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51bc69fc-daf9-4ecc-8fc9-f40f2df129a9 | Movements of the shoulder joint are flexion, extension, adduction, abduction, medial and lateral rotation. These are mainly caused by the muscles pectoralis major, deltoid, latissimus dorsi, teres major and minor and supraspinatus. BD chaurasia 7th edition,page 149-table 10.1 | Anatomy | Upper limb | Which of following muscle has no action at shoulder joint
A. Teres major
B. Pectoralis minor
C. Subscapularis
D. Trapezius
| Pectoralis minor |
dc0dc576-4d5a-4d3f-85f4-91af70ff0511 | Closed apex, extraoral dry time greater than 60 minutes, suggesting non-viable cells.
Delayed replantation has a poor long-term prognosis.
The periodontal ligament will be necrotic and cannot be expected to heal. The goal in delayed replantation is, in addition to restoring the tooth for aesthetic, functional, and psychological reasons, to maintain alveolar bone contour. However, the expected eventual outcome is ankylosis and resorption of the root, and the tooth will be lost eventually.
Treatment
Clean the area with water spray, saline, or chlorhexidine.
Re-implant the tooth in the socket.
Suture gingival lacerations, if present.
Verify normal position of the replanted tooth both clinically and radiographically.
Apply a flexible splint for up to 2 weeks.
Administer systemic antibiotics.
If the avulsed tooth has been in contact with soil and if tetanus coverage is uncertain, refer to physician for a tetanus booster.
Initiate root canal treatment 7-10 days after replantation and before splint removal.
To slow osseous replacement of the tooth, treatment of the root surface with fluoride prior to replantation has been suggested (2% sodium fluoride solution for 20 minutes).
Reference: McDONALD AND AVERY’S DENTISTRY for the CHILD and ADOLESCENT, 10th ed page no 594 | Dental | null | After more than 1 hour of extraoral time, an avulsed tooth is soaked in sodium hypochlorite solution, then it should be soaked in:
A. 10% NaF for 10 min
B. 2% NaF for 20 min
C. 8% SnF2 for 10 min
D. 2% SnF2 for 10 min
| 2% NaF for 20 min |
6d839bc8-4195-4f71-acd4-6130b0d67211 | Synthetic absorbable suture such as vicryl is preferred for CBD Vicryl sutures are used in general soft tissue approximation and vessel ligation Non absorbable sutures ordinarily remain when they are buried within the tissues. This can cause late complications such as the development of gallstones around Non-Absorbable sutures in the CBD or bladder stones in the urinary bladder. In these situations it is best to use absorbable materials Ref: Shackelford 7th edition Pgno : 2222-2224 | Anatomy | G.I.T | Best suture for common bile duct is
A. Synthetic absorbable
B. Synthetic Non-Absorbable
C. Non-synthetic absorbable
D. Non-synthetic Non-Absorbable
| Synthetic absorbable |
73db62af-2064-4d6b-a3ea-ea984b613912 | Corynebacterium diphtheriae secretes a protein of approximately 62,000 molecular weight that exhibits toxicity against mammalian cells. Therefore, it is called an exotoxin (i.e., a toxic protein that is secreted by bacterial cells). It is a single polypeptide chain held together by two disulfide bridges. Fragment A exhibits enzymatic activity, resulting in permanent inactivation of elongation factor 2 (EF-2), whereas fragment B binds to cells and mediates entry of the toxic poion. The diphtheria toxin binds to epithelial cells of the pharynx and initially produces local damage. However, the toxin is absorbed into the body and blood circulation (toxemia) and can induce deleterious effects distant from its site of production. Paralysis of the soft palate, pharynx, larynx, and respiratory muscles may appear weeks after onset of symptoms. The toxin may also cause myocarditis. Electrocardiography abnormalities correlate with the level of toxemia. In rare cases, hypotension, peripheral circulatory failure, and skin hemorrhages may occur. Ref : Ananthanarayana textbook of Microbiology 9th edition Pgno : 236 | Microbiology | Bacteriology | Which characteristic applies to the toxin produced by C. diphtheriae
A. It has only local effects
B. It consists of lipid
C. It is a poor antigen
D. It is an exotoxin
| It is an exotoxin |
041f71f9-cddf-4de2-9788-5acfd1596c59 | Ref: HL Sharma 3rd ed: Pg no:187 Tamsulosin is used to treat BPH specifically It acts only on receptors present on bladder and prostrate gland | Pharmacology | Autonomic nervous system | Which of the following is an alpha-blocker without any effect on blood pressure
A. Terazosin
B. Tamsulosin
C. Prazosin
D. Doxazosin
| Tamsulosin |
3a6ea7e9-f776-47c8-9b89-514d7124061c | Ans is 'a' i.e. SerotoninSerotonin or 5 hydroxytryptamine is catabolized to 5 Hydroxy indole acetic acid (5HIAA).The enzyme which catalyzes this reaction is - Monoamine oxidase.5 HIAA is excreted normally in urine. Normal adult excretes about 7 mg of HIAA per day. | Psychiatry | Drugs & Other Biological Methods of Treatment | HIAA is a metabolite of:
A. Serotonin
B. Dopamine
C. Epinophrine
D. Histamine
| Serotonin |
86943309-fd19-464f-a76c-01aa67b34cce | Ans. is 'b' i.e., Phospholipase o Activation of phospholipase (by stimulatory G protein) hydrolyses the membrane phospholipid phosphatidyl inositol 4, 5 bisphosphate (PIP2) to generate the second messenger inositol 1, 4, 5 - triphosphate (IP3) and diacylglycerol (DAG).o IP3 mobilizes Ca+2 from intracellular organelles - increased cytosolic Ca+2.o DAG enhances Protein Kinase 'c' activation by Ca+2.o Ca+2 acts as third messenger in this type of transduce mechanism and mediates the physiological effects of drugs. | Pharmacology | Pharmacodynamics | PI P2 is cleaved into IP3 and DAG by -
A. Protein kinase'C'
B. Phospholipase
C. cAMP
D. Caspases
| Phospholipase |
16747724-0a25-4c69-b7ef-7cf673393ef0 | Ans. is 'b' i.e. Myoneural junction Vecuronium is a non depolarizing neuromuscular blocking agent.It acts on nicotinic receptor at neuromuscular junctions and blocks the depolarization by inhibiting Na+ channels. | Pharmacology | A.N.S. | Vecuronium acts on :
A. Cerebral cortex
B. Myoneural junction
C. Muscle fibres
D. Spinal cord
| Myoneural junction |
8b1835d7-6195-4590-81f7-5cce5376563f | Post coital test (Sims or Huhner's test) is a test for evaluation of the potential role of Cervical factor in infertility.
It is designed to assess:
The quality of cervical mucus.
Presence and number of motile sperms in the female reproductive tract. after coitus.
Interaction between cervical mucus and sperms.
It gives an approximate idea of sperm count: (normally 10 - 50 motile sperms are seen per high power field in cervical mucus, if count is < 10 sperms/HPF it indicates the need for complete semen analysis).
Post coital test gives a very rough idea about sperm count, motility and morphology.
As far as fallopian tube block is concerned postcoital test has no relation.
Time of test:
It should be performed 1 or 2 days before the anticipated time of ovulation ,when maximum estrogen secretion is present.
For patients with irregular cycles, patients urinary LH surge may be helpful in scheduling the test.
Prerequisites for the test: - Abstinence of 2 days.
Intercourse to be performed 2 -12 hours before the test.
No use of lubricant. | Gynaecology & Obstetrics | null | Post coital test (PCT) is done for:
A. Cervical receptivity
B. Sperm motility
C. Absolute sperm count
D. Viable sperm count e. Endometrial function
| Cervical receptivity |
11eead34-3fe4-4435-8446-fdd318eb6ec3 | While fibrocystic disease may have many components, including cyst formation, apocrine metaplasia (a benign alteration of cyst epithelium to resemble that of apocrine sweat glands), sclerosing adenosis, and fibrosis, only the epithelial hyperplasia (usual, atypical, or carcinoma in situ) is thought to indicate significant premalignant (or malignant, for carcinoma in situ) potential. For this reason, most pathologists pay paicular attention to the epithelial lining of the ducts and lobules when evaluating breast biopsy specimens with fibrocystic disease. Fibrocystic breasts without any evidence of epithelial changes do not appear to have any significant increased risk of progression to breast cancer. (You should, however, be aware that a fibrocystic breast may make both breast palpation and mammography more difficult and make it more likely to miss a small lesion.) Fat necrosis is seen after breast trauma, and has no significant malignant potential. Ref: Chandrasoma P., Taylor C.R. (1998). Chapter 56. The Breast. In P. Chandrasoma, C.R. Taylor (Eds), Concise Pathology, 3e. | Pathology | null | Which of the following breast lesions is considered to have the greatest potential for eventual progression to a malignant lesion?
A. Apocrine metaplasia
B. Blue dome cyst
C. Epithelial hyperplasia
D. Fat necrosis
| Epithelial hyperplasia |
c3854e93-3d0e-4fc7-b939-aaf2992ea198 | Ans. is 'a' i.e. Crescent shaped hyperdense lesion Appearance of hematomas on CT* Biconvex (lens shaped or lenticular) hyperdense(2/3rd) or mixed density lesion(l/3rd) - Epidural hematoma.* Crescent (concao-convex) hyperdense (<2 weeks) or isodense (2-4 weeks) or hypodense (>4 weeks) lesion - subdural hematoma. | Radiology | Nervous System | Characteristic CT finding in acute SDH is-
A. Crescent shaped hyperdense lesion
B. Biconvex hyperdense lesion
C. Biconcave hyperdense lesion
D. Crescent shaped hypodense lesion
| Crescent shaped hyperdense lesion |
9d8f5636-2dfa-4c43-9be7-e16474e9b951 | Methylmalonic acidemia is an autosomal recessive disorder of amino acid metabolism, involving a defect in the conversion of methylmalonyl-coenzyme A (CoA) to succinyl-CoA. Patients typically present at the age of 1 month to 1 year with neurologic manifestations, such as seizure, encephalopathy, and stroke. Reference: GHAI Essential pediatrics, 8th edition | Pediatrics | Metabolic disorders | Which one of the following is not a Pyridoxine Dependent disorder
A. Homocystinuria
B. Methyl-malonic-acidemia
C. Cystathioninuria
D. Xanthurenic aciduria
| Methyl-malonic-acidemia |
744a68a1-570a-49d3-9b6f-1a39f1861518 | Rectal involvement (proctitis) is the hallmark of the disease, and the diagnosis should be seriously questioned if the rectal mucosa is not affected. | Surgery | Inflammatory bowel disease | Ulcerative colitis stas from:
A. Rectum
B. Sigmoid colon
C. Ascending colon
D. Any pa
| Rectum |
4309ceb9-93de-4a86-9601-309b974ab20e | Ans. is 'd' i.e., Posterior cord Supraclavicular branches of brachial plexuso Branches of brachial plexus which are above the clavicle are called supraclavicular branches,o These arise from roots and trunks.Supraclavicular branches of brachial plexusFrom roots1. Nerves to scaleni and longus colli2. Branch to phrenic nerve3. Dorsal scapular nerve4. Long thoracic nerveC5,6,7,8C5C5C5,6(7)From trunks1. Nerve to subclavius2. Suprascapular nerveC5,6C5,6Infraclavicular branches of brachial plexuso Branches of brachial plexus which are below the clavicle are called infraclavicular branches,o These arise from cords.Infra clavicular branches of brachial plexusLateral cordLateral pectoralC5.6,7MusculocutaneousC5,6,7Lateral root of medianC(5), 6,7Medial cordMedial pectoralC8,T1Medial cutaneous of forearmC8.T1Medial cutaneous of armC8,T1Medial root of medianC8.T1UlnarC(7), 8,T1Posterior cordUpper subscaputarC5t6Lowrer subscapularC5.6Thoracodorsal (Nerve to latissimus dorsi, middle subscapular nerve)C6,7,8AxillaryC5,6RadialC5,6,7,8, (Tl) | Anatomy | Nerves of Upper Extremity | Axillary nerve is a branch of which part of brachial plexus -
A. Trunk
B. Medial cord
C. Lateral cord
D. Posterior cord
| Posterior cord |
66f53bb8-5106-4c6d-b5b6-f5b8c6097f23 | Ans (b) Toxocara canis It generally seen when human infection occur with non human species of nematodes so larvae is unable to complete its normal development . It can also occur when parasitic nematodes infect immune person, so that its immunity does not allow normal progression of infection. Larva Migrans Cutaneous larva migrans Visceral larva migrans Larva migrans takes place in skin) (Larva migrans occurs in deeper tissues) Also called as creeping eruption Caused by migration of larvae of nonhuman species of nematodes that infect by oral route Caused by nematode larvae that infect by skin penetration Causes include Causes include Ancylostoma brazilense (MC) Toxocara canis (MC) A. caninum Toxocara call Necates americanus Anisakis Loa loca A. lumbricoides Ganasthoma spinigerum Ganasthoma spinigerum Clinical features Gnathostomiasis produce lesion in deeper subcutaneous tissue or in muscles Fever, hepatomegaly, pneumonitis, hyperglobal anemia, pica, neurological disturbances (called as neural larva migrans) and endophthalmitis (Ophthalmic larva migrans) Strongyloides stercoralis causes larava currens (= rapidly moving lesion) Diagnosis by passive hemoglutination, bentonite flocculation, micropreapitation, ELISA Loa loa, Dirofilaria Fasciola, paragonimus causes creeping lesion of abdominal wall Treatment is thiabendazole or deworming of household pets Hypoderma and Gastrophilus causes creeping myiasis | Microbiology | null | Visceral larva migrans caused by:
A. Strongyloides
B. Toxocara canis
C. Ankylostoma
D. Dirofilaria
| Toxocara canis |
ed7da8c0-e8fc-408c-92e1-a1ea68bbcc5a | Fibronectin is a glycoprotein normally present in cervical and vaginal secretions before 22 and after 37 weeks.It is the cement for the fusion of the chorioamniotic membranes with the decidua, a process that is completed after 22 weeks of gestation The biochemical marker of activation of the fetal membranes is the leakage of fetal fibronectin from the uterine membranes into the cervicovaginal secretions. At any other time its presence is predictive of preterm bih in symptomatic and asymptomatic high-risk women. | Gynaecology & Obstetrics | Preterm Labour | A 32 weeks pregnant woman presented with intermittent abdominal pain and vaginal discharge, on analysis of the cervicovaginal discharge showed fibronectin. What is the probable diagnosis?
A. Preterm labour
B. IUGR
C. IUD
D. Vaginal infection
| Preterm labour |
a80dd397-95b0-4686-886f-097b795126c2 | (D) (Cervical plexus) (84-85-BDC-3) 6th EditionCarotid sheath* Carotid sheath is a local consideration of the prevertebral, the pretracheal, and the investing layers of the deep fascia.* Contents -a) Common and internal carotid artery.b) Internal jugular vein.c) Vagus nerve.d) Deep cervical lymph nodes.* Relations -1) The ansa cervicalis lies embedded in the anterior wall of the carotid sheath.2) The cervical sympathetic chain lies behind the sheath, plastered to the prevertebral fascia.3) The sheath is overlapped by the anterior border of the sternocleidomastoid and is fused to the layers of the deep cervical fascia.* At the level of the upper border of the thyroid cartilage, the common carotid artery bifurcates into the internal and external carotid arteries. The pulsations of these arteries can be felt at this level. | Anatomy | Head & Neck | Which of the following is not a part of the carotid sheath -(84-85-BDC-3) 6th Edition
A. Carotid artery
B. Vagus nerve
C. Ansa-cervicalis
D. Cervical plexus
| Cervical plexus |
7e17462c-b9ed-4e1c-bf0e-83b3dfd463c0 | Ans. 'c' i.e., Urinary bladder o Transitional epithelium is a multilayered stretchable epithelium which has extra reserve of cells.Type of epitheliumTissue or organSimple squamousLung alveoliMesothelium lining serous surfacesEndocardium and endotheliumLoop of henle in nephronKeratinized stratified squamousEpidermis of skinDuct of sebaceous glandNon keratinized stratified squamousTongue, tonsil, pharynx, esophagusCorneaVaginaSimple columnar epithelium (without cilia and microvilli)Lining of stomach and large intestine Cervical canalColumnar epithelium with striated border (regularly arranged microvilli)Lining of small intestineColumnar epithelium with brush border (Irregularly placed microvilli)Gall bladderCiliated columnar epithelium (cilia on surface for propulsion of fluid)Uterus and fallopian tubesEustachian tubeCentral canal of spinal cord and ventricles of brainRespiratory epitheliumSecretory columnar epithelium (with goblet cells)Stomach and intestines Trachea and bronchiPseudostrati fled columnar epitheliumOlfactory epitheliumTracheaEustachian tubeVas + deferensUrethraCuboidal epitheliumDucts of glandsThyroid folliclesOvarian surface epitheliumTransitional epithelium (Urothelium)Renal pelvis, calyces, ureter, urinary bladder and part of urethra | Anatomy | Epithelium and Intraepithelial Glands | Transitional epithelium is seen in -
A. Esophagus
B. Vagina
C. Urinary bladder
D. Trachea
| Urinary bladder |
62ab9345-1607-41fe-a6eb-b4163687dcc5 | Quellung reaction Capsular swelling due to serological reaction Pneumococcal Capsular antigen + Antibody causes Capsular swelling Note:- MC fadyean's reaction Done for bacillus anthracis capsule (polypeptide) | Microbiology | FMGE 2018 | Quellung reaction is seen with:
A. Pneumococcus
B. Gonococcus
C. Streptococcus
D. Staphylococcus
| Pneumococcus |
c655ae07-65a8-4963-8a8c-94edb99189b9 | Topical steroids & topical calcipotriol can be used for treating psoriatic lesions involving <10% body surface area & calcipotriol is the drug of choice. | Dental | null | Drug of choice for treatment of psoriasis involving <10% of BSA (body surface area) is
A. Methotrexate
B. Oral steroids
C. Topical steroids
D. Topical calcipotriol
| Topical calcipotriol |
21de7491-4999-450e-b4ec-b48f5842b9f7 | The clinical vignette and the microscopic findings suggest the diagnosis of bacillary angiomatosis. Bacillary angiomatosis is a disease of severely immunocompromised patients, is caused by B. henselae or B. quintana, and is characterized by neovascular proliferative lesions involving the skin. It consists of lobular proliferations of small blood vessels lined by enlarged endothelial cells interspersed with mixed infiltrates of neutrophils and lymphocytes, with predominance of the former. Both bacillary angiomatosis and Kaposi&;s sarcoma can have clinical presentation as mentioned in the question. However, the major differentiating factor is the microscopic examination. While bacillary angiomatosis predominantly have mixed infiltrate accompanied by neutrophils with clumps of bacilli ,whereas Kaposi&;s sarcoma predominantly has plasma cells Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition | Microbiology | Bacteriology | A patient who is a known case of AIDS presents to the OPD with fever, chills, malaise and weight loss. The microscopic examination of the cutaneous lesion shown below revealed predominant neutrophilic infiltration. What is the most likely diagnosis?
A. Verruca peruana
B. Cavernous hemangioma
C. Kaposi sarcoma
D. Bacillary angiomatosis
| Bacillary angiomatosis |
e60e1faa-c9eb-45af-b039-3d9323687902 | Chronic pyelonephritis is defined here as a morphologic entity in which predominantly interstitial inflammation and scarring of the renal parenchyma are associated with grossly visible scarring and deformity of the pelvicalyceal system. Chronic pyelonephritis is an impoant cause of chronic renal failure. It can be divided into two forms: chronic obstructive pyelonephritis and chronic reflux-associated pyelonephritis Refer robbins 9/e p545 | Pathology | Urinary tract | Periglomerular fibrosis is considered typical of
A. Chronic pyelonephritis
B. Chronic glomerulonephritis
C. Aerionephrosclerosis
D. Malignant hypeension
| Aerionephrosclerosis |
121f58ec-1461-4b05-8ed1-06b14e603329 | Ans. (a) Pepper pot skull.Image source - http://68.media.tumblr.com/d46412907ee7900476a488e26758513b/tumblr_n04rfkqznM1ru4rx5o1_1280.jpg | Medicine | Disorder of Metabolism & Connective Tissue | Which is seen in the X-ray skull shown?
A. Pepper pot skull
B. Artifacts
C. Silver beaten appearance
D. Mug shot
| Pepper pot skull |
93bc6001-4307-491a-b8cf-657f05c83cc8 | The whiff test, is performed by adding a small amount of potassium hydroxide to a microscopic slide containing the vaginal discharge. A characteristic fishy odor is considered a positive whiff test and is suggestive of bacterial vaginosis. The presence of clue cells on wet mount is similar to the whiff test. Diagnosis of a yeast infection is done either microscopic examination or culturing. Serological testing is the most frequently used approach in the laboratory diagnosis of syphilis. Histopathological and mycobacteriological examinations have limited utility in the diagnosis of genital tuberculosis. | Gynaecology & Obstetrics | null | For diagnosing which of the following infection is Whiff test done?
A. Bacterial vaginosis
B. Vaginal Candidiasis
C. Syphilis
D. Genital tuberculosis
| Bacterial vaginosis |
ceddf62b-479e-4baf-a5d5-e5493782909a | Eisenmenger's Syndrome is an absolute contraindication for Surgery in Ventricular septal defect. | Pediatrics | null | NOT an indication for surgery in Ventricular septal
defect
A. Hepatomegaly
B. Suck- Rest-Suck cycle while feeding
C. Pulmonary: Systemic blood flow > 2:1
D. Eisenmenger's Syndrome
| Eisenmenger's Syndrome |
def828a1-b31e-40b5-a47a-9cf0c17af70b | *Make it very clear in your mind that popliteal aery injury can occur with both anterior and posterior dislocation of knee. But it is more common in posterior dislocation. Clinical evaluation : (vascular exam) -Measure Ankle-Brachial Index (ABI) if ABI >0.9 >>>> then monitor with serial examination if ABI <0.9 >>>> -If pulses are absent or diminished confirm that the knee joint is reduced or perform immediate reduction and reassessment - Immediate surgical exploration if pulses are still absent following reduction &;schema time >8 hours has amputation rates - If pulses present after reduction then measure ABI then consider observation vs. angiography Clinical evaluation : (vascular exam) -Priority is to rule out vascular injury on exam both before and after reduction serial examinations are mandatory. - Palpate the dorsalis pedis and posterior tibial pulses if pulses are present and normal , >> it does not indicate absence of aerial injury. Ref: Campbell's 13th/e p.2257 | Orthopaedics | Thigh, Knee,Leg,Foot & Ankle injuries | Popliteal aery injury is commonly seen in which type of traumatic knee dislocation?
A. Anterior dislocation
B. Posterior dislocation
C. Medial dislocation
D. Lateral dislocation
| Posterior dislocation |
cc35a379-0006-427f-8aee-e45d93ddeb64 | Among all oral precancerous lesions, Erythroplakia has the maximum potential to convert to malignancy. | Dental | null | Which of the following premalignant lesion has the highest potential of getting converted into malignancy?
A. Apthous ulcer
B. Leucoplakia
C. Erythroplakia
D. Lichen planus
| Erythroplakia |
10348718-f9a8-4e39-85be-4b1ff7c021ff | Most common organ involved by congenital TB is: Liver | Pediatrics | Impoant Bacterial Diseases in Children | Most common organ involved by congenital TB is:
A. Liver
B. Pancreas
C. Kidney
D. Lung
| Liver |
5b4e1857-d350-46ac-92f1-a52cb7bd53d1 | Cocaine leads to coronary vasoconstriction & ECG will show ST elevation. Option A: No, PCI because it is not case of STEMI, it is case of Cocaine vasoconstriction so dilate the vessel. Option B: Enoxaparin given to prevent development of re-occlusion of blood vessel or to prevent redevelopment of thrombus in case of MI. Option C: Calcium channel blocker Option D= b Blocker will not relieve vasospasm. Types of Mi Causes 1 MI Due to coronary aery thrombosis or coronary aery dissection 2 MI Anemia (severe), Cocaine overdose 3 MI Sudden cardiac death 4A MI During PCI 4B MI Latent stent thrombosis 5 MI During CABG | Medicine | CVS | A 30-year-old male presents to ER with multiple episodes of chest pain, lasting between 10-20 minutes over the last 2 hours. He admits that he did "a bit of coke" at a house pay. Clinical assessment reveals: Pulse: 95/min, Blood pressure: 135/93mm Hg, Sp02= 97% on room air. ECG during a fuher chest pain episode reveals ST elevation in leads V2-V6 and Troponin T is negative.Which of the following is the most appropriate intervention for this patient?
A. Percutaneous coronary intervention
B. Enoxaparin
C. Calcium channel blocker
D. Atenolol
| Calcium channel blocker |
6b8c932c-10a1-4800-816c-7990dce327e3 | Tolazoline is an alpha blocker used in peripheral aeriography as it produces vasodilatation and has more selective action on peripheral vessels. Refr: KD Tripathi 8th ed. | Pharmacology | Autonomic nervous system | Name the drug used for this procedure
A. Metoprolol
B. Atenolol
C. Phenoxybenzamine
D. Tolazoline
| Tolazoline |
6fa57232-44b4-4605-91a2-5aa0f610f450 | Refer kDT 6/e p 484 Angiotensin-conveing enzyme inhibitors (ACEIs) are contraindicated in patients with bilateral renal aery stenosis due to risk of azotemia resulting from preferential efferent aeriolar vasodilation in the renal glomerulus due to inhibition of angiotensin II. | Pharmacology | Cardiovascular system | ACE inhibitors are contraindicated in
A. Diabetes mellitus
B. Hypeension in age old patient
C. Scleroderma
D. Bilateral renal aery stenosis
| Bilateral renal aery stenosis |
80fcda77-e879-4c2e-8f0d-15fa65dfc613 | Ans. is 'c' i.e., Smith's fracture Smith fracture (Reverse colle's fracture) It is a fracture of distal third of radius with palmar displacement. Hence, it is called as reverse colles fracture (In colles fracture there is dorsal displacement). It is less common than colles fracture and is caused by fall on the back of hand. The deformity is opposite to that of colle's fracture and is called the 'garden spade deformity'. Treatment is closed reduction and immobilization in cast with forearm in supination and wrist in extension. o Percutaneous pinning may be done in unstable fractures. | Surgery | null | Garden spade deformity is seen in ?
A. Baon's fracture
B. Colle's fracture
C. Smith's fracture
D. Bennet's fracture
| Smith's fracture |
073d4a3a-e44f-4fa7-b696-d4343ca80b51 | Enterotoxigenic Escherichia coli (ETEC) is common cause of traveler's diarrhea. It is also associated with diarrhea in infants in developing countries. It causes watery diarrhea, abdominal cramps and low grade fever. The common etiologies of traveler's diarrhea may vary with location and with season. However, on a world-wide basis, the organism most frequently identified in patients with traveler's diarrhea is enterotoxigenic Escherichia coli. This organism accounts for between 30% and 70% of all cases of traveler's diarrhea. Transmission is usually through food or water that is fecally contaminated. The virulence factor implicated are as follows: Heat stable enterotoxin stimulates fluid secretion by activating guanylate cyclase in enteric epithelial cells. Heat labile exotoxin binds to the ganglioside at the brush border of epithelial cells of small intestine and leads to activation of adenylate cyclase. Colonization factors facilitate the attachment of ETEC to epithelial cells of intestine. Ref: Textbook of Microbiology ANANTHANARAYANAN, 8th Ed, page 274-277 | Microbiology | null | Which of the following strains of Escherichia coli is commonly implicated in traveler's diarrhea mediated by heat stable enterotoxin and heat labile exotoxin?
A. Enterotoxigenic
B. Enteroinvasive
C. Enteropathogenic
D. Enterohemorrhagic
| Enterotoxigenic |
232350fb-cd39-4ffd-ba03-f0cc3eb96a5e | Ans. is 'b' i.e., Reiter's disease Keratoderma Blenorrhagica is the characteristic skin lesion seen in patients with Reactive Ahritis. "The Characteristic skin lesions in Reactive Ahritis, Keratoderma Blenorrhagica, consist of vesicles that become hyperkeratotic, ultimately forming a crust before disappearing. These are seen in palms and soles. | Medicine | null | Keratoderma-Blenorrhagicum is pathogno-monic of
A. Behcet's disease
B. Reiter's disease
C. Lyme's disease
D. Glucagonoma
| Reiter's disease |
158f54f0-0c35-4013-b45c-4b8995c0dae3 | MDCT Diagnostic investigation in carcinoma pancreas is MDCT MDCT is investigation of choice for evaluation of lesions arising in the pancreas Investigation of choice for diagnosis, staging and follow up in CA pancreas : MDCT Ref:Sabiston 20th edition Pgno :1544 | Anatomy | G.I.T | Diagnostic investigation in carcinoma pan2
A. MDCT
B. PET scan
C. ERCP
D. MRCP
| MDCT |
e32ccb4e-99bb-411a-9de7-449f6639004f | A synarthrosis joint is a fibrous connection that allows minimal to no movement. In this case, virtually no movement is allowed by the interosseous membrane joint between the radius and ulna. Symphysis joints are permanent fibrocartilaginous fusions between two bones; pubic symphysis is an example. Synchondrosis is a temporary joint made of cartilage that transitions to bone typically after growth completes (i.e., epiphyseal plate). Trochoid joints are pivot joints, and the humeral-radial portion of the elbow joint is an example. Ginglymus joints are hinge joints located at the interphalangeal junctions in the hand and foot (PIPs and DIPs). | Anatomy | Upper Extremity | A 23-year-old woman arrives at the emergency department with a swollen, painful forearm. An MRI examination reveals a compartment syndrome originating at the interosseous membrane between the radius and ulna. Which of the following type of joint will most likely be affected?
A. Synarthrosis
B. Symphysis
C. Synchondrosis
D. Trochoid
| Synarthrosis |
44b16673-6f90-4bd8-a60a-78236cb343a1 | Ans. is 'a' i.e., Chromosome 11Ataxia-Telangiectasia Is an autosomal recessive disorder characterized by an ataxic-dyskinetic syndrome beginning in early childhood, with the subsequent development of telangiectasias in the conjunctiva and skin, along with immunodeficiency. o The ataxia-telangiectasia mutated (ATM) gene located on chromosome 11q22-q23 encodes a kinase with a critical role in orchestrating the cellular response to double-stranded DNA breaks. | Pathology | null | ATM gene is located on ?
A. Chromosome 11
B. Chromosome 7
C. Chromosome 5
D. Chromosome 8
| Chromosome 11 |
b9056360-f832-477a-b751-bb0d7847fa9c | Black eye( Raccoon's sign) in case of anterior cranial fossa fracture, extravasation of blood around the eye and in the periorbital tissue can be observed. It is due to percolation of blood to the periorbital tissue. This is called black eye. Battle's sign in case of middle cranial fossa fracture, there may be percolation of blood to the lateral aspect of head behind the dark which is called Battle's sign Cullen's sign Ectopic bruise around umbilicus in extraperitoneal or intra abdominal bleed or rupture ectopic pregnancy or acute pancreatitis. Grey -Turner's sign Ectopic bruise at flank in retroperitoneal hemorrhage. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 117 | Forensic Medicine | Mechanical injuries | Percolating of blood to the lateral aspect of head behind the ear is indicative of
A. Cullen's sign
B. Grey- Turner's sign
C. Raccoon's sign
D. Battle's sign
| Battle's sign |
7f27e270-322c-4a8f-97d1-7e6d26e7f8ee | 30% of fetal thyroxine at term is derived from mother. | Gynaecology & Obstetrics | null | Maternal sources account for what percentage of fetal thyroxine at term
A. 10%
B. 30%
C. 50%
D. 70%
| 30% |
a385b416-f79a-4ffe-9b09-567a682357ef | Vitamin A DEFICIENCY It is characterized by night blindness, conjunctival xerosis, Bitot spots, Keratomalacia and fundus changes in severe cases Treatment: <6 months of age - Vitamin A 50,000 IU orally/dose 6-12 months of age - Vitamin A 100,000 IU orally/dose >12 months of age - Vitamin A 2,00,000 IU orally/dose The same dose is repeated next day & 4 weeks later. - Clouding of cornea in a child with Vit A deficiency is emergency - requires parenteral administration of 50,000 - 100,000 IU Retinol - In keratomalacia - Local treatment with antibiotic drops & ointment , padding of eye - enhances healing | Pediatrics | FMGE 2018 | Dose of vitamin A for a 18 month old baby, with keratomalacia, weighing 10 kg is?
A. 50,000 IU
B. 1,00,000 IU
C. 2,00,000 IU
D. 5,00,000 IU
| 2,00,000 IU |
f269e00d-4952-43ec-a250-3a37fc22547a | Spinal cord in adults terminates at the lower border of the L1 veebra. In children , it usually terminates at the upper border of the L3 veebra. Structure/ Space Terminal extent Spinal cord at bih L3 upper border Spinal cord at 2 years L1 lower border Adult spinal cord L1 lower border Filum terminale 1st coccygeal segment Filum terminale internum, Dural sac S2 lower border Filum terminale externum 1st coccygeal segment Piameter 1st coccygeal segment Subarachnoid sheath and space, subdural space S2 lower border Cervical enlargement C3-T2 spinal segments Lumbar enlargement L1-S3 spinal segments Ref: Snell's Clinical Neuroanatomy 8th edition Pgno: 136 | Anatomy | Brain | Spinal cord in adults terminates at which level of veebrae?
A. Upper border of L1
B. Upper border of L3
C. Lower border of L1
D. Lower border of L3
| Lower border of L1 |
d9e66e66-7664-42ea-b7a1-a91fa07ada68 | For national and international comparisons and for monitoring, "reference or standard values" of growth are essential.
The well known reference standards are -
1. Harvard (or Boston) standards
Not in common used
Have been replaced by WHO reference values
2. WHO reference values
Most commonly used reference values for international use.
These values are based on the data assembled by the United States National Centre for health statistics (NCHS).
Classification of PEM is based on these standards.
3. Indian standards
Are used for Indian children
Values are based on the data assembled by the Indian Council of Medical Research (ICMR)
Note -
The normal, expected value is 50th percentile of the reference value.
When weight for age is <80% of expected (expected = 50th percentile of reference) → wasting.
When height for age is <90% of expected (expected = 50th percentile of reference) → stunting. | Pediatrics | null | Which of the following is the reference standard on which classification of protein-energy malnutrition is based –
A. Gomez classification
B. 10th percentile of weight for age of ICMR
C. 80% of the 50th percentile of weight of ICMR
D. 80% of the 50th percentile of weight for age of American standard
| 80% of the 50th percentile of weight for age of American standard |
f7bc917e-82a0-44f3-b3e5-3192efbe3a2b | Ans. is 'b' i.e., Formed over occipital bone Abscesses related to mastoid infection* Acute mastoiditis can be complicated by following abscesses:-1) Postauricular abscess:- This is the commonest subperiosteal abscess associated with acute mastoiditis. It occurs lateral to the cortex of mastoid in MacEwen's triangle.2) Bezold abscess: - Pus passes through mastoid tip(UP06) and presents as upper neck swelling. The abscess may:-i) Lies deep to stemocleidomastoid(DNB 07, A1IMS 92)ii) Follow the posterior belly of diagastric and presents swelling between mastoid tip and angle of jaw.iii) Be present in posterior triangleiv) Reach the parapharyngeal pouchv) Track down along the carotid vessels.3) Zygomatic abscess: - Infection of zygomatic air cells.4) Meatal (Luc's) abscess: - Pus passes between the antrum and external osseous meatus.5) Citelli's abscess : - Abscess is formed behind the mastoid more towards occipital bone. Some consider it as abscess of diagastric triangle.6) Parapharyngeal and retropharyngeal abscess. | ENT | Ear | Citelli's abscess is
A. Drained through external meatus
B. Formed over occipital bone
C. Presents as upper neck swelling
D. Retroorbital abscess
| Formed over occipital bone |
bd22147d-8dfd-4247-8609-75d36c0b1a74 | SACROCOCCYGEAL TERATOMA Teratomas occur most frequently in the neonatal period, sacrococcygeal region is the MC siteQ. TREATMENT Complete surgical excisionQ through a chevron-shaped buttock incision. | Surgery | Pediatric Surgery | Primitive streaks remnants give rise to:-
A. Neuroblastoma
B. Wilm's tumor
C. Sacrococcygeal teratoma
D. Hepatoblastoma
| Sacrococcygeal teratoma |
8b618533-d31f-4160-bee6-96fd0922a510 | Transversus abdominis is not pierced when paracentesis is performed using the midline approach Layers of abdomen if pierced in the midline approach (from superficial to deep) *Skin *Superficial fascia *linea alba *transveralis fascia *Extraperitoneal fat *parietal peritoneum There are no muscles pierced in the midline approach ***layers of abdomen if pierced in the *Skin *Superficial fascia *External oblique *internal oblique *transversus abdominis *transversalis fascia *Extraperitoneal fat *parietal peritoneum CLINICAL NOTE:Rectus abdominis results from a seperation of the two rectum abdominis muscles with an intact linea alba | Anatomy | Abdomen and pelvis | A patient with ascites comes to your clinic for paracentesis and you decide to use a midline approach to drain the fluid.Which of these structures is not pierced in this approach
A. Transversalis fascia
B. Extraperitoneal fat
C. Campers and Scarpa
D. Transversus abdominis muscle
| Transversus abdominis muscle |
89e26485-c1cd-4a5b-bfb5-708e8ba69139 | For the production of insulin enzymes in the pancreatic beta cells cleave the proinsulin molecule into insulin and C peptide, which are both present in insulin granules and are released in equimolar amounts when insulin is secreted into blood stream. In accidental exogenous Insulin administration, beta cell function is normal, and the release of endogenous insulin as well as C peptide is suppressed by the low circulating glucose level. Ref: Joslin's diabetes mellitus By Elliott Proctor Joslin, C. Ronald Kahn page1160; Clinical endocrinology By Ashley Grossman page 534; Problem solving in clinical medicine: from data to diagnosis By Paul Cutler page 204; Criminal poisoning: clinical and forensic perspectives By Christopher P. Holstege page 94 | Medicine | null | A patient presents with symptoms of Hypoglycemia. Investigations reveal decreased blood glucose and increased Insulin levels. C-peptide assay is done which shows normal levels of C-peptide. The most likely diagnosis is:
A. Insulinoma
B. Accidental sulfonylurea ingestion
C. Accidental exogenous Insulin administration
D. Accidental Metformin ingestion
| Accidental exogenous Insulin administration |
335cfb3a-e2ee-454c-bc72-c40b8a35be8a | Ans. is 'a' i.e., Ulcerative colitis Ulcerative colitis always involves the rectum and extends proximally in continuous fashion to involve pa or all pa of the colon. Involvement of terminal ileum in ulcerative colitis is called backwash ileitis | Medicine | null | Backwash ileitis is seen in
A. Ulcerative colitis
B. Crohn's disease
C. Colonic carcinoma
D. heal polyp
| Ulcerative colitis |
eff97fb0-6200-4c40-9dd4-5149564cc1fd | ANSWER: (D) AliskirenREF: Goodman Gillman page 525, KDT 6th edition page 482, Katzung 12th ed page 190, 300Repeat from Pharmacology June 2010, December 2008RENIN INHIBITORSCleavage of angiotensinogen by renin is the rate-limiting step in the formation of ANG II and thus represents a logical target for inhibition of the renin-angiotensin system. Drugsthat inhibit renin have been available for many years but have been limited by low potency, poor bioavailability, and short duration of action. However, a new class of nonpeptide, low- molecularweight, orally active inhibitors has recently been developed. Aliskiren, a renin inhibitor recently approved for hypertension, is in clinical trials for heart failure. Preliminary results suggest an efficacy similar to that of ACE inhibitors. Aliskiren is contraindicated in pregnancy.INHIBITION OF RENIN-ANGIOTENSIN SYSTEMSympatheticblockersPlasma renin activity is increased by reflex increase in sympathetic discharge. Sympathetic blockers decreases renin release.Clonidine decreases central sympathetic outflow and thus will decrease plasma renin activity.B blockersadrenergic neurone blockers,central sympatholytics:* Clonidine (a2 agonist)* Guanfacine (a2 agonist)* Methyldopa (a2 agonist)* Moxonidine (imidazoline receptor agonist)* Prazosin (a1, antagonist)* Rescinnamine (ACE inhibitor)* Reserpine (VMAT inhibitor)* Rilmenidine (imidazoline receptor agonist)RenininhibitorsRenin inhibitory peptides and renin specific antibodies block renin action-interferes with generation of A-I from angiotensinogen. (rate limiting step}Aliskiren (Oral: 150, 300 mg tablets)Angiotensin converting enzyme (ACE) inhibitorsPrevent generation of the active principle A-IICaptopril and enaiaprilAngiotensinreceptor(ATI)antagonistsBlock the action of A-II on target cellsLosartan, valsartan, eprosartan, irbesartan, candesartan, olmesartan , and telmisartanAldosteroneantagonistsBlock mineralocorticoid receptorseplerenonespironolactone | Pharmacology | Anti-Hypertensive | Which of the following drug is a renin inhibitor?
A. Enalapril
B. Losartan
C. Clonidine
D. Aliskiren
| Aliskiren |
307adbc8-98b1-4e80-b359-5f0013389344 | Ans. is d i.e., Conjoined twins Dizygotic twins 180%) o Result from fertilization of two ova, most likely ruptured from two distinct Graffian follicles usually from same or one from each ovary, bye two sperms during a single ovarian cycle. Monozygotic twins (20%) o Twinning may occur at different periods after fertilization. On rare occasion following possibilities may occur Diamniotic-dichorionic or D/D {30%):- if the division takes place within 72 hrs after the fertilization (prior to morula stage) resulting embryo will have two separate placenta, chorions and amnions. Diamniotic-monochorionic or D/M (66%):- if the division takes place between 4th & 8th day after the formation of inner cell mass when chorion has already developed. Monochorionic-monoamniotic or M/M (3%):- if the division takes place after 8th day of fertilization when amniotic cavity has already formed. 4) Conjoined twin or Siamese twin (<f %):- if the division takes place after 2 weeks of development of embryonic disc. | Gynaecology & Obstetrics | Multiple Pregnancy | Least common type of twins-
A. Diamniotic-dichorionic twins
B. Diamniotic -monochorionic twins
C. Monoamniotic-monochorionic twins
D. Conjoined twins
| Conjoined twins |
cb705b92-d426-4586-82d3-bc88cd425a2c | The intercostal vessels and nerves pass along the lower border of the ribs. To avoid injury to these structures, it is advised to pass needle close to upper borders of the ribs, during thoracocentesis. | Anatomy | null | While doing thoracocentesis, it is advisable to introduce needle along -
A. Upper border of the rib.
B. Lower border of the rib.
C. In the center of the intercostal space.
D. In anterior part of intercostal space.
| Upper border of the rib. |
6645308e-60f1-400b-9009-61bef197c691 | Ans. is 'c' i.e., Wide QT Torsades - de pointes is a cardiac arrhythmia, which may cause blackouts or even sudden death Q (d/t ventricular fibrillation).The phrase "Torsades de pointes" literally means "Twisting of the point referring to the characteristic appearance of the electrocardiogram during the rhythm abnormality.Torsade is defined as polymorphous VT in which the morphology of the QRS complexes varies from beat to beat.The ventricular rate can change from 150 beats per minute to 250 bpm.The regular variation of the morphology of the QRS vector changes from positive to net negative and back again.Thus the QRS complexes tend to be bizarre and multiform, and to have sharply pointed apices or nadirs.Both, the QRS form and axis undulate.Thus, the sharp points of the QRS complex may, for a short period of a few seconds, be directed upwards, to be followed, for a short period of few seconds by a change in the QRS contour where the sharp points are directed downwards.This was symbolically termed "Torsades - de pointes" or "twisting of the point" about the isoelectric axis because it is reminiscent of the Torsades - de pointes movement in the ballet.Most cases exhibit polymorphism, but the axis changes may not have regularity.The definition also requires that the OT interval be increased markedly (usually to 600msec or greater).Cases of polymorphous VT, which are not associated with a prolonged QT interval, are treated as generic VT. Torsades usually occurs in bursts that are not sustained; thus, the rhythm strip usually shows the patient's baseline QT prolongation.The underlying basic for rhythm disturbance is delay in the phase 3 of action potential.The delay is mediated by sodium or potassium channels.The prolonged period of repolarization and the inhomogeneity of repolarization times among myocardial fibres allow dysrhythmia to emerge. | Medicine | Arrhythmias | Torsades de pointes cause?
A. Eide QRS
B. Short QRS
C. Wide QT
D. Short QT
| Wide QT |
7a5ce0cf-8600-45dd-b2d4-3143729b15cf | Intraductal papillary mucinous neoplasm (IPMN)
IPMN is a papillary neoplasm that arises within the main pancreatic duct (MPD) or its branches.
IPMN is characterized by
Intraductal, papillomatous growth pattern
Excessive mucin secretion
Excessive mucin secretion results in progressive ductal dilatation and cyst formation
IPMNs are most commonly localized to the head of the pancreas, but they may occur at any site along the pancreatic ductal system.
IPMTs are premalignant and may histologically demonstrate areas ranging from hyperplasia to carcinoma within a single tumor.
IPMTs which is positive for MUG 2 (Intestinal-type secretory mucin) may form an adenocarcinoma (ductal adenocarcinoma). | Pathology | null | Intraductal papillary mucin neoplasm is a precursor of-
A. Mucinous cystic neoplasm
B. Mucinous non-cystic neoplasm
C. Ductal adenocarcinoma
D. Solid pseudopapillary neoplasm
| Ductal adenocarcinoma |
b4c4eef9-2e69-429e-b766-8e2136fbe605 | Answer- A. LymphangiosarcomaStewa-Treves' syndrome:Ulceration, non-healing bruises and raised purple-red nodules in patients with lymphatic disorders, should lead to suspicion of malignancy.Lymphangiosarcoma was originally described in postmastectomy oedema (Stewa-Treves'syndrome) | Surgery | null | Stewa-Treves syndrome is used to described development of
A. Lymphangiosarcoma
B. Rhabdomyoma
C. Angiosarcoma
D. Mesothelioma
| Lymphangiosarcoma |
d4e061f8-370e-4b38-b1db-5144c8a2e6cd | Ans. is 'a' i.e.. Leprosy ClassificationsRidley and JoplingIndianMadrido Tuberculoid (TT)o Indeterminate (I)o Indeterminateo Borderline tuberculoid (BT)o Tuberculoido Tuberculoid flat raisedo Borderline (BB)o Borderlineo Borderlineo Borderline lepromatous (BL)o Lepromatouso Lepromatouso Lepromatous (L.L)o Pure neuritic WHO classificationPauci bacillaryMultibacillaryo Bacteriological index <2o BI > 2o 5 or less skin lesionso 6 or more skin lesionso It includeso It includesB.T.B.B.T.T.B L.IndeterminateLL | Social & Preventive Medicine | Communicable Diseases | "Multibacillarv" is a spectrum of disease, seen in-
A. Leprosy
B. TB
C. Tetanus
D. Trachoma
| Leprosy |
9bb6393b-39f4-47e5-b8f1-f885dcb48703 | Anti histamines are classified into first generation and second generation compounds on the basis of CNS penetration and anti cholinergic propeies. First generation anti-histamine can penetrate blood brain barrier and possess additional anti cholinergic propeies which are lacking in second generation drugs. Cyclizine is a first generation where as cetrizine, loratidine and fexofenadine are second generation drugs Refer Goodman & Gilman 12/e p921 | Pharmacology | Autacoids | Which is not a 2nd generation anti-histamine agents
A. Cetirizine
B. Cyclizine
C. Loratidine
D. Fexofenadine
| Cyclizine |
2130aa01-956c-4fa4-be37-cd9da2c8d910 | Mean transformation time for HIV to AIDS is 10 years. The duration between primary infection and progression to clinical disease averages about 10 years. Facts about HIV infection (Jawetz): The typical course of "untreated HIV" infection spans around a decade (10 years) Following infection the period of clinical latency may last long as 10 years. The duration between primary infection infection and progression to clinical disease averages about 10 years. In untreated cases, death usually occurs within 2 years after the onset of clinical symptoms. Following primary infection, there is a 4- to 11- day period between mucosal infection and initial viremia. (The viremia is detectable for about 8-12 weeks) An acute mononucleosis-like sydrome develops in many patients (50-75%) 3-6 weeks after primary infection (There is significant drop in numbers of circulating CD4 T cells at this early time) An immune response to HIV occurs 1 week to 3 months after infection, plasma viremia drops, and levels of CD4 cells rebound. The t 1/2 (half-life) of virus in plasma is about 6 hours. The virus Life-cycle from the time of infectionn of a cell to the production of new progeny that infect the next cell averages 2.6 days. CD4 lymphocytes are the major target responsible for virus production and once productively infected the half-life of a CD4 cell is about 1.6 days. Ref: Jawetz textbook of Medical Microbiology 26th edition pgno: 657 | Microbiology | Virology | Mean transformation time for HIV and AIDS is:
A. 7.5 years
B. 10 years
C. 15 years
D. 12 years
| 10 years |
6712af3c-eb0d-43a8-ad30-cc82c50e9069 | Ans. is 'a' i.e., Emphysema * A "pink puffer" is a person where emphysema is the primary underlying pathology. In emphysema, not only there is less surface area for gas exchange, there is also less vascular bed for gas exchange. The body then has to compensate by hyperventilation (the "puffer"). Their arterial blood gases (ABGs) actually are relatively normal because of this compensatory hyperventilation. They actually have less hypoxemia (compared to blue bloaters) and appear to have a "pink" complexion and hence "pink puffer". Some of the pink appearance may also be due to the work (use of neck and chest muscles) these folks put into just drawing a breath.* A "blue bloater" is a person where the primary underlying lung pathology is chronic bronchitis. Chronic bronchitis is caused by excessive mucus production with airway obstruction resulting from hyperplasia of mucus- producing glands, goblet cell metaplasia, and chronic inflammation around bronchi. Unlike emphysema, the pulmonary capillary bed is undamaged. Instead, the body responds to the increased obstruction by decreasing ventilation and increasing cardiac output. There is a dreadful ventilation to perfusion mismatch leading to hypoxemia and polycythemia. In addition, they also have increased carbon dioxide retention (hypercapnia). Because of increasing obstruction, their residual lung volume gradually increases (the "bloating" part). They are hypoxemic/cyanotic because they actually have worse hypoxemia than pink puffers and this manifests as bluish lips and faces--the "blue" part. | Pathology | Respiration | Pink puffers are associated with?
A. Emphysema
B. Chronic bronchitis
C. Pneumonia
D. Bronchiectasis
| Emphysema |
a5c6d493-abdf-4709-aaf2-da0a8ff13cd4 | Lesion of hypoglossal nucleus: Lesion of the hypoglossal nucleus, there is ATROPHY of the muscles of the IPSILATERAL one-half of the tongue. This is a lower motor neuron lesion. Upon closer examination, FASCICULATIONS (tiny, spontaneous contractions) can be seen. Both fasciculations and atrophy result from the loss of the normal innervation of the muscle by the lower motor neurons in the hypoglossal nucleus. Upon protrusion, the tongue will dete TOWARD the side of the lesion (i.e., same side). This is due to the unopposed action of the genioglossus muscle on the normally innervated side of the tongue (the genioglossus pulls the tongue forward). Ref: Snells Clinical anatomy, 6th Edition, Page 736, 737. | Anatomy | null | In lesion of the right hypoglossal nucleus, the tip of the tonge on protrusion turns to:
A. Left side because of paralysis of left side tongue mscles
B. Right side because of paralysis of right side tongue mscles
C. Right side because of the unopposed action of left geniglossus muscle
D. Left side because of the unopposed action of left geniglossus muscle
| Right side because of the unopposed action of left geniglossus muscle |
3e4d72bb-5c62-4e1e-ba14-01ff7b2080dc | Answer is option4, roulex formation in blood. Multiple myeloma Much rouleaux formation of the red cells is in this thick area of red cell distribution. This is pathologic rouleaux in contrast to normal stacking of red cells in a thick area of a normal blood smear. The background has a bluish tinge. Two small lymphocytes and one mature neutrophil are in the field. Multiple myeloma (Blood - 50X) The stacking of cells (rouleaux formation) facilitates the rate of red cell sedimentation, a phenomenon that may be seen on a peripheral smear. www.labsnet.medical | Pathology | Haematology | Multiple myeloma is diagnosis by-
A. 24 hour urine protein
B. Kidney biopsy
C. >10% plasmacytoma
D. Rouleaux formation in blood
| Rouleaux formation in blood |
470d1799-6fd8-4df1-bd7e-e6a8f8de53a4 | Deep inguinal ring lies lateral to rectus abdominis, as an opening in fascia transversalis. | Anatomy | null | Deep inguinal ring is a deficiency in the -
A. Internal oblique muscle
B. Transversus abdominis muscle
C. Internal spermatic fascia
D. Transversalis fascia
| Transversalis fascia |
0d5cfc3d-c902-47f5-b50d-396144783470 | Most common organisms in infants and young children are Streptococcus pneumonia (30 c/o ), Haemophilus influenza(20%) and Moraxella catarrhalis(12%). Other organisms include Streptococcus pyogenes, Staphylococcus aureus and sometimes Pseudomonas aeruginosa. (Ref: Textbook of diseases of ENT, PL Dhingra, 7th edition, pg no. 67) | ENT | Ear | Commonest cause for acute otitis media in children is
A. H influenza
B. S pneumonia
C. S aureus
D. Pseudomonas
| S pneumonia |
4b19c20d-c66b-4694-8000-e9124c346826 | Ans. is 'b' i.e., Eye is open * The important PM findings of Hanging are :i) Ligature mark is above thyroid cartilage, incomplete, bilaterally symmetrical and directed obliquely upward extending to the angles of mandible, then to mastoid and finally to occipital protuberance. Ligature mark is an example of imprinted/pressure/patterned abrasion.ii) Under the ligature mark there is dry, white and glistening pad of fat.iii) There is dribbling of saliva from the angle of the mouth, which is confirmatory sign of antemortem hanging. This is due to irritation of submandibular and parotid glands by ligature.iv) There may be intimal tear of carotid arteries.v) In case of pressure of ligature on cervical sympathetic ganglia, the eye on that side is found open (La facie sympathique). It confirms antemortem hanging.vi) Fracture of hyoid is usually not seen (may be seen only in 10%). Fracture of thyroid cartilage (20-30% cases) and fracture of tracheal rings (5-10%) may be seen. There may be congestion and ecchymosis (hemorrhage) in trachea, larynx, epiglottis and esophagus. All these injuries are more common in strangulation because strangulation is more violent than hanging causing more severe injury to neck structures.vii) Tardieu spots (petechial hemorrhage) are not as pronounced as in strangulation. | Forensic Medicine | Death and Investigations | Sign of antemortem hanging is
A. Ligature mark
B. Eye is open
C. Fracture of hyoid
D. Tardieu spots
| Eye is open |
317e080b-38cf-4f43-a51c-e769f7aac7a7 | Corynebacterium diphtheriae is the causative agent for diphtheria. The incubation period is 3-4 days. The site of infections is faucial, nasal, otitic, laryngeal, cutaneous. According to clinical severity, malignant, septic and hemorrhagic types are there. Reference: Textbook of Microbiology; Anathanarayan and panicker's; 10th edition; Page no: 240 | Microbiology | Bacteriology | Clinical diphtheria is caused by
A. Corynebacterium diphtheriae
B. Corynebacterium parvum
C. Corynebacterium Ulcerans
D. Streptococcus pyogenes
| Corynebacterium diphtheriae |
28cf80d3-ad40-48ad-b0b4-d6903dc072bf | Most common secondary tumor in survivors of retinoblastoma is osteosarcoma. | Ophthalmology | null | The most common second malignant in survivors of retinoblastoma is –
A. Thyroid cancer
B. Nasopharyngeal carcinoma
C. Optic glioma
D. Osteosarcoma
| Osteosarcoma |
cf0dd7e6-dbb8-4f09-8f30-8db6f8eb131d | A form of type II hypersensitivity is called antibody-dependent cell-mediated cytotoxicity (ADCC). Here, cells exhibiting the foreign antigen are tagged with antibodies (IgG or IgM). These tagged cells are then recognized natural killer cells (NK) and macrophages ( the Fc region) to the effector cell surface receptor, CDCD16, which in turn kill these tagged cells. Ref: www.mayoclinic.com | Microbiology | Immunology | Killer cells are associated with type....immunologic response -
A. Type I
B. Type II
C. Type III
D. Type IV
| Type II |
1629e079-2fa9-4027-aa60-639615beb317 | Ionic Basis of Nerve Resting Membrane Potential
• RMP: Resting membrane potential is a potential difference across the cell membrane in millivolts, which is by convention -70 Mv.
• RMP is established by the diffusion potential that results from concentration differences of permeable ions.
• Resting membrane potential (-70 mV) is close to equilibrium potential of K+ and Cl (both-85 mV) and far from the equilibrium potential of Na+ (+65 mV). That means at rest the nerve membrane is more permeable to K+ than Na+
• Na+ is actively transported out of neurons and other cells and K+ is actively transported into cells, but because K+ permeability at rest is greater than Na+ permeability, K+ channels maintain the resting membrane potential. | Physiology | null | The permeability of which of the following ion leads to resting membrane potential?
A. Sodium
B. Calcium
C. Potassium
D. Chloride
| Potassium |
4e00dc4d-8973-4ae4-b741-c64f532179fb | Fibroblasts require vitamin C to produce collagen. There is an increase in the tensile strength of the wound due to increased collagen, which is at first deposited in a random fashion and consists of type III collagen. The remodelling phase is characterised by maturation of collagen (type I replacing type III until a ratio of 4:1 is achieved). There is a realignment of collagen fibres along the lines of tension Bailey and love 26th edition pg :25 | Surgery | General surgery | Which of the following is absolutely essential for wound healing?
A. Vitamin D
B. Carbohydrates
C. Vitamin C
D. Vitamin E
| Vitamin C |
38338abc-6d01-4e44-b126-5335acd11a56 | Ans. is 'd' i.e., 64 o The information needed to direct the synthesis of protein is contained in the mRNA in the form of a genetic code, which intum is transcribed from template strand of DNA and is therefore complementary to it.o The genetic code is the system of nucleotide sequences of mRNA that determines the sequence of amino acids in protein.o Codon is a sequence of three adjacent bases that corresponds to one amino acid,o There are 64 possible codon sequences.o Because four nucleotide bases A,G C and U are used to produce the three base codons, there are therefore 64(43) possible codon sequences. | Unknown | null | Total numbers of codons are -
A. 60
B. 61
C. 62
D. 64
| 64 |
594d3070-e4bd-44ba-824a-693ef24b00c9 | Refer Williams Vil 1.p 330 The tendons of the rotator cuff, not the muscle are most commonly involved and of the four, The supraspinatus us effected most frequently as it passes below the acromian | Anatomy | General anatomy | Most common muscle damaged in rotator cuff is
A. Supraspinatus
B. Infraspinatus
C. Subsacapularis
D. Teres minor
| Supraspinatus |
1d505258-fc72-4af9-a6fd-ee50e050fdbd | - The range for baroreceptor function is 60-180 mm Hg. - The normal set point for baroreceptors is 100 mm Hg. - At 100 mm Hg, there is a steady impulse discharge from baroreceptors to the VMC. - When BP increases --> impulse discharge increases; when BP decreases --> impulse discharge decreases. - Thus, impulse discharge will be maximum at 180 mm Hg. | Physiology | Circulation | Highest impulse discharge frequency from baroreceptors will be at what blood pressure?
A. 60 mm Hg
B. 100 mm Hg
C. 150 mm Hg
D. 180 mm Hg
| 180 mm Hg |
756c3ccd-e4b1-4cc0-a7c3-0ba6da860211 | Ref Goodman Gilman 11/e p 1173 Doxycycline is a tetracycline that act by inhibiting protein synthesis Cefotetan and oxacillin are beta lactam antibiotics that act by inhibiting cell wall synthesis Ciprofloxacin is a Fluroquinolone that acts by inhibiting DNA gyrase | Pharmacology | Chemotherapy | Which antibiotic acts by inhibiting protein synthesis
A. Cefotetan
B. Doxycycline
C. Ciprofloxacin
D. Oxacillin
| Doxycycline |
e2427dfb-a689-4d3a-80b9-47c3e517464f | Answer is B (Primary Hyperparathyroidism) : The most likely cause of asymptomatic hypercalcemia in a patient aged 30 .years is primary hyperparathyroidism. Familial hypocalciuric hypercalcemia, is most often detected in the first ten years of life when hypercalcemia due to primary hyperparathyroidism is a rarity. Both primary hypehyroidism and familial hypocalciuric hypercalcemia may present with asymptomatic hypercalcemia. The 'catch' in the above question lies in the 'are' of the patient Primary hyperparathyroidism Familial hypocalciuric hypercalcemia (F.H.H.) (autosomal dominant) * * The most common presentation in patients with primary hyperparathyroidism is `asymptomatic' hypercalcemia Commonly presents in third to fifth decade * * Affected individuals are discovered because of asymptomatic hypercalcemia Commonly presents in the first decade | Medicine | null | Asymptomatic hypercalcemia in a 30 year old young male is due to :
A. Occult primary malignancy
B. Primary Hyperparathyroidism
C. Familial hypocalciuria
D. Hyper-nephroma
| Primary Hyperparathyroidism |
4e6c00e4-ba44-4455-af58-c60e7e1f5348 | Otto Loewi is famous for discovery of acetylcholine for which he received a Nobel price. so the option 2.(Reference: www.nobelprize.org) | Physiology | General physiology | Otto Loewi is famous for discovery of
A. Succinyl choline
B. Acetyl choline
C. Adrenaline
D. Noradrenaline
| Acetyl choline |
c06a549f-c272-4b4a-b79d-5e0e669ab4dc | Ans. D: HypothalamusThermoregulation in both ectotherms and endotherms is controlled mainly by the preoptic area of the anterior hypothalamus.Such homeostatic control is separate from the sensation of temperature | Physiology | null | Temperature regulation is chiefly under the control of:September 2007
A. Midbrain
B. Pons
C. Medulla
D. Hypothalamus
| Hypothalamus |
f33945c0-3c8e-46b2-b326-75a799c12b7b | Ans. is 'a' i.e., Babble o A child is able to grasp an object (palmar grasp) at the age of 7 months. o A child can transfer the object form one hand to another by the age of 5-7 months. o So, the age of this child is 7 months. o A 7 months old child can do :? 1) Holds the objects with crude grasp from palm (palmar grasp) 2) Pivots 3) Shows stranger anxiety 4) Resists i fa toy is pulled from his hand 5) Babbles About other options o A child produces bisyllable sound (mama, dada) and stands with suppo by 9 months. o A child sits without suppo by 8 months. | Pediatrics | null | A boy can grasp a rattle & recently he become able to transfer objects, hand to hand. He can do-
A. Babble
B. Say 'mama' or dada
C. Sit without suppo
D. Stand with suppo
| Babble |
a79eb0b4-9c8e-427f-ba81-b7945fe5bab8 | We will illustrate, in addition, how biochemical measurements can pinpoint a disorder and allow one to determine which enzyme is functioning improperly.a. Mouth(1). Salivary glands produce a-amylase, which cleaves a-1,4 bonds between glucose residues in dietary starch. (Pancreatic a-amylase catalyzes the same reaction.)b. Stomach(1). Chief cells produce the proteolytic enzyme pepsin, as its inactive precursor pepsinogen. Pepsin digests proteins.(2). Parietal cells produce hydrochloric acid (HCl) and intrinsic factor.(a). HCl causes pepsinogen (the precursor of pepsin) to cleave itself (autocatalysis), producing pepsin.(b). Intrinsic factor binds dietary vitamin B12 and aids in its absorption.(c). Vitamin B12 is the cofactor for the conversion of homocysteine to methionine and methyl malonyl-CoA to succinyl-CoAc. Gallbladder(1). Bile salts, synthesized in the liver from cholesterol, pass through the gallbladder into the intestine, where they aid in lipid digestion.(2). Bilirubin diglucuronide, produced in the liver from bilirubin (the excretory product of heme degradation), passes through the gallbladder into the intestine.d. Pancreas(1). The pancreas produces bicarbonate (HCO3- ), which neutralizes stomach acid as it enters the intestinal lumen. The subsequent increase in pH in the lumen allows more extensive ionization of bile salts (so they serve as better detergents) and increases the activity of digestive enzymes.(2). The pancreas produces digestive enzymes (e.g., trypsin, chymotrypsin, the carboxypeptidases, elastase, a-amylase, lipase).(3). The B (or b) cells of the endocrine pancreas produce insulin (the hormone that stimulates the storage of fuels in the fed state) and the A (or a) cells produce glucagon (the hormone that stimulates the release of stored fuels during fasting).e. Intestine(1). The enzymes from the exocrine pancreas digest food in the intestinal lumen.(2). The intestinal digestive enzymes are bound to the brush borders of intestinal epithelial cells (aminopeptidases, dipeptidases and tripeptidases, lactase, sucrase, maltases, and isomaltases).(3). The absorption of digestive products occurs through the intestinal epithelial cells.(4). The intestinal epithelial cells produce chylomicrons from the digestive products of dietary fat (fatty acids and 2-monoacylglycerols) and secrete the chylomicrons into the lymph.(5). Most bile salts are resorbed in the ileum and recycled by the liver. Only 5% are excreted in the feces. This excretion of bile salts, along with cholesterol secreted by the liver into the gut via the gallbladder, is the major means by which the body disposes of the cholesterol ring structure (sterol nucleus).f. Liver (the enzymic regulation of liver function is summarized in Tables below)(1). Functions of the liver include:(a). Storage of glycogen produced from dietary carbohydrate.(b). Synthesis of very low-density lipoprotein (VLDL), mainly from dietary carbohydrate.(c). Production of high-density lipoprotein, which transfers CII and E apolipoproteins to chylomicrons and VLDL, converts cholesterol to cholesterol esters (via the lecithin-cholesterol acyltransferase reaction), and reduces blood by which cholesterol and cholesterol esters are transported from tissues to the liver (reverse cholesterol transport).(d). Maintenance of blood glucose levels during fasting via glycogenolysis and gluconeogenesis.(e). Production of urea from nitrogen derived, in part, from amino acids because they are being converted to glucose (via gluconeogenesis) during fasting.(f). Production of ketone bodies from fatty acids derived from lipolysis of adipose triacylglycerols during fasting.(g). Synthesis of cholesterol (which is also made in other tissues).(h). Conversion of cholesterol to bile salts.(i). Production of many blood proteins (e.g., albumin, blood-clotting proteins).(j). Production of purines and pyrimidines, which are transported to other tissues via red blood cells.(k). Degradation of purines (to uric acid) and pyrimidines (to CO2 , H2 O, and ammonia).(l). Oxidation of drugs and other toxic compounds via the cytochrome P450 system.(m). Conjugation of bilirubin and excretion of bilirubin diglucuronide into the bile.(n). Oxidation of alcohol via alcohol and acetaldehyde dehydrogenases and the microsomal ethanol-oxidizing system (MEOS).(o). Synthesis of creatine (from guanidinoacetate), which is used to produce creatine phosphate, mainly in the muscle and brain.(p). Conversion of dietary fructose to glycolytic intermediates.(2). If liver cell function is compromised (e.g., in viral hepatitis or alcoholic cirrhosis):(a). NH4+ , which is toxic (particularly to the central nervous system), increases in the blood.(b). The BUN level decreases because the liver has a decreased capacity to produce urea.(c). Blood glucose decreases because of decreased glycogenolysis and gluconeogenesis.(d). Blood cholesterol levels decrease owing to an inability to produce and secrete VLDL.(e). The production of bile salts decreases.(f). Bilirubin levels increase in the body (causing jaundice) because of reduced conjugation with glucuronic acid.(g). Lysis of damaged liver cells allows enzymes to leak into the blood.1. Lactate dehydrogenase increases.2. Alanine aminotransferase increases.3. Aspartate aminotransferase increases.4. Alkaline phosphatase increases.(h). Chronic liver problems result in decreased protein synthesis.1. Serum proteins (e.g., albumin) decrease.2. VLDL production decreases because of decreased apolipoprotein B-100 and triacylglycerols accumulate in the liver. A fatty liver results.g. Brain(1). Glucose is the major fuel for the brain.(2). The brain can use ketone bodies, but only after 3 to 5 days of fasting when blood ketone body levels are elevated.(3). The brain needs energy to think (i.e., memory involves RNA synthesis), conduct nerve impulses, synthesize neurotransmitters, and so on.h. Red blood cells(1). Red blood cells lack mitochondria, so they have no TCA cycle, b-oxidation of fatty acids, electron transport chain, and other pathways that occur in the mitochondria.(2). Glucose is the major fuel for red blood cells.(a). Glucose is converted to pyruvate and lactate.(3). Red blood cells carry bases and nucleosides from the liver to other tissues.(4). The major function of red blood cells is to carry O2 from the lungs to the tissues and to aid in the return of CO2 from the tissues to the lungs.i. Adipose tissue(1). The major fuel of adipose tissue is glucose.(2). Insulin stimulates the transport of glucose into adipose cells.(3). The function of adipose tissue is to store triacylglycerol in the fed state and release it (via lipolysis) during fasting.(a). In the fed state, insulin stimulates the synthesis and secretion of lipoprotein lipase (LPL), which degrades the triacylglycerols of chylomicrons and VLDL in the capillaries. Fatty acids from these lipoproteins enter adipose cells and are converted to triacylglycerols and stored. Glucose provides the glycerol moiety. (Glycerol is not used because adipose cells lack glycerol kinase.)(b). During fasting, adipocyte triglyceride lipase and hormone-sensitive lipase (phosphorylated and activated via a cAMP-mediated mechanism) initiate lipolysis in adipose cells.j. Muscle(1). Muscle uses all fuels that are available (glycogen stores, and fatty acids, glucose, ketone bodies, lactate, and amino acids from the blood) to obtain energy for contraction.(2). During fasting, muscle protein is degraded to provide amino acids (particularly alanine) for gluconeogenesis.(3). Creatine phosphate transports high-energy phosphate from the mitochondria to actinomyosin fibers and provides ATP for muscle contraction.(4). Creatinine is produced nonenzymatically from creatine phosphate, and a constant amount (dependent on the body muscle mass) is released into the blood each day and excreted by the kidneys.(5). Muscle glycogen phosphorylase differs from liver phosphorylase but catalyzes the same reaction (glycogen+Pi-glucose-1-phosphate).(6). Insulin stimulates the transport of glucose into muscle cells.k. Heart(1). The heart is a specialized muscle that uses all fuels from the blood.(2). The muscle-brain (MB) isozyme of CK is found in heart muscle. Its release can be used to monitor a heart attackl. Kidney(1). The kidney excretes substances from the body via the urine, including urea (produced by the urea cycle in the liver), uric acid (from purine degradation), creatinine (from creatine phosphate), NH4+ (from glutamine via glutaminase), H2SO4 (produced from the sulfur of cysteine and methionine), and phosphoric acid.(2). Daily creatinine excretion is constant and depends on the body muscle mass. It is used as a measure of kidney function (the creatinine-clearance rate).(3). Glutaminase action increases during acidosis and produces NH3 , which enters the urine and reacts with H+ to form NH4+ . NH4+ buffers the urine and removes acid (H+) from the body.(4). Uric acid excretion is inhibited by lead (Pb) and metabolic acids (ketone bodies and lactic acid). High blood uric acid can result in gout. Gout can be caused either by increased production or by decreased excretion of uric acid. Deficiency of the base salvage enzyme hypoxanthine guanine phosphoribosyl transferase in Lesch-Nyhan syndrome results in increased production of uric acid.(5). Kidney dysfunction can lead to increased BUN, creatinine, and uric acid in the blood and decreased levels of these compounds in the urine.(6). During ketoacidosis, ketone bodies are excreted by the kidney, and during lactic acidosis, lactic acid is excreted.(7). Elevated blood glucose levels (over 180 mg/dL) in DM results in the excretion of glucose in the urine.Muscles, particularly those with a preponderance of white fibers, use their glycogen stores when exercising. Weight training is an anaerobic activity, and the muscles will degrade their own glycogen stores to provide glucose for energy. Blood glucose will not become available until the AMP levels increase significantly in the muscle.When Blood Sugar Increases:When Blood Sugar Decreases:Insulin is released, which leads to the dephosphorylation of:Glucagon is released, which leads to the phosphorylation of:PFK-2 (kinase activity now active)PFK-2 (phosphatase activity now active)Pyruvate kinase (now active)Pyruvate kinase (now inactive)Glycogen synthase (now active)Glycogen synthase (now inactive)Phosphorylase kinase (now inactive)Phosphorylase kinase (now active)Glycogen phosphorylase (now inactive)Glycogen phosphorylase (now active)Pyruvate dehydrogenase (now active)Pyruvate dehydrogenase (now inactive)Acetyl-CoA carboxylase (now active)Acetyl-CoA carboxylase (now inactive)Which leads to activeGlycolysis GlycogenolysisFatty acid synthesisFatty acid oxidationGlycogen synthesisGluconeogenesis Liver Enzymes Regulated by Activation/InhibitionEnzymeActivated byState in Which ActivePhosphofructokinase 1Fructose 2,6-bisP, AMPFedPyruvate carboxylaseAcetyl-CoAFed and fastingAcetyl-CoA carboxylaseCitrateFedCarnitine palmitoyltransferase ILoss of inhibitor (malonyl-CoA)FastingLiver Enzymes Regulated by Phosphorylation/DephosphorylationEnzymeActive formState in Which ActiveGlycogen synthaseDephosphorylatedFedPhosphorylase kinasePhosphorylatedFastingGlycogen phosphorylasePhosphorylatedFastingPhosphofructokinase- 2/fructose 2,6-bisphosphatase (acts as a kinase, increasing fructose2,6-bisP levels)DephosphorylatedFedPhosphofructokinase-2/fructose 2,6-bisphosphatase (acts as aphosphatase, decreasing fructose 2,6-bisP levels)PhosphorylatedFastingPyruvate kinaseDephosphorylatedFedPyruvate dehydrogenaseDephosphorylatedFed | Biochemistry | Carbohydrates | Choose the major fuel that is being used by the chest muscles used during weightlifting.
A. Ketone bodies
B. Blood glucose
C. Fatty acids
D. Glycogen
| Glycogen |
4d1099f5-d131-403d-9284-afc5ff1b62c3 | In response to the unstructured ambiguity and conflicting uses of the term "the unconscious mind", Freud introduced the structured model of ego psychology (id, ego, super-ego) in the essay "Beyond the Pleasure Principle" (1920) and elaborated, refined, and made that model formal in the essay "The Ego and the Id According to Sigmund Freud's psychoanalytic theory of personality, the id is the personality component made up of unconscious psychic energy that works to satisfy basic urges, needs, and desires. The id operates based on the pleasure principle, which demands immediate gratification of needs. Ref Harrison20th edition pg 1378 | Dental | miscellaneous | The term "id" was coined by
A. Weyker
B. Freud
C. Blueler
D. Skinner
| Freud |
49a1c022-831b-4806-9995-cfdf503c0de0 | ref Robbins 9/e p622 Birbeck granules, also known as Birbeck bodies, are rod shaped or "tennis-racket" cytoplasmic organelles with a central linear density and a striated appearance. First described in 1961 (where they were simply termed "characteristic granules"), they are solely found in Langerhans cells. | Anatomy | General anatomy | Birbeck's granules in the cytoplasm are seen in
A. Langerhan's cells
B. Mast cell
C. Myelocytes
D. Thrombocytes
| Langerhan's cells |
0d11be55-52c9-459d-9e3a-537f1c66c977 | ANSWER: (A) Breast self examREF: Park 20th edition page 38, 334Indirect repeat from December 2009"Breast self examination is for early detection of breast cancer and its treatment as early as possible and hence it is a secondary prevention"Cancer education is a primordial prevention which is a type of primary prevention as per parkBefore emergence of risk factorsBefore disease onsetAfter disease onsetOngoingdisabilityDisabilityPrimordialpreventionPrimarypreventionSecondarypreventionTertiarypreventionTertiarypreventionIndividual & mass educationHealth promotion & Specific protectionEarly diagnosis (screening) and treatmentDisabilitylimitationRehabilitation | Social & Preventive Medicine | Concept of Control | Which of the following is not a primary prevention strategy?
A. Breast self exam
B. Control of tobacco
C. Radiation protection
D. Cancer education
| Breast self exam |
5bab108b-e5ca-4410-83b8-59625c8c479e | Beta-blockers provide quick symptomatic relief in thyrotoxicosis that result due to sympathetic overactivity like palpitations, tremors, sweating etc. They have no effect on the synthesis of the hormones in the thyroid gland. They are valuable in providing symptomatic relief while awaiting response to radioactive iodine, carbimazole and before thyroid surgery along with iodides. | Pharmacology | null | Beta blockers:
A. Relieve symptoms of thyrotoxicosis.
B. Should not be used along with carbimazole.
C. Reduce the synthesis of hormones in the gland.
D. Should not be given before thyroid surgery.
| Relieve symptoms of thyrotoxicosis. |
d906501c-43d1-4f22-aae2-acf370494b4e | Influenza Incubation period is the time elapsed between exposure to the pathogenic organism and when symptoms and signs are first apparent. Incubation period of some pathogens are: Varicella (Chickenpox) - usually 14 to 16 days Measles (Rubeola) - usually 10 days from exposure to onset of fever, and 14 days to appearance of rash Rubella (German Measles) - 2 to 3 weeks; usually 18 days Mumps - 2 to 3 weeks; usually 18 days Influenza - 18 to 72 hours Diphtheria - 2 to 6 days Peussis - usually 7 to 14 days, but not more than 3 weeks Meningiococcal Meningitis - usually 3 to 4 days. but may vary from 2 to 10 days Tuberculosis - the time from receipt of infection to the development of a positive tuberculin test ranges from 3 to 6 weeks, and thereafter, the development of disease depends upon the closeness of contact, extent of the disease and sputum positivity of the source case and host parasite relationship. Thus the incubation period of tuberculosis varies from weeks, months or years. Polio - usually 7 to 14 days Hepatitis A - 15 to 45 days (usually 25 to 30 days) Hepatitis B - 45 to 180 days Hepatitis C - 40 to 120 days Cholera - from few hours up to 5 days, but commonly 1- 2 days Typhoid - usually 10 - 14 days, but it may be as sho as 3 days or as long as 3 weeks depending on the dose of bacilli ingested. Amoebiasis - 2 to 4 weeks Ascariasis - about 2 months Filariasis - 8 to 16 months Rabies - highly variable from 4 days to many years but usually 3- 8 weeks Yellow fever - 3 to 6 days (6 days recognized under International Health Regulations) | Social & Preventive Medicine | null | Shoest incubation period is seen in:
A. Hepatitis A
B. Hepatitis B
C. Rubella
D. Influenza
| Influenza |
ae1311df-1403-41d7-9919-26511f53136b | Toxic shock syndrome
TSS is a potentially fatal multisystem disease characterized by sudden high fever, fainting, watery diarrhea, headache and muscle ache.
There are two types of TSS :-
1. Staphylococcal TSS
- Staphylococcal TSS results from the elaboration of toxic shock syndrome toxin type-1 (TSST-1) also known as enterotoxin type F or pyrogenic exotoxin C.
- Enterotoxin B or C may also produce TSS.
2. Streptococcal TSS
- Streptococcal TSS results from the elaboration of pyrogenic exotoxin A. | Microbiology | null | Toxic shock syndrome is caused by -a) Streptococcus pyogenesb) Staphylococcus aureusc) Strept albicansd) E.durans
A. ac
B. ab
C. ad
D. bc
| ab |
fe81823c-ee60-4667-a644-a2037f41af23 | Ans. (a) DVT(Ref: Robbins 9th/pg 127; 8th/pg 126)MC cause of venous embolism is DVTMost arise in the deep leg veins above the level of the knee. Q | Pathology | Hemodynamics | The most common source of embolism:
A. DVT
B. Trauma
C. Infection
D. Surgery
| DVT |
35260f62-9a8f-4150-be40-134ae3d5980f | Immunologically the SLE. is associated with an enomorous array of autoantibodies , Classically include Anti nuclear antibody. Anti-DNA antibody to native DNA in abnormal tier Robbins 9 th edition page no. 125 | Pathology | General pathology | Best marker of SLE?-
A. Anti Sm antibodies
B. Anti-ds DNA antibodies
C. Anti-Histone antibodies
D. Anti-Ro (SS-A) antibodies
| Anti-ds DNA antibodies |
8164abaf-7f79-4921-9bc5-62b187596936 | Answer is B (Chronic bronchitis): Chronic bronchitis does not cause clubbing Some causes of finger clubbing Respiratory Cardiovascular Bronchial carcinoma, especially epidermoid (squamous cell) type (major cause) Cyanotic hea disease Chronic suppurative lung disese Subacute infective endocarditis Bronchiectasis Lung abscess Miscellaneous Empyema Congenital -- no disease Cirrhosis Pulmonary fibrosis (e.g. cryptogenic fibrosing alveolitis) Inflammatory bowel disease Pleural and mediastinal tumours (e.g. mesothelioma) Primary billiary cirrhosis Crvptogenic organizing pneumonia | Medicine | null | One of the following condition is not associated with clubbing :
A. Primary biliary cirrhosis
B. Chronic bronchitis
C. Cryptogenic fibrosing alveolitis
D. Central bronchiectasis
| Chronic bronchitis |
728d48fa-9f18-402c-a8b2-30321c55be8d | Anti-Jo1 antibody is specific for polymyositis and dermatomyositis. | Pathology | null | Which antibodies can be detected in a patient suffering from polymyositis?
A. Anti-SSH
B. Anti-Scl70
C. Anti-Jo1
D. Anti-ds DNA
| Anti-Jo1 |
13931207-9486-4629-8da1-8964c90cc7f6 | Ans. A: Cesium Cobalt-60 and Cesium-137 sources are the most common ones used in radiotherapy. | Radiology | null | Which of the following isotope is commonly used in teletherapy: September 2010
A. Cesium
B. Iridium
C. Technetium
D. Iodine
| Cesium |
21bc15c4-b93f-4cb2-be12-1349fcb36f72 | Alkaline diuresis is useful for poisoning of acidic drugs as acidic drugs ionize in alkaline medium ionized drugs will get eliminated easily eg for acidic drugs- Barbiturates, benzodiazepines, tetracyclines, penicillins, sulphonamides, etc Ref: KD Tripathi pharmacology 7th edition (page.no: 81) | Pharmacology | General pharmacology | Alkaline diuresis is done for treatment of poisoning due to
A. Morphine
B. Amphetamine
C. phenobarbitone
D. Atropine
| phenobarbitone |
e829aa2c-d260-4a59-a2a3-3bf39766a77c | Flocculonodular lobe is phylogenetically the oldest pa of cerebellum has vestibular connections and is concerned with equilibrium and eye movements ie vestibulo ocular reflex.Ref: Ganong&;s review of medical physiology; 23rd edition; pg:257. | Physiology | Nervous system | Vestibulo ocular reflex concerned with
A. Archicerebellum
B. Neocerebellum
C. Floculomodular lobe
D. Occipital lobe
| Floculomodular lobe |
4e0fc7bb-6eea-4d7e-b6d4-5c78f06366f5 | Bacillus anthracis-medusa hair appearance like growth on nutrient agar Ref: Textbook of Microbiology Baveja 5th ed Pg 220 | Microbiology | Bacteriology | Medusahead colonies on nutrient agar point the diagnosis of infection with
A. Bacillus anthracis
B. Bacillus cereus
C. Anthracoid bacilli
D. Clostridium per fringes
| Bacillus anthracis |
9ea54383-3054-4cd2-8864-dad322dc33a0 | Zoster or shingles occurs due to reactivation of latent VZV present in the trigeminal ganglia that occurs mainly in adult life. Rashes are unilateral and segmental, confined to the area of skin supplied by affected nerves Ref: essentials of Medical microbiology apurba sastry 1st edition page 438 | Microbiology | Virology | Which of the following disease is associated with reactivation
A. Pleurodynia
B. Shingles
C. Infectious mononucleosis
D. Viral ahritis
| Shingles |
f1c3e162-a3e8-4422-8d4d-89745adf543a | Ans. is 'd' i.e., Hereditary spherocytosisOsmotic fragility of Red blood cells.Red blood cell osmotic fragility is the resistance of RBC hemolysis to osmotic changes.Normally RBC maintains osmotic equilibrium with the surrounding medium i.e., with serum that has 0.9% NaCI.As the surrounding medium becomes hypotonic fluid will enter into the cell along osmotic gradiant, eventuallyunder very hypotonic conditions the cell will enlarge to capacity and rupture Osmotic lysis.Osmotic fragility is determined by measuring the degree of hemolysis in hypotonic saline. Normal red cell begins to lyse at 0.5% NaC1 and the hemolysis is complete at 0.3 NaCl.Red blood cells osmotic fragility is considered to be increased if hemolysis occur in a NaCI concentration > 0-5%.Osmotic fragility is considered to be decreased if the hemolysis is not complete in a 0-3% of NaCI. | Pathology | null | Increased osmotic fragility seen in
A. Alpha thalasemmia
B. Beta thalassemia
C. Sickle cell anemia
D. Hereditary spherocytosis
| Hereditary spherocytosis |
09d56037-0c2f-4f2f-b082-8bfd5760a7d7 | Ans: b (Immediate surgery)Ref: Bailey & Love, 24th ed, p. 1279 & 23rd ed, p. 1150 | Surgery | Hernia | Treatment of strangulated hernia is:
A. Observation
B. Immediate surgery
C. Manual reduction
D. Analgesics
| Immediate surgery |
b1228939-5554-4a19-954e-557aeb3094ff | Clotting factors 2,7,9,10 are vitamin K dependent factors.
Six of the proteins involved in clotting require conversion of a number of glutamic acid residues to γ-carboxyglutamic acid residues before being released into the circulation, and hence all six are vitamin K-dependent. These proteins are factors II (prothrombin), VII, IX, and X, protein C, and protein S.
Coumarin derivatives such as dicumarol and warfarin are also effective anticoagulants. They inhibit the action of vitamin K, which is a necessary cofactor for the enzyme that catalyzes the conversion of glutamic acid residues to γ-carboxyglutamic acid residues.
Reference: Ganong’s Review of Medical Physiology T W E N T Y - F I F T H E D I T I O N page no 566,567 | Physiology | null | Which of the following factors are deficient in patients under warfarin therapy:
A. 9,10
B. 2,7,9,10
C. 5,7,9,10
D. 3,4,5,7,10
| 2,7,9,10 |
1061596c-e592-4ede-b560-c498a37373fc | Lynching : Form of homicidal hanging. A suspect, an accused or an enemy is overpowered by several persons, acting jointly and illegally, and hung him by means of a rope from a tree or some similar object. It was prevalent in Noh America, where it was practiced by whites on blacks. | Forensic Medicine | Hanging and strangulation | Lynching is:
A. Accidental hanging
B. Homicidal hanging
C. Accidental drowning
D. Homicidal drowning
| Homicidal hanging |
32aa7a99-5f32-44aa-bc68-f919d52fc3e4 | Parasitic cysts such as subconjunctival cysticercus, hydatid cyst, and filarial cyst are not infrequent in developing countries. cyst with hooklets on the optic disc has been repoed who also had sub-cutaneous and cerebral involvement. The differential diagnosis of orbital cysticercosis includes idiopathic myositis, tumours or metastasis, muscle abscess or haematoma, and other parasitic infections like hydatid cyst Conjunctival cysts need a careful surgical excision. The excised cyst should always be subjected to histopathological examination. Ref: Khurana; 4th ed; Pg 86 | Ophthalmology | Conjunctiva | Parasitic subconjunctival cysts are caused by
A. Toxoplasmosis
B. Cysticercosis
C. Leishmaniasis
D. Chagas disease
| Cysticercosis |
f203025b-7c16-47c9-a56b-655934064f0e | Ans. is 'a' i.e., 105 per gram It is 103-106 bacteria per gram. | Microbiology | null | Bacterial countindoudenum-
A. 105 per gram
B. 108 per gram
C. 1010 per gram
D. 1012 per gram
| 105 per gram |
401791b2-5d6b-43d2-9066-abd1c8c82824 | In LBBB, Left ventricular depolarisation is late than RV depolarisation, so A2 appeares late than P2. Causes of Reverse splitting : RV pacemaker WPW syndrome Eisen menkers syndrome AS LVF LBBB Ref : Harrison's 20th edition pg 1448 | Medicine | C.V.S | Reverse splitting of 2nd hea sound heard in -
A. RBBB
B. LBBB
C. Tricuspid stenosis
D. AR
| LBBB |
c82a6438-6d3d-4649-b585-d719559bb19b | Terminology Other names for the disease Etiology First disease Rubeola/ measles Measles virus Second disease Scarlet fever Streptococcus pyogenes Third disease Rubella/German measles/3- day measles Rubella virus Fouh disease Staphylococcal scalded skin syndrome/Ritter's disease Staphylococcus aureus Fifth diseases Erythema infectiosum Parvovirus B19 Sixth disease Exanthem subitum/ Roseola infantum Human Herpes Virus 6 or 7 | Pediatrics | FMGE 2019 | 6th day disease is?
A. Erythema Infectiosum
B. Exanthema subitum
C. Erythema marginatum
D. Erythema nodosum
| Exanthema subitum |
63329b01-dc68-4a5d-83b5-2bf04de06cbb | Mitral stenosis. A normal mitral valve will have an area of >4 cm2, but symptoms are usually only present once the stenosis is moderate-severe. Grading into mild, moderate, or severe disease is based on both the pressure needed to drive blood across the valve (mean pressure gradient) and the valve area. Ref Davidson 23rd edition pg 435 | Medicine | C.V.S | The severity of mitral stenosis is assessed by
A. Character of murmur
B. Splitting of S
C. Loudness of S,
D. S2-OS interval
| S2-OS interval |
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