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135
756af33e-abf5-47c6-b0de-962a839ea4ef
All of the following activities of Junior Red cross except –
Military hospital worker
Village uplift
Prevent epidemic work
Any of the above
0a
multi
null
Social & Preventive Medicine
null
889cd5fa-1c80-4a92-9a00-345831672c36
Web of causation of disease, which statement is most appropriate?
Mostly applicable for common diseases
Requires complete understanding of all factors associated with causation of disease
Epidemiological ratio
Helps to suggest ways to interrupt the risk of transmission
3d
multi
null
Dental
null
ab95a69c-2c74-4d78-8647-c95d7496d90d
Ghotna is:-
Heavy wooden log rolled on leg
Compressing the thighs with two roads
Tying the limps to the pole
Electric shock to genitalia
0a
single
Ghotna: Rolling a wooden log over the thighs up and down, while the log is weighed by one or two policemen standing on it Cattle prod: Electric shock especially over the genitals Sham execution: Victim is blind folded and asked to stand before a wall and then threatened that a vehicle is going to hit him. He hears the sound of a vehicle very near to him, causing fear and shock.
Forensic Medicine
Toure methods
eeda274b-3346-4a5e-8e25-1f5b8464155b
Epiphyseal enlargement occurs in -
Paget's disease
Sheurmann's disease
Epiphyseal dysplasia
Hemophilia
3d
single
Epiphyseal enlargement Most common causes of epiphyseal enlargement are chronic inflammation (e.g. JRA) or chronic increase in blood flow. Causes of Epiphyseal enlargement are:- a) Solitary (Enlargement of particular epiphysis) Post-inflammatory (JRA, Septic arthritis) Perthe's disease (in repair stage) Status post hip dislocation Hemophilia (Hemophilic arthropathy) Turner syndrome Klippel-trenaunay syndrome (angiohypertrophy syndrome) Kascibach - Merritt syndrome Beckwith - Wiedemann syndrome (Hemihypertrophy) Trevor disease (Dysplasia epiphysealis hemimelica) b) Generalized Hyperthyroidism    Acromegaly or cerebral gigantism          Adrenogenital syndrome   iv) Rickets Spondyloepiphyseal dysplasia McCune-Albright syndrome Kniest syndrome
Orthopaedics
null
b3e618e1-f9ae-460c-bcc2-702294d8d0fa
Treatment of Hodgkin&;s disease -
CHOP
MOPP
ABVD
None
2c
multi
<p>The ABVD(doxorubicin,vinblastine,bleomycin,dacarbazine) is used in the treatment of Hodgkin&;s disease .Thd incidence of infeility & secondary myelodysplasia /ALL is low with this regime. </p><p>Reference :Davidson&;s principles & practice of medicine 22nd edition pg no 1043 </p>
Medicine
Haematology
aad11664-5f83-44ac-926e-b56c35c9642d
DOC of GTCS in pregnancy
Lamotrigine
CBZ
Levetiracetam
Valproate
0a
single
Ans. is 'a' i.e., Lamotrigine
Medicine
null
e08a75ac-3fb1-4ca9-a24c-d6798f56a3f0
A 20 year female presents with a ovarian mass 6x 6 x 6cm in size. Ultrasonography reveals solid structures in the mass. Her serum biomarkers such as AFP. fO-hCG and CA 125 are normal, however, her serum alkaline phosphatase was found to be elevated. The most likely diagnosis is
Dysgerminoma
Endodermal sinus tumor
Malignant teratoma
Mucinous cystadenocarcinoma
0a
single
null
Gynaecology & Obstetrics
null
3ab81800-b571-4301-aefa-6164d7033052
When patient is on isotretinoin therapy, monitoring of which of the following is done
Liver function test
Lipid profile
Renal function tests
CBC
1b
single
Isotretinoin is indicated in severe nodulo cystic acne vulgaris. It may result in hyperlipidemia, arthralgia and myalgia
Unknown
null
c1f66ea8-e0c6-47ed-b2dc-c4ba1716bdbb
If GCS score is 8, head injury is classified as:
Mild
Moderate
Severe
Very severe
2c
single
Head injury can be classified as mild, moderate, or severe. For patients with a history of head trauma, classification is as follows: severe head injury if the GCS score is 3 to 8, moderate head injury if the GCS score is 9 to 12, and mild head injury if the GCS score is 13 to 15. Ref: Schwaz's principle of surgery 9th edition, chapter 42.
Surgery
null
3cd752c0-39e0-40c6-b843-9b38bb4fb8b7
All pencillins act by: September 2007
Inhibiting protein synthesis
Inhibiting cell wall synthesis
Antifolate
Inhibitis DNA gyrase
1b
multi
Ans. B: Inhibiting cell wall synthesis All penicillin derivatives produce their bacteriocidal effects by inhibition of bacterial cell wall synthesis. Specifically, the cross linking of peptides on the mucosaccharide chains is prevented. If cell walls are improperly made cell walls allow water to flow into the cell causing it to burst and bacterial lysis occurs.
Pharmacology
null
b6a0b1c9-9736-4de0-a022-31c371f4c883
Cause of Coxa vera ?
Congenital
Pehe's disease
SCFE
All of the above
0a
multi
Ans. is 'd' i.e., All of the above Coxa vera Coxa vera refers to reduced angle between the neck and shaft of the femur. Coxa vera may be congenital or acquired. 1. Congenital (developmental / Infantile) coxa vera This is coxa vara resulting from some unknown growth anomaly at the upper femoral epiphysis. It is noticed as a painless limp in a child who has just staed walking. In severe cases, shoening of the leg may be obvious. On examination, abduction and internal rotation of the hip are limited and the leg is sho. X - rays will show a reduction in neck - shaft angle. The epiphyseal plate may be too veical. There may be a separate triangle of bone in the inferior poion of the metaphysis, called Fairbank's triangle. Treatment is by a subtrochanteric corrective osteotomy. 2. Aquired coxa - vera Aquired coxa-vera is seen in :- SCFE (slipped capital femoral epiphysis) Sequelae of avascular necrosis of femoral epiphysis Legg-Calve Pehe's disease Femoral neck fracture Traumatic hip dislocation Post reduction of CDH Septic necrosis Associated with pathological bone disorders Osteogenesis imperfecta Fibrous dysplasia Osteopetrosis
Surgery
null
a4678614-75be-4cbe-8d71-aef897f838d4
Strength of topical ophthalmic preparations of tobramycin is : September 2009
3 mg/ ml
8 mg/ ml
10 mg/ml
13 mg/ml
0a
single
Ans. A: 3 mg/ml Tobramycin works by binding to a site on the bacterial 30S and 50S ribosome, preventing formation of the 70S complex. As a result, mRNA cannot be translated into protein and cell death ensues. Sterile Tobramycin Ophtha Solution (eye-drops) contains tobramycin concentration of 0.3%. It is mixed with 0.01% benzalkonium chloride as a preservative. This concentrations result in 3 mg per ml.
Pharmacology
null
c79d58c6-5782-49cb-a04f-f181e55e964c
Which of the following is given to prevent methotrexate toxicity?
MESNA
Flumazenil
Fomipezole
Calcium leucovorin
3d
single
Ans. d (Calcium leucovorin) (Ref. Harrison 18th/ p 476, 607)# Methotrexate inhibits dihydrofolate reductase, which regenerates reduced folates from the oxidized folates produced when thymidine monophosphate is formed from deoxyuridine monophosphate.# Without reduced folates, cells die a "thymineless" death.# N-5 tetrahydrofolate or N-5 formyltetrahydrofolate (leucovorin) can bypass this block and rescue cells from methotrexate, which is maintained in cells by polyglutamylation.METHOTREXATE - Side Effects:# In addition to bone marrow suppression and mucosal irritation, methotrexate can cause renal failure itself at high doses owing to crystallization in renal tubules; therefore high-dose regimens REQUIRE ALKALINIZATION OF URINE with increased flow by hydration.6# Less frequent adverse effects include reversible increases in transaminases and hypersensitivity-like pulmonary syndrome.# Chronic low-dose methotrexate can cause hepatic fibrosis.# When administered to the intrathecal space, methotrexate can cause chemical arachnoiditis and CNS dysfunction.# Trimetrexate is a methotrexate derivative that is not polyglutamylated and does not use the reduced folate carrier.# The effects of folate antagonists that inhibit dihydrofolate reductase can be counteracted by folinic acid (5-formyl tetrahydrofolate ) in a dose of 100 to 200 mg/d, which circumvents the block in folate metabolism by providing a form of folate that can be converted to 5,10-methylene THF.Methotrexate(Antimetabolite)# A folic acid analog that inhibits dihydrofolate reductase; decreased dTMP levels hinder DNA and thus protein synthesis# S-phase specificNeoplastic indications: leukemia, lymphomas, breast cancer, choriocarcinomaNonneoplastic indications; rheumatoid arthritis, psoriasis, termination of pregnancy (e.g., ectopic) Toxicities: suppresses bone marrow reversibly; folinic acid (leucovorin) is used to "rescue"; fatty change in liver
Medicine
Drugs
3e3e5fc1-5a9f-45a6-ab15-f122b966c0fd
A baby is born at 27 weeks of gestation required mechanical ventilation for next 4 weeks & O2 for next 1 week. He maintained at room temperature subsequently. As per new Bronchopulmonary dysplasia definition, he has which of the following –
Mild BPD
Moderate BPD
Severe BPD
No BPD
2c
single
null
Pediatrics
null
e771fccf-5bce-4dab-b78b-05974eca159c
Which drugs are used for prenatal therapy of congenital adrenal hyperplasia?
Hydrocoisone
Prednisolone
Fludrocoisone
Dexamethasone
3d
single
High risk pregnancies should be staed of Dexamathasone, that readily crosses placenta, in an amount of 20 mu/kg in 2-3 divided doses. This surpasses secretion of steroids by fetal adrenals, including secretion of fetal adrenal androgens. If staed 6 weeks of gestation, it ameliorates virilization of external genitals in affected female fetus. Ref: Kligman, Behrman, Jenson, Stanton (2008), Chapter 577, "Congenital Adrenal Hyperplasia", In the book, "Nelson's Textbook of Pediatrics", Volume 2, 18th Edition, New Delhi, Page 2364
Pediatrics
null
0291550c-be5c-420e-9e17-cea3e2d01371
In Breslau's second life test, organ tested is
Brain
Hea
Lung
Stomach and Intestine
3d
single
D i.e. Stomach & Intestine Breslau's second life (or Stomach Bowel) test says that air will be swallowed & so may pass into stomach & small intestine when respiration establishes.
Forensic Medicine
null
1e090da8-2146-4fe4-be3e-d23b0eee00f6
A person with eyes closed & mind wondering will have the following wave in
a-waves
b-waves
d-waves
t-waves
0a
single
(A) a-waves # Alpha Rhythm> In adult humans who are awake but at rest with the mind wandering and the eyes closed, the most prominent component of Ihe EEG is fairly regular pattern of waves at a frequency of 8-12 Hz and an amplitude of 50-100 pV when recorded from the scalp> This pattern is the alpha rhythm.> It is most marked in the parieto-occipital area.
Physiology
Nervous System
e8e48ba0-34e1-4e1d-b38c-7d4ecbcbf1c0
Which drug is used for topical application in respiratory papillomatosis?
Acyclovir
Ranitidine
Cidofovir
Ribavirin
2c
single
Cidofovir Gold standard treatment for respiratory papillomatosis is Laser MLS/ Powered MLS (using microdebrider). Cidofovir is a recent drug which is used intralesionally or topically. Its active metabolite, cidofovir diphosphate, inhibits viral replication by selectively inhibiting viral DNA polymerase.
Pathology
All India exam
9c17078a-330d-4cb5-aecd-aada730fb782
30 years old lady presented with acute pain abdomen, constipation and vomiting suspecting acute intestinal obstruction. The investigation of choice for the patient is -
Ba enema
X-ray abdomen erect posture
USG
CT scan
1b
single
Ans. is 'b' i.e. X-ray abdomen erect posture
Surgery
null
b7f56aef-7e80-47be-a7ed-a2cea8736a22
Which of the following reflex is NOT prominent in child at bih?
Moro's reflex
Glabellar tap
Crossed extensor reflex
Tonic neck reflex
3d
single
Tonic neck reflex is prominent between 2nd and 4th months. Persistence of reflex beyond the age of 6-9 months is abnormal. Impoant neonatal reflexes: Sucking, rooting, and swallowing reflexes Grasp reflex Moro's reflex Glabellar tap Crossed extension Ref: Essential paediatrics by OP Ghai, 6th edition, Page 146.
Pediatrics
null
d7047f37-c749-491f-9d12-ca52a4ae2317
Most potent statin is?
Simvastatin
Pitavastatin
Rosuvastatin
Atorvastatin
2c
single
Rosuvastatin - most potent best bioavailability: fluvastatin most commonly prescribed- atorvastatin safe for children- pravastatin Ref: KD Tripathi 8th ed
Pharmacology
Cardiovascular system
b37e1f58-0149-4dbd-8e0b-2e498aab6780
Niacin is synthesized from:
Phenylalanine
Tryptophan
Tyrosine
Methionine
1b
single
The liver can synthesize niacin from the essential amino acid tryptophan, but the synthesis is extremely inefficient; 60 mg of tryptophan are required to make one milligram of niacin. The 5-membered aromatic heterocycle of the essential amino acid, tryptophan, is cleaved and rearranged with the alpha amino group of tryptophan into the 6-membered aromatic heterocycle of niacin.
Biochemistry
null
2a51c715-b895-4042-81e0-f0e67598fbb3
What is irregular astigmatism-
Perpendicular principal meridians
Non perpendicular principal meridians
Any of the above
None of the above
1b
multi
Ans. is 'b' i.e., Non perpendicular principal meridians ASTIGMATISMo Astigmatism is a type of refractive error wherein the refraction varies in the different meridia. Consequently, the rays of light entering in the eye cannot converge to a point focus but form focal lines. The refractive error of the astigmatic eye stems from a difference in degree of curvature refraction of the two different meridians (i.e.,, the eye has different focal point in different planes). For example, the image may be clearly focused on retina in the horizontal plane, but not in the vertical plane.o The most common cause of astigmatism is abnormality of corneal curvature. Other less common causes are lenticular (curvature abnormality of lens,oblique position of lens) and retinal (oblique placement of macula). Types of astigmatismBased on axis of the principal meridiansRegular stigmatism : Principal meridians are perpendicularo With-the-rule astigmatism-the vertical meridian is steepest.o Against-the-rule astigmatism-the horizontal meridian is steepest.o Oblique astigmatism-the steepest curve lies in between 120 and 150 degrees and 30 and 60 degrees.Irregular astigmatism - principal meridians are not perpendicular.Based on focus of the principal meridiansSimple astigmatismo Simple hyperopic astigmatism - first focal line is on retina while the second is located behind the retinao Simple myopic astigmatism - first focal line is in front of the retina while the second is on the retina.Compound astigmatismo Compound hyperopic astigmatism-both focal lines are located behind the retina,o Compound myopic astigmatism-both focal lines are located in front of the retina.Mixed astigmatism-focal lines are on both sides of the retina (straddling the retina).Treatment of Astigmatismo Treatment of astigmatism consists : -Optical treatment: - It consists of cylindrical power spectacles or contact lens. Types of contact lenses used are permeable contact tens, Soft toric contact lens (for high degree astigmatism), hybrid lens, i.e,, soft on hard lens, hard contact lens.Surgical treatment: - Non-laser (astigmatic keratotomy) or laser (PRK, LASIK).
Ophthalmology
Types of Errors of Refraction
2c194873-0e6b-46bb-b97e-91a8320ef492
Pterygium all are true except:
Arise from any pa of conjunctiva
Can cause astigmatism
Surgery is treatment of choice
UV exposure is risk factor
0a
multi
Ans. Arise from any pa of conjunctiva
Ophthalmology
null
a3a14fbb-8907-4618-b971-0172c3f5b382
Gradient in pulmonary aery wedge pressure and left ventricular end diastolic pressure is seen in
Aoic regurgitation
Constrictive pericarditis
Left atrial myxoma
Pulmonary thromboembolism
2c
single
Answer is C (Left atrial myxoma) An increased gradient during diastole is suggestive of an obstructive lesion between Left atrium and Left ventricle that is not allowing pressures to normalize between the atria and ventricle such as atrial myxoma. Pulmonary aery wedge pressure represents Left atrial pressure. Left ventricular end diastolic pressure represents Left ventricular pressure. Gradient between Left atrial pressure (PCWP) and Left ventricular pressure during diastole: Normally there is no gradient during diastole as both pressures are equal. An increased gradient during diastole is suggestive of an obstructive lesion between Left atrium and Left ventricle that is not allowing pressures to normalize between the atria and ventricle. This may thus be seen in obstructive lesions between Left atria and ventricle such as : Mitral stcnosis Atrial myxomas
Medicine
null
2ef82f67-4906-4d5c-b65f-2edb36068c75
Which of the following opioid can be given intranasally?
Tramadol
Pethidine
Butorphanol
Buprenorphine
2c
multi
Butorphanol is full agonist at kappa & antagonist at μ receptor that can be given intranasally.
Pharmacology
null
2a1f7def-52f0-4cce-8886-825025aee58d
Most important in diagnosing Acute Hepatitis B is
IgG Anti-HBc
Anti HBs
IgM Anti-HBc
HBsAg
2c
single
null
Social & Preventive Medicine
null
9126ca9f-1c09-4270-aad6-3cc552e36660
A 55-year-old woman was found to have Ca cervix, FIGO stage 2-3, locally advanced. What would be the management?:
Surgery plus chemotherapy
radiotherapy plus chemotherapy
Chemotherapy
Radiotherapy plus HPV vaccine
1b
multi
As discussed in detail in preceeding text best for cervical cancer of (stages II B to IV A) is chemoradiation (i.e. chemotherapy and radiotherapy), where by cisplatin is used as a radiosensitiser to increase the sensitivity of the cells to radiotherapy before giving radiotherapy. Since in this question –chemotherapy + radiotherapy is given as one of the options, hence, we will mark it as the correct option.
Gynaecology & Obstetrics
null
6b88fdc4-c9bb-45c3-85e1-3ab05576e47f
What is TRUE about Lovastatin
Inhibits HMG CoA synthetase
Inhibits HMG CoA reductase
Myositis may result from its prolonged use
Decrease synthesis of cholesterol and causes lenticular opacity
1b
multi
Ans. is 'b' i.e., Inhibits HMG CoA reductase 'c' i.e., Myositis results from prolonged use 'd' i.e., Decrease synthesis of cholesterol and cause lenticular opacityLovastatin:Mechanism of actionInhibition of HMGCoA reductase Mode of actionDecreased cholesterol synthesis Increased LDL receptors Lipoproteins affectedLDL- DecreasedVLDL- DecreasedTG- DecreasedHDL- IncreasedSite EffectsHepatic dysfunction Severe myositis, | CPK Lens opacities ContraindicationsImpaired renal function andIn combination with Gemfibrozil or Nicotinic acid Risk of myositis is increased in these conditions
Pharmacology
Hypolipidemic
5c7764ee-b244-4277-84da-2585dca30644
Which cancer is most commonly associated with increased estrogen levels?
Cervix
Ovarian
Breast
GTN
2c
single
Ans. is 'c' i.e., Breast Important risk factors for breast cancer1) Increased age8) High fat diet2) Female sex9) High socioeconomic status3) Western countries10) Irradiation4) Early menarche11) Hormone replacement therapy5) Late menopause12) Family history positive6) Obesity13) Somatic mutation in p53 gene (in 40% cases)7) Nulliparity * Most of these factors are related to increased exposure of estrogen to breast.* Breast feeding is protective against breast cancer. Thus women who avoid breast cancer are at increased risk to develop breast cancer. Oral contraceptives and smoking do not appear to increase the risk of breast cancer.* 3 most important cancer associated with estrogen are breast, endometrium and uterine.Note - There is also an increased risk of ovarian cancer with long term large dose estrogen therapy, but much less common as compared to breast cancer.
Pathology
Female Genital Tract
15e94c41-2c31-4e05-9a4c-4f2500ee9319
Which among the following occupation is a risk factor for this presenting illness?
A lifeguard in swimming pool
A poultry worker
Farmer
A kennel worker
0a
single
Ans. (a) A lifeguard in swimming poolCutaneous larva migrans (CLM) is a clinical syndrome consisting of an erythematous migrating linear or serpiginous cutaneous track;It is also called as creeping eruptionsIndividuals at greatest risk include travelers, children, swimmers in lakes, and laborers whose activities bring their skin in contact with contaminated soilLarva migrans:* It is caused by nematodes that usually cause infection to animals* When they accidentally enters humans - it cannot complete the cycle and hence gets arrested in the body causing larva migrans* It is of two types:# Cutaneous larva migrans# Visceral larva migransComparison between Cutaneous and visceral larva migransCutaneous larva migransVisceral larva migrans* Ancylostoma braziliense (M/c)* Toxocara can is* Ancylostoma caninum (second M/c)* Toxocara cati* Necator americanus* Gnathostoma* Ancylostoma duodenale* Anisakis* Gnathostoma spinigerum * Strongloides * Loa loa * Fasciola * Paragonimus * The question is quite a tricky one. A lifeguard in swimming pool has risk comparatively, as poultry has no link with these organisms. Most of the organisms are dog and canines sources.
Microbiology
Virology
a66c0e2d-95c7-4ae6-94ef-3f70b612a1d6
Vaccination causing intussusception is
Rotavirus
Parvovirus
Poliovirus
BCG
0a
single
Rotavirus vaccination - there is a potentially high risk of intussusception with the first dose when this vaccine is given to infants aged more than 12weeks. Ref: Park&;s textbook of preventive and social medicine; 23rd edition.
Microbiology
Virology
85c2c1ef-e36a-4240-bd6c-fb614655b4c9
Most common cause of urethral stricture is
Trauma
Infection
Congenital
Post endoscopy
0a
single
Urethral stricture CAUSES The common causes of urethral stricture are: * Inflammatory * Secondary to urethritis * Secondary to balanitis xerotica obliterans (BXO) * Traumatic (MC) * Bulbar urethral injury * Pelvic fracture urethral disruption injury * Iatrogenic * Secondary to urethral instrumentation including cath- eterisation and transurethral prostatectomy * Secondary to radical prostatectomy * Secondary to radiotherapy for prostate cancer * Idiopathic CLINICAL FEATURES Symptoms are usually hesitancy of micturition, straining to void and a poor urinary stream. The relative youthfulness of the patient often rules out prostatic enlargement, which characteristically occurs after the age of 50. As the stream becomes narrower, micturition is prolonged and is followed by postmicturition dribbling as a result of urine trickling from the dilated urethra proximal to the stricture. Urinary frequency by day and night is common and is due to incomplete bladder emptying, coexisting detrusor overactivity or urinary infection. If the stricture is tight enough, the patient will go into acute retention, although this is rare. If this happens, there is a danger that clumsy attempts to pass a urethral catheter will result in a false passage. If a patient has gone into retention because of a urethral stricture, its lumen will be too narrow to pass even a tiny catheter and suprapubic catheterisation is required. Investigation involves uroflowmetry, urethroscopy, urethrography and ultrasound scanning to assess bladder emptying and to detect any upper tract dilatation. The urinary flow rate is typically prolonged and plateau shaped while urethroscopy allows the stricture to be viewedas a circumferential scar. Openings of false passages commemorate previous misguided attempts to pass a urethral catheter. Urethrography using a water-soluble contrast medium will show the extent and severity of the stricture Ref: Bailey and love 27th edition Pgno : 1482
Surgery
Urology
5fa6fe98-04b1-4380-b01a-5ad1ef2ef021
Egg on side appearance of heart is seen in the radiograph of?
TAPVC
TGA
ASD
VSD
1b
single
Ans. (b) TGARef: Sutton 7thed different pages. Pediatrics Radiology: The Requisites by Johan G. Blickman, Bruce R. Parker; M.D. Patrick D. Barnes p-52
Radiology
Cardiac and Pericardiac Imaging
8c2244a1-242d-4266-bd4e-1b0ed86a5724
Which amino acid migrates fastest on paper chromatography on methylcellulose medium?
Aspartic acid
Valine
Lysine
Glycine
1b
single
Chromatography paper contains about 15-20% water, held to the paper fibers. This water acts as the stationary phase in paper chromatography. Amino acids are separated according to their solubility in the water and in an organic solvent (the mobile phase) moving up the paper. The most non-polar amino acids migrate the farthest, due to their greater solubility in the organic solvent. Paper also acts as an adsorbent, having an affinity for polar groups. Among the given options, Glycine and Valine are non-polar amino acids (hydrophobic). Aspartic acid and Lysine are polar amino acids. Valine is more non-polar than glycine.
Biochemistry
null
81e801d1-39cc-4d64-ab64-10619c171673
An eleven year old boy is having tinea capitis on his scalp. The most appropriate line of treatment is –
Oral griseofulvin therapy
Topical griseofulvin therapy
Shaving of the scalp
Selenium sulphide shampoo
0a
single
Systemic therapy for all dermatophytosis Terbinafm  → DOC Griseofulvin → 2nd choice Once the mainstay of systemic therapy for dermatophytic infection, has now replaced by terbinafine.
Dental
null
ae9c43e2-af3b-412d-a34a-12b769131fb2
Which of the following metabolic abnormality is seen in multiple myeloma -
Hyponatremia
Hypokalemia
Hypercalcemia
Hyperphosphatemia
2c
single
Ans: C
Unknown
null
c4b2c3a1-08bf-446f-8d90-6ce515240968
IPC 193 is for -
Perjury
Punishment for perjury
Issuing false certificate
Causing disappearance of evidence
1b
multi
Ans. is 'b' i.e., Punishment for perjury Perjury, Hostile witness and false certificate* 191 IPC: (i) Giving false evidence (perjury) under oath and (ii) hostile witness.* 192 IPC: Fabricating false evidence (perjury).* 193 IPC: Punishment for false evidence (punishment for perjury): imprisonment upto 7 years + fine.* 194 IPC: Giving or fabricating false evidence to procure conviction of capital offence.* 195 IPC: Giving or fabricating false evidence to procure conviction of offence punishable with imprisonment for life.* 197 IPC: Issuing or signing (attesting) false certificate by a doctor is a criminal offence.* 201 IPC: Causing disappearance of evidence.
Forensic Medicine
Law & Medicine, Identification, Autopsy & Burn
02d3f297-7d16-40af-982a-c3ec035e7975
Which of the following types of bronchogenic carcinomas are most likely to develop within a residual area of peripheral scar tissue?
Small-cell carcinoma
Squamous-cell carcinoma
. Large-cell carcinoma
Adenocarcinoma
3d
multi
Adenocarcinomas are the most common primary lung cancer to develop within an area of peripheral scar. Scar tissue formation may be secondary to previous granulomatous disease (tuberculosis), infarction, or interstitial diseases of the lung associated with fibrosis (e.g., progressive systemic sclerosis). The pathogenesis of scar carcinoma is not completely understood. One theory is that scar tissue blocks lymphatic drainage, causing an increased concentration of anthracotic pigment-containing carcinogens. Persistent hyperplasia of tissue and the potential for a mutation leading to cancer are other mechanisms that may be similar to those of cancers that develop in fistulous tracts draining pus (e.g., chronic osteomyelitis).
Surgery
null
4c3e57b3-a083-48ad-94b9-57a768bbf837
Provison of PHC was done by
Bhore Committee
Chadah Committee
Shrivastava Committee
Bajaj Committee
0a
single
Ans. is 'a' i.e.,Bhore Committe Bhore CommitteIt is also known as 'Health Survey and Development Committee'. Its recommendations were :1) Integration of preventive and curative services at all administration levels2) Sho term and long term recommendationsSho term : PHC to cater to a population of 40,000Long term (3 million plan) : PHC units to be set up with 75 bedded hospital for each 10,000 to 20,000 population3) Major charger in medical education including 3 months training in social and preventive medicine to prepare 'social physicians'.
Social & Preventive Medicine
null
2949e449-38c9-4f18-9e3e-c107a5e10241
What is the most common malignancy affecting spleen
Angiosarcoma
Hamaoma
Secondaries
Lymphoma
3d
single
The most common neoplastic tumour is lymphoma(Hodgkin) and the most common benign tumour is a hemangioma, rest like angiosarcoma, secondaries and hamaomas are rare tumours of the spleen. Bailey and love&;s 24 the edition page no. 1091
Surgery
G.I.T
d4997c65-4cd7-4838-a990-d823d8c67e4b
A key gluconeogenic amino acid is:
Alanine
Serine
Valine
Tyrosine
0a
single
Alanine is a key gluconeogenic amino acid. The rate of hepatic gluconeogenesis from alanine is far higher than from all other amino acids. The capacity of the liver for gluconeogenesis from alanine does not reach saturation until the alanine concentration reaches 20 to 30 times its normal physiologic level. Ref: Harper’s illustrated biochemistry. 30th edition page no: 289
Biochemistry
null
0ba013b0-d7d2-4620-b17d-e236eff2bbd1
NARP syndrome is seen in
A. Mitochondrial diseases
B. Glycogen storage diseases
C. Lysosomal storage diseases
D. Lipid storage diseases
0a
single
NARP syndrome (neuropathy ,ataxia, & retinitis pigmentosa) is a condition related to changes in mitochondrial DNA Refer Harrison 17/316-317 Robbins 8/1328
Anatomy
General anatomy
38219c20-a4c7-4b9b-a7de-2d6a84c2f163
Most common post splenectomy infection is:
Pneumococcus
Meningococcus
Staphy lococcus
Corynebacterium
0a
single
Pneumococcus
Microbiology
null
dd15f11d-78d3-4937-98b0-16af19db9191
Hand signs of liver cell failure are all except?
Palmar erythema
Clubbing
Dupuytren's contracture
Splinter hemorrhages
3d
multi
The hand manifestations of CLD consist of: Spider naevi (invariably on the upper half of the body), Palmar erythema (mottled redness of the thenar & hypothenar eminences) Dupuytren's contractures Clubbing.
Medicine
Cirrhosis
e6ab0bd7-9762-44a7-87dc-020f53fe8f4c
Membranous urethral rupture causes collection of blood in -
Ischiorectal fossa
Deep perineal pouch
Superficial inguinal region
Pelvic diaphragm
1b
single
Ans. is 'b' i.e., Deep perineal pouch
Surgery
null
721896e1-42f1-4ba5-b5b3-b9f8f528b108
Function of peroxisomes is:
Generate hydrogen peroxide
Degrade hydrogen peroxide
Both
None
2c
multi
Peroxisomes are associated with: Production of peroxides and degradation of peroxides
Anatomy
General anatomy
48fc95d5-b54d-456e-a4dd-e110387c4aab
Protrusion of tongue not possible in damage of ?
Styloglossus
Hyoglossus
Palatoglossus
Genioglossus
3d
single
Ans. is 'd i.e., Genioglossus
Anatomy
null
80540eb0-f1ba-479b-91d9-315c407c1db8
Which disease doesn't require chemoprophylaxis?
Measles
Conjunctivitis
Cholera
Malaria
0a
single
Measles prevention is only by immunisation and vaccination. No chemoprophylaxis(Ref.PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE 21st Edition page no.136)
Social & Preventive Medicine
Communicable diseases
f068a90e-be9d-484d-93e1-1fa7718f8742
Alpha la adrenergic blocker giving symptomatic relief in BPH?
Tamsulosin
Prazosin
Oxazocin
Dolazoline
0a
single
ANSWER: (A) TamsulosinREF: KDT 7th ed p. 135, Goodman Gillman s 11th ed p. 173Tamsulosin:This unselective alpha! ./alpha blocker has been found to be as effective as terazocin for symptomatic control of BPHPrazosin: blocks all subtypes of alpha receptors equally, used for symptomatic control of BPH Terazosin: long acting, more popular for BPH due to single daily dose
Pharmacology
Anti Adrenergic System
ec5bbaf3-f792-4643-87a0-172b1ae93dd6
True about glycolysis are all except ?
Provide nutrition to cancer cells
Substrate level phosphorylation at pyruvate kinase
Two carbon end product is formed
NADPH is formed by glyceraldhyde-3-phosphate dehydrogenase
2c
multi
Ans. is 'c' i.e., Two carbon end product is formed Impoant facts about glycolysis An impoant biochemical significance is the ability of glycolysis to provide ATP in the absence of oxygen (anerobic glycolysis) and allows tissues to survive anoxic episodes. It occurs in cytosol 3 Carbon atoms end product (pyruvate or lactate) is produced. Irreversible steps are catalyzed by : - Glucokinase/Hexokinase, phosphofructohnase-I, and pyruvate kinase. Reversible steps are catalyzed by : - Phosphohexose isomerase, aldolase, phosphotriose isomerase, glyceraldehyde 3-phosphate dehydrogenase, Phosphoglycerate kinase, Phosphoglycerate mutase, Enolase. Energy (ATP) using steps are catalyzee by : - Hexokinase/glucokinase, phosphofurctokinase. Energy (ATP) production at substrate level are catalyzed by : Phosphoglycerate kinase, Pyruvate kinase. Reducing equivalent (NADH) production is catalyzed by : Glyceraldehyde 3-phosphate dehydrogenase. Cancer cells derive nutrition from glycolysis as they have lack of 02 supply because of lack of capillary network. Glycolysis (anaerobic glycolysis) is the only metabolic pathway in the body which can provide energy by glucose metabolism in anerobic conditions.
Biochemistry
null
c2c522e9-595e-4327-a763-7eb93c7fcb88
A 68-year-old male is brought to the outpatient by his wife due to increasing forgetfulness. On taking history in details, wife repoed that for around 6 months patient is having trouble in organising the finances and paying bills, something he has done all his life. He has also become withdrawn and has decreased meeting people. The patient also behaved inappropriately with a female neighbour couple of says back, which is much against his usual nature. The patient denies having any problems and seems indifferent to his wife's concern. He has a medical history of hypeension and type 2 diabetes mellitus There is a family history of Alzheimer disease. On MMSE, score came out to be 23. Which of the following is the most likely diagnosis?
Alzheimer disease
Creutzfeldt-Jakob disease
Dementia with Lewy bodies
Frontotemporal dementia
3d
multi
The history is suggestive of executive dysfunction (trouble in organising the finances and paying bills), apathy and disinhibition (decreased socialisation and inappropriate behaviour with women), lack of insight (denies having any problem) and memory disturbances. This is suggestive of frontotemporal dementia, in which personality changes are prominent, memory disturbances appear later in frontotemporal dementia. In contrast, in alzheimers disease memory disturbances are prominent early in the disorder and personality changes later. Creutzfeldt-Jakob disease which is caused by a prion manifests with rapidly progressive dementia, myoclonus, and cerebellar dysfunction.
Psychiatry
Organic Mental Disorders
d65aa85f-a8cb-4ec2-bac2-dd60e3b71e91
Which is the anesthetic agent of choice in a case of status asthmaticus?
Ketamine
Thiopentone
Ether
Nitrous Oxide
0a
single
Ketamine along with adjunctive therapy is the standard therapy in the treatment of children with status asthmaticus and impending respiratory failure. Ketamine cause bronchodilation through the inhibition of vagal tone, release of endogenous catecholamines and by direct muscle relaxation.
Anaesthesia
null
00df1399-fbd8-4c08-a065-e8d70301270b
In starvation activities of all of the following enzyme is increased except ?
Pyruvate carboxylase
Pyruvate kinase
PEP carboxykinase
Glucose 6 phosphatase
1b
multi
In starvation activity of all enzymes responsible for gluconeogenesis are increased. Pyruvate kinase is the enzyme of glycolysis. Activity of enzymes of glycolysis are suppressed in starvation. So pyruvate kinase activity is suppressed in starvation. All other enzymes given in this question are gluconeogenic enzyme whose activity is enhanced in starvation.
Unknown
null
f9265d72-9be4-4de6-b409-52cd81663674
A 22 year old man had a Beef sandwich and Potato salad. He Vomited 2 hours after the meal. What is the probable diagnosis
S. aureus poisoning
Bacillus cereus poisoning
Clostridial poisonong
Helicobacter pylori poisoning
0a
single
Preformed toxin of S. aureus causes nausea within 1-6 hours of ingestion. Common food associated are: Poultry, potato and egg salad.
Medicine
null
0137d79b-5dab-4d10-8025-54d4320c6508
The most potent drugs to reduce plasma cholesterol level are:
Plant sterols
Fibrates
Anion exchange resins
Statins
3d
single
null
Pharmacology
null
1a5d2120-82c3-4fca-b575-b773993b55c0
Which of the following is an alkaloid
Morphine
Neostigmine
Emetine
Atropine
1b
single
Neostigmine, sold under the brand name Prostigmin among others, is a medication used to treat myasthenia gravis, Ogilvie syndrome, and urinary retention without the presence of a blockage. It is also used together with atropine to end the effects of neuromuscular blocking medication of the non-depolarizing type. Refer 7/105
Anatomy
General anatomy
3eb968f4-8a7f-46a9-8aab-03c9631fcf1b
The incubation period of mumps is-
1 -2 weeks
2-3 weeks
3-4 weeks
4-5 weeks
1b
single
Incubation period of mumps is 2-3 wks Ref Harrison20th edition pg 897
Medicine
Infection
db5f0cb3-4db8-402c-92e2-028d7e41f7e7
During a hysterectomy and an oophorectomy, the uterine and ovarian vessels must be ligated. These vessels can be found in which ligaments?
Broad and ovarian
Broad and suspensory
Round and ovarian
Round and suspensory
1b
single
The uterine vessels are found in the inferior poion of the broad ligament, while the ovarian vessels are found in the suspensory ligaments of the ovaries. The suspensory ligaments of the ovaries are peritoneal folds covering ovarian aeries , veins, nerves, and lymphatics as the structures pass over the pelvic brim to reach the ovary. The ovarian ligament proper is a round cord which attaches the ovary to the uterus, just below the entrance of the uterine tube into the uterus. The round ligament of the uterus is a connective tissue band that attaches the uterus to the inner aspect of the labium majus,it traverses the inguinal canal and it is found in the broad ligament. Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 38. Anatomy. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e.
Gynaecology & Obstetrics
null
6459cbf2-9cb5-4d04-bfc3-f75278df9306
A 10-year-old male child with sho stature presented to the pediatric OPD with complaints of frequent headaches over the past 6 months along with slowly progressive loss of vision of the right eye. Lately the child has also staed having trouble in walking along with frequent mood changes and excessive thirst. MRI brain showed a tumour in the sellar region which was resected. HPE examination showed reticular epithelial cells that have appearances reminiscent of the enamel pulp of developing teeth along with calcifications and wet keratin nodules. The gene involved in causing the above condition is also involved in causing which other condition: -
Hepatocellular carcinoma
Melanoma
Neuroblastoma
CML
0a
multi
This is a case of Craniopharyngioma. Benign tumour Arise in sellar/suprasellar region Arise from vestigial remnants of Rathke's pouch Bimodal age distribution Presents with headache and visual disturbance May present with sho stature due to GH deficiency (Pituitary hypofunction). Most commonly due to abnormalities in WNT signaling pathway including the activating mutations of the beta-catenin. MRI image shows a mass in the suprasellar region- likely craniopharyngioma OTHER CANCERS DUE TO WNT PATHWAY Mutations in b-catenin are present in: - 50% of hepatoblastomas. 20% of Hepatocellular carcinomas GENES INVOLVED IN: - Melanoma- NRAS, FGF3, HST1 Neuroblastoma- N-MYC, ALK CML- ABL
Unknown
Integrated QBank
1f278c06-d2bf-41ec-be34-690107f150f9
Fatty acid present in breast milk which is important for growth and CNS development is:
Docosahexaenoic acid
Palmitic acid
Linoleic acid
Linolenic acid
0a
single
Ans. A. Docosahexaenoic acidDocosahexaenoic acid (DHA) is a long-chain polyunsaturated fatty acid found in breast milk that plays a role in neurodevelopment. Breast milk DHA concentration is influenced by DHA in the mother's diet.
Pediatrics
Nutrition
72f98331-484c-46c5-acd5-8f267f35471c
The commonest cause of limp in a child of seven years is -
T.B. hip
C.D.H
Perthe's disease
Slipped upper femoral epiphysis
2c
single
The most common cause of limp in a child between 3-10 years is transient synovitis of hip. However, among the given options Perthe's disease is the best answer as Perthes disease is the second most common cause of limp in a child between 5-10 years.
Orthopaedics
null
f6d8a925-07c5-4d4c-88d2-ff9d41d960a5
A 64-year-old lady Kamla complains of severe unilateral headache on the right side and blindness for 2 days. On examination, there is a thick cord-like structure on the lateral side of the head. The ESR is 80 mm / hr. in the first hour. The most likely diagnosis is :
Temporal arteritis
A migraine
Cluster headache
Sinusitis
0a
single
Ans. is 'a' i.e.,. Temporal Arteritis The symptom and the laboratory examination of the patients almost confirm the diagnosis of temporal arteritis.This question has been asked too frequently in various PGME examination you are required to be well versed with the differential diagnosis of a headache.Let's see the diagnostic features of various headaches.A migraineAge - Females after pubertySex - Females > malePresentationLateralised*usually frontotemporalPain preceded by Aura*Builds up gradually*May lasts for several hoursUsually throbbing but may be dull*Onset is after awakening & quietened by Sleep*.* Associated symptoms includeNausea, vomiting, Diarrhoea, photophobia* & Visual disturbance*Paresthesia with tingling and numbness*Other focal neurological symptoms such as clumsiness & weakness *.Cluster HeadacheMen in 20 - 50*Male>F (7 to 8 times)*Lateralised*Periorbital*Pain(periodic attacks 1-2/days)*Begins without warning. Reach crescendo within 5 min last for 45 minutes*Excruciating deep, explosive but only rarely pulsatile*.Commonly awakens the patients from sleep*.Associated SymptomsHomolateral lacrimation*Reddening of eye*Nasal stuffiness*Ptosis*Nausea*Trigeminal Neuralgia> 40 YearsOccurs along the distribution of Maxillary nerve*Electric in character*Episodic each episode lasts 2-4 min.The typical course is relapsing-remitting over several years.Temporal ArteritisMedian age 75 yrs*Female (Account for 65% cases)*Unilateral or Bilateral located temporarily in 50% patients*Usually appear graduallyOccasionally it is explosive.Dull and boring in character,Seldom throbbing.Scalp tenderness*Patients also complains of pain in jaw*Headache is usually worse at night.Associated symptomsHeadache, fever, weight lossJaw claudication*Polymyalgia Rheumatica*ESR Increase*Anemia*Blindness d/t ophthalmic artery involvement*.A tension HeadacheAt all agesFemalesBilateral Frontal area *Builds up slowlyFluctuates in severityPersists continuously for many days.A headache may be episodic or chronic.A tight band like discomfort*Associated symptomsNot prominentSometimes post neck muscles are tight*May be associated with anxiety & depression*.
Unknown
null
b96d7fdd-45c3-4d6e-90ef-bc406926908b
Half–life of lithium is:
8 hours
16 hours
24 hours
36 hours
2c
single
null
Pharmacology
null
a43d1445-5179-42a6-ab42-f912910cc947
A 44-year-old patient comes to his primary care physician complaining of double vision. On examination, he is unable to adduct or abduct his right eye- On further examination, he is also found to be unable to adduct his left eye. The remainder of the physical examination is normal. which of the following is the most likely location of the patient’s lesion?
Left abducens nerve
Left abducens nucleus and left medial longitudinal fasciculus
Right abducens nerve
Right abducens nucleus and right medial longitudinal fasciculus
0a
single
null
Medicine
null
bdb318ff-7fe0-4ac5-b1bd-45ea0d21e3b6
An 85 years old man underwent transurethral resection of prostate. A histological examination of his specimen showed T1a stage of adenocarcinoma: management will be:
Endocrine therapy
Radical surgery
Hormone therapy
No fuher treatment
3d
single
Management of CA prostate- T1a- observation+ Follow up (DRE+ PSA)- T1b, T1c, T2* > 70 years - Observation + follow up* < 70 years - Radical prostectomy Or RadiotherapyT3, T4 * Hormone therapy > Palliative radiotherapy* Bilateral Orchidectomy + Flutamide* LHRH Agonist (Goserelin, Leuperolide) + Flutamide- Goserelin -Recently FDA approved for advanced and metastatic CA prostate
Surgery
Prostate and seminal vesicles
b2f17630-fca5-4877-8e6d-89d5a26f3829
Ulnar nerve supplies all except-
Adductor pollicis
Abductor digiti minimi
Interossei
1st & 2nd lumbricals
3d
multi
Ans. is 'd' i.e., 1st & 2nd lumbricals Nerve supply of intrinsic muscles of HandThenar muscleso Abductor pollicis brevis. Flexor pollicis brevis, opponens pollicis - Median nerveo Adductor pollicis - Deep branch of ulnar nerveHypothenar muscleso Abductor digiti minimi, Flexor digiti minimi, opponens digiti minimi - Deep branch of ulner nerveo Palmaris brevis - Superficial branch of ulnar nerveInterosseio Palmar interossei - Deep branch of ulnar nerveo Dorsal interossei - Superficial branch of ulnar nerveLumbricalso 1st & 2nd (lateral two) lumbricals - Median nerveo 3rd & 4th (medial two) lumbricals - Deep branch of ulnar nerve
Anatomy
Nerves of Upper Extremity
c12f99d7-f993-4384-8330-f5b2e9a18e5c
Which of the gene is most often implicated in congenital cataract and alpha crystallin mutation?
GLC3A
PAX6
PITX2
CRYAA
3d
multi
CRYAA is implicated in congenital cataract and alpha crystallin mutation.
Ophthalmology
Cataract
dfb7bf91-be8a-4b4a-93bf-cc85bae1f43f
According to WHO guideline, all are indications for hospital admission in Pneumonia except
Convulsions
Persistent vomiting
Chest indrawing
Severe malnutrition
2c
multi
Child with chest indrawing ⇒ Pneumonia ⇒ Oral Amoxycillin Rest are danger signs ⇒ Severe Pneumonia ⇒ Referal to hospital.
Pediatrics
null
c19add0c-c0d2-469f-9b8b-2d5521c2b638
Naltrexone is used to maintain abstinence following opioid withdrawal in addicts. It blocks all of the following featues of opioid use, except -
Euphoriant effects of opioids
Craving for opioids
Miosis
Respiratory depression
1b
multi
Ans. is 'b' i.e., Craving for opioids o Naltrexone can reverse all effects of opioids like sedation, analgesia, constipation, respiratory depression and miosis, but it does not reduce craving. "Craving for opioids may continue during naltrexone treatment" Principles of addiction medicine o It is interesting to know that naltrexone does not reduce craving for opioid, but it reduces craving for alcohol in chronic alcoholism
Pharmacology
null
61101eb1-e9ca-4553-a8d3-e88dc64822cb
Causing hu by means of poison, etc with an intent to commit an offence is punishable under
Sec. 328 IPC
Sec.326 A IPC
Sec.327 IPC
Sec. 329 IPC
0a
single
- Sec. 328 IPC - Causing hu by means of poison, etc with an intent to commit an offence shall be Punishment is imprisonment upto 10 years and also fine. - Sec.326 A IPC - voluntarily causing grievous hu by means of acid - Sec.327 IPC - voluntarily causing hu to exto propey - Sec. 329 IPC - voluntarily causing grievous hu to exto propey
Forensic Medicine
Indian Legal system, Legal sections & Cou procedures
926e9e5a-3041-4194-834a-912da7d0e5a2
All of the following are precipitating factor for hepatic encephalopathy in patients with chronic liver disease except
Hypokalemia
Hyponatremia
Hypoxia
Metabolic acidosis
3d
multi
Answer is D (Metabolic acidosis): Hepatic encephalopathy is precipitated by metabolic alkalosis and not by metabolic acidosis. Electrolyte and Metabolic imbalances that precipitate Hepatic Encephalopathy Hypokalemia Alkaosis (Metabolic Alkalosis) Hypoxia Hyponatremia
Medicine
null
d5bae941-204d-4b71-b5d6-3364f4b41375
DIC is seen most commonly seen in which ANIL type?
M2
M3
M4
M5
1b
single
Answer is option 2 M3 DIC is common, especially in M3, with prolonged prothrombin time, low levels of fibrinogen and fibrin degradation products (FDPs) present. myeloid luekemia.
Pathology
Haematology
b46fdf56-8165-424e-aa70-2d8e3342bf52
Aspirin is contraindicated in?
Fever
Peptic ulcer
Unstable angina
Myalgia
1b
single
Ans. is 'b' i.e., Peptic ulcer Contraindications of Aspirin Peptic ulcer Prostaglandin has cytoprotective function for gastric mucosa by inhibiting acid secretion and promoting secretion of mucus. Aspirin inhibits synthesis of cytoprotective PG -3 bleeding & perforation may occur. Children with chicken pox & influenza Aspirin can cause Reye's syndrome (hepatic encephalopathy). Acknowledging this aspirin should not be given to children < 12 years, e.g. in JRA. Bleeding tendencies By its antiplatelet action, aspirin can exacerbate bleeding. Chronic liver disease Long-term therapy with high dose aspirin can cause insidious onset hepatic injury.
Pharmacology
null
f3ac6c89-6b79-4199-b4cd-f3320777bd03
In the international death ceificate, one of the following is not true-
Pa I of the ceificate deals with the immediate cause only
Pa I of of the ceificate deals with the immediate cause and also the underlying cause
Pa II records significantly associated diseases
The ceificate has been recommended by the WHO for international use
0a
multi
ref: Park&;s 23rd edition pg 56 International Death Ceificate: Recommended by WHO for international use. 2 pas: PA 1: deals with immediate cause, and the underlying cause which staed the whole trend of events leading to death. The underlying cause of death is reccorded on line (c). PA 2: any significant associated diseases that contributed to the death but did not directly lead to it.
Social & Preventive Medicine
Epidemiology
89325751-0142-4585-aaff-5821e3839742
Semicircular canals are stimulated by:
Gravity
Linear acceleration
Rotation
Sound
2c
single
Semicircular canals contain cristae which sense angular or rotational acceleration
ENT
Anatomy of Inner Ear
c73b027a-2655-46e3-b2dd-45c618bcc1d5
Which is true regarding ovary:
Mesovarium contains ovarian vessels
Ovarian ligament connects ovaries to uterus
Ovarian fossa is related to ilioinguinal
Suspensory ligament of ovary connects ovaries to uterus
1b
multi
Ans. is b i.e. Ovarian ligament connects ovar ovaries to uterus.REMEMBERMesovarium connects ovary posteriorly to the broad ligament.Ovarian ligament connects ovary to uterus (option b)Suspensory ligament or infundibulopelvic ligament connects ovary to lateral pelvic wall.Ovarian vessels and nerves are present in suspensory ligament.Ovarian fossa is related posteriorly to obturator nerve, not ilioinguinal nerve.
Gynaecology & Obstetrics
Gynaecological Anatomy
b5995935-1945-42d4-abab-eefd51264856
Vitamin K dependent coagulation factors include
II and III
IX and X
III and V
VIII and XII
1b
single
Vitamin K is an essential factor to a liver carboxylase that adds a carboxyl group to glutamic acid residues on five of the impoant clotting factors: prothrombin, Factor VII, Factor IX, Factor X, and protein C.Ref: Guyton and Hall textbook of medical physiology 13th edition. Page: 490
Physiology
Cardiovascular system
d43669d3-ef22-4e81-ade1-38fe3c80d444
Cells are most radio-resistant in
S phase
M phase
G1 phase
G2 phase
0a
single
Cell cycle Correct sequence: G0-G1-S-G2-M Most impoant checkpoint: G1-S Cellular content doubled in: S phase Cyclins D,E,A,B appears sequentially Cyclin D - first to increase in cell cycle Cyclin D - controls G1-S transition P16 (CDKN2A), P53& RB - Induce cell cycle arrest at G1-S Cyclin B - controls G2-M transition Fixed time is required for: S & M phase Most radio-resistant phase: S Most radio-sensitive phase: M
Pathology
General pathology
880ae4ba-25ac-459d-a968-ae3b73ff5fc6
Useful diagnostic studies in the evaluation of upper-extremity pain include all of the following, EXCEPT?
Cervical spine x-ray
Chest X-ray
Neural conduction studies of the median nerve
Adson's test
3d
multi
Pain in the upper extremity may be of musculoskeletal or neurologic origin. Compression of the nerves supplying the upper extremity can occur at various levels from the spinal cord all the way down to the fingers. Cervical spine x-ray is helpful for detecting bony abnormalities, which may cause nerve compression. Pancoast's tumor, which can be demonstrated on chest x-ray, may be responsible for pain. Neural conduction studies of the median nerve may disclose the presence of carpal tunnel syndrome as the cause of pain. Finkelstein's test produces pain in patients with de Quervain's disease. The test is performed by asking the patient to grab his own thumb with the other fingers of the same hand and then move the wrist in the ulnar direction. If pain is elicited, then the test is positive. Adson's test is very helpful in detecting the presence or absence of collateral circulation between the radial and ulnar aeries and is not diagnostic for pain.
Anatomy
null
6ed3224a-48d6-40ac-8257-02cc32b89e23
Which of following is the feature of Y chromosome?
Acrocentric
Telocentric
Submetacentric
Metacentric
0a
single
A normal chromosome appear constricted at the centromere, this divides each chromosome into two arms. The sho arm is designated as p arm and the long arm is designated as q. Ref: Primate Anatomy: An Introduction By Friderun Ankel-Simon, 3rd Edition, Page 552 ; Clinical Laboratory Medicine By Kenneth D. McClatchey 2nd Edition, Page 568 ; Folia Biologica 2001, Page 146
Anatomy
null
1ad07ab1-92bb-46c4-a7b5-bb319c05e303
Calcification of interveebral disc is seen in -
Gout
Rheumatoid ahritis
Alkaptonuria
Psoriasis
2c
single
Interveebral disc calcification seen in : Ochronosis /Alkaptonuria Ankylosing spondylitis Pseudogout Hemochromatosis Hypervitaminosis D Transient interveebral disc calcification Juvenile chronic ahritis Hyperparathyroidism Amyloidosis Poliomyelitis Acromegaly
Radiology
Skeletal system
fb18b4d4-bc87-4c42-8fd9-e084c0f7f2b7
A 70 - year old male presents with a C/O fatigue & jaundice. There is no H/O alcohol or liver disease. The liver and spleen are nonpalpable. He has a normocytic, normochromic anemia. The first step in evaluation of this patient is
CT scan of the abdomen
Hepatitis profile
LFT
Abdominal ultrasound
2c
multi
The first step in evaluating patient with asymptomatic jaundice is to determine whether the increased bilirubin, as evidenced by scleral icterus, is conjugated or unconjugated hyperbilirubinemia. Patients with unconjugated hyperbilirubinemia do not have bilirubin in their urine because unconjugated bilirubin (bound to albumin) is not excreted in the urine; these patients usually have either hemolysis or an enzyme deficiency in the path way for excretion of bilirubin. Conjugated hyperbilirubinemia suggests liver dysfunction and requires fuher assessment
Surgery
null
bae7d2c4-9b99-4430-b7a6-130821e5f863
Normal turnover rate of epidermis:
2 weeks
4 weeks
6 weeks
8 weeks
3d
single
Epidermal turnover time - skin doubling time -Time taken by keratinocytes to move from Stratum Basale to environment. -Around 14 days are required to move from Stratum Basale to reach lowermost layer of Stratum Corneum & 14 days to cross Stratum Corneum. -Sloughing off requires 28 days So total ETT =56 days (8 weeks) The turnover time in psoriasis = 4 days.
Dental
Layers of epidermis, dermis
fbfe0884-8400-4d65-94e7-83a076275f8e
Which one of the following describes the flavouring substance asafoetida (Fling)?
Dried leaf extract
Exudate from chopped roots
Pith of stem boiled and dried
Dried and hardened paste of fruit
1b
single
Ans. is 'b' i.e., Exudate from chopped roots
Social & Preventive Medicine
null
9b04ce12-b330-46ae-94e4-fa1de80c9ebd
Anion gap is increased in all except: September 2009
Ureterostomy
Ethylene glycol
Methylene glycol
Diabetic ketoacidosis
0a
multi
Ans. A: Ureterostomy
Medicine
null
3c3d9c6f-a887-44d5-b8bd-3a141c2ef245
Hypopituitarism in the adult is usually due to infarction of the pituitary called as:
Simmonds’ diseases
Hilton's disease
Wilson disease
Addison disease
0a
multi
Hypopituitarism in the adult is usually due to an infarction of the pituitary called Simmonds’ disease.   It is characterized by loss of weight and diminished sexual function. The basal metabolic rate is markedly lowered, and since Simmonds’ disease represents a panhypopituitarism, there is a decrease in the activity of the many hormones of the pituitary gland and of those glands that are under pituitary regulation. In this disease, the skin shows atrophic alterations. Changes in the head include thin eyebrows, loss of eyelashes, sharp features, thin lips, and an immobile expression. There will be a decreased salivary flow due to hyperfunctioning of salivary glands which leads to increased caries activity and periodontal disease.
Pathology
null
7d82f68a-0eca-45b1-8416-517eda2b1d63
During diastole, arterial pressure is maintained by
Elastic recoil of aorta
Musculature of arteries
Constriction of capillaries
Contraction of left ventricle
0a
single
null
Physiology
null
82ad2997-b4fb-4e6b-ba46-9f8f89533d15
Vesicular lesions, indistinguishable from primary infection, which arise in other pas of the body of an allergic individual infected with Trichophyton are referred to as
Dermatiphytids
Trichophytins
Eschars
Carbuncles
0a
multi
Dermatiphytids - Hypersensitivity to dermatophyte antigen may occur which leads to appearence of secondary eruption in sensitized patients because of circulation of allergic products. These lesions are indistinguishable , but these lesions are distinct from the primary ringworm lesion as they occur distal to primary site and fungal culture often turns negative.
Microbiology
Mycology
2af27555-a585-41f3-bb0a-5dc47a4389eb
In which of the following condition serum ascites-to-albumin gradient is > 1.1
Nephrotic syndrome
Pancreatitis
Peritoneal carcinomatosis
Budd chiari syndrome
3d
single
The development of the serum ascites-to-albumin gradient (SAAG) has replaced the description of exudative or transudative fluid. When the gradient between the serum albumin level and the ascitic fluid albumin level is >1.1 g/dL, the cause of the ascites is most likely due to poal hypeension; this is usually in the setting of cirrhosis. When the gradient is <1.1 g/dL, infectious or malignant causes of ascites should be consideredIn Budd Chiari syndrome SAAG is >1.1 i.e poal hypeensionReference: Harrison&;s Principles of Internal medicine; 19th edition; Chapter 35; Cirrhosis and its complications
Medicine
Nutrition
e2547915-23cc-46fe-ba40-e174e7a1ee87
Regarding autoimmune hemolytic anemia in pregnancy all are true except
Direct coombs test is usually positive
Pregnancy accelerates hemolysis
Usually does not respond to steroids
Fetal michrochimerism results in aberrant antibody production
2c
multi
During pregnancy, autoimmune hemolytic anaemia usually responds to prednisolone.
Gynaecology & Obstetrics
null
2f8274f0-571b-45c3-b659-96f1e775c238
AIDS day is: September 2004
7 April
3-May
5-Jun
1-Dec
3d
single
Ans. D i.e. 1 December
Social & Preventive Medicine
null
8938a363-bbbd-4803-b642-668bf411a632
The strength attained by amalgam within 8 hours is
60%
70%
80%
90%
1b
single
The strength attained by amalgam within 8 hours is 70%. Reference: Phillip’s Science of Dental Materials, Pg-353
Dental
null
ca9573d1-628b-41dc-ae29-7504f151c923
All are cause of Respiratory distress in newborn and Ipsilateral shift of mediastinum
Alelectasis
Lung collapse
Pulmonary hypoplasia
Hyaline membrane disease
3d
multi
No mediastinal shift in hyaline membrane disease.
Radiology
null
6c7333fe-f4a7-4348-8d85-1e4a688bf885
A non diabetic, non hypertensive patient has some extra beats in pulse. Doctor informed that is benign and no intervention required. But patient is worried that it is a serious cardiac disorder and is still going for repeated investigation & going from doctor to doctor. This is a type of:
Conversion disorder
Hypochondriosis
Somatization
Depression
1b
single
Interpretation of benign symptom (extra beats) as a serious illness (cardiac disorder) is suggestive of Hypochondriosis.
Psychiatry
null
0ee3c4b9-838c-4cb3-84b4-394d0328f0b3
Ascorbic acid is a potent enhancer of iron absorption because it:
Enhances the absorption of heme iron
Enhances the activity of heme oxygenase
Is a reducing agent, thereby helping to keep iron in the ferrous state
Decreases the production of ferritin by enterocytes
2c
single
Ans. C. Is a reducing agent, thereby helping to keep iron in the ferrous stateAscorbic acid enhances iron absorption mostly by its reducing capacity, keeping iron in the ferrous state. Ascorbic acid does not enhance heme iron absorption, nor does it affect heme oxygenase activity or the production of ferritin or transferrin.
Physiology
Misc.
572f1e60-d4de-4ba0-95f8-9a8daea9bc84
Most common cause of unilateral proptosis is
Thyrotoxicosis
Retinoblastoma
Intraocular haemorrhage
Raised intracranial tension
0a
single
A i.e. Thyrotoxicosis Grave's ophthalmopathy is most common cause of U/L or B/L proptosis in adults Q between age of 25-50 yrsQ
Ophthalmology
null
78e10b6f-d2a8-439c-b5a5-be9044e57c8d
Powders of dental plaster and dental stone differ mainly in:
Solubility
Shelf life
Chemical formula
Particle porosity
3d
single
null
Dental
null
d106f34f-e225-4f44-b0fe-f8396edb8366
Macrophage is -
Monocytes
Eosinophils
Neutrophils
Lymphocytes
0a
single
Ans. is 'a'i.e., Monocytes o The monocytes migrate to tissues and become part of the tissue (fixed) macrophages.o Blood macrophages - Monocyteso Tissue macrophages - HistiocytesTissue macrophages (histiocytes) in different tissue are mentioned below -o Lung: 'Alveolar macrophages' or 'Dust' cellso Placenta: Hoffbauer cellso Brain: Microgliao Kidney : Mesangial cellso Liver : Kupffer cellso Spleen : Littoral cellso Bone: Osteoclastso Synovium: Type-A lining cellso Skin: Langerhans cellso Spleen: Red pulp sinusoidal lining cellso Connective tissue: Histiocytes (tissue macrophages)o Life span of monocytes in circulation is 1-3 days whereas tissue macrophages have life span of 3 months to years
Pathology
Cell and Tissue Regeneration
3b5dbd14-6150-4279-a72f-366177887fad
INH induced neuropathy is treated with
Thiamine
Pyridoxine
Niacin
Riboflavin
1b
single
null
Pharmacology
null