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135
2f6fcd3f-af72-46f2-8644-03a5c17ae86e
Calorie requirement per day of a child weighing 15 kg would be -
1150 kcal
1250 kcal
1450 kcal
1550 kcal
1b
single
Ans. is 'b' i.e., 1250 kcal
Pediatrics
null
bf3060de-91b5-4462-a42b-1bf648b02f59
A 24-year-old medical student was bitten at the base of her thumb by her dog. The wound became infected and the infection spread into the radial bursa. The tendon(s) of which muscle will most likely be affected?
Flexor digitorum profundus
Flexor digitorum superficialis
Flexor pollicis longus
Flexor carpi radialis
2c
single
Tenosynovitis can be due to an infection of the synovial sheaths of the digits. Tenosynovitis in the thumb may spread through the synovial sheath of the flexor pollicis longus tendon, also known as the radial bursa. The tendons of the flexor digitorum superficialis and profundus muscles are enveloped in the common synovial flexor sheath, or ulnar bursa. Neither the flexor carpi radialis nor flexor pollicis brevis tendons are contained in synovial flexor sheaths.
Anatomy
Upper Extremity
bf6aaafa-666b-4a31-a39c-722047c206e5
A two way process of exchanging or shaping ideas, feeling and information is called as
Education
Communication
Interview
Suggestion
1b
multi
null
Dental
null
a0b89dad-2295-4fd8-8f50-587a9e839518
Angular vein infection causes thrombosis in:
Cavernous sinus
Suprasaggital sinus
Transverse sinus
Inferior petrosal sinus
0a
single
Ans. A Cavernous sinusRef: Gray's Anatomy, 40th ed. Ch; 29* The upper most segment of the facial vein, above its junction with the superior labial vein, is also called the angular vein.* Any infection of the mouth or face can spread via the angular veins to the cavernous sinuses resulting in thrombosis.
Anatomy
Neuroanatomy
90076952-1966-402b-bbb6-081a567b5606
Which laxative acts by opening of Chloride channels ?
Docusate
Anthraquinone
Lubiprostone
Bisacodyl
2c
multi
Ans. is 'c' i.e., Lubiprostone o Lubiprostone is used for chronic constipation, it acts by - o Stimulating Cl- channel opening in the intestine. Increasing liquid secretion in gut. Decreasing transit time.
Pharmacology
null
d33408ca-e883-4a13-b671-fbb040d11c3b
All the following features favour ventricular tachycardia as the cause of broad-complex tachycardia, except -
Fusion beats
Extreme left axis deviation
Very broad QRS complexes (> 140 ms)
Non response to carotid sinus massage
2c
multi
null
Medicine
null
9098c2de-0c09-4332-b14c-04bb60bcafd8
Lallu a 22 yrs. old male suffers from decreased sleep, increased sexual activity, excitement and spending excessive money for last 8 days. The diagnosis is-
Confusion
Mania
Hyperactivity
Loss of memory
1b
multi
Decreased sleep, increased sexual activity, excitement and spending excessive money are symptoms of mania.
Psychiatry
null
681e1bdf-6ba1-43a8-ae80-3a540a83bd0a
Branches of celiac trunk are all except-
Splenic artery
Left gastric artery
Hepatic artery
Inferior phrenic artery
3d
multi
Ans. is 'd' i.e.. Inferior phrenic artery Inferior phrenic artery is a branch of abdominal aorta, not of Celiac trunk. Branches of Celiac trunk is a extremely important topic for PG exams. Branches of important arteries are very often asked in PG exams. I am giving a list of important arteries. Learn their branches by heart if you want to get selected Celiac trunk Superior mesentric artery Inferior mesentric artery Abdominal aorta Thoracic aorta Internal iliac artery Subclavian artery Axillary artery Carotid artery Maxillary artery Basilar artery Don't waste time on learning the course or relation of arteries. They are never or very rarely asked.
Anatomy
Blood Vessels of Abdomen and Pelvis
201e9563-123a-4a5d-ac11-65848ed09624
The disease process that best accounts for this problem:
Ethylene glycol poisoning
Chronic obstructive pulmonary disease
Congestive hea failure
Vomiting
3d
single
Vomiting
Pathology
null
e3101271-1440-4695-9f7e-0dd47023b1d2
Loeffler&;s syndrome occurs in all except
Toxocara
Stongyloides
Ascaris
Giardia
3d
multi
*Giardia lamblia -intestinal flagellate,causing intestinal infection. *Loeffler syndrome- inflammatory and hypersensitivity reaction in the lungs lead to cough ,fever, dyspnoea and eosinophilia *toxocara causes visceral larva migrans . ref:Baveja textbook of parasitology 3rd edition.
Microbiology
parasitology
e7fae33e-47a9-47f4-afd0-82ac4ebeeb09
A 7-day-old premature infant born at 26 weeks of gestation now has a grossly bloody stool, abdominal distention, and increasing oxygen requirements. choose the best initial diagnostic step in the evaluation of the patient's apparent GI hemorrhage.
Abdominal series
Fiberoptic endoscopy
Apt test
Routine stool culture
0a
multi
Necrotizing enterocolitis (NEC) is a life-threatening condition seen mostly in premature infants. Although the precise etiology is unknown, contributing factors include GI tract ischemia, impaired host immunity, the presence of bacterial or viral pathogens, and the presence of breast milk or formula in the gut. Findings include bloody stools, abdominal distension, hypoxia, acidosis, and emesis. The initial diagnostic test of choice is plain film radiographs. The characteristic finding in NEC is pneumatosis intestinalis; free air in the peritoneum may also be seen. Perforation is a surgical emergency, otherwise observation and antibiotics are indicated.
Pediatrics
Gastro Intestinal System
88596a8b-498f-4e5f-950d-4bb1b2ad683f
Lactic acid is produced in mouth by
Saccharolytic bacteria in supragingival region
Saccharolytic bacteria in subgingival region
Non-saccharolytic bacteria in supragingival region
Non-saccharolytic bacteria in subgingival region
0a
single
null
Dental
null
40dacf03-d7e8-45a4-945c-094f30a1abb1
Commonest site of liquifactive necrosis is
Brain
Kidney
Liver
Spleen
0a
single
Ans. a (Brain). (Ref. Robbins, Pathologic Basis of Disease, 8th/pg.7-13)NECROSIS# Enzymatic degradation of a cell resulting from exogenous injury.# Characterized by enzymatic digestion and protein denaturation, with release of intracellular components.# Morphologically occurs as coagulative (heart, liver, kidney), liquefactive (brain), caseous (tuberculosis), fat (pancreas), fibrinoid (blood vessels), or gangrenous (limbs, GI tract).# Kidney infarct exhibiting coagulative necrosis will be seen with loss of nuclei and clumping of cytoplasm but with preservation of basic outlines of glomerular and tubular architecture.# Liquefactive necrosis in the kidney can be caused by fungal infection, which will be seen filled with white cells and cellular debris, creating a renal abscess that obliterates the normal architecture.IRREVERSIBLE INJURY AND CELL DEATHMORPHOLOGIC PATTERNCHARACTERSTICSCOAGULATIVE NECROSISMost common type (e.g. Heart, liver, kidney)LIQUEFACTIVE NECROSISAbscesses, brain infarcts, pancreatic necrosisCellular destruction by hydrolytic enzymesCASEOUS NECROSISSeen in tuberculosisCombination of coagulation and liquefaction necrosis soft, friable, and "cottage-cheese-like" appearanceFAT NECROSISCaused by the action of lipases on fatty tissue (e.g. with pancreatic damage)Chalky white appearanceFIBRINOID NECROSISEosinophilic homogenous appearance - resembles fibrinGANGRENOUS NECROSISCommon sites: lower limbs, gallbladder, Gl tract and testesDry gangrene - coagulative necrosisWet gangrene - liquefactive necrosisAPOPTOSISA specialized form of programmed cell death, an active process under genetic control.Executed in mitochondria.Mediated by a cascade of caspases (digest nuclear and cytoskeletal proteins and active endonucleases).
Pathology
Cellular Pathology
dd848b66-6eb0-4347-bd1d-9ab8fb1b2dce
Ixabepilone is used in:
Melanoma
Breast carcinoma
Oat cell carcinoma
Small cell carcinoma lung
1b
multi
Chemotherapy regimen in CA BreastMnemonic- CMF- C- cyclophosphamide- M- methotrexate- F -5- FUMnemonic-CAF- C- cyclophosphamide- A- Adriamycin (doxorubicin) (anthracycline derivative)- F - 5 - FU- The preferred form of chemotherapy for CA breast - CAF or Adriamycin or Anthracycline based Chemotherapy.- Usually 6 cycles are given- For Adriamycin resistant breast cancer - Taxanes are given (Docetaxel, Paclitaxel)- Chemotherapy agent given in Adriamycin & Taxane resistant breast cancer - IXABEPILONE- LAPATINIB - 2nd line agent for HER-2-NEU + ve breast cancer- HERCEPTIN /TRASTUZUMAB - 1st line agent for HER-2-neu +ve breast cancer Drug given in metastatic and refractory breast cancer - SUNITINIB 1st line agent for advanced and metastatic RCC - SUNITINIBDrug of choice for Imatinib resistant GIST - SUNITINIB.
Surgery
Breast
48ddbb5f-15ba-4013-923c-73c6461af514
Head of sperm is derived from:
Golgi Body.
Nucleus
Mitochondria.
Centromere
1b
single
Ans. B. NucleusThe spermatozoon consists of head, neck, and tail. The tail is further divided into three parts: middle piece, principle piece, and end piece.a. The head mainly consists of a nucleus that contains the condensed chromatin material (mostly DNA).b. Anterior two-third of the nucleus is covered by an acrosomal cap that contains various enzymes including hyaluronidase and acrosin.c. Neck contains a funnel-shaped basal plate and a centriole. The centriole gives rise to axial filament that extends throughout the tail.d. Middle piece contains the axial filament in the center that is surrounded by spirally arranged mitochondrial sheath.
Anatomy
Embryology
c31211a0-71b3-44de-99fa-d8ef79bfaa24
Hepatitis A virus shedding in faeces is
One week before the symptoms appear
Two weeks after the symptoms appear
One week before the symptoms and one week thereafter
Two weeks before the symptoms and two week thereafter
3d
single
null
Social & Preventive Medicine
null
3f534cc4-19c7-4c02-b881-6c298b1e49ea
Spinal anaesthesia in an adult is given at this level:
T12-L1
L1-L2
L3-L4
L5-S1
2c
single
Spinal cord ends at lower border of L1 in adults .Hence spinal anesthesia can be given at levels below L1 . L2-L3 or L4-L5 are considered best in adults
Anaesthesia
FMGE 2019
4f5b188c-9468-45e8-b4e0-4d33e0e244e8
Decreased motility of fallopian tube is seen in -
Churg- strauss syndrome
Kartagener s syndrome
Noonan syndrome
Turner syndrome
1b
multi
Ans-B
Unknown
null
cbce5334-28c5-48e1-b2f3-2a3b5e79e913
The earliest manifestation of increased intracranial pressure following head injury is
Ipsilateral pupillary dilatation
Contralateral pupillary dilation
Altered mental status
Hemiparesis
2c
single
• Early signs of elevated ICP includes drowsiness and a diminished level of consciousness. • Coma and unilateral papillary changes are late signs and require immediate intervention.
Surgery
null
0921441e-f890-4483-9124-d73958608213
What is the most likely diagnosis in this 50-year-old woman?
Metastasis
Onychomycosis
Psoriasis
Thromboangiitis obliterans
0a
single
Answer A. MetastasisFollowing radiography that revealed a lytic lesion of the terminal phalynx, the firm 2-cm lesion with a scab in the center was biopsied and found to represent a metastasis from follicular thyroid carcinoma.
Medicine
Immunology and Rheumatology
4a671b2d-e0fa-4ad8-8dec-3a6c34401060
At what level of b-hCG is it that normal pregnancy can be earliest detected by TVS (transvaginal USG)?
500 IU/mL
1000 IU/mL
1500 IU/mL
2000 IU/mL
1b
single
Ans. is b, i.e. 1000IU/MLRef Dutta Obs. 7/e, p 642Critical titre of hCG:b-hCG level (mIU/ml)Structure visibleTVS/TAS* 1000-1200Gestational sacTVS* 6000Gestational SacTAS
Gynaecology & Obstetrics
Diagnosis in Obstetrics
b10e59eb-0900-4404-92d6-d8f568a19a25
In a patient of cholangitis, surgical intervention was performed. In post-operative period, on 10th day this investigation was performed. What is the name of this investigation?
ERCP
MRCP
T-tube cholangiogram
PTC
2c
single
The investigation is T-tube cholangiogram.
Surgery
Bile duct
cdb2d02d-eb8a-4707-ab9c-ed0a9248c687
Hepatitis B virus is NOT present in
Milk
Sweat
Stool
Lymph
3d
single
(ref: Harrison's 18/e p2108)
Medicine
All India exam
dcfb499f-109b-420c-a939-9bf6f2b01f58
Milroys disease is lymphedema which is-
Familial
Follows filariasis
Follows erysipelas
A sequele to white leg
0a
single
null
Surgery
null
467828b5-1027-442a-a27a-6a5cea4f8dab
Erythropoietin is inhibited by
Estrogen
Progesterone
Thyroxine
Testosterone
0a
single
Glycoprotein hormone that controls erythropoiesis, or red blood cell production. Estrogen inhibits the erythropoietin whereas testosterone stimuates production . Ref: Ganong's Review of Medical Physiology; 24th edition; page no: 709
Physiology
Renal physiology
01c55c70-9f52-42ba-8b6d-473f0bcabc81
Other than nitrogen and oxygen, which one of the following is the most abundant gas in the eah's atmosphere?
Argon
Carbon dioxide
Hydrogen
Methane
0a
single
Atmosphere composition Nitrogen 78% O2 21% Argon 0.9% CO2 0.03%
Social & Preventive Medicine
Environment and health
32ac0d34-327f-4c22-b1c6-1c866e7aaec6
Blood spill disinfection by:
Isopropyl alcohol
Hypochlorite
Formalin
Glutaraldehyde
1b
single
ANS. B# Spaulding's classification for sterilization1. Critical, e.g. heart lung machine, scalpel (contact with blood)2. Semicritical, e.g. endoscopes3. Noncritical, e.g. stethoscope, BP cuff, plasters.Method of sterilization1. Critical: Autoclave/ethylene oxide2. Semicritical: 2% glutaraldehyde for 20 minutes3. For plastic tubes: Gamma rays
Microbiology
General
ddbd5348-4545-4df3-85f7-b5456de5b261
Most permissible capillaries are seen in
Kidney
Liver
Brain
Skin
1b
single
Capillaries are classified in toContinuous or non fenestrated capillaries - Endothelial cells are arranged without any gap in between them. Eg. Skin, BBB. Allows only very small molecules to pass through. Fenestrated capillaries - Gaps in between endothelial cells ranging from 70-100nm in diameter which are lined by basement membrane. Eg. Capillaries of intestinal villi, renal glomeruli, choroid plexus of the ventricles of the brain, ciliary process of eyes and endocrine glandsDiscontinuous type- Very wide cleft are present in between endothelial cells. The basement membrane is incomplete or absent. Almost all substance in plasma can cross this gap. Seen in liver sinusoids, sinusoids of spleen, anterior pituitary and parathyroid gland Ref: Textbook of medical physiology by N Geetha, 2nd edition, page no. 194
Physiology
Cardiovascular system
b3809ff9-ba9a-4aa0-a8b0-d11acaf1e6c9
A 41-year-old male patient presented with recurrent episodes of bloody diarrhoea for 5 years. Despite regular treatment with adequate doses of sulfasalazine, he has had several exacerbations of his disease and required several weeks of steroids for the control for flares. What should be the next line of treatment for him?
Methotrexate
Azathioprine
Cyclosporine
Cyclophosphamide
1b
single
null
Medicine
null
e7f62a9d-8b4e-420e-a43b-0e60ddc26f2e
Anaplasia is a hallmark feature of _________.
Benign tumors
Malignant tumors
Both 1 & 2
Normal cell
1b
multi
Anaplastic cells often display the following morphologic features: Pleomorphism (i.e. variation in size and shape). Nuclear abnormalities, consisting of extreme hyperchromatism (dark-staining), variation in nuclear size and shape, or unusually prominent single or multiple nucleoli. Enlargement of nuclei may result in an increased nuclear-to-cytoplasmic ratio that approaches 1:1 instead of the normal 1:4 or 1:6. Nucleoli may attain astounding sizes, sometimes approaching the diameter of normal lymphocytes. Tumor giant cells may be formed.  Atypical mitoses, which may be numerous. Anarchic multiple spindles may produce tripolar or quadripolar mitotic figures.  Loss of polarity. ​Reference-Robbins BASIC PATHOLOGY 10th edition pg-193
Pathology
null
235c3a69-e95b-424e-b21f-4dc98224af20
Active moiety of CoA is
Acetyl group
Pantothenic acid
Thiol of beta alanine
Thiol of pantothenic acid
3d
single
- Synthesis of coenzyme A from pantothenate occurs in a series of  reactions. Pantothenate is  first phosphorylated to  which  cysteine is  added. Decarboxylation, followed by addition of AMP moiety and a phosphate (each from ATP) results in  coenzyme A. -Coenzyme A serves as a carrier of activated acetyl or acyl groups (as thiol esters).
Biochemistry
null
ac475a01-ae53-4926-85fa-935ab971633d
All the following are radiological features of Chronic Cor pulmonale except-
Kerley B lines
Prominent lower lobe vessels
Pleural effusion
Cardiomegaly
1b
multi
Answer is B (Prominent lower lobe vessels) : Chronic Cor Palmonale is associated with prominence of upper lobe and not lower lobe veins. Features of Congestive Cardiac Failure(CCF / CHF) include : 1. Enlarged cardiac silhouette / Cardiac shadow on chest X-rayQ 2. Ground glass appearance of pulmonary edema Q 3. 'Kerley B' linesQ 4. Prominence of upper lobe blood vessels Q (not lower lobe veins) 5. Pleural effusion, usually bilateral Q 'Kerley B' lines', also known as 'Septa' lines', represent dilated lymphatics and distended interlobular septa. They occur most commonly in pulmonary edema as a result of chronic pulmonary venous hypeension (in CCF). Kerley 'A' lines stand for Apex, 'B' for Base, and 'C' for Central region. B lines are most commonly seen Q.Infact they have a relation with left atrial pressure Q :They are invariably present if LA pressure goes above 20 mmHg. Q Small bilateral pleural effusions are frequently seen in acute LVF. Large effusion may be present in long standing cases of congestive hea failure.
Medicine
null
a781147f-a578-4163-a83f-95778f7d19d6
Nestritide is a -
Brain Natriuretic peptide analogue
Endothelin R antagonist
Gp Ilb/IIIa antagonist
INF-a antagonist
0a
single
Ans. is 'a' i.e., Brain natriuretic peptide analogue
Pharmacology
null
74e23f7d-e084-4311-a004-be92a6400a52
Leukoplakia appears white due to :
Cornified layer which imbibes water.
Thick epithelium
Underlying connective tissue
All of the above
0a
multi
null
Pathology
null
0bf5934a-b2bc-4813-847d-34f919d1b329
Which of the following tooth can show any of the eight types of Vertucci’s classification?
Lower 1st premolar
Upper 1st premolar
Lower 2nd premolar
Upper 2nd premolar
3d
single
Maxillary 2nd premolar can show any of the eight types of Vertucci's classification.
Dental
null
404ff199-6c04-4e7a-a59c-60162a7ecf07
A 25 yr old lady develops brown macular lesions over the bridge of nose and cheeks following exposure to sunlight. What is the most probable diagnosis?
Chloasma
Photodermatitis
SLE
Acne rosacea
0a
single
This lady is showing features of chloasma which is a brownish macular hyperpigmentation of the face mostly over the cheek, forehead, nose, upper lip and chin. In a small percentage of cases it is also seen on the malar or mandibular areas of the face and occasionally the dorsum of the forearms. It is exacerbated by sunlight. This is usually seen in women during pregnancy, in women taking OCPs and living in sunny regions. It is also associated with the ingestion of diphenylhydantoin. Ref: Suurmond D. (2009). Section 13. Pigmentary Disorders. In D. Suurmond (Ed), Fitzpatrick's Color Atlas & Synopsis of Clinical Dermatology, 6e.
Skin
null
6eff9805-f407-4f47-8aa7-82a5883fda08
Which of the following is a BNP analogue?
Eplerenone
Nesiritide
Levosimendan
Coenzyme Q
1b
multi
Ans. B. NesiritideBNP (Brain natriuretic peptide) is peptide which is secreted & formed in right atrium of the heart. This is responsible for vasodilation & hence used in CHF. Nesiritide is BNP analogue
Medicine
Drugs
0dc94947-2686-40a2-9018-e47bde111e26
Intravascular heamolysis occurs in
Hereditory spherocytosis
Antoimmune haemolytic anemia
Paroxysmal nocturnal hemoglobinuria
Thalassemia
2c
single
Paroxysmal noctural hemoglobunuria (PNH) is the only hemolytic anemia caused by an acquired intrinsic defect in the cell membrane. It is associated with intravascular hemolysis. Rest all conditions causes extravascular heamolysis.
Pathology
null
168ac3e1-1ace-4015-9b17-8a137842c2ee
Healing of a wound which simply restores the continuity of the diseased marginal gingiva is known as
Regeneration
new attachment
Repair
reattachment
2c
single
null
Dental
null
4e32fcdc-8948-4f07-b12f-76a1b354b80b
Intra uterine growth retardation can be caused by all except -
Nicotine
Alcohol
Propranolol
Phenothiazine
3d
multi
Ans. is d i.e., Phenotiazines
Pediatrics
null
974166b0-214b-4d84-8785-3a6ad189abd0
An alcoholic is brought to the casualty, 3 days after he quit alcohol, with the complaints of irrelevant talking. On examination, he is found to be disoriented to time, place and person. He also has visual illusions and hallucinations. There is no history of head injury. The most probable diagnosis is:
Schizophrenia
Delirium tremens
Dementia praecox
Korsakoff psychosis
1b
multi
This patient in the question who is a chronic alcoholic is showing features of delirium tremens, which typically appears after 3-4 days of abstinence from alcohol (24 hours to 7 days). Ref: CURRENT Diagnosis and Treatment: Emergency Medicine, 7th Edition, Chapter 37 ; CURRENT Diagnosis and Treatment: Psychiatry, 2nd Edition, Chapter 14
Psychiatry
null
e5bc9f94-51f4-407d-9faa-11bbcdb838ec
Repeat upper GI endoscopy in a patient with a gastric ulcer is performed after how many weeks of PPI therapy to assess the healing of the ulcer and confirm absence of malignancy:
2 weeks
4 weeks
6 weeks
12 weeks
2c
single
Repeat upper endoscopy is done in patients with a gastric ulcer after 6 to 10 weeks of acid suppressive therapy to confirm healing of the ulcer and absence of malignancy. 2% to 4% of repeat upper endoscopies have been repoed to disclose gastric cancer. Ref: Sleisenger and Fordtran's, E-9, P-305
Medicine
null
57a57575-091f-48dd-9940-862caf87e7aa
Hassal's corpuscles are seen in
Thymus
Thyroid
Parathyroid
Spleen
0a
single
Corpuscles of hassall present in the medulla of thymus Formed from eosinophilic epithelial reticular cells arranged concentrically INDERBIR SINGH'S TEXTBOOK OF HUMAN HISTOLOGY SEVENT EDITION PAGE NO139
Anatomy
Thorax
8f0b9096-9005-43ab-8e23-36b881563dbd
True regarding amaurosis fugax are all except:
Transient, recurrent episodes of visual loss
Binocular lesion
Embolus from carotid aery is commonest cause
Ocular examination may be normal
1b
multi
Amaurosis fugax Sudden, temporary and painless monocular visual loss occurring due to a transient failure of retinal circulation. Uniocular lesion Lasts for 2-5 minutes and resolves in the reverse pattern of progression, leaving no residual deficit. Fundus : May be normal or shows retinal ischemia-Retinal oedema and small superficialhaemorrhages Causes : Carotid transient ischaemic attacks (TIA) Embolization of retinal circulation Papilloedema Giant cell aeritis Raynaud's disease Migraine Hypeensive retinopathy Venous stasis retinopathy
Ophthalmology
Investigation in ophthalmology and miscellaneous topics
4aa671f1-1545-4290-87a8-e5950218cc3d
Not a indication for admission in pneumonia ?
Fever of 390 c
Cyanosis
Chest retracion
Not feeding well
0a
single
Ans. is 'a' i.e., Fever of 39degC Indications for urgent referral for hospital in AI Not able to drink Convulsions Severe malnutrition Stridor in calm child Abnormally sleepy or difficult to wake o All these are signs of very severe disease which is an indication for urgent hospital referrel. o Signs of very severe pneumonia i.e., chest retraction, cyanosis are also indications for urgent referrel to a hospital.
Social & Preventive Medicine
null
31290290-fc1f-45dc-b8ad-072454002c9d
A dental floss is applied to the distal bow of a clamp, its function is:
To facilitate the removal of the clamp
To prevent aspiration of clamp
To anchor the dam as cervically as possible
To stabilize the clamp
1b
multi
null
Dental
null
92a7ea49-5e3e-4106-8fe5-d6930a2f8caa
Best way to prevent infection after cataract surgery is
Antibiotics
Eye brow shaving
Through irrigation
None of the above
0a
multi
Topical antibiotics such as tobramycin or gentamicin or ciprofloxacin QID for 3 days just before surgery is advisable as prophylaxis against endophthalmitis.Ref: Khurana; 4th edition; Pg- 184
Ophthalmology
Lens
4d0bf425-6430-4174-a993-e4302bd601b7
Which of the following antismoking drugs can lead to suicidal ideation?
Baclofen
Rimonobant
Varenicline
Naltrexone
2c
single
Vareniciline is a partial agonist at α4 β2 substype of nicotine receptor used to treat tobbacco addiction. Side effects include suicidal ideation, nausea, headache & insomnia.
Psychiatry
null
9d2de2c9-2f85-4301-8fc1-a8b4707ff042
Positive dipstick for RBC with red color urine and red supernatant and clear sediment with positive dipstick -
Porphyria
Hematuria
Hemolysis
Rhabdomyolysis
3d
single
Answer- D. RhabdomyolysisIf a urine dipstick of the red supernatant is positive for heme, the patient has either hemoglobinuria or myoglobinuria.If a urine dipstick of the red supernatant is negative for heme, the patient may have one of a variety of unusual conditions
Medicine
null
848170a9-b979-4ec5-893e-d48199d1b78d
Complications of obesity is/are: 1. Venous ulcer 2. Pulmonary embolism 3. Pickwickian syndrome 4. Hernias 5. Pulmonary hypeension
1,2,3 & 4
2,3,4 & 5
1,2,3 & 5
All are true
3d
multi
Clinical presentation of obesity The morbidly obese patients often presents with chronic weight-related problems such as migraine headaches; back and lower extremity joint pain from degenerative joint disease; venous ulcers; dyspnea on exeion; biliary colic; stress urinary incontinence; dysmenorrhea; infeility; gastroesophageal reflux; and inguinal, umbilical, and incisional hernias. Obesity has a profound effect on overall health and life expectancy. The morbidly obese are predisposed to developing serious weight-related comorbidities, including hypeension, CAD, adult onset DM, sleep apnea and/or obesity hypoventilation syndrome (Pickwickian syndrome), deep venous thrombosis, pulmonary embolism, hypercoagulability, hyperlipidemia, and depression among others. Physiological abnormalities resulting from OSA include hypoxemia, hypercapnia, pulmonary and systemic vasoconstriction, and secondary polycythemia (from recurrent hypoxemia). These result in an increased risk of ischemic hea disease and cerebrovascular disease. Right ventricular failure can occur from hypoxic pulmonary vasoconstriction. Obesity is now considered to be the second leading cause of preventable death behind cigarette smoking. The incidence of comorbidities and moalities is directly related to the degree of obesity. in a study with 12 year follow up, moalities rates for those weighing 50% over average weight were doubled. Moalities and morbidities is largely attributable to the comorbidities of obesity. Ref: Schwaz 9/e, Page 1743.
Surgery
null
a32d45ac-63f1-4691-875f-07ef3e9ba287
All are true about popliteus except -
Flexes the knee
Unlocks the knee .
Inserted on medial meniscus
Intracapsular
2c
multi
Popliteus has an intracapsular origin that arises from lateral surface of lateral condyle of femur and from outer margin of lateral meniscus of knee. It inserts onto the posterior surface of shaft of tibia above the soleal line. Nerve supply: Tibial nerve. Action: Unlocking of knee joint by lateral rotation of femur, prior to flexion. It is also an accessory flexor of the knee joint.
Anatomy
null
4e7735c0-2333-41cd-b07a-3321ad59f8f9
Which among the following is it best inotrope drug for use in right hea failure
Dobutamine
Digoxin
Dopamine
Milrinone
3d
multi
(Ref Goamnan and Gilman, 11/e p575, inotropic drugs are not used for treatment of right sided where the major treatment is diuretics and vasodilators. Milriinone being a phosphodiesterase inhibitor act as an inodilator. Thus, this is the only inotropic drug that should be used in right sided failure due to its ablity to produce vasodilation. It is indicated in right hea failure with pulmonary hypeension.
Pharmacology
Cardiovascular system
d245218a-8c82-4c5a-a9fd-624f78b331d9
Which of the following is a disadvantage of topically applied sodium fluoride solution?
Need to prepare a fresh solution for each patient
Taste is not well accepted by patients
Patient must make four visits to the dentist within a relatively short period of time
The solution should be allowed to dry for 5 minutes
2c
multi
Advantages of neutral sodium fluoride solution- 1. It is relatively stable when kept in a plastic container and there is no need to prepare a fresh solution for each patient.  2. The taste is well accepted by patients.  3. The  solution  is non-irritating  to the gingiva.  4. It does not cause discoloration of tooth structure.  5. Once applied to the teeth, the solution is allowed to dry for 3 minutes. Thus the clinician in public health programs can pursue a multiple-chair procedure.  6. The series of treatments must be repeated only four times in the general age range of 3  to  13, rather than  at annual or semiannual intervals, therefore in a public health program, other groups of children can be treated in theJintervening years.  Disadvantage of neutral sodium fluoride solution- 1. The major disadvantage of the use of sodium fluoride is that the patient must make four visits to the dentist within a relatively short period of time.
Dental
null
e9f93c17-5f03-4b8c-becb-ffbc05332f50
The antimicrobial agent which inhibits the ergosterol biosynthesis is:
Ketoconazole
Amphotericin B
5-Flucytosine
Griseofulvin
0a
single
IMIDAZOLES AND TRIAZOLES: These are presently the most extensively used antifungal drugs. Four irnidazoles are entirely topical, while ketoconazole is used both orally and topically. Two triazoles fluconazole and itraconazole have largely replaced ketoconazole for systemic mycosis because of greater efficacy, longer tlh, fewer side effects and drug interactions. The imidazoles and triazoles have broadspectrum antifungal activity covering dermatophytes, Candida, other fungi involved in deep mycosis (except mucor), Nocardia, some grampositive and anaerobic bacteria, e.g. Staph. aureus, Strep. faecal is, Bac. fragilis and Leishmania. The mechanism of action of irnidazoles and triazoles is the same. They inhibit the fungal cytochrome P450 enzyme &;lanosterol l4--demethylase&; and thus impair ergosterol synthesis leading to a cascade of membrane abnormalities in the fungus. The lower host toxicity of triazoles compared to irnidazoles has correlated with their lower affinity for mammalian CYP450 enzymes and lesser propensity to inhibit mammalian sterol synthesis. However, because they are active against ceain bacteria as well (which do not have ergosterol), other mechanisms of action also appear to be involved. Ketoconazole (KTZ): It is the first orally effective broad-spectrum antifungal drug, useful in both dermatophytosis and deep myc osis. The oral absorption of KTZ is facilitated by gastric acidity because it is more soluble at lower pH. Hepatic metabolism is extensive; metabolites are excreted in urine and faeces. Elimination of KTZ is dose dependent: tlh varies from llh to 6 hours. Penetration in CSF is poor: not effective in fungal men ingitis. However, therapeutic concentrations are attained in the skin and vaginal fluid. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:761,762
Pharmacology
Chemotherapy
30bf8f20-b0ac-465b-9d9f-61f5990b2fd4
In embalmingr solution is given through ?
Veins
Aeries
Lymphatics
none of above
1b
multi
Emblamings may be aerial emblaming and cavity emblaming.
Forensic Medicine
null
0acf2241-a277-4c9f-8561-4c7942ff83de
Lipids are transferred from intestine to liver by
Chylomicrons
VLDL
HDL
LDL
0a
single
.
Physiology
All India exam
55f90618-002b-4943-95d2-e6bebee1e018
A 7 year old boy presented with generalized edema.Urine examination revealed marked albuminuria.Serum biochemical examinations showed hypoalbuminaemia with hyperlipidemia.Kidney biopsy was undeaken.On light microscopic examination, the kidney appeared normal.Electron microscopic examination is most likely to reveal
Fusion of foot processes of the glomerular epithelial cells
Rarefaction of glomerular basement membrane
Deposition of electron dense material in the basement membrane
Thin basement membrane
0a
single
Answer is A (Fusion of foot processes of the glomerular epithelial cells):The presence of generalized edema is a 7 year old boy with proteinuria suggests a diagnosis of Nephrotic syndrome. This child is likely to have. Minimal change disease as this is the most common cause of Nephrotic syndrome in children and is associated with normal findings on Light microscopyGeneralized edema May develop Pleural effusion, pulmonary edema, ascitis Patients with minimal change disease characteristically show fusion of foot processes of the glomerular epethelial cells on electron microscopy.Minimal change Disease: ReviewMost common cause of Nephrotic syndrome in children (80% in children; 20% in adults)Peak Age of onset is between 6-8 years of Age (usually < 10 years)Type of onset : InsiduousClinical featuresPeripheral Edema: Presenting FeatureNephrotic syndrome is the typical presentationPeripheral edema is the hallmark of Nephrotic syndrome occurring when serum albumin levels become less than 3g/dlInitially dependent Edema > Generalized edema May develop Pleural effusion, pulmonary edema, ascitisHematuria : 20-30%Hypeension : V. RareRenal failure : Does not usually progress to renal failureLaboratory (Features of Nephrotic syndrome)ProteinuriaHypoalbuminemiaHyperlipidemia/Hyper cholesterolemia (Increased hepatic prduction of lipids)HypercoagulabilityRenal pathology (Biopsy)InvestigationLight microscopy QElectron microscopy QImmunofluorescence QObservationNo abnormality hence the term minimal changeFusion of foot processesAbsence of immunoglobulin or complementPrognosisPrognosis is GoodResponse to steroids is ExcellentDoes not progress to Renal FailureTreatmentsCoicosteroids form the mainstay for treatment of MCD
Medicine
null
01ad49c6-2d21-4eef-944b-19b294e022c6
Which is not synthesized by the vascular epithelium?
Prostacyclin
Angiotensin 2
Endothelin
Heparin
1b
single
Endothelial cells constitute a large and impoant tissue. They secrete many growth factors and vasoactive substances. The vasoactive substances include prostaglandins and thromboxanes, nitric oxide, and endothelins.Lungs activate angiotensin I to angiotensin II; this reaction is paicularly prominent in the lungsRef: Ganong's Review of Medical Physiology;23rd edition; Page No: 606
Physiology
Cardiovascular system
73f8b2f6-0db0-430f-b323-7152825a669f
All true about conus syndrome except
Begins at the level of lower 3 sacral and coccygeal segment
Absent knee and ankle jerks
Flexor plantar reflex
Saddle anaesthesia
1b
multi
Since the spinal segments involved in knee and ankle jerks are at higher level than the level of lesion, they are preserved.and not lost. Root value of knee reflex is L-2,3 and 4 and for the ankle reflex is S-1 Conus medullary syndrome is lower motor neuron lesion and involves the lower 3 sacral and coccygeal segments Plantar reflex remains flexor in this syndrome since its spinal arc is also above the level of lesion and is unaffected Root value of plantar reflex is S-1,2. Conus medullary syndrome produces saddle anaesthesia in the perineal region as per the dermatomal pattern. Ref: Gray's 39e/p-227
Anatomy
Brain
d26d26a0-70c4-409c-be81-fec5aa637411
An infant with respiratory distress was intubated. The fastest and accurate method to confirm intubation
Capnography
Clinically by auscultation
Chest radiography
Airway pressure measurement
0a
multi
Ans. a. Capnography Capnography is the surest confirmatory sign of correct intubationQ So, the fastest and accurate method to confirm intubation in the above mentioned infant is capnography Capnography Capnography is the continuous measurement of end tidal carbon dioxide (ETCO,) and its waveform. Normal: 32 to 42 mmHe (3 to 4 mmHg less than aerial pCO, which is 35 to 45 mmHg) Principle: Infrared light is absorbed by carbon dioxide Uses of Capnography It is the surest confirmatory sign of correct intubation (esophageal intubation will yield ETCO2=0) Intraoperative displacement of endotracheal tubedeg (ETCO2 will become zero) Diagnosis of malignant hypehermie (ETCO, may rise to more than 100 mm Hg) For detecting obstructions and disconnections of endotracheal tubes (ETCO, will fall) Capnography Uses of Capnography Diagnosing pulmonary embolism by air, fat or thrombus (sudden fall of ETCO2 occurs. It may become zero if embolus is large enough to block total pulmonary circulation) Exhausted sodalime or defective valves of closed circuit will show high ETCO2 values. To control level of hypocapnia during hyperventilation in neurosurgery Indicator of cardiac output. In cardiac arrest ETCO, is zero.
Anaesthesia
null
d015b2a6-c776-4b90-9e10-2e2d6daf9d5f
All are impoant mechanisms in the formation of lithogenic bile:
Increased biliary secretion of cholesterol
Increased activity of HMG CoA reductase
Clofibrate
Low calorie and cholesterol rich diet
3d
multi
Mechanisms in the formation of lithogenic (stone-forming) bile. The most impoant is increased biliary secretion of cholesterol. This may occur in association with obesity, the metabolic syndrome, high-caloric and cholesterol-rich diets, or drugs (e.g., clofibrate) and may result from increased activity of hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase. Reference: Harrisons Principles of Internal Medicine, 18th Edition, Page 2617
Medicine
null
e912320b-0b7f-4a78-981b-1381655673ea
Which of the following is not true of caloric test?
Induction of nystagmus by thermal stimulation
Normally, cold water induces nystatmus to opposite side and warm water to same side
In canal paresis, the test is inconclusive
None
2c
multi
Nystagmus can be induced both by cold as well as thermal stimulationCold stimulation causes nystagmus towards opposite side while thermal stimulation causes Nystagmus towards same side. (COWS)In canal paresis either there is a reduced or absent response (causes of U/L canal paresis are-U/L vestibular Schwannoma or vestibular neuritis).B/L absence of caloric nystagmus is seen in case of amminoglycoside ototoxicity or postmeningitis
ENT
null
87476c2f-6674-45ee-b9d3-3db7a7a9069a
Enlarged liver with Hepatocellular dysfunction may be seen in all of the following, except:
Wilson's disease
Budd Chirai syndrome
Alcoholic hepatitis
Post necrotic syndrome
3d
multi
Answer is D (Post necrotic cirrhosis) Liver is typically shrunken in size and not enlarged in post necrotic cirrhosis. Alcoholic hepatitis, NASH, Wilson's disease and Budd chiari syndrome may all present with enlarged liver and hepatocellular dysfunction.
Medicine
null
e14342e0-5d78-4346-8f5f-c5363d2a5500
Right-sided vocal cord palsy seen in -
Larynx carcinoma
Aortic aneurysm
Mediastinal lymphadenopathy
Vocal nodule
0a
single
First I would like to exclude other three options : - Aortic aneurysm (option b) and mediastinal lymphadenopathy (option c) cause left sided vocal cord paralysis. Vocal nodules does not cause vocal cord paralysis.  Now we are left with option 'a' only : - "Laryngeal carcinoma especially glottic can cause unilateral or bilateral vocal cord paralysis" ─ Conn's current therapy So, answer of this question is laryngeal carcinoma as it can cause unilateral (right or left) or bilateral vocal cord paralysis.
ENT
null
a89f8a22-61dd-4346-a843-b268c502044c
The Efferent fibers bundle of the substantia nigra transmits dopamine to one of the following areas
Thalamus
Corpus striatum
Tegmentum of pons
Tectum of midbrain
1b
single
Ans. (b) Corpus striatum(Ref: Ganong, 25th ed/p.243)The Efferent fibers bundle of the substantia nigra transmits dopamine to corpus striatum
Physiology
Nervous System
8d55010e-8c36-4486-a693-5027e759e9b6
About lidocaine, all are true except :
LA effect
Cardiac arrhythmia
Ester
Acts on mucous membranes
2c
multi
C i.e. Ester
Anaesthesia
null
db52dd1f-7aad-4ef7-87a8-6b562593b059
Acid fast organisms are -
Spores
Nocardia
Legionella
Rodococcus
0a
single
Spores may be seen in unstained preparations as Refractile bodies. The forespore stains intensely but once the spores envelope is laid down the spores does not stain readly. Spores appear as unstained areas in Gram-stained preparations but being more acid fast than the vegetative cells they can be stained by a modification of the Diehl -Nelson technique. Ref: Ananthanarayan & paniker's Textbook of Microbiology 9th edition pg no 21
Microbiology
general microbiology
6806e3f4-88b1-4014-ab2c-bb77759b2faa
Maternal disomy of chromosome 15 is seen in
Prader - Willi syndrome
Klinefelter's syndrome
Angelman syndrome
Turner's syndrome
0a
single
Uniparental disomy occurs when both chromosomes of a pair or areas from 2 chromosome in any individual have been inherited from a single parent. Maternal uniparental disomy is seen in Leader -Willi syndrome. Paternal uniparental disomy is seen in Angelman syndrome . Reference: Nelson TB of pediatrics pg 412 19th edition.
Pediatrics
Genetic and genetic disorders
8ac6392a-2271-4587-89a8-6036dab8c4d2
The mesentery of small intestine, along its attachment to the posterior abdominal wall, crosses all of the following structures except:
Left gonadal vessels
Third pa of duodenum.
Aoa
Right ureter.
0a
multi
A i.e. Left gonadal vesselsRoot of mesentery crosses (successively) te ascending (4th) and inferior horizontal (3rd) pas of duodenum, abdominal aoa, IVC, right ureter, right psoas major and right gonadal (testicular/ovarian) vesselQ. It does not cross left ureter, leftgonadal vessels and superior mesenteric vessels.
Anatomy
null
c57fd827-2013-4a34-b244-4948f1d3abc5
Drug used to prolong action of LA in Hypeensive pts?
Clonidine
Felypressin
Dexmeditomidate
Noradrenalin
1b
single
Ans. is 'b'.e., Felypressin
Anaesthesia
null
6ee5545a-f23b-4c7c-9bf3-50d07d435cc5
Congenital syndrome associated with lymphoproliferative malignancy- a) Bloom syndrome b) Fanconi's anemia c) Turner syndrome d) Chediak Higashi syndrome e) Ataxia telangiectasia
ab
bd
ca
de
3d
single
null
Medicine
null
85ca8da1-9a77-479a-8436-3f43c5c79cfd
A 28 year old female nearing her date of delivery has been admitted following regular contractions. The resident doctor did an examination documents that the head is at +1 station.Where is the exact position of head?
High up in the FALSE pelvis
Just above ischial spine
Just below ischial spine
At the perineum
2c
multi
Station is leading point of Head. Station 0 = Head at level of Ischial spines + means below Ischial spines - means above Ischial spines Numbers like 1 , 2 denote distance in cm below or above Ischial spine
Gynaecology & Obstetrics
Labour - normal, abnormal, malposition, malpresentation and their management
f2e050a4-21a3-4316-8df5-e077c84c4187
Capillary refill time in a child with shock is?
>1 second
>2 seconds
>3 seconds
>4 seconds
2c
single
Capillary refill is a simple test that assesses how quickly blood returns to the skin after pressure is applied. It is carried out by applying pressure to the pink part of the nail bed of the thumb or big toe in a child and over the sternum or forehead in a young infant for 3 seconds. The capillary refill time is the time from release of pressure to complete return of the pink colour. It should be less than 3 seconds. If it is more than 3 seconds the child may be in shock. Lift the limb slightly above heart level to assess arteriolar capillary refill and not venous stasis. This sign is reliable except when the room temperature is low, as the cold environment can cause a delayed capillary refill. In such a situation check the pulses and decide about shock
Pediatrics
null
8e34ba21-a399-41d8-a07d-2f494ed05902
All the following are congenital cysts except
External angular dermoid cyst
Sebaceous cyst
Branchial cyst
Thyroglossal cyst
1b
multi
null
Surgery
null
e3918480-8802-495e-aa17-aa50e6c170f3
In a lady at 32 weeks pregnancy is given an injection of dexamethasone to prevent which of the following in the newborn ?
Respiratory Distress Syndrome
Neonatal convulsion
Neonatal jaundice
Cerebral palsy
0a
single
The lung maturity occurs at 34 weeks of gestation and this is ceified by checking the L:S ratio which should be > 2:1 or appearance of Phosphatidyl glycerol in the amniotic fluid. Maternal administration of coicosteroid is advocated where the pregnancy is less than 34 weeks. This helps in fetal lung maturation so that the incidence of RDS, Intra Ventricular Hemorrhage , Necrotising Enterocolitis , and Patent Ductus Aeriosus are minimized. Respiratory distress of newborn often results in multiple debility in the fetus if not prevented.
Gynaecology & Obstetrics
Preterm Labour
f47de07e-6e98-41b6-ad78-d81adf7dbbb3
Most common site for contact ulcer in larynx is
Arytenoids
Corniculate
Anterior 1/3 rd of vocal cord
Cricoid
0a
single
null
ENT
null
6a455c6d-bf8d-4fb9-8458-8a10418744de
Initial site of RBC production in fetus-
Gestational sac
Yolk sac
Placeta
Fetal bones
1b
single
Ans. is 'b' i.e., Yolk sac* Embryonic and fetal hematopoiesis occurs in three phases: megaloblastic, hepatic, and myeloid. At each phase of RBC development both the sites of production and the cell composition change.* Sites and stages of fetal erythropoiesis: Primitive erythropoiesis begins in the yolk sac at 2 to 3 weeks after conception. By the end of the first trimester, the liver has become the main erythroid organ. The liver is the primary source of red blood cells during the second trimester, and the bone marrow is the primary source of red blood cells during the last trimester
Gynaecology & Obstetrics
Miscellaneous (Gynae)
ee86b126-91ed-41d4-9331-9ba7abf20155
Best anaesthetic agent for out patient anasthesia is
Fentanyl
Morphine
Alfentanyl
Penthidine
2c
single
C i.e. Alfentanyl
Anaesthesia
null
4b20eac9-8b96-464a-b04b-78934c21345a
A 24 yr-old female has flaccid bullae over the skin and oral erosions. Histopathology shows intraepidermal blister with acantholytic cells. Diagnosis is:
Pemphigoid
Erythema multiforme
Pemphigus vulgaris
Dermatitis herpetiformis
2c
single
The features of intaepidermal acantholytic blisters coupled with flacid bullae over skin and oral erosions points towards P. vulgaris. The other 3 diseases do now show intraepidermal blistering. They are devoid of mucosal involement. Erythema Multiforme: Target lesion seen on distal extremeties. If mucosa involved it is called as Epidermal Multiforme Major Dermatitis herpetiformis: Extremely pruritic vesicopapules over extensors Pemphigoid: Tense bullae
Dental
Blistering disorders
c6902efa-0d40-4220-8d8b-af620342c247
After postmoem body is handed over to :
The authority who has conducted inquest in that paicular case
Police station near by
Coroner
Chief magistrate
0a
single
A i.e. The authority who has conducted inquest in that paicular case
Forensic Medicine
null
0790541e-01e7-497d-8fe7-ae413e607936
A 16-year-old female presents with primary amenorrhea and raised FSH. On examination, her height was 58 inches. What would be the histopathological finding in the ovary?
Absence of oocytes in the ovaries (streak ovaries)
Mucinous cystadenoma
Psamomma bodies
Hemorrhagic Corpus Leuteum
0a
single
Ans. (a) Absence of oocytes in the ovaries (streak ovaries)(Ref: Robbins 9th/pg 166-167; 8th/pg 165-166)In this question, the patient is presenting with primary amenorrhea and raised FSH, along with short stature(Given Height =58 inches, which is less than 5th percentile of expected at 16 years age). All these features are suggestive of Turner Syndrome.Infertility Q due to rudimentary uterus and streak ovaries is an important feature Q, as ovaries are reduced to atrophic fibrous strands without ova and follicles in Turner syndrome
Pathology
Genetics
ce41e196-9993-479f-8b5b-690d4f6f3a4d
Pseudohemoptysis is caused by:
Histoplasma capsulatum
Serratia marcescens
Proteus
Klebsiella
1b
single
Serratia grows in sputum after collection and makes sputum red (pigment production) This condition is pseudohemoptysis.
Microbiology
null
e555f8f1-34db-4673-b7a2-c04d76d229c5
Interstitial keratitis is commonly seen in: March 2005
Fungal keratitis
Congenital syphilis
Phlyctenular keratitis
Trachoma
1b
single
Ans. B: Congenital syphilis It develop from host immune mechanisms to active infections or antigens within the stromal keratocytes. Diseases known to cause interstitial keratitis include: congenital syphilis, herpes simplex, herpes zoster, Epstein-Barr, tuberculosis and leprosy. Clinical manifestations: superficial stromal scarring, necrotizing stromal keratitis and disciform keratitis. As the inflammation subsides, intracorneal blood vessels will regress and become nonperfused vascular channels, which are known as "ghost" vessels. These vessels can be readily visualized using slit lamp biomicroscopy and can become active if inflammation recurs.
Ophthalmology
null
4378cf86-1e36-445e-bad3-dfed51e7fc89
Most common cause of gangrene of foot of 30 years old farmer who is a chronic smoker -
Raynaud's disease
Myocardial infarction
Atherosclerosis
Thromboangitis obliterans
3d
single
All four can cause gangrene (Myocardial infarction can cause gangrene by thromboembolism) Lets see, each option one by one. Raynauds disease Is ds of young women* (F:M ratio is 5:1) commonly the upper limbs* are affected specially the fingers (the thumb is generally escaped) The disease is characterized by Raynauds phenomenon* which is a series of attacks of Local syncope → digits become cold and white* Local asphyxia → digits turn blue with burning sensation* Local recovery →digits regain normal colour* Pulses remain unaffected* as this is the disease which affects arterioles With the help of points (a) and (b) Raynauds ds can be ruled out. Atherosclerosis (Senile gangrene) Seen in elderly people over 50 years of age. Thus because of age factor we can rule out atherosclerosis. Myocardial infaction Age factor again helps in ruling it out as MI is generally seen in elderly, though its incidence is increasing in young, but it cannot be a more common cause than Buerger's disease. Buerger's (Thromboangitis obliterans)  Usual victims of this ds are young men below 40 yrs of age, who are smokers (ds is not seen in females and nonsmokers). Buerger ds is the inflammatory reaction in the arterial wall with involvement of the neighbouring vein and nerve, terminating in thrombosis of the artery. It characterstically involves small and medium sized arteries (plantars, tibial and radial artery) Both upper and lower extremities are affected. In lower extremity the ds. occurs beyond the popliteal artery. In upper extremity the ds occurs beyond the brachial art. Early in the course of Buergers ds the superficial veins are involved producing the characterstic migratory, recurrent superficial thrombophlebitis. An imp difference with atheroselerosis is that, atherosclerosis is a disease of large sized arteries, buergers is a ds of small arteries.
Surgery
null
a8e0c826-eee1-45b4-bf7a-f8e8caf50e67
The most commonly seen primary orbital tumour in children is
Optic nerve sheath meningioma
Retinoblastoma
Rhabdomyosarcoma
Glioma of optic nerve
2c
single
Rhabdomyosarcoma It is a highly malignant tumour of the orbit arising from the extraocular muscles. It is the most common primary orbital tumour among children, usually occurring below the age of 15 years (90%). Clinical features: It classically presents as rapidly progressive proptosis of sudden onset in a child of 7-8 years. Massive proptosis due to rhabdomyosarcoma located in the superonasal quadrant (mimmicking acute inflammatory process). The clinical presentation mimics an inflammatory process. The tumour commonly involves the superionasal quadrant; but may invade any pa of the orbit. Ref:- A K KHURANA; pg num:-394
Ophthalmology
Tumors
8dba1081-01c3-45b1-b6c0-85b86d299a95
All is true regarding case fatality rate except ?
Represents killing power of disease
Closely related to viruleance
Very useful for chronic diseases
May vary in different epidemic for same disease
2c
multi
Ans. is 'c' i.e., Very useful for chronic disease CFR is typically used in acute infectious disease e.g. food poisoning, cholera, measles. o Its usefulness in chronic disease is limited, because the period from onset to death is long and variable. CFR is closely related to virulence of agent. o Limitation of CFR is that time period is not specified. o The case fatality rate for the same disease may vary in different epidemics because of changes in host, agent and environment factors. o Case fatality rate is the complement of survival rate. CFR =1 - survival rate CRF will be more if survival rate is less more patients are dying due to disease (i.CFR) or in other words less patients are surviving survival rate).
Social & Preventive Medicine
null
63142155-4e5a-4837-9680-ca8afc3622ea
Length of naso lacrimal duct is:
10 mm
11 mm
12 mm
9 mm
2c
single
Ans. 12 mm
Ophthalmology
null
b6b37b96-384a-415a-ad6a-a66584a7de9c
A collection of information in a table has been arranged as satisfied, very satisfied and dissatisfied. Which of the following will be the right term for such information?
Interval data
Ratio data
Nominal data
Ordinal data
3d
single
Ordinal data is that data which has a meaningful arrangement of order but no valuable data or information can be obtained from the order arrangement. For example in the above question, though the data is arranged as satisfied, very satisfied and dissatisfied no information is obtainable as to what is the difference between satisfied and very satisfied and the difference between very satisfied and dissatisfied and so on. Thus this data is a ordinal data. Ref: High-Yield Bio statistics By Anthony N. Glaser; 3rd Edition; Page 4; Statistics for Management and Economics By Gerald Keller; Pages 13 - 16
Social & Preventive Medicine
null
85522213-04c6-4ae7-9336-446cde546851
Subcapsular orchiectomy is done for
Ca testis
Ca prostate
Ca penis
Ca urethra
1b
single
Orchidectomy Orchidectomy is performed in advanced disease. In 1941, prostate cancer was shown to be responsive to such treatment by Charles Huggins, the only urologist to win a Nobel Prize. Bilateral orchidectomy, whether total or subcapsular, will eliminate the major source of testosterone production. Ref: Bailey and love 27th edition Pgno : 1474
Surgery
Urology
08f26dfc-5327-4afa-a1f8-0402cc92d178
Neostigmine antagonizes non depolarising blockade by all of the following mechanism except
Decreasing the breakdown of acetyl choline at the motor end plate
Preventing the K+efflux
Increasing the release of acetyl choline at the motor end plate
Depolarization at the motor end plate
0a
multi
Refer Katzung 10/e p 436 Neostigmine is an anti cholinerasterase. It inhibits the breakdown of ACh at the mother end plate This results in increased activity of ACh that causes depolarization of motor end plate by opening Na+channels . It posseses some direct agonistic activating on NM receptors resulting in depolarization
Pharmacology
Anesthesia
27f0fa7b-5a74-461c-b370-78e870f13914
True about peripheral nerve injury in upper limb-a) Radial nerve injury cause anaesthesia over anatomical snuff boxb) Median nerve injury cause wrist dropc) Ulnar nerve injury cause claw handd) Index finger anesthesia is caused by median nerve injurye) Thumb anaesthesia is caused by ulnar nerve injury
abc
ad
acd
bde
2c
multi
Radial nerve injury causes wrist drop. Thumb anaesthesia is due to median nerve injury.
Anatomy
null
2fe46123-3284-4ee9-8a65-d65a95552163
All of the following are synonymous codon pair EXCEPT
CAU & CAC
AUU & AUC
AUG & AUA
AAU & AAC
2c
multi
Synonymous codons Codons that specify the same amino acids. E.g- GGA, GGG, GGU, and GGC codes for glycine Methionine is coded by AUG only. So, there is no synonymous codon for methionine.
Biochemistry
Mutations & Codons
1bebf87f-ec8c-4fe1-829a-ab7afb31ae59
Widened anion gap is caused by all EXCEPT :
Lactic acidosis
Diarrhea
Diabetic keto-acidosis
Methanol poisoning
1b
multi
Ans.(b) Diarrhea* Anion gap :The anion gap is the difference between primary measured cations (sodium Na+ and potassium K+) and the primary measured anions (chloride Cl and bicarbonate HCO3) in serum.* So we take value of sodium and from it subtract the value of chloride and bicarbonate.* Value of Normal anion gap =10 to 12 mmol/LAG calculated as follows: AG = Na+ - (Cl" + HCO3~)Normal anion gap(Mn: FUSED CAR)Increased anion gap(Mn: MUDPILES)Decreased anion gap(Mn: BPH-M)F- Fistula pancreaticM - MethanolBromide intoxicationU- UreterosigmoidostomyU - UremiaPlasma cell dyscrasiaS- Small bowel fistulaD - DKA/ AKA/ SKA (diabetic/alcoholic/ starvation)HypoalbuminemiaE- Extra chlorideP - Paraldehyde / phenforminMonoclonal proteinD- Diarrhea1 - Iron / INH C- Carbonic anhydraseInhibitor (acetazolamide)L - Lactic acidosis A- Adrenal insufficiencyR- Renal tubular acidosisE - Ethylene glycol S - Salicylates
Medicine
Fluid & Electrolyte
dc3d4830-90f0-4247-a81b-a91383dd61f4
All of the following provisions are included in the Primary health care according to the Alma Ata declaration except:
Adequate supply of safe drinking water
Nutrition
Provision of free medicines
Basic sanitation
2c
multi
ALMA - ATA CONFERENCE: Called for WHO Goal of "Health for All" by 2000 India is a signatory Provisions included under Primary Health Care according to Alma Ata conference: E- Essential drugs ; 33-38 essential drugs are included in PHC. Most essential drug is Paracetamol L - Locally endemic disease prevention & control E - Education M - Maternal & child health E - EPI 1978; UIP- 1985 N- Nutrition T - Treatment of common ailments S - Safe water supply & sanitation
Social & Preventive Medicine
PH Care, Elements & Principles
009ad99c-6912-431b-a13e-cc9cdde03953
Gradient in pulmonary artery wedge pressure and left venticular end diastolic pressure is seen in
Aortic regurgitation
Constrictive pericarditis
Left atrial myxoma
Pulmonary thromboembolism
2c
single
null
Medicine
null
b326349f-be05-4904-ad6e-b661620f54e8
A 65yr old male with his of Diabetes and HTN presents Ito OPD with complaints of diplopia and squint on examination secondary detion is seen to be more than primary detion Which of the following is the most probable diagnosis
Paralytic squint
Incomitant squint
Restrictive squint
Pseudo squint
0a
single
ref : ak khurana 7th ed
Ophthalmology
All India exam
8a26ae07-2a40-4081-95a7-e0b7a0f776bf
NOT included in third stage of labour
Controlled cord traction
lM-oxytocin
IV methergin
Uterine massage
2c
single
(C) (IV - Methergin) (142 - Dutta 7th)Methergin 0.2 mg IM (Intramuscular) to the mother within one minute of delivery of the babyOyxtocin may be given with crowning of the head, with delivery of the anterior shoulder of the baby or after the delivery of the placenta.Components of Active Management of Third stage of Labour (WHO)* Administration of uterotonic (oxytocin/Ergometrine) soon after birth of baby* Delayed cord clamping and cutting* Controlled Cord traction for delivery of placenta* Uterine massageCurrent evidence show that delayed cord clamping is beneficial for baby, immediate cord clamping has been shown to increase the incidence of iron deficiency anemia for premature and LBW babies immediate cord clamping can also increase the risk of intraventricular haemorrhage and late onset sepsis
Gynaecology & Obstetrics
Miscellaneous (Gynae)
360e78bf-2f2e-4809-a4d7-151c0e2ca47b
All are common causes of childhood blindness except
Malnutrition
Glaucoma
Ophthalmia neonatorum
Congenital dacryocystitis
3d
multi
Congenital dacryocystitis [Ref: Khurana 4/e,p 369, 447; Parson's 20/e, p 530-531 Repeat from May07 Causes of impaired vision in childhood Anatomical classification Whole globe: microphthalmos, anophthalmos, phthisis bulbi, atrophic bulbi Cornea: scar, anterior staphyloma, dystrophy Lens: cataract, dislocation, aphakia Uvea: aniridia, coloboma, uveitis Retina: retinopathy of prematurity, retinal dystrophy, retinal detachment, vasculitis Glaucoma: buphthalmos Optic nerve optic atrophy, hypoplasia Other: coical blindness, amblyopia Aetiological classification Hereditary: chromosomal disorders, single-gene defects Intrauterine: congenital rubella, foetal alcohol syndrome Perinatal: ophthalmia neonatorum, retinopathy of prematurity, bih trauma Childhood: vitamin A deficiency, measles, trauma Unclassified: impossible to determine the underlying cause Congenital dacryocystitis (also k/a dacryocystitis neonatorum) is an inflammation of the lacrimal sac occurring in newborn infants, and thus also known as dacryocystitis neonatorum it is d/t stasis of secretion in the lacrimal following congenital blockage in the nasolacrimal duct. congenital dacryocystis presents as - epiphora, usually developing after 7 days of bih, followed by copious mucopurulent discharge from the eyes - swelling on the sac area It may be complicated by - recurrent conjunctivitis - acute on chronic dacryocistitis - lacrimal abscess & fistula formation
Ophthalmology
null
e43c0165-438a-48b2-93ca-da859d41f5b6
Effective for common gram-negative anaerobes ?
Aztreonam
Doxycycline
Vancomycin
Tobramycin
0a
single
Ans. is 'a' i.e., Aztreonam
Microbiology
null
16c7ae2d-b8d1-4c34-9c66-05487bec8c50
The recipient twin in monochorionic twin gestation effected by twin-twin transfusion syndrome is characterised by all except
Thrombosis
Hypovolemia
Kernicterus
Heart failure
1b
multi
In TTTS, recipient twin has circulatory overload, hyper volemia and heart failure.
Gynaecology & Obstetrics
null