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135
adc1a438-b584-4d16-803a-8792b308af1e
An attack of migraine can be easily terminated by:
Acetylcholine
Ergotamine
Morphine
Ibuprofen
1b
single
SPECIFIC ANTIMIGRAINE DRUGS Ergotamine: It is the most effective ergot alkaloid for migraine. Given early in attack, lower doses generally suffice, and relief is often dramatic. However, when pain has become severe-larger doses are needed and control may be achieved only after few hours. Oral/sublingual route is preferred. 1 mg is given at half hour intervals till relief is obtained or a total of 6 mg is given. Parenteral administration, though rapid in action is more hazardous. Ergotamine acts by constricting the dilated cranial vessels and/or by specific constriction of carotid A-V shunt channels. Ergotamine and DHE have also been shown to reduce neurogenic inflammation and leakage of plasma in duramater that occurs due to retrograde stimulation of periascular afferent nerves. These actions appear to be mediated through partial agonism at 5-HTID/IB receptors in and around cranial vessels. Reference: Essentials of Medical Pharmacology Eighth Edition KD TRIPATHI page no 193​
Pharmacology
null
34fad896-5100-48e5-a0be-9a4353d7b3b0
In trauma, which of the following is increased -
Epinephrine
ACTH
Glucagon
All
3d
multi
Answer is 'a' i.e. Epinephrine; 'b' i.e. ACTH ; 'c' i.e. Glucagon As already mentioned in one of the previous questions, the neuroendocrine response to injury is an impoant pa of the stress response. The release of various hormones, creates an altered metabolic state which helps the individual to survive through the injury or the adverse circumstances. The neuroendocrine response begins with activation of the hypothalamic-pituitary-adrenal axis hypothalmic activation leads to - ADH (or vasopressin) release from the neurohypophysis epinephrine secretion from the adrenal medulla norepinephrine release from sympathetic nerve endings - CRH travels to adenohypophysis, stimualting ACTH production. ACTH acts on adrenal coex, producing coisol release (ACTH also stimulates release of aldosterone from the adrenal coex) About other hormones Insulin - hormones and inflammatory mediators associated with stress response inhibit insulin release. This is required to achieve the hyperglycemic state after injury. Glucagon - increased Aldosterone - increased Thyroid hormones : Thyroxine-no change; T3 - decreased 3 - increased Sex hormones - decreased
Surgery
null
9b1eb3bf-ee5f-445a-8b0b-100ea8db446d
A liver biopsy reveals following findings. What is true about this condition
Nodular regenerative hyperplasia of liver induced due to OCP
Nutmeg liver with dark areas of perivenular dead hepatocytes and gray areas of periportal viable hepatocytes
Nutmeg liver with pale areas of necrosis and dark congested areas of perivenular viable hepatocytes
Cirrhotic liver with fibrotic nodules.
1b
multi
This is a classical picture of nutmeg liver seen in chronic passive venous congestion on the liver. The dark congested areas consist of necrotic hepatocytes while the surrounding paler and brownish appearing regions are viable hepatocytes. "The combination of hypoperfusion and retrograde congestion acts synergistically to cause centrilobular hemorrhagic necrosis. The liver takes on a variegated mottled appearance, reflecting haemorrhage and necrosis in the centrilobular regions. This finding is known as nutmeg liver due to its resemblance to the cut surface of a nutmeg. ” — Robbins 9/e p864  Passive Congestion and Centrilobular Necrosis Hepatic manifestations of systemic circulatory compromise-passive congestion & centrilobular necrosis can be seen in both left & right-sided heart failure. Pathology Right-sided cardiac decompensation leads to passive congestion of the liver. The liver is slightly enlarged, tense, and cyanotic, with rounded edges. Microscopically there is congestion of centrilobular sinusoids. With time, centrilobular hepatocytes become atrophic, resulting in markedly attenuated liver cell plates. Left-sided cardiac failure or shock may lead to hepatic hypoperfusion & hypoxia, causing ischemic coagulative necrosis of hepatocytes in the central region of the lobule (centrilobular necrosis). Combination of hypoperfusion & retrograde congestion acts synergistically to cause centrilobular hemorrhagic necrosis. The liver takes on a variegated mottled appearance, reflecting hemorrhage & necrosis in the centrilobular regions. This finding is known as nutmeg liver due to its resemblance to the cut surface of a nutmeg.
Pathology
null
adbbdcc1-24c8-4e6c-9f6f-00a7c65a9ca7
A patients complains of occasional vomiting of food paicles eaten a few days ago. His wife repos that his breath smells foul. The most likely diagnosis is ?
Pyloric obstruction
Carcinoma stomach
Carcinoma esophagus
Achalasia cardia
3d
single
Ans. is 'd' i.e., Achalasia cardia
Surgery
null
5f09a2dc-d2d5-4c09-9037-7ab4d6083e3b
An 80 year old male presents to OPD with c/o rapidly enlarging neck mass and Hoarseness of voice . He gives a history of untreated papillary carcinoma of thyroid . What would be the likely diagnosis?
Medullary thyroid cancer
Huhle cell carcinoma
Papillary thyroid cancer
Anaplastic thyroid cancer
3d
single
Anaplastic carcinoma - Seen in 7th-8th decade -C/F Sudden increase in the size of swelling Severe pain over the swelling Most common route of spread- Direct invasion Evidence of compression of Trachea - Dyspnea Esophagus - Dysphagia Recurrent laryngeal nerve - Hoarseness of voice Most common site of metastasis - Lungs - Investigations IOC for Diagnosis- FNAC - Treatment For resectable tumor - Total thyroidectomy For unresectable tumor - Tracheostomy (lifesaving procedure when tumor is obstructing trachea) - Poor prognosis.
Surgery
Thyroid
dea104a5-9261-4433-9af9-1471b6083ea6
Grooves, which are present in gum pads between the canine and the 1st molars and relates the upper and lower gum pads are called as
Gingival groove
dental groove
Vestibular sulcus
lateral sulcus
3d
multi
null
Dental
null
42000f85-9f65-4053-9706-2f27289eed18
True statement about Korsakoff's psychosis is -
Severe antegrade + Mild retrograde memory defect
Mild antegrade + severe retrograde memory defect
Only antegrade memory defect
Only retrograde memory defect
0a
multi
Korsakoff syndrome has sever antegrade amnesia and less severe retrograde amnesia.
Psychiatry
null
35d5fa63-b158-4718-8d21-9d9ac9329c8a
Which of the following acts by inhibition of 30 S ribosome -
Tetracycline
Chloramphenical
Erythromycin
Penicillin
0a
single
Ans. is 'a' i.e., Tetracycline
Pharmacology
null
5069cfc1-c276-431a-9173-63b39a7fdabc
Male comes with acute scrotal pain. To differentiate between testicular torsion and epididymo-orchitis which is the best way
Angel sign
Prehn sign
Color Doppler
MRI
2c
single
Angel sign and prehn sign are not reliable.color Doppler is investigation of choice
Surgery
null
df7097b5-b421-4ae9-9c41-446868bab50b
NaF preservative is added in suspected cases of poisoning by ?
Cocaine
Alcohol
Cyanide
All the above
1b
multi
Ans. is 'b' i.e., Alcohol
Forensic Medicine
null
a43c21de-b405-408a-adbb-bdce12c3931b
All are true about Erlotinib except :
Used in non small cell carcinoma of lung
It is a small molecule tyrosine kinase inhibitor acting as EGFR antagonist
Food decreases absorption
It causes skin rashes and diarrhea
2c
multi
null
Pharmacology
null
cd32cf0f-9e05-4493-941f-0e3a685050be
V asomotor eentre of medulla is associated with:
Acts with the cardiovagal centre to maintain BP
Independent of corticohypothalamic inputs
Influenced by baroreceptors not chemoreceptors
Essentially silent in sleep
0a
multi
Ans, a. Acts with the cardiovagal centre to maintain BPVasomotor centre (VMC) controlling sympathetic outflow acts along with cardiovagal centre (CVC) controlling parasympathetic out flow to maintain blood pressure."Vasomotor centre (VMC) controlling sympathetic outflow acts along with cardiovagal centre (CVC) controlling parasympathetic out flow to maintain blood pressure. Baroreceptors, chemoreceptors and cortico hypothalamic inputs influence VMCG. Baroreceptors are tonically active stretch receptors located in walls of aortic arch and carotid sinus. Discharge from baroreceptors cause inhibition of Cl neurons of vasomotor center (VMC) situated in upper (rostral) half of ventrolateral medullaQ andfacilitation of cardiovagal centre (CVC) or nucleus ambiguous. "Medullary Centres regulating Blood PressureVasomotor Centre (VMC)Cardiovagal Centre (CVC)* Collection of glutaminergic neurons in superficial medullary reticular formation, known as C1 neurons, serves as pressure area of VMC. Cell bodies of C1 cells lie in ventrolateral region of upper half of medulla.* These neurons are spontaneously active day and night, tonically discharging impulses (in rhythmic manner) to the heart and blood vessels through lateral reticulospinal tract* It refers to nucleus ambiguous which lies lateral to VMC (medullary reticular neurons)* It receives afferents via Nucleus tractus solitaries (NTS) and in turn sends parasympathetic impulses to heart via the vagus, so named cardiovagal centre* The neurons in CVC do not discharge rhythmically (i.e. are not tonically active) Medullary Centres regulating Blood PressureVasomotor Centre (VMC)Cardiovagal Centre (CVC)* These reticulospinal tracts synapse with preganglionic neurons of sympathetic nervous system located in intermediolateral grey column of spinal cord (thoraoo lumbar sympathetic out flow)* Post ganglionic sympathetic neuron secrete nor adrenaline thereby increasing sympathetic activity and causing tonic vasoconstrictor and cardio accelerator activity resulting in:* The discharge increases parasympathetic activity there by resulting in: * Vasodilation* BP* Cardiac output* Heart rate * Vasoconstriction* BP* Cardiac output* Stroke volume
Physiology
Cerebellum and Brainstem
760b8a5d-ca64-4971-a384-ae2a7665fe04
Usual time for symptoms to appear in Rabid animal -
2 days
7 days
10 days
1 month
2c
single
Post exposure prophylaxis may be discontinued if the suspected animal is proved by appropriate laboratory examination to be free of rabies or in the case of domestic dogs, cats or ferrets, the animal remains healthy throughout a 10 day observation period staing from the date of bite Reference ; Park&;s Textbook of preventive and social medicine,24th edition.Pg no. 297
Social & Preventive Medicine
Communicable diseases
71aa3ccc-e7cc-4921-b3c4-af7250186372
The diagnostic characteristics of Plasmodium falciparum are best described by which one of the following statements?
An impoant diagnostic feature is the irregular appearance of the edges of the infected RBC.
A period of 72 hours is required for the development of the mature schizont, which resembles a rosette with only 8 to 10 oval merozoites.
Except in infections with very high parasitemia, only ring forms of early trophozoites and the gametocytes are seen in the peripheral blood.
Schuffner stippling is routinely seen in RBC's that harbor parasites.
2c
multi
P. Falciparum infection Distinguished by the appearance of ring forms of early trophozoites and gametocytes, both of which can be found in the peripheral blood. The size of the RBC is usually normal.Double chromatin dots in the rings are common. Schuffner stippling is routinely seen in RBC's that harbor P.vivax.
Microbiology
Parasitology Pa 1 (Protozoology)
2c1cf6b1-a19e-4264-a9ca-a3cb0697410e
Hypercalcemia is seen in which cancer
RCC
Carcinoma stomach
Small cell carcinoma lung
Hepatocellular carcinoma
0a
multi
Ref:Textbook of pathology (Harsh mohan) 6th edition,page no.695 CLINICAL FEATURES. Renal cell carcinoma is generally a slow-growing tumour and the tumour may have been present for years before it is detected. The classical clinical evidence for diagnosis of renal cell carcinoma is the triad of gross haematuria, flank plain and palpable abdominal mass. The most common presenting abnormality is haematuria that occurs in about 60% of cases. By the time the tumour is detected, it has spread to distant sites haematogenous route to the lungs, brain and bone, and locally to the liver and perirenal lymph nodes. Systemic symptoms of fatiguability, weight loss, cachexia and intermittent fever unassociated with evidence of infection are found in many cases at presentation. A number of paraneoplastic syndromes due to ectopic hormone production by the renal cell carcinoma have been described. These include polycythaemia (by erythropoietin), hypercalcaemia (by parathyroid hormone and prostaglandins), hypeension (by renin), effects of feminisation or masculinisation (by gonadotropins) and Cushing's syndrome (by glucocoicoids).
Pathology
Respiratory system
1c0e36c6-f364-47a3-b28c-408b3e14fb91
Which is the only nearly pure metal used for dental casting purposes?
Gold
Palladium
Silver
Pure titanium CP Ti
3d
multi
CP titanium, which is classified in four different grades, can technically be considered as an alloy because small percentages of other impurity elements are allowed as specified by a standard that has been established by the American Society for Testing and Materials (ASTM) for each grade. Although it is classified as commercially pure, grade 2 CP-Ti may contain up to 0.10% C, 0.30% Fe, 0.015% H, 0.03% N, 0.25% O, and 0.40% of other elements. Phillips 12th edition page 71
Dental
null
65ce9544-23cf-4f27-ad19-6ec66db53dbf
Drug used in triple drug therapy of H. Pylori:
Metronidazole
Erythromycin
Ciprofloxacin
Aminoglycosides
0a
single
Ans. A. MetronidazoleH pylori have triple and 4 drug therapy for H. Pylori where 4 antibiotics can be given like amoxicillin, clarithromycin, Metronidazole and tetracycline. Other drugs are PPI like omeprazole and bismuth sub citrate.
Pharmacology
Anti Microbial
cd3c8698-a5b7-4a2c-9d08-02c526fe3b77
Selective serotonin reuptake inhibitors are drugs of choice for all of the following conditions except:
Acute panic attack
Social phobia
Post traumatic stress disorder
Generalized anxiety disorder
0a
multi
Ref: KDT 6/e p448,449 *SSRIs are drug of choice for depression,sustained treatment of panic disorder and generalized anxiety disorder, obsessive compulsive disorder, post-traumatic stress disorder, social and other phobia and bulimia. *In acute panic attacks and for acute treatment of generalized anxiety disorder, benzodiazepines are preferred.
Pharmacology
Central Nervous system
0dada956-3573-4c8e-9f37-0658522c76fd
Complete regression of which of the following veins causes this anomaly in the development of IVC (Figure).
Right vitelline vein
Left vitelline vein
Right supra-cardinal vein
Left supra-cardinal vein
2c
single
Ans: (c) Right supra-cardinal veinRef: Essentials of Human Embryology, A.K.Datta, 5th edition, 2005, Page 205-208 4The anomaly shown in picture is Retrocaval ureter (right ureter) passes at first behind the IVC, and then appears in front of it after winding the medial margin of IVC.Retrocaval ureter occurs when the post-renal segment of the IVC is developed from the right posterior cardinal vein and the right supra-cardinal vein regress entirely.Development of IVCIVC developed from the following sources from below upwards1. Persistent caudal part of the right posterior cardinal vein2. Right supra-cardinal vein (this part receives 3rd and 4th pairs of lumbar veins)3. Anastomosis between right supra-cardinal and right sub-cardinal veins (this part receives the right gonadal vein).4. Upper part of the right sub-cardinal vein (this part receives both renal veins and right supra-renal vein).5. A new vessel grows dorsal to the liver and communicates the right sub-cardinal vein with the common hepatic vein (intrahepatic part of IVC).6. Common hepatic vein-which is developed from the suprahepatic part of the right vitelline vein (terminal part of IVC).Anomalies of IVC1. Double IVC - IVC persist on both sides below the level of renal veins. This occurs when the left common iliac vein fails to develop and the infra-renal segment of the left supra-cardinal vein fails to regress.2. Retro-caval ureter (as explained earlier).
Anatomy
Abdomen & Pelvis
3b7b402f-7af2-490a-968d-06233fc6e8b4
Compute the median for the following set of data, 1,2,3,4,5,6:
3
3.5
4
4.5
1b
single
If the number of samples is an even number, the median is midway between the two middle scores. (3+4)/2=3.5 Ref : Medical biostatistics, 1st edition pg: 111
Social & Preventive Medicine
null
62478e16-22da-4330-bb17-882ba3d575ba
A 50-years-old male Raju, presents with occasional dysphagia for solids, regurgitation of food and foul smelling breath. Probable diagnosis is:
Achalasia cardia
Zenker's diveiculum
CA esophagus
Diabetic gastroparesis
1b
single
Clinical feature Usually seen in patients over 50 years MC symptom is dysphagia Undigested food is regurgitated into the mouth, especially when the patient is in the recumbent position Swelling of the neck, gurgling noise after eating, halitosis, and a sour metallic taste in the mouth are common symptoms Cervical webs are seen associated in 50% of patients with Zenker's diveicula, can cause dysphagia post-operatively if not treated.
Surgery
Esophagus
df37f05d-34e0-4cc9-b6d8-5af459c16d02
Which of the following is not seen in pseudogout
Small joints affected
Large joints affected
Chondrocalcinosis
Deposition of calcium pyrophosphate
0a
multi
Small joints affected Pseudogout commonly involves the larger joints.Knee joint is most commonly involved; other sites are wrist, elbow, shoulder, ankele. Involvement of small joints is uncommon. Pseudogout It is one of the forms of "Calcium pyrophosphate dehydrate" (CPPD) ahropathy Age group is > 60 yrs. In CPPD ahropathy, CPPD deposition occurs in aicular tissues. It can present in any of the following three forms 1)Asympatoinatic chonclrocalcinosis 2)Acute synovitis - Pseudogout 3)Chronic pyrophosphate ahropathy The radiologic hallmark of CPPD is "Chondrocalcinosis" Chondrocalcinosis is seen as punctate and/or linear radiodense deposits in fibroc:ailaginous joint menisci or aicular hyaline cailage. Definitive diagnosis is made by synol fluid polarised light microscopy which shows weakly positive, birefringent, rhomboid crystals of CPPD. In acute synovitis form, leucocytosis (thousands to 1 lac cells/g1) is seen in synol fluid examination. It may be associated with ceain underlying disease such as ? - Primary hyperparathyroidism - Hemochromatosis - Hypomagnesemia - Hypophosphatasia - Hypothyroidism Pseudogout can be differentiated from gout as follows - Gout Pseudogout Smaller joints Large joints Intense pain Moderate pain Joint inflammed Swollen joint Hyperuricemia Chondrocalcinosis Uric acid crystals Calcium pyrophosphate dehydrate crystal Treatment The treatment of pseudogout is the same as that of acute gout: rest and high dose anti-inflammatory therapy. In elderly patients, joint aspiration and infra-aicular caicosteroid injection is the treatment of choice as these patients are more vulnerable to the side effects of NSAIDs. Urate lowering therapy is ineffective in CPPD
Surgery
null
8b80eee4-d1de-4099-a82f-be6d7dd9e7ec
The neurosurgeon had removed a portion of the dense tissue (dura mater) covering the brain of the patient when she removed the tumor that had invaded the skull. To replace this important tissue covering of the brain, she took a band of the aponeurotic tissue of the lateral aspect of the thigh, covering the vastus lateralis muscle. What muscle, supplied by the inferior gluteal nerve, inserts into this band of dense tissue as part of its insertion?
Gluteus medius
Gluteus minimus
Gluteus maximus
Tensor fasciae latae
2c
single
The tensor fasciae latae (which is innervated by the superior gluteal nerve) and the iliotibial tract are dense, wide aponeurosis that receives the insertion of the tensor fasciae latae and about 75% of the gluteus maximus. The gluteus maximus is the only one of the muscles listed that is supplied by the inferior gluteal nerve; in fact, it is the only muscle innervated by the inferior gluteal nerve. Gluteus medius and minimus insert on the greater trochanter and are innervated by the superior gluteal nerve. The rectus femoris, supplied by the femoral nerve, inserts via the quadriceps tendon on the patella and tibial tuberosity.
Anatomy
Lower Extremity
657707aa-3094-46a0-a592-60dbeb39680d
The potentially hazardous irrigant causing an emergency during treatment is
Saliva
Chlorhexidine
Sodium Hypochlorite
Metrogyl
2c
multi
null
Dental
null
c99c2168-c8a1-4d85-a620-77f56a249ebb
Which of the following does not supply the palate-
Tonsilar branch of facial artery
Ascending palatine artery
Descending palatine artery
Ascending pharyngeal artery
0a
single
Blood supply of soft palate Arterial supply of soft palate is as follows:- Greater palatine branch of the descending palatine artery, which in turn is a branch of the maxillary artery. Ascending palatine branch of the facial artery. Palatine branch of ascending pharyngeal artery. Lesser palatine artery a branch of descending palatine artery, which is a branch of the maxillary artery.
Anatomy
null
03660a6a-229c-4f9f-a9d9-c3c029170e1b
Millard's 'Rule of Ten' includes all except -
10 lbs
10 weeks
10 gm % Hemoglobin
10 months
3d
multi
Ans- D Rule often is the criteria used to judge the "readiness" of an infant for surgical repair of a cleft lip. The infant must weigh 10 Ib; be 10 weeks old; have a hemoglobin value of 10gm/dl and have a WBC count < 10,000.
Unknown
null
401377e9-c05e-4315-bc20-40b6343f2942
Which is the preferred incision for abdominal exploration in blunt abdominal injury ?
Transverse incision
Paramedian incision
Always midline incision
Depending upon the organ
2c
single
The preferred incision for emergency abdominal exploration in blunt injury abdomen is midline laparotomy. This type of incision is preferred as it provides adequate exposure, associated with minimal blood loss, minimal nerve and muscle injury. Ref: Current Surgical Diagnosis & Treatment, 12th Edition, By Gerard M. Dohey, Page 230,31; Bailey and Love's Sho practice of surgery , 24th Edition, Page 288
Surgery
null
c9797bc4-a4b4-4832-983f-3f9fc40f54e2
Molten wax appearance is seen in
Achondroplasia
Pseudogout
Melorheostosis
Osteopetrosis
2c
single
Motten wax or Flowing candle wax appearance feature of Melorheostosis.
Radiology
null
d661b8c8-f966-4c03-94a9-2c5f31dd0e1d
Golden hour of fracture femur is?
1 hr after injury
1 hr prior to injury
1 hr after reaching the hospital
1 hr after surgical procedure
0a
single
Ans. is 'a' i.e., 1 hr after injury Golden Hour It is the first hour from the time of trauma. It is the most critical for life and for the limb bility following fracture femur. Best prognosis is for the patients with fracture femur are for those who reach the OR in the golden hour. The emergency medical team should not take more than 10 minutes from the time of trauma in patients with fracture femur to decide and sta shifting the patient. This is described as "Platinum Ten". Thus, Golden hour -1 hour from the time of injury. Platinum hour - ten minutes from the time of injury.
Surgery
null
193767e1-e7f4-4e7f-bccc-57605e6e5768
Most common malignancy in AIDS is: March 2011
Kaposi sarcoma
Hodgkins lymphoma
Leukemia
Multiple myeloma
0a
single
Ans. A: Kaposi sarcoma The neoplastic diseases clearly seen with an increased frequency in patients with HIV infection are Kaposi sarcoma and non-Hodgkin's lymphoma
Medicine
null
d4591a67-4704-4912-9b1d-c23952e49a77
RCH phase 2 does not include
Immunization of pregnant women
Treatment of STD/RTI
Early registration of pregnancy upto 12-16 weeks
Feed to malnourished children
3d
single
null
Social & Preventive Medicine
null
20a6bd81-ce9d-4727-ae59-a5102fd6ce0c
Brachytherapy is used in :
Stage lb Ca cervix
Ovarian Ca
Stage IV Ca vagina
Stage 11 fallopian tube Ca
0a
multi
Ans. is a i.e. Stage lb Ca cervix Radiotherapy is recommended in advanced stages of Ca cervix i.e. stage IIB onwards.deg Brachytherapy is commonly used. For larger tumours initially external radiation then brachytherapy is given In small tumours brachytherapy is given first followed by external radiation. For stage IB and IIA - both surgery and radiotherapy yield similar results. There is very little scope of radiotherapy in ovary tumors. Only Granulosa cell tumour and dysgerminoma are radiosensitive and external radiotherapy is instituted for elderly woman. Vaginal Squamous cell Ca is only moderately sensitive to irradiation. In all advanced cases exenteration operation is done. Fallopian tube carcinoma -Total hysterectomy with Bilateral Salpingo-oophorectomy along with omentectomy followed by external pelvic radiation is the Treatment of Choice in Ca of Fallopian Tube.
Gynaecology & Obstetrics
null
4dd8b7f0-61c1-4ee4-961e-62abb4238f33
Child begins to sit with suppo, able to transfer objects from one hand to another hand and speak monosyllabic babbles at the age of -
3 months
6 months
9 months
12 months
1b
single
Ans. is 'b' i.e., 6 months
Pediatrics
null
bb7328f7-92c0-4dfd-b8ba-6ea2a8723f95
Maximum increase in prolactin level is caused by:-
Risperidone
Clozapine
Olanzapine
Aripiprazole
0a
single
Prolactin is inhibited by dopamine, so, any drug which blocks D2 recptor will lead to increase in prolactin. Anti-psychotics are D2 blocking drugs. They are of two types: * Typical anti-psychotic drug are amily D2 blocker. * Atypical anti-psychotics are mainly 5HT2 blocker but among them the maximum D2 blocking action is caused by Resperidone. So, Resperidone has the maximum chance of causing hyerprolactinema and also the maximum chance of causing EPS(Extra pyramidal symptoms) among the atypical anti-psychotics. Clozapine and Olanzapine are 5HT2 and D2 blocker. Aripiprazole is D2 paial agonist so, no chances of hyper-prolactinemia.
Pharmacology
NEET 2018
5def7c8a-7647-4298-8a56-63a1be239920
Ramkali bai, a 35-year-old female presented with a one-year history of menstrual irregularity and galactorrhoea. She also had off and on headache, her examination revealed bitemporal superior quadrantanopia. Her fundus examination showed primary optic atrophy. Which of the following is a most likely diagnosis in this case -
Craniopharyngioma
Pituitary macroadenoma
Ophthalamic IcA Aneurysm
Chiasmal Glioma
1b
single
A 35 year old woman complaining of amenorrhoea — galactorrhoea syndrome along with visual field defects confirms the diagnosis of pituitary macrodenoma (prolactinoma) Amenorrhoea and galactorrhoea results due to increased secretion of prolactin. Headache and visual field defects are seen due to mass effect of the tumours on the optic nerve. Now, the closest d/d of prolactinoma i.e. craniopharyngioma Bimodal age of incidence with one peak in childhood and the other in old age at 60 years. These tumours are suprasellar in location and the symptoms are produced due to mass effect of tumour either on the pituitary or optic chiasm. (It does not secrete any hormone) ​"Craniopharyngioma will never produce the Amenorrhoea galactorrhoea syndrome. Craniopharyngioma does not secrete any hormone." ​
Medicine
null
d1479b93-cb4d-4e37-b336-49c121114d19
A young female patient with long history of sinusitis presented with frequent fever along with personality changes and headache of recent origin. The fundus examination revealed papilledema. The most likely diagnosis is -
Frontal lobe abscess
Meningitis
Encephalitis
Frontal bone osteomyelitis
0a
single
null
Medicine
null
d4aa2b8f-ceb6-4de2-a80e-b23e76bdb79d
Ceain sign of onset of labor: March 2013
Labor pains
Show
Dilatation of internal os
Formation of bag of waters
3d
single
Ans. D i.e. Formation of bag of waters The first symptom to appear is intermittent painful uterine contractions followed by expulsion of blood stained mucus (show) per vaginum But formation of 'bag of membranes' is almost a ceain sign of onset of labor
Gynaecology & Obstetrics
null
03f5c7c9-a106-426b-ab7f-6cb6ac6a6cbc
Linear accelerator produces?
X rays
Beta rays
Gamma rays
Neutrons
0a
single
ANSWER: (A) X raysREF: Oxford oncology 2nd edition page 398, O P Tondon's Inorganic chemistryRepeat from December 2009Linear accelerator and Betatron are used to produce X Rays by accelerating electronsCyclotron is used to produce Gamma rays.
Radiology
Fundamentals In Radiology
82cf2a00-3b7f-4de1-b6f7-c848beb2915f
During normal inspiration diaphragm goes down by?
1-2 cm
3-5 cm
5-7 cm
7-9 cm
0a
single
Ans. is 'a' i.e., 1-2 cmIn normal inspiration, the diaphragm descends 1-2 cm into the abdominal cavity producing a pressure difference of 1-3 mm hg and the inhalation of about 500 ml of air.
Physiology
null
4aca470c-b6a9-4d98-9ad6-6cd87ed322ec
Gene therapy is most commonly targeted against:
SCID
cancer
cystic fibrosis
Leukemia
0a
single
a. SCID(Ref: Nelson's 20/e p 584-586)FDA-approved gene therapy is used for ADA-SCID, Leber's congenital amaurosis, multiple myeloma & Adrenoleukodystrophy
Pediatrics
Genetics And Genetic Disorders
a9bbcbfa-4ce5-4430-9f86-9f855877e4b8
A 50 years old male with type 2 diabetes mellitus is found to have 24-hour urinary albumin of 250 mg. Which of the following drugs may be used to retard progression of the renal disease?
Hydrochlorothiazide
Enalapril
Amiloride
Aspirin
1b
single
Antihypeensive drugs in Diabetes MellitusACE inhibitors (enalapril) or angiotensin receptor blockers are the first line of therapy in hypeensive individuals with type 2 DM.They have no known adverse action on glucose or lipid metabolism.Minimize the development of diabetic nephropathy (by reducing renal vascular resistance and renal perfusion pressure-the primary factor underlying renal deterioration in these patients).(Refer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 2054-2058)
Pathology
All India exam
4847b9de-8cc0-45d8-8a0e-500c934ef408
Teeth bite marks are a type of: March 2011
Contusion
Pressure abrasion
Graze
Linear abrasion
1b
single
Ans. B: Pressure Abrasion Teeth marks in biting and ligature marks in hanging and strangulation are example of imprint, pressure or contact abrasion Abrasion It as also known as - Graze or Scratch or Impression. An abrasion is a superficial injury to the skin which involves the loss of superficial epithelial layer (Uppermost layers of the cells of skin) of skin. Abrasions are produced by ? - Blow - Fall on some rough and hard substance - Dragging as in vehicular accidents. - Scratching with finger nails, bites and thorns etc. - Friction on some hard substance. Pressure of rope or cord as is found in strangulation and hanging etc. - Rubbing. - Indenting of the objects. Varieties of Abrasions Scratches- They are due to a sharp or a pointed object pressing across the skin, moving the surface layers in front of it and causing the heaping up of layers of skin. Grazes- They are modified scratches. - In this, the broader surface of skin comes in contact with the uneven rough object. - In this, the depth may vary at different places. - The direction is indicated by presence of clean commencement and tag at the finishing end. Impact Abrasions/Pressure Abrasions - They are also known as "Imprint abrasions". - They are caused by the stamping of some object against the skin like radiators of cars in vehicular accidents or - They may be caused by pressure on the skin which is accompanied by movements as found in? Ligature in cases of hanging or strangulation. Injuries caused by lashes with whip Sites of Abrasions ? The abrasions resulting from friction against rough surface during a fall are generally found on the bony pas and are accompanied with contusions or lacerations The abrasions caused by finger nails are seen on the exposed of body like - Face near forearm, hands, thighs etc. They are cresentric in shape, when finger nails are used. Ecchymosis is a common accompaniment. The abrasions caused by teeth bite are elliptical or circular in shape and often present separate marks. Typical impression of teeth by different sets of teeth (Deciduous or permanent) is marked. The intervening area is only a bruised area. The abrasions from radiators are honey-comb in appearance and are .commonly found in vehicular accidents Difference between Antemoem and Postmoem Bruise Antemoem abrasions will show signs of inflammation and repair whereas these will be absent in postmoem abrasions.
Forensic Medicine
null
91c7b767-7888-4ca3-a0dc-cf9befe07699
Drug (s) used in the treatment of multiple myeloma is/are-
Boezomib
Methotrexate
Hydroxyurea
Ketoconazole
0a
single
Drugs used as first line treatment of multiple myeloma include boezomib(proteasome inhibitor) & thalidomide( anti- angiogenic effects against tumour blood vessels & immunomodulatory effects).Reference :Davidson's principles &practice of medicine 22nd edition pg no 1047.
Medicine
Haematology
90a73069-eec5-49f4-9b87-4f4875744f16
The following can be associated with fatty liver except -
Amiodarone
Zidovudine
Sodium valproate
Chlorpropamide
3d
multi
Amiodarone-induced liver damage may present as Reye's syndrome in kids and may present as asymptomatic elevation of liver enzymes in adults. Asymptomatic liver enzyme elevation occurs in 25% of the population treated with amiodarone and is usually reversible upon discontinuation of therapy zidovudine-induced myopathy and hepatotoxicity in patients Valproic acid may cause serious or life-threatening damage to the liver that is most likely to occur within the first 6 months of therapy Chlorpropamide doesn't cause fatty liver Ref Davidson edition23rd pg774
Medicine
G.I.T
f18feca8-9180-40a9-8f3d-235bf160ba42
Immunostimulant used for the treatment of malignant melanoma is :
Levamisole
BCG
Aldesleukin
Methotrexate
2c
single
It is a recombinant IL-2 used for the treatment of renal cell carcinoma and malignant melanoma.
Pharmacology
null
6032f068-924c-4060-8891-a8a78660e443
An advanced diagnostic technique which has been suggested as an alternative to culture methods is:
Phase contrast microscopy
Direct immunofluorescence
Latex agglutination
Indirect immonofluorescent microscope assays
0a
single
null
Dental
null
ce847bdd-59d2-4e49-87d5-0ecfa4095abe
Nucleosome consist of
Histone
DNA
RNA
DNA & RNA both
0a
multi
A nucleosome is a basic unit of DNA packaging in eukaryotes, consisting of a segment of DNA wound in sequence around eight histone protein cores. This structure is often compared to thread wrapped around a spool. Nucleosomes form the fundamental repeating units of eukaryotic chromatin, which is used to pack the large eukaryotic genomes into the nucleus while still ensuring appropriate access to it (in mammalian cells approximately 2 m of linear DNA have to be packed into a nucleus of roughly 10 um diameter). Nucleosomes are folded through a series of successively higher order structures to eventually form a chromosome; this both compacts DNA and creates an added layer of regulatory control, which ensures correct gene expression. Nucleosomes are thought to carry epigenetically inherited information in the form of covalent modifications of their core histones.
Biochemistry
Metabolism of nucleic acids
530ce5fc-c3a8-4fd8-b7a9-130743c30ebd
Niacin deficiency causes all except
Dermatitis
Dactylitis
Diarrhea
Dementia
1b
multi
The classic triad of pellagra is dermatitis, diarrhea, and dementia. Ref: Page 182; Nelson textbook of pediatrics; 17th edition
Pediatrics
Nutrition
4203efb3-e2ba-4a39-9e99-00e6bb0965e0
Larynx extends from -
C2 - C7
Cl - C4
C5 - C6
C3 - C6
3d
single
The larynx is situated in front of hypopharynx opposite third to sixth cervical vertebrae.
Anatomy
null
d637db6f-75d5-46e4-aefc-f3934bde8072
Apple jelly nodules on the nasal septum are found in cases of ?
Tuberculosis
Syphilis
Lupus Vulgaris
Rhinoscleroma
2c
single
Ans. is 'c' i.e., Lupus vulgaris Lupus vulgaris It is an indolent and chronic form of tuberculous infection. Female to male ratio is 2:1. Most common site is the mucocutaneous junction of the nasal septum, the nasal, vestibule and the ala. Characteristic Feature is the presence of apple- jelly nodules (Brown gelatinous nodules) in skin. Lupus can cause perforation of cailaginous pa of nasal septum. Confirmation is by Biopsy
Skin
null
47d5f6e5-b148-4f01-b4c6-c3a9eb438fc0
The best investigation to diagnose a case of acoustic neuroma is –
Gadolinium enhanced MRI
CT scan
Audiometric analysis
PET scan
0a
single
null
Radiology
null
192ac4dc-e9fe-4c3b-8ce1-c9a34f35df54
For clinically detectable ascites, the minimal amount of fluid should be
300 cc
600 cc
1 litre
2 litre
0a
multi
This is a direct pick from National Boards.
Medicine
null
c21b88d7-6a25-4828-8982-99c8849476cf
Which statements is not true regarding acute starvation?
Increased Lipolysis
Increased gluconeogenesis in liver
Only ketone bodies utilized by brain for energy
Increased glycogenolysis in liver
2c
multi
In starvation: Increased Lipolysis Increased gluconeogenesis in liver andIncreased glycogenolysis in liverIn fasting and starvation, glucose must be provided for the brain and red blood cells; in the early fasting state, this is supplied from glycogen reserves.In order to spare glucose, muscle and other tissues do not take up glucose when insulin secretion is low; they utilize fatty acids (and later ketone bodies) as their preferred fuelRef: Harper 27e pg: 149
Biochemistry
nutrition and digestion
0450b153-ca62-4391-968e-c939741b84a1
Which of the following is a diagnosis?
Klatskin tumor
Carolicyts
Bryler disease
Primary sclerosing cholangitis
0a
single
Ans. (a) Klatskin tumor.Imagesource- style="font-family: Times New Roman, Times, serif">
Medicine
Gall Bladder
dbdd7db5-6c9e-4978-8de8-2fc2b07fcbd7
A young girl presents with primary amenorrhoea, grade V thelarche, grade II pubarche and no axillary hair. The most probable diagnosis is
Testicular feminization
Mullerian agenesis
Turner syndrome
Gonadal dysgenesis
0a
single
Testicular feminization syndrome - complete androgen resistance, presents as phenotypic young woman without sexual hair but with normal breast development and primary amenorrhoea Complete testicular feminization is a common form of male pseudohermaphroditism. It is the 3rd most common cause of primary amenorrhea after gonadal dysgenesis and congenital absence of the vagina. The features are characteristic. Namely, a ''woman" is asceained either because of inguinal hernia (prepubeal) or primary amenorrhea (postpubeal). The development of the breasts, the habitus, and the distribution of body fat are female in character so that most have a ''truly" feminine appearance. Axillary and pubic hairs are absent or scanty, but some vulval hairs are usually present. Scalp hairs are that of a normal woman, and facial hairs are absent. The external genitalia are unambiguously female, and the clitoris is normal. The vagina is sho and blind-ending and may be absent or rudimentary. All internal genitalia are absent except for testes that contain normal Leydig cells and seminiferous tubules without spermatogenesis. The testes may be located in the abdomen, along the course of the inguinal canal, or in the labia majora.
Surgery
null
ee5d7742-e557-4091-8d83-3180b2af97d3
Antiepileptics used as analgesics are :
Carbamazepine and valproate
Phenytoin and valproate
Carbamazepine and phenytoin
Diazepam and Chlorpromazine
2c
single
null
Pharmacology
null
a033fce2-9a88-43fc-b4c3-df82ec23fe6e
An 8 days old male infant is brought to the emergency department with vomiting, lethargy, dehydration and features of shock. Clinical examination reveals hyperpigmentation of the genital skin and normal external genitalia. Abdominal examination is unremarkable. blood tests revealed sodium of 124 mecill, potassium of 7 meq/1 and hypoglycemia. Which of the following is the most likely diagnosis:
Congenital Adrenal FIyperplasia (CAH)
Adrenal Haemorrhage
Acute Gastorenteritis with dehydration
Hyperaldosteronism
0a
single
Presence of vomiting, lethargy, dehydration, hyponatremia, hyperkalemia, hypoglycemia and shock in this eight-year-old male infant suggest a diagnosis of neonatal adrenal insufficiency/crisis. Congenital Adrenal Hyperplasia is the most prevalent cause of adrenal insufficiency in neonates (typically 7-14 days post delivery) and the single best answer amongst the options provided, Clinical features of CAH (21 hydroxylase deficiency) Symptoms of classical CAH due to 21 hydroxylase deficiency are: Clinical: Lethargy, vomiting, Anorexia, weight loss, dehydration, hypotension, shock Mineralocorticoid deficiency: Hyponatremia, hyperkalemia, hypotension Cortisol deficiency: Hypoglycemia, Hyperpigmentation of areolar and scrotal areas in males and genital creases in females (due to ↑ ACTH secretion) Excess Androgen Males: Phenotypically normal for some years, precocious puberty Females: Virilization (female pseudohermaphrodite)
Pediatrics
null
98fce862-9c14-427f-b580-5a9f6deed767
Incidence of undescended testis in term infants is:
<5%
<1%
8%
10%
0a
single
The incidence of undescended testes is approximately 30% in preterm infants and 1 to 3% in term infants. Ref: Schwaz's principle of surgery 9th edition, chapter 39.
Surgery
null
6de9f79e-6ce8-4985-a982-060cfd8b2fd7
Irregular and infrequent menstruation is known as:
Amenorrhoea
Oligomenorrhoea
Polymenorrhoea
Menorrhagia
1b
single
Oligomenorrhoea - Infrequent and irregularly timed episodes of bleeding usually occuring at intervals of more than 35 days Polymenorrhoea - Frequent episodes of mentruation usually occurring at intervals of 21 days or less Menorrhagia - Increased menstrual flow/Increased duration at regular cycles Hypomenorrhoea - Scanty bleeding and shoer days of bleeding Metrorrhagia - Irregular bleeding in between the cycles Menometrorrhagia - Increased menstrual flow as well as irregular bleeding between the cycles
Gynaecology & Obstetrics
FMGE 2018
d7bc5212-de11-40ef-bbd9-302531e5314f
To induce vomiting at home in a child who has ingested a poison, the recommended agent of choice would be –
Oral rehydration solution
Mustard in warm water
Apomorphine
Syrup of ipecac
3d
single
null
Pediatrics
null
89431310-c27d-40e2-a755-2cdc08a2777e
All are true about Xeroderma Pigmentosum except
It is autosomal dominant inheritance
Due to defective DNA repair
Associated with squamous cell carcinoma
Thymine dimers
0a
multi
(A) It is autosomal dominant inheritance # XERODERNA PIGMENTOSUM (XP)> Is an autosomal recessive genetic disease.> The clinical syndrome includes marked sensitivity to sunlight (ultraviolet) with subsequent formation of multiple skin cancers and premature death.> The risk of developing skin cancer is increased 1000- to 2000-fold.> The inherited defect seems to involve the repair of damaged DNA, particularly thymine dimers.> Cells cultured from patients with xeroderma pigmentosum exhibit low activity for the nucleotide excision-repair process.> Seven complementation groups have been identified using hybrid cell analyses, so at least seven gene products (XPA-XPG) Are involved.> Two of these (XPA and XPC) are involved in recognition and excision.> XPB and XPD are helicases and, interestingly, are subunits of the transcription factor TFIIH.
Medicine
Miscellaneous
b6df4c0d-3037-4219-817e-6db9492caeb0
Exposure of a female fetus to androgen in early embryogenesis may arrest differentiation of :
Mullerian
Ovary
Urogential sinus
Mesonephric ducts
2c
single
Sholy after the tip of para mesonephric ducts reach the urogenital sinus two solid evaginations grow out from the pelvic pa of the sinus.From these evaginations the sinovaginal bulbs proliferates to form the vaginal plates. The androgen exposure may arrest the differentiation of urogenital sinus LANGMAN'S MEDICAL EMBRYOLOGY, Pg no:229,12th edition
Gynaecology & Obstetrics
Sexuality and intersexuality
bfb06f8d-6dc7-465c-8dc9-8d9766eabef0
In obstruction of second pa of axillay aery, theanostomosis between the following aery will maintain the blood supply of upper limb:
Deep branch of transverse cervical aery & subscapular aery
Anterior & posterior circumflex humeral
Posterior circumflex humeral & circumflex scapular aery
Suprascapular & anterior circumflex humeral aery
0a
single
Deep branch of transverse cervical aery & subscapular aery [Ref: BDC 4/e, Vol 1, p 56, 82; Snell's Clinical Anatomy 6/e, p 412-413, 657; Moore Clinical Anatomy 5/a, p 766-7671Axillary aery is the continuation of the subclan aery. It is crossed by pectoralis minor muscle which devides it into three pas.A rich anastomosis exists around the scapula between branches of subclan aery (first pa) & the axillary aery (third pa).This anastomosis provides a collateral circulation through which blood can flow to the limb when the distal pa of subclan aery or the proximal pa of axillary aery is blocked.Anastomosis around the scapula :Formed by branches of-Subclan aery - first pa- Suprascapular aery- Deep branch of transverse cervical aeryAxillary aery - third pa- Subscapular aery & its circumflex scapular branchThere are other smaller anastomoses over the acromion process, which also helps to maintain .flow to arm. (BDC Vol I, 4/e, p 82)Anastomoses over the acromion processFormed by -a)Acromial br. of thoraco-acromial aeryb)Acromial br. of suprascapular aeryc)Acromial br. of posterior circumflex humeral aeryThe subscapular aery also forms anastomoses with intercostal aeries
Anatomy
null
1404e9cd-a3e1-4b30-afc0-0a4b9b703f79
Drug of choice for surgically unresectable renal cell carcinoma is ?
Sorafenib
Sunitinib
Imatinib
Cetuximab
1b
multi
.
Surgery
Urology
92af6f84-a794-4ce9-a7b2-e3161ab24b21
Which of the following markers in the blood is the most reliable indicator of recent hepatitis B- infection?
HBsAg
lgG anti - HBs
lgM anti - HBc
lgM anti - HBe
2c
single
Ans. is 'c' i.e. IgM anti-HBc You are sure to get questions on serological marker of Hepatitis in every PG exams (particularly AIIMS & AI). This topic has been thoroughly discussed.See Q. No 58 of Nov. 2001.Coming to the question; Hbs Ag is also present in recent hepatitis B infection but it is not a reliable marker because it can also be seen in carriers, whereas IgM anti- HBc is seen only in acute or recent hepatitis and is replaced by IgG anti Hbc in chronic infections.
Medicine
Immunology and Rheumatology
080139cb-a495-44a8-908e-26689b910af6
After a leisure trip, a patient comes with gritty pain in eye, and joint pain following an episode of urinary infection. What is the most probable diagnosis?
Reiter's syndrome
Bachet's syndrome
Sarcoidosis
SLE
0a
single
Reiter 's syndrome now referred to as reactive ahritis (ReA), is a classic triad of ahritis, nongonococcal urethritis and conjunctivitis. Reactive ahritis is triggered following enteric or urogenital infections. Reactive ahritis is associated with human leukocyte antigen (HLA)-B27. Bacteria associated with reactive ahritis are generally enteric or venereal. Reactive ahritis falls under the rheumatic disease category of seronegative spondyloahropathies, which includes ankylosing spondylitis, psoriatic ahritis, the ahropathy of associated inflammatory bowel disease, juvenile-onset ankylosing spondylitis, juvenile chronic ahritis, and undifferentiated spondyloahritis.
Medicine
null
3d589011-377d-4bf7-8be7-e0cd561668d1
Millard repair is used for treatment of:
Cleft lip
Cleft palate
Meningocele
Saddle nose
0a
single
The rotation advancement cleft lip repair, also referred to as a Millard repair, is probably the most commonly performed repair today. Almost no tissue is discarded; the medial lip element is rotated downward, even with a back cut, if necessary, and the lateral lip element is advanced into the defect under the nasal sill. Mucosal flaps are used to line the nose and the vestibule of the lip
ENT
null
277f2e39-ee6d-4669-980d-d2937a3f1eec
During water analysis in a hostel, amoebic cysts were seen. The best step to manage it is –
Iodine
Boiling
U.V Rays
Chlorination
0a
multi
"Amoebic infection is spread by ingestion of food or water contaminated with cysts. since an asymptomatic carrier may excrete upto 15 million cysts/day. Prevention of infection requires adequate sanitation and eradication of cyst carriage. In high risk areas infection can be minimized by avoidance of unpeeled fruits and the use of Bottled water. Because cysts are resistant to readily attainable levels of chlorine, disinfection by iodination (Tetraglycine hyperiodide) is recommended." - Harrison
Social & Preventive Medicine
null
6800db63-aa34-4d3a-aed7-52c02e9f16ac
Lillys antidote does not contain
Sodium Nitrite
Amyl Nitrite
Sodium Thiosulfate
Dicobalt EDTA
3d
single
Lillys antidote Used for cyanide poisoning. Composition Sodium nitrite Amyl nitrite Sodium Thiosulfate
Forensic Medicine
Toxicology - 3
b143d3bd-b355-4fbe-b9d8-768ace63d42a
CD marker specific for myeloid series is:
CD34
CD45
CD99
CD117
3d
single
. CD117
Pathology
null
09d79543-b3b5-471a-95a6-c849364b389f
Fine reticular pigmentation with palmar pits are seen in -
Dowling - Degos disease
Rothmund thornpson syndrome
Cockyane syndrome
Bloom's syndrome
0a
single
Fine reticular pigmentation with palmar pits is characteristic of downing Degos disease Dowling-Degos disease (DDD) is a type of reticulate pigmentary disorder in which hyperpigmented macules are found in the flexures. Iadvl text book of dermatology, page 737
Dental
miscellaneous
64245f90-6419-469d-ad04-bab2d3fac51d
Imaging tool of choice for GD?
DWI MRI with ADC maps
HMPAO SPECT
MR Spectroscopy
PET
0a
single
Ans ACreutzfeldt-Jacob disease is a spongiform encephalopathy caused by prions. On MRI T2 hyperintensity in basal ganglia, thalamus (Hockey stick sign), cortex and white matter with persistent diffusion restriction in considered most sensitive sign. On PET scan there can be hypometabolsim in affected area however it is less sensitive
Radiology
Nervous System
630f1606-e863-416b-b7a3-7d122c9257f5
A 16 years old girl presented with history of nasal obstruction for last 2 months. A CT Scan was done and following findings are seen. What is the most likely diagnosis?
Juvenile Nasopharyngeal Angiofibroma
Antrochoanal polyp
Nasopharyngeal carcinoma
Adenoid Hyperophy
1b
single
CT Scan picture shows Crescent sign or Dodd's Sign seen in Antrochoanal Polyp Adenoid hyperophy: Dodd's Sign is negative JNAF- Epistaxis in adolescent males NPC- Old age, presents generally with Neck node metastasis
ENT
ENT Q Bank
9ff4ff7d-f226-4a51-a63c-2d29943d3e37
A 2-year-old child comes with ear discharge, seborrheic dermatitis, polyuria and hepatosplenomegaly. Which of the following is the most likely diagnosis?
Leukemia
Lymphoma
Langerhan's cell histiocytosis
Germ cell tumor
2c
single
c. Langerhan's cell histiocytosis(Ref: Nelson's 20/e p 2484-2489], Ghai 8/e p 620-623)Seborrheic dermatitis, polyuria, hepatosplenomegaly and ear discharge suggests diagnosis of LCH.
Pediatrics
C.V.S.
fd3f4eb2-f406-4bd7-98a9-ca67c033eb95
Which of this following pas of veebral canal will show secondary curves with concavity towards back?
Cervical Veibral Canal
Thoracic Veibral Canal
Sacral Veibral Canal
Coccyx Veibral Canal
0a
single
In adults, the cervical curve and lumbar curve is concave backwards. The thoracic and sacral curve is convex backwards.Ref: Clinical Anatomy by Systems, Richard S. Snell, Edition 2007, Chapter 12, Page 860; Anatomy at a Glance, Omar Faiz, 3rd Edition, Chapter 77, Page 175.
Anatomy
null
0e8a51d7-4054-44f6-8c40-aec842909426
Most common congenital dysplasia of Ear is
Michel aplasia
Mondini's dysplasia
Alexander's dysplasia
Scheibe's dysplasia
3d
single
null
ENT
null
44f96048-66e0-4b34-8a32-185c72a171dd
KSY is
Empowerment of females under maternity benefit scheme
Adolescent girls scheme under ICDS
Free and compulsory education for girl child
Child care home scheme female juvenile delinquents
1b
single
At present, there are two schemes for adolescent girls &;Kishore shakti yojana&; and &;Nutrition programme for adolescent girls&;Kishore shakti yojana is being implemented using the infrastructure of ICDS. The scheme targets adolescent girls in the age group of 11 to 18 years and address their needs of self-development, nutrition and health status, literacy and numerical and vocational skills.Nutrition programme for adolescent girls also being implemented using the infrastructure of ICDS. Undernourished adolescent girls in the age group 11 to 19 years (<30 in 11-15 ages and <35 in 15 to 19) are covered under the scheme.Park 23e pg: 592
Social & Preventive Medicine
Maternal and child care
556e4cea-2111-4d04-9200-d8cda8b934c0
Which is not an intracanal medicament :
Calcium hydroxide.
Chlorhexidine digluconate.
MTAD.
None.
2c
multi
The two antimicrobial intracanal medicaments recommended in contemporary endodontic practice are as follows: Calcium hydroxide Chlorhexidine digluconate
Dental
null
c527a587-c3de-4943-be1d-97452d277b91
If annual growth rate of a population is 1.5-2%, what number of years will be required to double the population
70-47 years
35-47 years
35-28 years
28-23 years
1b
single
When crude death rate is substracted from crude bih rate , the net residual is current annual grow rate , exclusive of migration. When the annual growth rate of a population is 1.5% to 2.0%, it takes 35-47 years to double the size of population. Reference : Park&;s textbook of preventive and social medicine, 23rd edition, pg no: 481, table 5
Social & Preventive Medicine
Demography and family planning
2ad1afd2-1588-486d-b926-e17958c71b25
HIV virus contains:
Single stranded DNA
Single stranded RNA
Double stranded DNA
Double stranded RNA
1b
single
Ans. is 'b' i.e., Single stranded RNA(Ref: Ananthanarayan, 9th/e, p. 571 and 8th/e, p. 570)* The genome in HIV is diploid, composed of two identical single stranded positive sense RNA copies.
Microbiology
Human Immunodeficiency Virus
77a7099f-d422-4ce4-86de-4c40717977bb
A young man with tuberculosis presents with massive recurrent hemoptysis. Most probable cause would be.
Pulmonary aery
Bronchial aery
Pulomary vein
Superior vena cava
1b
single
B i.e. Broncheal aery In great majority of patients hemoptysis originates from systemic rather than pulmonary aeries and the bronchial vessels are almost universally involved. (Grainger) Massive hemoptysis in a patient of T.B. is usually d/ t erosion of bronchial aery which bleeds at systemic pressure.
Radiology
null
016fe751-47c7-4387-853d-7a85d0cc9f5f
25 years old male presented with diarrhea for 6 months. On examination the causative agent was found to be acid fast with 12 micro meter diameter. The most likely agent is -
Cryptosporidium
Isospora
Cyclospora
Giardia
2c
single
Ans. is 'c' i.e., Cyclospora All the parasites mentioned in the question cause chronic diarrhoea {mostly in immunocompromised patients).All of them reveal oocyst on stool examination. In Giardiasis, parasite is also seen along with oocyst stool examination.Oocyst of all the organisms except giardia are acid fast. The diagnosis rests on the size of the oocyst.DIAGNOSIS OF INTESTINAL PROTOZOAL INFECTIONParasiteStoolFecal acid fast stainSize of the oocystGiardiaOocyst + Parasite 4 nuclei 8-12 x 7 x 10 pmCryptospo- ridiumOocyst+Small, 4-5 pm in diameterIsosporaOocyst+Large 25 pm in diameterCyclosporaOocyst+Medium 8-10 pm diameterMicrosporidiaSpores Special fecal stains, tissue biopsiesMore on this topicParasites causing chronic diarrhoeaGiardiaCryptosporidiosisIsosporaCyclosporaHookwormAmoebiasisStrongyloidesAcid fast organisms are -MycobacteriumLepra bacilliNocardiaIsosporaBacterial sporesRhodococcusSmegma bacilliSpermatic headCryptosporidiumCyclospora
Microbiology
Parasitology
ac34f3c3-947a-40b4-98a1-cc945cae0e9a
Skin surface elevation caused by hyperplasia and projections of the epidermis form an undulating surface under microscopic examination. What is this known as?
Saw toothing
Papillomatosis
Villi
Parakeratosis
1b
single
Papillomatosis of skin Skin surface elevation caused by hyperplasia and enlargement of contiguous dermal papillae. Papillary projections of the epidermis form an undulating surface under microscopic examination.
Dental
Tumours of skin
3f235765-8249-4d27-b799-9b4ec65449fe
Hyoid bone fracture does not occur in -
Hanging
Strangulation
Throttling
Choking
3d
single
Ans. is 'd' i.e., Choking Features Hanging Strangulation Cause (mostly) Sigus of struggle Ligature mark Suicidal No * Above thyroid cartilageQ * Incomplete and directed obliquely upward * No skin damage under knot *Abrasion and bruise around ligature mark are * Dissection reveals a dry glistening white band of subcutaneous tissueQ Homicidal Present * Below thyroid cartilageQ * Completely encircelsQ neck horizontalQ * May be more than one turns * Abrasion and bruises are common *Dissection reveals ecchymosed subcutaneous tissueQ * Stretching of neck * Fracture-dislocation of vertebrae Present Absent * Fracture of hyoid, laryngeal cartilage, tracheal rings * Injury to neck muscles * Injury to carotid artery Rare Common Note - Throttling is m.c. cause of hyoid fracture Saliva Running out of angle of mouth vertically down Usually saliva not espaced but if so usually blood tinged and may not be vertically down * External signs of asphyxia *Face * Bleeding from nose and mouth Not well marked Pale Rare Well marked Congested, Cynosed with petechiaeQ Common
Forensic Medicine
Misc.
f139912a-c07a-4af0-830e-9d38780acd2d
Cell shape and motility are provided by
Microfilaments
Microtubules
Golgi apparatus
Mitochondria
1b
single
Microtubules are polymers of tubulin that form pa of the cytoskeleton and provide structure and shape to cells
Biochemistry
Enzymes
aeeed478-5ceb-4585-b41c-72384697c28d
Mean weight of 100 children was 12 kg. The standard detion was 3. Calculate the percent Coefficient of variation:
25%
35%
45%
55%
0a
single
Coefficient of variation: - Is a measure used to compare relative variability - Is a unit-free measure to compare dispersion of one variable with another - Is SD expressed as percentage of mean CV = In the given question, Mean weight (u) = 12 kg, n = 100, Standard detion (s) = 3 Thus, coefficient of variance =s/ux 100 = 3/12 x100 = 25%
Social & Preventive Medicine
Central tendency, Dispersion
f7c14563-0d0a-486e-bba1-088c1585b21c
About inverse agonism, true is:
Action on the target receptors is similar to that of agonist
Binds to the same receptor binding-site as an agonist for that receptor but exerts the opposite pharmacological effect
Effective against receptors having intrinsic activity without acting of a ligand upon them
None
1b
multi
Ans. b (Binds to the same receptor binding-site as an agonist for that receptor but exerts the opposite pharmacological effect). (Ref. KDT, Pharmacology, 6th ed., p 41)# Receptor agonists, antagonists and inverse agonists bind to the same receptor types:DefinitionAgonistsincrease the inhibitory transmitter GABA potencyInverse agonistsdecrease GABA potencyAntagonistsblock action of agonists and antagonists# An inverse agonist is an agent which binds to the same receptor binding-site as an agonist for that receptor but exerts the opposite pharmacological effect. Inverse agonists are effective against certain types of receptors (e.g. certain histamine receptors/GABA receptors) which have intrinsic activity without the acting of a ligand upon them (also referred to as 'constitutive activity'.)# One particular example is R015-4513 which the inverse agonist of the benzodiazepine class of drugs.# Gabapentin acts by facilitation of GABA mediated CT channel opening. It does not block GABA receptors. Substances called Beta carboline which also bend this receptor cause stimulation anxiety, increased muscle tone and convulsions. They are inverse agonists of benzodiazepine receptors.
Pharmacology
General Pharmacology
71d59db0-4d22-4500-9088-6351eccef4fe
Linoleic acid is maximum in
Groundnut oil
Safflower oil
Mustard oil
Coconut oil
1b
single
null
Social & Preventive Medicine
null
ddb2fe1c-105e-4ccf-a740-fe383571d102
A 30 year old male was brought for evaluation. The history revealed that the patients 3 year old son died, 5 months back after being hit by a car. At the time of accident, patient was standing nearby and witnessed the accident. For last 5 months, he has been having symptoms of sadness of mood, crying spells, feelings of wohlessness, poor sleep and poor appetite. He has twice thought of killing himself but stopped at the end moment. He has not been attending the office of last 5 months. What is the likely diagnosis:
Post traumatic stress disorder
Normal grief
Major depression
Adjustment disorder
2c
single
Depression: A major depressive disorder occurs without a history of a manic, mixed, or hypomanic episode. A major depressive episode must last at least 2 weeks DIAGNOSIS: Major Depressive Disorder The DSM-5 diagnostic criteria for major depression Sadness of mood Diminished interest in pleasure Significant weight loss or gain more than 5% in a month Crying spells Feeling of wohlessness Poor sleep (Insomnia or hypersomnia) Suicidal thoughts Psychomotor retardation Fatigue or loss of energy. Five or more of these symptoms present for 2 weeks or more or either depressed mood or loss of interest or pleasure.
Psychiatry
Schizophrenia Spectrum and Other Psychotic Disorders
fe292ade-80e2-4c0e-bdbb-86881762d2c2
Most common type of skin carcinoma on face, in light skinned, is: March 2013
Squamous cell carcinoma
Basal cell carcinoma
Bowen's disease
Erythroplasia of Queyrat
1b
single
Ans. B i.e. Basal cell carcinoma In darkly pigmented racial groups, squamous cell carcinoma is the MC skin malignancy Skin tumours Basal cell carcinoma does not show lymphatic spread Conditions predisposing to Squamous cell carcinoma: - Actinic keratosis, - DLE Basal cell carcinoma MC site of BCC: Face MC type of BCC: Nodulo-ulcerative type Mode of spread: Direct Excision procedure done: Moh's micrographic excision
Surgery
null
4ea61b65-a813-449d-bc40-6617fe89fd43
Typhoid revaccination is recommended every ... years in endemic area-
1
3
5
10
1b
single
Ans. is 'b' i.e., 3 o To maintain protection, revaccination is recommended every 3 years.
Social & Preventive Medicine
null
daaafa76-9e3d-4e51-b9ee-028e238e4c5d
Length of esophagus in adults is:
25 cm
10 cm
15 cm
20 cm
0a
single
The esophagus is a muscular, collapsible tube about 10 in. (25 cm) long that joins the pharynx to the stomach. The esophagus enters the abdomen through an opening in the right crus of the diaphragm.After a course of about 0.5 in. (1.25 cm), it enters the stomach on its right side.
Anatomy
null
8cde7268-48cd-4fca-b874-8851de8ea3da
All are true for normal saline except
normal saline 0.9% is most suitable to treat acute severe hyponatremia
fluid of choice for head injury patient
fluid of choice for hypovolemic shock
lead to hyperchloremic metabolic acidosis
0a
multi
NaCl Is preferred in conditions in which increased plasma sodium is beneficial e.g traumatic brain injury Not suitable for treatment of acute severe hyponatremia as it has little effect on plasma sodium levels When infused > 30ml/kg/hr may lead to hyperchloremic acidosis
Anaesthesia
Anaesthesia Q Bank
b631c86e-1c53-4e61-bb5a-9e2882b0da6a
All are true about Abnormal uterine bleeding except :
Blood loss of less than 50 ml
Cycle duration is more than 35 days or less than 21 days
Bleeding period lasting 7 days or more
Irregular bleeding during a regular cycle
0a
multi
Normal Menstrual Loss The upper limit of blood loss in a normal menstruation is considered as 80ml. Any bleeding above the specified normal limit is termed as abnormal uterine bleeding. Normal Menustration: Cycle interval-28days(21-35 days) Menustral flow- 4 to 5 days Menustral blood loss-35ml (20- 80ml) Common causes of AUB: 1.DUB 2.Infections 3.Endocrine Dysfunction 4.Pregnancy Complications 5.Hematological disorders 6.Neoplastic growth. Reference: Textbook of Gynaecology; Sheila balakrishnan; 2nd edition; Page 48 DC Dutta's Textbook of Gynecology; 7th edition ,page 152
Gynaecology & Obstetrics
Disorders of menstruation
d22d3c23-8890-41a0-9e55-4da64e49053c
Which influenza strain was isolated in 1989 spreading to many other countries?
H2N2
H1N1
H3N2
H5N1
1b
single
In 1989, epidemic - the reappearance of swine HINI virus Influenza can occur sporadically, as epidemics or pandemics In 2009, H1N1 Epidemic occurred in Mexico-recent Ref: Baveja 5th ed Pg: 468
Microbiology
Virology
c4bbad16-cd04-4fe4-af7b-4d027889bb29
All statements are true about the eye of a newborn except –
Optic nerve is myelinated only upto lamina cribrosa
Orbit is more divergent than adult
Apart from macular area the retina is fully differentiated
New born is usually myopic by –2 to –3D
3d
multi
Newborn is usually hypermetropic by +2 to +3D (not myopic).
Ophthalmology
null
c523d0a9-6d7f-4910-80e5-5a265f49fc6f
Which of the following is the national system that provides annual national as well as state reliable estimates of feility and Moality
Civil registration system
Census
Ad-hoc survey
Sample registration system
3d
single
Sample registration system (SRS) : Was initiated in 1964-65 (on a pilot basis ; Full scale from 1969-70) to provide national as well as state level reliable estimates of feility and Moality SRS is a dual record system Field investigation : Continuous enumeration of bihs and deaths by an enumerator Independent retrospective survey : Every 6 months by an investigator-supervisor Findings of SRS survey Crude bih rate (CBR) : 20.4 per 1000 mid year population Crude Death rate (CDR) : 6. 4 per 1000 mid year population Natural growth rate : 14% Infant Moality rate (IMR) : 34 per 1000 live bihs Ref: Park 23rd edition 904
Social & Preventive Medicine
Demography and family planning
c0b789c0-2c55-4377-a003-1b6ec67bcd00
Homocystein is not associated with
Coronary aery disease
Fracture
Hearing loss
Neuropsychiatric manifestations
2c
single
Ans. is 'c' i.e., Hearing lossElevated level of homocysteine (hyperhomocysteinemia) is associated with -i) Thrombosis, coronary aery disease & stroke.ii) Osteoporosis & fracture.iii) Neuropsychiatric manifestations.iv) Developmental delay.v) Visual disturbances.vi) Microalbuminuria.
Biochemistry
null
4ea5213c-1232-4e0d-8d88-801b3e9963bf
Arthrocentesis can be performed efficiently by:
Single needle technique.
Two needle technique.
Both of the above.
None.
1b
multi
null
Surgery
null
3844d831-16b7-4786-b6ec-c6f3c115a548
All are complications of chronic staphylo-coccal blepharoconjunctivitis except:
Chalazion
Marginal conjunctivitis
Follicular conjunctivitis
Phylectenular conjunctivitis
0a
multi
Ans. Chalazion
Ophthalmology
null