulating vasopressin levels.=
| Characterized by sudden increase in urine volume with decrease in urine osmolality independent of circulating vasopressin levels. |
9e7d4311-f779-4154-8fd3-9a53421481bc | An interesting phenomenon observed in malignant peripheral nerve sheath tumour (MPNST) is described as "divergent differentiation." This term refers to the presence of focal areas that exhibit other lines of differentiation, including glandular, cailaginous, osseous (bone), or rhabdomyoblastic (striated muscle) morphology. MPNST exhibiting the rhabdomyoblastic differentiation is referred to as Triton tumour. Most MPNSTs (approximately 85%) are high-grade tumors. Most are associated with larger peripheral nerves in the chest, abdomen, pelvis, neck, or limb-girdle. Typical cases show a fasciculated arrangement of spindle shaped tumour cells. | Pathology | AIIMS 2018 | Malignant peripheral nerve sheath tumour showing which of the following differentiation is termed as "Triton tumour"?
A. Glandular
B. Rhabdomyoblastic
C. Cailaginous
D. Osseous
| Rhabdomyoblastic |
1b9a6722-b53a-4dcf-8040-e3ad8bf8ba9f | Prevalence of pit & fissure caries is measured with transillumination. | Dental | null | Prevalence of pit & fissure caries is measured with:
A. ICDAS
B. DMF
C. def/dmf
D. Transillumination
| Transillumination |
fbd3b828-a75a-47d5-bee7-3068e78b2e6f | Ans: B. Lateral thigh(Ref Goodman Gilman 12/e p1252)Insulin injection:Usually injected into subcutaneous tissues of abdomen, buttock, anterior thigh, or dorsal arm.Absorption most rapid from abdominal wall, followed by arm, buttock & thigh. | Pharmacology | null | Which of the following sites is least commonly preferred for insulin injection?
A. Anterior thigh
B. Lateral thigh
C. Dorsum of arm
D. Around umbilicus
| Lateral thigh |
0fe00e95-fdf2-420f-bc42-8325787a7aae | Ans: A. Lateral cutaneous nerve of thigh(Ref Sabiston 19/e pink Schwaz 10/e p-1515, 9/e p1313-1315; Sehackelford 7/e p562-565)Neuropathic groin pain:Caused by damage to a nerve in the groin region and may he due to paial or complete division, stretching, contusion, crushing, suturing, or electrocautery.Nerves involved:Ilioinguinal nerve, iliohypogastric nerve, both the genital and femoral branches of the genitofemoral nerve, and the lateral femoral-1 cutaneous nerve of the thigh.1st two more prone to injury during an open herniorrhaphy.Latter (i.e. Lateral cutaneous nerve of thigh) are more likely damaged during laparoscopy.The genital and femoral branches of the genitofemoral nerve and the lateral cutaneous nerve of the thigh are most at risk when the surgeon staples below the iliopubic tract when lateral to the internal .spermatic vessels.A burning, tingling pain along the lateral aspect of the thigh in the distribution of the lateral femoral cutaneous nerve is known as meralgia parestheticaDue to entrapment of that nerve.Affected skin area:Hyperaesthetic and/or pruritic.Complain of tactile hallucination of a sensation of small insects creeping under the skin (formication). | Surgery | null | During laparoscopic inguinal hernia repair a tacker was accidently placed below and lateral to the ilio-pubic tract. Postoperatively the patient complained of pain and soreness in the thigh. This is due to the involvement of:
A. Lateral cutaneous nerve of thigh
B. llioinguinal nerve
C. Genital branch of genitofemoral nerve
D. Obturator nerve
| Lateral cutaneous nerve of thigh |
8adc8a84-b0a1-4b6c-b076-91ba05e9a37e | The deep nuclei provide the only output for the spinocerebellum, & neocerebellum. Purkinje cell axons are the only output from the cerebellar cortex, generally pass to deep nuclei. | Anatomy | null | Efferent tracts from cerebellum arises from:
A. Purkinje cells
B. Deep cerebellar nuclei
C. Cerebellar cortex
D. Vermis of cerebellum
| Purkinje cells |
c7c97482-3fe5-4798-bd40-50926d7595f8 | Diagnosis of urinary tract infection
A UTI may be suspected based on the symptoms or finding on urinalysis or both, but a urine culture is necessary for confirmation and appropriate therapy.
Thus the diagnosis of UTI depends on having the proper sample of urine.
There are several ways to obtain a urine sample, some are more accurate than others.
These methods are —
Midstream urine sample —
It is satisfactory in toilet trained children and in circumcised boys. But in young infants and boys who cannot ratract their foreskin, it is not reliable. Such samples will usually reflect periurethral and prepucial organisms and cells.
Collection in an adhesive sealed sterile collection bag after disinfection of the genitals
Is a useful technique in infants, but potential contamination from genitals and perianal area can occur.
3. Urine specimen through catheterization or indwelling catheter —
Urine specimen through a catheter is less likely to be contaminated than the voided specimens as described above. It is also less invasive than suprapubic aspiration, but it is not as sensitive as suprapubic aspiration.
A catherized specimen is reliable if the first portion of the urine that may contain urethral organisms is discarded and specimen is taken from later flow through the catheter, but it has the disadvantage of being traumatic and of potentially introducing urethral organisms into sterile bladder
Suprapubic aspiration -
Suprapubic aspiration is best method to collect urine specimen for culture.
It is the most reliable method
It can be performed safely in children and in premature infants by 21 or 22 gauge needle.
This procedure avoids any sort of contamination, however it is invasive. So it is used only in infants and selected patients.
Note:
The sensitivity of suprapubic aspiration is 99 %
The sensitivity of catherization is 95% | Pediatrics | null | Which of the following is the most appropriate method for obtaining a urine specimen for culture in an 8 month old girl –
A. Suprapubic aspiration
B. Indwelling catheter sample
C. Clean catch void
D. Urinary bag sample
| Suprapubic aspiration |
4a073cec-41b0-49ef-aa57-a010c2bfe5d9 | Trigeminal nerve nuclei - one Motor nucleus (in pons) two sensory nuclei Motor nucleus: - In pons Controls muscles of mastication (1st pharyngeal arch) Sensory nuclei: 1. Main sensory nucleus: In pons Receives fine touch & vibration senses 2. Mesencephalic sensory nucleus: - In mid brain Receives proprioception from eyeball, mandible & tongue 3. Spinal sensory nucleus: In medulla oblongata & spinal cord Receives pain, temperature, crude touch | Anatomy | AIIMS 2018 | Which of the following sensation is NOT perceived by spinal nucleus of trigeminal nerve
A. Touch
B. Pain
C. Temperature
D. Proprioception
| Proprioception |
0fc0b4ce-9bfd-48a2-920d-88c67e2c4e9c | Answer- C. Sagittal sinus thrombosisVenous sinus thrombosis of the lateral or sagittal sinus or of small coical veins (coical vein thrombosis) occurs as a complication of oral contraceptive use, pregnancy and the postpaum period, inflammatory bowel disease, intracranial infections (meningitis), and dehydration.Patients present with headache and may also have focal neurologic signs (especially paraparesis) and seizures. | Gynaecology & Obstetrics | null | A 26 years old healthy female got pregnant for 1st time and LSCS was done for fetal distress. Mild hypeension was present during pregnancy. Two days after delivery she had headache and seizures but proteinuria was not seen. CT scan shows 2 x 3 cm parasagittal hematoma. Diagnosis is:
A. Eclampsia
B. Hypeensive intracranial hemorrhage
C. Sagittal sinus thrombosis
D. Pituitary apoplexy
| Sagittal sinus thrombosis |
8af7d0f2-0e2b-4c59-b8bd-4e3c9ebdceac | Skeletal findings are an underdeveloped midface, creating a prognathic occlusal relationship. Oral findings include mouth breathing, open bite, appearance of macroglossia, fissured lips and tongue, angular cheilitis, delayed eruption times, missing and malformed teeth, oligodontia, small roots, microdontia, crowding, and a low level of caries. Children with Down syndrome experience a high incidence of rapid, destructive periodontal disease, which may be related to local factors such as tooth morphology, bruxism, malocclusion, and poor oral hygiene.
Reference: McDONALD AND AVERY’S DENTISTRY for the CHILD and ADOLESCENT, 10th ed page no 527 | Dental | null | Which is the typical facies of Down syndrome?
A. Hypoplastic maxilla
B. Prognathic maxilla
C. Retrognathic mandible
D. Prognathic mandible
| Hypoplastic maxilla |
cb6588a7-e4ef-4670-b6aa-7eae297fb443 | Ans. C: 40 weeksChildbih usually occurs about 38 weeks after conception; i.e., approximately 40 weeks from the last normal menstrual period (LNMP).The World Health Organization defines normal term for delivery as between 37 weeks and 42 weeksEDD is calculated by Naegele's ruleAdd 7 days to the first day of the last period and subtract 3 monthsNaegele's rule is based on 28 days regular cycle.If the cycle is shoer or longer than 28 days, EDD will be corrected and written as corrected EDD.Examples:40 days cycle regularly, to get corrected EDD, add 12 days (40-28) with the EDD calculated from LMP.21 days cycle regularly, to get corrected EDD, subtract 7 days (28-21) with the EDD calculated from LMP. | Gynaecology & Obstetrics | null | Exact number of weeks between last menstrual period and expected date of delivery :March 2005
A. 38 weeks
B. 39 weeks
C. 40 weeks
D. 41 weeks
| 40 weeks |
62e089d3-5425-4349-8edc-3ce132c0bf66 | The 5' is upstream; the 3' is downstream. DNA and RNA are synthesized in the 5' to 3' direction In DNA Replication whenever synthesis occurs new nucleotide is added to 3' end In transcription, RNA is getting synthesized in 5' to 3' direction RNA editing It occurs in 3'-5' direction Post transcriptional modification in which differential RNA processing occurs. Also called chemical modification of RNA, in which mostly Cytosine gets conveed to Uracil. DNA Replication ,Proof reading DNA Repair 3'-5' exonuclease activity Mostly endonuclease activity, but sometimes it is 5'-3' exonuclease activity. | Biochemistry | AIIMS 2019 | Which of the following doesn't occur in 5' to 3' direction?
A. DNA repair
B. DNA replication
C. RNA editing
D. Transcription
| RNA editing |
7983c1d8-d7ec-4426-82d8-c0bdc1568aa9 | The grooved nuclei, lytic lesion in first decade suggests Langerhan's cell histiocytosis. LANGERHANS CELL HISTIOCYTOSIS (LCH): DE!STRUCTION DUE TO HISTIOCYTES, IDIOPATHIC1. Letterer-Siwe disease: a fulminant systemic disease, age group < 3 years, fatal2. Hand-Schuller-Christian disease: Triad of skull lesions (lytic lesion), Exophthalmos and diabetes insipidus. 3. Eosinophilic Granuloma: Solitary lesion of bone or lung (Pulmonary histiocytosis X) 1st decade of life. Skull is the most common site in skeletal system - Bevelled edge lytic lesion is seen in skull (double contour).Biopsy: Gold standard (cells with Birbeck's granules (tennis racket appearance) under election microscopy) grooved nuclei are seen. TreatmentSpontaneous resolution. Highly radiosensitive and Excision + Curettage for resistant cases. | Orthopaedics | AIIMS 2019 | A 9 year old boy presenting with lytic lesion on midshaft tibia. On HPE, there are grooved nuclei, giant cells eosinophilic cytoplasm and fibroblastic proliferation. Xray is as shown below. What is the likely diagnosis?
A. Langerhans cell histiocytosis
B. Giant cell tumor
C. Chondroblastoma
D. Osteoid osteoma
| Langerhans cell histiocytosis |
3f35a6bd-899c-4ab8-8525-9256dbb71851 | *Connective Tissue: - Loose Areolar Connective Tissue: Have less fibers Example 1. Sub epithelial Lamina propria 2. Superficial papillary layer of dermis - Dense Connective Tissue: Have more fibers *Dense irregular CT- Collagen fibers are arranged in irregular pattern. Example 1. Periosteum 2. Capsules (liver, spleen capsules etc) 3. Perichondrium 4. Deep reticular layer of dermis *Dense Regular Connective Tissue: *Fibers are arranged regularly in parallel fashion - to pull bone Example 1. Ligament 2. Tendon 3. Aponeurosis Given options (a) Dermis - maximum is deep reticular layer - Dense irregular CT (b) Lamina propria - Loose areolar CT | Anatomy | AIIMS 2017 | Dense irregular connective tissue is found in
A. Dermis
B. Lamina propria
C. Tendon
D. Ligament
| Dermis |
1a3ceadc-b414-43e2-a674-bf52546b7d89 | Mechanism of Action
Metronidazole is a prodrug requiring reductive activation of the nitro group by susceptible organisms.
Unlike their aerobic counterparts, anaerobic and microaerophilic pathogens contain electron transport components that have a sufficiently negative redox potential to donate electrons to metronidazole.
The single-electron transfer forms a highly reactive nitro radical anion that kills susceptible organisms by radical-mediated mechanisms that target DNA.
Reference: Goodman & Gilman’s THE PHARMACOLOGICAL BASIS OF THERAPEUTICS THIRTEENTH EDITION
Page no 991 | Pharmacology | null | Antibiotic that interferes with DNA function is:
A. Metronidazole
B. Nystatin
C. Tetracycline
D. Sulphonamides
| Metronidazole |
0acff0e8-a28e-4c44-ba99-7bf1ea71951f | Ans. C. 28-37weeksBefore 28 weeks pregnant: there's no evidence you are at increased risk of suffering a miscarriage. However, there's a small risk baby could develop foetal varicella syndrome (FVS). FVS can damage the baby's skin, eyes, legs, arms, brain, bladder or bowel.Between weeks 28 and 36 of pregnancy: the virus stays in the baby's body but doesn't cause any symptoms. However, it may become active again in the first few years of the baby's life, causing shingles.After 36 weeks of pregnancy: baby may be infected and could be born with chickenpox. | Gynaecology & Obstetrics | null | Chicken pox infection in mother most dangerous for the baby when it occurs at -
A. 14-28 weeks
B. 3 -9 weeks
C. 28-37weeks
D. 8-14weeks
| 28-37weeks |
427b1e29-9386-4ca4-af88-7c3fe4b37e15 | Soft tissues of the joint (articular disk) can be imaged with MRI or Arthrography. MRI produces superb images of the soft tissues in internal derangement of the disk. Arthrography is invasive and has the risk of infection and allergic reaction due to the contrast agent. | Radiology | null | In an internal derangement of TMJ fracture, panoramic view has been taken for the patient. To confirm our diagnosis, we may take the help of
A. MRI
B. CT scan
C. Arthroscopy
D. Bone scan
| MRI |
dc248bc1-20c6-4aca-a7db-3642df59fe8a | Apoptosis results from the activation of enzymes called caspases (so named because they are cysteine proteases that cleave proteins after aspaic residues). Two distinct pathways converge on caspase activation: the mitochondrial pathway (Intrinsic pathway) and the death receptor pathway( Extrinsic Pathway). | Pathology | AIIMS 2019 | Which of the following is activated by intrinsic or extrinsic pathway's?
A. Necroptosis
B. Apoptosis
C. Necrosis
D. Pyroptosis
| Apoptosis |
c34c9996-5391-4655-9249-948fe2cb0d2b | Vasopressor of choice in pregnancy is ephedrine. | Gynaecology & Obstetrics | null | Vasopressor of choice in pregnancy is:
A. Ephedrine
B. Phenylephrine
C. Methoxamine
D. Mephentermine
| Ephedrine |
8919343b-cb06-4265-8e82-209b335117b3 | Ans: D. Nasopharyngeal carcinoma(Ref Ananthanaravan 10/e p557, 9/e p553)Human infections caused by HPVDiseasesSerotypeSkin was (Plantar wa, common wa, flat wa &Epidermodysplasia verruciformis)1, 2, 43,Papilloma (Laryngeal, Oral)6, 11Condyloma acuminatum (genital wa)6, 11Oral squamous cell carcinoma16, 18Cervical intraepithelial neoplasia (CIN)6, 11Carcinoma cervix16, 18, 31, 33, 35, 42-44 Infectious AgentLymphoid MalignancyHIVDiffuse large B cell lymphomadegBurkitt's lymphomadeg | Microbiology | null | Which of the following malignancy is not caused by Human Papilloma Virus (HPV) infection?
A. Carcinoma base of tongue
B. Cervical carcinoma
C. Tonsillar carcinoma
D. Nasopharyngeal carcinoma
| Nasopharyngeal carcinoma |
ae166e0e-586c-42ab-9438-dd02125e35c0 | Answer- D. Habitual passive agentLateral traction test is done in unnatural sexual offences in habitual passive agent.The useful guide as to the patient's habituation to anal intercourse is lateral buttock traction test.In lateral buttock traction test, the thumb is placed on the cheeks of the buttock on either side of the anus and gentle lateral traction is applied.In patients who are not accustomed to anal penetration (penile or instrumental or any other) the traction results in reflex constriction of anal sphincter.The patients, who are used to anal penetration, react to the lateral traction test by relaxation of the sphincter. | Forensic Medicine | null | Lateral traction test is done in unnatural sexual offences in:
A. Habitual active agent
B. Pedophilia active agent
C. Bestiality active agent
D. Habitual passive agent
| Habitual passive agent |
b3eb29e7-c094-4225-8379-8e4341a621a6 | Elevated lymphocytes with normal protein & sugar point towards viral cause- Coxsackie infection Option A- TB meningitis should have >100 finding of proteins with low sugar. Option B- Sugar normal so bact. meningitis is ruled out as in bact. meningitis there is reduced (|) sugar. Option C- No information of AIDS, CD4 count less is not mentioned in the question and there should be normal CSF so ruled out. | Medicine | AIIMS 2017 | A patient comes to ED with fever and headache. On examination he has neck stiffness. CSF analysis was done:- Parameter Finding Normal range Glucose (mg/dl) 55 50-80 Protein (g/L) 0.50 0.18-0.45 ICT (cmH2O) 35 5-20 WBC 25 (predominantly lymphocytes) <5 Most likely diagnosis is-
A. TB
B. N. Gonorrhea
C. Cryptococcus
D. Coxsackie
| Coxsackie |
a04c4de3-ed44-43ac-8771-4ea6743009f0 | Ans: C. 27 minutesRef: Lehninger principles of biochemistry, 6t' ed., pg. 204During derivation of Michaelis-Menten equation,If total enzyme concentration is reduced by 1/3 and is very high then Vmax also become l/3.So in this question same amount of product will be fbrmed in 27 rninutes (3 x 9min) | Biochemistry | null | In a reaction substrate is available in a concentration that is l000times the Km value of the enzyme. After 9 minutes of reaction, l7o substrate is conveed to product (12 microgram/ml). If the concentration of the enzyme is changed to 1/3 and concentration of substrate is doubled. What is the time taken to conve the substrate into the same amount of product, i.e. I 2microgram/ml?
A. 9 minutes
B. 4.5 minutes
C. 27 minutes
D. 13.5 minutes
| 27 minutes |
e2dd93d8-8047-4e9a-9389-e2b1781f8a35 | Peau-d-Orange Peau-d-orange is due to cutaneous lymphatic edema, where the infiltrated skin is tethered by sweat ducts, it cannot swell, leading to an appearance like orange skin. Due to obstruction of subdermal lymphatics (lymphatic permeation by tumor cells) Seen in advanced breast cancer (may be seen in chronic abscess) | Surgery | AIIMS 2018 | Which is the most conspicuous sign in breast cancer?
A. Nipple retraction
B. Peau d'orange
C. Puckering
D. Cancer en-cuirasse
| Peau d'orange |
6f9ebf7c-17e8-470e-9f14-99a0c17a368c | Spastic diplegia is commoner in preten-n babies and is associated with periventricular leukomalacia. Periventricular leukomalacia
Periventricular leukomalacia is a form of brain injury characterized by the death of white matter near the cerebral ventricles due to damage and softening of brain tissue.
Premature infants are at the greatest risk of developing periventricular leulcomalacia.
Affected individuals develop : -
i) Motor control problems
ii) Other developmental delay
iii) Cerebral palsy (especially spastic diplegia)
iv) Epilepsy | Pediatrics | null | Most common sequelae due to periventricular leukomalacia –
A. Spastic diplegia
B. Spastic quadriplegia
C. Mental retardation
D. Seizures
| Spastic diplegia |
5d786de9-1f31-4d77-9ef6-9bfefa3f86ba | Advocated patient positions:
Unconscious patient:; supine position.
Foreign body aspiration;: Trendelenburg position.
Asthmatic patient;: semi erect position. | Dental | null | What should be the position of child during asthmatic attack:
A. Supine
B. Semi erect
C. Erect
D. Trendelenburg
| Semi erect |
a3254f11-cbb8-4b34-b1fa-db125225541f | Ans. d. 120-160 mEq over 24 hoursExcept in unusual circumstances, the total amount of potassium administered daily should not exceed 200 mEq.Potassium SupplementationA prudent protocol to follow is to add potassium chloride to IV solutions at a final concentration of 40-60 mEq/L and to administer no more than 10-20 mEq/L of potassium per hourExcept in unusual circumstances, the total amount of potassium administered daily should not exceed 200 mEq.IV potassium replacement is indicated for patients with severe hypokalemia and for those who can not take oral supplementation.For severe deficiency, potassium may be given through a peripheral IV line in a concentration that should exceed 40 mEq/L, at the rates upto 40 mEq/L/Hour.Continuous ECG monitoring is indicated and the serum potassium levels should be checked every 3-6 hours.For the initial administration, avoid glucose containing fluid to prevent fuher shift of potassium intothe cells. .Magnesium deficiency also needs to be corrected at the same time, paicularly in refractory hypokalemia | Medicine | null | A patient on amphotericin B develops hypokalemia of 2.3 meq/l. K+ supplementation required?
A. 40 mEq over 24 hours
B. 60 mEq over 24 hours
C. 80 mEq over 24 hours
D. 120-160 mEq over 24 hours
| 120-160 mEq over 24 hours |
fa304b14-4fa8-415b-8fba-3e670529cc8a | Answer- A (Protein C)'Inherited thrombophilia causes both early and late miscarriages due to intravascular thrombosis. Protein C resistance (factor V Leiden mutation) is the most common causeProtein C is the natural inhibitor or coagulation - Dutta | Gynaecology & Obstetrics | null | A 28 years old female presented with the history of recurrent aboions, pain in calves for 4 years. Patient is suffering from congenital deficiency of:
A. Protein C
B. Thrombin
C. Plasmin
D. Factor XIII
| Protein C |
f588af9c-fc27-43ff-a9f6-2cd26f075654 | Nitoprusside and nitrates act by production of NO (nitric oxide). NO stimulates guanylate cyclase in smooth muscles which leads to formation of cGMP. cGMP act on smooth muscles to cause vasodilation. | Pharmacology | AIIMS 2018 | Sodium nitroprusside is metabolized to form an active metabolite. This active metabolite of sodium nitroprusside act activation of:-
A. Phospholipase A
B. Phospholipase C
C. Guanylate cyclase
D. Protein kinase C
| Guanylate cyclase |
883563e3-4fe8-4b33-926b-5237f09d9c60 | Pterion is the area in the temporal fossa where 4 bones (frontal, parietal, temporal and sphenoid) adjoin each other forming an H-shaped suture.’ | Anatomy | null | Pterion is:
A. Is a point of articulation of four skull bones
B. It is a point where 'bregma' and 'lamba' meet
C. It is region of the postero-lateral fontanelle merge
D. Lies deep to the zygomatic arch
| Is a point of articulation of four skull bones |
ddf70117-84c0-4fe8-a4f4-143205abf2c9 | - In the given A-P view X-ray we could see the curvature of the spine and the presence of Hemiveebrae indicating it as a case of Scoliosis with congenital origin 3D CT image & Radiograph image showing Hemiveebrae SCOLIOSIS:* Scoliosis is defined as a lateral spinal curvature with a cobb angle of 10o or more* A curve with a Cobb angle of less than 10o is asymptomatic and does not progress; this state is known as spinal asymmetry, not Scoliosis * Cobb's angleo The angle formed by meeting of the two parallel tangential lines drawn from End Veebrae is known as Cobb's angleo Apex veebra - Fahest veebra from the spineo End veebra - Veebra that is tilted the mosto Neutral veebra - Veebra that is tilted the leasto Stable veebra - Veebra that is in line with the central sacral line * Levoscoliosis: Curvature towards the left* Dextroscoliosis: Curvature towards the right* Major/Main curvature: Curvature formed by the deformity* Minor curvature: It is a compensatory curvature Main Class and Subtype Demographic and Clinical Characteristics Idiopathic Infantile Occurs in the first 3 years of life; male preponderance; levoscoliosis is more common than dextroscoliosis Juvenile Occurs at age 4-10 years; female preponderance; dextroscoliosis is more common than levoscoliosis Adolescent Occurs at age 10-18 years; female preponderance; dextroscoliosis is more common than levoscoliosis Congenital Osteogenic Wedge - shaped veebrae, hemiveebrae, fused veebrae, unilateral bar Neuropathic Tethered cord, syringomyelia, Chiari malformation, (myelo) meningocele, diastematomyelia Developmental Skeletal dysplasia Achondroplasia Skeletal dyostosis Neurofibromatosis, osteogenesis imperfecta Neuromuscular Neuropathic (acquired) Cerebral palsy, spinocerebellar, degeneration, poliomyelitis Myopathic Muscular dystrophy of various types (eg, Duchenne dystrophy) Tumor - associated Osseous Osteoid osteoma, osteoblastoma Extraosseous Extramedullary (eg, neurofibroma) or intramedullary (eg, astrocytoma) tumor | Radiology | AIIMS 2019 | A 10 year old presented to ohopaedic OPD with a Curved Back, AP and Lateral Radiographs are obtained, what is the most likely cause of such deformity?
A. Congenital
B. Neurofibromatosis
C. Idiopathic
D. Neuromuscular
| Congenital |
645de065-8ca4-48b5-b6c5-0b5894eca245 | DOCOSA HEXAENOIC ACID (DHA)
Sources: Human milk, Fish liver oils, Algal oils
Synthesized in the body from α Linolenic acid.
Highest concentration of DHA found in retina, cerebral cortex, sperms.
Functions: Needed for the development of fetal brain and retina
DHA is supplied transplacentally and through breast milk.
Clinical significance: Low DHA is associated with increased risk of Retinitis Pigmentosa. | Biochemistry | null | Essential fatty acid present in breast milk which is required for normal growth of child
is:
A. Lenoleic acid
B. Palmitic acid
C. Docosahexanoic acid
D. EPA
| Docosahexanoic acid |
7ef97e72-288b-4b7d-8942-2a9c9fc21daa | Fibrous histiocytoma is the most common primary mesenchymal orbital tumor in adults.
It may involve ocular structures such as the orbit, lids, conjunctiva, and ocular limbus.
Most fibrous histiocytomas are benign, but some are locally aggressive and malignant. | Pathology | null | Fibrous histiocytoma involves most commonly:
A. Eyelid
B. Epibular
C. Intraocular
D. Orbit
| Orbit |
a2f3d532-e063-4203-bba6-7f590a162dc7 | Congenital syphilis is characterized by Hutchinson's triad which includes- 1) Interstitial keratitis 2) Malformed teeth 3) SNHL | Pediatrics | AIIMS 2017 | Hutchinson's triad includes?
A. Interstitial keratitis, malformed molars, conductive deafness
B. Interstitial keratitis, malformed molars, sensorineural deafness
C. Conductive deafness, malformed incisors, interstitial keratitis
D. Interstitial keratitis, malformed molars, conductive deafness
| Interstitial keratitis, malformed molars, sensorineural deafness |
040b2ed8-9b17-4749-8191-2fcc6ead4f73 | Ans: A. VenlafaxineRef: Katzung, I3'h ed., pg. 524-525 and Goodman & Gilman, l3'h ed-, pg. 27372.Sudden withdrawal of Shoer acting antidepressants paicularly SSRIs (paroxetine and seraline) and SNRI (venlafaxine) can lead to discontinuation syndrome and troublesome side effects.These symptoms may include dizziness, headache, nervousness, nausea, anxiety and insomnia.Out of the options provided Venlafaxine is the best answer. | Pharmacology | null | Stoppage of which of the following drugs can result in anxiety and insomnia causing discontinuation syndrome?
A. Venlafaxine
B. ImiPramine
C. Valproate
D. OlanzaPine
| Venlafaxine |
4080f3a3-a88c-4bcb-a8a3-2add0483fca0 | Answer- B. Southampton scoreSouthampton score and ASEPSIS criteria are used for wound infection.There are scoring systems for the severity of wound infection, which are paicularly useful in surveillance and research.Examples are the Southampton and ASEPSIS systemsGradeAppearance0Normal healingINormal healing with mild bruising or erythemaIaSome bruisingIbConsiderable bruisingIcMild erythemaIIErythema plus other signs of inflammationIIaAt one pointIIbAround suturesIIcAlong woundIIdAround woundIIIClear or haemoserous dischargeIIIaAt one point only (IIIbAlong wound (>2 cm)IIIcLarge-volumeIIIdProlonged (>3 days) Major complicationsIVPusIVaAt one point only (IVbAlong wound (>2 cm)VDeep or severe wound infection with or without tissuebreakdown; hematoma requiring aspiration | Surgery | null | Which score is used for wound infection
A. Glasgow coma scale
B. Southampton score
C. Apgar score
D. SIRS score
| Southampton score |
e22738ff-f770-4eed-a79e-19f5156b9ff7 | Ans: A. To be given empty stomach with a glass of water(Ref: Gilman 12/e p1296; Katzung 13/e p754. 12/e p776; KDT 7/e p344, 6/e p334; 19/e p2.Esophageal irritation:Minimized by taking the drug with full glass of water and remaining upright for 30 minutes or by using the intravenous forms of these compounds.GI side effects:Oral bisphosphonates (including alendronate, ibandronate & risedronate) - Cause heaburn, esophageal irritation /esophagitis.Also cause abdominal pain & diarrhea.Symptoms often abate when patients take the medication after an overnight fast, with tap or filtered water (not mineral water), and remain upright. | Pharmacology | null | What are the appropriate instructions to be given while prescribing bisphosphonates to a patient:
A. To be given empty stomach with a glass of water
B. Taken along with food
C. Stop if features of gastritis develop
D. Stop if bone pains occur.
| To be given empty stomach with a glass of water |
baacab5b-7e28-4b0d-b78e-73253e5c7dde | Shin splints (stress fracture) are seen in runners, army recruits or any vigorous physical activity. STRESS/FATIGUE FRACTUREStress fracture is due to imbalance between load and resistance of bone. It is of 2 types:1. Fatigue Fracture: caused by application of abnormal stress on normal bone.2. Insufficiency Fracture: caused by normal activity on weak bone. Sites of Stress FracturesLower Extremity* March fracture is a stress fatigue fracture of second metatarsal neck > 3rd metatarsal neck.* The most common site is metatarsal neck followed by tibia (proximal third in children, middle third in athlete and lower third in elderly).* Tibia stress fracture = Shin splints* Femoral neck (inferomedial compression side in young and superior tension side in older patients).* Rarely fibula lower end (runners fracture). Upper Extremity* Olecranon is most common site of upper limb stress fractures. Pelvis and SpinePars inter aicularis of 5th lumbar veebral (causing spondylolysis) is commonest in spine. Clinical Presentation* Load related pain often bilateral* The hallmark physical finding is tenderness with palpation and stress. InvestigationMRI provide excellent sensitivity and superior specificity compared to bone scan in differentiating from infections or tumors.Bone scan is preferable for bilateral cases due to feasibility, also bilateral cases go in our of stress fracture as compared to Infection or tumor and also can scan the whole body.* Treatment is symptomatic with cast and cessation of activity. | Orthopaedics | AIIMS 2019 | A young marathon runner is paicipating in a marathon competition. After running for 100 m, he develops at the anteromedial aspect of tibia which was mild to sta with, but increased on fuher running. X ray was normal. The doctor ordered a bonescan. What is the likely diagnosis?
A. Lisfranc fracture
B. Jones fracture
C. Shin splint
D. Nutcracker fracture
| Shin splint |
0f49668c-7988-48a6-ba11-ad49aa561259 | Answer- D. Autosomal dominant inheritanceClinical findings like rashes on face, decreased mental function with macular lesions on the skin and intracranial calcification on CT scan is highly suggestive of tuberous sclerosis, which has an autosomal dominant condition. | Skin | null | A man presents it n rashes on face and also complains of decreased mental function. He is also having few macular lesions on his skin. On CT scan, intracranial calcification was seen. His wife is normal. His 10-year old daughter is also normal but his 6-year old son is also having similar skin lesions. What would be the most likely diagnosis?
A. Neurofibrornatosis-1
B. Neurofibromatosis-2
C. Xeroderma pigmentosum
D. Autosomal dominant inheritance
| Autosomal dominant inheritance |
93b42b71-45b2-4314-9bb5-b71c362c50cf | Bupivacaine - Local anesthetic Dexmedetomidine - Anesthesia adjuvant Lorazepam - Anesthetic agent for induction Neostigmine - Reversal agent | Anaesthesia | AIIMS 2017 | Which of the following is used in the induction of anesthesia:-
A. Bupivacaine
B. Dexmediatomidine
C. Lorazepam
D. Neostigimine
| Lorazepam |
852daded-7198-4d4a-94df-f3bc1ab8938c | The reaction of the periradicular tissues to noxious products of tissue necrosis, bacterial products and antigenic agents from the root canal has been described by Fish.
The four zones
Zone of infection
Zone of contamination
Zone of irritation
Zone of stimulation
Zone of Infection:
This is present in the center of the lesion.
It is characterized by PMNL's.
Zone of Contamination:
It is characterized by round cell infiltration.
It demonstrates cellular destruction due to toxins from the central zone or zone of infection. Because of autolysis and death of bone cells, the lacunae were empty.
Lymphocytes are prevalent everywhere.
Zone of Irritation:
This zone is characterized by macrophages and osteoclasts.
The collagen framework was digested by phagocytic cells, the macrophages, while osteoclasts attacked the bone tissue. This opens a gap in the bone all around the center of lesion. That space becomes filled with PMNL's. It contains cholesterol crystals.
This zone demonstrates much activity preparatory to repair.
Zone of Stimulation: (Peripheral zone)
This zone is characterized by fibroblasts and osteoblasts.
In this zone, the effects of toxins were mild enough to be stimulant which results in laying down of collagen fibers around the zone of irritation that acts both as a wall of defense and as a scaffolding on which the osteoblasts built new bone.
This new bone was built in an irregular fashion. | Dental | null | Which of the following zone is characterized by macrophages and osteoclasts?
A. Zone of infection
B. Zone of contamination
C. Zone of irritation
D. Zone of stimulation
| Zone of irritation |
42924e5a-723d-478f-ab78-a46ec8e8041b | “Deceleration is defined as a decrease in fetal heart rate below the base line of 15 beats per minute or more.”
Variable deceleration is seen in case of cord-compression/prolapse. In case of cord-compression/prolapse patient should not be allowed to rest in supine position as it will lead to more pressure on the cord. In cord prolapse the patient is allowed to rest in exaggerated elevated Sims position with a pillow under the hip.
Management of Non-reassuring fetal status (Fetal Distress)
Lateral positioning avoids compression of vena cava and aorta by the gravid uterus. This increases cardiac output and uteroplacental perfusion.
Oxygen is administered to the mother with mask to improve fetal SaO2.
Correction of dehydration by IV fluids (crystalloids) improves intravascular volume and uterine perfusion.
Correction of maternal hypotension (following epidural analgesia) with immediate infusion of 1 litre of Crystalloid (Ringer’s solution).
Stoppage of oxytocin to improve fetal oxygenation. Fetal hypoxia may be due to strong and sustained uterine contractions. With reassuring FHR and in absence of fetal acidemia, oxytocin may be restarted.
Tocolytic (Injection terbutaline 0.25 mg S.C.) is given when uterus is hypertonic and there is nonreassuring FHR.
Amnioinfusion is the process to increase the intrauterine fluid volume with warm normal saline (500 ml). Indications are:
– Oligohydramnios and cord compression
– To dilute or to wash out meconium
– To improve variable or prolonged decelerations.
Advantages : Reduces cord compression, meconium aspiration, and improves Apgar score. | Gynaecology & Obstetrics | null | A pregnant lady with persistent late, variable deceleration with cervical dilatation of 6 cm shifted to OT for surgery. Which of the following is not done in Mmn:
A. Supine position
B. O2 inhalation
C. I.V. fluid
D. Subcutaneous terbutaline
| Supine position |
443af13e-78ee-4ce6-8638-353eabbdaccc | The outermost odontoblast layer,(Single layer outlining pulp ) contains odontoblasts as principal secretory cells for Dentin while they also secrete Collagen Type 1 and type 5 collagen fibers | Dental | null | Principle secretory cells found in the single layer outlining the pulp (Ourtermost zone of pulp)
A. Fibroblasts
B. Odontoblast
C. Ameloblast
D. Undifferentiated cells
| Odontoblast |
26a95f8b-cbdd-4e14-b3fc-fcf2b9efbd20 | Answer: . B. HIV reverse transcriptase >2 years (Ref Goodman and Gilman 12/e p14051Chloroquine related eye disease risk is high if duration of treatment is more than 5 yearsHigh Risk for Chloroquine Age >60 yearsdegDuration of treatment >5 yearsdegDaily dose >6.5 mg/kg/day of3.0 mg/kg/day of High body fatdegLiver diseasedegRenal diseasedegConcomitant retinal diseasedeg | Pharmacology | null | Chloroquine related eye disease risk is
A. HIV protease
B. HIV reverse transcriptase
C. HIV integrase
D. HIV entry into the cell
| HIV reverse transcriptase |
d462a540-afc7-4f6a-a396-daddb1b5c3ef | Cervical resorption is usually painless, until the resorption exposes the pulp, necessitating endodontic therapy. Intracanal dressings of calcium hydroxide are often successful in halting further tooth resorption.
Severe external root resorption often necessitates extraction of the tooth.
Moderate root resorption can be treated by orthodontically extruding the tooth and restoring it with a post-retained crown, but the prognosis of this treatment can be doubtful.
Mild cervical resorption can be treated by surgical access, curettage, and placement of a restoration. | Dental | null | Cervical resorption after bleaching is prevented by:
A. 80% alcohol drying immediately after bleaching
B. Alpha tocopherol applied immediately after bleaching
C. Sodium perborate + sodium hypochlorite
D. Sodium perborate + calcium hydroxide
| Sodium perborate + calcium hydroxide |
f8844c8c-594b-417e-81a5-e46ebe4b65d8 | Ans: A. Beta HCG and PAPP-A1st trimester aneuploidy screening:Human chorionic gonadotropin (either intact or free (b-hCG).Pregnancy-associated plasma protein A (PAPP-A).Fetal Down syndrome in 1st trimester:Higher serum free beta-hCG level.Lower PAPP-A levels.Trisomy 18 & 13:Lowered levels of both HCG PAPPP-A.2nd trimester analytes:Serum integrated screening.Accuracy of aneuploidy detection:Greater on combination with,Sonographic NT measurement. | Gynaecology & Obstetrics | null | Which of the following is done for screening of Down's syndrome in first trimester?
A. Beta HCG and PAPP-A
B. Unconjugated estradiol and PAPPA
C. AFP and Inhibin A
D. AFP and Beta HCG
| Beta HCG and PAPP-A |
Subsets and Splits