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d65ade7a-0f33-40a8-a229-e945717f69ee | Drug used for Buerger's disease: | Xanthinol nicotinate | Propranolol | CCBs | All of the above | 0a
| multi | Xanthinol Nicotinate Xanthinol nicotinate (or xanthinol niacinate or complamina) is a vasodilatorQ. It is a combination of xanthinol and niacin (nicotinic acid) This vasodilator is used in the treatment of Raynaud's phenomenon and Buerger's disease. All other forms of pharmacologic treatment have been generally ineffective in the treatment of Buerger's disease, including, steroids, calcium channel blockers, reserpine, vasodilators, antiplatelet drugs. | Surgery | Aerial disorders |
dbe167ed-95b1-48cd-890f-1846f9375bea | True about centchroman are all, EXCEPT : | It is synthetic non -- steroidal contraceptive | The only side effect is oligomenorrhoea | Safe in liver disease | Can be used as post -- coital pill | 2c
| multi | Safe in liver disease | Gynaecology & Obstetrics | null |
09b74a26-896d-429c-8765-c8bb07819f3b | Alcohol anti-craving agents are all, except: AIIMS 09 | Lorazepam | Clonidine | Acamprosate | Naltrexone | 0a
| multi | Ans. Lorazepam | Forensic Medicine | null |
1d9fb803-31b6-4c88-b8a3-ec2a7a806839 | No effect on hea | Chloroform | Ether | Methoxyflurane | Halothane | 1b
| single | B i.e. Ether | Anaesthesia | null |
8b5168d2-3bdb-46bf-a8ae-74a30027b245 | In type I hypersensitivity, the mediators is | IgE | IgG | IgM | IgC | 0a
| single | (IgE) (161-AN 7th) (202-206-CP)Types of hypersensitivity reactions and their featuresType of reactionClinical syndromeMediatorsType I: IgE1. Anaphylaxis2. Atopy P. K. reactionIgE, histamine and other pharmacological agentsType II: Cytolytic and CytotoxicAntibody-mediated damage- thrombocytopenia-agranulocytosis, hemolytic anemiaIgG: IgM, CType III: Immune complex1. Arthrus reaction2. Serum sickness3. Glomerulonephritis, rheumatic fever and rheumatoid arthritisIgG: IgM C Leucocytes.Type IV: Delayed hypersensitivity1. Tuberculin test - Lepromin test, Frei-test, Histoplasmin and toxoplasmin tests viral infections such as herpes simplex and mumps2. Contact dermatitis - drugs, metal (Nickle, chromium), chemicals3. Granulomatous type TB, Leprosy, Schistosomiasis, sarcoidosis and Crohn's diseaseT. cells, Lymphokines, macrophages | Microbiology | Immunology |
0524a605-a4ee-4ae8-b71e-0b306a28d15e | Microvesicular type of fatty liver is Seen in the following except | Acute fatty liver of pregnancy | Alcoholic liver disease | Reye's syndrome | Phosphorus intoxication | 1b
| multi | Fatty liver disease means you have extra fat in your liver. You might hear your doctor call it hepatic steatosis. Heavy drinking makes you more likely to get it. Over time, too much alcohol leads to a buildup of fat inside your liver cells. This makes it harder for your liver to work. But you can get fatty liver disease even if you don't drink a lot of alcohol Refer robbins 9/e | Pathology | G.I.T |
3fc9309c-3954-42a1-8d48-db096fa64252 | Northern blot is used for identification of: (Repeat) | RNA | DNA | Protein | Antibodies | 0a
| single | Ans: A (RNA) Ref: Ananthanarayan R, Paniker CKJ. Textbook of Microbiology. 8th Edition. Hyderabad: Universities Press; 2009. Pg. 69Explanation:Southern blotting:The highly sensitive technique for identifying DNA fragments by DNA-DNA hybridisation is called Southern blotting, after EM Southern who devised it. This technique has very wide applications in DNA analysis.Northern blotting:An analogous procedure for the analysis of RNA has been called northern blotting (as opposed to Southern blotting). Here the RNA mixture is separated by gel electrophoresis, blotted and identified using labelled DNA or RNA probes.Western blotting:A similar technique for the identification of proteins (antigens) is called immunoblotting (or, in conformity with other blotting techniques, western blotting). Here the protein antigen mixture is separated by SDS- PAGE (sodium dodecylsulfate-polyacrylamide gel electrophoresis), blotted on to nitrocellulose strips and identified by radiolabeled or enzyme-labeled antibodies as probes. E.g. Western blot test for detection of antibodies directed against different antigens of HIV | Microbiology | Immunology |
40220284-efb3-4c4e-b5e1-506438ce3cdb | Snowman's heart sign on chest X-ray is seen in - | Ebstein anomaly | Total anomalous pulmonary venous connection (TAPVC) | Tetrology of Fallot | Transposition of great vessels | 1b
| multi | Ans. is 'b' i.e., Total anomalous pulmonary venous connection (TAPVC) o "Snowman" or "figure of 8" or "cottage loaf sign" is characteristic of supracardiac TAP VC.Cardiac configrationo "Boot-shaped" heart (cour en sabot)Fallot's tetralogyo "Egg on side" heart ("egg in cup" heart)Transposition of great arterieso "Egg in cup" HeartConstrictive pericarditiso "Snowman" sign ("figure of 8, or cottage loaf' sign)Supracardiac TAPVCo "Ground - glass" appearance of lungObstructive TAPVCo "Sitting-duck" heartPersistent truncus arteriosuso "Water-bottle" or flasked shaped or money bag heartPericardial effusion, hypothyroidismo "Box-shaped" heartTricuspid atresia, Ebstein's anomalyo Tubular heartAddison's disease, emphysemao "Tear -drop" heartChronic emphysemao "Cor-triatum"Pulmonary vein obstructiono "Jug handle" appearancePrimary pulmonary hypertensiono "Pentagon-shaped" heartMitral incompetenceo "Triangular-shaped" heartConstrictive pericarditis | Radiology | Cardiac and Pericardiac Imaging |
e580e119-d0e3-47e3-b1d4-4e6519ae1c02 | Continuous Renal Replacement Therapy is initiated in which of the following phases of Acute Renal Failure: | Initiation | Maintenance | Diuretic Phase | Recovery Phase | 1b
| single | Answer is B (Maintenance) Continuous Renal Replacement Therapy should be initiated during the Maintenance phase (Oliguric Phase) of Acute Renal Failure. Maintenance phase refers to the phase of Renal Failure in which the renal injury becomes established. It is also known as the Oliguric Phase. During this phase the GFR and Urine output progressively decrease until they stabilize at their lowest. Fluid retention gives rise to edema, water intoxication, and pulmonary congestion if the period of oliguria is prolonged. Hypeension frequently develops during this phase. Uremic complications and Electrolyte imbalance typically arise during this phase. Continuous Renal Replacement Therapy (CR) or Dialysis should be initiated in this phase. The oliguric-anuric phase generally lasts 10 to 14 days but can last for several more. The longer the patient remains in this phase, the poorer the prognosis for a return to normal renal function. | Medicine | null |
648aca31-f7e3-446e-adcb-4623c1ae3240 | True about montoux is - | False negative in fulminant diseases | If once done, next time it is always positive | Results are given in terms of positive & negative | Indurations given in terms of length & breadth | 0a
| multi | Ans. is 'a' i.e., False negative in fulminant disease . A positive tuberculin test indicates hypersensitivity to tuberculoprotein, it may be due to : - Active infection - Subclinical infection - Past infection - BCG vaccination . In overwhelming tuberculosis (fulminant cases) due to depressed cellular immunity montoux test may be false negative. | Microbiology | null |
d00f4589-370b-4e3a-a127-5baba6e828c4 | Which of the following receptors is activated by acetylcholine and blocked by atropine. | Nicotinic | Muscarinic | Alpha 1 and 2 | Beta 1 and 2 | 1b
| single | null | Pharmacology | null |
c7fecf9f-a7be-4f63-9649-c230d8cd426f | Embolectomy should be done within | 4 hours | 6 hours | 8 hours | 10 hours | 1b
| single | Embolectomy should be done within 6 hours as after 6 hours, irreverside changes occur. | Surgery | null |
44f32545-3ae7-48a3-bed3-ac10255d0ab9 | Adverse effect of clozapine: | Hypeension | Sialorrhea | Extrapyramidal S/E | Neuroleptic malignant syndrome | 1b
| single | B i.e. Sialorrhea | Psychiatry | null |
dcda1202-699d-4aac-945a-605e85b2fb95 | Rough and Irregular surface produced on the impression is because of? | Improper application of pressure during impression making | Air incorporated during mixing | Too rapid polymerization | Presence of moisture in impression area | 2c
| single | null | Dental | null |
b43198f1-8a92-4411-b3ab-4b495873c4ea | A 58 year old male presents with fatigue, abdominal pain and bloody stools. Colonoscopy reveals a mass in the descending colon. For surgical removal of the mass, ligation of which of the following arteries is required? | Superior mesenteric artery | Inferior mesenteric artery | External iliac artery | Internal iliac artery | 1b
| single | Answer: b) Inferior mesenteric artery (SABISTON 19th ED, P-1299; SCHWARTZ 10TH ED, P-1187)Left Colectomy.For lesions or disease states confined to the distal transverse colon, splenic flexure, or descending colon, a left colectomy is performed.The left branches of the middle colic vessels, the left colic vessels, and the first branches of the sigmoid vessels are ligated.A colocolonic anastomosis can usually be performed. | Surgery | Small & Large Intestine |
399f3276-a466-484c-87a1-7b02932035bc | All of the following statements regarding Clostridium perfringens are true, EXCEPT: | It is the commonest cause of gas gangrene | It is normally present in human faeces | The principal toxin of C. perfringens is the alpha toxin | Gas gangrene producing strains of C. perfringens produce heat resistant spores | 3d
| multi | Spores of clostridium perfringens are killed within 5 minutes by boiling, it is also killed by autoclaving at 121 degree Celsius for 15 minutes. But spores of clostridium perfringens which produce food poisoning are heat resistant. Clostridium perfringens produces multiple exotoxins and is classified into five types (A to E). The most impoant exotoxin alpha toxin, is a phospholipase that hydrolyzes lecithin and sphingomyelin, thus disrupting the cell membranes of various host cells, including erythrocytes, leukocytes, and muscle cells. Gas Gangrene occur due to alpha toxin. In this, infection passes along the muscle bundles, producing rapidly spreading edema and necrosis as well as conditions that are more orable for growth of the bacteria. Ref: Sherris Medical Microbiology, 5th Edition, Chapter 29; Principles and Practice of Clinical Bacteriology By Stephen H. Gillespi, 2nd Edition, Page 569; Textbook of Microbiology and Immunology By Parij, Page 239 | Microbiology | null |
866ff8e3-87ce-4cfa-848e-6dccf3ca929e | The cardiac jelly formed around the heart tube during early development, contributes to the formation of: | Pericardium | Mesocardium | Myocardium | Endocardium | 3d
| single | Ans. is D. The most appropriate answer to this question is actually endocardial cushion. | Anatomy | Cardiovascular System |
c08b0520-376e-40fa-9829-37549138c60c | True about HIV epidemiology - | Children rarely affected | <10% of HIV infected person progress to AIDS | Southern africa have 72% of total global burden | Seminal secretion is more infectious than vaginal secretion | 0a
| multi | Key facts about Epidemiology of HIV infection Reservoir: Cases and carriers Source: Virus is in greatest concentration in blood, seen and CSF (Lower concentrations in tear, saliva, breast milk, urine, cervical and vaginal secretions) Children under 15 years make only 3% cases Basic modes of transmission Sexual Blood and blood products Neddles/syringes Mother to child transmission (MTCT) Incubation period : few months to 10 years Ref: Park 25th edition Pgno : 363-367 | Social & Preventive Medicine | Communicable diseases |
5dbdfee3-5bdf-4f73-ae33-b0298165dccd | who gave the stage of trust versus mistrust | seligman | erikson | lorenz | bleuler | 1b
| single | ERIC ERIKSON ERIC ERIKSON gave the psychosocail stages of development There are 8 psychosocial stages A person has to succesfully pass one stage to move to the next stage If he gets arrested in one stage he may develop some disorders Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, pf no. 485 | Anatomy | Treatment in psychiatry |
e9234440-4543-4250-bb0b-75284b5ff71f | Which of the following statements about Xanthogranulomatous pyelonephritis is not true ? | Foam cells are seen | Associated with tuberculosis | Yellow nodules are seen | Giant cells may be seen | 1b
| multi | Ans. is 'b' i.e., Associated with tuberculosisXanthogranulomatous pyelonephritis o Xanthogranulomatous pyelonephritis is a chronic infective condition of the kidney associated with chronic bacterial infection.o The most common organism implicated in causation is proteus followed by E coli (not tuberculosis). o Most of the cases occur in old ages (5th-6" decade), but may occur at any age.o Females are more commonly affected.o Usually involves one kidney (unilateral), but may be bilateral.o Affected kidney, almost always has:(i) Obstruction (large staghorn calculus)(ii) HydronephrosisPathological findings1. Gross featureso Enlarged kidney o Dilated pelvisStones of staghorn varietyo Calyces are typically filled with pusCoex is studded with yellowish nodules that line the calyces (Granulomatous areas).2. Microscopic featureso Yellow nodules are due to large foam cells (lipid laden histiocytes). Also known as Xanthoma cells.o These foam cells contain lipid and PAS positive granuleso Along with foam cells, lymphocytes, plasma cells and multinucleated giant cells are also present.o Lymphoid follicles may be seen.o Fibrosis may be seen which may contain foreign body giant cells.o Foci of calcification may be seen. | Pathology | null |
b90e68fd-292e-46e3-a51d-20c7e13803ea | A 1.5 year old female is brought to the clinic with complaints of excessive enlargement of head, intolerance to feeds and severe malnourishment. MRI imaging was suggestive of a medulloblastoma causing obstructive hydrocephalus. Which of the following is an example of irrational manattem,-the patient? | Craniotomy and sub-total excision of the tumour. Surgeon leaves the layer of the tumour adherent with colliculus | First ventirculoperitoneal shunt was done | CCNU and vincristine were given as chemotherapy | Radiotherapy 35-40 Gy was given to the whole craniospinal axis | 3d
| single | Ans. d. Radiotherapy 35-40 Gy was given to the whole craniospinal axis | Pediatrics | null |
ded3964c-409d-4722-92f8-703f0f2e6e7e | Polysaccharides are | Polymers | Acids | Proteins | Oils | 0a
| single | Polysaccharides are polymers of monosaccharides. They are of two types- homopolysaccharides that contain a single type of monosaccharide (e.g., starch, insulin, cellulose) and heteropolysaccharides with two or more different types of monosaccharides (e.g., heparin, chondroitin sulfate).. Ref: Biochemistry by U. Satyanarayana 3rd edition Pgno : 10 | Biochemistry | Metabolism of carbohydrate |
0024f7d2-17f6-40ba-b71b-57c2024fa8d2 | Which of these need both V and X factors-a) Hemophilus influenzaeb) H. ducreic) H. paraphrophilusd) H. aegyptiuse) H. haemolyticus | ade | bde | abd | ad | 0a
| multi | null | Microbiology | null |
915ad4c1-bf13-40b9-a1e6-734369acb4d5 | What is seen in neurogenic shock ? | Bradycardia and hypotension | Tachycardia and hypotension | Bradycardia and hypetension | Tachycardia and hypetension | 0a
| single | Neurogenic shock is a distributive type of shock resulting in low blood pressure, occasionally with a slowed hea rate, that is attributed to the disruption of the autonomic pathways within the spinal cord. It can occur after damage to the central nervous system, such as spinal cord injury and traumatic brain injury. Ref -davidson 23rd edtion pg 1148 | Medicine | Miscellaneous |
e3f28754-e7bc-429a-90aa-feb6befea9a2 | Combined oral pills protect the woman against all except - | Menorrhagia | Benign breast disease | Pelvic inflammatory disease | Venous thromboembolism | 3d
| multi | Ans. is 'd' i.e., Venous thromboembolism | Social & Preventive Medicine | null |
9f9bab31-201c-46e5-b90e-68eb19e05d0d | Poor prognostic indicator in ALL - | Age < 2 year | TLC 4000-10,000 | Presence of testicular involvement at presentation | Presence of blasts in peripheral smear | 0a
| multi | Ans. is 'a' i.e. Age < 2 year | Pathology | null |
1eb3a07c-0761-4109-b442-1df43d6381ef | Plasma ceruloplasmin alpha 2 globulin is a | alpha 1 globulin | alpha 2 globulin | beta 1 globulin | beta 2 globulin | 1b
| single | null | Physiology | null |
821ccf4a-0bc6-4609-9739-8a57449cc17f | Vogt Koyanagi Harada syndrome is - | Cataract | C.N.S. tumour | Uveitis | Polycystic kidney | 2c
| single | Ans. is 'c' i.e., UveitisClinical manifestations of Vogt Kavanadi Harada syndromeOccular involvementC.N.S. involvementAuditory manifestationCutaneous manifestationOccular involvementB/L panuveitis ino Meningismuso Hearing losso VitiligoB/L panuveitis inassociation with serouso Headacheo Tinnituso Alopeciaassociation w'ith serousretinal detachmento C.S.F. Pleocytosis retinal detachmentAccording to American uveitis society the criteria for diagnosis of VKH syndromeo No history' of ocular trauma or surgery.o At least three of four of the following signsBilateral chronic iridocyclitis.Posterior uveitis, including exudative retina! detachment, disc hyperemia or edema and sunset glow fundus.Neurological sign of tinnitus, neck stiffness cranial nerve or CNS problems or CSF pleocytosis.Cutaneous finding of alopecia, poliosis or vitiligo. | Medicine | Eye |
7ec6f55a-a1be-4320-8b2d-c7d3964a9cd3 | Which of the following ultrasound marker is associated with greatest increased risk for Trisomy 21 in fetus? | Echogenic foci in hea | Hyperechogenic bowel | Choroid plexus cysts | Nuchal edema | 3d
| single | Ans. Nuchal edema | Radiology | null |
da8fa56e-18b4-4702-b11d-1ce1652710a7 | Cyanide affects respiratory chain by | Non-competitive reversible inhibition | Competitive reversible inhibition | Suicide irreversible inhibition | Non-competitive irreversible inhibition | 3d
| single | The toxicity of cyanide is due to its inhibitory effect on the terminal cytochrome which brings cellular respiration to a standstill. The inhibitor usually binds to a different domain on the enzyme, other than the substrate binding site. Since these inhibitors have no structural resemblance to the substrate, an increase in the substrate concentration generally does not relieve this inhibition.Ref: DM Vasudevan, Page no: 234 | Biochemistry | Enzymes |
952f9b45-e625-4c8c-9094-85977dd21b8e | Presence of it indicates remote contamination of water | Streptococci | Staphalococci | Clastridium pertringes | Nibrio | 2c
| single | null | Social & Preventive Medicine | null |
5b674035-82a3-4593-8b06-636d644d9da4 | Mercury affects which part of the kidney - | PCT | DCT | Collecting duct | Loop of Henle | 0a
| single | Ans. (a) PCT(Ref: Robbins 9th/pg 928; 8th/pg 938)Nephrotoxic AKI*Caused by Gentamicin, radiographic contrast agents, heavy metals (eg mercury), organic solvents (eg CCl4 ).*Extensive necrosis along mainly proximal convoluted tubule (PCT) & ascending limb of Henle's loop.*On histologic examination, non-specific tubular necrosis, with some distinctive features:Mercuric chlorideSeverly injured cells contain large acidophilic inclusions, become totally necrotic, & may undergo calcification.Carbon tetrachlorideAccumulation of neutral lipids (fatty change), followed by necrosis.Ethylene glycolMarked ballooning & hydropic or vacuolar degeneration of proximal convoluted tubules. Ca oxalate crystals are often found in the tubular lumens in such poisoning. | Pathology | Kidney |
4784b4a0-3e02-4726-8621-dc15e6b39e3b | A 30 year old lady is to undergo surgery under intravenous regional anesthesia for her left 'trigger finger'. Which one of the following should not be used for patient? | Lignocaine | Bupivacaine | Prilocaine | Lignocaine + ketorolac. | 1b
| single | B i.e. Bupivacaine | Anaesthesia | null |
317109c4-c462-41bd-8418-b7f1f0cbb633 | One primary oocyte forms how many ovum/ova | 1 | 2 | 3 | 4 | 0a
| single | Observe that whereas one primary spermatocyte gives rise to four spermatozoa, one primary oocyte forms only one ovumHuman embryology Inderbir Singh&;s Tenth edition Pg 23 | Anatomy | General anatomy |
8678449c-ba36-4d30-b7c9-0cd10161a980 | The age by which most of the normal babies know their gender is | 1 year | 2 years | 3 years | 4 years | 2c
| single | <p>. Developmental milestones:- GROSS MOTOR DEVELOPMENT: 2 months: Holds head in plane of rest of the body when held in ventral suspension. In prone position in bed, the chin lifts momentarily. 3 months:lift head above the plane of the body. Head control stas by 3 months and fully developed by 5 months. 4 months:Remain on forearm suppo if put in prone position, lifting the upper pa of the body off the bed. 5 months: Rolls over. 6 months:sit in tripod fashion. 8 months: sits without suppo., crawling 9 months: Takes a few steps with one hand held. Pulls to standing and cruises holding on to furniture by 10 months. 10 months: creeps 12 months:creeps well, walk but falls, stand without suppo. 15 months: walks well, walks backward/ sideways pulling a toy. May crawl upstairs. 18 months: Runs, walks upstair with one hand held. Explores drawers 2 years: walk up and downstairs, jumps. 3 years : rides tricycle, alternate feet going upstairs. 4 years: hops on one foot, alternate feet going downstairs. 5 years:skips FINE MOTOR DEVELOPMENT:- 2 months- eyes follow objects to 180 deg. 3 months-Grasp reflex disappears and hand is open most of the time. 4 months- Bidextrous approach( reaching out for objects with both hands). 6 months- Unidextrous approach( Reach for an object with one hand). 8 months- radial grasp sta to develop. Turns to sound above the level of ear. 9 months- immature pincer grasp, probes with forefinger. 12 months-Unassisted pincer grasp. Releases object on request.Uses objects predominantly for playing, not for mouthing. Holds block on each hand and bang them together. 15 months- imitate scribbling , tower of two blocks 18 months- scribbles, tower of 3 blocks.turn pages of a book, 2-3 at a time. 2 years- tower of 6 blocks, veical and circular stroke. 3 years-Tower of 9 blocks, dressing and undressing with some help, can do buttoning. 4 years- copies cross, bridge with blocks 5 years- copies triangle, gate with blocks. SOCIAL AND ADAPTIVE MILESTONES: 2 months: social smile(smile after being talked to).watches mother when spoken to and may smile. 3 months:Recognizes mother, anticipates feeds. 4 months: Holds rattle when placed in hand and regards it . Laughs aloud. Excited at the sight of food. 6 months:recognizes strangers, stranger anxiety . Enjoy watching own image in mirror, shows displeasure when toy pulled off. 9 months:waves bye bye 12 months:comes when called, plays simple ball game.kisses the parent on request. Makes postural adjustments for dressing. 15 months:jargon, stas imitating mother. 18 months: copies parents in tasking, dry by day, calls mother when he wants potty, points to three pas of body on request. 2 years: ask for food, drink, toilet, pulls people to show toys. 3 years:shares toys, know fullname and gender, dry by night. 4 years:Plays cooperatively in a group, goes to toilet alone, washes face, brushes teeth. Role play . 5 years:helps in household task , dresses and undresses. LANGUAGE MILESTONES: 1 month: Ales to sound. 2 month:respond to sound by stale or quitening to a smooth voice. 3 months: babbles when spoken to. Makes sounds (ahh,coos, ) laughs. 4 months: laughs aloud. 6 months: monosyllables 9 months: understands spoken words, bisyllables. 12 months: 1-2 words with meaning. 18 months: vocabulary of 10 words. Can name one pa of body. 2 years: 3 word simple sentences 3 years:asks questions, knows full name and gender. 4 years: says songs or poem, tells story, knows three colours. 5 years: ask meaning of words. {Reference: GHAI Essential pediatrics, eighth edition} | Pediatrics | Growth and development |
c097ad16-73b2-420c-8ead-ed9e90bfec34 | True about nucleosome | Use only one type of histone protein | Each complex is separated from each other by non histone proteins | Regular repeating structure of DNA & histone proteins | Reflect small nucleus | 2c
| multi | In biology, histones are highly alkaline proteins found in eukaryotic cell nuclei that package and order the DNA into structural units called nucleosomes. They are the chief protein components of chromatin, acting as spools around which DNA winds, and playing a role in gene regulation. Without histones, the unwound DNA in chromosomes would be very long (a length to width ratio of more than 10 million to 1 in human DNA). For example, each human diploid cell (containing 23 pairs of chromosomes) has about 1.8 meters of DNA, but wound on the histones it has about 90 micrometers (0.09 mm) of chromatin, which, when duplicated and condensed during mitosis, resulting in about 120 micrometers of chromosomes | Biochemistry | Metabolism of nucleic acids |
761d031c-0374-4bf3-a46f-d4e076f8055e | A 64 year old hypertensive obsese female was undergoing surgery for fracture femur under general anaesthesia. Intra-operatively her end-tidal carbon dioxide decreased to 20 from 40 mm of Hg, followed by hypotension and oxygen saturation of 85%. What could be the most probable cause? | Fat embolism | Hypovolemia | Bronchospasm | Myocardial infarction | 0a
| single | "Arterial blood gas analysis reveals hypoxemia and hypocapnia, with subsequent metabolic acidosis in severe pulmonary embolism. During anaesthesia, end tidal CO2 concentration may fall dramatically because of increased dead space and reduced cardiac output". _________ Anesthesia & Intensive care
Note : Fat embolism can present as pulmonary embolism when an extensive fat embolism of lung is present. | Orthopaedics | null |
f5bda2fd-4fea-4d2f-a8dd-d82652a8a70c | Which of the following drugs is taken during the first pa of the meal for the purpose of delaying absorption of dietary carbohydrates? | Acarbose | Glipizide | Metformin | Exenatide | 0a
| single | Acarbose is alpha glucosidase inhibitor. It inhibits the breakdown of complex carbohydrates to simple carbohydrates and thus they decrease the absorption. Glipizide is second generation sulphonylurea which helps in secretion of insulin. Metformin is biguanide which decrease the synthesis of glucose. Exenatide is GLP-1 analogue which delay in gastric emptying, decrease appetite and augment glucose secretion. | Pharmacology | Pancreas |
ccaf0db5-f94b-484c-a030-dcba9337654b | Test for tight iliotibial band is | Ober's test | Osber's test | Simmond's test | Charnley's test | 0a
| single | OBER&;S TEST:Used in physical examination to identify tightness of iliotibial band. During the test ,the patient lies on his side with the unaffected leg on the bottom with their shoulder and pelvis in line. The knee may extended or flexed to 90 or 30 degrees.The hip is maintained in slight extension.The test leg is abducted,then allowed to lower toward the table with the pelvis stabilized NORMAL: able to abduct parallel to the examining surface Inability to adduct to parallel indicates tightness of iliotibial band REF : MAHESWARI 9TH ED | Orthopaedics | Bony dysplasia and soft tissue affection |
6413275e-0cae-4aac-ab68-ac3c51233325 | The antiepileptic drug effective in Lennox-Gastaut syndrome is: | Lamotrigine | Gabapentin | Tiagabine | Primidone | 0a
| single | Lamotrigine is the most effective drug among the given options. Ref: Harrisons principles of internal medicine, 18 th edition ; Page : 3263, Table : 369/9. | Medicine | null |
fb22bfc1-6edc-4099-9d59-5ab1aec761e2 | Ten days after an exploratory laparotomy and lysis of adhesions, a patient, who previously underwent a low anterior resection for rectal cancer followed by postoperative chemoradiation, is noted to have succus draining from the wound. She appears to have adequate source control--she is afebrile with a normal white blood count. The output from the fistula is approximately 150 cc per day. Which of the following factors is most likely to prevent closure of the enterocutaneous fistula? | Previous radiation | Previous chemotherapy | Recent surgery | History of malignancy | 0a
| single | Factors that predispose to fistula formation and may prevent closure include foreign body, radiation, inflammation, epithelialization of the tract, neoplasm, distal obstruction, and steroids.Factors that result in unhealthy or abnormal tissue surrounding the enterocutaneous fistula decrease the likelihood of spontaneous resolution. For example, radiation therapy, such as used for treatment of pelvic gynecologic and rectal malignancies, can result in chronic injury to the small intestine characterized by fibrosis and poor wound healing. High-output fistulas, defined as those with more than 500 cc per day output, are usually proximal and unlikely to close. Treatment consists of source control, nutritional supplementation, wound care, and delayed surgical intervention if the fistula fails to close. | Anaesthesia | Preoperative assessment and monitoring in anaesthesia |
35d38266-5b7a-4c72-a7cb-193ceed76f3e | All are causes of hypertension with hypokalemia except, | Bilateral renal artery stenosis | End stage renal disease | Primary hyperaldosteronism | Cushing disease | 1b
| multi | Ans. is 'b' i.e. End stage renal disease Hypertension with HypokalemiaHigh reninRenal artery stenosisAccelerated hypertensionRenin-secreting tumorEstrogen therapyLow reninPrimary aldosteronismAdenomaHyperplasiaCarcinomaAdrenal enzyme defects1 1b- Hydroxylase deficiency17a- Hydroxylase deficiencyCushing's syndrome or diseaseOtherLicoriceCarbenoxoloneChewer's tobaccoLydia Pinkham tabletsAlso know.Hypokalemia without hypertensionBARTER'S SyndromeGUELMAN'S Syndrome | Medicine | Electrolyte |
147e51b1-897e-41db-82dc-a08be5d897c0 | All are autosomal dominant except - | Familial hypercholesterolemia | Hereditary spherocytosis | Acute intermittent parphyria | Phenylketonuria | 3d
| multi | Phenylketonuria (PKU) is an inborn error of metabolism that results in decreased metabolism of the amino acid phenylalanine.] Untreated PKU can lead to intellectual disability, seizures, behavioral problems, and mental disorder. It may also result in a musty smell and lighter skin. Babies born to mothers who have poorly treated PKU may have hea problems, a small head, and low bih weight. Phenylketonuria is a genetic disorder inherited from a person's parents. It is due to mutations in the PAH gene which results in low levels of the enzyme phenylalanine hydroxylase. This results in the build up of dietary phenylalanine to potentially toxic levels. It is autosomal recessive meaning that both copies of the gene must be mutated for the condition to develop. There are two main types, classic PKU and variant PKU, depending on if any enzyme function remains. Those with one copy of a mutated gene typically do not have symptoms | Pathology | General pathology |
273dda97-7fed-4d82-b195-833c128a1a63 | Primary structural defect of an organ is termed - | Malformation | Disruption | Deformation | Association | 0a
| single | Ans. (a) Malformation(Ref: Robbins 9th/pg 452)Malformation refers to primary structural defect of an organ due to intrinsically abnormal developmental process (multifactorial); Eg Anencephaly, Congenital heart defects | Pathology | Disease of Infancy & Childhood |
1be6340e-dfa4-4824-a04a-45685b6a3538 | Major basic protein is an important constituent of which leucocyte: | Neutrophil | Eosinophil | Basophil | Lymphocyte | 1b
| single | null | Physiology | null |
e606ba31-702f-4b9e-b881-573e88acc7eb | First investigation done for abnormal uterine bleeding in reproductive age group is _______ | Ultrasonography transabdominal | Pap smear | Urine Beta HCG | Ultrasonography transvaginal | 2c
| single | The first investigation for abnormal uterine bleeding is Urine Beta HCG to rule ouut pregnancy. Abnormal Uterine Bleeding(AUB): is a common and debilitating condition. Chronic AUB was defined as &;bleeding from the uterine corpus that is abnormal in volume, regularity and/or timing that has been present for the majority of the last 6 months. AUB may affect females of all ages. Factors that influence incidence most greatly are age and reproductive status. A structured approach for establishing the cause using the FIGO PALM COEIN classification system will facilitate accurate diagnosis and inform treatment options. In the reproductive age group , the hypothalamic-pituitary-ovarian (HPO) axis matures, and anovulatory uterine bleeding is encountered less often. The diagnostic goal is exclusion of pregnancy and identification of the underlying pathology to allow optimal treatment. Miscarriage, ectopic pregnancies, and hydatidiform moles may cause life-threatening hemorrhage. Pregnancy complications are quickly excluded with determination of urine and serum Beta-human chorionic gonadotrophin (hCG levels). This is typically obtained on all reproductive-aged women. Other options: Pap smear evaluation is usually done for cervical and endometrial cancers which are commonly seen in peri and post menopausal women. Transvaginal sonography (TVS) typically offers greater patient comfo and suitable detection of postmenopausal endometrial hyperplasia and cancer compared to transabdominal ultrasonography. Ref: Shaw&;s textbook of Gynaecology 17th edition Pgno: 139 | Gynaecology & Obstetrics | Disorders of menstruation |
81cd9759-0f73-42e8-80b2-6fad72c0be57 | Female sterilization is absolutely contraindicated in: | Hea disease | Diabetes mellitus | Hypeension | None of the above | 3d
| multi | There is no absolute medical contraindication for female sterilization. Also remember, : FEMALE STERILIZATION MALE STERILIZATION - Married - Married - 22-49 yrs old female - 22-60 yrs old male - >= 1 child - >= 1 child - No past history in self/ spouse sterilization - No past history in self/ spouse sterilization - MINILAP - Done by trained MBBS/ MD Gyn-obs/ DGO - Conventional vasectomy - Trained MBBS & above - Laproscopic sterilization- MD Gyn-obg /DGO - MS surgery - No scalpel vasectomy - Trained MBBS & above | Social & Preventive Medicine | Other FP Methods and New Initiatives in Family Planning |
acf4efba-a38c-4bf9-a87c-22861c5a7619 | Causes of biliary tract carcinoma after ingesting infected fish - | Grathostoma | Angiostrongylus cantonens | Clonorchis sinensis | H. Dimunata | 2c
| single | In most cases the disease tends to remain low grade and chronic producing only minor symptoms of abdominal distress,intermittent diarrhea and liver pain or tenderness.C.sinensis has been linked to bile duct carcinoma.It is mostly observed in areas where chlonorchiasis is endemic (refer pgno:126 baveja 3 rd edition) | Microbiology | parasitology |
35300445-fc06-4e52-bc1e-4befe09b76ae | Joint not involved in Rheumatoid ahritis according to 1987 modified ARA criteria? | Knee | Ankle | Tarsometatarsal | Met at arsophalangeal | 2c
| single | Tarsometatarsal The 1987 Revised Criteria for the Rheumatoid ahritis 4 out of 7 criteria are required to classify a patient as having rheumatoid ahritis Patients with 2 or more clinical diagnoses are not excluded. 1.Morning stiffness: morning stiffness in and around joints lasting at least 1 hour before maximal improvement 2.Ahritis of 3 or more joint areas: soft tissue swelling (ahritis) of 3 or more joint areas observed simultaneously by a physician. The 14 possible joint areas involved are, right or left: - proximal interphalangeal metacarpophalangeal wrist elbow knee - ankle metatarsophalangeal Ahritis of hand joints: swelling (ahritis) of the proximal interphalangeal, metacarpophalangeal, or wrist joints Symmetric ahritis: simultaneous involvement of the same joint areas on both sides of the body Rheumatoid nodules: subcutaneous nodules over bony prominences, extensor surfaces, or juxtaaicular regions Serum rheumatoid factor: demonstration of abnormal amounts of serum rheumatoid factor Radiographic changes: radiographic erosions and/or periaicular osteopenia in hand and/or wrist joints Criteria 1 to 4 must be present, for at least 6 weeks. Criteria 2 to 5 must be observed by a physician. | Surgery | null |
aefcd39e-dcc9-4f29-89db-abb4c7922853 | Antibody transfer mother to fetus - | IgG | IgM | IgD | IgA | 0a
| single | Ans. is 'a' i.e., IgG | Microbiology | null |
685d2f83-c9ce-40b4-90c4-0acd533bb8d5 | Hydrocephalus in infant is best diagnosed by | USG cranium | CT scan head | Encephalogram | Lumbar-puncture | 0a
| single | Ans. a (USG cranium). (Ref. Grainger, Diagnostic Radiology, 4th ed., 2469)Cranial ultrasound of Infants# USG cranium is best method to diagnose hydrocephalus through the anterior and posterior fontanalles.# Progression of hydrocephalus can be estimated by comparison with previous studies.# USG is also helpful in following ventricular decompression in patients treated for hydrocephalus.# Neonatal hydrocephalus can also be evaluated by Doppler to assess indirectly intracranial pressure and help to determine the need for shunt placement.Cranial CT# CT enable us to evaluate the brain structure and ventricular size by noninvasive highly reliable technique.# But due to the ionizing radiations hazard, CT as a screening investigation is less preferable.Qhstretk. (Fetal) Cranial ultrasound# Obstretic ultrasound study is one of the best methods for antenatal diagnosis of hydrocephalus as it is noninvasive & hazard free not only to fetus as well as to mother. However assessment prior to GA of 20 weeks may be difficult, as ventricles constitute a large portion of cranial vault.# Signs suggestive of fetal hydrocephalus on obstretic USG study are:- Atrial size > 10 mm- Dangling "Choroid plexus" sign- BPD > 95th percentile- +- PolyhydramniosEducational points:# Lemon sign:- Concave/linear frontal contour abnormality located at coronal suture strongly associated with spina bifida.# Banana sign:- Cerebellum wrapped around posterior brainstem + obliteration of cisterna magna secondary to small posterior fossa + downward traction of spinal cord in Chiari II malformation.# Key points about Obstetric color Doppler study:- Assessment of flow in MCA is important parameter to diagnose fetal anemia.- Assessment of flow in umbilical vessels is important parameter to diagnose fetoplacental insufficiency.- Reduced diastolic flow in umbilical artery is the earliest sign of fetoplacental insufficiency.- Reversal of flow in umbilical artery (as well as pulsatile flow in umbilical vein) is the most ominous sign and may indicate impending fetal death. | Radiology | Nervous System |
2e717f2e-854c-4a1d-9bff-06fe78da7b1e | Non-Inflammatory arthritis is | Rheumatoid arthritis | Reiter's syndrome | Gonococcal arthritis | Osteo-arthritis | 3d
| single | null | Orthopaedics | null |
066df44b-90cf-4603-a51b-83b306c71ca8 | TRUE/FALSE statements about radial nerve is/are: 1. Branch of posterior cord 2. Nerve of extensor compament of forearm 3. Arise from C5 - T1 4. Anterior interosseous nerve is a branch of it 5. Supply skin of extensor compament | 1,2,3 true & 4,5 false | 1,2,3,4 true & 5 false | 1,2,3,5 true & 4 false | All are true | 2c
| multi | Radial nerve is the largest branch of the posterior cord of the brachial plexus with a root value of C5 - C8 and T1. The radial nerve is commonly injured in the region of the spiral groove. this result in the wrist drop and sensory loss over a narrow strip on the back of forearm, and on the lateral side of the dorsum of the hand. Posterior interosseous nerve is the branch of radial nerve given off in the cubital fossa while anterior interosseous nerve is a branch of the median nerve given off in the upper pa of the forearm. Skin of the back of the forearm (i.e. extensor compament) is supplied by the posterior cutaneous nerve of the forearm which is a branch of radial nerve. | Anatomy | null |
81df78f3-28c4-4f25-bb89-94571ead91bf | Which is not a common enzyme for glycolysis and gluconeogenesis? | Aldolase | Glucose-6-phosphatase | Phosphoglycerate mutase | Phosphoglycerate kinase | 1b
| single | Seven of the reactions of glycolysis are reversible and are used in the synthesis of glucose by gluconeogenesis. Thus, seven enzymes are common to both glycolysis and gluconeogenesis : (i) Phosphohexose isomerase; (ii) Aldolase; (iii) Phosphotriose isomerase, (iv) Glyceraldehyde 3-phosphate dehydrogenase; (v) Phosphoglycerate kinase; (vi) Phosphoglycerate mutase; (vii) Enolase. Three reactions of glycolysis are irreversible which are circumvented in gluconeogenesis by four reactions. So, enzymes at these steps are different in glycolysis and gluconeogenesis. | Biochemistry | null |
31fe7b54-b8d4-4012-a442-e0a6de1a1518 | Hepatotoxic agent is - | Halothane | Ketamine | N2O | Ether | 0a
| single | Ans. is 'a' i.e., Halothane o Halothane is the most hepatotoxic anesthetic.o Hepatotoxic anaesthetic agents are :1. Chloroform2. Halothane3. Carbon tetrachloride4. Trichloroethylene5. MethoxyfluraneRemembero Nitric oxide is least potent inhalation agent (MAC - 105%).o Halothane is most potent inhalation agent-MAC - 0.75 (Methoxyflurane was the most potent inhalation agent hut it is not used now due to its nephrotoxic action).o Desflurane is fastest acting inhalation agent.o Diethyl ether is slowest acting (Previously it was methoxyflurane).o Ether has highest muscle relaxant action.o N2O has least muscle relaxant action.o N2O is least lipid soluble.o Halothane is most lipid soluble.o Most of the Inhaled anaesthetics are eliminated from lung, though some metabolism in liver may occur - In terms of the extent of hepatic metabolism, the rank of order is methoxyflurane > Halothane > enflurane > sevoflurane > isoflurane > desflurane > nitrous oxide. | Anaesthesia | Anesthesia for Liver Disease |
a03a141d-c3b3-499d-9c9f-7ab5090be664 | Which of the following is the "Least common" complication of measles- | Diarrhoea | Pneumonia | Otitis media | SSPE | 3d
| single | <p>measles complications:- Most common complications are 1. Measles associated diarrhoea. 2. Pneumonia 3. Otitis media 4. Respiratory complications Pneumonia is the most life threatening complication. Pulmonary complications account for more than 90% of deaths due to measles. Neurological complications:- 1. Febrile convulsions 2. SSPE (subacute sclerosing pan encephalitis). This is a rare complication occuring after many years after measles infection. It is characterised by mental deterioration, paralysis, involuntary movements, muscle rigidity and coma. 3. Encephalitis Measles during pregnancy causes congenital anomalies in children. {Reference: park&;s textbook of preventive and social medicine, 23rd edition, pg no.148}</p> | Social & Preventive Medicine | Communicable diseases |
053c2e27-a695-4e2c-b003-2d02c43e4c6f | COX pathway is inhibited by : | Aspirin | Indomethacin | Diclofenac | All of these | 3d
| multi | Aspirin inhibits COX irreversibly by acetylating one of its serine residues; return of COX activity depends on synthesis of fresh enzyme. Other NSAIDS like indomethacin, diclofenac etc are competitive and reversible inhibitors of COX, return of activity depends on their dissociation from the enzyme which in turn is governed by the pharmacokinetic characteristics of the compound. Corticosteroids like betamethasone act by inhibiting phospholipase A2. | Pharmacology | null |
b59dc2c9-8a3a-435f-84f5-6dac3261bbf3 | Poor prognostic factor in chizophrenia is: | Acute onset | Family history of affective disorder | Middle age | Past history of schizophrenia | 3d
| single | Past history of schizophrenia | Psychiatry | null |
4b195c3e-3bba-4c0d-b70b-0f54c78c7d6c | In ETC cmplex-4 is inhibited by all except - | CO | CN- | H2S | BAL | 3d
| multi | Ans. is 'd' i.e., BAL o Rotenone inhibits complex I (NADH-CoQ reductase).Inhibitors of electron transport chain-o Inhibitors of respiratory chain may be divided into three groups : -Inhibitors of electron transport chain properThese inhibitors inhibit the flow of electrons through the respiratory chain. This occurs at following sites.Complex I (NADH to CoQ) is inhibited by: - Barbiturates (amobarbital), Piericidin A (an antibiotic), rotenone (an insectiside), chlorpromazine (a tranquilizer), and guanethidine (an antihypertensive). These inhibitors block the transfer of reducing equivalents from FeS protein to CoQ.Complex II is inhibited by : - Carboxin and TTFA inhibit transfer of electon from FADH2 to CoQ, whereas malanate competitively inhibit from succinate to complex II.Complex III (Cytochrome b to cytochrome Cl) is inhibited by : - Dimercaprol, antimycin A, BAL (British anti lewisite), Naphthyloquinone. These inhibitors block the transfer of electrons from cytochrome b to cytochrome C i.Complex IV (cytochrome C oxidase) is inhibited by : - Carbon monoxide, CN-, ITS and azide (N3). These inhibitors block the transfer of electrons from cytochrome aa3 to molecular oxygen and therefore can totally arrest cellular respiration.Inhibitors of oxidative phosphorylationThese compounds directly inhibit phosphorylation of ADP to .ATP. Oligomycin inhibits Fo component of F0F1 ATPase. Atractiloside inhibits translocase, a transport protein that transports ADP into mitochondria for phosphorylation into ATP.UncouplesAs the name suggests, these componds block the coupeling of oxidation with phosphorylation. These compounds allow the transfer of reducing equivalents in respiratory chain but prevent the phosphorylation of ADP to ATP by uncoupling the linkage between ETC and phosphorylation. Thus the energy instead of being trapped by phosphory lation is dissipated as heat. Uncouplers may be :- Natural :-Thermogenin, thyroxineSynthetic :- 2, 4-dinitrophenol (2, 4-DNP), 2, 4-dinitrocresol (2, 4-DNC), and CCCP (chlorocarbonylcyanidephenyl hydrazone). | Biochemistry | Respiratory Chain |
29205d8f-9b6e-424d-862a-470f1f439941 | Which cranial nerve(s) is/are not involved in "Locked in syndrome"? | 9 | 10 | 11 | 12 | 2c
| single | Locked-in Syndrome: A pseudo-coma state in which an awake patient has no means of producing speech or volitional movement Retains voluntary veical eye movements and lid elevation Pupils are normally reactive. Aphonic because of the involvement of pyramidal fibers Involvement of medulla leads to 9th, 10th, 12th nerves. Conscious, ale and awake as the tegmental Ascending Reticular Activating System (ARAS) is intact. Veical eye movements are intact as it is controlled by the interstitial nucleus of Cajal and the rostral pa of the M.L.F Horizontal movements are lost ,basalis pontis is involved- 6th cranial nerve involvement | Medicine | Stroke and TIA |
ec6c978a-dca9-41b7-abe1-a06f0ba06389 | True regarding scrum pox is all except | Common in rugby players | Caused by varicella zoster virus | Acyclovir is treatment | Vesicular Lesions and fever seen | 1b
| multi | Serum pox is caused by HSV - type I. | Surgery | null |
ba65970e-96d2-48a2-a1f7-44b0b1a9dc7c | All of the following syndromes are seen with obesity except: | Prader - Willi syndrome | Cohen syndrome | Laurence Moon - Biedl syndrome | Carcinoid syndrome | 3d
| multi | Cohen syndrome - Cohen syndrome is Paternal inheritance always associated with obesity Carcinoid syndrome - Excess of 5 HT derivatives : Serotonin increase leads to secretory diarrhea & will Result in weight loss Prader willi syndrome - caused by deletion of chromosome 15 Sho stature, obesity, inappropriate laugh so called as happy puppets and intellectual disability. | Medicine | FMGE 2017 |
dfb2a593-3762-4073-86bf-65bc2a8e689a | A case of injury to right brow due to a fall from scooter present with sudden loss of vision in the right eye.The pupil shows absent direct reflex but a normal consensual pupillary reflex is present. The fundus is normal. The treatment of choice is- | Intensive intravenous corticosteroids as prescribed for spinal injuries to be instituted within six hours | Pulse methyl Prednisolone 250 mg four times daily for three days | Oral Prednisolone 1.5 mg/kg body weight | Emergency optic canal decompression | 0a
| multi | Sudden loss of vision, absent Ipsilateral direct light reflex and normal ipsilateral consensual light reflex suggest the diagnosis of optic nerve injury.
Within 8 hours of injury megadose of iv steroid (methylprednisolone) should be given. If there is no response or deterioration, optic canal decompression should be done. If vision is improving, steroids should be tapered gradually. If on tapering steroids, vision deteriorates, optic canal decompression is indicated. | Ophthalmology | null |
83b524ec-a747-489a-8021-3a2d96f64b2b | Cauliflower ear is associated with: | Otomycosis | Hematoma | Otosclerosis | None of the above | 1b
| multi | A patient with an auricular hematoma usually presents with an edematous, fluctuant, and ecchymotic pinna, with loss of the normal cailaginous landmarks. Failure to evacuate the hematoma may lead to cailage necrosis and permanent disfigurement known as "cauliflower ear." | ENT | null |
cc224eb0-6588-4be6-9341-76c5d4f45270 | True statements regarding epilepsy in pregnancy is: | Seizure frequency decreases in majority | Monotherapy is preferred to polydrug therapy | No increase in incidence of epilepsy in offspring | Breastfeeding is contraindicated | 1b
| multi | Ans. is b, i.e. Monotherapy is preferred to polydrug therapy --Dutta Obs 7/e, p 291As discussed earlier, seizure frequency remains unchanged in majority during pregnancy."Frequency of convulsions is unchanged in majority (50%) and is increased in some." --Dutta 7/e, p 291"The risk of developing epilepsy to the offspring of an epileptic mother is 10%." --Dutta 7/e, p 291So, option c is incorrect."There is no contraindication for breastfeeding." --Dutta 7/e, p 291so option d is incorrect.We have read time and again that monotherapy is preferred in pregnant epileptic patient. | Gynaecology & Obstetrics | Medical & Surgical Illness Complication Pregnancy |
37550fd7-46d1-4623-bb64-a1d925af5830 | Spinal cord in an infant terminates at | L1 | L2 | L3 | L4 | 2c
| single | In premature & term neonates- it lies b/w 1st & 3rd lumbar veebrae. In children between ages of (1-7yrs)- it lies between 12th thoracic and 3rd lumbar veebra. In adults, it terminates at the level of middle 3rd of body of 1st lumbar veebra which corresponds approximately to transpyloric plane. Spinal cord occupies superior 2/3rd of veebral canal It continues cranially with medulla oblongata, just below the level of foramen magnum, at the upper border of atlas and terminates caudally as conus medullaris. During development, veebral column elongates more rapidly than spinal cord, so there is increasing discrepancy b/w anatomical level of spinal cord segments & their corresponding veebrae. | Anatomy | Neuroanatomy 3 |
76ee4517-2f17-4c9a-90bf-901f14682d41 | A 67 yr male with history of chronic smoking hemoptysis with cough. Bronchoscopic biopsy from centrally located mass shows undifferentiated tumor histopathologically. Most useful I.H.C. (immunohistochemical) marker to make a proper diagnosis would be: | Cytokeratin | Parvalbumin | HMB-45 | Hep-par1 | 0a
| multi | The presence of chronic smoking, cough and hemoptysis in old man is a pointer towards a diagnosis of bronchogenic cancer. The central location suggests the possibility of a squamous cell cancer. Histologically, this tumor is characterized by the presence of keratinization and/or intercellular bridges. HMB (melanoma), Hep par1 (liver cancer) and parvalbumin (schizophrenia). | Pathology | Lung Tumor |
5e02ac03-bcd7-4299-af6c-13c74b7826ea | Malignant cold nodule in thyroid diagnostic on USG by all EXCEPT | No cystic lesion | Irregular margins | Calcification at margin of tumour | Hypoechoic | 0a
| multi | (A) No cystic lesion > USG can also be used to aid in the differentiation between benign and malignant nodules. The following criteria can be used by USG, and favor a diagnosis of malignancy:1) Absence of a halo sign2) Uniformly solid tumor with occasional central necrosis3) Irregular margins4) Fine calcifications5) Heterogenous echos and large size6) Surrounding tissue invasion | Surgery | Miscellaneous |
c4d7a407-b64a-4299-956b-43a71a09d2a5 | Most common type of germinal cell tumor in testis is? | Teratoma | Embryonal carcinoma | Seminoma | Endodermal sinus tumor | 2c
| single | Ans. is 'c' i.e., Seminoma * Testicular tumors are divided into two major categories : (i) Germ cell tumors, and (ii) Sex cord tumors.A) Germ cell tumors# More than 95% of testicular tumors are germ cell tumors. They are further divided into -i) Seminoma* It is the most common germ cell tumor of testis. Female counterpart of seminoma is dysgerminoma of ovary.ii) Non-seminoma germ cell tumors (NSGCT)* These are spermatocytic seminomay embryonal carcinoma, Yolk sac tumor (also called endodermal sinus tumor or infantile embryonal carcinoma), teratoma, and choriocarcinoma.# Risk factors for germ cell tumors of testis are -i) Cryptorchidism (abdominal > inguinal, i.e. higher the undescended testis more the chances of malignancy).ii) Testicular feminization syndrome and Klinefelter syndrome.iii) Excess 12P copy number either in the term of i(12P) or increased 12P an aberranthy banded marker chromosome.B) Non-germ cell tumors (sex cord tumors)# These are ley dig cell tumor and sertoli cell tumor.# Leydig (interstitial) cell tumors are positive for Reinke crystalloids. | Pathology | Male Genital Tract |
2fe9b9ab-7973-472b-a08d-af1afa5608a8 | An order for exhumation can be given by: Maharashtra 08 | District collector | Additional district magistrate | Sub-collector | Any of the above | 3d
| multi | Ans. Any of the above | Forensic Medicine | null |
d0b80584-9ab0-477e-a844-187560c2d54b | Langerhans cells in skin are : | Antigen presenting cells | Pigment producing cells | Keratin synthesisng cells | Sensory neurons | 0a
| single | A i.e Antigen presenting cells | Skin | null |
a18d43d0-c54e-44eb-a80a-346c206ebbcf | In hyperkalemia with bradycardia treatment is: - | Calcium gluconate | Steroid | Salbutamol | K+ resin | 0a
| single | The treatment for hyperkalemia can be thought of in 3 distinct steps. First, antagonize the effects of hyperkalemia at the cellular level (membrane stabilization). Second, decrease serum potassium levels by promoting the influx of potassium into cells throughout the body.(insulin,beta2 agonist) Third, remove potassium from the body.(k+resins) In cells with calcium-dependent action potentials, such as SA and atrioventricular nodal cells, and in cells in which the sodium current is depressed, an increase in extracellular calcium concentration will increase the magnitude of the calcium inward current and the Vmax by increasing the electrochemical gradient across the myocyte. This would be expected to speed impulse propagation in such tissues, reversing the myocyte depression seen with severe hyperkalemia. The effects of intravenous calcium occur within 1 to 3 minutes but last for only 30 to 60 minutes. Therefore, fuher, more definitive treatment is needed to lower serum potassium levels. Calcium gluconate is the preferred preparation of intravenous calcium. The dose should be 10 mL of a 10% calcium gluconate solution infused over 2 to 3 minutes. | Medicine | ECG and Arrhythmias 1 |
0f1909b4-9e8a-4be9-9b38-f9bd0aa22dfe | In human body, methionine is synthesized from ? | Cysteine | Proline | Threonine | None | 3d
| multi | Ans. is 'd' i.e., None Methionine is an essential amino acid, cannot be synthesized in body. | Biochemistry | null |
d679cbbc-5167-4004-b2ce-e2f6f29dc960 | Not a common cause of night blindness: | Cataract | RP | Oguchi disease | Pathological myopia | 0a
| single | Cataract is not a common cause of night blindness. Other causes are more recognized causes. Causes of Night Blindness Vitamin A deficiency (first symptom is red-green differentiation anomaly) Pathological myopia Tapetoretinal degenerations{eg. Retinitis pigmentosa(RP)} Familial congenital night blindness Oguchi's disease | Ophthalmology | Neuro Ophthalmology |
291d5c67-079f-4fc0-98c0-e35c3f1cf723 | In recent surveillance reports cases of diphtheria are reducing. This is due to - | Chemoprophylaxis | Improved standard of living | Vaccination | Health education | 2c
| single | Ans. is 'c' i.e., Vaccination o The reduced incidence of diphtheria in India is primarily due to the high coverage of appropriate immunization in children and to an apparent reduction in toxin-producing strains of the bacterium. | Social & Preventive Medicine | Diphtheria |
d411bf42-cc87-43c8-b545-4867293a74d3 | Total lung capacity depends on: | Size of airway | Closing tidal volume | Lung compliance | Residual volume | 2c
| single | Ans. C. Lung compliancea. TLC is the maximum volume to which the lungs can be expanded with the greatest possible inspiratory effort.b. TLC=IRV+TV+ERV+RV=IC+RVc. Compliance (stretch ability) of lungs: D is increased in Emphysema (obstructive lungs dis) and decreased in Interstitial pulmonary fibrosis (Restrictive lung disease). Compliance of lung is change in lung volume per unit change in airways pressure.d. TLC is increased in obstructive lung disease (eg. emphysema, COPD) and decreased in the restrictive lung disease (Interstitial pulmonary fibrosis). | Physiology | Respiratory System |
f0ec4b5a-e631-40fb-9c51-14f9d877d6f4 | Which of the following decrease sex hormone binding globulin | Oral contraceptive pills | Insulin | Thyroxine Hormone | Pregnancy | 1b
| single | null | Gynaecology & Obstetrics | null |
a95598c5-7baa-4c35-a3bd-2027974759f9 | A 65-year-old man suffers a sudden fall in mean aerial pressure, 4 hours after his CABG surgery. Other findings include elevated JVP. What is the best next step in the management of this case? | PRBC Transfusion | Vasopressors along with the inotropes | Immediate re-exploration of the mediastinum | Intra-aoic balloon pump | 2c
| multi | This clinical presentation points towards a likely diagnosis of Cardiac tamponade. It is a common complication post CABG. It can be confirmed on an Echocardiography. It is a life-threatening condition hence it should be managed by immediate return to the OT for exploration and drainage of mediastinal hematoma. | Surgery | Thorax And Mediastinum |
eeb66d6f-fb93-4291-8af6-b0671388b458 | Type IV complex of ETC is inhibited by | Oligomycin | Antimycin | Cyanide | CO2 | 2c
| single | Cyanide is probably the most potent inhibitor of ETC (Complex IV). It binds to Fe3+ of cytochrome oxidase blocking mitochondrial respiration leading to cell death. Cyanide poisoning causes death due to tissue asphyxia (mostly of the central nervous system) In Acute cyanide poisoning Amyl nitrite is given followed by sodium thiosulphate. This is an example of Chemical antagonism i.e. one drug binding to other making it unavailable in body. | Biochemistry | FMGE 2019 |
7ef8dfdf-60ce-4701-8fd5-f7a6553d8fb9 | A 60 yr old smoker came with a history of painless gross hematuria for one day. Most logical investigation would be | Urine routine | Plain X ray KUB | USG KUB | Urine microscopy for malignant cytology | 3d
| single | In this case, we should suspect bladder carcinoma ( transitional cell carcinoma ) . Smokers are at a higher risk of developing TCC.Other risk factors being chemical .industry workers in western countries and schistosomiasis in endemic regions . It is more common in males -3:1. They usually presents with painless gross hematuria. Thus the best option here is urine microsopy for RBC's and malignant cells.urine cytology even though not a good screening test because of lack of sensitivity is highly specific . Mainstay of diagnosis is cystourethroscopy. investigations include imaging ( CT , MRI ,USG ,IVU ) and blood investigations for HB , electrolytes and urea . Bailey and Love 27th edition.chapter 77.pg no 1449. | Surgery | Urology |
b7dd95d8-e3a4-4562-aa6d-cea8f6f9daac | Which Ca has best prognosis: | Carcinoma lip | Carcinoma cheek | Carcinoma tongue | Carcinoma palate | 0a
| single | Oral malignancy with best prognosis is carcinoma lips. Oral cancer with worst prognosis is floor of mouth carcinoma. | ENT | null |
4ef8a385-8685-4e05-82ba-f852da1c95ca | Net reproduction rate is : | Number of girl babies born to a women | Number of babies born to a women | Number of girl babies born to a women and taking into account only alive once | None of the above | 2c
| multi | Total Fertility Rate(TFR) : Number of babies born to a woman
Gross Fertility Rate(GFR) : Number of girl babies born to a woman
Net reproduction rate(NRR) : Number of girl babies born to a woman and taking into account only alive once. | Social & Preventive Medicine | null |
301e8f91-f5fc-4073-94a7-b9e6abf97d72 | What is the common change in cell death associated with both apoptosis and necrosis ? | Cell shrinkage | Bleb formation | Chromatin condensation | Presence of inflammation | 2c
| multi | Answer- C. Chromatin condensationBoth form of cell death, finally lead to nuclear changes i.e. chromatin condensation (pyknosis). | Pathology | null |
8a4b25d1-a225-465a-9845-b866b911232b | Drug the choice for hyperthyroidism in first trimester of pregnancy is | Methimazole | Propylthiouraril | Carbimazole | Perchlorate | 1b
| single | Propylthiouracil is the only thioamide which is least teratogenic and hence it is the drug of choice to hyperthyroidism in pregnancy and lactation. | Pharmacology | null |
36059aab-677f-4156-8ff8-0ba0327b51bf | Which of the following coagulation factors causes cross-linking and stabilization of clot? | Factor XIII | Thrombin | Factor VIII | Factor IX | 0a
| single | The loose aggregation of platelets in the temporary plug is bound together and conveed into definitive clot bg fibrin. Fibrin is initially a loose mesh of interlacing strands. It is conveed by the formation of covalent cross-linkages to a dense tight aggregate. The latter reaction is catalyzed by activated factor 13 and requires calcium. Ref: Ganong&;s Review of medical physiology, 24th edition.Pg no. 566 | Physiology | Cardiovascular system |
4f51b5ae-b096-4799-aa67-cca487e45df8 | Phage typing is widely used for the intraspecies classification of one of the following bacteria - | Staphylococci | E. coli | Klebsiella pneumoniae | Pseudomonas aeruginosa | 0a
| single | null | Microbiology | null |
0ba8f749-55e4-4ff3-bd9a-dcaea7af1835 | The first step when doing a pneumonectomy for cancer of the bronchus is to: | Ligate the pulmonary vein | Ligate pulmonary aery | Divide the bronchus | Perform lymph node clearance | 1b
| multi | Pneumonectomy Pneumonectomy is anatomically more straightforward than lobectomy (in carcinoma bronchus): The pulmonary aery is first dissected, divided and sutured. The pulmonary veins are then isolated divided and sutured. The main bronchus is divided so that no blind stump remains. The technique of stump closure is impoant if a bronchopleural fistula is to be avoided. The tissues are carefully handled and the stump is usually stapled. | Surgery | Thorax And Mediastinum |
366600fe-eb40-4d9a-bd9f-d9c8f0082dcd | All are true about DOTS, except ? | Sho course of chemotherapy | Drugs are given free of cost | Supervised drugs intake in intensive phase | Daily treatment is recommended | 3d
| multi | Ans. is 'd' i.e., Daily treatment is recommended Directly observed treatment sho course (DOTS) In the Revised National Tuberculosis Control Programme (RNTCP), patients are provided sho course chemotherapy as DOTS. All patients are provided sho-course chemotherapy free of charge. During the intensive phase of treatment a health worker watches as the patient swallows the drug in his presence. o During continuation phase, the patient is issued medicine for one week in a multiblister combipack of which the first dose is swallowed by the patient in the presence of health worker. The consumption of medicine in the continuation phase is also checked by return of empty multiblister combipack when the patient comes to collect medicine for the next week. In this programme, alternate day treatment is given. Under RNTCP, active case finding is no longer pursued. Case finding is passive. Patients presenting themselves with symptoms suspicious of tuberculosis are treated with DOTS therapy. The colour of boxes (containing the drugs for full course of treatment) is according to the category of regimen? Category I patients - Red Category II patients - Blue Category III patients - Green | Social & Preventive Medicine | null |
c7f9fab1-4168-46a1-9291-705eb0cd0c43 | A patient on warfarin was given phenobarbitone, The result would have been - | Increase the dose of warfarin | Decrease the dose of warfarin | Increase the dose of phenobarbitone | Decerease the dose of phenobarbitone | 0a
| single | Ans. is 'a' i.e., Increase the dose of warfarin | Pharmacology | null |
88bd8dd0-5572-4109-8ab9-241a5e04085d | Which of the following dings is not used for anxiety? | Propanolol | Aiprazolam | Buspirone | Haloperidol | 3d
| single | Ans. is 'd' i.e., Haloperidol | Pharmacology | null |
a0898369-2a07-4dee-b43c-6db914fc7175 | True about carotid body receptors ? | Most potent stimulus is high PCO2 | Dopamine is neurotransmitter | Low blood flow | Afferent through vagus nerve | 1b
| multi | Ans. is 'b' i.e., Dopamine is neurotransmitter Peripheral chemoreceptors The peripheral chemoreceptors which regulate respiration are located in the carotid body and aoic bodies. These bodies are located in the connective tissue associated with the vessel wall, at the bifurcation of the common carotid, and on the arch of aoa, respectively. The characteristic cells of both these structures are called glomus cells. Type I glomus cells have a high dopamine content, which they possibly employ as a neurotransmetter. Peripheral chemoreceptors convey information to the DRG of neurons in medulla, for which purpose the afferent neurons from the carotid bodies pass through glossopharyngeal nerve and from the aoic bodies pass through vagus nerve. The most potent natural stimulus for peripheral chemoreceptors is low aerial P02 (hypoxic hypoxia). The other stimuli which activate peripheral chemoreceptors are high aerial PCO2, and an increase in aerial hydrogen ion concentration (acidosis or low pH). The response to activation of peripheral chemoreceptors is an increase in pulmonary ventilation through an increase in the rate and depth of breathing. The blood flow to peripheral chemoreceptors, on per unit mass basis, is the highest to any tissue in the body. With a blood flow of 2000 ml/min/100 gm tissue, the carotid and aoic bodies, inspite of their high metabolic rate, hardly remove any oxygen from the blood supplies to them. That is why the aeriovenous oxygen difference is negligible in these bodies. Thus these structures are idealy built to sense change in aerial P02. It is good to keep in mind that stimulation of peripheral chemoreceptors not only stimulates medullary respiratory centers but also medullary vasomotor center. Therefore, the response to their stimulation is tachycardia, vasoconstriction and increase BP along with hyperventilation. | Physiology | null |
32f92251-058a-4101-86e4-69e0e3929edf | A mother calls you on the telephone and says that her 4-year-old son bit the hand of her 2-year-old son 2 days ago. The area around the injury has become red, indurated, and tender, and he has a temperature of 39.4degC (103degF). Which of the following is the most appropriate response? | Arrange for a plastic surgery consultation at the next available appointment. | Admit the child to the hospital immediately for surgical debridement and antibiotic treatment. | Prescribe penicillin over the telephone and have the mother apply warm soaks for 15 minutes four times a day. | Suggest purchase of bacitracin ointment to apply to the lesion three times a day. | 1b
| multi | Human bites can pose a significant problem. They can become infected with oropharyngeal bacteria, including S aureus, Streptococcus viridans, Eikenella corrodens, and anaerobes. A patient with an infected human bite of the hand requires hospitalization for appropriate drainage procedures, Gram stain and culture of the exudate, vigorous cleaning, debridement, and appropriate antibiotics. The infected wound should be left open and allowed to heal by secondary intention (healing by granulation tissue rather than closure with sutures). Empiric antibiotic therapy for an infected bite should be penicillinase-resistant; amoxicillin-clavulanate orally, or ticarcillin-clavulanate or ampicillin-sulbactam IV are good choices. Antibiotic prophylaxis for noninfected bite wounds remains controversial, but some experts recommend prophylaxis for all significant human bites. | Pediatrics | Growth, Development, and Behavior |
7bf2b381-3b5d-408a-8b8d-91843953adee | Most common malignancy in children is – | Leukemia | Lymphoma | Wilm's tumor | Neuroblastoma | 0a
| single | Most common childhood tumor → Leukaemia
Most common childhood leukemia → ALL
Most common solid tumor of childhood → Brain tumor
Most common tumor in infancy → Neuroblastoma
Most common abdominal tumor in child → Neuroblastoma | Pediatrics | null |
da6c0cfc-0bc2-4ccd-b640-124cb4bc2bee | A factory worker presents with excessive salivation, blue lines on gums, tremors, disturbed personality, insomnia, and loss of appetite. The most likely poisoning is - | Mercury | Lead | Arsenic | Phosphorus | 0a
| single | Excessive salivation, blue line on gums, tremors (i.e. Hatter's shake), disturbed personality (i.e. erethism) and loss of appetite (anorexia) suggest the diagnosis of mercury poisoning. | Forensic Medicine | null |
af573629-e465-47a1-9544-c520a4c44597 | Role of carnitine in lipid metabolism - | Catalyzation of the cyclization sequence | Essential for extracellular transfer of fatty acids | Essential for biosynthesis of fatty acids | Transfer of activated long chain FFA into mitochondria | 3d
| single | Ans. is 'd' i.e.. Transfer of activated long chain FFA into mitochondria o Activated long chain fatty acid (acyl CoA) cannot penetrate inner mitochondrial membrane.o Acyl group of acyl CoA is transferred to carnitine, resulting in formation of acylcarnitine.o Acylcarnitine is then transported across the inner mitochondrial membrane into the mitochondrial matrix by translocase.o Once inside the mitochondrion, acyl group of acylcarnitine is transferred back to CoA, resulting in formation of acvl-CoA which undergoes b-oxidation. | Biochemistry | Lipid Oxidation and Synthesis |
1a1c1412-b518-4dfe-859f-f2c7c82278e5 | CAMP reaction is shown by which streptococci? | Group A | Group B | Group C | Group D | 1b
| single | Ans. b (Group B). (Ref. Textbook of microbiology by Ananthanarayan 6th ed. 187).Serological or Lancefield classification system for streptococci1Group A streptococciCatalase -,Beta-hemolysis,Bacitracin sensitive,PYR test +,Ribose not fermented.Includes Streptococcus pyogenes.2Group B streptococciCAMP + and Beta-hemolysis +.CAMP reaction (Christie, Atkins and Munch Peterson reaction) due to their ability to hydrolyze hippurate, which can be demonstrated as accentuated zone of hemolysis when streptococcus agalactiae is inoculated perpendicular to streak of staph aureus grown on blood agar.Includes only one bacterium, S. agalactiae.Currently, it has been found to be a cause of sexually transmitted urogenital infections in females.3Group C streptococciRibose and trehalose fermentation4Group D streptococciGrow in 6.5% NaCI and are optochin sensitive.Hydrolysis of bile esculin (dark brown medium)-this indicates the ability of the bacteria to tolerate bile from the liver and growth in high salt cone.Includes Enterococcus and non-Enterococcus.The Enterococci include E. faecalis, a cause of urinary tract infections, and E. faecium, a bacterium resistant to many common antibiotics. Diseases such as septicemia, endocarditis, and appendicitis have also been attributed to group D Strep. Once identified, Group D Strep can be treated with ampicillin alone or in combination with gentamicin. Viridans GroupThe Viridans Streptococci, consisting of S. mutans and S. mitis, are alpha-hemolytic bacteria.These bacteria inhabit the mouth.In fact, a large percentage of tooth decay can be attributed to S. mutans.5Group F streptococciMinute streptococci;streptococcus MG. | Microbiology | Bacteria |
33c55ea6-00ad-44e9-9af8-5d7ac4d03646 | One gram of smokeless gunpowder produces: Karnataka 11 | 3000-4000 cc of gas | 9000-10,000 cc of gas | 12,000-13,000 cc of gas | 15,000-16,000 cc of gas | 2c
| single | Ans. 12,000-13,000 cc of gas | Forensic Medicine | null |
9b424535-eb42-4c23-a467-7a50cf60c294 | Cranial pa of accessory nerve supplies | Sternocleidomastoid | Trapezius | Levator scapulae | Levator palatini | 0a
| single | Sternocleidomastoid and trapezius develop from branchial arch mesoderm and are supplied by spinal pa of the accessory nerve. Levator scapulae are supplied by a branch from dorsal scapular nerve and branches from C3, C4. BD Chaurasia 7th edition Page no: 65 | Anatomy | Upper limb |
79103c19-09f0-4e51-865e-ce76f2219d88 | Marcus Gunn pupil is due to - | Total afferent pupillary defect | Relative afferent pupillary defect | Efferent pathway defect | Cerebral lesion | 1b
| single | The Relative Afferent Pupillary Defect (RAPD), or Marcus-Gunn Pupil is an extremely significant and highly objective clinical finding in the examination of the visual system. The "swinging flashlight test" is probably the best test for identifying an RAPD. In this test, a strong, steady light is used. The light is shined into one eye, and then quickly switched to the other. This is repeated back and foh, until one of four conclusions is reached (listed below). Since light in one pupil causes both pupils to constrict, quickly switching from one eye to the other will give a "relative" indication of the functioning of each eye and optic nerve. If both eyes are equally dysfunctional, no "relative" defect would be found. | Ophthalmology | Neuro-ophthalmology |
04f88cb5-f9f0-4906-b45d-b223bc90ede1 | The impression with the least dimensional change upon disinfection is | Addition poly silicone | Agar-agar | Polysulphide | Polyether | 0a
| single | null | Dental | null |
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