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87212064-fe05-47a9-a8d9-4a0b6953e830 | Non depolarising neuromuscular blocker is competitive antagonist at nicotinic cholinergic receptor. It doesn’t cause fasciculations . it is reversed by neostigmine. | Anaesthesia | null | Non depolarizing neuromuscular blocker is
A. Non competitive neuromuscular blocker
B. Reversed by neostigmine
C. Persistent stimulator of nicotinic cholinergic receptors
D. Induces fasciculations
| Reversed by neostigmine |
4531a50b-6cbe-48b6-b099-b877e32f7db7 | The release of NO and VIP (Vasoactive intestinal polypeptide) from the cholinergic neurons passing in an anterograde direction relaxes the segment of the intestine ahead of the stimulus. Peristalsis involves the contraction of a segment of intestine behind the bolus of food and relaxation of a segment behind the bolus of food and relaxation of a segment of the intestine in front of the bolus of food. Cholinergic neurons passing in retrograde direction produce substance P and acetylcholine which cause contraction of a segment of intestine. Cholinergic neurons passing in anterograde direction produce NO and VIp which causes relaxation of a segment of the intestine in front of a bolus of food. Ref: Ganong&;s Review of medical physiology 26th edition Pgno: 495 | Physiology | G.I.T | Which of the following is involved in peristalsis by causing relaxation
A. Acetyl choline
B. Substance P
C. Noradrenaline
D. Vasoactive Intestinal Polypeptide
| Vasoactive Intestinal Polypeptide |
2ab53485-16d7-4c3e-beb8-c2d90851bf88 | Ans. is 'c' i.e., Stratum corneum o Stratum basale, stratum spinosum and stratum granulosum, together form the living layer and constitute the site of synthesis of keratin (Keratin is mostly synthesized in stratum spinosum). o Stratum corneum is the dead layer Layers of the epidermis (From deep to superficial) In palm & sole (5 lavers) i) Stratum basale ii) Stratum spinosum iii) Stratum granulosum iv) Stratum lucidum v) Stratum corneum Elsewhere (4 lavers) i) Stratum basale ii) Stratum spinosum iii) Stratum granulosum iv) Stratum corneum | Unknown | null | Dead layer of epidermis -
A. Stratum basale
B. Stratum spinosum
C. Stratum corneum
D. Stratum granulosum
| Stratum corneum |
5aa21e24-83bc-4987-9108-5f3c3d9e2146 | The following are the anti-inflammatory cytokines: IL-10 TGF-b IL-4 IL-13 Pro-inflammatory cytokines IL-1 IL-6 TNF-Alpha Major anti-inflammatory cytokines include interleukin (IL)-1 receptor antagonist, IL-4, IL-6, IL-10, IL-11, and IL-13. Specific cytokine receptors for IL-1, tumor necrosis factor-alpha, and IL-18 also function as proinflammatory cytokine inhibitors ref basic pathology robbins 9th ed page 48 | Pathology | General pathology | Which of the following is anti-inflammatory?
A. IL-1
B. IL-4
C. IL-6
D. TNF-Alpha
| IL-4 |
771b9340-292d-4103-9b46-63b4069eb1a0 | Pulmonary anthrax : Common among workers of the wool factory due to inhalation of spores from infected wool. Hemorrhagic pneumonia with a high fatality rate. Hemorrhagic meningitis may occur as a complication. Reference: Textbook of Microbiology; Anathanarayan and paniker's; 10th edition; Page no: 250 | Microbiology | Bacteriology | Woolsoer&;s disease is
A. Pneumonic form of anthrax
B. Pneumonic plague
C. Hydatid disease of the lung
D. Caused by psittacosis
| Pneumonic form of anthrax |
688a84d9-2cef-4f47-9e51-ecc4439340c2 | Tennis elbow is also known as lateral epicondylitis . It is a condition characterised by pain and tenderness at the lateral epicondyle of the humerus due to non specific inflammation at the origin of the extensor muscles of forearm. Although it is sometimes seen in tennis players, other activities such as squeezing clothes, carrying suitcase etc. are frequently responsible Reference-Essential ohopaedics- Maheshwari-5th edn-pg no 302 | Orthopaedics | Bony dysplasia and soft tissue affection | &;Tennis elbow', is characterized by -
A. Tenderness over the medial epicondyle
B. Tendinitis of common extensor origin
C. Tendinitis of common flexor origin
D. Painful flexion and extension
| Tendinitis of common extensor origin |
1e8e9f94-cdfe-4071-bcdc-1087f2a2deae | Cutaneous anthrax: caused by Bacillus anthracis. The lesion stas as a papule 1-3 days after infection and becomes vesicular, containing fluid which may be clear or bloodstained. The whole area is congested and edematous and several satellite lesions filled with serum or yellow fluid are arranged around a central necrotic lesion which is covered by a black eschar. This is a malignant pustule. Reference: Textbook of Microbiology; Anathanarayan and paniker's; 10th edition; Page no: 249 | Microbiology | Bacteriology | A malignant pustule is seen in infection with
A. Yersinia pestis
B. Bacillus cereus
C. Clostridium welchii
D. Bacillus anthracis
| Bacillus anthracis |
6975b1cd-9f68-42bf-8b82-23612e91ccab | Ans is 'b' i.e. Cl. perfringens Necrotising enteritis (enteritis necroticans or Pigbel) is caused by Cl. perfringens. | Microbiology | null | Gasterointestinal enteritis necroticans is caused by -
A. Clostridium difficale
B. Clostridium perfringens
C. Botulinum
D. C. Jejuni
| Clostridium perfringens |
3ad352b2-0397-4e3d-9160-29dfa78847d3 | Mitral stenosis leads to increased left atrial and hence pulmonary venous pressures. The prominence of pulmonary veins on chest X-rays leads to Upturned Moustache sign or Antler sign. | Medicine | null | Upturned Moustache sign or Antler sign is seen in
A. Mitral regurgitation
B. Aortic stenosis
C. Aortic regurgitation
D. Mitral stenosis
| Mitral stenosis |
ab51efbb-aaf5-42da-8989-7a748642711a | * CXR shows consolidation in lung fields with pneumatocele: seen in Staphylococcal pneumonia | Pediatrics | Respiratory infections | A child with pneumonia shows the following chest X-ray. Which of the following could be the most common underlying causative organism?
A. Mycobacterium tuberculosis
B. Hemophilus influenza
C. Streptococcus pneumoniae
D. Staphylococcus aureus
| Staphylococcus aureus |
a4daaf9f-672c-4aa7-846f-743682090170 | Ref: Katzung's Pharmacology, 14th ed. pg. 846* Dose of Ethambutol: 15-25mg/kg OD dose.* About 20% drug is excreted in feces and 50% in urine in unchanged form.* Ethambutol accumulates in renal failure, and the dose should be reduced by half if creatinine clearance is less than 10mL/min.* Side effect: Most common serious adverse event is retrobulbar neuritis, resulting in loss of visual acuity and red green color blindness (Patient develop BLUE VISION).# It can also cause hyperuricemia and peripheral neuritis.* It is also Contraindicated in children as they are unable to report loss of visual acuity and red-green color discrimination. | Pharmacology | Anti Microbial | Which of the following anti tubercular drug requires dose adjustment in renal failure:
A. Isoniazid
B. Rifampicin
C. Pyrazinamide
D. Ethambutol
| Ethambutol |
43c8fc00-bf84-4d21-910b-af720992b616 | D i.e. Superior vesicle aery Vas (ductus) deferens is 45 cm long muscular tube which conveys sperms from epidytlimis to ejaculatory duct. It receives blood from its own aery (i.e., aery to ductus deferens) which usually arises from superior vesical aeryQ (but may occasionally arise from inferior vesical aery). Aery to ductus deferens anastomose with testicular aery to supply epididymis and testis.- Testicular aery also supplies perirenal fat, ureter, & iliac lymph node (in abdomen), and cremaster (in inguinal canal). The testicular aery represent peisistent lateral splanchnic aoic branches.Testis is mainly supplied by testicular aeryQ (an anterior branch of aoa). It also recieves blood from the cremasteric branch of inferior epigastric aery and from aery to vas (ductus) deferens (branch of superior vesicle aery)Q. That's why ligation of testicular aery high in abdomen usually leave testis unharmed, whereas interruption in the region of spermatic cord may interefere with all vessels & cause infarction.- In treating varicocele, both testicular aery & vein are ligated quite high up, which provides the advantage of ligating venae comitantes of aery. If left open these venae comitantes can lead to recurrence because of their anastomoses with internal spermatic veins | Anatomy | null | Which of the following aeries gives blood supply to the ductus deferens?
A. Cremastric aery
B. Inferior epigastric aery
C. Middle rectal aery
D. Superior vescial aery
| Superior vescial aery |
271febf6-1650-4007-b2ce-323382e7e8f3 | Ketone bodies are weak acids. In diabetic ketoacidosis, the liver produces ketone bodies, which will reduce the brain's dependency on glucose as its sole energy source. This is due to the lack of insulin and the liver switching to starvation mode owing to the constant signaling by glucagon. Hb in the red blood cells and bicarbonate, both in the red blood cells and the plasma, are two of the body's major buffers, and their overproduction would not lead to an acidosis. HCl overproduction within the stomach might lead to duodenal ulcers or gastroesophageal reflux, but not to an overall metabolic acidosis, because the protons do not find their way into the circulation. A loss of chloride, if severe enough, could produce a metabolic alkalosis, but not an acidosis. | Biochemistry | Miscellaneous (Bio-Chemistry) | A person with type 1 diabetes ran out of her prescription insulin and has not been able to inject insulin for the past 3 days. An overproduction of which of the following could cause a metabolic acidosis?
A. Hb
B. Ketone bodies
C. HCl
D. Bicarbonate
| Ketone bodies |
d2891c6c-dbff-4c48-8c9e-550c69c8c6d6 | During this phase, the cell copies its DNA in preparation for mitosis.There are three stages of interphaseG1 (Gap 1), in which the cell grows and functions normally. During this time, a high amount of protein synthesis occurs and the cell growsSynthesis (S), in which the cell duplicates its DNA ( semi-conservative replication).G2 (Gap 2), in which the cell resumes its growth in preparation for division.Ref: DM Vasudevan, 7th edition, page no: 582 | Biochemistry | Metabolism of nucleic acids | New DNA synthesis occurs in
A. Prophase
B. Anaphase
C. Telophase
D. Interphase
| Interphase |
77020625-61bf-45a5-97f8-ac0c94d480a4 | B i.e. Fetal HbAlkali denaturation test (ADT) - done for fetal hemoglobin. HbF is alkali denaturation resistantQ. | Physiology | null | Alkali denaturation test (ADT) test is for:
A. Bence jounes protein
B. Fetabl Hb
C. Albumin
D. Myoglobin
| Fetabl Hb |
b2deb849-34bd-4193-994d-6b92719b6db3 | Answer is.A (Neonatal Alveolar Proteinosis): The child in question is presenting with characteristic features of Neonatal Pulmonary Alveolar Proteinosis (PAP). Familial cases of Neonatal Pulmonary Alveolar Proteinosis have been observed and a genetic basis has been suggested. None of the other options have a familial basis and hence neonatal PAP is the single best answer of choice. TAPVC is unlikely as ECHO is unremarkable and TAPVC does not have a familial basis. Meconium aspiration syndrome is unlikely as it does not have a familial basis and the question provides no other clinical clues to suggest meconium aspiration such as meconium staining Congenital Herpes infection has an entirely different mode of presentation and can he safely excluded. Pulmonary Alveolar Proteinosis (PAP) PAP is a disorder characterized by the intra-alveolar accumulation of pulmonary surfactant proteins Etiology Defect in surfactant proteins (SP) (SP -B & SP -C) Defect in colony stimulating factor receptor (GM -CSF) gene Defect in ATP - binding cassette transpoer Gene (ABCA3 It may present in neonates (Neonatal PAP) and in older infants, children and adults Neonatal (Congenital PAP) This has a fulminant course and is often fatal PAP in older children and Adults (Adult PAP) This has a gradually progressive course (Note that the neonatal and adult forms are distinct entities and have different etiologies and manifestations) Familial cases have been observed and a genetic basis (Autosomal recessive) has been suggested for neonatal congenital PAP. No Gender difference in frequency has been observed. Neonatal PAP presents with severe respiratory distress in the neonatal period. Radiological features resemble those of hyaline membrane disease and may show fine reticulonodular infiltrates radiating from the hilum. It has a fulminant course and leads to death from rapidly developing respiratory failure. | Medicine | null | A male born at term after an uncomplicated pregnancy, labor and delivery develops severe respiratory distress within a few hours of bih. Results of routine culture were negative. The chest roengogram reveals a normal hea shadow and fine reticulonodular infiltrates radiating from the hilum. ECHO findings reveal no abnormality. Family history reveals similar clinical course and death of a male and female sibling at 1 month and 2 months of age respectively. The most likely diagnosis is:
A. Neonatal Alveolar Proteinosis
B. Total Anomalous Pulmonary Venous Circulation (TAPVC)
C. Meconium Aspiration Syndrome
D. Diffuse Herpes simplex infection
| Neonatal Alveolar Proteinosis |
7baa97b4-5625-4528-9779-9fcf99cc8fc5 | In association with insulin, chromium promotes the utilization of glucose Chromium is a component of a protein namely chromodulin which facilitates the binding of insulin to cell receptor sites Chromium It is an essential nutrient for the maintenance of normal glucose tolerance Its deficiency causes insulin resistance. Chromium administration has also been shown in several studies to lower glucose and insulin levels in patients with type 2 diabetes. It has been classified as not essential for mammals. (Cr (III) or Cr3+). Ref: Guyton 12th Ed. | Physiology | All India exam | Which of the following is required for proper effects of Insulin?
A. Selenium
B. Iron
C. Copper
D. Chromium
| Chromium |
68d19891-c502-40b1-8552-d042806c08d9 | In a larger bruise, the colour change stas from periphery (healing of contusion) The contusion regains its normal colour in 1-2 weeks. | Forensic Medicine | Mechanical Injuries | In a larger bruise, the colour changes begins at:
A. The periphery
B. From the centre
C. There is no rule
D. No colour change
| The periphery |
961c61b2-6264-49d6-afdb-f4be12500f67 | Ans. (a) Placenta accretaRef: Williams obstetrics 23rded, Ch 35.* The nitabuch layer is a zone of fibrinoid degeneration in which invading trophoblasts meet the decidua. If the decidua is defective, as in placenta accreta, the Nitabuch layer is usually absent.Also Know* Placenta accreta indicates that villi are attached to the myometrium.* Placenta increta, villi actually invade the myometrium.* Placenta percreta defines villi that penetrate through the myometrium and to or through the serosa. | Gynaecology & Obstetrics | Abortion | Nitabuch's membrane is absent in:
A. Placenta accrete
B. Vasa previa
C. Abruption placenta
D. Placenta previa
| Placenta accrete |
2e3e2bcc-8033-44c2-b06b-c0a664f7c574 | CO2 is used in laproscopy because it is common to the human body and can be absorbed by tissue and removed by the respiratory system. It is also non-flammable, which is impoant because electrosurgical devices are commonly used in laparoscopic procedures. | Surgery | null | Which of the following gas is most commonly used in laproscopy?
A. CO2
B. N2O
C. O2
D. Helium
| CO2 |
6d89c93a-fd2f-4750-88d2-dfe53bc03754 | increased 11+/Ref: Ganong 23/e p627-629] The primary direct stimulus for central chemoreceptors is increased Ir concentration in the CSF and brain interstitial fluid. (But the H+ conc. in the brain parallels the aerial PCO2 and not aerial H+ conc.) There are 2 types of chemoreceptors regulating ventilation: central chemoreceptors (located in brain stem, mainly medulla) and the peripheral chemoreceptors (aoic and carotid bodies). They regulate ventilation by resonding to increased aerial H+ conc., increased PaCO2, and decreased Pa02. Thus the peripheral chemoreceptors are stimulated by hypoxia, hypercapnia, and acidemia to cause hyperventilation; whereas central chemoreceptors are stimulated only by hypercapnia. Why the central chemoreceptors respond to blood PaCO2 and not to blood H+ cone?. Even though the central chemoreceptors are directly stimulated by H+ ions: the blood H+ ions are poorly permeable through the blood brain barrier and hence are not able to regulate ventilation through the central chemoreceptors. Whereas CO2 is highly permeable to the blood brain barrier. It enters the brain, where it is hydrated to give rise to H+ and HCO3- ions. Now these H+ ions directly stimulate the central chemoreceptors to regulate the ventilation. So the central chemoreceptors respond to changes in H+ ions in the cerebrospinal fluid and brain interstial which are brought about by changes in aerial PaCO2. Remember: The link between metabolism and ventilation is CO2 and not 02. | Physiology | null | The primary direct stimulus for excitation of central chemoreceptors regulating ventilation is?
A. >Increased ft
B. >Increased CO2
C. >Increased 02
D. >Decreased CO2
| >Increased ft |
2db1c2e5-b953-4cee-9242-a5a3d02ad2e0 | Complications of Anaesthesia During anaesthesia: > Respiratory depression - Salivation, respiratory secretions > Cardiac arrhythmias > Fall in BP >Aspiration >Laryngospasm and >asphyxia >Awareness > Delirium and convulsion > Fire and explosion | Anaesthesia | Preoperative assessment and monitoring in anaesthesia | Sudden decreasd end tidal CO2 in GA causes
A. Cardiac arrest
B. Pulmonary hypeension
C. Malignant hypehermia
D. Malignant extubation
| Cardiac arrest |
579f48fb-40f3-4ad5-8a24-bfb94bb433b6 | . Ans. is 'c' i.e., Intraorbital Optic nerve Each optic nerve (second cranial nerve) stas from the optic disc and extends up to optic chiasma, where the two nerves meet. It is the backward continuation of the nerve fibre layer of the retina, which consists of the second order neurons i.e., axon originating from the ganglion cells. It also contains the afferent fibres of the papillary light reflex. Morphologically and embryologically, the optic nerve is comparable to a sensory tract. Unlike peripheral nerves it is not covered by neurilemma (so it does not regenerate when cut). The fibres of optic nerve, numbering about a million, are very fine (2-10 m in diameter as compared to 20 mm of sensory nerves). Optic nerve is about 47-50 mm in length and can be divided into 4 pas : ? Intraocular pa (1 mm) : - It begins at optic disc (optic nerve head) and exits the nerve through a hole in sclera that is occupied by a mesh like structure called the lamina cribrosa. The nerve fibres from the retina leave the eye through pores (holes) in lamina cribrosa, a sieve-like structure made up of collagen meshwork. Intraorbital pa (30 mm) : - Extends from back of the eyeball (at lamina cribrosa) to the optic foramina. Intracanalicular pa (6-9 mm) : - It lies within the optic canal and closely related to ophthalmic aery which crosses obliquely over it. Intracranial pa (10 mm) : - It lies above the cavernous sinus and converges with its fellow from contralateral side to form optic chiasma. Like other pas of CNS, the optic nerve is covered by meningeal sheaths (Pia, archnoid and dura mater) as soon as the nerve leaves the eyeball. | Anaesthesia | null | Longest pa of optic nerve ?
A. Intraocular
B. Intracranial
C. Intraorbital
D. Intracranial
| Intraorbital |
9be01bcd-942c-4600-af57-bdb840bc427b | Treatment consists of oxygen administration, adequateanalgesia (including opiates) and physiotherapy. If achest tube is in situ, topical intrapleural local analgesia introduced the tube, can also be used. Ventilation is reservedfor cases developing respiratory failure despite adequate analgesiaand oxygen. Surgery to stabilize the flail segment using internal fixation of the ribs may be useful in a selected group of patients with isolated or severe chest injury and pulmonary contusion.Bailey and love 27e pg: 368 | Surgery | Trauma | A patient is diagnosed with flail chest. Patient is stable, what is the treatment?
A. Analgesia, Oxygen
B. Internal fixation of ribs
C. Positive pressure ventilation
D. Chest strapping
| Analgesia, Oxygen |
ee113f77-5c5c-4ecc-a578-7ef02fb0743d | Metronidazole is the drug which is used to treat antibiotic associated pseudomembranous enterocolitis and is a component of anti H. pylori triple drug regimen. PSEUDO-MEMBRANE COLITIS MC organism responsible Clostridium difficile MC cause 3rd Gen. Cephalosporins > clindamycin DOC Metronidazole - Oral vancomycin According to latest guidelines, now oral vancomycin has become DOC for Pseudomembranous colitis. | Pharmacology | Anti-Parasitic Drugs | Select the drug which is used to treat antibiotic associated pseudomembranous enterocolitis and is a component of anti H. pylori triple drug regimen:
A. Amoxicillin
B. Vancomycin
C. Metronidazole
D. Clotrimazole
| Metronidazole |
cc7bb33b-b3a7-47fc-8685-672e34259347 | Ans. a (PCT). (Ref. Ganong, Physiology, 21st/pg.713; Table 38-6.)PROXIMAL CONVOLUTED TUBULE (PCT) - "Workhorse of the nephron".# Reabsorbs all of the glucose, inorganic phosphate, Cl, lactate and amino acids and most of the bicarbonate, sodium, and water.# Secretes ammonia, which acts as a buffer for secreted H\Transport Proteins Involved in the Movement of Na+ and Cl Across the Apical Membranes of Renal Tubular Cells.SiteApical TransporterFunctionProximal tubuleNa+/ glucose CTNa+ uptake, glucose uptake Na+/ Pi CTNa+ uptake, Pi uptake Na+ amino acid CTNa+ uptake, amino acid uptake Na+/lactate CTNa+ uptake, lactate uptake Na+/H+ exchangerNa+ uptake, H extrusion Cl-/base exchangerCl- uptakeThick ascending limbNa+-K4-2CINa+ uptake, Cl uptake, K+ uptake Na+/H+ exchangerNa+ uptake, H+ extrusion K+ channelsK+ extrusion (recycling)Distal convoluted tubuleNaCI CTNa+ uptake, Cl uptakeCollecting ductNa+ channel (ENaC)Na+ uptake | Physiology | Kidneys and Body Fluids | Glucose is reabsorbed in
A. PCT
B. DCT
C. Loop of Henle
D. Collecting tubules
| PCT |
54251260-04ac-4a0d-9c67-65c3c6a5e774 | Dry drowning: On contact with water, especially cold water, there results in intense laryngospasm, so that water does not enter the lungs.
Death is due to asphyxia because of laryngospasm. | Forensic Medicine | null | Dry drowning is defined as -
A. Drowning in sea water
B. Drowning in cold water, death due to cardiac arrest
C. Drowning in a dehydrated body
D. Drowning where death is due to laryngospasm
| Drowning where death is due to laryngospasm |
516e4cb5-71df-4342-80b1-339e9c79f0f1 | EMLA is eutectic mixture of local anesthetics (2.5% lidocaine and 2.5% prilocaine) | Anaesthesia | Regional anaesthesia | Eutectic mixture of local anaesthetic (EMLA) cream
A. Bupivacaine 2.0% +Prilocaine 2.5%
B. Lidocaine 2.5% + Priocaine 2.5%
C. Lidocaine 2.5% + Prilocaine 5%
D. Bupivacaine 0.5% + Lidocaine 2.5%
| Lidocaine 2.5% + Priocaine 2.5% |
2cc70655-c45e-443f-8bd8-0b9b46c37bc4 | Incidence of preterm in twin pregnancy is 50% Mean gestational age for twins is 37weeks Causes of prematurity: Overdistention of uterus Hydromnios Premature rupture of membranes Ref: Dutta Obs 9e pg 193. | Gynaecology & Obstetrics | General obstetrics | Incidence of preterm delivery in twin pregnancy is
A. 25%
B. 50%
C. 75%
D. 100%
| 50% |
7ef4f72c-5121-481c-9a60-c27d50c6dafb | Ans. is 'a' i.e., Pterygium o Stocker's line is line of iron deposition in the corneal epithelium seen adjacent to the head of the pterygium.Pigmentorv glaucomao It is a type of secondary open angle glaucoma where in clogging up of trabecular meshwork occurs by the pigment particles.o The condition typically occurs in young myopic males.o The characteristic feature is the deposition of pigment granules in the anterior segment structures such as iris, posterior surface of the cornea (Krukenberg's spindle), trabecular meshwork, ciliary zonules and the crystalline lens,o Gonioscopy shows pigment accumulation along the schwalbe's line especially inferiorly (Sampalesi's line),o Iris transillumination shows radial slit-like transillumination defects in the mid periphery (pathognomonicfeature),o Treatment is as for primary open angle glaucoma. | Ophthalmology | Degenerative Conditions | Stocker's line is seen in-
A. Pterygium
B. Glaucoma
C. Posteriorscleritis
D. Diabetic retinopathy
| Pterygium |
5927edc3-37df-4db1-91de-c774689a0cf9 | MUCORMYCOSIS It is fungal infection of nose and paranasal sinuses which may prove rapidly fatal. I It is seen in uncontrolled diabetics or in those taking immunosuppressive drugs. From the nose and sinuses, infection can spread to orbit, cribriform plate, meninges and brain. The rapid destruction associated with the disease is due to affinity of the fungus to invade the aeries and cause endothelial damage and thrombosis. Typical finding is the presence of a black necrotic mass filling the nasal cavity and eroding the septum and hard palate. Special stains help to identify the fungus in tissue sections. Treatment is by amphotericin B and surgical debridement of the affected tissues and control of underlying predisposing cause. Ref : Dhingra 7e pg 178. | ENT | Nose and paranasal sinuses | 1.The 68 year old Chandu is a diabetic and presented with black,foul smelling discharge from the nose.Examination revealed blackish discoloration of the inferior turbinate.The diagnosis is:
A. Mucormycosis
B. Aspergillosis
C. Infarct of inferior turbinate
D. Foreign body
| Mucormycosis |
8ba51ac3-0818-41fe-8df0-27cc11c9168f | Ans. is 'a' i.e., Neuropraxia Seddon's classification of nerve injuries Seddon identified three types of injuries 1. Neuropraxia There is contusion of the peripheral nerve which causes reversible physiological nerve conduction block. The axis cylinder (i.e., axon with its endoneurium) is preserved. Thus, there is physiological conduction block without anatomic disruption. The injury is temporary and recovery is complete. It is seen in crutchpalsy, tourniquet palsy, and saturday night palsy. 2. Axonotemesis There is injury to axon but endoneurium is preserved. Spontaneous recovery is expected in some cases. This is seen in closed fractures and dislocations. 3. Neurotemesis There is complete anatomical section of nerve. No recovery possible. It is seen in open wound. | Surgery | null | Saturday night palsy is which type of nerve injury?
A. Neuropraxia
B. Axonotemesis
C. Neurotemesis
D. Complete section
| Neuropraxia |
d6a052d9-924d-48c0-84cf-27507d1b6b8b | for international use the approved vaccine is 17D vaccine.which is grown in chick embryo cells.but its sensitivity to heat is a major drawback.reconstituted vaccine should be kept on ice.route of administration is subcutaneous in a single dose of 0.5 ml irrespective of age.immunity begins to appear on the 7th day and lasts for around 35 years .contraindicated in pregnancy,children belw 9 months,and people with severe allergies to egg protein. ref:park&;s textbook,ed 22,pg no 258 | Social & Preventive Medicine | Epidemiology | Which vaccine is most effective-
A. Cholera
B. Typhoid
C. Yellow fever
D. Chicken pox
| Yellow fever |
7febb171-0a3f-4f1b-bcb6-1cc167232466 | At the lower end of pharynx, at the level of lower border of cricoid cartilage, esophagus begins. It is narrowest at its beginning due to cricopharyngeal sphincter. Then it runs a curved route rather than being straight. | Anatomy | null | The esophagus -
A. Begins at the upper border of cricoid cartilage
B. Runs a straight course throughout
C. Is narrowest at its termination
D. Is narrowest at its beginning
| Is narrowest at its beginning |
4a77b48e-aaf9-40dd-a0ff-2cca4230d5b9 | Ans. d. Subarachnoid hemorrhage (Ref: Harrison 19/e p1784, 18/e p2262-2263; Sabiston 19/e p1880-1882: Schwartz 9/e p1534-1536: Bailey 25/e p304)Most likely diagnosis in an adult hypertensive male with sudden onset severe headache, vomiting with marked neck rigidity without focal neurological deficit would be subarachnoid hemorrhage.A patient developed sudden severe headache two hours ago and become unconscious. Upon regaining conscious, patient developed photophobia and neck rigidity. Most probable diagnosis in this case is subarachnoid hemorrhage. NCCT head should be done in this case to confirm the diagnosis.Subarachnoid HemorrhageMC cause: Trauma >Spontaneous rupture of Berry aneurysmQClinical Features:Sudden transient loss of consciousnessQ (occurs in nearly half of the patients)Excruciating severe headacheQ: presenting complaint in 45% of case s (worst headache of patients life) more common upon regaining consciousness when loss of consciousness is associatedNeck stiffness and vomitingQ: are common associationsFocal neurological deficit: uncommon.Sudden headache in the absence of focal neurological deficit is the hallmark of aneurysmal rupture. QAssociated prodromal symptoms (suggest location of progressively enlarging unruptured aneurysm):Third cranial nerve palsvQ: Aneurysm at junction of PCA and ICASixth nerve palsyQ: Aneurysm in cavernous sinusOccipital and posterior cervical pain: Inferior cerebellar artery aneurysmPain in or behind the eyeQ: MCA aneurysmDiagnosis:Noncontrast CT scan: Investigation of choice (Lumbar puncture is not indicated prior to an imaging procedure)CSF picture: Hallmark of aneurysmal rupture is blood in CSF (Xanthochromic spinal fluidQ)Lumbar puncture should be performed if the CT scan fails to establish the diagnosis of SAH and no mass lesion or obstructive hydrocephalus is found to establish the presence of subarachnoid bloodQTreatment:Traumatic subarachnoid hemorrhage is managed conservativelyQ.Prognosis assessed by:Hunt and Hess Scale.WFNS (World Federal of Neurological Scale | Medicine | C.N.S. | An adult hypertensive male presented with sudden onset severe headache and vomiting. On examination, there is marked neck rigidity and no focal neurological deficit was found. The symptoms are most likely due to:
A. Intracerebral parenchymal hemorrhage
B. Ischemic stroke
C. Meningitis
D. Subarachnoid hemorrhage
| Subarachnoid hemorrhage |
126670b3-9ffc-4835-816a-b63ad219aa92 | Steroid-dependent patients, frequent relapses, and steroid-resistant patients may be candidates for alternative agents, paicularly if the child suffers severe coicosteroid toxicity (cushingoid appearance, hypeension, cataracts, and/or growth failure). Cyclophosphamide prolongs the duration of remission and reduces the number of relapses in children with frequently relapsing and steroid-dependent nephrotic syndrome. The potential side effects of the drug (neutropenia, disseminated varicella, hemorrhagic cystitis, alopecia, sterility, increased risk of future malignancy) should be carefully reviewed with the family before initiating treatment. The dose of cyclophosphamide is 2-3 mg/kg/24 hr given as a single oral dose, for a total duration of 8-12 wk. Alternate-day prednisone therapy is often continued during the course of cyclophosphamide administration. During cyclophosphamide therapy, the white blood cell count must be monitored weekly and the drug should be withheld if the count falls below 5,000/mm3 | Pediatrics | Nephritic & Nephrotic Syndrome | A 7-year-old child with steroid dependent nephrotic syndrome has developed coicosteroid toxicity and posterior subcapsular cataracts. Which of the following is the best alternative for the treatment of the patient?
A. Levamisole
B. Cyclophosphamide
C. Mycophenolate mofetil
D. Rituximab
| Cyclophosphamide |
0f845486-80ba-4c50-b2e6-f3e1214c8b05 | Ans. (B) 28 weeks of pregnancy(Ref: Williams Obstetrics 24th/e p312)Anti-D immune globulin is given prophylactically to all Rh D-negative, unsensitized women at approximately 28 weeks, and a second dose is given after delivery if the infant is Rh D-positive Following delivery, anti-D immune globulin should be given within 72 hours.If immune globulin is inadvertently not administered following delivery, it should be given as soon as the omission is recognized, because there may be some protection up to 28 days postpartum.Anti-D immune globulin is also administered after pregnancy-related events that could result in fetomaternal hemorrhage. | Pharmacology | Immunomodulatory: DMARDS, Monoclonal Antibodies | Best time to give Rh anti-D prophylaxis is:
A. 12 weeks of pregnancy
B. 28 weeks of pregnancy
C. 36 weeks of pregnancy
D. After delivery
| 28 weeks of pregnancy |
d593e640-3bac-45e5-b759-6e4665d33ad6 | Major Glucose Transpoers and its locations: GLUT 1 Brain, kidney, colon, placenta, erythrocytes GLUT 2 Liver, pancreatic beta cell, small intestine, kidney GLUT 3 Brain, kidney, placenta GLUT 4 Hea and skeletal muscle, adipose tissue GLUT 5 Small intestine Ref: Harper's Illustrated Biochemistry, 29e > Chapter 20. Gluconeogenesis & the Control of Blood Glucose > Blood Glucose Is Derived from the Diet, Gluconeogenesis, & Glycogenolysis > Metabolic & Hormonal Mechanisms Regulate the Concentration of Blood Glucose > Table 20-2. | Physiology | null | Facilitative glucose transpoers (GLUTs) comprise a large family. Which of the following is a glucose transpoer in myocytes?
A. GLUT 1
B. GLUT 2
C. GLUT 3
D. GLUT 4
| GLUT 4 |
1086306c-85ea-4478-9b5e-3eb28a4c0737 | Sawtooth waves are primarily seen in REM sleep Sleep spindles and K-complexes are seen in stage 2 Delta waves are in deep sleep (stage3 and stage 4) | Psychiatry | Sleep Disorders | Sawtooth waves are most characteristic of what sleep stage?
A. Stage 1
B. Stage 2
C. Stages 3 and 4
D. REM sleep
| REM sleep |
5759ad52-9bbd-4c2d-9b69-32ba29083070 | Stupor refers to a higher degree of arousability in which the patient can be transiently awakened only by vigorous stimuli, accompanied by motor behavior that leads to avoidance of uncomfoable or aggravating stimuli. Ref: Harrison's Principles Of Internal Medicine 18th edition chapter 274; Localization of Clinical Syndromes in Neuropsychology and Neuroscience By Joseph M. Tonkonogy, page 266. | Psychiatry | null | In which of the following state, a person is mute and akinetic, but can be awaken and even be ale?
A. Stupor
B. Delirium
C. Twilight state
D. Oneroid state
| Stupor |
77d6f63c-66fa-49b4-9bc0-79f3ac8ee89a | Ans. is 'a' i.e., Femur Stature can be calculated from the length of long bones and used for identification. Femur and tibia give more accurate values compared to humerus and radius Stature is determined in dismembered body (skeletal remains) by : Length from the tip of middle finger to the tip of opposite middle finger when arms are fully extended. Twice the length of one arm + 30 cm (of two clavicles) + 4 cm (for the sternum). Humerus length is 1/5th of height. The length from the veex to the symphysis pubis is half of the total length. The length from the sternal notch to Symphysis pubis x 3.3. The length of forearm measured from tip of middle finger is =5/19 of total length. The height of head measured by the veical distance from the top of the head (veex) to the tip of chin = 1/8 of the total length. The length of veebral column = 34/100 of total length. To the length of entire skeleton, add 2.5 to 4 cm for thickness of the soft pas. As a general rule humerus is 20%, tibia is 22%, femur is 27% and spine is 35% of individual height. | Forensic Medicine | null | Commonly used long bone for identification ?
A. Femur
B. Radius
C. Ulna
D. Humerus
| Femur |
4e87cdb3-15b9-429c-aad7-e8fd7ec25ed0 | Primary cardiac tumors are uncommon; moreover, most also are (founately) benign. The five most common have no malignant potential and account for 80% to 90% of all primary hea tumors. In descending order of frequency, these are myxomas, fibromas, lipomas, papillary fibroelastomas, and rhabdomyomas. Angiosarcomas constitute the most common primary malignant tumor of the hea. Myxomas are the most common primary tumors of the adult hea . Roughly 90% are atrial, with the left atrium accounting for 80% of those. (Robbins Basic pathology,9th edition.pg no.404) | Pathology | Cardiovascular system | The common primary tumor of hea is-
A. Rhabdomyoma
B. Fibroma
C. Myxoma
D. Lipoma
| Myxoma |
ce49fb9d-d9f4-4ce9-be40-d175c581fd18 | Liquefaction or colliquative necrosis also occurs commonly due to ischaemic injury and bacterial or fungal infections but hydrolytic enzymes in tissue degradation have a dominant role in causing semi-fluid material. The common examples are infarct brain and abscess cavity. | Pathology | Cellular Pathology | Colliquative necrosis is seen in?
A. Arthus phenomenon
B. Malignant hypertension
C. Tuberculoma
D. Lung abscess
| Lung abscess |
67e34020-3bf1-4ab8-a263-38d10573ee58 | HBeAg appearance- high levels of virus replication and reflects the presence of circulating intact virions and detectable HBV DNA. Patients with precore mutations cannot synthesize HBeAg In self-limited HBV infections, HBeAg becomes undetectable sholy after peak elevations in aminotransferase activity, before the disappearance of HBsAg, and anti-HBe then becomes detectable, coinciding with a period of relatively lower infectivity. | Medicine | Hepatitis | Which of the following viral markers signifies the ongoing viral replication in the case of Hepatitis-B infection?
A. Anti-HBs
B. Anti-HBc
C. HBe Ag
D. HBs Ag
| HBe Ag |
140070b5-e218-46d8-99df-65819d82453c | Po wine stain treatment is with intense pulsed light and pulse dye laser . PWS may be associated with various syndroms Sturge-Weber syndrome Klippel-Trenaunay syndrome Proteus syndrome: Bailey and love 26th edition pg 599 | Surgery | General surgery | The best cosmetics results for large capillary (po wine) hemangiomas are achieved by
A. Exision and split-thickness skin
B. Laser ablation
C. Cryosurgery
D. Tattooing
| Laser ablation |
0f33e5ef-5ef2-4eeb-822f-7824860275d6 | (A) Diarrheoa # CAUSES OF NON-ANION GAP METABOLIC ACIDOSIS> Gastrointestinal bicarbonate loss: Diarrhea; External pancreatic or small-bowel drainage; Ureterosigmoidostomy, jejunal loop, ileal loop Drugs: Calcium chloride (acidifying agent); Magnesium sulfate (diarrhoea); Cholestyramine (bile acid diarrhea)> Renal acidosis: Hypokalaemia Proximal RTA (type 2) Distal (classic) RTA (type 1)> Hyperkalemia: Generalized distal nephron dysfunction (type 4 RTA) Mineralocorticoid deficiency Mineralocorticoid resistance inc. Na+ delivery to distal nephron Tubulointerstitial disease Ammonium excretion defect> Drug-induced hyperkalemia (with insufficiency):Potassium-sparing diuretics (amiloride, triamterene, spironolactone) Trimethoprim Pentamidine Angiotensin-converting enzyme inhibitors and AT-II receptor blockers Nonsteroidal anti-inflammatory drugs Cyclosporine> Others: Acid loads (ammonium chloride, hyperalimentation) Loss of potential bicarbonate: ketosis with ketone excretion Expansion acidosis (rapid saline administration) Hippurate, Cation exchange resins In lactic acidosis, DKA and salicylate poisoning high anionic gap metabolic acidosis is seen. | Medicine | Miscellaneous | Non Anionic gap acidosis is seen in
A. Diarrhoea
B. Lactic acidosis
C. Salicylate poisoning
D. Diabetic ketoacidosis
| Diarrhoea |
e813d0a9-2c87-4efd-b6a0-c13fdc4c36eb | Over time, the estrogen and progestin contents of COCs have been reduced remarkably to minimize hormone-related adverse effects. Currently, the lowest acceptable dose is limited by their ability to prevent pregnancy and unacceptable breakthrough bleeding. Although daily estrogen content varies from 20 to 50 g of ethinyl estradiol, most contain 35 ug or less. Low-dose COCs usually contains 20 ug ethinyl estradiol. Ref: Leveno K.J., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 32. Contraception. In K.J. Leveno, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e. | Gynaecology & Obstetrics | null | The amount of estrogen in low dose oral contraceptive pills is:
A. 30 micrograms
B. 40 micrograms
C. 50 micrograms
D. 20 micrograms
| 20 micrograms |
d5811b0f-6435-4d4d-9f76-d4143568b0d2 | Ans. is 'b' i.e., Posterior [Ref: Essential of orthopedic surgery 3rd/e p. 1179)* There are three main types of dislocations of the hipi) Posterior dislocationii) Anterior dislocationiii) Central fracture dislocation* Of the three, the posterior dislocation is the most common . | Orthopaedics | Injuries Around Hip | Most common type of hip dislocation is :
A. Anterior
B. Posterior
C. Central
D. Inferior
| Posterior |
0a1900c2-e96a-455b-8173-885be1b0d2a4 | Ans. is 'c' i.e., Topical steroids and salicylic acid * Preferred treatment for localized psoriasis is topical coal tar or short contact, dithroanol.* Alternative is topical steroids + Salicylic acid* Methotrexate is the DOC for Erythrodermic psoriasis. Acitretin is an alternative.Treatment of choice for different types of Psoriasis1. Plaque psoriasis (Psoriasis vulgaris)a) Localized (30%) - Topical coal tar or short contact, dithroanol.Alternative - topical steroids + Salicylic acidb) Extensive (> 30% surface area) - Narrow band UVBc) Focal lesions - Topical steroids2. Guttate psoriasis - Antibiotics + Emollients3. Flexural psoriosis - Topical steroids + antifungal agents.4. Pustular psoriosisa) Localized - Topical steroids + Salicylic acid or topical PUVAb) Generalized - Acitretin (first choice), Methotrexate (second choice). Oral corticosteroids are the DOC in Pregnancy. Cyclosporine is also very effective for pustular psoriasis.5. Erythrodermic psoriasis - Methotrexate, Acitretin6. Psoriatic arthritis - Methotrexate. | Skin | Papulosquamous Disorders | Multiple psoriatic lesions on hands. Treatment of choice is?
A. NBUVB
B. Systemic methotrexate
C. Topical steroids and salicylic acid
D. Systemic steroids
| Topical steroids and salicylic acid |
e5ca1670-8880-49fd-bed4-c1d7b7da1365 | The adult worm lives in the human intestine, usually in the jejunum, where it lies in several folds in the lumen. Commonly only a single worm is present, but rarely several worms may be seen, upto 25 or more in a patient Ref: panickers textbook of Medical parasitology 8th edition ...page :115 | Microbiology | parasitology | Tape worm is found in -
A. Stomach
B. Liver
C. Ileum and jejunum
D. Caecum
| Ileum and jejunum |
a55f9166-1ac7-49aa-8be1-30c840a768b1 | Acute diarrhoea This is extremely common and is usually caused by faecal-oral transmission of bacteria or their toxins, viruses or parasites . Infective diarrhoea is usually sho-lived and patients who present with a history of diarrhoea lasting more than 10 days rarely have an infective cause. A variety of drugs, including antibiotics, cytotoxic drugs, PPIs and NSAIDs, may be responsible. Chronic or relapsing diarrhoea The most common cause is irritable bowel syndrome , which can present with increased frequency of defecation and loose, watery or pellety stools. Diarrhoea rarely occurs at night and is most severe before and after breakfast. At other times, the patient is constipated and there are other characteristic symptoms of irritable bowel syndrome. The stool often contains mucus but never blood, and 24-hour stool volume is less than 200 g. Chronic diarrhoea can be categorised as being caused by disease of the colon or small bowel, or to malabsorption . Clinical presentation, examination of the stool, routine blood tests and imaging reveal a diagnosis in many cases. A series of negative investigations usually implies irritable bowel syndrome but some patients clearly have organic disease and need more extensive investigations. Ref Davidson edition23rd pg 783 | Medicine | G.I.T | Which of the following causes of diarrhoea decreases after prolonged fasting
A. Osmotic diarrhoea
B. Bloody diarrhoea
C. Infective diarrhoea
D. Secretory diarrhoea
| Osmotic diarrhoea |
b38187a5-1157-4595-bf33-3cd7f123659f | Child woman ratio: Is number of 0-4 years aged children expressed per 1000 women in reproductive age group. (15 - 49 years) OTHER IMPOANT PARAMETERS: GFR :- x1000. DR :- / . | Social & Preventive Medicine | Definition & Concepts | In child woman ratio, number of 0-4 years aged children are expressed:
A. Per 1000 women
B. Per 1000 women in reproductive age group (15-49 years)
C. Per 1000 married women in reproductive age group
D. Per 1000 married women in post - reproductive age group
| Per 1000 women in reproductive age group (15-49 years) |
33e4af37-31d9-485c-a715-7619ef4e4cc5 | Methoxyflurane Nephrotoxic Has maximum chloride release. Sevoflurane Sweat smelling - administrable face mask. Induction and emergence form anesthesia are fast Desflurane :Has pungent odour, is less potent ,therefore higher concentration has to be used It can cause Air passage irritation Coughing Breathe holding Laryngospasm Isoflurane - mildly pungent Causes vasodilation while cardiac output is maintained. Good in patients with myocardial insufficiency Dilates coronaries - can cause coronary steal phenomenon in CAD patients | Anaesthesia | FMGE 2018 | Which of the following inhalational agent is the induction agent of choice in children?
A. Methoxyflurane
B. Sevoflurane
C. Desflurane
D. Isoflurane
| Sevoflurane |
52a64ecd-cca5-41a9-b4f5-ef90c4b41e2c | A i.e. Local hormonesPrecapillary sphincters are layer of smooth muscle fibres present just at the point where a metaeriole.There is no innervation on precapillary sphincter.Q- Their dilatation or constriction (to control the blood flow) depends on local hormones.Q , product of metabolism, hydrogen ions etc.Catecholamines causes sphincter constriction.Factors affecting the caliber of aeriole- Decreased local temperature - Autoregulation- Endothelin-1- Platelet serotonin- Thromboxane A2Epinephrin (except in skeletal muscle & liver)- Norepinephrin- AVP- Angiotensin II- Neuropeptide YDilatationIncreased K+, adenosine.- Increased CO2- Decreased 02- Decreased local pH- Decreased local temperature- NO- Prostacyclin- Kinins- Epinephrin in skeletal muscle & liver Q- Substance P Q- Histamine Q- ANP- VIP | Physiology | null | Which of these mediate the precapillary sphincter relaxation:
A. Local hormones
B. Sympathetic stimulations
C. Catcholamines
D. Capillary filling
| Local hormones |
cd118e69-cfbc-4cbf-87a9-8c3a325dbd44 | Systemic inflammatory response syndrome (SIRS) is an inflammatory state affecting the whole body. It is the body's response to an infectious or noninfectious insult. Although the definition of SIRS refers to it as an "inflammatory" response, it actually has pro- and anti-inflammatory components Ref Davidson 23rd edition pg 1337 | Medicine | Miscellaneous | Criteria for diagnosis of SIRS is -
A. Hea rate> 90/min
B. Raised CRP
C. Decreased BP
D. Decreased plasma
| Hea rate> 90/min |
fbd04480-fa63-49f8-bf4a-a5c259336544 | The citric acid cycle is not only a pathway for oxidation of two carbon units, but is also a major pathway for interconversion of metabolites arising from transamination and deamination of amino acids, and providing the substrates for amino acid synthesis by transamination, as well as for gluconeogenesis and fatty acid synthesis. Because it functions in both oxidative and synthetic processes, it is amphibolic. Reference: Harper; 30th edition; Page no: 164 | Biochemistry | Metabolism of carbohydrate | Which of the following is an amphibolic pathway?
A. Glycolysis
B. Citric acid cycle
C. Gluconeogenesis
D. Glycogenolysis
| Citric acid cycle |
04bbd3ee-990c-4a18-a095-953ee2dabef0 | Coliform oarganisms are used as indicators of faecal pollution rather than the water borne pathogens because: Coliform organisms are constantly present in abundance in human intestine. They are easily detected by culture methods as small as one bacteria in 100 ml of water whereas other methods of detecting pathogens are complicated and time consuming. They survive longer than pathogens They have greater resistance to forces of natural purification than the water borne pathogens. Parks textbook of preventive and social medicine.K Park. Edition 23.Pg no: 721 | Social & Preventive Medicine | Environment and health | The following organism because of its easy culture methods is widely used as bacteriology indicator of water pollution-
A. Foecal streptococci
B. Escherichia coli
C. Clostridium perfringes
D. Salmonella Typhi
| Escherichia coli |
9ff5d92c-1eb1-4883-a40a-8fee5145ece6 | CMV infection and Toxoplasmosis are the two most common intrauterine infections with frequent and serious CNS involvement. The group of CMV and Toxoplasmosis is therefore the single best answer of exclusion. Ref: Harrison 17th Edition, Page 1310, 1110; Vope's Neurology of the born 3rd Edition, Page 675, 685, 691 | Pediatrics | null | CNS involvement is most commonly associated with which group of congenital intrauterine infections:
A. CMV and Toxoplasmosis
B. Rubella and Toxoplasmosis
C. Rubella and HSV
D. CMV and Syphillis
| CMV and Toxoplasmosis |
6a593298-be72-41ce-8d30-e5259713e227 | Type of pleural effusion and appearance: Pseudochylothorax and chylothorax- Milky white Urinothorax- Urine Anaerobic empyema-Putrid Chylothorax-Bile stained Aspergillus infection-Black Empyema-Turbid Amebic liver abscess-"Anchovy" brown Esophageal rupture-Food paicles Ref: AJCC AMERICAN JOURNAL OF CRITICAL CARE, March 2011, Volume 20, No. 2 | Medicine | null | Black colored pleural effusion is seen in:
A. Anaerobic empyema
B. Pseudochylothorax
C. Amebic liver abscess
D. Aspergillus infection
| Aspergillus infection |
b6b5ebe0-ab79-4c1f-a62f-2765f1792adc | Ans. is 'a' i.e., Endorphines Endorphins have major action on receptors. Enkephalins have major action on a receptors. Dynorphins have major action on c receptors. | Pharmacology | null | Sibutramine is ?
A. Antithyroid drug
B. Antiobesity drug
C. Antimalarial drug
D. Antitubercoulous drug
| Antithyroid drug |
3177f3fd-871d-4dc5-85e3-034b78cc7fbb | Ans. b. Mullerian agenesis (Ref: Shaw's Gynecology 14/256-257; Novak's Gynecology 14/1036)Mullerian agenesis is the cause of primary amenorrhea, which is characterized by absence of uterus /vagina, also known as Rokitansky-Kuster- Hausen syndrome.Most likely diagnosis in a 16-year old girl who presents with primary amenorrhea, normal sexual development, normal breasts ( Tanner stage 5) but minimal pubic hair ( Tanner stage 1) is androgen insensitivity syndrome."Androgen Insensitivity Syndrome: Because the testes produce normal amounts of mullerian-inhibiting factor (MIF), also known as mullerian-inhibiting substance (MIS) or anti-mullerian hormone/factor (AMH/AMF), affected individuals do not have fallopian tubes, a uterus, or a proximal (upper) vagina. Most cases are identified in the newborn period by the presence of inguinal masses, which later are identified as testes during surgery. Some patients are first seen in the teenage years for evaluation of primary amenorrhea. In addition, adolescent patients have no pubic and axillary hair, with otherwise scanty body hair, and lack acne, although breast is normal as a result of conversion of testosterone to estradiol.Turner's syndrome* All secondary sexual characters are absent.Mullerian agenesis* Patient presents with primary amenorrhea with well-developed secondary sexual characters (breast and pubic hair).Premature ovarian failure* Patient presents with secondary amenorrhea Classification of Sexual Maturity States in GirlsSMR StagePubic HairBreasts1PreadolescentPreadolescent2Sparse, lightly pigmented, straight medial border of labiaBreast and papilla elevated as small mound; diameter of areola increased3Darker, beginning to curl, increased amountBreast and areola enlarged, no contour separation4Coarse, curly, abundant, but less than in adultAreola and papilla form secondary mound5Adult feminine triangle, spread to medial surface of thighsMature, nipple projects, areola part of general breast contourAndrogen insensitivity syndrome (AIS)Androgen insensitivity syndrome formerly known as testicular Feminization, is an X-linked recessive condition resulting in a Failure of normal masculinization of the external genitalia in chromosomally male individuals.This failure of virilisaiion can be either complete androgen insensitivity syndrome (CAIS) or partial androgen insensitivity syndrome (PAIS), depending on the amount of residual receptor function.Complete Androgen Insensitivity SyndromePartial Androgen Insensitivity Syndrome* Karyotype: 46,XY* Female external genitalia with normal labia, clitoris, and vaginal introitus.* Affected individuals have normal testes with normal production of testosterone and normal conversion to dihydrotestosterone (DHT), which differentiates this condition from 5-alpha reductase deficiency.* Because the testes produce normal amounts of mullerian-inhibiting factor (MIF), also known as mullerian-inhibiting substance (MIS) or anti-mullerian hormone/factor (AMU/ AMF). affected individuals do not have fallopian tubes, a uterus, or a proximal (upper) vagina.* Karyotype: 46.XY* Range from mildly virilised female external genitalia (clitorimegaly without other external anomalies) to mildly underviriiized male external genitalia (hypospadias and/or diminished penile size).* Affected individuals have normal testes with normal production of testosterone and normal conversion to dihydrotestosterone (DHT), which differentiates this condition from 5-alpha reductase deficiency.* Because the testes produce normal amounts of mullerian-inhibiting factor (MIF), also known as mullerian-inhibiting substance (MIS) or anti-mulierian hormone/factor (AMH/ AMF), affected individuals do not have fallopian tubes, a uterus, or a proximal (upper) vagina.Characteristic Features:Most cases are identified in the newborn period by the presence of inguinal masses, which later are identified as testes during surgery.Some patients are first seen in the teenage years for evaluation of primary amenorrhea. Many of these patients have a history of surgery for hernias and/or the presence of gonads in the inguinal canals, which were considered ovaries and returned to the abdomen.In addition, adolescent patients have no pubic and axillary hair, with otherwise scanty body hair, and lack acne, although breast is normal as a result of conversion of testosterone to estradiol.Management:Management of AIS is currently limited to symptomatic management: no method is currently available to correct the malfunctioning androgen receptor proteins produced by AR gene mutationsQ.Areas of management include sex assignment, genitoplasty, gonadectomy in relation to tumor risk, hormone replacement therapy, genetic counseling, and psychological counseling.Rokitansky-Kuster-Hauser syndromeMullerian agenesis is the cause of primary amenorrhea, which is characterized by absence of uterus /vagina, also known as Rokitansky-Kuster- Hauser syndromeQRare disorder; Prevalence: 1:4000-5000 female birthsPatients have a 46,XX karyotype and normal secondary sex characteristicsQ.Characteristic Features of Rokitan sky-Kuster-Hauser SyndromeExternal genitalia appear normal, but only a shallow vaginal pouch is presentQ.Ovarian function is normalQ.Absence of both the vagina and uterusQ.Only symmetric uterine remnants (the muscular buds), normal fallopian tubes, and normal ovaries are presentQ. | Gynaecology & Obstetrics | Primary Amenorrhea | A 19 years old patient came to the out patient department with complaints of primary amenorrhea. She had well- developed breast and pubic hair. However there was absence of vagina and uterus but normal ovaries. Likely diagnosis is:
A. XYY
B. Mullerian agenesis
C. Gonadal dysgenesis
D. Klinefelter's syndrome
| Mullerian agenesis |
2abaf64a-2643-4659-b503-caabf820f273 | The patient fulfills the criteria for applying low forceps The criteria for applying low forceps - (1) Leading point of fetal skull at station+ 2 cm and not on the pelvic floor, (2) Rotation is 45o or less. If the fetal head is at station below this or rotation doesn't exceed 45o, then one can apply outlet forceps. A: Unrotated head in transverse position B: 45 degree sho of complete rotation C: fully rotated head (ideal for application of forceps) In modern obstetrics there is no role of midcavity or high forceps, i.e. only station +2 and below are extracted with forceps (low and outlet forceps) | Gynaecology & Obstetrics | Labour - normal, abnormal, malposition, malpresentation and their management | A primigravida is in second stage of labour since 1 hr. On examination the leading point of fetal skull is at +2 station and rotation is 450 sho. This can fuher be managed by
A. Applying outlet forceps
B. Applying low forceps
C. Applying mid forceps
D. Applying high forceps
| Applying low forceps |
e241875a-f925-4c8d-b695-f219af34b54f | Ans. (a) Renal cell cancerRef. Campbell-Walsh Urology, 11th Edition, Pages 1337-38* Renal Cell Cancer invade the IVC and best evaluated by MRI | Surgery | Kidney & Ureturs | Which of the following can invade the IVC?
A. Renal cell carcinoma
B. Breast cancer
C. Bladder cancer
D. Head of pancreas cancer
| Renal cell carcinoma |
a76110c1-556a-4e96-b9d6-15e4adf8563b | Kala-azar or Visceral leishmaniasis (VL) is a disease of low altitude (approximately 500 meters mean sea level). In India, however cases have been repoed from sub-Himalayan region (350-960 meters MSL) of Kumaon region of Uttaranchal. | Microbiology | FMGE 2019 | Kala azar cannot occur at an altitude of;
A. 400 meters
B. 500 meters
C. 600 meters
D. 200 meters
| 600 meters |
76f49ed8-0118-46c5-9b95-620f33c56d87 | Mycobacteria, such as the causative organism of this patient's tuberculosis, are "acid fast" because they have an envelope that contains large amounts of lipids and even true waxes (unlike envelopes of other types of bacteria) that prevents the acid-fast stain (carbol fuchsin) from leaking out. The other characteristics listed in the answers are commonly tested features of specific bacteria: Nutritional requirement for factors V and X is a feature of Haemophilus influenzae. Streptokinase is a feature of Streptococci. Toxic shock syndrome toxin is a feature of Staphylococcus aureus. Ref: Ray C.G., Ryan K.J. (2010). Chapter 27. Mycobacteria. In C.G. Ray, K.J. Ryan (Eds), Sherris Medical Microbiology, 5e. | Microbiology | null | A patient with a cavitary lung lesion coughs up sputum that contains thin, acid-fast positive rods. Which of the following features would most likely be associated with these bacteria?
A. Nutritional requirement for factors V and X
B. Streptokinase
C. Toxic shock syndrome toxin
D. Waxy envelope
| Waxy envelope |
aeea268b-a219-4ad1-a9de-505777a76f8c | Frameshift Mutation:
Due to insertion or deletion of nucleotides that are not a multiple of three results in frameshift mutation.
Reading frame is garbled.
Reference- Harper 30th edition page 417 | Biochemistry | null | Frame shift mutation is caused by:
A. Deletion
B. Point mutation
C. Substitution
D. Transversion
| Deletion |
2d7219b3-81f1-4b7f-88fb-7afbe1a463f5 | Calmodulin is the calcium binding protein in the smooth muscle. It is similar to troponin C of Skeletal muscle.(REF: TEXTBOOK OF MEDICAL PHYSIOLOGY GEETHA N 2 EDITION, PAGE NO - 59) | Physiology | General physiology | Protein-specific for smooth muscle contraction is
A. Troponin
B. Tropomyosin
C. Myosin
D. Calmodulin
| Calmodulin |
9b805aad-ad46-4139-a68b-1c11a996d0a3 | Blount's disease is a progressive bow-leg deformity associated with abnormal growth of posterior-medial pa of proximal tibia. Ithas a triad: Internal Rotation of leg Tibia vara Hyperextension of the knee | Orthopaedics | FMGE 2018 | Blount Disease is involvement of
A. Proximal tibia
B. Distal tibia
C. Proximal femur
D. Distal femur
| Proximal tibia |
4a7a8857-22e9-48ce-b914-f63ac62f774b | Five phases of caries management
Urgent phase - management of pain, swelling, bleeding, infection before initiation of subsequent phases.
Control phase - eliminate active disease, remove conditions preventing maintenance, eliminate cause of the disease and begin preventive alternatives.
Reevaluation phase.
Definitive phase.
Recare and reassessment phase.
Reference- Sturdevant 6th ed pg- 107 | Dental | null | Which treatment goal is not included in the control phase of caries management?
A. Eliminate active disease
B. Eliminate cause of disease
C. Manage symptoms like swelling and pain
D. Remove conditions preventing maintenance
| Manage symptoms like swelling and pain |
e315ec69-6335-4eac-88f9-a402b15458cf | This reflects the lung protection strategy with permissive hypercarbia. There is no need for hyperoxia, and PaO2 >90 mm Hg is a sign to reduce the FiO2 and thus potentially decrease the risk of oxygen toxicity. | Surgery | null | In the suppo of the child with severe ARDS, appropriate goals for pH, oxygenation, and PCO2 include:
A. pH 7.40; PaO2 90 mm Hg; PCO2 40 mm Hg
B. pH 7.50; PaO2 125 mm Hg; PCO2 25 mm Hg
C. pH 7.35; PaO2 100 mm Hg; PCO2 45 mm Hg
D. pH 7.25; PaO2 60 mm Hg; PCO2 60 mm Hg
| pH 7.25; PaO2 60 mm Hg; PCO2 60 mm Hg |
1f0be7c4-3e4d-4d3d-8842-e2d49857aa27 | This patient is having delusional dysmorphophobia. | Psychiatry | null | A patient came with complaints of having a deformed nose and also complained that nobody takes him seriously because of the deformity of his nose. He has visited several cosmetic surgeons but they have sent him back saying that there is nothing wrong with his nose. He is probably suffering from-
A. Hypochondriasis
B. Somatization
C. Delusional disorder
D. OCD
| Delusional disorder |
c566cbf7-1ad4-4944-b624-f0b532439e9d | t(11;14)/CyclinD1-IGH translocation is a feature of Mantle cell lymphoma. The given case has features suggestive of Burkitt lymphoma. In Burkitt lymphoma, involved tissues are effaced by a diffuse infiltrate of intermediate-sized lymphoid cells. Cells have high mitotic index, numerous apoptotic cells are seen The apoptotic remnants are phagocytosed by many tingible body macrophages which have abundant clear cytoplasm, scattered in between tumour cells giving rise to a 'starry-sky' pattern. Sporadic Burkitt lymphoma (non-endemic/non-African) most often appears as a mass involving the ileocecum and peritoneum. The tumour cells are mature B cells that express surface IgM, CD19, CD20, CD10, and BCL6, a phenotype consistent with a germinal center B-cell origin. All forms of Burkitt lymphoma are associated with translocations of the MYC gene on chromosome 8. MYC translocation paner is usually IGH locus , but may also be Ig k or Ig l light chain loci. | Pathology | Non Hodgkin Iymphoma | A 5 yr old boy presented to the ER with vomiting and abdominal distension. Abdominal imaging showed mass in the ileocecal region. Histopathological examination of biopsy from the region showed diffuse infiltrate of lymphoid cells admixed with macrophages giving a 'starry-sky' appearance. Which of the following translocations is unlikely to be seen in this condition?
A. t(2;8)
B. t(8;22)
C. t(8;14)
D. t(11;14)
| t(11;14) |
8f483ac1-1f3e-419f-8d14-7377266cb53f | Questionnaire is to check toxicity after alcohol intake REF;THE SYNOPSIS OF FORENSIC MEDICINE:KS NARAYANA REDDY;28th EDITION; | Forensic Medicine | Poisoning | Questionnaire is to check toxicity after -
A. Alcohol
B. Nicotine
C. Opium
D. Heroine
| Alcohol |
68918b46-2f05-4261-b936-0f1fd7a6c8f3 | A syndrome of colicky pain, passage of blood per rectum and a palpable mass (the intussuscepted segment) is characteristic of intussusception. | Surgery | null | A patient has acute abdominal pain with blood and mucus in stool with palpable mass per abdomen is due to -
A. Meckels diverticulum
B. Volvulus
C. Intussusception
D. Hypertrophic pyloric stenosis
| Intussusception |
0634b351-e651-472d-a03e-1717dd256f00 | Ans. is 'a' i.e., IgG IDOPATHIC THROMBOCYTOPENIC PURPURAo There are two clinical subtypes of primary I.T.P, acute and chronic both are autoimmune disorders in which platelet destruction results from formation of antiplatelet antibodies.Pathogenesiso Chronic I TP is caused by the formation of autoantibodies against platelet membrane glycoproteins most often IIb-IIIa or Ib-IX.o In overwhelming majority of cases the antiplatelet antibodies are of the IgG class.o The mechanism of platelet destruction is similar to that seen in autoimmune hemolytic anemias. Opsonized platelets are rendered susceptible to phagocytosis by the cells of the mononuclear phagocyte system.o The spleen is the major site of the destruction of platelets.Pathologyo The principal morphologic lesions of thrombocytopenic purpura are found in the spleen and bone marrow but they are not diagnostic.o The point to stress is that despite the increased destruction of platelets in spleen, the spleen size remains normalo On histological examination there is congestion of the sinusoids and hyperactivity and enlargement of the splenic follicles manifested by the formation of prominent germinal centres. Sometimes scattered megakaryocytes are found within the sinuses and sinusoidal walls. This represents a very mild.form of extramedullary hematopoiesis.These splenic findings are not sufficiently distinctive to be considered diagnostic.Bone Marrowo Bone marrow reveals a modestly increased number of megakaryocytes.o These findings are not specific for autoimmune thrombocytopenic purpura, but merely reflect accelerated thrombopoiesis, being found in most forms of thrombocytopenia resulting from increased platelet destruction.o The importance of bone marrow examination is to rule out thrombocytopenias resulting from bone marrow failure.o A decrease in the number of megakaryocytes goes against the diagnosis of I.T.P. | Pathology | Autoimmune Diseases | Antibodies in ITP are -
A. IgG
B. IgM
C. IgE
D. IgD
| IgG |
bda19d9d-9fc9-4332-90a7-fe5288be32e5 | "initial care at the accident scene may be critical to survival. The first steps are to establish an airway, maintain oxygenation and immobilize the cervical spine". *Many of the spinal injury patients are multiple trauma victims and therefore require emergency treatment. *The treatment priorities are preserving life(1st), limb, and. function. The spine must be protected as these priorities are addressed sequentially. *The ABCs of trauma are followed in order of priority, with airway ventilation and circulation being secured before fuher evaluation proceeds. ref : maheswari 9th ed | Anatomy | Spinal injuries | On accident there is a damage if cervical spine, first line of management is-
A. X- ray
B. Turn head to side
C. Maintain airway
D. Stabilise the cervical spine
| Maintain airway |
6e356d73-bb9d-422b-8efd-1e1bf5b62d43 | The movement of virus in the axon is passive at a speed of about 3mm per hour. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO-532 | Microbiology | Virology | Speed of rabies virus in axon is?
A. 1 mm per hour
B. 3 mm per hour
C. 5 mm per hour
D. 7 mm per hour
| 3 mm per hour |
390c6227-7f7d-4237-b57c-af97cba2efad | A i.e. At the end of 2nd month of pregnancy Clavicle is the first bone in the body to sta ossifyingQ and is ossified from 3 centres. The shaft of clavicle is ossified from 2 (medical & lateral) primary centres, which appear between the 5th & 6", weeks of intra uterine lifeQ, and fuse about the 45th day meeting between the middle and lateral third of clavicle. A secondary centre for sternal end (and sometimes for acromial end) appears in late teens or early twenties (18-20). | Anatomy | null | The first centres of ossification appears during which month of pregnancy?
A. At the end of 2nd month of pregnancy
B. At the beginning of 3rd month of pregnancy
C. At the end of 3rd month of pregnancy
D. At the end of 4th month of pregnancy
| At the end of 2nd month of pregnancy |
ddecfad4-5757-48b6-9e22-8f9baadabaa6 | Malignant transformation is rare and occurs in the following situations: Congenital melanocytic naevi:6% of lesions undergo malignant change , risk of malignant transformation is greater in giant lesions. Dysplastic naevus syndrome: in melanoma prone families. From illustrated synopsis of dermatology and sexually transmitted diseases neena khanna 5th edition page no 382 | Dental | Skin tumors | Which naevi commonly predispose to malignant melanoma ?
A. Dermal
B. Junctional
C. Congenital
D. Lentigo
| Congenital |
60a09605-4fd0-4d6e-a038-8745fb95f30d | Ans. is 'a1 i.e., Children RETINOBLASTOMAo Retinoblastoma is the most common intraocular tumor in children. The tumor is confined to infancy and very young children (1-2 years). There is no sex predisposition. Retinoblastoma is unilateral in 70-75% of cases and bilateral in 25-30% of cases.Etiologyo Retinoblastoma gene (RB gene) is located on 14 band on the long arm of chromosome 12 (13ql4). RB gene is a tumor supressor gene. Retinoblastoma develops when both the normal alleles of the RB genes are inactived or alteredAi is typical example of Knudson's two hit hypothesis. In Hereditary retinoblastoma first genetic change (first hit) in RB gene is inherited from an affected parent, where as second mutation (second hit) occurs in postnatal life and both alleles are lost. In non- hereditary retinoblastoma, both mutations (first and second hits) occur postnataly.Pathologyo The tumor arises from smalt round cells with large nuclei, i.e., it is a tumor of a group called small round blue cell tumors. Microscopic features of a well differentiated tumor include Flexner- wintersteiner rosettes (specific for retinoblastoma), Homer- wright rosettes, pseudorosettes and fleurettes formation. There are areas of necrosis and calcification.Clinical featureso Retinoblastoma can present with following featuresLeukocoria or amauratic cat's eye reflex this is the most common manifestation. The leukocoria or the white glow' in the pupil is caused by reflection of light from the white intraocular tumor.Strabismus - second most common manifestationSecondary' glaucomaRedeyeExcessive tearsBuphthalmos & proptosisCorneal clouding due to elevated intraocular pressureDiscoloration of iris (due to neovascularization of iris)Orbital cellulitisPainful red eye usually associated with pseudohypopyon and or hyphaemia (picture simulating iridocyclitis),o Spread of retinoblastoma to distant structures occursDirect extension by continuity to the optic nerve and brain is common. Therefore, after enucleation optic nerve is always examined to see invasion of optic nerve, which helps to decide about postoperative chemoradiation.Lymphatic spread to preauricular lymph nodesMetastasis by blood stream to cranial and other bones. | Ophthalmology | Intra Ocular Tumour | Retinoblastoma is seen in -
A. Children
B. Adults
C. Old age
D. At any age
| Children |
79fd1474-3a34-448e-ae06-615c11b0901e | The surface of a wax pattern that is not completely wetted investment results in surface irregularities in the casting that destroy its accuracy.
These irregularities can be minimized by applying a surface-active wetting agent on the wax.
The function of the wetting agent is to reduce the contact angle of a liquid with the wax surface.
Wetting agents also remove any oily film that is left on the wax pattern from the separating medium.
The contact angles are 98 degrees for the plain wax surface and 61 degrees for the treated wax surface.
The lower contact angle indicates that the treated wax surface has an affinity for water, which results in the investment being able to spread more easily over the wax.
Because the surface-active agents are quite soluble, the wax pattern with water after the application defeats the purpose of their use. | Dental | null | The function of wetting agents used in casting procedures is
A. To facilitate wetting of ring liner
B. To facilitate mixing investment
C. To reduce contact angle of a liquid with the wax surface
D. For better wax elimination
| To reduce contact angle of a liquid with the wax surface |
ba6890b7-cfc3-4a57-8c8e-6cd5dc682fc4 | Cephalic Index ( CI ) of various race groups:Type of skullCIRace groupsDolico-cephalic (long-headed)70 - 75Pure Aryans, Aborigines, NegroesMesaticephalic (medium headed)75- 80Europeans and ChineseBrachycephalic (sho-headed)80-85Mongolian | Microbiology | All India exam | Given type of skull is seen in
A. Mongolians
B. Pure Aryans
C. Chinese
D. Europeans
| Pure Aryans |
31b1f6a6-6182-4a05-874c-59b6eb6cc5de | The uterine tubes, or oviducts, or Fallopian tubes are two muscular tubes with considerable mobility, each measuring about 12 cm in length. Each has a funnel-shaped end, the infundibulum, opening into the peritoneal cavity next to the ovary and with a fringe of finger like extensions called fimbriae. The sequence of regions along each tube is as follows: Infundibulum, Ampulla, the longest and expanded area where feilization normally occurs, Isthmus, a more narrow region nearer the uterus, and Uterine or intramural pa, which passes through the wall of the uterus and opens into the interior of this organ. Ref: Mescher A.L. (2010). Chapter 22. The Female Reproductive System. In A.L. Mescher (Ed), Junqueira's Basic Histology: Text & Atlas, 12e. | Gynaecology & Obstetrics | null | Which among the following is the commonest site of feilisation in uterine tubes?
A. Isthmic
B. Ampulla
C. Infundibulum
D. Interstitial
| Ampulla |
73a0fdf2-658c-4c38-8f41-ffdd24a3f41f | Ans. is 'b' i.e., Adrenaline Treatment of anaphylactic shock* First adrenaline should be given im to raise the blood pressure and to dilate the bronchi.* If the treatment is delayed and shock has developed, adrenaline should be given i.v. by slow injection.* The adrenaline should be accompanied by H1 antihistaminic (Chlorphenamine) and hydrocortisone - Antihistaminic slowly antagonizes the effect of histamine on H receptors, and steroids reduce vascular permeability & suppresses further response to the antigen-antibody reaction. | Pharmacology | D.O.C | DOC for anaphylaxis is -
A. Morphine
B. Adrenaline
C. Hydrocortisone
D. Chlorpheniramine
| Adrenaline |
36be970c-b532-4d05-8687-c220ecabf9d1 | Ans:A.)Phenylethanolamine-N-methyltransferaseMethylation of norepinephrine by S-adenosyl-methionine gives epinephrine, reaction being catalysed by phenylethanolamine N-methyltransferase Phenylethanolamine N-methyltransferase (PNMT)It is an enzyme found in the adrenal medulla that conves Norepinephrine (Noradrenaline) to Epinephrine (Adrenaline).PNMT is positively influenced by coisol, which is produced in the adrenal coex.S-adenosyl-L-methionine ('SAM') is a required cofactor. | Biochemistry | null | Norepinephrine to epinephrine conversion requires which enzyme:
A. Phenylethanolamine-N-methyltransferase
B. Transaldolase
C. Tyrosine hydroxylase
D. Alpha ketoglutarate
| Phenylethanolamine-N-methyltransferase |
fa338597-d5a4-49e4-9a98-fd0be102d2c6 | ROS are produced normally in small amounts in all cells during the reduction-oxidation (redox) reactions that occur during mitochondrial respiration and energy generation.
Free radical-mediated cell injury is seen in many circumstances, including chemical and radiation injury, hypoxia, cellular aging, tissue injury caused by inflammatory cells, and ischemia-reperfusion injury. In all these cases, cell death may be by necrosis, apoptosis, or the mixed pattern of necroptosis.
The ROS are generated in the phagosomes and phagolysosomes of leukocytes by a process that is similar to mitochondrial respiration and is called the respiratory burst (or oxidative burst).
In the presence of metals, such as Fe2+, H2O2 is converted to the highly reactive hydroxyl radical by the Fenton reaction.
Robin’s Textbook of pathology 10th ed Page 43-44 | Pathology | null | Which of the following is not responsible for the generation of Reactive Oxygen Species?
A. Reperfusion of ischemic tissues
B. Mitochondrial respiration and energy generation
C. Presence of Fe+++ ions
D. Respiratory burst
| Presence of Fe+++ ions |
77a59eb2-1bff-4497-bca6-2c08785a671c | Megaesophagus and megacolon occur as complications of chronic Chagas disease.
T. cruzi causes Chagas' disease
Chaga's disease
1. Acute form
Occurs in infants and children.
Presents with fever, unilateral face swelling, lymphadenopathy, splenomegaly and chagoma (Localized swelling of the skin).
2. Chronic form
Occurs in adolescent and adults
Presents with cardiac arrhythmias and neurological manifestations.
Complications → megacolon, megaesophagus, cardiomyopathy.
Romana's sign
When entry of the parasite is through the conjunctiva, an edematous swelling of eyelids of one eye develops. | Microbiology | null | Protozoa associated with megaesophagus
A. Trypanosome
B. Amoeba
C. Giardia
D. Gnathostoma
| Trypanosome |
54251cd8-dd2a-49d3-8859-d94866ff4fde | Lymphatic Drainage of Reproductive Tract:
Uterine Corpus –
1. Fundus-Para-aortic lymph nodes
2. Cornu-Superficial inguinal
3. Body-External Iliac L N
Cervix 1. Paramatrial
2. Internal iliac group
3. Obtruator group
4. External iliac group
5. Sacral
All these drain into common iliac and superior lumbar group
Fallopian tube and ovary-Superior lumbar group
Vagina - Upper 2/3-Like cervix
Lower 1/3-Inguinal and external iliac nodes
Vulva- Superficial inguinal
Deep inguinal
External iliac | Unknown | null | The lymphatics of vulva:
A. Do not freely communicate with each other
B. Do not cross the labiocrual fold
C. Transverse the labia from medial to lateral margin
D. Drain directly into the deep femoral glands
| Transverse the labia from medial to lateral margin |
45fd6118-4b7e-43dd-a79b-0e097e37fdb7 | Ans. is d, i.e. Congenital adrenal hyperplasiaRef: Dutta Gynae 4th/ed, p404; Williams Gynae 1st/ed, p409; Novak 14th/ed, p102Most common cause of female Pseudohermaphroditism is Congenital adrenal hyperplasia | Gynaecology & Obstetrics | Sex Intersexuality | Most common cause of female pseudohermaphroditism is:
A. Virilizing ovarian tumor
B. Ovarian dysgenesis
C. Exogenous androgen
D. Congenital adrenal hyperplasia
| Congenital adrenal hyperplasia |
5444e1ad-45a5-4523-bf94-5f07b7a63083 | In front of the arm, the radial nerve supplies brachioradialis, brachialis and extensor carpi radial is longus. Dorsum of the forehand is supplied by the superficial branch of the radial nerve. In cubital fossa, the radial nerve divides into superficial and deep branches. Deep branch supplies extensor carpi radialis brevis and supinator. Reference: BD Chaurasia 7th edition Page no: 180 Figure: BD Chaurasia , 7th edition, - & upper limb& thorax, page no:179. | Anatomy | Upper limb | Not seen in distal radial nerve injury is?
A. Inability to extend fingers
B. Weakness fo extensor carpi radialis brevis
C. Loss of sensations over dorsum of hand
D. Paralysis of Brachiradialis
| Inability to extend fingers |
8d72108e-9f58-4a64-b0ec-37b294e06242 | Answer is B (Homocysteine) There is a strong positive correlation between atherosclerosis and circulating levels of Homocysteine'' Hyperhomocysteinemia has been most consistently linked with atherosclerosis and coronary thrombotic events "Patient with clinical and angiographic evidence of coronary aery disease tend to have higher levels of plasma homocysteine. The relationship has not been extended to cerebrovascular and peripheral vascular disease"- CMDT "A large body of literature suggests a relationship between hyperhomocysteinemia and coronary events. Several mutations in the enzymes involved in homocysteine accumulation correlate to thrombosis and (in some studies) coronary risk" An increase of 5 micromol / L of homocysteine in serum elevates the risk of coronary aery disease by as much as cholesterol increase of 20 mg /dl. Homocysteine interacts with lysyl residues of collagen interfering with collagen cross linking. It forms homocysteine thiolactone, a highly reactive free radical which thiolates LDL paicles. These paicles tend to aggregate, are endocytosed by macrophages and increase the tendency for atherogenesis. Providing adequate quantity of pyridoxine, vitamin B12 and folic acid will keep homocysteine in blood in normal levels. Maternal hyperhomocysteinemia is known to increase the chances of neural tube defects in foetus. So, high doses of folic acid are advised in pregnancy. | Medicine | null | The amino acid which is associated with atherosclerosis is :
A. Lysine
B. Homocysteine
C. Cysteine
D. Alanine
| Homocysteine |
4905d386-8584-4fb1-b53f-ad501b93d4e0 | Ans. is 'a' i.e., Liver GLUCLROMDATIONo This is the most important synthetic reaction carried out by a group of UDP-glucuronosyl transferases (UGTs).o Glucuronidation occurs mainly in the liver, although the enzyme responsible for its catalysis, UDP-glucuronvltransferase, has been found in all major body organs (e.g., intestine, kidneys, brain, adrenal gland, spleen, and thymus).o Compounds with a hydroxyl or carboxylic acid group are easily conjugated with glucuronic acid which is derived from glucose.o Examples are- chloramphenicol, aspirin, paracetamol, lorazepam, morphine, metronidazole,o Not only drugs but endogenous substrates like bilirubin, steroidal hormones and thyroxine utilize this pathway.o Glucuronidation increases the molecular wreight of the drug which favours its excretion in bile,o Drug glucuronides excreted in bile can be hydrolysed bybacteria in the gut-the liberated drug is reabsorbed and undergoes the same fate. This enterohepatic cycling of the drug prolongs its action, e.g. phenolphthalein, oral contraceptives. | Pharmacology | Pharmacokinetics | Glucuronidation takes place in -
A. Liver
B. RBC
C. Pancreas
D. Thyroid
| Liver |
5eec45ae-b235-4b03-8c6f-3364abf3d31f | Drugs used in multiple myeloma include boezomib(proteasome inhibitor) & lenalidomide( a derivative of thalidomide ) as first line treatment .In older patients ,thalidomide combined with melphalan & prednisolone is used. Thalidomide has both anti-angiogenic effects against tumour blood vessels & immunomodulatory effects.Reference :Davidson's principles & practice of medicine 22nd edition pg no 1047. | Medicine | Haematology | Drug not used for multiple myeloma is -
A. Boezonib
B. Lenalidomide
C. Methotrexate
D. Prednisone
| Methotrexate |
9cff4457-d4cf-4ee8-b4a5-384a1fe95e1c | Ecchymosis is a larger superficial hemorrhage in the skin. Following hemorrhage, the initially purple discoloration of the skin turns green and then yellow before resolving. This sequence of events reflects the progressive oxidation of bilirubin released from the hemoglobin of degraded erythrocytes. A "black eye" is a good example of an ecchymosis. Petechiae (choice D) are pinpoint hemorrhages, usually in the skin or conjunctiva. Purpura (choice E) is a diffuse superficial hemorrhage in the skin up to 1 cm in diameter.Diagnosis: Ecchymosis | Pathology | Hemodynamics | A 42-year-old woman undergoes a face lift. Two days later, she presents for follow-up care with confluent bluish hemorrhages in the skin around her eyes ("black eyes"). Which of the following best describes this pattern of superficial skin hemorrhage?
A. Ecchymosis
B. Hematocephalus
C. Maculopapular rash
D. Petechiae
| Ecchymosis |
6c0ffe29-13c3-4912-b679-65e4c6fd723f | Cardio esophageal junction REF: With text "Spontaneous rupture of the esophagus is probably related to the violent pressure excursions which occur at the cardioesophageal junction during emesis" REF: Cole and Zollinger textbook of surgery 9th edition page 719 "Spontaneous rupture almost always occurs on the left side of the distal third of the oesophagus" REF: Mastery of surgery: Volume 1 by Josef E. Fischer, K. I. Bland Page 789 "Spontaneous rupture is the second most common cause of oesophageal perforation. The most common site of spontaneous perforation is the left lateral wall of the distal oesophagus because of relative weakness of wall in this region" REF: The Esophagus byJoel E. Richter, Donald 0. Castell Page 759 Spontaneous rupture of the esophagus is associated with a high moality rate because of the delay in recognition and treatment. Although there usually is a history of resisting vomiting, in a small number of patients, the injury occurs silently, without any antecedent history. When the chest radiogram of a patient with an esophageal perforation shows air or an effusion in the pleural space, the condition is often misdiagnosed as a pneumothorax or pancreatitis. An elevated serum amylase caused by the extrusion of saliva through the perforation may fix the diagnosis of pancreatitis in the mind of an unwary physician. If the chest radiogram is normal, a mistaken diagnosis of myocardial infarction or dissecting aneurysm is often made. REF: Schwaz's Principles of Surgery 9th edition Chapter 25 Esophagus and Diaphragmatic Hernia | Surgery | null | Most common site of spontaneous rupture of esophagus is?
A. Cricopharyngeal junction
B. Cardio esophageal junction
C. Mid esophagus
D. After the crossing of arch of aoa
| Cardio esophageal junction |
66b58816-1dd0-4bb3-9f75-2b47695031bc | Diarrhoea- lose of bicarbonate in stool- causes normal anion gap metabolic acidosis. Deep & rapid respiration- compensatory mechanism | Pediatrics | FMGE 2018 | A child with diarrhea has deep & rapid respiration. Most likely diagnosis is:
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
| Metabolic acidosis |
9613bc75-8f27-4af6-a236-f5dd2b400f80 | Occupational handlers of meat, poultry or fish have a high incidence of hand was where the skin is in prolonged contact with moist animal flesh. HPV-2 is frequently found in butchers' was, but HPV-7 is present in a third to a half of lesions. Ref: Rook's textbook of dermatology, 8th edition, Pg 33.47 | Skin | null | Butchers' was are caused by:
A. HPV 2
B. HPV 6
C. HPV 27
D. HPV 56
| HPV 2 |
331f242a-cd2d-4010-8218-c62e3c33a630 | (A) Hyperkalemia # ST Elevation:> Most important cause of ST segment elevation is acute Ischemia.> Other causes are: Early repolarization Acute pericarditis: ST elevation in all leads except aVR Pulmonary embolism: ST elevation in V1 and aVR Hypothermia: ST elevation in V3-V6, II, III and aVF Hypertrophic cardiomyopathy: V3-V5 (sometimes V6) High potassium (hyperkalemia): V1-V2 (V3) During acute neurologic events: all leads, primarily V1-V6 Acute sympathetic stress: all leads, especially V1-V6 Brugada syndrome Cardiac aneurysm Cardiac contusion Left ventricular hypertrophy Idioventricular rhythm including paced rhythm | Medicine | Miscellaneous | The following ECG with ST elevation on VI V2 is associated with the diagnosis of
A. Hyperkalemia
B. Hypokalemia
C. Hyperthermia
D. Hypercalcemia
| Hyperkalemia |
0f44e0e0-b129-48a9-8b21-72ac84b989ff | Ans. is 'a' i.e., Alcohol o The CAGE questionnaire is a tool used to assess individuals for potential alcohol problems, including dependence. It is useful because it involves 4 simple questions, of which only 2 need to be answered positively for the individual to be indicated as possibly alcohol dependent. Do you ever feel like you should Cut down your drinking? (C) Do you ever feel Angry/Annoyed when people try to talk to you about drinking? (A) Do you ever feel Guilty as a consequence of drinking? (G) Do you ever need an Eye opener-a drink of alcohol in the morning - before you can function? (E) o The SAD-Q (severity of alcohol-dependent questionnaire) is more specific 20 questionnaires designed to measure the severity of alcohol dependence. There are five subscales with four items in each: Physical withdrawal, effective withdrawal, withdrawal relief drinking, alcohol consumption and rapidity of reinstatement Each item is scored on a 4 point scale, ranging from 'almost never ' to 'Nearly always resulting in a corresponding score to 3. Thus the total maximum score possible is 60 and the minimum is 0. | Unknown | null | The CAGE questionnaire is to check toxicity after -
A. Alcohol
B. Nicotine
C. Opium
D. Heroine
| Alcohol |
262cf2e1-2c78-4024-a346-50dc0e4fdb7f | ANTICHOLINESTERASES Anticholinesterases (anti-ChEs) are agents which inhibit ChE, protect ACh from hydrolysis--produce cholinergic effects. ANTICHOLINESTERASE POISONING Anticholinesterases are used as agricultural and household insecticides; accidental as well as suicidal and homicidal poisoning is common. muscarinic manifestations:- They are-- * Irritation of eye, lacrimation, salivation, sweating, copious tracheo-bronchial secretions, miosis, blurring of vision, bronchospasm, breathlessness, colic, involuntary defecation and urination. * Fall in BP, bradycardia or tachycardia, cardiac arrhythmias, vascular collapse. * Muscular fasciculations, weakness, respiratory paralysis (central as well as peripheral). * Irritability, disorientation, unsteadiness, tremor, ataxia, convulsions, coma and death. * Death is generally due to respiratory failure. Ref:- kd tripathi; pg num:-105,110,111 | Pharmacology | Autonomic nervous system | A 10-year-old child becomes ill while visiting relatives farm and complained of severe abdominal cramps with vomiting and diarrhea and profuse lacrimation and salivation.Pupillary constriction is marked. The most likely cause is exposure to
A. Herbicides
B. Insecticides
C. Lead-based paint
D. Rat poison
| Insecticides |
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