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135
04064d27-20f9-4662-8b5c-cc40f630ee68
Serous papillary cystadenocarcinomas of the ovaries express
CA-125
CA-19
CEA
AFP
0a
single
CA-125
Pathology
null
60bcfb33-d285-49df-94d8-7c73af06694d
Among the following which is a feature of testicu- lar feminization syndrome:
XX pattern
Commonly reared as male
Well formed female internal genitalia
High testosterone levels
3d
single
null
Gynaecology & Obstetrics
null
cf286767-0d81-4316-bb83-6e783c2f5b12
Lymph from glans penis drain into
External iliac lymph nodes
Internal iliac lymph nodes
Deep inguinal lymph nodes
Superficial inguinal lymph nodes
2c
single
Lymphatics from the glans drain into the deep inguinal nodes also called gland of Cloquet. Lymphatics from the rest of the penis drain into the superficial inguinal lymph nodes.Ref: Vishram Singh; Volume II; 2nd edition; Page no: 464
Anatomy
Abdomen and pelvis
cb4b2fd4-8ca5-48d3-8f68-4abdb9655bf9
A pregnant lady at 32 weeks' gestation period presents with a BP of 160/110 mm Hg, Proteinuria with Retinal Hemorrhage What is the Definitive Management of choice in this case?
Ritodrine
Nifedipine
Magnesium sulphates
Termination of pregnancy
3d
single
Ans. D. Termination of pregnancyPatient presents with the characteristics of Severe Hypertension indicating delivery.Induction of labor is the best suited management of choice.Magnesium Sulfate prophylaxis should be provided to prevent the onset of seizures.Severe pre-eclampsia can be characterized as:* Pulmonary edema* BP >160/110* Fetal growth restriction* >-3+ proteinuria* Complaints of convulsion, headache, upper abdominal pain, oliguria and visual disturbances* Increased levels of serum creatinine, serum transaminase or presence of thrombocytopenia
Gynaecology & Obstetrics
Hypertensive Disorders in Pregnancy
34c38399-862e-4996-9085-148048cca486
The ridge that descends from the cuspal tip towards the central part of the occlusal surface in a maxillary molar is
Triangular ridge
Marginal ridge
Transverse ridge
Oblique ridge
0a
single
null
Dental
null
43504d8a-760b-4c4d-91b9-cfa32188d7d5
No treatment of withdrawal is req uired in -
LSD
Opium
Alcohol
Amphetamine
0a
single
Ans. is 'a' i.e., LSD o Clinically significant withdrawal syndrome (requires treatment)Alcohol, opioids, amphetamines, Barbiturates, BZDs, Nicotine.o No or minimal clinically significant withdrawal syndrome (requires no treatment) :-LSD (nil). Cannabis (minimal).
Pharmacology
C.N.S
bdc0746c-496d-480e-8aa9-32394e2cc6b9
Complications of placenta pre include all except ___________
Malpresentation
Premature labor
Rapid dilation of cervix
Retained placenta
2c
multi
Complication of placenta pre: Maternal complications Antepaum Labour Postpaum Puerperium APH Cord Prolapse PPH Sepsis Malpresentation Intrapaum hemorrahage Retained placenta Premature labour Early rupture of membranes Associated abruptio: 10% Fetal complications Low bih weight: 15% (Most common fetal complication) Bih Asphyxia IUD Bih injuries Congenital malformation (3X risk) Most common complication of abruptio placenta: Prematurity Most common complication of placenta prec: LBW Ref: DC Dutta&;s Textbook of Obstetrics 8th edition Pgno: 288, 289
Gynaecology & Obstetrics
General obstetrics
5a184f05-c50b-41a9-b44b-5f86660c3716
National institute of Homeopathy is located in:
Delhi
Kolkata
Chennai
Mumbai
1b
single
The government of india has established a national institute of Ayurveda in Jaipur and a national institute of homeopathy in Kolkata. Ref: Park 21st edition, page 849.
Social & Preventive Medicine
null
dcb97307-a7cc-4397-b92b-4afad19f5d04
Karyotyping is useful in diagnosis of -
Autosomal recessive disorders
X-linked recessive disorders
Chromosomal abnormalities
Biochemical abnormalities
2c
single
Ans. is 'c' i.e., Chromosomal abnormalitieso Karyotyping is the study of chromosomes and is used in cytogenetics to study the chromosomal abnormalities. o After arresting the cells in metaphase the chromosomes are examined to see for:(i) Numbers --> to detect abnormalities in chromosome numbers such as aneuploidy (trisomy, tetrasomy), polyploidy.(ii) Structure ---> to detect structural chromosomal anomalies such as translocations, deletions, inversions.
Pathology
null
4f1a7890-deb6-49ab-b522-b92264092e47
In Complete deft the hard palate is totally separated from?
Maxilla
Soft palate
Vomer
All
2c
multi
ANSWER: (C) VomerREF: With textPalate cleft can occur as complete (soft and hard palate, possibly including a gap in the jaw) or incomplete (a 'hole' in the roof of the mouth, usually as a cleft soft palate).Normally the hard palate is continuous in front and laterally with the alveolar processes of the maxilla, and gives attachment posteriorly to the soft palate."In cleft palate the hard palate may or may not be attached to the vomer. If it is attached to the vomer, it is called as incomplete. Hard palate in complete cleft palate is totally separated from vomer' REF: Cleft lip and palate: diagnosis and management - Samuel Berkowitz Page 50."In incomplete unilateral cleft palate, nasal septum (Vomer) is attached to the uncleft side of hard palate. In bilateral complete deft lip and palate, Vomer is free and septum hangs freely"REF: Synopsis of Oral & Maxillofacial Surgery by Ghosh page 155Incomplete deft palateUnilateral complete lip and palateBilateral complete lip and palate
ENT
Oral Cavity
489433be-0c41-4873-9dea-493a0b31f0c7
All vaccines are contraindicated in pregnancy except
BCG Vaccine
Measles Vaccines
OPV Vaccine
Yellow fever vaccine
3d
multi
All live vaccines are contraindicated in pregnancy except yellow fever vaccine.
Social & Preventive Medicine
null
27021304-6316-4b34-903a-79819c835f76
Inclusion conjunctivitis is caused by:
Chlamydia trachomatis
Chlamydia psittaci
Herpes
Gonorrhoea
0a
single
Ans. is 'a' i.e. Chlamydia trachomatis Inclusion conjunctivitis is caused by chlamydia trachomatis (serotypes D- K).Chlamydial inclusion conjunctivitis is generally spread by sexual transmission from the genital reservoir of infection. The primary source of infection is a benign subclinical venereal disease producing a mild urethritis in the male and cervicitis in the female.The modes of transmission are orogenital activities and hand to eye spread of infective genital secretions. A common mode of transmission is through the water in swimming pools; thus the disease may occur in local epidemics (swimming pool conjunctivitis). It is also transmitted from the mother to the newborn.Treatment- azithromycin or doxycycline
Ophthalmology
Inflammations of Conjunctiva - Infective
18c9fafd-6e63-4afd-b795-82895464ffb7
Example of Type IV hypersensitivity is -
Serum sickness
Granulomatous reaction
Shwartzman reaction
Arthus reaction
1b
single
Ans. (b) Granulomatous reaction(Ref: Robbins 9th/pg 208-211; 8th/pg 205-208; Illustrated Dictionary of Immunology by M.P.Arora - Page 501)Granulomatous reaction is an example of type IV hypersensitivitySerum sickness & Arthus reactions are examples of type III hypersensitivityShwartzman reaction is a non-immunologic phenomenon in which endotoxin (lipopolysaccharide) induces local & systemic reactions; It can either be local or systemic type;
Pathology
Immunity
0cc3357c-d323-4645-bdb4-3cf083bdafc6
In colposcopy following are visualised except:
Upper 2/3rdendocervix
Cervical carinoma in situ
Cervical polyp
Cervical dysplasia
0a
multi
null
Gynaecology & Obstetrics
null
ff2276eb-fe5a-42f9-8102-32bb250fab59
Which of the following changes in C-MYC oncogene may be associated with colonic malignancy?
Point mutation
Amplification
Rearrangement
Deletion
1b
single
C- MYC amplification may be responsible for Ca breast, Ca colon, Ca stomach and lung. L - MYC amplification is associated with Ca lung and bladder. N- MYC amplification is associated with neuroblastoma and Ca lung. Ref: Harrison, 17th Edition, Page 496
Pathology
null
6d291b0d-377b-4b1e-814d-c02c07083358
Name of the curved laryngoscope ?
Miller
Macintosh
Muller
Merkel
1b
single
Laryngoscopy (larynx + scopy) is a medical procedure that is used to obtain a view of the vocal folds and the glottis. Following are the types of the available laryngoscopes :- i) Straight blade: Miller ii) Curved blade: Macintosh
ENT
null
e778f2c3-910b-40a7-8d69-92b5a3f04feb
The hilum of the right lung is arched by:
Recurrent laryngeal nerve
Azygos vein
Thoracic duct
Vagus nerve
1b
single
B i.e. Azygous vein
Anatomy
null
92ecdf25-6ae8-495b-877b-3da11122ed8e
Half life of factor 8
4 hrs
8 hrs
24 hrs
30 hrs
1b
single
Factor VIII is also called as anti hemophilic factor Its half life is 8-12 hrs Ref: Harrison's 19th edition Pgno :138
Anatomy
General anatomy
c5c85fb3-b838-4e07-b572-0fd85f5a0ebc
Most common cause of lower respiratory tract infection in 3 year old child is
Klebsella
H-influenza
Streptococcal pneumonia
Staphe aureus
2c
single
Ans. is 'c' i.e., Streptococcal pneumonia
Pediatrics
null
d310a055-355a-4997-9b9b-9d2f6bb7ce6d
In which condition doctor is passive
Classical psychoanalysis
Psychoanalytic psychoanalysis
Both
None
0a
multi
Classical Psychoanalysis No detailed history taking, mental status examination, or formalised psychiatric diagnosis is attempted. The patient is allowed to communicate unguided, by using 'free association'. The therapist remains passive with a non-directive approach; however, the therapist constantly challenges the existing defences and interprets resistance (during the therapy) and transference (patient's feelings, behaviours and relationship with the therapist). No direct advice is ever given to the patient. The crux of the therapy is on interpretation. During the therapy, the patient typically lies on the couch, with the therapist sitting just out of vision. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 213
Psychiatry
Treatment in psychiatry
84048add-bdc5-4728-b544-f841dcc04818
Irradiation can be used to sterilize A/E -
Bone graft
Suture
Artificial tissue graft
Bronchoscope
3d
single
Ans. is 'd' i.e., BronchoscopeEndoscopes are sterilized by chemical methods Methods for sterilization of endoscopes Rigid endoscope - Autoclave Flexible - Glutaraldehyde Peracetic acidNowadays musculoskeletal tissue allografts are being increasingly used for knee reconstructive procedures.The soft tissue allografts commonly being used are bone-patellar tendon-bone, Achilles tendon, fascia lata, anterior and posterior tibial tendon.Infections with allografts is a serious concern.Therefore these allografts need proper sterilization and disinfection.The proper sterilization procedure for these allografts is Gamma/Electron beam irradiation.
Microbiology
General
48397be3-6bec-4cd5-9129-1ff7a259dcfc
Normal intraabdominal pressure is ?
0 - 8mmHg
10 - 15mmHg
15 - 20mmHg
20 - 26mmHg
0a
single
Ans. is'a'i.e., 0 - 8 mmHgNormal intra-abdominal pressure is 0-6 mmHg.
Physiology
null
b71a1d35-abf9-4f4b-b100-8763da6ab444
True regarding fluorosis are all except –
Fluorosis is the most common cause of dental caries in children
Fluorosis can cause fluoride deposition in bones
Defluoridation is done by Nalgonda technique
Fluorosis can cause genu valgum
0a
multi
null
Social & Preventive Medicine
null
3e454fc7-1ed5-4de8-bb90-e980d5a63f1b
Conduction velocity of nerves is NOT affected by which of the following?
Leprosy
Motor neuron disease
Hereditary neuropathy
A.I.D.P
1b
single
Motor neuron disease is at anterior horn cell, pyramidal neurons and not the nerves. Thus the conduction velocity in the nerves is normal. Leprosy - Affects nerves and both sensory nerve conduction /motor nerve conduction studies may demonstrate reduced amplitude in affected nerves but occasionally may reveal demyelinating features. Charcot-Marie-Tooth disease (CMT) -MC hereditary neuropathy and has reduced motor nerve conduction velocity A.I.D.P -Segmental demyelination in the spinal cord and peripheral nerves. Early features-prolonged F-wave latencies Prolonged distal latencies Reduced amplitudes of compound muscle action potentials, d/t involvements of nerve roots and distal motor nerve terminals
Medicine
Amyotrophic Lateral Sclerosis and other motor neuron diseases
36672a93-fda0-4188-9825-b7a86ebd9590
Arteriole is
Conducting vessel
Resistance vessel
Exchange vessels
Capacitance vessel
1b
single
Arterioles regulate the distribution of blood flow by altering their diameter to increase or decrease the peripheral resistance as required.
Physiology
null
f30456db-62bb-43d2-bc91-8e77c1092888
Ether was first used by:
Preistly
Moon
Wells
Simpson
1b
single
Moon
Anaesthesia
null
30510bbb-818d-4e5d-b2b3-ad3e7ef9a418
In which of the following Arbiskov cells are seen ?
Myelodysplastic syndrome
Multiple myeloma
Granulocytic sarcoma
Leukemia cutis
2c
single
Granulocytic Sarcoma Also known as Choloroma or myeloblastoma. It is a hematopoietic stem cell tumour. It is an extramedullary tumor of immature granulocytic series cells. It is a localised tumour forming a mass in the skin of orbital & periorbital tissue due to infiltration of tissues by leukemic cells. It is most commonly associated with AML M2 Arbiskov cells are monocytes which can be seen in choloroma.
Pathology
Acute Myelogenous Leukemia
04e8a383-bb55-4dc4-83d7-165c63f84848
Epistaxis in elderly person is most commonly due to:
Foreign body
Bleeding disorder
Hypertension
Nasopharyngeal carcinoma
2c
single
(c) Hypertension(Ref. Cummings, 6th ed. 680)The most common cause of epistaxis in an elderly person is hypertension.Foreign body is not seen at this age.Bleeding disorder will present with bleeding from multiple sites.Nasopharyngeal carcinoma presents with upper deep cervical lymph node. Nasal obstruction and blood tinged nasal discharge can occur later on.
ENT
Epistaxis
adff28ff-34c2-43af-b347-852c499020d2
A pregnant mother at 32 weeks gestation presents in preterm labour. Therapy with antenatal steroids to induce lung maturity in the fetus may be given in all of the following conditions except:
Prolonged rupture of membranes for more than 24 hours
Pregnancy induced hypertension
Diabetes mellitus
Chorioamnionitis
3d
multi
“Corticosteroids can be given even in presence of maternal hypertension or diabetes mellitus, but should preferably be avoided if PROM is associated with definitive evidence of chorioamnionitis” Meherban Singh 5/e, p 227 “Steroid treatment is contraindicated in presence of overt infection.” Fernando Arias 3/e, p 220 Steroid therapy in preterm labour: Steroids are recommended for all women in preterm labour before 32 weeks with or without membrane ruptures in whom there is no evidence of chorioamnionitis. According to ACOG, single dose steroid injection is recommended between 24 to 32 weeks. There is no concensus regarding treatment between 32-34 weeks. Corticosteroid therapy is not recommended before 24 weeks. Advantage: Steroids reduce the rate of respiratory distress syndrome, intraventricular hemorrhage and necrotising enterocolitis in the newborn. The effect of treatment is maximal between 24 hours of the first dose and uptil 7 days. Earlier it was recommended to give repeated doses weekly till the patient delivers but this practice is associated with significant fetal and neonatal side effects like cerebral palsy and should be abandoned. Betamethasone is the steroid of choice as it also prevents periventricular leukomalacia although dexamethasone can also be used. Dose: Betamethasone = 2 doses of 12 mg, 24 hours apart, Dexamethosane: 4 doses of 6 mg, 12 hours apart.
Gynaecology & Obstetrics
null
18b158c0-ca9d-4df9-a0f4-23a65ce4a404
Insulin inhibits ketogenesis by all except
Inhibiting lipolysis
Increased esterification of fatty acids
Directing acetyl-CoA to TCA cycle
Increasing b-oxidation
3d
multi
Insulin inhibits lipolysis in adipose tissue due to inhibition of hormone-sensitive lipase Insulin depresses HMG CoA synthase and so ketogenesis is decreased In the presence of insulin, acetyl CoA is completely utilized in the citric acid cycle because oxaloacetate generated from glucose is available in plenty. Insulin also ours fatty acid synthesis from acetyl CoA. All these factors reduce the availability of acetyl CoA so that production of ketone bodies reduced.Ref: DM Vasudevan, 7th edition, page no: 322
Biochemistry
Endocrinology
0079d515-4515-4555-b705-e3003b9a1db1
Treatment for dendritic ulcer includes all except: March 2009
Penetrating keratoplasty
Acyclovir
Steroids
Debridement of the edges of the ulcer
2c
multi
Ans. C: Steroids Debridement of the edges of the ulcer with a moistened, fine cotton tipped applicators helps in reducing the load of active virus-infected cells. The standard treatment is idoxuridine drops/ trifluridine drops/ acyclovir 3% eye ointment/ 3% vidarabine ointment produces a resolution of herpes in 95% of the patients. Steroids are contraindicated in suspected cases of herpes simplex epithelial keratitis paicularly in the presence of active viral replication. Penetrating keratoplasty is useful in cases with herpetic scarring where the eye has been free of activity for a year.
Ophthalmology
null
4db320d6-ed9a-48c7-8f3c-3393937bf44e
Which of the following condition is associated with limitation of both adduction and abduction of the affected eye?
Duane retraction syndrome Type 1
Duane retraction syndrome Type 2
Duane retraction syndrome Type 3
Double elevator palsy
2c
multi
Weakness of both adduction and abduction of the eye is a feature of Duane retraction syndrome type 3. Duane retraction syndrome is a congenital, incomitant ocular motility disorder characterized by abnormal function of lateral rectus muscle in the affected eye together with retraction of the globe and narrowing of the palpabrel fissure on attempted adduction. Retraction of the globe and narrowing of the palpabrel fissure occur due to simultaneous contraction of medial and lateral rectus muscles on attempted adduction. There are of 3 types: DRS type 1 - limited abduction, normal adduction DRS type 2 - limited adduction, normal abduction DRS type 3 - limited adduction and abduction
Ophthalmology
null
2e393aa4-25b0-4736-a206-f08161b0030b
The only one flexible minor connector is
that connecting clasp assembly to major connector
that connecting indirect retainer assembly to the major connector
that joining the denture base to major connector
that approach arm of a bar type clasp
3d
single
null
Dental
null
2eb2df01-2c9a-48cd-bd36-0746be39a901
In an infant born to a HIV infected mother, at what age of child the ELISA test can reliably diagnose HIV infection
18 months
9 months
12 months
3 months
0a
single
Enzyme-linked immunosorbent assay (ELISA) and Western blotting are used to initially detect HIV-specific antibodies but these tests are not used for diagnosis in patients younger than 18 months of age. This is because of the persistence of the maternal HIV antibody in infants younger than 18 months. Infants younger than 18 months require virologic assays that directly detect HIV in order to diagnose HIV infection.
Pediatrics
null
02cf570c-1c2b-414b-a650-add41404d88f
Vitamin A requirement in infant is -
350 mg
600 mg
800 mg
1000 mg
0a
single
- daily intake of vitamin A recommended by ICMR for infants is 350 mcg retinol. - daily intake of vitamin A recommended by ICMR for infants is 2800 mcg beta carotene. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no:616 <\p>
Social & Preventive Medicine
Nutrition and health
4294eaef-3fab-4069-9b86-293f4cac94fa
Sarcoma botryoides of vagina commonly occurs in which age group-
<10 years
20-30 years
40-50 years
50-60 years
0a
single
Ans. is 'a' i.e., < 10 years * Sarcoma botryoides or botryoid rhabdomyosarcoma is a subtype of embryonal rhabdomyosarcoma, that can be observed in the walls of hollow, mucosa lined structures such as the nasopharynx, common bile duct, urinary bladder of infants and young children or the vagina in females, typically younger than age 8. The name comes from the gross appearance of "grape bunches" (botryoid in Greek).
Gynaecology & Obstetrics
Miscellaneous (Gynae)
750794f1-4afe-46e4-ba92-e0e11bf94b43
A 70-year-old man with hypeension wakes up with severe chest pain and diaphoresis. On examination he has bounding pulses with wide pulse pressure. A diastolic murmur is heard along the right sternal border. Which of the following is the possible etiology?
Aoic dissection
STEMI with papillary muscle dysfunction
Myocarditis with functional regurgitation
Flash pulmonary edema
0a
single
Option A= High B.P | Aoic dissection | Leads to Retrograde spread | develop Aoic Root dilation | Leads to develop Aoic Regurgitation- Diastolic Murmur Option B= STEMI with Papillary muscle dysfunction have systolic murmur. Option C= Myocarditis with functional regurgitation- Systolic murmur Option D= Flash Pulmonary edema related to Renal aery stenosis/Reno vascular hypeension
Medicine
CVS
5e85625f-1660-46fd-861b-bc34e3220d7d
All of the following about gastrointestinal carcinoid tumours are true, Except
Small intestine and appendix account for almost 60% of all gastrointestinal carcinoid
Rectum is spared
5 year survival for carcinoid tumors is > 60%
Appendical carcinoids are more common in females than males
1b
multi
About 15% rectum is involved in a carcinoid tumour it arises from the submucosa with the overlying intact mucous membrane. Reference SRB 5 the edition page no. 877
Surgery
G.I.T
35808bff-963d-4ea2-9406-16b9ad41fe45
Obesity is associated with all of the following except:
Osteoahritis
Hypeension
Gall stones
Pancreatitis
3d
multi
Answer is D (Pancreatitis): Pancreatitis has no association with obesity. RISKS OF OBESITY INCLUDE THE FOLLOWING : A. Cardiovascular disease : -increased risk of atherosclerosis -increased risk of hypeension - increased risk of sudden death B. Pulmonary function : Sleep apnea and Right hea failure C. Gall bladder disease : Increased incidence of Gall stones D. Joint : - Increased risk of osteoahritis Q :paly due to added trauma of increased weight bearing - Increased incidence of Gout 2:due to impairment in urate clearance. E. Diabetes mellitus : Type II diabetes mellitus Q is almost always seen in the obese. F. Cancer : Increased incidence of endometrial carcinoma post menopausal breast cancer prostate cancer Q - colorectal carcinoma G. Skin : Increased incidence of Acanthosis nigricans Q H. Endocrine : Insulin Resistance : leading to Hyperinsulinemia is directly related to degree of obesity. Growth hormone Q :secretions is reduced but IGF-I levels are normal thus growth is not affected. Testosterone level is reduced.Q
Medicine
null
4b65bfd9-50dd-49b7-9f03-3768c7f8d400
Syndrome characterized by an elaborate delusion that the patient is passionately loved by another person is also known as: COMEDK 15
Ekbom's syndrome
De Clerambault's syndrome
Querulous paranoia
Othello syndrome
1b
single
Ans. De Clerambault's syndrome
Forensic Medicine
null
ffeefa0f-de35-453f-84ea-6873d9cec9bb
Which one of the following is the treatment of choice in a child with inguinal hernia
Bassini's repair
Shouldice repair
Herniotomy alone
Lichtenstein reapir
2c
single
null
Surgery
null
bbdb3307-0b26-4d45-883b-c5e4f10e3df1
When the concentration of the etchant is more than 50%, it forms a complex which prevents further dissolution. The complex is
hydroxyapatite
calcium phosphate
monocalcium phosphate monohydrate
none of the above
2c
multi
null
Dental
null
5d356a71-c7a1-4f0b-ad57-bd55ac2d5c1b
Which of the following indications of deep brain stimulation is not FDA approved?
OCD
Major depression
Parkinsonism
Dystonia
1b
single
FDA approved indications for deep brain stimulation are: a. Parkinson's disease and essential tremors b. Dystonia c. Obsessive compulsive disorder
Psychiatry
Mood Disorders
4fd5e89b-9ec7-4917-9c75-e46af0336940
An 18 yr old male presents with massive hematemesis; he has history of fever for the past 14 days for which he was managed with drugs; moderate splenomegaly is present; diagnosis is:
NSAID induced duodenal ulcer
Drug induced gastritis
Esophageal varices
None of the above.
2c
multi
Answer is C (Esophageal varices) Presence of massive haematemesis in the background of moderate splenomegaly suggests a diagnosis of esophageal varices secondary to poal hypeension. Esophageal varices : Most common presentation of esophageal varices is Hematemesis. 'Splenomegaly, sometimes with hipersplenism, is the next most common presenting feature in the poal vein obstruction.'
Medicine
null
bafd2068-e156-4a6f-a93a-94429906c21e
Most sensitive investigation to see intracranial bleed in a patient with head injury -
MRI
X-ray
CT-scan
Ultrasound
2c
single
Ans. is 'c' i.e., CT-scan o Has been explained in previous session
Unknown
null
74fdbb59-a63e-483a-ac26-7190bcb19523
Autoantigen is ?
Blood group antigen
Forssman antigen
Both
None
3d
multi
None
Microbiology
null
1879669a-1e58-429d-922f-d523d80a9279
Which one of following is Polysaccharide vaccine:-
Peussis
Hepatitis B
Meningococcal
Yellow fever
2c
single
Polysaccharide vaccines are: Typhim-Vi Pneumococcal vaccine Meningococcal vaccine Hib.
Social & Preventive Medicine
Concepts of Immunity, Classification of Vaccines
0a2b4c53-243f-4966-9c06-b9201364a8a8
Vaccine which requires the most stringent conditions for storage
DPT
OPV
BCG
TT
1b
single
Among the vaccines, polio is the most sensitive to heat, requiring storage at minus 20 degree Celsius. Vaccines which must be stored in the vaccine compaments are polio and measles. The cold chain is a system of storage and transpo of vaccines at low temperature from the manufacturer to the actual vaccination site (refer pgno:109 park 23 rd edition)
Social & Preventive Medicine
Epidemiology
13c6ced0-158d-4db3-9bbb-6d3f6669b486
As the alveolar bone height moves apically, center of resistance moves:
Apically
Coronally
Mesially
Infinity
0a
multi
null
Dental
null
80e65ded-43bd-44a4-b0ed-60988a0906bb
Which among the following condition is positive for double stranded DNA antibody?
SLE
Sjogren's syndrome
Scleroderma
Mixed Connective Tissue Disorder
0a
single
Serum antinuclear antibodies (ANAs) are found in nearly all individuals with active SLE. Antibodies to native double-stranded DNA (dsDNA) are relatively specific for the diagnosis of SLE. Anti-SSA or anti-SSB antibodies are seen in Sjogren's syndrome. Topoisomerase I antibodies (also known as Scl-70), Anticentromere antibodies, Fibrillarin antibodies and antibodies to ribonucleoprotein (RNP) are present in scleroderma. Anti-U1-RNP antibodies, and antibodies against U1-70 kd small nuclear ribonucleoprotein (snRNP) are characteristic of mixed connective tissue disorder (MCTD).
Medicine
null
36d41b07-8c5a-4823-85f3-f3b9bc433ee1
A 60 year old male was diagnosed as carcinoma right lung. On CECT chest there was a tumor of 5 ✕ 5 cm in upper lobe and another 2 ✕ 2 cm size tumor nodule in middle lobe. The primary modality of treatment is -
Radiotherapy
Chemotherapy
Surgery
Supportive treatment
2c
single
null
Surgery
null
d653240c-9ab4-412a-80a6-3a4643993d78
The drug of choice for treatment of meningococcal meningitis is
Piperacillin
Ceftriaxone
Ampicillin
Meropenem
1b
single
Ans. b. CeftriaxoneRef: Goodman Gilman 13th E/PI 035Ceftriaxone is the drug of choice for treatment of meningitis caused by H. influenza, N. meningitidis (meningococcal meningitis) and S. pneumoniae.Ampicillin is the drug of choice for treatment of meningitis caused by L. monocytogenes.Meningitis seen in post neurosurgery or penetrating head trauma patients caused by staphylococcus, Propionibacterium, pseudomonas or acinetobacter is treated by meropenem+vancomycin.Note: For prophylaxis of meningococcal meningitis (contacts or mass chemoprophylaxis) ciprofloxacin is the drug of choice. Ceftriaxone though us the best drug for prophylaxis is not the drug of choice as it is a parenteral drug.
Pharmacology
Anti Microbial
35971f4c-67b5-4560-9f73-286e844bdf01
Which of the following topical agent boosts cell - mediated immunity in burns
Mafenide acelate
Silver nitrate
Cerium nitrate
Povidone iodine
2c
single
Cerium nitrate boosts cell - mediated immunity and forms sterile eschar in burns.
Surgery
null
8d286edf-0818-4531-88ab-8afaa6569623
A 40yr old patient developed high fever of sudden onset .Peripheral blood film showed malaria parasite pigment was yellowish brown and schizonts were 9-10microns and contained 20 merozoites each
Pl vivax
Pl falciparum
Pl malariae
Pl ovale
0a
single
The features are consistent with the diagnosis of Pl vivax .yellow brown pigment-vivax Dark brown pigment-falciparum Ref: D.R. Arora. Medical parasitology 4th ed pg. 77
Microbiology
parasitology
0c069ff7-c4c1-4c85-9d9b-1dfbc3ab1674
The cells which lie outside blood testis barrier:
Sertoli cells
Spermatocyte
Spermatid
Leydig cells
3d
single
Ans. is d, i.e. Leydig cellsBlood testis barrier is formed by Sertoli cells which keeps the growing germ cells (its all stages) separated from blood.
Gynaecology & Obstetrics
Endometriosis and Infertility
d257bc3e-6c24-4ae2-84eb-4d7699ac5910
All are true about supraglottic laryngeal carcinoma except:
It is the most common site for carcinoma larynx
Involvement of upper & middle juglar Lymph nodes is seen
Point on swelling is the most common symptom
Stage T1 is treated by external beam radia therapy
0a
multi
Glottie part is the most common sites for carcinoma larynx followed by supraglottic & subglottic pats respectively.
Surgery
null
8423e689-1634-4c4c-8c1e-65a51791921b
Order of anastomosis in lung transplant:
Pulmonary aery, pulmonary vein, bronchus
Pulmonary vein, bronchus, pulmonary aery
Pulmonary vein, pulmonary aery, bronchus
Pulmonary aery, bronchus, pulmonary vein
1b
single
Order of anastomosis in lung transplant pulmonary vein, bronchus, pulmonary aery. LUNG TRANSPLANTATION PROCEDURE SLT: Performed through posterolateral thoracotomyQ image on left side DLT: Performed through bilateral thoracotomy or median sternotomyQ Sequence of anastomoses in lung transplantation (PV By BA PA): Pulmonary Vein - Bronchial Anastomosis - Pulmonary AeryQ COMPLICATIONS OF LUNG TRANSPLANTATION Dehiscence of airway anastomosisQ Late airway stenosis at bronchial anastomosis due to ischemia: Treated by dilatationQ
Surgery
Transplantation
daea49e0-f3a9-4c41-b5a2-2bed34f05dd9
Which statement is FALSE regarding specific learning disorders (SLD)
The overall estimates of the prevalence of SLD range from 3-1096
It is a type of neurodevelopmental dysfunctions
Terms as dysgraphia or dyscalculia had been revolutionized
Includes students did well in academic testing but not in intelligence testing
3d
multi
Specific developmental disorders of scholastic Skills (specific learning disorders) includes reading disorder, spelling disorder, disorder of arithmetical skills, and mixed disorder of Scholastic Skills. Dyslexia (reading disorder) is included in lCD-10 in a separate category of symbolic dysfunction. The terms, Dyscalculia (mathematics disorder), and Dysgraphia (written language disorder) are also used by investigators and clinicians, but their inclusion in diagnostic classihcation systems has been inconsistent and a source of some disagreement among expes. A student exhibiting a significant discrepancy between scores on tests of intelligence and tests of academic achievement could be classified as a student with an SLD, and would subsequently be eligible for Special Education Services i.e. those student may did very well in IQ testing but not in academic achievement or tests. Ref:- Nelson&;s textbook of paediatrics; pg num:- 672
Pediatrics
Growth and development
079d565e-2a47-4500-96af-30bb792d8137
An 8-month-old child presented with reduced appetite, abdominal distension and pain and psychomotor retardation. The child was normal at bih and both parents are normal. O/E: - Hepatosplenomegaly Moderate lymphadenopathy Abnormal posturing of the limbs, trunk, and face Impaired voluntary rapid eye movements Cheery red spot on fundus examination. Bony defects Lymph node-histopathology and electron microscopy. EM findings Which of the following enzymes is most likely deficient in the above disease: -
Hexosaminidase A
Alpha-galactosidase A
Glucocerebrosidase
Sphingomyelinase
3d
multi
This is a case of Niemann-pick disease. 1. Autosomal recessive disease 2. Divided into 2 groups depending on deficiency: - Deficiency of acid sphingomyelinase enzyme- Type A and B Impaired intracellular cholesterol trafficking- Type C and D 3. Normal at bih 4. Presents with hepatosplenomegaly, lymphadenopathy and cherry red spot on fundus examination. 5. HPE image shows Niemann-pick cells- These are foam cells with soap suds appearance (Distention of Lysosomes due to sphingomyelin and cholesterol) 6. Electron microscopy shows Zebra bodies - These are concentric lamellated myelin figures (in engorged secondary lysosomes). OTHER ENZYME DEFICIENCIES: - Hexosaminidase A- Tay-sach's disease Alpha-galactosidase A - Fabry's disease Glucocerebrosidase - Gaucher's disease
Unknown
Integrated QBank
fa052bdd-545f-468b-bcb3-e7e2177c4b7d
Feature of hydrops fetalis in a fetus can be due to:
Ebstein barr virus
Human papilloma virus
Parvovirus B19
Influenza Virus
2c
single
Hydrops fetalis - Excessive destruction of the fetal red cells leads to severe anemia, tissue anoxemia and metabolic acidosis It is accumulation of fluid in the body of the fetus in two out of three compaments: ascites, pleural effusion, pericardial effusion Most common cause of immune hydrops fetalis - Rh incompatibility Others causes of hydrops fetalis Cardio vascular cause - congenital hea block ( Most common) Chromosomal cause - turner syndrome (45 XO ), triploidy , trisomies 21,18 and 13 Hematological - a 4 - thalassemia (HB bas) , fetomaternal hemorrhage Infections - Parvovirus B19(mc) , syphilis , cytomegalovirus, toxoplasmosis Rubella, HSV
Gynaecology & Obstetrics
FMGE 2018
116eb27d-967f-4fca-ae48-044c916602a4
Pulmonary endothelium is NOT concerned with which of the following:
Lipoprotein lipase
Plasminogen activator
Thrombin
Factor X
3d
single
null
Physiology
null
5515a65b-4f9e-4862-842b-4b9f86f5e29f
Carrier stage seen in -a) Poliob) Cholerac) Pertusis d) Plague e) Tetanus
da
abc
dea
ac
1b
single
null
Social & Preventive Medicine
null
82c572eb-03a7-4490-b580-340fadc693cb
A 40-year old man presented with acute onset pain and swelling of left great toe. On X-ray, punched out lytic lesion seen on phalanx with sclerotic margins and overhanging bony edges. Diagnosis is:
Gout
Rheumatoid ahritis
Psoriatic ahritis
Reiter's syndrome
0a
single
Ans. a. Gout
Gynaecology & Obstetrics
null
bb511a89-547a-4ac9-8997-f7878bdb1b1f
Which of the following statements is true concerning the vascular response to injury?
Vasoconstriction is an early event in the response to injury
Vasodilatation is a detrimental response to injury with normal body processes working to avoid this process
Vascular permeability is maintained to prevent fuher cellular injury
Histamine, prostaglandin E2 (PGE2) and prostacyclin (PGI2) are impoant mediators of local vasoconstriction
0a
multi
After wounding, there is transient vasoconstriction mediated by catecholamines, thromboxane, and prostaglandin F2 (PGF2a). This period of vasoconstriction lasts for only five to ten minutes. Once a clot has been formed and active bleeding has stopped, vasodilatation occurs in an around the wound. Vasodilatation increases local blood flow to the wounded area, supplying the cells and substrate necessary for fuher wound repair. The vascular endothelial cells also deform, increasing vascular permeability. The vasodilatation and increased endothelial permeability is mediated by histamine, PGE2, and prostacyclin as well as growth factor VEGF (vascular endothelial cell growth factor). These vasodilatory substances are released by injured endothelial cells and mast cells and enhance the egress of cells and substrate into the wound and tissue.
Surgery
null
8c2aadc2-d526-471d-8dd2-14cfe0ea3061
60 yr old male presented with dysphagia. Mucosal biopsy is provided here which show?
Squamous metaplasia
Columnar metaplasia
Anaplasia
Connective tissue metaplasia
1b
single
.
Anatomy
All India exam
5d685a8f-e95e-483e-9468-edfe7b76934c
The most common ovarian cause of increased androgenic state is:
PCOD
Premature adrenarche
Androgen secreting tumor
Choriocarcinoma
0a
single
(A) PCOD# Polycystic Ovarian Syndrome (PCOS):> it was earlier known as Stein Leventhal syndrome. 1% female population suffers from PCOS, and the patients are mostly 15-25 years age.> PCOS includes chronic non-ovulation and hyperandrogenemia associated with normal or raised oestrogen (E2), raised, LH & low FSH/LH ratio.> In PCOS-LH>FSH: Obesity and hirsuitism are important features PCOS includes chronic non- ovulation and hyper androgenemia.
Gynaecology & Obstetrics
Miscellaneous (Gynae)
05650403-1dc7-48cf-a10a-2945177204c7
Measles vaccine is not given before:
9 months
12 months
15 months
18 months
0a
single
9 months
Social & Preventive Medicine
null
a9f085e0-16af-4daf-9525-119c415bca6f
All of the following are features if CD4 count drop below 50cells/ mmcubic, except
HIV associated dementia.
CMV retinitis.
Disseminated mycobacterium avium intracellulare.
None.
0a
multi
null
Medicine
null
3a941dcf-241d-407d-8d47-e9192b2b2718
What is the major source of extracellular cholesterol for human tissues?
Very-low-density lipoproteins (VLDLs)
Low-density lipoproteins (LDLs)
High-density lipoproteins (HDLs)
Albumin
1b
single
The uptake of exogenous cholesterol by cells results in a marked suppression of endogenous cholesterol synthesis. Low-density human lipoprotein not only contains the greatest ratio of bound cholesterol to protein but also has the greatest potency in suppressing endogenous cholesterogenesis. normally suppress cholesterol synthesis by binding to a specific membrane receptor that mediates inhibition of hydroxymethylglutaryl (HMG) coenzyme A reductase. In familial hypercholesterolemia the LDL receptor is dysfunctional, with the result that cholesterol synthesis is less responsive to plasma cholesterol levels. Suppression of HMG CoA reductase is attained using inhibitors (statins) that mimic the structure of mevalonic acid, the natural feedback inhibitor of the enzyme. Note: The LDL (apoB-100, E) receptor is defective in familial hypercholesterolemia, a genetic condition in which blood LDL cholesterol levels are increased, causing premature atherosclerosis. Ref: Botham K.M., Mayes P.A. (2011). Chapter 25. Lipid Transpo & Storage. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e.
Biochemistry
null
d100554a-cc02-43f3-bb78-b1ccea518562
Hallucinations are -
Feeling of familiarity with unfamiliar thing
Alteration of perception of ones reality
Misinterpretation of stimuli
Perception occurring without external stimulation
3d
multi
null
Psychiatry
null
1d83a082-3511-4e2c-990c-1d066a7cc378
Inferior tibiofibular joint is which type of joint
Gomphosis
Condylar
Syndesmosis
Synchondrosis
2c
single
syndesmosis is a fibrous joint between two bones and linked by ligaments and a strong membrane. The distal tibiofibular syndesmosis is asyndesmotic joint. Ref: Maheshwari 6e pg 159,162,163.
Orthopaedics
All India exam
b842efa3-fae6-40c2-b473-c436ff68e227
Which is used in CA Breast?
Daunorubicin
Doxorubicin
Cisplatin
Actinomycin D
1b
single
Ans. (b) Doxorubicin(Ref: Bailey 26/e p815, 25/e p844; Schwartz 10/e p550-551, 9/e p263)* In CAF regimen- Adriamycin (Anthracylcines- Doxorubicin or Epirubicin) is used* Anthracyclines have cardio toxicity
Surgery
Breast
f8bd7ba3-6393-42ff-886e-617391a8f9d2
The hard palate contains
Keratinized epithelium, submucosa, minor salivary glands
Keratinised epithelium, absent submucosa, no salivary glands
Non-keratinised epithelium, submucosa, minor salivary glands
Non-keratinised epithelium, absent submucosa, minor salivary glands
0a
single
The hard palate contains keratinized stratified squamous epithelium, has a submucosa, and contains minor salivary gland. The bony structure of the hard palate is covered by a firmly attached mucosa in the central pa. In the lateral pas, the hard palate also has a submucosal layer containing blood vessels. There are minor mucous type salivary glands in the submucosa in the posterior pa of the hard palate. Ref: Gray&;s Anatomy 41st edition Pgno: 510
Anatomy
All India exam
07dd0e57-d225-476b-9604-015f4af82c3d
Subtle presentation of hyperparathyroidism is:
Psychiatric manifestation
Neprocalcinosis
Abdominal pain
Asymptomatic hypercalcemia
3d
single
Answer is D (Asymptomatic hypercalcemia) In view of the above facts from Harrison the best option to consider a 'subtle presentation' should probably be `asymptomatic hypercalcemia'
Medicine
null
e0b2cf62-719e-4fbf-a498-06fddb109424
Which bullet may produce key hole entry wound?
Tracer bullet
Tandem bullet
Dum-Dum bullet
Yawning bullet
3d
single
Yawning bullet is irregular pattern, thus producing key hole entry wound in some cases.
Forensic Medicine
null
0eef9be8-69a2-4c6d-a529-bbd8ccbd69cc
Cardinal signs of Inflammation are all except?
Rubor
Tumor
Color
Cyanosis
3d
multi
Ans. is 'd' i.e., Cyanosis o Cardinal signs of acute inflammation (celsus' signs): Rubor (redness), tumor (swelling), color (warmth), Dolor (pain).
Pathology
Acute Inflammation - Overview and Morphologic Patterns
3d7b4a32-c889-427e-abe9-c9f6fa3ea115
Oral hypoglycemic drug that is less likely to cause hypoglycemia is:
Repaglinide
Gliclazide
Rosiglitazone
Glimipiride
2c
single
Rosilglitazone are selective agonists for the nuclear peroxisome proliferator activated receptor,which enhances the transcription of several insulin responsive genes Metformin and glitazones- antihyperglycemic agents- no hypoglycemia but reduce excess plasma glucose levels REF: K D TRIPATHI 6 Edition, Page No - 270)
Pharmacology
Endocrinology
a548535f-9998-402b-92f7-dd94627040e6
A 66-year-old man with obstructive jaundice is found on ERCP to have periampullary carcinoma. He is otherwise in excellent physical shape and there is no evidence of metastasis. What is the most appropriate treatment?
Radical excision (Whipple procedure) where possible
Local excision and radiotherapy
External radiotherapy
Internal radiation seeds via catheter
0a
single
Carcinoma of the head of the pancreas is treated with radical excision of the head of the pancreas along with the duodenum. Continuity of the biliary and GI tract is established by performing hepaticojejunostomy, pancreaticojejunostomy, and gastrojejunostomy (Figure below). The 5-year survival rate is higher for periampullary carcinoma (30%) than that for pancreatic head lesions (10%). Most centers do not give irradiation routinely before or after surgery, because pancreatic cancers do not respond well to radiotherapy. Endoscopically placed stents alone are used only in palliative circumstances in patients with limited life expectancy.Pancreaticoduodenectomy (Whipple procedure). A: Preoperative anatomic relationships showing a tumor in the head of the pancreas. B: Postoperative reconstruction showing pancreatic, biliary, and gastric anastomoses. A cholecystectomy and bilateral truncal vagotomy are also part of the procedure. In many cases, the distal stomach and pylorus can be preserved, and vagotomy is then unnecessary
Surgery
Pancreas
6da8add8-d101-4ad3-bce5-ade8ac3c4d6a
Reflux laryngitis produces -a) Sub- glottic stenosis b) Ca larynxc) Cord fixationd) Acute supra- glottitise) Laryngitis
abe
bcd
cde
acd
0a
single
There are lots of controversies regarding the reflux laryngitis secondary to reflux gastrointestinal disease. But now some studies document that there is a clear relation between the two. Reflux laryngitis may have the following sequlae: – Bronchospasm – Chemical pneumonitis – Refractory subglottic stenosis – Refractory contact ulcer – Peptic laryngeal granuloma – Acid laryngitis (Heart burn, burning pharyngeal discomfort, nocturnal chocking due to interarytenoid pachydermia) – Laryngeal Carcinoma (According to recent reports laryngeal reflux is the cause of laryngeal carcinoma in patients who are life time non-smokers). Laryngopharyngeal Reflux Here classical GERD symptoms are absent. Patients have more of daytime/upright reflux without the nocturnal/supine reflux of GERD. In laryngopharyngeal reflux esophageal motility and lower esophageal sphincter is normal, while upper esophageal sphincter is abnormal. The traditional diagnostic tests for GERD are not useful in LPR. Symptom Chronic or Intermittent dysphonia, vocal strain, foreign body sensation, excessive throat mucus, Postnasal discharge and cough. Laryngeal findings: Interarytenoid bunching, Posterior laryngitis and subglottic edema (Pseudosulcus) Sequelae of Laryngopharyngeal Reflux Subglottic stenosis Carcinoma larynx Contact ulcer/granuloma Cricoarytenoid joint fixity Vocal nodule/polyp Sudden infant deaths Laryngomalacia (Association) Treatment is in similar lines as GERD, but we need to give proton pump inhibitors at a higher dose and for a longer duration (at least 6–8 months).
ENT
null
6f93f3dd-b118-4520-9e7d-f4cb6c42178c
Activation of classical complement pathway ?
IgA
IgG
IgM
IgD
2c
single
Ans. is 'c' i.e., IgM
Microbiology
null
99783c64-4789-4c10-88d0-9d2ed314d422
The greatest incidence of bronchopleural fistula is follwing -
Segmental resection
Lobectomies
Pneumonectomies
Thorocotomy
1b
single
null
Surgery
null
28c69602-3c54-4503-93dc-74d54517725d
Fusion of the caudal portions of the kidneys during embryonic development is most likely to result in which of the following congenital conditions?
Bicornuate uterus
Cryptorchidism
Horseshoe kidney
Hypospadias
2c
single
During development, the kidneys typically "ascend" from a position in the pelvis to a position high on the posterior abdominal wall. Although the kidneys are bilateral structures, occasionally the inferior poles of the two kidneys fuse. When this happens, the "ascent" of the fused kidneys is arrested by the first midline structure they encounter, the inferior mesenteric artery. The incidence of horseshoe kidney is about 0.25% of the population.
Anatomy
Abdomen & Pelvis
76ddc44c-b631-4394-9443-7d05acccba7e
Mitochondrial chromosomal abnormaity leads to
Lebers hereditary optic neuropathy
Angelman syndrome
Prader villi syndrome
Myotonic dystrophy
0a
single
Diseases caused by mutations in mitochondrial genes are rare. Because mitochondrial DNA encodes enzymes involved in oxidative phosphorylation, diseases caused by mutations in such genes affect organs most dependent on oxidative phosphorylation (skeletal muscle, hea, brain). Leber hereditary optic neuropathy is the prototypical disorder in this group. This neurodegenerative disease manifests itself as progressive bilateral loss of central vision that leads in due course to blindness. Prader-Willi and Angelman Syndromes- Diseases Caused by Alterations of Imprinted Regions (Robbins Basic Pathology, 9 th edition. page : 243)
Pathology
General pathology
b3254c83-a2db-4343-a57d-e431c1e0533a
True about protooncogene-
Impoant for normal cell growth
Oncogenesis
C-myc overexpression causes lymphoma
Mutation causes Retinoblastoma
0a
multi
A proto-oncogene is a normal gene that could become an oncogene due to mutations or increased expression. Proto-oncogenes code for proteins that help to regulate cell growth and differentiation. Proto-oncogenes are often involved in signal transduction and execution of mitogenic signals, usually through their protein products. Upon acquiring an activating mutation, a proto-oncogene becomes a tumor-inducing agent, an oncogene. Examples of proto-oncogenes include RAS, WNT, MYC, ERK, and TRK. The MYC gene is implicated in Burkitt's Lymphoma, which stas when a chromosomal translocation moves an enhancer sequence within the vicinity of the MYC gene. The MYC gene codes for widely used transcription factors. When the enhancer sequence is wrongly placed, these transcription factors are produced at much higher rates. Another example of an oncogene is the Bcr-Abl gene found on the Philadelphia Chromosome, a piece of genetic material seen in Chronic Myelogenous Leukemia caused by the translocation of pieces from chromosomes 9 and 22. Bcr-Abl codes for a tyrosine kinase, which is constitutively active, leading to uncontrolled cell proliferation.
Pathology
General pathology
e966ba8d-8106-48b9-8427-1e2cdcc9c86f
The CNS tumor present with calcification:
Oligodendroglioma
Astrocytoma
Medulloblastoma
Pheochromocytoma
0a
single
Oligodendroglioma is associated with calcification. BT associated with calcification (COM):CraniopharyngiomaQ (most) > ODGQ (90%) > MeningiomaQ (20-25%)
Surgery
CNS Tumors
dfab643d-31aa-4b30-a909-2d0433ecde71
True about plummer-vinson syndrome -a) Microcytic hypochronic anemia b) Sideroblastic anemiac) Common in old aged) Post cricoid carcinoma is commone) Oesophageal webs
acd
bde
ade
ad
2c
multi
null
Medicine
null
3b711854-e88f-4782-906c-ae57b5335427
Sellick manouever is used to prevent:
Alveolar collapse
Hypeension
Aspiration of Gastric content
Bradycardia
2c
single
C i.e. Aspiration of Gastric content
Anaesthesia
null
fdca6483-b0b9-4f5d-8079-6281016f6332
A plant prick can produce sporotrichosis. All are true statements about sporotrichosis except
Is a chronic mycotic disease that typically involves skin, subcutaneous tissue and regional lymphatics
Most cases are acquired cutaneous inoculation
Enlarged lymph nodes extending centripetally as a beaded chain are a characteristic finding
It is an occupational disease of butchers and doctors
3d
multi
Sporotrichosis is a chronic infection involving cutaneous, subcutaneous and lymphatic tissue. It is frequently encountered in Gardners, forest workers and manual labourers. It may develop in otherwise healthy individuals also. Ref: Textbook of Microbiology, Ananthanarayan and Paniker; 9th edition
Microbiology
mycology
22a01327-5bbe-4144-95ef-e02cfd0db63f
The major difference between typical and atypical antipsychotics is that
The latter cause minimal or no increase in prolactin
The former cause tardive dyskinesia
The former are available as parenteral preparations
The latter cause substantial sedation
1b
single
The most impoant reason to classify the antipsychotics in typical and atypical agents is the occurrence of extrapyramidal symptoms. Typical antipsychotics have significant extrapyramidal symptoms such as parkinsonism, acute muscle dystonia and tardive dyskinesia. These side-effects are negligible or minimal with atypical agents like clozapine, olanzapine and risperidone.
Psychiatry
Schizophrenia Spectrum and Other Psychotic Disorders
8f3f97c6-c0ff-4fe8-8f0a-6adedd15cf8d
Opsomyoclonus is encountered as C/F of-
Meningioma
Neuroblastoma
Neurofibromatosis
Excision
1b
single
Ans. is 'b' i.e., Neuroblastoma o Neuroblastoma can present as paraneoplastic syndrome of autoimune origin manifesting as ataxia or oposmyoclonus (Dancing eyes and dancing feat). o In such cases primary tumor is in the chest or abdomen and the brain is negative for tumor. o Some tumor produce catecholamines that can cause sweating and HTN and some release vasoactive intestinal peptide (VIP) causing secretary diarrhea.
Pediatrics
null
5a435162-567a-4ae6-9e8d-e5ee94169cdf
Examine the renal histopathology slide. What is the probable diagnosis?
Membranoproliferative GN
Rapidly profilerative GN
Post streptococcal glomerulonephritis
Diabetic nephropathy
2c
single
The presence of diffuse involvement of glomeruli and histologically showing enlarged hyper cellular glomeruli is suggestive of Acute infectious GN. It can be both infectious and non-infectious (SLE) but the most common infectious acute proliferative GN is post streptococcal GN. So, the likely answer is post streptococcal glomerulonephritis.
Pathology
Systemic Pathology
a8d7aa5c-ddf4-4091-b912-61fe207915ee
Diveiculum most common site is
Sigmoid colon
Ileum
Ascending colon
Transverse colon
0a
single
Sigmoid diveiculitis Diveicular disease refers to acquired pseudo diveicular outpouchings of the colonic mucosa and submucosa. Rare below 30yrs but prevalence approaches 50% beyond 60yrs. Diveicula generally are multiple and the condition is referred to as diveiculosis. PATHOGENESIS Colonic diveicula tend to develop under conditions of elevated intraluminal pressure in the sigmoid colon TEXT BOOK OF ROBBINS BASIC PATHOLOGY NINTH EDITION PAGE.586 IMAGE REF: ROBBINS BASIC PATHOLOGY NINTH EDITION FIG: 14-25 PAGE 586
Pathology
G.I.T
565d9b0e-bed6-4df3-861d-c7bfa9ecdd87
"Inflation of lungs induces fuher inflation" is explained by:
Hering-Breuer inflation reflex
Hering-Breuer deflation reflex
Head's paradoxical reflex
J-reflex
2c
single
C i.e Head's paradoxical reflex.Inflation of lungs, under ceain conditions, enhances inspiratory activity.Since inflation induces fuher inflation of lungs, the reflex is considered paradoxical.The vagal fibers mediating Head's paradoxical reflex carry information originating in receptors present in lungs.This reflex has a role in the initiation of respiration at bih. Ref: Understanding Medical Physiology By R.L. Bijlani, M.D., RL Bijlani MD SM DSc (Hon Causa) FAMS, S. Manjunatha, M.D., 2010, Page 245.
Physiology
null
a8f309e8-245c-460c-b443-e6001ed617cc
Flexner-Wintersteiner rossette is seen in-
Hepatoblastoma
Nephroblastoma
Neuroblastoma
Retinoblastoma
3d
single
Harshmohan textbook of pathology 7th edition the microscopic structures of retinoblastoma characteristically arranged in rossettes. The rossettes are of 2 types 1. Flexner Wintersteiner rossettes characterised by small tumor cells arranged around a lumen with their nuclei away from the lumen. 2. Homer Wright rosettes- having radial arranarrangement of the tumor cells around the central neurofibrillar structure..
Pathology
General pathology
fdea496c-fd2a-415a-b788-196680960cf7
Merkels cells of Epidermis are derived from
Neural tube
Notochord
Neural crest
Neural pore
2c
single
(C) Neural crest # MERKEL CELLS, which are believed to be derived from the neural crest, contain many large (50-100 nm) dense-cored vesicles, presumably containing transmitters, which are concentrated near the junction with the axon. F.S. Merkel referred to these cells as Tastzellen or "touch cells" Merkel cells are found in the skin and some parts of the mucosa (stratum germinativum) of all vertebrates. In mammalian skin, they are clear cells found in the stratum basale (at the bottom of sweat duct ridges) of the epidermis approximately 10 pm in diameter. They also occur in epidermal invaginations of the plantar foot surface called rete ridges. Most often, they are associated with sensory nerve endings, when they are known as Merkel nerve endings (Merkel cell-neurite complex). They are associated with slowly adapting (SA1) somatosensory nerve fibers. They are associated with the sense of light touch discrimination of shapes and textures. They can turn malignant and form the skin tumor known as Merkel cell carcinoma.DERIVATIVES OF NEURAL CRESTDerivative of neural crestDeveloping partsNeurons1. Spinal posterior nerve root ganglion (dorsal root ganglia) 2. Sensory ganglia of V, VII, VIII, IX & X cranial nerves 3. Sympathetic gangliaPiamater & Arachnoid mater (Not duramater)--Schwann cellsNeurolemmal sheaths of all peripheral nervesAdrenal medullaChromaffin tissuePigment cells of skinMelanoblasts; Merkel's cells of epidermisMesenchyme of dental papilla & Odontoblasts--Cells from cranial part of neural crest (Somatomeres)Development of musculature of head & in formation of face
Anatomy
Misc.
30525681-a5ee-4629-b61a-04c0bd76ee77
A patient of 18 years of age presents with sudden agonising pain in the groin and the lower abdomen. The patient feels nausea and gives a history of vomiting. On physical examination, the testis seems high. The cremasteric reflex is lost. What is the most possible cause?
Epididymo-orchitis
Mumps orchitis
Idiopathic scrotal edema
Testicular torsion
3d
single
Ans. (d) Testicular torsion.Testicular torsion is most common between 10 and 25 years of age, although a few cases occur in infancy. Typically, there is sudden agonising pain in the groin and the lower abdomen. The patient feels nauseated and may vomit. Torsion of a fully descended testis is usually easily recognized. The testis seems high and the tender twisted cord can be palpated above it. The cremasteric reflex is lost.Image source- style="font-family: Times New Roman, Times, serif">
Surgery
Miscellaneous (Testis & Scrotum)
9126fe16-c7a0-40b3-8e1f-fffa5934b079
Pleomorphism is seen in:
Chickenpox
Rubella
Smallpox
Toxocara
0a
multi
(Chickenpox): Ref: (134-Park 20th)* Chickenpox shows pleomorphic rash i.e. different stages of the rash evident at one given time because rash appears in successive crops
Social & Preventive Medicine
Communicable Diseases
ecb1b103-3b7e-43b2-98df-595d59dd1317
Laparoscopic cholecystectomy done in a patient with cholelithiasis.Pathology report shows adenocarcinoma with invasion of muscle layer. CT was normal. Further tit is:
Wait and regular follow up
Wedge hepatic resection with lymph node dissection
Excise all port sites
Radiotherapy
1b
multi
null
Surgery
null
a7f3389a-7a40-40a8-8a7b-dc5d78cdba62
Placental alkaline phosphates is marker of:
Theca cell tumour
Teratoma
Choriocarcinoma
Seminoma
3d
single
PLAP-most useful marker for bulk disease. Tumour marker for seminoma is PLAP. BETA HCG is also raised in 5-10% of pure seminomas as they contain syncytiotrophoblast like giant cells.
Surgery
Testis and scrotum
6c6b22c9-d7ca-4a7c-bf55-f656026639c0
Cimetidine inhibits the metabolism of all of the following drugs except.
Phenytoin
Warfarin
Ketoconazole
Diazepam
2c
multi
Ans. (C) Ketoconazole(Ref: KDT 8th/e p698)Cimetidine is a potent inhibitor of microsomal enzymes. It prolongs the half lives of warfarin, theophylline, phenytoin, oral hypoglycemic agents, alcohol and benzodiazepines.
Pharmacology
Anti-Ulcer