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135
824e0c8e-0f1e-46b2-ad56-59ff9d397fe9
The daily requirement of Vitamin C is-
40mg.
Ming
200 mg
500 mg
0a
single
Ans. is 'a' i.e., 40 mgo The daily requirement for vitamin C --> 40 mg.
Social & Preventive Medicine
null
7962f32d-bfd6-40eb-af61-6c9cbd61519e
Diseases caused by coxsackievirus are all except:
Herpangina
Hand foot and mouth disease
Acute lymphonodular pharyngitis
Herpes
3d
multi
In oral cavity CV causes: Herpangina Hand foot and mouth disease Acute lymphonodular pharyngitis.
Pathology
null
5825fa3e-65b7-4a63-96ed-cb0f31f32663
True about Wilsons disease is?
Increased serum ceruloplasmin
Decreased liver copper
Increased urinary copper excretion
Decreased urine copper excretion
2c
multi
Ans. is 'c' i.e., Increased urinary copper excretion
Pediatrics
null
e30debe4-b1da-4023-956a-01560b484681
The chyle from intestine is rich with chylomicrons. Which of the following form the protein core of chylomicrons?
Triglyceride only
Triglyceride + cholesterol
Triglyceride + cholesterol + phospholipid
Only cholesterol
2c
single
The triacylglycerol, cholesterol ester and phospholipid molecules along with apoproteins B48, and apo-A are incorporated into chylomicrons. Four major groups of lipoproteins: Chylomicrons, derived from intestinal absorption of triacylglycerol and other lipids. Very low density lipoproteins (VLDL, or pre--lipoproteins), derived from the liver for the expo of triacylglycerol. Low-density lipoproteins (LDL, or -lipoproteins), representing a final stage in the catabolism of VLDL. High-density lipoproteins (HDL, or -lipoproteins), involved in cholesterol transpo and also in VLDL and chylomicron metabolism. Triacylglycerol is the predominant lipid in chylomicrons and VLDL, whereas cholesterol and phospholipid are the predominant lipids in LDL and HDL, respectively. 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
22dba812-e588-4e97-be24-f665c33c4f98
Which of the following is known as monkey fever -
Plague
KFD
Yellow fever
Trench fever
1b
single
Ans. is 'b' i.e., KFDo White disease- AIDSo Poverty disease - Cholerao Hundred day cough: Pertussis (Whooping cough)o 5 day fever: Trench fevero 8th day disease: Tetanuso Black sickness: Kala azaro Black death: Plagueo Cerebrospinal fever: Meningococcal meningitiso Kochs phenomenon: Tuberculosiso Hansen s disease: Leprosyo Break-bone fever: Dengueo Slim disease: AIDSo Monkey fever: KFDo First disease/ Rubeolla: Measleso Second disease: Scarlet fevero Third disease/ German Measles: Rubellao Fourth disease: Duke's diseaseo Fifth disease: Erythema infectiosum (Parvovirus)o Sixth disease/Baby Measles/3-day fever: Exanthem subitum/ Roseola infantumo Barometer of Social Welfare (India): Tuberculosiso Father of Public Health: Cholerao River Blindness: Onchocerciasis
Social & Preventive Medicine
KFP
8d7b5a1b-4dd0-4e9e-8081-ff9c4b70c6b2
The shortest root on a maxillary first molar is:
Mesio-buccal
Disto-buccal
Lingual
All are of equal length
1b
multi
null
Dental
null
4202a3b2-8c62-45f4-a44d-a06266b3cfda
Antiparkinsonian drug activating D2 receptors directly
Pramipixole
Entacapone
Benserazide
Selegiline
0a
single
Direct D2 activators are bromcriptine , pergolide,pramipexole,ropinirole. ENtcapone and tolcapone are COMT inhibitors and selegiline is a MAO inbibitor used in PD.In PD there is decrease of dopamine in the substansia nigra. Ref:KDT 6/e p419
Pharmacology
All India exam
5682968d-117f-42ac-a832-993d218f5fab
Treatment of atropine toxicity -
2-pralidoxime
Naloxone
Flumazenil
Physostigmine
3d
single
Ans. is 'd' i.e., Physostigmine o Atropine blocks cholinergic receptors. So, for atropine overdose, we require a drug that increases cholinergic action. o Physostigmine increases the concentration of Ach. Physostigmine counteracts central (because it crosses BBB) as well as peripheral symptoms of atropine toxicity (other anticholinesterases like neostigmine and pyridostigmine counteract only peripheral symptoms as they cannot cross BBB) --> Physostigmine is the DOC.
Pharmacology
null
69d9e480-742a-4692-9ef8-8cdf1d99da4e
76 year old man presents with lytic lesion in the vebrae. X-Ray skull showed multiple punched out lesions. The diagnosis is
Metastasis
Multiple myeloma
Osteomalacia
Hyperparathyroidism
1b
single
B i.e. Multiple Myeloma Old age, male sex & veebral involvement (lytic lesion) indicate towards diagnosis of Metastasis & Multiple myeloma. But Absence of primary and characterestic multiple punched out lesions on X-Ray skull is diagnostic of Multiple myelomaQ. Osteomalacia: - Looser's zoned or PseudofractureQ (Hallmark) Mnemonic - "Losse Pencilin Fish" - Pencilling-in- of veebral bodies - Cod - fish (marked biconvex) veebraeQ Hyper parathyroidism : - Brown tumorQ Mnemonic - - Sub periosteal ErosionQ "Brown Erosed Salt Basket" - Salt & Pepper or Pepper - Pot skullQ - Basket work appearanceQ of coex Renal Osteodystrophy(d/t CRF): - It combines findings of ostemalacia, hyperparathyroidism and bone sclerosis - Osteomalacia lit Looser's zone - Hyper PTH 1/t Subperiosteal Erosion of bone - Osteosclerosis Vt Rugger Jersey spineQ (End plate sclerosis with alternating bands of radiolucency) In children with CRF, the combination of rickets & hyperparathyroidism leads to Rotting Fence Post appearance.Q Multiple Myeloma: Two cardinal features are: Generalized reduction of bone density (Osteopenia) Localized areas of radiolucency (Punched outQ/Rain drop lesionsQ) in red marrow areas i.e. axial skeletal - spine & skull. In multiple Myeloma lytic lesions of spine are usually associated with some collapse & soft tissue extension i.e. paraveebral soft tissue shadows (differentiation from Metastasis). Differentiation from inflamatory lesions can be made as the interveebral disc space & aicular surfaces are not affected.
Radiology
null
f778e06a-9bd0-42e8-9775-c71202d8f449
All the following increase insulin release except
Rosiglitazone
Nateglinide
Glipizide
Exenatide
0a
multi
Glitazones -insulin sensitizers.they will not produce insulin from beta cells.a cells of pancreas There are insulin sensitizers and insulin secretogogues. insulin secretogogues increase the insulin secretion from the beta cells of pancreas.where as insulin sensitizres help in secsitizing the tissue to already present insulin. which include GLP 1 analogue,glinides,sulfonylureas. Ref: Katzung 12th ed.
Pharmacology
Endocrinology
8ecbc824-aee8-4d33-80ca-843f8f2b2782
Observe the following curves. What will happen to Sensitivity and Specificity if curve changes from Blue to Red?
Both Sensitivity & Specificity increase
Both Sensitivity & Specificity decrease
Sensitivity increase & Specificity decrease
Sensitivity decrease & Specificity increase
0a
multi
(a) Both Sensitivity & Specificity increase* If Blue color curve changes to Red color curve (see Photograph in Question), then- FN will reduce, Sensitivity will increase (see Photograph given in Answer)- FP will reduce, Specificity will increase (see Photograph given in Answer).
Social & Preventive Medicine
Screening for Disease
1e2f190f-3bee-465e-94b2-c6664ab2e4bf
Vegetable fat differs from animal oil in being –
More saturated
More stable
More atherosclerotic
Contains less fat soluble vitamin
3d
single
Vegetable fats are more unsaturated than animal fats, PUFA is found mostly in vegetable fats. However, there are exceptions, as for example coconut and palm oils although vegetable oils, have an extremely high percentage of saturated fatty acids. On the other hand , fish oil contain good percentage of PUFA Vegetable fats are less stable. They contain high no. of unsaturated bonds which undergo spontaneous oxidation at the double bond forming aldehydes,ketones and resins. Vegetable fats are less atherosclerotic; In fact PUFA have a favorable effect on serum lipid profile. They decrease LDL and increase HDL ( good cholesterol ).Essential fatty acids ( high percentage in vegetable fat) decrease the platelet adhesiveness. Vegetable fat contains less fat soluble vitamins (A,D,E & K vitamin). For this reason Vanaspati Ghee is fortified with vit. A *& D by government regulation (DALDA)
Social & Preventive Medicine
null
86f394fd-9888-418f-bd99-2af11caff81b
Sympathetic stimulation increases blood flow except:
Skin
Coronary circulation
Cerebral
Renal
0a
multi
Ans. a. Skin Sympathetic stimulation decreases blood flow in skin. Sympathetic Stimulation Stimulation of sympathetic fibers causes vasoconstriction but it is not impoant, as the vasocontricor system is not well developed in cerebral vascular bed. Sympathetic stimulation increases myocardial blood flow through an increased metabolic demand and a predominance of beta-receptor activation.
Anatomy
null
22c5ed96-7f61-4836-9a7a-a1517d8c81ad
Amount of blood loss in class II circulatory failure/Haemorrhagic shock?
<15%
15-30%
30-40%
>40%
1b
single
-Hemorrhagic shock has been divided into 4 classes according to ATLS course. Class 1 Class2 Class 3 Class 4 Blood volume lost as % of total < 15 % 15-30% 30-40% >40% Four Classes of Hemorrhagic Shock (According to the ATLS course) Parameter I II III IV Blood loss (%) 0-15% 15-30 30-40 >40 CNS Slightly anxious Mildly anxious Anxious or confused Confused or lethargic Pulse (beats/ min) <100 >100 >120 >140 Blood pressure Normal Normal Decreased Decreased Pulse pressure Normal Decreased Decreased Decreased Respiratory rate 14-20/min 20-30/min 30-40/min >35/min Urine (mL/hr) >30 20-30 5-15 Negligible Fluid Crystalloid Crystalloid Crystalloid + blood Crystalloid + blood Base deficit 0 to -2 mEq/L -2 to 6 mEq/L -6 to -10 mEq/L -10 mEq/L or less -Please refer to the above table as many such questions are asked from the table.
Surgery
Trauma
650490c8-230c-4b41-8029-8d20f12d6e1d
An adult hypeensive male presented with sudden onset severe headache and vomiting. On examination, there is marked neck rigidity and no focal neurological deficit was found. The symptoms are most likely due to:
Intracerebral parenchymal hemorrhage
Ischemic stroke
Meningitis
Subarachnoid hemorrhage
3d
single
Ans. d. Subarachnoid hemorrhage Most likely diagnosis in an adult hypeensive male with sudden onset severe headache, vomiting with marked neck rigidity without focal neurological deficit would be subarachnoid hemorrhage.
Medicine
null
6bc67e67-e2c0-4ce7-a9a0-be96517d6388
Down's syndrome is due to:
5/12 translocation
18 trisomy
21trisomy
14/21 trisomy
2c
single
Ans: c (21 trisomy)Ref: Nelson Pediatrics, 19th ed., Pg. 384Trisomy 21, Down's syndrome seen in 1/600-800 births. Please note the clinical features which are often asked Hypotonia Dysplasia of the pelvis Flat face, cardiac malformations Speckled irises Simian crease (Brushfield spots) Varying degrees of mental Short, broad hands and growth retardation Hypoplasia of middle Upward slanted palpebral phalanx of 5th finger fissures and epicanthic folds Intestinal atresia, and high arched palate
Gynaecology & Obstetrics
Miscellaneous (Gynae)
0b8458c4-1517-4ddd-9b82-29e005327ffe
Man is the only reservoir for
Salmonella
Campylobacter jejuni
E. histolytica
Y. enterocolitica
2c
single
Entamoeba histolytica is predominantly found in primates (including humans) and occasionally in dogs, cats, cattle and pigs.  The parasite has a worldwide distribution and is prevalent in tropical and subtropical countries. Salmonella - The most common are animal reservoirs are chickens, turkeys, pigs, and cows; dozens of other domestic and wild animals also harbor these organisms. Campylobacter jejuni - C. jejuni is carried by most of these animal reservoirs and is the predominant species isolated from chickens and cattle. Y. Enterocolitica - dogs, sheep, wild rodents, and environmental water may also be a reservoir of pathogenic Y. enterocolitica strains. Ref : http://parasite.org.au/para-site/text/entamoeba-text.html#:~:text=Host%20range%3A%20Entamoeba%20histolytica%20is,in%20tropical%20and%20subtropical%20countries
Microbiology
null
8b72e649-4f11-4f2b-b585-e5c4dc2c82f4
All of the following effects can occur if vagus is stimulated, except: March 2009
Reduction in blood pressure
Increase in secretions of the intestine
Intestinal musculature constriction
Bronchial musculature relaxation
3d
multi
Ans. D: Bronchial musculature relaxation
Physiology
null
c4c6a97d-3520-4a45-8005-685b24060a6d
Denosumab is used in:-
Osteomalacia
Osteoahritis
Osteoporosis
Osteosarcoma
2c
single
Denosumab is a monoclonal antibody against RANK - ligand which inhibits binding to RANK receptor and inhibits the activation of osteoclasts and inhibits bone resorption so it is used in treatment of Osteoporosis.
Pharmacology
NSAIDs, Gout and Rheumatoid Ahritis
39eb0f13-d1ca-408b-9475-731c9c82aa19
When information memorized afterward is interfered by the information learned earlier, it is called :
Retroactive inhibition
Proactive inhibition
Simple inhibition
Inhibition
1b
multi
Earlier learning interferes with retrieval of new information →  proactive interference. Newly acquired information interferes with the retrieval of previously learnt information → retroactive inhibition.
Psychiatry
null
0bfc4bd8-8a99-4f3a-ac5e-78a73be88807
Viral Conjunctivitis is most commonly caused by
Herpes simplex
Enterovirus
Adenovirus
Coxackie A Virus
2c
single
Viral Conjunctivitis is most commonly caused by Adenovirus.
Ophthalmology
null
1e9e6e00-6a17-4f13-b584-0cdd57c19dfb
True for Hodgkin's stage IA is -
Chemotherapy is best
Radiotherapy is best
Total radiation therapy is best treatment
Fever and wt loss is always present
1b
multi
null
Medicine
null
79300959-787e-401a-8d17-547ae558f24c
About retinitis pigmentosa all are true, EXCEPT:
Night blindness
Waxy disc
Early loss of central vision
Attenuation of retinal vessels is seen
2c
multi
In retinitis pigmentosa rods are involved first followed by cones. As the disease progresses there is loss of night vision and peripheral field of vision. Only in the later stages of the disese there is loss of central vision. Retinitis Pigmentosa is a group of hereditary retinal degenerative disorder characterized by progressive dysfunction of photoreceptors, associated with progressive cell loss and atrophy of several retinal layers. Hallmark symptoms are: night blindness, progressive loss of peripheral field of vision and coalescing ring scotomas. Characteristic fundoscopic findings are: attenuated retinal aerioles, waxy pale optic disc, mottling of retinal pigment epithelium, and peripheral retinal pigment clumping (bone spicule formation). ERG shows reduced/absent retinal function. EOG lacks usual light rise.
Ophthalmology
null
18b75565-80b4-40c8-a385-854d6cad5a35
Common peroneal nerve is related to which of the following structures
Shaft of tibia
Neck of fibula
Lower tibio-fibular joint
Shaft of fibula
1b
single
B i.e., Neck of fibula Common peroneal nerve winds around neck of fibula to enter peroneus longus muscle. Because of its subcutaneous position it can be easily palpated here & is very prone to injury. So fracture neck of fibula may cause foot drop.
Anatomy
null
e26da4c8-e70c-47b9-ae8a-ecbef4abab75
Chromosomal mutation can be identified by all except:
Single strand polymorphism
Agarose gel electrophoresis
Denaturating Gradient gel electrophoresis
Dideoxynucleotide trail sequencing
1b
multi
Chromosomal mutation can't be identified by Agarose gel electrophoresis Agarose Gel electrophoresis Used to separate the DNA by charge or by size. The smaller the fragment, the more rapid the migration. Overall rate of migration and optimal range of size for separation are determined by the chemical nature of the gel and by the degree of its crosslinking. Highly cross-linked gels optimize the separation of small DNA fragments. The dye ethidium bromide forms a brightly fluorescent color as it binds to DNA, and so small amounts of separated DNA fragments can be photographed on gels. Specific DNA fragments can be recognized by probes containing complementary sequences. Usually performed to visualize the amplified DNA after PCR, but may be used as a preparative technique prior to use of other Just a method of visualizing the DNA after separating by size. So it is always used as a pa of any molecular method to visualize the DNA. But alone it cannot be used to detect any mutations.
Microbiology
General Microbiology (Sterilization and Bacterial Genetics)
8baf7744-5638-4479-8e6a-dd6b8b05f382
Upper limb deformity in Erb's palsy -
Adduction and lateral rotation of arm
Adduction and medial rotation of arm
Abduction and lateral rotation of arm
Abduction and medial rotation of arm
1b
single
Ans. is 'b' i.e., Adduction and medial rotation of arm Clinical features of Erb's palsy A) Muscles paralyzed: Mainly biceps brachii, deltoid, brachialis and brachioradialis. Partly supraspinatus, infraspinatus and supinator. B) Deformity (position of the limb) i) Arm : Hangs by the side; it is adducted and medially rotated. ii) Forearm : Extended and pronated. The deformity is known as 'policeman's tip hand' or 'porter's tip hand'. C) Disability: The following movements are lost. o Abduction and lateral rotation of the arm (shoulder). o Flexion and supination of the forearm. o Biceps and supinator jerks are lost. o Sensations are lost over a small area over the lower part of the deltoid.
Unknown
null
475409da-9f13-46dc-add5-49945e4b8fbe
In angle closure glaucoma, obstruction to outflow of aqueous humour mainly due to the involvement of: September 2007
Canal of schlemm
Trabecular meshwork
Iris
Scleral venous plexus
2c
single
Ans. C: Iris
Ophthalmology
null
ba04ff8c-8f69-4464-8bb3-b96fa71744ef
Which one of the following bacteria ois oxidase positive?
Vibrio
Pseudomonas
Clostridium
E.coli
0a
single
Oxidase test: The test is used to identifying bacteria containing cytochrome oxidase. I t is useful in differentiating the oxidase negative Enterobacteriaceae from the oxidase positive Pseudomonas organisms and the oxidase positive group of vibrios and related bacterias (Aeromonas, Plesiomonas). Neisseria organisms also test positive. the presence of cytochrome oxidase can is detected through the use of an oxidase disc which acts as an electron donor to cytochrome oxidase. if the test bacterium oxidizes the disc, the disk turns pin indicating a positive test. If there is no change in color the test is negative for the bacterium REF:Ananthanarayan & Panicker's Textbook of Microbiology 8th Edition pg no: 675
Microbiology
general microbiology
f81f33e2-3042-4a59-874e-3d1c6d2f91d0
Dose of rifampicin in RNTCP is -
600 mg
450 mg
300 mg
100 mg
1b
single
Ans. is 'b' i.e., 450 mg TREATMENT REGIMEN SPUTUM EXAMINATIONS FOR PULMON ARY TBCategory of treatmentType of patientRegimentPre treatment sputumTest at monthIf result isTHEN -Start continuation phase, test sputum 6 monthsNew casesNew sputum smear-positive2(HRZE)3+-2 Category 1New sputum semar-negative+ +Continue intesive phase for one more montfRed BoxNew extra-pulmonaryNew others4 (HR)3 Complete the treatment in 7 monthsPreviouslySputum smear-positive Relapse2(HRZES}3 -Start continuation phase, test sputum again 6 months, completion of treatmentTreatedSputum smear-positive Fa ilure+ Category IISputum smear-positive1 (HRZE)3+3+Continue intensive phase for one more monthBlue Boxtreatment after default Others+5 (HRE)3 again at 4 months if sputum is positive sene sputum for culture and drug sensitivity as might be a case of MDR-TBo The number before the letters refers to the number of months of treatment. The subscript after the letters refers to the number of doses per week- H : Isomazid (600 mg), R : Rifampicin (450 mg), Z : Pyrazinamide (1500 mg), E : Ethambuiol (1200 mg), S : Streptomycin (750 mg). Patients who weight more than 60 kg receive additional Rifampicin 150 mg. Patients more than 50 years old receive streptomycin 500 mg- Patient in categories I and 11, Who have a positive sputum smear at the end of the initial intensive phase, receive an additional month of intensive phase treatment.o Examples of seriously ill extra-pulmonary TB cases are meningitis, disseminated TB, tuberculous pericarditis, peritonitis, bilateral or extensive pleurisy, spinal TB with neurological complications and intestinal and genito-urinary TB.o In rare and exeptional cases, patients who are sputum smear-negative or who have extra-pulmonary disease can have relapse or failure. This diagnosis in all such cases should always be made by an MO and should be supported by culture or histological evidence of current, active tuberculosis. In these cases, the patient should be categorized as 'other' and given category II treatment.o Any patient treated writb category I who has a positive smear at 5 months of treatment should be considered a Failure and started on category II treatment, afresh. If category I sputum smear-ve case fails to improve or if patient develops pulmonary signs and positive smear at the end of intensive phase, it is considered treatment failure. Start category II treatment and confirm failure by culture and perform DST.
Social & Preventive Medicine
Communicable Diseases
889d7522-a081-4024-ad90-38873c42d2c8
Fasciculations are caused by
Scoline
Ketamine
Halothane
Atracurium
0a
single
Ans. a (Scoline). (Ref. KD Tripathi, Pharamacology, 6th ed., 150)SUXAMETHONIUM CHLORIDE OR SUCCINYL CHOLINE (SCOLINE)Introduction- It is a short acting muscle relaxant.- It is a phase II blocker.- Depolarising muscle i.e. depolarising block at motor end-plate.- It is dichlor ester of succinic acid.- The action lasts for 3-5 minutes.- Action is prolonged in liver disease.- Metabolised by pseudocholinesterase.- It gives good intubating condition in shortest time (less than one minute).Uses- Endotracheal intubation in dose of 1 to 2 mg/kg body weight.- To modify electroconvulsive therapy.- For procedures requiring short duration relaxation.- Excellent for operative abet and caesaerian section.Side effects(Mnemonic=ABRHAM on FTV)- Apnoea (Prolonged),- Bradycardia,- Raised intraocular pressure- Hyperkalemia- Ache (Myalgia/ Post-operative muscle ache)- Malignant hyperpyrexia- Fasciculation,- Tachyphylaxis- Ventricular fibrillationIts S/E can be prevented by- Self-taming with 10 mg suxamethonium given a minute before induction of an anaesthesia.PrecurarizationAlso remember:# Malignant hyperpyrexia:- It is due to release of Ca++ from sarcoplasmic reticulum in sensitive person- It can be caused also bya) Halothane,b) Methoxyflurane andc) Isoflurane- Rx- dantrolene.- Dantrolene is muscle relaxant acting directly on muscle. {MH 2006)
Anaesthesia
Muscle Relaxant
02fcc3dc-8831-41cd-9c7f-7983eaf42476
Which of the following conditions cause congestive hea failure in neonates ?
Bicuspid aoic valve
Tetralogy of Fallot
ASD
Total anomalous pulmonary venous return
3d
multi
In TAPVR can produce CHF in neonate. Ghai essential of pediatrics, eighth edition, p.no:397
Pediatrics
C.V.S
10ab2efb-e7bd-4512-bec5-aed5b65f2dfa
Which of the following statements is true about diaphragm?
Left side pushed down by hea
Left side lower than right side
Right side lower than left side
Hernia common on right side
2c
multi
The Diaphragm This thin fibromuscular paition between thoracic and abdominal cavities is an impoant muscle of respiration.When it contracts,it increases the veical extend of thoracic cavity by paially flatenning its dome and displacingthe abdominal contents downwards.The firous,central pa of the diapgragm(central tendon)is slightly depressed by the hea and thus it has right and left domes.The right dome,suppoed by the liver,lies at slightly at a higher level(a little inferior to the nipple in the male)than the left. REF.Cunningham's manual of practical anatomy,Vol.2,PG.172
Anatomy
Thorax
7ce757a5-9c27-47eb-9922-1e91e8f88a1d
What is the S.I. unit of effective dose?
Becquerel
Sievert
Gray
Roentgen
1b
single
The effective dose (E) is used to estimate the risk in humans. It is hard to compare the risk from a dental exposure with, for example, the risk from a radiographic chest examination because different tissues with different radiosensitivities are exposed.  The unit of effective dose is the Sv.
Radiology
null
b83bf1a4-62c4-4558-a167-05b2fdcdb506
Type II Respiratory failure is characterised by (Davidson)
Low PaO2 /Low PaCO2
Normal PaCO2 / Low PaO2
Low PaO2 /High PaCO2
High PaO2 / Low PaCO2
2c
single
(Low PaO2/High PaCO2) (1684 -H17th)Respiratory failure - PaO2 <8.0 kPa (60mmHg) and PaCO2 > 6.5 kPa (50 mmHg)Type 1 - PaO2 low, PaCO2 normal or lowType II - PaCO2 raised, PaO2 low - Ventilatory failure* Most important - cause in chronic type II respiratory failure is - chronic bronchitis
Medicine
Respiratory
4615d01b-e5ff-4bb2-a8d6-f613900007a5
In post-hepatic jaundice, the concentation of conjugatedbilirubin in the blood is higher than that ofunconjugated bilirubin because :
There is an increased rate of destruction of red blood cells.
The unconjugated bilirubin is trapped by the bile stone produced in the bile duct.
The conjugation process of bilirubin in liver remains operative without any interference.
The UDP- glulcuronoyltransferase activity is in creased manifold in obstructive jaundice.
2c
single
. The conjugation process of bilirubin in liver remains operative without any interference.
Pathology
null
23753048-91b9-41e9-9fc8-761719932eeb
Zone of HOHL refers to:
Cell-free zone.
Cell rich zone.
Pulp proper.
None.
1b
multi
1. Cell-free zone (Zone of weil) Width approx. 40 µm Not always present Absent in young pulp (Active secretion of primary dentine) and older pulp (tertiary dentine) CONTENTS Capillaries Unmyelinated nerve fibers Cytoplasmic process of fibroblasts 2. Cell Rich Zone (Zone of HOHL) Most numerous cells are fibroblasts Fibroblasts secrete Type I and Type III collagen Also contains undifferentiated mesenchymal stem cells. Vascular supply is extensive and more than cell free zone and odontoblast zone.
Dental
null
3d988571-2ccd-4e9c-98f4-63608bc68b43
Hernia into pouch of Douglas is __________ hernia :
Beclard's
Bochdaleks
Blandin's
Berger's
3d
single
Beclard's hernia → is the femoral hernia through the opening of the saphenous vein (named after Pierre Augustin Beclard).
Surgery
null
7915bbe9-63ad-4b52-b265-4bdb31ce15ec
True about primary aldosteronism
Pedal oedema
Increased rennin
Increased Na+
All
2c
multi
Answer is C (Increased Na+) Primary Aldosteronism (Conn's syndrome) is associated with Hypeension, Hypernatremia ( tNa+) and Hypokalemia (iK+)
Medicine
null
d684a487-c638-494d-9ee2-18b81d7166b2
A patient is found to have a duodenal ulcer by upper endoscopy. The likelihood of this patient having H. pylori in the gastric antrum is?
5%
20%
60%
95%
2c
single
.
Microbiology
All India exam
fcaeb408-9b61-4332-87d0-f90a990e6185
A community has a population of 10,000 and a bih rate of 36 per 1000. 6 maternal deaths were repoed in the current year. The Maternal Moality Rate (MMR) is:
14.5
16.6
20
5
1b
single
Total no.of female deaths due to complication of pregnancy, childbih or within 42 days of delivery from puerperal causes in an area during a given year. ---------------------------------------------------------------------------------------------------- x 1000 Total no. of live bihs in the same area and year. 6/360 x 1000= 0.0166 x 1000 = 16.6 Ref: Park, 20th Edition, Page 479.
Social & Preventive Medicine
null
d8f139ee-da8c-43c3-9a5b-e7880e448e4c
Acute infectious purpura fulminans is caused by
Neisseria meningitidis and varicella
Gonococi
E. coli
Proteus
0a
single
Purpura fulminans is an acute, often fatal, thrombotic disorder which manifests as blood spots, bruising and discolouration of the skin resulting from coagulation in small blood vessels within the skin and rapidly leads to skin necrosis and disseminated intravascular coagulation caused by Neisseria meningitidis and varicella Ref Harrison20th edition pg 1078
Medicine
Infection
c237c958-1fbe-4779-8960-16083e729536
Not a component of Brain stem
Mid brain
Pons
Medulla
Spinal cord
3d
single
Brainstem 1. Medulla:responsible for regulating and/ or coordination of: - Blood pressure. - Breathing. - Swallowing. - Coughing. - Vomiting. 2. Pons : participates in respiratory regulation and the relay of information from cerebral hemispheres to the cerebellum. 3. Midbrain : participates in coordination of visual and auditory systems.
Physiology
null
b7f73943-ee43-40ce-ad29-e81f5315089a
Urinary tract infection exists when the bacterial count in 1 ml. of midstream specimen of urine is ?
100
1000
104
105 or over
3d
single
Ans. is 'd' i.e., 105 or over
Surgery
null
9b64d59a-5c75-4a76-98e8-33d909bd906a
Both APTT and PT are prolonged in which conditions?
Factor II deficiency
Factor XIII deficiency
Heparin administration
Thrombocytopenia
0a
multi
ANSWER: (A) Factor II deficiencyREF: Mastery of Surgery by Josef E. Fischer, K. I. Bland, 5th edition Part I page 90, Saint-Frances guide: clinical clerkship in outpatient medicine. Page 434 8; 235, Harrison 17th ed table 59-4See APPENDIX-50 below for "BLE EDIN G/C O AG U L ATI ON DISORDERS" and APPROACH TO A PATIENT WITH BLEEDING DISORDER APPENDIX - 50BLEEDING/COAGULATION DISORDERSTable from Mastery of Surgery by Josef E. Fischer, K. I. Bland, 5th edition Part I page 90, http://en.uikipedia.org/wiki/ Bleeding_diathesisConditionProthrombinTimePartialThromboplastinTimeBleedingTimePlateletCountAspirinNormalNormalProlongedNormalCongenital afibrinogenemiaProlongedprolongedProlongedNormalDisseminated intravascular coagulationProlongedprolongedprolongedDecreasedEarly Liver failureProlongedNormalNormalNormalEnd-stage Liver failureProlongedprolongedprolongedDecreasedHaemophilia A (Factor 8}NormalProlongedNormalNormalHaemophilia B (Factor 9) Christmas diseaseNormalProlongedNormalNormalParahemophelia (factor 2,5,10)ProlongedProlongedNormalNormalFactor 7 deficiencyProlongedNormalNormalNormal! ThrombocytopeniaNormalNormalProlongedDecreasedBernard-Soulier syndromeNormalNormalProlongedDecreasedGlanzmann s thrombastheniaNormalNormalProlongedNormalUremiaNormalNormalProlongedNormalVitamin K deficiency or warfarinProlongedProlongedNormalNormalVon Willebrand diseaseNormalNormalProlongedNormalAPPROACH TO A PATIENT WITH BLEEDING DISORDER Obtain PT/ PTT and Platelet count Increased PT, Normal PTTNormal PT,Both PT &Both PT & PTT normalIncreased PTTPTT increasedPlatelet count* Early DIC* Liver disease* Warfarin therapy* Mild Vitamin K deficiency* Factor 7 deficiency* Coagulation factor deficiency* Coagulation factor inhibitor* Antiphospholipid antibody* Heparin therapy* Severe DIC* Severe liver disease* Warfarin overdose* Severe vitamin K deficiency* Factor 2, 5,10 deficiency* Heparin therapy> 90,000/pL Do Bleeding time< 90,000/uL ThrombocytopeniaSee extension of table below Do bleeding timeNormal bleeding timeIncreased bleeding time* Deficiency of inhibitors of fibrinolysis* Dysfibrinogenemia* Factor 13 deficiencyPlatelet dysfunctionAcquiredInherited* Severe renal disease* Severe liver disease* Myeloploreferative disorder* Autoantibodies* Paraprotenemia* DIC* vWD* Bernard Soulier disease* Glanzmann thrombasthenia
Medicine
Bleeding and Thrombotic Disorders
da4532de-1c98-4687-aaa7-00fbbf26a127
The greatest volume of gastric secretion occurs during:
Cephalic phase
Gastric phase
Intestinal phase
Deglutition
1b
single
B: The gastric phase is the period of greatest gastric secretion. This phase is responsible for the greatest volume of gastric secretions, and it is activated by the presence of food in the stomach. A: The cephalic phase of stomach secretion is anticipatory and prepares the stomach to receive food. In the cephalic phase, sensations of taste, the smell of food, stimulation of tactile receptors during the process of chewing and swallowing, and pleasant thoughts of food stimulate centers within the medulla oblongata that influence gastric secretions. C: The intestinal phase of gastric secretion primarily inhibits gastric secretions. It is controlled by the entrance of acidic chyme into the duodenum. The presence of chyme in the duodenum initiates both neural and hormonal mechanisms. D: Deglutition the action or process of swallowing.
Pathology
null
ea5f1823-e6eb-443b-a8ba-fd006d951f58
A 38-year-old gentleman repos of decreased hearing in the right ear for the last two years. On testing with a 512 Hz tuning fork, the Rinne&;s test without masking is negative in the right ear and positive on the left ear. With Weber&;s test, the tone is perceived as louder in the right ear. The most likely diagnosis in the patient is
Right conductive hearing loss
Right sensorineural hearing loss
Left sensorineural hearing loss
Left conductive hearing loss
0a
single
The characteristics of conductive hearing loss are: 1. Negative Rinne test, i.e. BC > AC. 2. Weber lateralized to poorer ear. 3. Normal absolute bone conduction. 4. Low frequencies affected more. 5. Audiometry shows bone conduction better than air conduction with air-bone gap. Greater the air-bone gap, more is the conductive loss 6. Loss is not more than 60 dB. 7. Speech discrimination is good. Ref: Dhingra 7e pg 31.
ENT
Ear
725d026e-c8e8-49c1-9c1f-b7205515af74
Structure superficial to mylohyoid in anterior digastric triangle are:
Deep pa of submandibular gland
Hypoglossal nerve
Pa of parotid gland
Mylohyoid aery & nerve
3d
single
Deep pa of submandibular gland & hypoglossal neve are deep to mylohyoid muscle.Structures passing superficial to mylohyoid in anterior pa of digastric triangle are submandibular gland (superficial pa), facial vein, facial aery, mylohyoid nerve & vessels, hypoglossal nerve & submandibular nodes.
Anatomy
null
9e32c0e0-0f29-4560-b179-3c6e8d0e13cb
Treatment of Acute pancreatitis includes all except
Calcium
Feeding through ryles tube
Cholestyramine
None of the above
3d
multi
Oral administration of food and TPN is not recommended. Patient is fed via NGT to jeyunum.
Surgery
null
05f44b18-2b84-47dc-8607-869781e0559b
A 78-year-old woman has an acute anterior wall MI with hypotension and pulmonary congestion. Her blood pressure is 90/70 mm Hg, pulse 110/min, JVP at 8 cm, and the heart sounds are normal. The lungs have bibasilar crackles, and her extremities are cool and diaphoretic. What would central hemodynamic monitoring reveal?For the above patient, select the hemodynamic parameters that are most likely to apply.
decreased right atrial pressure (RAP), low cardiac output (CO), and increased systemic vascular resistance (SVR)
increased RAP, decreased CO, increased SVR
increased RAP, decreased CO, decreased SVR
decreased RAP, increased CO, decreased SVR
1b
multi
Cardiogenic shock is characterized by high right atrial pressure (although it can be normal at times), high PA wedge pressure, high systemic vascular resistance, and low cardiac output.
Medicine
C.V.S.
b304ec3c-d9e2-4eeb-be72-ff3d4178fb50
Which of the following physiological change take place by Bainbridge reflex?
Increase in HR
Decrease in HR
Increase in BP
Distension of large somatic veins
0a
single
Atrial A and B receptors are located at the venoatrial junctions and have distinct functions. Type A receptors react primarily to hea rate but adapt to long-term changes in atrial volume. Type B receptors increase their discharge during atrial distension. C fibers arise from receptors scattered through the atria; these discharge with a low frequency and respond with increased discharge to increase in atrial pressure. The A and B receptors are thought to mediate the increase in hea rate associated with atrial distension (such as can occur with intravenous infusions) known as the Bainbridge reflex. In contrast, activation of atrial C fibers generally produces a vasodepressor effect (bradycardia and peripheral vasodilation). Ref: Hoit B.D., Walsh R.A. (2011). Chapter 5. Normal Physiology of the Cardiovascular System. In V. Fuster, R.A. Walsh, R.A. Harrington (Eds), Hurst's The Hea, 13e.
Physiology
null
4fd74a4e-6bd0-4ed8-bece-37d258fcb0d7
Goiter that appears along with toxic symptoms is:
Primary thyrotoxicosis.
Secondary thyrotoxicosis.
Toxic nodule.
None.
0a
multi
null
Surgery
null
2111acd2-b02f-42a9-922a-cd368fff9308
The heme portion of the hemoglobin molecule consists of:
Porphyrin ring with a molecule of Fe in the center
A polypeptide chain containing Fe
A pyrole ring with four molecules of Fe in the center
Four porphyrin rings, each containing a molecule of Fe in the center
3d
single
Structurally, porphyrin consists of four pyrrole rings (five-membered closed structures containing one nitrogen and four carbon atoms) linked to each other by methine groups (−CH=). The iron atom is kept in the centre of the porphyrin ring by interaction with the four nitrogen atoms.
Pathology
null
0fdceeae-831b-4f8c-980a-0536290745f4
Palpable purpura could occur in the following conditions, except:
Thrombocytopenia
Small-vessel vasculitis
Disseminated gonococcal infection
Acute meningococcemia
0a
multi
Answer is A (Thrombocytopenia) Thrombocytopenia is associated with non palpable purpura'. Causes of Non palpable pupura: Primary cutaneous disorders Systemic diseases Clotting disturbance Vascular fragility Thrombosis 1 Emboli Possible immune complex Trauma Thrombocytopenia Amyloidosis Disseminated Cholesterol Gardner-Diamond syndrome Solar purpura (including ITP) Ehlers-Danlos intravascular Fat Waldenstrom's Steroid purpura Abnormal platelet syndome coagulation hypergammaglobulinemic Capillaritis Livedoid vasculitis function Clotting factor defects . Scurvy Monoclonal cryoglobulinemia Thrombotic thrombocytopenic purpura purpura Warfarin reaction
Medicine
null
70ecd26a-0a54-441b-849a-befd1c44825a
The maneuver shown below helps specifically in
Identification of fetal lie
Determination of Fetal orientation
Confirmation of fetal presentation
Determining the degree of descent
3d
multi
The image shows 4th leopold maneuverThe first maneuver assesses the uterine fundus. It permits identification of fetal lie and determination of which fetal pole--that is, cephalic or podalic--occupies the fundus. The second maneuver is accomplished as the palms are placed on either side of the maternal abdomen, and gentle but deep pressure is exeed.. By noting whether the back is directed anteriorly, transversely, or posteriorly, fetal orientation can be determined.The third maneuver aids confirmation of fetal presentation. The thumb and fingers of one hand grasp the lower poion of the maternal abdomen just above the symphysis pubis. If the presenting pa is not engaged, a movable mass will be felt, usually the head. The fouh maneuver helps determine the degree of descent.Reference: William's Obstetrics; 25th edition; Chapter 22; Normal Labor
Gynaecology & Obstetrics
General obstetrics
1a441911-c5a3-4c79-8726-8b971ec11180
Carpal tunnel contains all except -
Median nerve
FDS tendon
FPL tendon
FCU tendon
3d
multi
Ans-D
Unknown
null
0282fd52-868f-4e4b-939e-efee5d53d2a6
Age of closure of spheno-occipital synchondrosis:
6 years
12 years
18 years
25 years
2c
single
Postnatally, the posterior cranial base becomes longer primarily due to growth at the spheno-occipital synchondrosis. Histologic studies have shown that the spheno-occipital synchondrosis fuses at approximately 16 to 17 years in females and 18 to 19 years in males. Ref: Graber LW, Vanarsdall RL, Vig KW, Huang GJ. Orthodontics: current principles and techniques. Edition 6 page no 10
Dental
null
7d1914a9-1d7a-4d93-a292-416a2ee8d004
Disulphiram acts by competitive inhibition of which enzyme?
Alcohol dehydrogenase
Aldehyde dehydrogenase
Alcohol carboxylase
Aldyhyde carboxylase
1b
single
Ans. (b) Aldehyde dehydrogenaseRef KDT 6th ed. / 386EthanolAlcohol Dehydrogenase-------------------Acetaldehyde Aldehyde Dehydrogenase---------------------Acetate* Disulfiram is an anti-craving agent for alcoholics. It has been used as an aversion technique in alcoholics.* Disulfiram acts by inhibiting aldehyde dehydrogenase. If a person still takes alcohol while on disulfiram treatment, alcohol is metabolized as usual, but acetaldehyde accumulates.* This accumulation of acetaldehyde gives some distressing symptoms like flushing, burning sensation, throbbing headache, perspiration, dizziness, vomiting, confusion and circulatory collapse.* Therefore, it is recommended only for those alcoholics who are motivated and sincerely desire to leave the habit.* Drugs causing Disulfiram like reaction:# Metronidazole# Chlorpropamide# Cefoperazone# Cefotetan# Trimethorprim* Other drugs that decrease craving for alcohol and smoking: (remembered as NATO)# NALTREXONE# ACAMPROSATE# TOPIRAMATE# ONDANSETRONAlso Know* Drug which inhibit alcohol dehydrogenase - FOMEPIZOLE* Antidote for methanol poisoning: FOMEPIZOLE > ETHANOL* Antidote for ethelene glycol poisoning: FOMEPIZOLE
Pharmacology
Pharmacokinetics
2c06389d-5a6d-42b0-90a9-c639f051c6ff
Fast breathing in a 6-month old infant is taken as
>60 breaths/ min
>50 breaths/ min
>40 breaths/ min
>30 breaths/ min
1b
single
Criteria for fast breathing AGE Respiratory Rate <2 months >60/minute 2-12 months >50/minute 12 months-5 years >40/minute
Social & Preventive Medicine
NEET 2019
72851095-b074-4906-a336-abc25704c53b
Shivering" is observed in the early pa of postoperative period due to
Chloroform
Halothane
Trichloroethylene
Ether
1b
single
Postoperative shivering (halothane shakes) and hypothermia is maximum with halothane among inhalational anesthetics. It can be used to sta or maintain anaesthesia. One of its benefits is that it does not increase the production of saliva, which can be paicularly useful in those who are difficult to intubate
Pharmacology
Anesthesia
ad4bc406-bbc7-4172-8b95-d258c2205534
Malignant glaucoma is seen in –a) Anterior chamber normalb) Misdirected aqueous flowc) Pilocarpine is the drug of choiced) Management is medical onlye) Atropine is also given
ab
be
bc
ce
1b
single
In malignant glaucoma there is misdirection of aqueous posteriorly into the vitreous. It is characterized by markedly raised IOP and shallow or absent anterior chamber. Treatment includes :- i) Medical :- Atropine (DOC), phenylephrine, osmotic agents, (β-blockers, α-agonists, carbonic anhydrase inhibitors; ii) YAG laser hyaloidotomy; iii) Surgery :- pars plana vitrectomy.
Ophthalmology
null
87522f7c-b107-4080-a9ef-1077995ee2f0
Staph, epidermis has become important due to
Biofilm formation
Virulence
Wide spectrum antibiotics
Novobiocin resistance
0a
single
* S. epidermis is a pathogenic organism which affects interventions like catheter, canula.* It is an organism which can form biofilm.* It is novobiocin sensitive.
Microbiology
Bacteria
e731f18d-eafe-4ab9-baf1-af659a3b8968
CRF is associated with?
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
2c
single
ANSWER: (C) Metabolic acidosisREF: Harrison 17th ed chapter 274, Essentials of Pathophysiology: Concepts of Altered Health States by Carol Mattson Forth page 200Chronic kidney disease is the most common cause of chronic metabolic acidosis. The kidneys normally conserve HCO3-- and secrete H+ ions into the urine as a means of regulating acid-base balance. In chronic kidney disease, there is loss of both glomerular and tubular function with retention of nitrogenous waste and metabolic acids. In condition called renal tubular acidosis, glomerular function is normal, but tubular secretion of H+ or reabsorption of HC03~ is abnormal.
Medicine
Chronic Kidney Disease and Uremia
858e4e64-7849-4437-80b6-800f62b5cfa3
All are dopaminergic agonists used for parkinsonism EXCEPT
Bromocriptine
Ropinerole
Pramipexole
Selegiline
3d
multi
Selegiline REF: KDT 6th Ed p. 415 DRUGS USED FOR PARKINSONISM Drugs affecting dopaminergic system Dopamine precursor Levodopa Peripheral decarboxylase inhibitors Carbidopa , benzaseride Dopaminergic agonists Bromocriptine , ropinerole , pramipexole MAO-B inhibitor Selegiline COMT inhibitor Entacapone , tolcapone Dopamine facilitator Amantadine Drugs affecting brain cholinergic system Central anticholinergics Trihexyphenidyl , procyclidine , biperidin Antihistamines Orphenadrine , promethazine
Pharmacology
null
f8e76c48-5538-40dc-b5aa-9e7b5e780565
Incestuous relationship between mother and son is called as?
Oedipus complex
Electra complex
Family incest
None
0a
multi
Ans. is 'a' i.e., Oedipus complex * In psychoanalysis, the Oedipus complex is a child's desire, that the mind keeps in the unconscious via dynamic repression, to have sexual relations with the parent of the opposite sex (i.e. males attracted to their mothers, and females attracted to their fathers)* The Oedipus complex occurs in the third -- phallic stage (ages 3-6) of the psychosexual development.* Sigmund Freud coined the term "Oedipus complex"* Boys and girls experience the complex differently: boys in a form of castration anxiety & girls in a form of penis envy (Electra complex).
Psychiatry
Sexual Disorders
60e24262-1cfd-4ddb-8dd0-7abeb2b39501
Suspensory ligament of Lockwood encloses which pair of muscles
Inferior rectus and inferior oblique
Superior rectus and superior oblique
Medial rectus and lateral rectus
Inferior rectus and lateral rectus
0a
single
Suspensory ligament of Lockwood: A specialized lower pa of the fascial sheath of the eyeball is the suspensory ligament, which suppos the eyeball. This sling-like structure is made up of fascial sheath of the eyeball. It has contribution from these muscles : Inferior oblique & Inferior rectus. In an event of orbital floor fracture it protects drop down of eyeball .
Anatomy
Eye, Nose and Ear
46d863fe-143b-4334-a65c-574c9c9d118d
The major constituents in agar are
Fats
Aminoacids
Polysaccharides
Polypeptides
2c
single
Agar, a polysaccharide extract of a marine alga, is uniquely suitable for microbial cultivation because it is resistant to microbial action and becauseit dissolves at 100degC but does not gel until cooled below 45degC; cells can be suspended in the medium at 45degC and the medium quickly cooled to a gel without harming them.Ref: Jawetz, Melnick, & Adelberg's Medical Microbiology; Twenty-Seventh Edition; Chapter 5; Cultivation of Microorganisms
Microbiology
general microbiology
dc80c84f-0f07-4372-9023-98c2b5bf9def
For optimum esthetics when setting maxillary denture teeth, the incisal edges of the maxillary incisors should follow the _____.
Lower lips during smiling
Upper lips during smiling
Lower lips when relaxed
Upper lips when relaxed
0a
single
Maxillary teeth should contact the wet dry lip line when fricative sounds f, v, and ph are made. These sounds help to determine the position of the incisal edges of the maxillary anterior teeth.
Dental
null
c12635ab-7943-4c66-b1c2-201ec2447974
All are true about polio vaccines except
OPV is live attenuated vaccine
IPV Provides Intestinal immunity
IPV is killed formalised vaccine
OPV is effective than IPV during Epidemics
1b
multi
null
Social & Preventive Medicine
null
b443bf27-4436-4127-9cd0-889a9cddeb46
Osteosclerotic metastasis is common in cancer of:
Prostate
Lungs
Malignant melanoma
Renal cell carcinoma
0a
single
Ans. A. Prostate cancerProstate cancer leads to osteosclerotic metastasis because of release of PTH like proteinsa. Prostate carcinoma cells secrete factors that directly and indirectly alter the osteoblastic function and express factors critical for normal bone development and remodeling, including bone morphogenetic proteins (BMPs), TGF-b, platelet- derived growth factor, adrenomedullin, insulin-like growth factor (IGF-1), fibroblast growth factor and vascular endothelial growth factor (VEGF).b. The osteolytic factor, PTHrP, is also abundantly expressed in Prostate carcinoma metastases, despite the fact that these lesions are primarily blastic. It has been demonstrated that PTHrP increases osteoblastic progenitor cell proliferation and induces early Osteoblastic differentiation.c. Another study says that Wants (a large family of proteins that promote bone growth) contribute to prostate cancer- mediated osteoblastic activity. Prostate cancer bone metastases have both an osteolytic and osteoblastic component, there is a shift in the balance from osteolytic to osteoblastic activity as prostate cancer progresses, which results in osteosclerotic (Osteoblastic) metastasis.
Orthopaedics
Bone Tumour
8306b9be-2fc4-48cc-ad78-abd0fd3ceeb4
True statements about alpha -1 - anti-trypsin deficiency-a) Autosomal dominant diseaseb) Emphysemac) Fibrosis of Portal tractd) Diastase resistant positive hepatocytese) Orcein positive granules
abc
acd
bcd
bd
2c
multi
Fibrosis of portal tract develop when there is cirrhosis.
Pathology
null
903d47a6-a61f-4dba-b522-8a70a1b538fd
The age at which a child can make a tower of 9 cubes and draw a circle is
24 months
30 months
36 months
42 months
2c
single
Key fine motor developmental milestones4mo - Bidextrous reach (reaching out for objects with both hands)6mo - Unidextrous reach (reaching out for objects with one hand); transfers objects9mo - Immature pincer grasp; probes with a forefinger12mo - Pincer grasp mature15mo- Imitates scribbling; tower of 2 blocks18 mo- Scribbles; tower of 3 blocks2 yr - Tower of 6 blocks; veical and circular stroke3 yr - Tower of 9 blocks; copies circle4 yr - Copies cross; bridge with blocks5 yr- Copies triangle; gate with blocks Ref:Ghai 8e pg:50
Physiology
Nervous system
c1b5b67f-8bc2-4292-9ce9-6175ac75c84f
In chronic inflammation confined to poal tract with intact limiting membrane and normal lobular parenchyma, the histoapathological diagnosis would be -
Active hepatitis
Chronic active hepatitis
Chronic persistent hepatitis
Acoholic heaptitis
2c
single
Ans. is 'c' i.e., Chronic persistent hepatitiso Intact limiting membrae with inflammation confined to poal area is seen in chronic persistent hepatitis.
Pathology
null
975923ab-aafe-4add-bd98-285b5b36aa61
The minimum period required for post exposure chemo prophylaxis for HIV is-
4 weeks
6 weeks
8 weeks
12 weeks
0a
single
null
Medicine
null
d5b7cadc-61e2-43a6-9b1e-dbffb1897c86
Most common site of hypospadias:
Proximal to Glans
Scrotum
Perineum
Mid penis
0a
single
Ans. (a) Proximal to GlansRef Page 1478, Bailey and Love 27th editionHypospadias:* Incidence- 1 in 200* MC congenital anomaly of urethra* External meatus opens on under side (Ventral surface)* Dorsal Hood and ventral chordee seen.* MC site of opening- proximal to the normal opening in Glans Penis (MC)* Others: Coronal, penile, Penoscrotal, Perineal.* Most severe type is perineal, luckily it is the rarest also.* Procedure of choice: Tabularized incised plate Urethroplasty for distal hypospadias for proximal hypospadias Foreskin is used.* As per Bailey Surgery done before 18 months (correct answer is 6 months)
Surgery
Urethra & Penis
c2502c7a-5826-4be2-888c-fc7a711cceba
Per Rectal palpation of uterus is done in :
Primigravida
Virgins
Grand multi paras
Placenta pre
1b
single
Virgins
Gynaecology & Obstetrics
null
8713d532-349f-484d-93fb-faff6d1ed14d
All of the followings are true about Sprengel's deformity, except:
Associated with congental scoliosis
Associated with diastematomyelia
High incidence with Klippel-Feil syndrome
Associated with dextrocardia
3d
multi
ANS. DSprengel's deformity: It is congenital elevation of the scapula.Is a complex deformity of the shoulder and the most common congenital shoulder anomaly.Associations of Sprengel's deformity:* Klippel-Feil syndrome* Spina bifida* Diastematomyelia* Torticollis* Kyphoscoliosis# Klippel-Feil syndromeThe most common sign of the disorder is restricted mobility of the neck and upper spine. A short neck and low hairline at the back of the head may occur in some patients.
Orthopaedics
Pediatric Orthopedics
e6dbd902-b0f3-4fd9-a182-46e2a4480a41
The commonest cause of primary hyperparathyroidism is-
Carcinoma parathyroid
Solitary adenoma of parathyroid
Chronic renal failure
Hyperplasia of the parathyroid
1b
single
solitary adenoma ie a single abnormal gland is the cause in 80% of patients ( Harrison 17 pg 2380)
Medicine
Endocrinology
a57c3f4b-6d8b-4912-8f90-5ad9914b6749
Aminoglycoside affects ?
Outer hair cells in basal area
Inner hair cells in basal area
Outer hair cells in apical area
Inner hair cells in apical area
0a
single
Ans. is 'a' i.e., Outer hair cells in basal area Cochlear damage with the use of aminoglycosides stas from the base and spreads to the apex; hearing loss affects the high frequency sound first, then progressively encompasses the lower frequencies. Outer hair cells are easily damaged by ototoxic drugs (aminoglycosides) and high intensity noise. Inner hair cells are more resistant.
Pharmacology
null
c5e71c0d-6938-408f-8d93-cf7ec8f6f473
Which of the following statements about Histamine is true: September 2012
Is found in Mast cells
Increases gastric acid secretion
Related to arousal and blood pressure
All of the above
3d
multi
Ans: D i.e. All of the above Histamine Histamine is formed by: Decarboxylation of histidine Function of histamine: Mediates triple response
Medicine
null
c316723b-3964-4f59-adde-0d3128de0c0d
Accessory renal aery:-
Remnant of degenerated mesonephric aery
May encircle around the kidney
May lead to hydronephrosis
All of above
3d
multi
The accessory renal aery is the precocious origin of a segmental aery which sometimes arises from the aoa and supplies upper or lower pole of the kidney. The accessory renal aery is the remnant of the degenerated mesonephric aery. The aery for the lower pole usually passes behind the pelvis of ureter and may cause obstruction to urine flow producing hydronephrosis.
Anatomy
GIT 1
ece49a74-395a-47c5-a4c2-4d5b885e6b6c
Blood pressure in right ventricle
25 mmHg
80 mmHg
95 mmHg
120 mmHg
0a
single
Peak pressures in theright ventricles is about 25 mm HgRef: Ganong's Review of Medical Physiology Twenty-Third Edition Page No:508
Physiology
Cardiovascular system
84118d6a-fb53-4ff7-86e4-b50ac606c2ac
Tzank smear helps in the diagnosis of :
Herpes viral infection
Bullous pemphigoids
Carcinoma of cervix
None
0a
multi
A. i.e. Herpes
Skin
null
31547333-9156-43d4-bed6-621a902439c7
Which of the following is the most common cataract in the newborn -
Zonular Cataract
Morgagnian Cataract
Ant. polar Cataract
Post, polar Cataract
0a
single
Answer: A The commonest cataract in childhood is Blue Dot cataract which presents without visual obstruction. And the commonest congenital cataract which presents with a visual defect is zonular cataract.
Unknown
null
fa4d1794-6330-474e-a881-c98d638e1135
Row of tombstone is seen in which skin disorder:
Pemphigus vulgaris
Pemphigus foliaceous
Paraneoplastic pemphigus
Bullous pemphigoid
0a
single
Ans. A. Pemphigus vulgaris* Pemphigus vulgaris is characterized by following signs:1. Bulla spread sign2. Perilesional, and distant Nikolsky sign3. Tzanck smear: Acantholytic cell* Histopathology shows suprabasal blister with row of tomb stone appearance of basal cells.* Direct immunofluorescence from perilesional skin demonstrated intra epidermal IgG deposits' in a fishnet pattern.
Skin
Vesiculobullous (Blistering) Disorders
8bc8d3dd-c2a1-417c-a3e9-a02b0d4a1107
A 25year old male presents with painless sudden loss of vision, ocular and systemic examination is not contributory. What is probable diagnosis
Retinal detachment
Eale's disease
Glaucoma
Cataract
1b
single
Ans is Eale's disease Both Eale's disease and Retinal detachment are causes of painless sudden loss of vision, however Eale's disease is a much more common cause than RD in a young male. Ocular and systemic examinations in both the conditions may be normal.Eale's diseaseIt is a disease of young adult males, who otherwise are healthy, in developing countries (especially India).It is an idiopathic inflammation of peripheral retinal veins; characterized by recurrent vitreous hemorrhage.(Periphlebitis leads to obliteration of the affected vessels. Hypoxia leads to neovascularization which lead to recurrent vitreous hemorrhage)The etiology is unknown. Hypersensitivity to tuberculin protein has been reported, however no clear relationship to tuberculosis has been found.Usually bilateral.The common presenting symptoms are sudden appearance of floaters or painless loss of vision.The vitreous hemorrhage clears spontaneously, but after a few recurrence the hemorrhage may organize, and may cause fractional retinal detachment or secondary glaucoma.Treatment:systemic steroids in early vasculitis stageLaser photocoagulation for abnormal vessels is used in neovascularization stagevitreoretinal surgery is required for marked vitreous traction threatening the macula.Causes of sudden, painless loss of visionUnilateralBilateralSubluxation or dislocation of lensVitreous hemorrhageRetinal hemorrhageRetinal detachmentRetinal vascular occlusionExudative age-related macular degenerationPosterior uveitis Diabetic retinopathyGrade IV hypertensive retinopathy with macular star Atypical optic neuritis Toxic optic neuropathy Bilateral occipital infarction
Ophthalmology
Vitreous Haemorrhage Vitrectomy
84a4d9e1-2302-4d4a-a39d-5dd5389fe498
Jumping gene is known as?
Transposon
Retroposon
Insertion sequence
Integron
0a
single
* Transposons, also called jumping genes, are pieces of DNA that move readily from one site to another.* They move either within or between the DNAs of bacteria, plasmids and bacteriophages in a manner, that plasmid genes can become part of the chromosomal complement of genes.* Interestingly, when transposons transfer to a new site, it is usually a copy of the transposon that moves, while the original remains in situ (like photocopying).* Transposons can code for metabolic or drug resistance enzymes and toxins. They may also cause mutations in the gene into which they insert or alter the expression of nearby genes.* In contrast to plasmids or bacterial viruses, transposons cannot replicate independently of the recipient DNA. More than one transposon can be located in the DNA for example, resistance genes. Thus, transposons can jump from:# The host genomic DNA to a plasmid# One plasmid to another# A plasmid to genomic DNA.* An insertion sequence is a short DNA sequence that acts as a simple transposable element. Insertion sequences have two major characteristics: they are small relative to other transposable elements (generally around 700 to 2500bp in length) and only code for proteins implicated in the transposition activity (they are thus different from other transposons, which also carry accessory genes such as antibiotic resistance genes.
Pathology
Neoplasia
b89b3d84-45ce-4624-96b9-b4337fdd177e
Which of the following X-ray should be advised for age determination between 1-13 years of age
Shoulder
Wrist
Elbow
Iliac bones
1b
single
A bone age study helps doctors estimate the maturity of a child&;s skeletal system. It&;s usually done by taking a single X-ray of the left wrist, hand, and fingers. It is a safe and painless procedure that uses a small amount of radiation. ... The bone age is measured in years . Reference: GHAI Essential pediatrics, 8th edition
Pediatrics
Growth and development
cfb916d1-1d99-4207-8278-1cc72de700c3
Plague epidemic in Surat in 1995 has occurred after a 'silence period' of
18 years
23 years
28 years
30 years
2c
single
The last case of plague in India was repoed in 1966 and after that there was a 'silence period' of 28 years till the reappearance of the disease in September 1994, when there was an outbreak of bubonic plague in Beed district of Maharashtra and pneumonic plague in Surat (Gujarat).
Anatomy
All India exam
da2ac323-faef-464a-834f-c76390d6eab1
Vitamin D analogue calcitriol is useful in the treatment of ?
Lichen planus
Psoriasis
Phemphigus
Leprosy
1b
single
Ans. is 'b' i.e., Psoriasis
Skin
null
41f2965c-fd9b-43ce-ac28-30d62d21372d
Radiation protector drug in clinical use among the following is
Amifostine
Cisplatin
Mesna
Tirapazamine
0a
single
Amifostine is used therapeutically to reduce the incidence of neutropenia-related fever and infection induced by DNA-binding chemotherapeutic agents including alkylating agents and platinum-containing agents . It is also used to decrease the cumulative nephrotoxicity associated with platinum-containing agents. Amifostine is also indicated to reduce the incidence of xerostomia in patients undergoing radiotherapy for head and neck cancerReference: Perez and Brady&;s textbook of radiation oncology; 6th edition
Pharmacology
Chemotherapy
8c0c5496-7657-415b-b71a-48505ecb10f8
Biochemical etiology of Alzheimer's disease relates to
Serotonin
Dopamine
Acetylcholine
GABA
2c
single
Neurotransmitters, which are decreased in Alzheimer's disease:- Acetylcholine (most important), norepinephrine, somatostatin, corticotropin.
Psychiatry
null
ab32941a-6551-44a8-96cf-f1e60d6f7ea2
Max risk of stroke after TIA:
First 48 hours
First week
First month
First year
0a
single
Ans. a. First 48 hoursTransient ischemic attack (TIA) is sudden, transitory loss of neurologic function that comes on without headache and resolves spontaneously within 24 hours (but usually lasts less than 1 hour), leaving no neurologic sequelae.The specific symptoms depend on the area of the brain affected, which is in turn related to the vessels involved. The most common origin is high-grade stenosis (>=70%) of the internal carotid, or ulcerated plaque at the carotid bifurcation.Stroke may be indistinguishable from a TIA at the time of presentation: Duration of symptoms is the determining difference.Symptoms are transient with a TIA because reperfusion occurs, either because of collateral circulation or because of the breaking up of an embolus.The blockage in blood flow does not last long enough to cause permanent infarction.Once a patient has a TIA, there is a high risk of stroke in 10-15% in the first 3 months, with most events occurring in the first 2 days. The risk of a stroke in a patient with a history of TIA is about 10% per year. TIAs carry a 30% 5-year risk of stroke. Therefore, cardiac risk factors should be closely investigated and, if possible, eliminated in a patient who has had a TIA.Cases may present only with transient loss of vision in one eye, known as amaurosis fugax. This happens during a transient ischemic attack because the first branch of the internal carotid artery is the ophthalmic artery.Note:TIAs are never due to hemorrhage; hemorrhages do not resolve in 24 hours.The importance of TIAs is that they are predictors of stroke, and timely elective carotid endarterectomy may prevent or minimize that possibility.Workup starts with.noninvasive Duplex studies.Carotid endarterectomy is indicated if the lesions are found in the location that explains the neurologic symptoms.Angioplasty and stent can be performed in high risk surgical patients
Medicine
C.N.S.
ff604516-e8e7-43c4-8500-844f636d7ae9
'Cloudy cornea' is a feature of?
Hurler's disease
Morquio's disease
Maroteaux Lamy disease
All of the above
3d
multi
Ans. D. All of the above. (Ref Essential Paediatrics by OP Ghai 7th/pg. 637)'Cloudy cornea' is known to be a feature of Hurler's disease/IH, Scheie's disease/IS, Morquio's disease/IV and Maroteaux Lamy disease/VI.C/f of mucopolysaccharidoses:Eponyms/MPS numbersMentalretardationCoarse faciesHepatospleno-megalyDysostosismultiplexCorneal clouding1. Hurler/IH+++++2. Scheie's/IS----+3. Hunter/U++++-4. Sanfilipo/lll+----5. Morquio/IV---++6. Maroteaux-Lamy / VI---++7. Sly/VII--++-Features of Hurler Syndrome:# H: Hepatosplenomegaly# U: Ugly facies# R: Recessive (AR)# L: L-iduronidase deficiency# E: Eyes (Cornea) clouded# R: Retarded mentally# S: Short stubby fingers
Pediatrics
Inborn Errors of Metabolism
686e52c0-4220-456d-8577-1e90389ec229
Painful are syndrome is seen in all except -
Complete tear of supraspinatus
# greater tuberosity
Subacromial bursitis
Supraspinatus tendinitis
0a
multi
Painful are syndrome is seen in incomplete tear of supraspinatus tendon (not in complete tear).
Orthopaedics
null
68cd8375-b7d2-4435-ae9d-3fb038daa99f
In Thyrotoxicosis, B-blockers do not control -
Anxiety
Termors
Tachycardia
Oxygen consumption
3d
single
Beta blockers ameliorate the symptoms of hypehyroidism that are caused by increased beta-adrenergic tone. These include palpitations, tachycardia, tremulousness, anxiety, and heat intolerance. n many tissues, hypehyroidism is associated with an increased number of beta-adrenergic receptors . The ensuing increase in beta-adrenergic activity is responsible for many of the symptoms associated with this disorder. It also explains the ability of beta blockers to ameliorate rapidly many of the symptoms, including palpitations, tachycardia, tremulousness, anxiety, and heat intolerance. Ref - pubmed.com
Medicine
Endocrinology
9f2bcc7a-532c-42e0-a665-2496c6c386b4
Arousal response is mediated by
Dorsal column
Reticular activating system
Spinothalamic tract
Vestibulo cerebellar tract
1b
single
Arousal response in cerebral cortex is activated by stimulation of Reticular activating system.
Physiology
null
ef80da19-8d47-4150-a464-71b3ac0d260d
Lymphoplasmacytoid lymphomas may be associated with
IgG
IgM
IgA
IgE
1b
single
Ans. (b) IgM(Ref: Robbins 9th/pg 598-602)Lymphoplasmacytic cell proliferation in marrow (Lymphoplasmacytic lymphoma) with secretion of IgM
Pathology
Misc. (W.B.C)
f4da212d-ed50-4b1f-aa43-97cdc1167c60
Massive edema in body in a patients of burns is due to
Cardiac dysfunction due to release of cardiac depressants
Basement membrane injury causing altered pressure gradient
Acute Renal failure
Fluid overload
1b
single
Massive edema in burns is due to altered pressure gradient because of injury to basement membrane.
Surgery
null
88be0ec3-1fb4-4162-91f3-b1b644740a0e
True about Fibrolamellar carcinoma of Liver is all,except-
Females do not have increased incidence than males
Has good prognosis
Not associated with liver cirrhosis
Serum AFP levels are usually >1000 mg/ltr
3d
multi
Fibrolamellar carcinoma - It is a distinctive variant of hepatocellular carcinoma It is seen in young adults (20-40 yrs of age) It has equal sex incidence It has a better prognosis It has no association with HBV or cirrhosis It is grossly encapsulated mass. AFP elevation is not seen in Fibrolamellar Ca
Pathology
null
90f46657-01d9-423a-a918-4a1e460e99f7
Cocospinal tract lesion leads to:
Spaticity
Extensor plantar response
Exaggerated tendon reflexes
All
3d
multi
A, B, C i.e. Spaticity, Extensor plantar response, Exaggerated tendon reflexes
Physiology
null