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Mitochondria] DNA inheritance is transmitted from: UP 10
Ans. Mother
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Pseudouridine found in
Pseudouridine (abbreted by the Greek letter psi- Ps) is an isomer of the nucleoside uridine in which the uracil is attached a carbon-carbon instead of a nitrogen-carbon glycosidic bond. It is the most prevalent of the over one hundred different modified nucleosides found in RNA. Ps is found in all species and in many classes of RNA. Ref-Harpers illustrated biochemistry 30/e p649
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False about the phenomenon illustrated below is:
Diffuse radiolucent areas with ill-defined borders may be apparent radiographically on the mesial or distal aspects of teeth in the cervical regions between the edge of the enamel cap and the crest of the alveolar ridge (The gap between the CEJ and the alveolar bone crest contains dentin only). This phenomenon, called cervical burnout, is caused by the normal configuration of the affected teeth, which results in decreased X-ray absorption in the areas in question. Close inspection reveals intact edges of the proximal surfaces. The perception of these radiolucent areas results from the contrast with the adjacent, relatively opaque enamel and alveolar bone. Such radiolucencies should be anticipated in almost all teeth and should not be confused with root surface caries, which frequently have a similar appearance.
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Coarctation of aoa is most commonly associated with -
Ans. is 'c' i.e., Bicuspid aoic valve o 98% of coarctation of aoa is Juxta-ductal (at the origin of ductus aeriosus just below the origin of subclan aery). o Bicuspid aoic valve is associated in more than 70% of patients. o It is also associated with : ----> PDA, VSD, ASD, TGA, Hypoplastic left hea o It is the most common CHD seen in Turner syndrome.
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A 45 yrs old male came to the psychiatric OPD complaining of continuous, dull, non-progressive headache for the last 8 years. The patient has seen numerous neurologists in the belief that he has a brain tumor even though all his investigations have been normal. The patient insisted that he had a brain tumor and requested yet another workup. Psychiatric evaluation reveals disease conviction in the background of normal investigations. The most probable diagnosis is
Hypochondriasis:- This disorder is characterized by a preoccupation with the fear of having, or the idea that one has one or more serious physical illnesses. The preoccupation persists despite normal investigation results as well as doctors reassurances. It is impoant to differentiate hypochondriasis from somatization disorder. The emphasis in hypochondriasis is on the diagnosis whereas the emphasis in somatization disorder is on the symptoms. Also, hypochondriasis must be differentiated from delusional disorder (somatic type). In patients with hypochondriasis the belief is not as fixed as it is in delusional disorder. The patient with hypochondriasis may doubt his belief atleast for sho-term, after a normal investigation or medical reassurance. In contrast in delusional disorder, the belief is fixed and totally unshakeable. Ref:- Psychiatry by Sandeep Govil; pg num:-164
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Basic laboratory service is not available at PHC for which disease -
Ans. is 'd' i.e., Leprosy Basic laboratory services at PHCRoutine urine, stool and blood tests.Bleeding time, clotting time.Diagnosis of RTI/STDs with wet mounting, Grama stain, etc.Sputum testing for tuberculosis (if designated as a microscopy center under RNTCP).Blood smear examination for malarial parasite.Rapid tests for pregnancy.RPR test for Svphilis/YAWS surveillance.Rapid diagnostic tests for typhoid (Typhi Dot) and malaria.Raid test kit for faecal contamination of water.Estimation of chlorine level of water using orthotoludine reagent.
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Tourniquet test is used for monitoring patients with?
The tourniquet test is a pa of WHO case definition for dengue. It is a market for capillary fragility Procedure of Tourniquet test 1) Take the BP, example 120/80 2) Inflate cuff to midway between SBP and DBP (120+80/2)=100mm Hg and maintain for 5 minutes. 3) Reduce the cuff pressure and wait for 2 minutes 4) Count the petechiae below antecubital fossa. A positive test is >10 or more petechiae per square inch
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Most common site of salivary gland tumor is?
Ans. is 'a' i.e., Parotid salivary gland * Most common salivary gland tumor - Pleomorphic adenoma (mixed tumor).* Site of Pleomorphic adenoma - Parotid > Submandibular > minor salivary glands
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A pregnant woman with a family history of fragile X syndrome undergoes prenatal testing of her fetus. PCR analysis to amplify the appropriate region of the FMR1 gene is attempted using DNA from amniotic fluid cells, but no amplified products are obtained. Which of the following is the most appropriate next step?
Failure to find amplified product by PCR analysis in such a case could mean that the fetus is not affected, or that there is a full mutation that is too large to be detected by PCR. The next logical step is a Southern blot analysis of genomic DNA from fetal cells. Routine karyotyping of the amniotic fluid cells is much less sensitive than a Southern blot analysis. Karyotyping of the unaffected father cannot provide information about the status of the FMR1 gene in the fetus because amplification of the trinucleotide occurs during oogenesis. For the same reason, PCR analysis of the mother's FMR1 gene is of no value.
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Fracture of the proximal humerus in an elderly patient is best treated by?
Fracture Proximal Humerus MC fracture in osteoporotic postmenopausal women Classification of fracture - Neer classification Complications - Axillary nerve injury, Shoulder stiffness & Malunion, AVN of the humeral head Treatment Undisplaced - Immobilization in a sling (Cuff & Collar or Triangular sling) x 4 weeksDisplaced & Unstable - Closed reduction & internal fixation with percutaneous pinning or nailing(Refer: Watson Jones Textbook of Ohopedics & Trauma, 6thedition, pg no: 536-538)
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Scrambled egg appearance is seen in -
Ans. is 'c' i.e., Pancreatic carcinoma
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Ohobaric oxygen is used in:-
Ans is 'a' i.e., CO Poisoning Ohobaric Oxygen - 100% oxygen at atmospheric pressure. Ohobaric oxygen is used in CO poisoning. It reduces the half life of carboxyhemoglobin complex. About use of hyperbaric oxygen in CO poisoning. - Although hyperbaric oxygen therapy is often recommended for patients with coma, syncope, seizures, and cardiovascular instability, for those who do not respond to ohobaric oxygen therapy, recent data suggest that it is no more effective than ohobaric oxygen therapy -
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Skin manifestations of PCOS are all except
Ans. is c, i.e. Seborrheic dermatitisRef: Jeffcoates 9th/ed, p467Skin manifestations of PCOS are:* Acne* Hirsutism* Alopecia (androgenic alopecia)* Acanthosis nigricans
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Drug used for acute severe asthma is
Magnesium produce broncho dilatationRef:Harrison 17th ed Pg 1605
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Macula densa in kidney is located in relation to ?
B i.e. DCT
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A young male after sudden unconsciousness following an episode of seizure.ori awakening, finds that both of his arms were adducted and internally rotated. The most probable diagnosis i
Ans. b. Posterior dislocation Posterior Dislocation of Shoulder is caused by indirect force producing marked internal rotation and adduction, most commonly during a fit, convulsions or an electric shock Posterior Dislocation of Shoulder Mechanism of injury: Indirect force producing marked internal rotation and adductionQ most commonly during a fit, convulsions or an electric shockQ Clinical Presentation: Diagnosis is frequently misseddeg, patient may have normal contour of shoulder The classical clinical feature is arm is held in medial rotation and is locked in that positiondeg and the examiner cannot externally rotate it. Diagnosis: X-Ray: Due to medial rotation, head looks abnormal (electric bulb sign)deg and it stands away somewhat from glenoid fossa (empty glenoid sign)Q
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Cork screw esophagus is seen in -
Ans. is 'a' i.e., Diffuse esophageal spasm o Radiological appearances of diffuse esophageal spasm have been described as:Curling esophagusCorkscrew esophagus orPseudodiverticulosiso Diffuse esophageal spasm is a motor disorder of esophagus characterized by repetitive simultaneous non-peristal tic contractions.o Symptoms are substernal chest pain and/or dysphagiao Diagnosed by manometry
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Site of IM injection without injuring any vessels or nerves
(B) Upper outer quadrant of buttock
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Highest level of integration in health service is?
The Bhore committee in 1946 gave the concept of primary health center as a basic health unit to provide as close to the people as possible an intergrated curative and preventive health care to the rural population with emphasis on preventive and promotive aspects of health care (refer pgno:904 park 23rd edition)
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All of the following are risks seen in administration of pure oxygen to the hypoxic patients, except:
In some patients with severe lung disease, the hypoxic drive to ventilation becomes very important. These patients have chronic CO2 retention, and the pH of their brain extracellular fluid has returned to near normal in spite of a raised pCO2  (renal compensation). Thus, they have lost most of their increase in the stimulus to ventilation from CO2. Under these conditions, the arterial hypoxemia becomes the chief stimulus to ventilation. If such a patient is given a high O2 mixture to breathe to relieve the hypoxemia, ventilation may become grossly depressed. Pulmonary edema and convulsion are side effects of pure oxygen therapy.
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All are feature of prematurity in neonate except
*Preterm bih, also known as premature bih, is the bih of a baby at fewer than 37 weeks gestational age* These babies are known as preemies or premmies.*Symptoms of preterm labor include uterine contractions which occur more often than every ten minutes or the leaking of fluid from the vagina.*Premature infants are at greater risk for cerebral palsy, delays in development, hearing problems, and sight problems. These risks are greater the earlier a baby is born.*The cause of preterm bih is often not known.*Risk factors include diabetes, high blood pressure, being pregnant with more than one baby, being either obese or underweight, a number of vaginal infections, tobacco smoking, and psychological stress, among others.*It is recommended that labor not be medically induced before 39 weeks unless required for other medical reasons. The same recommendation applies to cesarean section.* Medical reasons for early delivery include preeclampsia.often babies have empty scrotum , thick lanugo , no creases . Reference: GHAI Essential pediatrics, 8th edition
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A 45-year-old construction worker suffers a penetrating wound of the left leg, which is cleaned and sutured. Three days later, the patient presents with sudden onset of severe pain at the site of injury. Physical examination shows darkening of the surrounding skin, hemorrhage, and cutaneous necrosis. The wound shows a thick serosanguinous discharge with gas bubbles and a fragrant odor. Which of the following is the most likely etiology of this patient's wound infection?
Gas gangrene (clostridial myonecrosis) is a necrotizing, gas-forming infection that begins in contaminated wounds and spreads rapidly to adjacent tissues. The disease can be fatal within hours of onset. Gas gangrene follows the deposition of C. perfringens into tissues under anaerobic conditions. Such conditions occur in areas of extensive necrosis (e.g., severe trauma, war-time injuries, and septic abortions). Clostridial myonecrosis is rare when the wound is subjected to prompt and thorough debridement of dead tissue. Damage to previously healthy muscle is mediated by a myotoxin. C. botulinum (choice A) secretes a preformed neurotoxin.Diagnosis: Gas gangrene, clostridial myonecrosis
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Which of the following parameters is not monitored in a patient on methotrexate therapy:
Methotrexate is an antimetabolite chemotherapeutic agent that binds to the enzyme dihydrofolate reductase, which is involved in the synthesis of purine nucleotides. This interferes with deoxyribonucleic acid (DNA) synthesis and disrupts cell multiplication. Methotrexate has long been known to be effective in the treatment of leukemias, lymphomas, and carcinomas of the head, neck, breast, ovary, and bladder. It has also been used as an immunosuppressive agent in the prevention of graft versus host disease and in the treatment of severe psoriasis and rheumatoid ahritis. The effectiveness of methotrexate on trophoblastic tissue has been well established and is derived from experience gained in using this agent in the treatment of hydatiform moles and choriocarcinomas. As used in the treatment of ectopic pregnancy, methotrexate is administered in a single or in multiple intramuscular (IM) injections. Treatment with methotrexate is an especially attractive option when the pregnancy is located on the cervix or ovary or in the interstitial or the cornual poion of the tube. Surgical treatment in these cases is often associated with increased risk of hemorrhage, often resulting in hysterectomy or oophorectomy. Indications Medical therapy for ectopic pregnancy involving methotrexate may be indicated in ceain patients. To determine acceptable candidates for methotrexate therapy, first establish the diagnosis by one of the following criteria: Abnormal doubling rate of the beta-human chorionic gonadotropin (b-HCG) level and ultrasonographic identification of a gestational sac outside of the uterus Abnormal doubling rate of the b-HCG level, an empty uterus, and menstrual aspiration with no chorionic villi A number of other factors must also be considered once the diagnosis is established, as follows: The patient must be hemodynamically stable, with no signs or symptoms of active bleeding or hemoperitoneum (must be met by every patient) The patient must be reliable, compliant, and able to return for follow-up care (must be met by every patient) The size of the gestation should not exceed 4cm at its greatest dimension (or exceed 3.5 cm with cardiac activity) on ultrasonographic measurement - Exceeding this size is a relative, but not absolute, contraindication to medical therapy Absence of fetal cardiac activity on ultrasonographic findings - The presence of fetal cardiac activity is a relative contraindication No evidence of tubal rupture - Evidence of tubal rupture is an absolute contraindication b-HCG level less than 5000 mIU/mL - Higher levels are a relative contraindication Methotrexate Treatment Protocols A number of accepted protocols with injected methotrexate exist for the treatment of ectopic pregnancy. Multiple-dose regimen Initial experience used multiple doses of methotrexate with leucovorin to minimize adverse effects. Leucovorin is folinic acid that is the end product of the reaction catalyzed by dihydrofolate reductase, the same enzyme inhibited by methotrexate. Normal dividing cells preferentially absorb leucovorin; hence, it decreases the action of methotrexate, thereby decreasing methotrexate's adverse systemic effects. This regimen involves administration of methotrexate as 1 mg/kg IM on days 0, 2, 4, and 6, followed by 4 doses of leucovorin as 0.1 mg/kg on days 1, 3, 5, and 7. Because of a higher incidence of adverse effects and the increased need for patient motivation and compliance, the multiple dosage regimen has fallen out of or in the United States. Single-dose regimen The more popular regimen today is the single-dose injection, which involves injection of methotrexate as 50 mg/m2 IM in a single injection or as a divided dose injected into each buttock. Studies comparing the multiple methotrexate dosage regimen with the single dosage regimen have demonstrated that the 2 methods have similar efficacy. With smaller dosing and fewer injections, fewer adverse effects are anticipated, and the use of leucovorin can be abandoned. The protocol for single-dose methotrexate is detailed below. Using this protocol, Stovall et al achieved a 96% success rate with a single injection of methotrexate. Day 0 Obtain b-HCG level, ultrasonography, and +/- dilatation and curettage. Day 1 Obtain levels of the following: b-HCG Liver function - Eg, aspaate aminotransferase (AST or serum glutamic-oxaloacetic transaminase ), alanine aminotransferase (ALT or serum glutamic-pyruvic transaminase ) Blood urea nitrogen (BUN) Creatinine Evidence of hepatic or renal compromise is a contraindication to methotrexate therapy. Blood type, Rh status, and antibody screening are also performed, and all Rh-negative patients are given Rh immunoglobulin REFERENCE: emedicine.medscape.com
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A 1-year-old infant has biphasic stridor, barking cough and difficulty in breathing since 3-4 days. He has high-grade fever and leukocyte count is increased. Which of the following would not be a true statement regarding the clinical condition of the child?
CROUP (laryngotracheitis and laryngotracheobronchitis) Management Once the diagnosis of croup is made, mist therapy, coicosteroids and epinephrine are the usual treatments. Since croup is chiefly viral in etiology, antibiotics play no role. Mist therapy (warm or cool) is thought to reduce the severity of croup by moistening the mucosa and reducing the viscosity of exudates, making coughing more productive. For patients with mild symptoms, mist therapy may be all that is required and can be provided at home. For more severe cases, fuher intervention may be required like oxygen inhalation by mask, racemic epinephrine given by nebulizer, coicosteroids and intubation or tracheostomy.
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Which is the most common site for duodenal ulcer
About 95 percentage of duodenal ulcers occur within 2 centimetres of the pylorus
158,924
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The emeiocytosis or reverse pinocytosis requires which ion
C i.e. Ca++
158,925
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True regarding fibromuscular dysplasia are all except
OCPS predispose Fibromuscular dysplasia affects mainly medium and large aeries. Sometimes alteration of the normal normal structure of the aerial wall gives rise to true aneurysms. There is also associated irregular hyperplasia. Muir's Textbook of pathology Edited by JR Anderson, 12 th edition, page no 14.36 Answer is option 2
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Which is the longest chromosome?
Chromosome 1 is the longest chromosome. In a karyotype, chromosomes- arranged according to their length and banding features. Chromosomes 1 to 22 are arranged according to their length, in the descending order. Chromosome X is longer than the Y Chromosome.
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Oculomotor nerve leaves cranium through:
Ans a) superior orbital fissureStructure passing through Superior orbital fissureMedialMiddleLateralInferior ophthalmic veinSympathetic nerves around internal carotid arteryNasociliary nerveOtulomotur nerveAbducent nerveSuperior ophthalmic veinlacrimal nerveFrontal nerveTrochlear nerveMnemonic- Inferior sympathyMnemonic- NOAMnemonic Superior LPTInferior orbital fissure* Zygomatic br of maxillary nerve* Infraorbital nerve and vessels* Rami of Pterygoid ganglion* Communicating vein b/w inferior ophthalmic & pterygoid plexus of veinsOptic canal* Optic nerve* Ophthalmic arteryInfraorbital canal- Infra orbital nerve & vessels
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A 33 year old male presented with homonymous hemianopia. He also has ataxia and personality changes. Characteristic inclusions are seen in oligodendrocytes. What is the MOST probable diagnosis in this patient?
Progressive multifocal leukoencephalopathy(PML) is characterized pathologically by multifocal areas of demyelination of varying size distributed throughout the brain but sparing the spinal cord and optic nerves. Characteristic microscopic feature: 1. Oligodendrocytes have enlarged, densely staining nuclei that contain viral inclusions formed by crystalline arrays of JC virus (JCV) paicles. 2. Astrocytes are enlarged and contain hyperchromatic, deformed, and bizarre nuclei and frequent mitotic figures. Clinical presentation: Visual deficits (45%), typically a homonymous hemianopia Mental impairment (38%) (dementia, confusion, personality change) Weakness, including hemi- or monoparesis Ataxia Ref: Roos K.L., Tyler K.L. (2012). Chapter 381. Meningitis, Encephalitis, Brain Abscess, and Empyema. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.
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Pilocarpine is drug of choice in -
Ans. is 'b' i.e., Acute angle-closure glaucoma Important factsAngle-closure glaucomao Treatment of choice for acute congestive glaucoma - Laser iridotomy( 1st choice), Peripheral iridescence (2nd choice)o Drug of choice for acute congestive glaucoma - Pilocarpineo Initially, IOP is controlled (the first drug used) - Systemic mannitol or acetazolamideOpen-angle glaucomao Treatment of choice Topical antiglaucoma drugso Drug of choice b- blocker (Timolol, betaxolol, levobunolol)o Surgery of choice Argon or diode laser trabeculoplasty
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Anaesthesia breathing circuit recommended for spontaneous breathing is
TypeA or Magills circuit is used in Spontaneous ventilation. Type D is used in controlled ventilation. TypeB and Type C are obselete nowadays
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Pancreatic juice becomes thick if it has impaired
As the volume of pancreatic secretion increases, its Cl- concentration falls and its HCO3- concentration increases.The magnitude of the exchange is inversely propoionate to the rate of flow.In cystic fibrosis where this exchange mechanism is lost, pancreatic secretions become dehydrated and thickenedREF: GANONG&;S REVIEW OF MEDICAL PHYSIOLOGY, TWENTY-THIRD EDITION, PAGE NO:435,436
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All of the following are acceptable criteria for water quality except -
The dissolved oxygen content of water is influenced by the raw water temperature,composition,treatment and any chemical or biological processes taking place in the distribution system.No health based guideline value has been recommended (refer pgno:720 park 23rd edition)
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Name of the procedure
This is V-to-Y advancement. Commonly used for fingeips and extremities.Ref: Bailey and love, 27e, page: 641
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Taurine seen in bile acid metabolism is synthesized from which amino acid ?
Ans. is 'b' i.e., Cysteine Taurine is synthesized from cysteine. Synthesis of other impoant amino acid is as follows :? Glutamate is synthesized from a-ketoglutarate by enzyme glutamate dehydrogenase. Glutamine is synthesized from glutamate by enzyme glutamine synthase. Alanine is synthesized from pyruvate by transamination. Aspaate is synthesized from oxaloacetate by transamination. Asparagine is synthesized from aspaate by enzyme asparagine synthase. Serine is synthesized from 3-phosphoglycerate (a glycolytic intermediate). It can also be synthesized from glycine as conversion of serine to glycine is reversible. Glycine is synthesized from (i) glyoxylate and glutamate or alanine; (ii) choline; and (iii) serine Proline is synthesized from glutamate Cysteine is synthesized from methionine and serine Tyrosine is synthesized from phenylalanine.
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Color of diphtheretic membrane is -
Ans. is 'a' i.e., Grey
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why do GLYCOPYROLATE is used as pre-anesthetic medication ?
* Actions of glycopyrrolate are similar to atropine except for some differences,as given below.. * CNS-minimal CNS effects. * CVS-increased hea rate is to a lesser extent and for shoer duration than atropine,hence ,lodynamic sLao.ay when used as premedication. * Similar actions on RS,GIT,GUT and other smooth muscles and glands as atropine. * 2 times more potent rntisialogoguE than atropine. ref : kd tripathi 8th ed
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The pregnant female dies while doing illegal abortion. The doctor can be punished under
Refer the byte "Legal sections".
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Rodent ulcer is ?
Ans. is 'c' i.e., Basal cell carcinoma Advanced basal cell carcinoma may ulcerate and extensive local invasion of bone or facial sinus may occur after many years of neglected or in unusually aggressive tumors, explaining the archaic designation rodent ulcer.
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Select the drug which is used exclusively in organ transplantation and autoimmune diseases, but not in cancers:
CALCINEURIN INHIBITORS (Specific T-cell inhibitors) Cyclosporine Mech of action:- It inhibits T lymphocyte proliferation, IL-2 and other cytokine production as well as response of inducer T cells to IL-1. Cyclosporin binds with protein cyclophiin-A and inactivate calcineurin and the transcription of genes involved in synthesis of IL2 and T Cell activation. Cyclosporine is most active when administered before antigen exposure uses:- 1) Cyclosporin selectively suppresses cell- mediated immunity (CMI), prevents graft rejection reaction. It is routinely used in renal, hepatic, cardiac, bone marrow and other transplantations. For induction it is staed orally 12 hours before the transplant and continued for as long as needed. 2) it is a second line drug in autoimmune diseases, like severe rheumatoid ahritis, uveitis, bronchial asthma, inflammatory bowel disease, dermatomyositis, etc. and in psoriasis, especially to suppress acute exacerbations. Ref:- kd tripathi; pg num:-878,880,881
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Injury to cervical nerve C5, C6 causes:
Ans. (a) Erb's paralysisRef: Apley's orthopedics 9th ed./ 279-80Erb's paralysis- Erb's palsy or Erb-Duchenne palsy is a paralysis of the arm caused by injury to the upper group of the arm's main nerves, specifically the severing of the upper trunk C5-C6 nerves.Position of hand in Erb's paralysis: Adducted, Internally rotated, and pronatedKlumpke's paralysisKlumpke's Palsy involves the eighth cervical vertebra and the first thoracic vertebra (C8 and Tl).Position of hand: Elbow flexed, arm supinatedThere may be unilateral homer syndromeHorner syndromeSeen with Pancoast tumor and presents with Ptosis, Miosis, enopthalmos, anhydrosis, loss of ciliospinal reflex.Central cord syndromeSeen most often after a hyperextension injury in an individual with long-standing cervical spondylosis. It presents with features of cortico-spinal pathway.
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'Doughnut' sign and 'Coiled spring' appearance are seen in
(A) Intusussception # Ultrasound Axial images of intussusception showed a doughnut pattern.> Hypoechoic external ring was formed by the everted returning limb of intussusceptum and, to a lesser degree, by the intussuscipiens.> Doughnut's center varied according to the scan level.> Scans obtained at the middle or at the base of the intussusception showed a characteristic hyperechoic crescent in all cases.> This crescent was formed by the mesentery enclosing the entering limb of the intussusceptum, which the authors have termed the Crescent-in-doughnut sign'.> On scans obtained at the apex of the intussusception, the center was hypoechoic owing to the entering limb of the intussusceptum and the absence of the mesentery.> Crescent-in-doughnut sign appears to be a characteristic feature of intussusception.> Contrast enema remains the gold standard, demonstrating the intussusception as an occluding mass prolapsing into the lurren, giving the "coiled spring" appearance (barium in the lumen of the intussusceptum and in the intraluminal space).> Main contraindication for an enema is a perforation.
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Profuse watery diarrhea in an immuno compromised child is due to -
Ans. is 'c' i.e., Giardia Diarrhea in immunocompromised child (AIDS) include bacterial (salmonella, compylobacter) ,protozoal (giardiasis, cryptosporidium), and viral (CMV, HSV) causes.
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Latest retinoid drug used in acne is: March 2005
Ans. C: Adapalane Adapalene is an aromatic naphthoic acid derivative. Adapalene is stable in the presence of light and resistant to oxidation by benzoyl peroxide. Additionally, it differs from tretinoin/ retinoic acid in its affinity for various retinoic acid receptors. Moreover, adapalene is a very effective antiacne agent and shows low irritation potential, no sensitization, and no phototoxicity. Adapalene was approved for the topical treatment of acne in 1996
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Metabolic changes associated with excessive vomiting includes the following
Vomiting causes loss of gastric secretions which include HCl & K+ ions, resulting in metabolic alkalosis, hypokalemia and hypochloremia. However note that the moderate to severe hypokalemia seen with excessive vomiting is not merely explained by loss of K+ ions in vomiting. "In fact the hypokalemia is primarily due to increased renal K+ excretion. Loss of gastric contents results in volume depletion and metabolic alkalosis, both of which promote Kaliuresis.
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Gastric lavage in contraindicated in which of the following poisonings?
Ans. A. Hydrocarbon poisoningGastric lavage involves the passage of a oro gastric tube with sequential administration and aspiration of small volumes of normal saline with the intent of removing toxic substances present in the stomach. Contraindications to gastric lavage include ingestion of hydrocarbons because of high aspiration potential, ingestion of corrosive substances, and risk of hemorrhage or GI perforation resulting from pathology or recent surgery. As with induction of emesis, the effectiveness of this procedure is dependent on the time of ingestion and is likely to be most effective within the first 1 to 2 hours post intoxication
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Which of the following enzyme deficiency is the most common cause of pseudohermaphroditism in a female child?
Most common cause of female pseudohermaphroditism is congenital adrenal hyperplasia mostly caused by deficiency of the enzyme 21 hydroxylase. Due to this enzyme deficiency, there is deficient production of adrenal coisol and aldosterone and overproduction of adrenal androgens.
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All the following in the Light's criteria are suggestive of exudative pleural effusion except -
Ans. is 'b' i.e.. Pleural fluid ADA <16 Diagnostic criteriao The Light's Criteria Rule is a traditional method of differentiating transudates and exudates that measures serum and pleural fluid protein and LDH.According to the traditional Light's Criteria Rule, if at least one of the following three criteria lie, component tests of the rule) is fulfilled, the fluid is defined as an exudate.o Pleural fluid protein/serum protein ratio greater than 0.5. oro Pleural fluid LDH/serum LDH ratio greater than 0.6 oro Pleural fluid LDH greater than two-thirds the upper limits of the laboratory's normal serum LDH.
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Most common inherited cause of Aplastic anemia
M/C acquired cause - Idiopataic. M/C inherited - Fanconi anemia.
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Most potent stimulator of naive Tcells?
Ans. is 'a' i.e., Mature dendritic cells . Mature B cells and T-cells before antigenic exposure are called naive B and T cells respectively. Sequence of events in activation of naive T cells : . Immature dendritic cells in the epidermis are called langerhans cells. . These immature dendritic cells ( langerhans cells) capture the antigen in the epidermis. . After capturing the antigen, these cells secrete cytokines. . These cytokines cause loss of adhesiveness of langerhans cells. . Langerhans cells separate from each other and migrate to lymphatic vessels. . In lymphatic vessel, maturation of langerhans cells takes place. . Then these mature langerhan dendritic cells reach to naive T cells in the lymph nodes and present antigen to these cells and activate them.
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Which of the following is the national level system that provides annual national and state level reliable estimates of feility?
General Feility Rate (GFR):It is the "number of live bihs per 1000 women in the reproductive age-group (15-44 or 49 years) in a given year".GFR = in the same area in same year] x 1000General feility rate is a better measure of feility than the crude bih rate because the denominator is restricted to the number of women in the child-bearing age, rather than the whole population. The major weakness of this rate is that not all women in the denominator are exposed to the risk of childbih. Ref: Park; 23rd ed; Pg 488
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Graft from homozygotic twin is known as ?
Ans. is 'b' i.e., Isograft Graft from homozygotic (identical) twin is called as isograft. Graft A tissue graft is a medical procedure in which tissue from a donor is used to replace missing or damaged tissue on a patient ( recipient).
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Cumulative increase in the height of the baby at 6 months:
Ans: B (18 cm) Ref: Nelson Textbook of Pediatrics, 19th edition and Achar Textbook of Pediatrics, 4th edition.Explanation:Average Length/Height at different Postnatal AgesAt Birth - 50 cmAt 3 months - 60 cmAt 6 months - 65 cmAt 9 months - 70 cmAt 1 year - 75 cmAt 2 years - 87.5 cmAt 4 years - 100 cmAt 8 years-125 cmAt 12 years - 150 cm>>>Expected adult height can be calculated by the formula 2 * Height at 2 years of age.Average Cumulative Gain in HeightAt 3 months - 10 cmAt 6 months - 15 cmAt 1 year - 25 cmAt 2 years - 37.5 cmAlso Note:In first year of life, the height increases by 25 cm.In second year of life, the height increases by 12.5 cm.From 2-12 years - the height increases 6 cm per year.Weech FormulaTo calculate expected height between 2-12 yearsExpected Height (2 to 12 year) = Age 6+77 (in cm)Waterlow Classification of StuntingPercentage of ideal height expected for ageGrade of stunting>95%No Stunting90 - 95%Grade 185 - 89%Grade 2<85%Grade 3
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Management of stone on CBD includes following except
Medical dissolution of stone is used for gallstones, not the CBD stones CBD ctones are rarely asymptomatic, often present with complication CBD stones should be treated, if diagnosed. Treatment options include ERCP, laparoscopic or open CBD exploration Ref : Bailey and love 27th edition Pgno : 1200
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What is the probable diagnosis in the patient with below flow volume loop (FVL)?
The above FVL is a typical of fixed central airway obstruction (Either above or below the thoracic inlet) such as tracheal stenosis. In this, there is limitation to peak flow rate,Flattened inspiratory and expiratory curves are seen. Other FVL patterns: 1.Normal 2. Airflow obstruction:- COPD 3. Fixed Upper Airway obstruction 4.Variable upper airway obstruction 5.
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The minimum amount of normal perfused liver parenchyma to be left intact when a hepatic resection is planned is -
• Up to 70% to 75% of the hepatic volume may be resected with good recovery in patients with relatively normal hepatic parenchyma (without active hepatitis, cirrhosis, or metabolic defects), as long as the remnant liver has adequate portal venous and hepatic arterial inflow, adequate hepatic venous outflow, and adequate biliary drainage.
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A -wave in JVP indicates:
Ans. B: Atrial contraction Waves - a - presystolic; produced by right atrial contraction - c - bulging of tricuspid valve into the right atrium during ventricular systole (isovolumic phase) - v - occurs in late ventricular systole; increased blood in right atrium from venous return Descents - x - combination of atrial relaxation, downward movement of the tricuspid valve and ventricular systole - y - tricuspid valve opens and blood flows in to the right ventricle Abnormal waveform causes Dominant a wave - Pulmonary stenosis - Pulmonary hypeension - Tricuspid stenosis Cannon a wave - Complete hea block - Paroxysmal nodal tachycardia Ventricular tachycardia Dominant v wave - Tricuspid regurgitation Absent x descent - Atrial fibrillation Exaggerated x descent - Cardiac tamponade - Constrictive pericarditis Sharp y descent - Constrictive pericarditis - Tricuspid regurgitation Slow y descent - Right atrial myxoma
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A 35 year old pregnant female at 40 weeks gestational age presents with pain and regular uterine contractions every 4-5 min. On arrival,the patient is in lot of pain and requesting relief immediately. Her cervix is 5cm dilated. What is the most appropriate method of pain control for this patient?
When complete relief of pain is needed throughout labour,epidural analgesia is safest and simplest. Ref: Williams Obs 24e pg 513 .
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A 2- year old child presented with leucocoria in the right eye since 2 months. On examination a total retinal detachment was present in the same eye. Ultrasound B scan revealed a heterogenous subretinal mass with calcification. The most likely clinical diagnosis is:
B i.e. Retinoblastoma Leukokoria in a child less than 6 years with hetrogenous mass & calcification on USG or CT scan is diagnostic of retinoblastomaQ. It may lead to secondary glaucoma & retinal detachment.
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Sudden cardiac death may occur in all of the following except :
Answer is D (Ventricular septal defect) Amongst the options provided ventricular septal defect is the least likely diagnosis to result in sudden cardiac death. Hyperophic and Dilated Cardiomyopathy : The cardiomyopathies (Hyperophic and Dilated) are the second most common category of diseases associated with risk of 'Sudden cardiac death'.- Harrison 16th/1620 Eisenmenger's Syndrome : "Most patients with the Eisenmenger's syndrome die of 'sudden cardiac death', probably from a ventricular arrythmia." Ventricular septal defect : The occurance of sudden cardiac death in cases of isolated ventricular septal defect has not been emphasized in literature. Sudden death may probably be seen in early childhood but only isolated case repos have been documented. VSD therefore is the least likely diagnosis and hence the answer of exclusion.
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Bleeding vessel in haemorrhoids is
Bleeding vessel in haemorrhoids is superior rectal vein which is a branch of inferior mesenteric vein at the level of rectum. Dilation of these vessels leads to bleeding leading to internal haemorrhoids. Veins are better option than aery.
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Hydrochloric acid is produced by?
Ans. C Oxyntic cellsRef: Ganong, 23rd ed. pg. 431-32Secretion in Stomach* Oxyntic cell (parietal cell) secretes: HCl and intrinsic factor of castle* Chief cell (zymogen or peptic cell) secrete: pepsinogen* G cell secrete: Gastrin* D cell secrete: Somatostatin* ECL cells secrete: Histamine
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Which of the following is shown in the diagram shown below?
Ans. (c) Entropion.The image shows presence of lower eyelid Entropion which is a malposition showing inversion of eyelid margin. The subtype is of involutional type with relative Enophthalmos.
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Which of the following contract together with stapes to stiffen the ossicular chain and protect the inner ear from noise damage?
Stapedius and tensor tympani muscles contract through a neural reflex arc mediated by loud sounds (>80 dB). They act to stiffen the ossicular chain and protect the inner ear from noise damage, paicularly at low frequencies. In contrast, cholesteatoma formation in the middle ear can contact the ossicular chain, increasing the total mass, causing a predominantly high-frequency conductive hearing loss.
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Recommended level of fluoride in drinking water?
Ans. is 'b' i.e., 0.5 - 0.8 mg/L The recommended level of fluoride in drinking water in the country is accepted as 0.5 to 0.8 mg/ Liter. -Park Maximum permissible limit is 1.5 mg/Lit.
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All lesions are seen in leprosy except –
Leprosy is not a vesiculo-bullous (blistering) disorder.
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Choose the appropriate lettered structure in this MRI scan showing a sagittal section through the head and neck. Tears drain through the nasolacrimal duct into the space below which structure?
(b) The inferior nasal meatus below the inferior concha receives the nasolacrimal duct.
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Tetracycline ointment for mass prophylaxis:
Ans. 0.1%
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Late Complication of radiotherapy
Mucositis (Inflammation of mucosa) is a late complication.
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HIV primarily infects?
ANSWER: (A) CD4+ cellsREF: Jawetz, Melnick, & Adelberg's Medical Microbiology, 24TH edition Chapter 44Repeat Microbiology December 2010
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The magnetic field in MRI is measured in
Tesla =magnetic fieldHounsfield units =CT numberMHz = To denote probe frequency in USGThe units of magnetic field strength are Gauss and Tesla. Tesla was the father of alternating current and Gauss was German mathematician. 1Tesla = 10 KG = 10, 000 Gauss Gauss is a measure of low magnetic field strength. Eah's magnetic field strength is approximately 0.6 G. MR systems used for clinical purpose have the strength ranging from 0.2 to 3 Tesla. Field strengths higher than 3T are used for research purposes. SNR and resolution increase with the field strength. Advanced MR applications like Spectroscopy, functional MRI, cardiac MR are possible only on higher field strengths like 1.5 T and above.(Ref: MRI made Easy by Chavan; 2nd Edition, Page No 23)
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A 42 yr old engineer developed redness of the glans and radial fissuring of the prepuce 2 weeks ago. A potassium hydroxide preparation of scrapings from the glans showed pseudohyphae and buds. Which one of the following systemic illness should he be screened for?
Visualization of pseudohyphae s/o candidiasis and DM is a predisposing factor for it. Candidiasis Predisposing factors or conditions (especially for disseminated form): DM Antibacterial agents Indwelling urinary catheters Parenteral glucocoicoids Neutropenia Abdominal and thoracic surgery Immunocompromised state Patients with severe burns low-bih-weight neonates persons using illicit IV drugs
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Treatment of choice for congenital hydrocele?
Ans. B. Herniotomy. (Ref. Bailey and Love 26th/pg. 1382; 381).# In congenital hydrocele, the processus vaginalis is patent and connects with the peritoneal cavity. The communication is usually too small to allow herniation of intra-abdominal contents. Pressure on the hydrocele does not always empty it but the hydrocele fluid may drain into the peritoneal cavity when the child is lying down; thus, the hydrocele is often intermittent. Ascites should be considered if the swellings are bilateral.# Congenital hydroceles are treated by herniotomy if they do not resolve spontaneously.# Established acquired hydroceles often have thick walls. Lord's operation is suitable when the sac is reasonably thin- walled. There is minimal dissection and the risk of haematoma is reduced. Eversion of the sac with placement of the testis in a pouch prepared by dissection in the fascial planes of the scrotum is an alternative (Jaboulay's procedure).# Herniotomy: In children who have lateral hernias with a persistent processus, it is sufficient only to remove and close the sac. This is called a herniotomy. In adult surgery, herniotomy alone has a high recurrence rate and some form of muscle strengthening is added (herniorrhaphy).
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Which one of the following is not associated with carbohydrate digestion, absorption, or both?
Enterokinase is an intestinal enzyme that activates trypsinogen as it enters the small intestine from the pancreas. Enterokinase is secreted into the lumen by mucosa cells, but much of it adheres to the enterocyte membrane. Once activated, trypsin can fuher activate itself as well as other inactive proteases. Amylase is secreted in active form and does not depend on enterokinase to be effective.Amylase is found in saliva and pancreatic juice.Starch is ingested in two forms, amylose and amylopectin. Amylase hydrolyzes amylose to maltose or maltotriose. Amylopectin contains -1,6 branch points, which cannot be digested by amylase. In this case, a limit dextrins are produced; they are polysaccharide fragments of variable size, each containing an -1,6 linkage. The brush-border enzyme -dextrinase completes the digestion of a-limit dextrins to single glucose units.Sucrase is a brush-border enzyme that hydrolyzes sucrose to glucose and fructose. These monosaccharides are subsequently absorbed by the enterocyte.The absorption of glucose and galactose is secondary active transpo. The absorption is sodium dependent. A carrier molecule in the mucosal membrane binds two sodium molecules for every glucose or galactose molecule; these two monosaccharides share the same transpo protein. Basolateral membrane sodium-potassium ATPase pumps keep the enterocyte intracellular concentration of sodium low. This situation provides a concentration gradient that ors the movement of sodium from the lumen into the enterocyte. Sodium moving down its concentration gradient can bring glucose or galactose into the enterocyte, even against a concentration gradient.
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Which of the following is the late toxic manifestation of diphtheria in child?
Polyneuropathy and myocarditis are late toxic manifestations of diphtheria. Myocarditis is typically associated with dysrhythmia of the conduction tract and dilated cardiomyopathy. Other complications of diphtheria include pneumonia, renal failure, encephalitis, cerebral infarction, and pulmonary embolism. Neurologic manifestations may appear during the first or second week of illness, typically beginning with dysphagia and nasal dysahria and progressing to other signs of cranial nerve involvement, including weakness of the tongue and facial numbness. Ref: Bishai W.R., Murphy J.R. (2012). Chapter 138. Diphtheria and Other Infections Caused by Corynebacteria and Related Species. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e
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When can a child begin to take a biscuit to his mouth?
By 6 months, a child can begin to take a biscuit to his mouth. By 12 months, he can try to feed self with a cup but spills some of contents. By 15 months, he can drink from cup without much spilling By 18 months, he can feed himself well with a spoon
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Early recovery of Sudeck's atrophy can be best seen by:
It is claimed to be the most successful treatment
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If a conraceptive has failure rate of 15, how many unplanned pregnancies will the female have in her reproductive period.
Ans. is 'c' i.e., 4.5 Failure rate per HWY =Total accidental pregnancies--------------------------Total months of exposurex 1200"A woman's reproductive period is roughly from 15 to 45 years, i.e a period of 30 years"------ Park24th/e - 521* Thus,15 =Total accidental pregnancies--------------------------30 x 12x 1200Total accidental pregnancies = 4.5
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Saturated fatty acids is maximum in which of the following:
Saturated fatty acids are a long-chain carboxylic acid that usually has between 12 and 24 carbon atoms that has no double bonds.Thus, saturated fatty acids are saturated with hydrogen (since double bonds reduce the number of hydrogens on each carbon).example; 1) Lauric acid (12 C) 2) Myristic acid (14 C) 3) Palmitic acid (16 C) 4) Stearic acid ( 18 C) 5) Arachidic acid (20 C)Coconut oil contains approximately 92.1% saturated fatty acids, 6.2% monounsaturated fatty acids, 1.6% polyunsaturated fatty acids.
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Shortest diameter is:
Ans. is b, i.e. Obstetric conjugateRef. Dutta Obs. 9/e, p 80-81Anteroposterior diameters of the pelvic inlet.DiametersFeatureMeasurement IObstetric conjugate* It is the distance between the midpoint of the sacral promontory to prominent bony projection in the midline on the inner surface of the symphysis pubis.* It is the smallest AP diameter of pelvic inlet.* It is the diameter through which the fetus must pass.* It can not be measured clinically, but can be derived by subtracting 1.5 cm from diagonal conjugate.10-10.5 cmTrue conjugate(Anatomical conjugate)* It is the distance between the midpoint of the sacral promontory to the inner margin of the upper border of symphysis pubis.* It has no obstetrical significance.11 cmDiagonal conjugate* It is the distance between the midpoint of the sacral promontory to the lower border of symphysis pubis.* Its importance as that it can be measured clinically.12 cm
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Drug used in severe hypercalcemia -
Medical Management 1.Rehydration until serum calcium level falls (4-6 litres of normal saline in first 24 hrs) 2.Correct electrolyte imbalance and give frusemide 100 mg 1-2 hours 3.Other methods to decrease serum calcium are: a.Salmon calcitonin 200-400 IU 8 hourly subcutaneously b.Mithramycin 25 ug/kg IV c.Neutral phosphate IV (500 ml over 6-8 hrs) 4.Avoid drugs like digoxin (hypercalcaemia and hypocalcaemia may potentiate its toxicity), thiazides (decrease the calcium excretion), vitamin A, D (increase the bone turnover) oestrogen and antioestrogen. R ALAGAPPAN MANUAL OF PRACTICAL MEDICINE 4TH EDITION PAGE NO-631
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The aqueous flare is best demonstrated by:
Ans. Biomicroscope
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Best investigation when there is clinical suspicion of pulmonary embolism in a patient is -
CT pulminary angiography is the first-line diagnostic test.It has the advantages of visualising the distribution and extent of the emboli,or highlighting an alternative diagnosis,such as consolidation,pneumothorax, or aoic dissection.A definitive diagnosis of PE depends on visualisation of an intraluminal filling defect in more than one projection.Secondary signs of PE include abrupt occlusion("cut-off") of vessels,segmental oligemia or avascularity,a prolonged aerial phase with slow filling,and touous,tapering peripheral vessels. Reference:Harrison's medicine-18th edition,page no:2174;Davidson's medicine-22nd edition,page no:722.
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In EEG, delta waves are seen:
Ans. C. In deep sleep Type Frequency (Hz)LocationNormallyPathologicallyDeltaup to 3frontal, high amplitude (20- 200uV)Adults*deep sleep* infants* subcortical lesions* diffuse lesionsTheta4-7 HzParietal and temporal regions* young children*drowsiness (early sleep)* focal subcortical lesionsAlpha8 -12 HzParietal and occipital (50- 100 uV)* closing the eyes and by relaxation.Frequency decreases in: hypoglycemia, hypothermia, hypercapnia, GA, sleep, comaBeta12 - 30 HzFrontal region; low amplitude waves 10 uV* active, busy or anxious thinking, active concentration* sedatives
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Thimble bladder is seen in -
Ans. is 'a' i.e., Tuberculosis o Bladder tuberculosis is almost always secondaryto renal tuberculosiso The disease starts at the ureteric opening, the earliest evidence being pallor of the mucosa due to submucosal edema.o Subsequently tiny white transluscent tubercles develop all over. Gradually these tubercles enlarge and may ulcerate (but do not cause bladder perforation).o These tubercles lend 'cobblestone* appearance on cystoscopy.o There is considerable submucous fibrosis which causes diminished capacity of bladder. Scarred & fibrosed, small capacity bladder is b'a thimble bladder.o The fibrosis which usually starts around the ureter, contracts to cause a pull at the ureters. This either leads to a stricture or displaced, dilated and rigid wide mouthed ureter k/a golf hole ureters, this almost always leads to ureteral reflux.
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"Crumbled egg appearance" in liver is seen in?
Ans is 'c' i.e., Hydatid liver disease
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Alkalinization of urine ameliorates the toxicity of which of the following drugs
refer Goodman Gilman 12/e p85 Alkalinization of urine speeds the clearance of weakly acidic drugs like. Aspirin Phenobarbitone Chlotpropapamide Methotrexate
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Cystic hygroma may be associated with:
Cystic hygroma Cystic hygromas are multiloculated cystic spaces lined by endothelial cells It results due to sequestration of a poion of jugular lymph sac from the lymphatic system Cysts are filled with clear lymph and are lined by endothelium Turner's syndrome is associated with cystic hygroma Most cystic hygromas involve the lymphatic jugular sacs Cystic hygroma MC site: Posterior neck region Other common sites: Axilla, mediastinum, inguinal & retroperitoneal regions Approximately 50% of them present at bih It may show spontaneous regression Clinical features Usually present at soft cystic masses that disto the surrounding anatomy, can result in acute airway obstruction. Usually manifests in the neonates or in early infancy (50% present at bih) Prone to infection & hemorrhage within the mass Swelling is soft & paially compressible and invariably increases in size when the child coughs or cries. Characteristic features: Brilliantly translucent Diagnosis MRI play a crucial role in preoperative planning Treatment Complete surgical excision is the preferred treatment Injection of Sclerosing agents such as bleomycin or OK-432 (Picibanil), derived from streptococcus pyogenes may eradicate the cystic hygroma.
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Minimum separable distance for two-point threshold test is greatest at?
The size of the receptive fields for light touch can be measured by the two-point threshold test. In this procedure, the two points on a pair of calipers are simultaneously positioned on the skin and one determines the minimum distance between the two caliper points that can be perceived as separate points of stimulation. This is called the two-point discrimination threshold.If the distance is very small, each caliper point touches the receptive field of only one sensory neuron. If the distance between stimulation points is less than this threshold, only one point of stimulation can be felt. Thus, the two-point discrimination threshold is a measure of tactile acuity. The magnitude of two-point discrimination thresholds varies from place to place on the body and is smallest where touch receptors are most abundant.Stimulus points on the back, for instance, must be separated by at least 65 mm before they can be distinguished as separate, whereas on the fingeips two stimuli are recognized if they are separated by as little as 2 mm. Blind individuals benefit from the tactile acuity of fingeips to facilitate the ability to read Braille; the dots forming Braille symbols are separated by 2.5 mm. Two-point discrimination is used to test the integrity of the dorsal column (medial lemniscus) system, the central pathway for touch and proprioception.
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Erotomania is seen in: NEET 13
Ans. Bipolar mania
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Antibodies to one of the following infection are not transmitted to a child –
Protective Antibodies against pertussis do not cross placenta. So, early immunization is desired.
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According to Herrington classification the decerebrate rigidity is characterised by all EXCEPT
(Rigidity occurs in all muscles of the body) (210-11 Ganong 22nd) (692- Guyton 11th) (247- Ganong 23rd)DECEREBRATE - RIGIDITY -* When the brain stem of an animal is sectioned below the mid level of the mesencephalon. But the pontine and medullary reticular system as well as the vestibular system are left intact, the animal develops a condition called decerebrate rigidity* This rigidity does not occur in all muscles of the body but does occur in the antigravity muscles - the muscles of the neck and trunk and the extensors of the leg.* The cause of decerebrate rigidity is blockage of normally strong input to the medullary reticular nuclei from the cerebral cortex, the red nucleus and the basal ganglia. Lacking this input, the medullary reticular inhibitor system become non functional; Full overactivity of the pontine excitatory system occurs, and rigidity develops.* Decerebrate rigidity is found to be spasticity due to diffuse facilitation of stretch reflexes* The facilitation is due to two factors: increased general excitability of the motor neuron pool and increased in the rate of discharge in the y' efferent neuron* Decerebration produces no phenomenon akin to spinal shock. And the rigidity develops as soon as the brain stem is transected
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BCRABL gene mutation is seen in? (A)CML (B)AML (C)CLL (D)ALL
Chronic Myeloid leukemia o Chronic myeloid leukemia is a stem cell disease that is characterized by leucocytosis with granulocyc immaturies, basophilia, splenomegaly and disnct chromosomal abnormality - Philadelphia (Ph') chromosome. It is one of the chronic myeloproliferave disorders. Pathogenesis of chronic mveloid leukemia o CML is an acquired disease of haemopoiec stem cell and Ph’ chromosome is demonstrable in erythroid, myeloid and megakaryocyc precursors. Philadelphia chromosome BCR-ABL fusion gene Philadelphia chromosome is formed as a result of reciprocal translocaon between long arm of chromosome 22 and chromosome 9 i.e. + (9:22) ABL proto-oncogene from chromosome 9 is translocated to chromosome 22 where BCR is present and results in formaon of BCR-ABL fusion chimeric gene BCR ABL gene is hallmark of CML.
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An infant brought to emergency, unresponsive, bradycardia, shallow breathing. Next step of management:
d. Cardiopulmonary resuscitationThe sequence of resuscitation in infants & children is C-A-B (compressions, airway, breathing) rather than A-B-C i.e initiate CPR with chest compressions, rather than with rescue breaths
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Which protein prevents contraction by covering binding sites on action and myosin :
D i.e. Tropomyosin
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The most common causative organism of canaliculitis is
Chronic canaliculitis is an uncommon condition, frequently caused by Actinomyces israelii, anaerobic Gram-positive bacteria. Occasionally scarring and canalicular obstruction may result. Presentation is with unilateral epiphora associated with chronic mucopurulent conjunctivitis refractory to conventional treatment. There is pericanalicular redness and oedema, and mucopurulent discharge on pressure over the canaliculus. A 'pouting' punctum may be a diagnostic clue in mild cases. In contrast to dacryocystitis, there is no lacrimal sac involvement. Concretions (sulfur granules) are metabolic products of Actinomyces and other hydrogen sulfide-utilizing bacteria, and classically are expressed on canalicular compression or following canaliculotomy
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Fever increase w ater losses by ______ ml/day per degree Celsius -
Ans. is 'b' i.e., 200 ml/day per degree Celsius \
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In root, the inner cell layer of root sheath induce the formation of:
The inner cell layer of the root sheath forms from the inner enamel epithelium or ameloblasts in the crown, and enamel is produced. In the root, these cells induce odontoblasts of the dental papilla to differentiate and form dentin. The root sheath originates at the point that.
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The impression material with lowest viscosity is
Impression plaster is a β-calcium sulfate hemihydrate used at a water/powder ratio of approximately 0.5 to 0.6. Its fluidity makes it suitable for making impressions of soft tissues in the uncompressed state, a characteristic of mucostatic impression material. Ref: Phillips 12 ed page no 177
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