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0ae7f626-85b1-4a0d-9480-c0ba1d2e0c64
Last organ to be affected in putrefaction-a) Prostateb) Uterusc) Kidneyd) Thyroid
ab
ac
bd
cd
0a
single
Last soft tissue affected in male → Prostate Last soft tissue affected in female → Uterus Overall, last tissue affected (both in male & female) →3 Bone
Forensic Medicine
null
482d038c-4d99-4128-b191-cb8a9f4720b9
All are true about 'Molluscum contagiosum' , EXCEPT ?
Caused by pox virus.
Commonly seen in HIV and immune compromised subject.
Treated by cryotherapy.
Treated with metronidazole and doxyxycline.
3d
multi
Molluscum Contagiosum Benign viral infection caused by the poxvirus. Spread by close sexual or nonsexual contact and by autoinoculation Clinical features Presents with a crop of small domed vesicles with central umbilication measuring 1-5 mm in size. Diagnosis Giemsa staining of the discharge (white waxy material) reveals intracytoplasmic molluscum bodies Rx It consists of evacuation of the white material, excision of the nodule with a dermal curet and Rx of the base with Monsel's solution (ferric subsulphate) or 85% trichloracetic acid. Cryotherapy and electrocoagulation may be considered as an alternative therapy.
Gynaecology & Obstetrics
Genital Tract Infections (Too hot to handle!)
a2367fbd-03d3-46d5-9f19-f56fc23095f4
Intramuscular injections are given which quadrant of the buttock
Inferomedial
Superomedial
Superolateral
Superomedial
2c
single
The buttocks are the preferred site for administration of the intramuscular injection.  The muscles (gluteal) of this area are thick and are utilized frequently in daily activities, thus causing complete absorption of drugs.  To give the injection at the proper site, the gluteal region can be divided into four quadrant - i) Superomedial (upper inner quadrant) ii) Superolateral (upper outer quadrant) iii) Inferomedial (lower inner quadrant) iv) Inferolateral (lower outer quadrant)  The proper location for an injection is the upper outer quadrant (superolateral) because this is the location where there is least possibility of hitting bone, large blood vessels or the sciatic nerve.
Pharmacology
null
e6b80815-52c2-4f67-b73e-c2c58fd04ee5
Melanin pigmentation in pregnancy is known as
Melasma
Melanoma
Epulis
Melanosis
0a
single
null
Pathology
null
46b83bda-58b0-480a-8eea-eaaee1404ba6
A 63-year-old man becomes febrile and begins expectorating large amounts of mucopurulent sputum. Sputum cultures are positive for Gram-positive diplococci. Which of the following mediators of inflammation provides potent chemotactic factors for the directed migration of inflammatory cells into the alveolar air spaces of this patient?
Bradykinin
Histamine
Myeloperoxidase
N-formylated peptides
3d
single
Chemotactic factors are substance that stimulalte cellular migration The most potent chemotactic factors for leukocytes at the site of injury are:- Complement proteins (e.g., C5a) Bacterial and mitochondrial products, paicularly low molecular weight N-formylated peptides Products of arachidonic acid metabolism (especially LTB4) -Plasmin is a fibrinolytic enzyme generated by activated Hageman factor (clotting factor XII).
Pathology
Chemical mediators in plasma: Kinin system
115e3890-5181-4e09-9669-2aff536477ad
An 8-year-old child is evaluated by the pediatrician, who notes small cafe-au-lait spots on the child's torso. In addition, on close inspection of the eyes, the presence of Lisch nodules is noted. The patient is eventually diagnosed with neurofibromatosis type 1. The protein that is mutated in this disorder normally does which of the following functions?
Activates the GTPase activity of Ras
Cleaves cellular proteins during apoptosis
Functions as a cell cycle checkpoint regulator
Promotes angiogenesis
0a
multi
The normal function of NF1 is to promote the intrinsic GTPase function of the RAS oncogene. Mechanism:- RAS has an intrinsic GTPase activity that is accelerated by GTPase-activating proteins (GAPs), which bind to active RAS and augment its GTPase activity by more than 1000-fold, thereby terminating signal transduction. Thus, GAPs prevent uncontrolled RAS activity. When the Ras protein is bound to GTP, the growth-promoting function of the molecule is "ON". On hydrolysis of the GTP to GDP, Ras is conveed to an inactive state. GAPs (GTPase Activating Proteins), such as NF-1, suppress cell growth by stimulating GTP hydrolysis. Disabling mutations of neurofibromin 1, a GAP (GTPase-activating protein) encoded by the NF1 gene, are associated with the inherited cancer syndrome familial neurofibromatosis type 1. NF1 is therefore an example of a tumor suppressor gene that acts through negative regulation of RAS signaling (inhibitor of RAS/MAPK signaling). Other Options:- Caspases function to cleave cellular proteins once apoptosis is triggered Vascular endothelial growth factor promotes tumor angiogenesis RB and TP53 function as cell cycle checkpoint regulators
Pathology
Genetic Basics Of Carcinogenesis
1c95bcfc-167a-46bd-9622-4553eeadb70d
False about estrogen action ?
Stimulates secondery sex characters in female
Stimulates osteoclasts
Decreases LDL
Increases blood coagulability
1b
multi
Ans. is 'b' i.e., Stimulates osteoclastsMajor action of estrogen on bone is to inhibit osteoclastic bone resorption. Estrogen blocks the action of IL-6, a potent stimulator of osteoclasts.Estrogen also induces apoptosis of osteoclasts.Other three options are correct.Actions of estrogen have been explained in previous sessions.
Physiology
null
3d70488e-7db6-419d-b462-a045a25fa000
Glaucoma drug which is b-1 selectve p-blocker is ?
Timolol
Laevobuno I ol
Caeolol
Betaxolol
3d
single
Ans. is 'd' i.e., Betaxolol o Among the given options, only betaxolol is 0-1 selective.
Pharmacology
null
071d22c9-7b7c-4412-aafb-af231173b2ec
A 6-month-old male baby comes with vomiting, lethargy and severe jaundice when weaning was staed with fruit juice. Which of the following enzymes is defective?
Fructokinase
Aldolase A
Aldolase B
Sucrase
2c
single
The above clinical features on the initiation of fruit juice suggests a disorder of fructose metabolism. Hereditary fructose intolerance (HFI) is due to deficiency of the enzyme Aldolase B. Individuals affected with HFI are asymptomatic until they ingest fructose or sucrose (usually in the form of fruit, fruit juice or sweetened cereal). Symptoms include : Hepatomegaly Jaundice Vomiting Lethargy Convulsions Hypoglycemia Urine reducing sugar (Benedict's test) and tests for ketoses (Rapid Furfural and Seliwanoff's test) are positive. Treatment is removal of fructose and sucrose from the diet. Reference: Lippincott's Illustrated biochemisty 6th Edition Pg 138
Biochemistry
Metabolism of carbohydrate
62e1536d-542e-4044-9500-17b82ccfbb25
Esthetic changes occurs after/during RCT:
Decrease translucency.
Increase color chroma.
Increase saturation of color.
All of the above.
3d
multi
null
Dental
null
cf73a788-f558-4a74-aecb-a282090595ca
About first order kinetics true statement is:
Clearance remains constant
Fixed amount of the drug is eliminated
Half life increase with dose
Decreased clearance with increasing dose
0a
multi
null
Pharmacology
null
deeb01ef-b9aa-4153-ac6d-f5d0a77169ac
In which of the following uveitic conditions is it contraindicated to put intraocular lens after cataract extraction
Fuchs heterochromic cyclitis
Juvenile rheumatoid ahritis
Psoriatic ahritis
Reiters syndrome
1b
single
Inflammatory reaction in children is always serious and if the child is already suffering from uveitis IOL implantations can detoriate the condition Bewafa. REF:Khurana 6th edition page number 205
Ophthalmology
Lens
071b822d-0b92-4499-bfa3-710331047cae
A 23-year-old female maid was making a bed in a hotel bedroom. As she straightened the sheet by running her right hand over the surface with her fingers extended, she caught the end of the index finger in a fold. She experienced a sudden, severe pain over the base of the terminal phalanx. Several hours later when the pain had diminished, she noted that the end of her right index finger was swollen and she could not completely extend the terminal interphalangeal joint. Which one of the following structures within the digit was most likely injured?
The proper palmar digital branch of the median nerve
The vinculum longa
The insertion of the tendon of the extensor digitorum onto the base of the distal phalanx
The insertion of the flexor digitorum profundus tendon
2c
single
The contraction of the extensor mechanism produces extension of the distal interphalangeal joint. When it is torn from the distal phalanx, the digit is pulled into flexion by the flexor digitorum profundus. The proper palmar digital branches of the median nerve supply lumbrical muscles and carry sensation from their respective digits. Vincula longa are slender, bandlike connections from the deep flexor tendons to the phalanx that can carry blood supply to the tendons. The insertions of the flexor digitorum superficialis and profundus are on the flexor surface of the middle and distal phalanges, respectively, and act to flex the interphalangeal joints.
Anatomy
Upper Extremity
29b96727-f439-43f6-9548-7a8f68877d53
After 28 weeks of gestation true is/are :
Viable
> 1000 gm
Type II pneumocytes present
All
3d
multi
Ans. is a, b and d i.e. Viable: >1000 gm: and Type II pneumocytes present
Gynaecology & Obstetrics
null
6887c803-6a1b-4bb6-80c1-4e4e53c56d79
The drug used for leishmaniasis treatment
Pyrimethamine
Albendazole
Sodium stibogluconate
Tinidazole
2c
single
Sodium stibogluconate, is drug of choice in leishmaniasis. Meglumine antimoniate, Pentamidine, Amphotericin B, Miltefosine, Paromomycin are alternative drugs Basic and clinical pharmacology Katzung 13th edition pg 902
Pharmacology
Chemotherapy
07776d87-38b0-4011-87a3-e2a2625981ef
Fencing attitude of the dead bodies is caused by
Coagulation of proteins
Emulsification of fat
Exposure to excess cold
Electric shock
0a
single
PUGILISTIC ATTITUDE OR BOXING OR FENCING OR DEFENCE ATTITUDE: The posture of the body which has been exposed to great heat is often characteristic. POSITION: the legs are flexed at hips and knees the arms are flexed at the elbow and held in front of the body head slightly extended all fingers are hooked like claws contraction of paraspinal muscles often causes a marked OPISTHOTONOS in an attitude commonly adopted by boxers CAUSE: Coagulation of proteins occurs whether the person was alive or dead at the time of burning The flexor muscles being bulkier than extensors contract more due to which joints of all limbs are flexed. REFERENCE: The Synopsis of Forensic Medicine and Toxicology 29th edition page no: 161.
Forensic Medicine
Thermal injury
9c0be76a-1fab-45e0-b5d8-40a8ca10029f
All of the following statements are true regarding retinoblastoma, except:
Rb genes play major role in cell cycle regulation
Require deletion of both the Rb genes
Familial variant is autosomal dominant in inheritance
Rb gene is on chromosome 14p13
3d
multi
Rb gene Governor of the cell cycle Negative regulator of the G1/S cell cycle transition. Located on 13q14 chromosome. To explain the two patterns of occurrence of retinoblastoma, Knudson proposed "two hit" hypothesis of oncogenesis. Two mutations (hits), involving both alleles of RB at chromosome locus 13q14, are required to produce retinoblastoma. Familial variant is autosomal dominant in inheritance.
Pathology
Genetic Basics Of Carcinogenesis
fb3ae3f0-528b-4644-9f0f-613a2e26209c
Organs first to be injured in blast -
Ear, lung
Kidney, spleen
Pancreas, duodenum
Liver, muscle
0a
single
The synopsis of forensic medicine & toxicology ; Dr k.s narayan reddy ;28th edition ; pg.no. 138 Tympanic membrane rupture most commonly with hemorrhage in the ear . Blast lung is the other most common injury .
Forensic Medicine
Mechanical injuries
59f89dec-c0dc-49ca-b63f-fc682ce49129
Immunoprophylaxis of leprosy is best done by which of the following given choices?
MMR
Killed ICRC bacillus
Plague bacillus
Anthrax bacillus
1b
single
Maximum work has been done with BCG+ heat killed M. leprae (will be the best answer). In the choices given Cat 2 killed ICRC bacillus is used for Immunoprophylaxis of leprosy. Ref: Park, 20th Edition, Page 286.
Social & Preventive Medicine
null
0ddd6de0-cc23-4250-8267-1d7dc8572d74
A highly ionized drug
Is excreted mainly by kidney
Can carry placental barrier easily
Is well absorbed from intestine
Accumulates in cellular lipids
0a
single
Ionized molecules cannot cross the biological membranes .therfore they are less likely to be absorbed . Entry of the molecules through blood brain barrier and blood placental barrier is also restricted .these drugs cannot be reabsorbed in the nephron,thus are excreted by the kidney . Refer kDT 7/e p29
Anatomy
General anatomy
48d6cd86-ea34-4ea6-aa46-08b15a532a5f
Acute Hepatitis B marker(s) is/ are
HBsAg
HBeAg
Anti HBc
Anti HBs
1b
single
null
Social & Preventive Medicine
null
d2e9e0e1-840c-431e-9eb6-22e24898394f
'Bull-neck' is seen in severe cases of which of the following?
Diphtheria
Tubercular lymphadenitis
Mumps
Goitre
0a
single
Ans. a. Diphtheria (Ref: Harrison 19/e p978, 18/e p1189-1190)Bull-neck is seen in severe cases of diphtheria.Respiratory DiphtheriaClinical Features:The clinical diagnosis of diphtheria is based on:Constellation of sore throatQAdherent tonsillar, pharyngeal, or nasal pseudomembranous lesionsQLow-grade feverQOccasionally, weakness, dysphagia, headache, and voice change are the initial manifestationsQ.Neck edema and difficulty breathing are seen in more advanced cases and carry a poor prognosisQ.The systemic manifestations of diphtheria stem from the effects of diphtheria toxin and include weakness as a result of neurotoxicity and cardiac arrhythmias or congestive heart failure due to myocarditisQ.The pseudomembranous lesion is most often located in the tonsiilopharyngeal regionQ.The diphtheritic pseudomembrane is gray or whitish and sharply demarcatedQ.Pseudomembrane in diphtheria is tightly adherent to the underlying tissuesQ.Less commonly, the lesions are detected in the larynx, nares. and trachea or bronchial passages.Large pseudomembranes are associated with severe disease and a poor prognosisQ.A few patients develop swelling of the tonsils and present with "bull-neck" diphtheria, which results from massive edema of the submandibular and paratracheal region and is further characterized by foul breath, thick speech, and stridorous breathingQ.Unlike the exudative lesion associated with streptococcal pharyngitis, the pseudomembrane in diphtheria is tightly adherent to the underlying tissuesQ.Diagnosis:Attempts to dislodge the membrane may cause bleeding.Hoarsensess suggests laryngeal diphtheria, in which laryngoscopy may be diagnostically helpful.In addition, diagnosis requires the isolation of C. diphtheria or the histopathologic isolation of compatible grampositive organismsQ.
Pediatrics
Infection
5a21e550-4d1a-43ac-943f-0063e0345dfa
Danazol is not used in :
Precocious pubey
Endometrial Ca
Endometriosis
DUB
1b
single
Endometrial Ca
Gynaecology & Obstetrics
null
f18945f6-c44c-40fc-8d1c-eafcb75594bb
All are transmitted by Soft Tick, except-
KFD
Tularemia
Qfever
Relapsing fever
1b
multi
Ans. is 'b' i.e., Tularemia
Social & Preventive Medicine
null
b3a6d639-1092-43ae-acda-47bf782268d6
The given below instrument is used for:
For cutting ribs in spinal surgery
For smoothening of the edges in amputation surgery
Used as nibbler and remove fibrous tissue from non-union site
To hold the hard tissues
2c
single
Ans. (c) Used as nibbler and remove fibrous tissue from non-union siteRef: Textbook of Orthopedics 4th Ed by John Ebnezar; Page No- 861* It is a Double-action bone nibbler (Rounger). The double- action nibblers are mechanically superior.* Bone nibbler is available in various sizes and with different angle of the nose.# Curved nibbler - use for spinal surgery# Straight nibbler -general use# Double action nibbler - straight or curved.
Orthopaedics
General
b9a034a3-0168-4406-8299-64154feb8833
Deep peroneal nerve supplies?
First web space of foot
Anterolateral aspect of leg
Fourth web space of foot
Lateral aspect of foot
0a
single
First web space of foot is supplied by deep peroneal nerve while the rest three web spaces are supplied by superficial peroneal nerve.
Anatomy
null
f4b2c116-e524-4d7a-9769-06a2d9d247b7
YAG laser is used in the treatment of:
Retinal detachment
Diabetic retinopathy
Open-angle glaucoma
After cataract
3d
single
Ans. After cataract
Ophthalmology
null
82145933-24b3-4dd7-9389-52ac9f253b9a
Virus that has increased association with anal was:
HPV
HIV
LMV
EBV
0a
single
Anal Was Or Condylomata Accumulata HPV forms the etiological basis of: Anal and perianal was, AIN and SCC of the anus Subtypes (16,18,31,33) are associated with a greater risk of progression to dysplasia and malignancy Condylomata accuminata is the MC STD encountered by colorectal surgeons Most frequently observed inn homosexual men Clinical Presentation: Many are asymptomatic but pruritus, discharge, bleeding and pain are usual presenting complaints Rarely, relentless growth results in gaint condylomata (Buschke-Lowenstein tumour) which may obliterate the anal orifice Diagnosis is confirmed by biopsy Treatment: Application of 25% podophyllin Surgical excision Recurrence is common Ref: Sabiston 20th edition Pgno: 1412
Surgery
G.I.T
279b1b3c-efe7-446a-a6d5-425370705cce
Main LDL receptors is:
APO-A
APO-B-100
APOc-100
APO-100 & APO-E
1b
single
Ans. (b) APO B 100Ref: Harper's Biochemistry, 30th ed. pg. 254* The low-density-lipoprotein (LDL) receptor is a cell- surface protein that plays an important part in the metabolism of cholesterol by mediating the uptake of LDL from plasma into cells.* Although LDL particles bind to the LDL receptor through their apolipoprotein B (apo B) and apolipoprotein E (apo E) moieties, other apo E-containing particles, like chylomicron remnants, are not dependent on the LDL receptor for uptake into cells.* ApoB100 levels are associated with coronary heart disease, and are even a better predictor of it than is LDL level. A simple way of explaining this observation is to use the idea that ApoB-100 reflects lipoprotein particle number (independent of their cholesterol content). In this way, one can infer that the number of ApoB100- containing lipoprotein particles is a determinant of atherosclerosis and heart disease.* Most important apoprotein in HDL: Apo A-I* Most important apoprotein in chylomicrons: Apo B-48, E* Most important apoprotein in LDL, IDL, VLDL: Apo B-100* Apo protein for IDL - Apo B 100 and E
Biochemistry
Lipids
8e12dc09-7316-4b24-8723-261543c662d7
HLA B 27 is not seen in which of the following
Ankylosing spondylitis
Reiter's syndrome
Rheumatoid ahritis
Psoriatic ahritis
2c
single
Ref Robbins 9/e p215 HLA and diseases, the association of B27 with ankylosing spondylitis (AS) is the strongest. The B27 antigen is present in over 90% of patients with AS as com- pared with the B27 prevalence of 8% in Caucasians in general. A strong but slightly minor association has also been found between B27 and Reiter's syndrome (RS), reactive ahritis (ReA), and acute anterior uveitis (AAU). It is negative in rheumatoid ahritis
Anatomy
General anatomy
7ae9a470-7c33-431b-b432-ee7348e81737
A 11-year-old patent wearing full-banded orthodontic appliance has inflamed gingiva. The family dentist should
Encourage better oral hygiene
Perform deep scaling and curettage
Perform gingivoplasty after debanding
Ask orthodontist to remove the bands so that healing can occur
0a
single
null
Dental
null
0bb303d8-557a-418a-9077-eccaff9ef30c
Typical clinical features of Homer's syndrome include all except:
Dilated pupil
Ptosis
Enophthalmos
Nasal stuffiness
0a
multi
Homer's syndrome is due to interruption of sympathetic fibres and therefore causes meiosis (constriction of pupil). Nasal stuffiness is due to dilatation of blood vessels.
ENT
Facial Nerve And Its Disorders
48e89586-46c3-4700-b3c2-90f564bf9fad
Which one of the following is not a treatment of gastroesophageal variceal haemorrhage ?
Sclerotherapy
Sengstaken tube
Transjugular intrahepatic poacaval shunt
Gastric freezing
3d
single
Ans. is 'd' i.e., Gastric freezing
Surgery
null
62d22aa9-e04e-4f26-ab6b-2d83ed2479b1
Absolute contraindication for MRI:
Pacemaker
Claustrophobia
Penile prosthesis
Joint replacement
0a
single
Ans. (a) PacemakerRef: Harrison 19th ed. /440e-tContraindications of MRIAbsolute contraindicationRelative contraindication* Pacemaker* Metallic foreign body in the eye* Deep brain stimulator* Swan-Ganz catheter* Bullets or gunshot pellets* Cerebral aneurysm clips* Cochlear implant* Magnetic dental implants* AAA stent* stapes implant* Implanted drug infusion device* Neuro or bone growth stimulator* Surgical clips, wire sutures, screws or mesh* Ocular prosthesis* Penile prosthesis* Joint replacement or prosthesis* Other implants, in particular mechanical devices
Radiology
Ultrasonography, CT, and MRI
5c797ceb-51fe-4380-a5ca-a8b884d0d222
Which of the following enzyme is inhibited by Aminophylline ?
Monoamine oxidase
Alcohol dehydrogenase
Cytochrome P-450
Phosphodiesterase
3d
single
Theophylline is a non selective phosphodiesterase inhibitor. Inhibition of this enzyme cause elevation of cellular cAMP and cGMP and cause bronchodilation. Other mechanism of action of Aminophylline includes: Antagonises adenosine receptor Increase release of IL 10 which has anti inflammatory effect It prevents the translocation of the pro-inflammatory transcription factor NF-kB into the nucleus, potentially reducing the expression of inflammatory genes in asthma and COPD. Side effects: Headache Nausea Vomiting Abdominal discomfo Restlessness Increased acid secretion Diuresis At high concentration it cause cardiac arrhythmias Very high concentration causes seizures Ref: Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e chapter 36.
Pharmacology
null
5abc90e4-b8fd-4357-aae6-4099eb3d8310
A patient presented to ENT OPD with complaints of headache and nasal stuffiness. On CT scan Heterogeneous opacification involving multiple sinuses along with Bone erosion (as shown below) was noticed. What would be the most likely diagnosis?
Acute bacterial rhinosinusitis
Chronic Bacterial rhinosinusitis
Allergic Fungal rhinosinusitis
Invasive Fungal Rhinosinusitis
2c
multi
Heterogeneous opacification in multiple sinuses with areas of central hypoattenuation is characteristic of AFRS. Erosion of medial wall of right orbit can be clearly seen without any invasion into the orbit as Medial Rectus Muscle can be clearly seen with out distoion. ( compare with Left Side) Areas of increased signal intensity are thought to be due to the accumulation of heavy metals such as iron, manganese, and calcium within the inspissated allergic mucin.
ENT
Diseases of Nose and Paranasal Sinuses
f12ace64-2538-49ea-8132-3493b641f355
Most characteristic of megaloblastic anemia ?
Target cell
Macrocyte
Microovalocyte
Macroovalocyte
3d
single
Ans. is 'd' i.e., Macroovalocyte
Pathology
null
a8fe09e4-ef75-4466-80ee-957b1213785b
Protein synthesis occurs in
Ribosome
Golgi apparatus
Lysosomes
Endosomes
0a
single
Synthesis of proteins are based on the grnic information present on the DNA which is transcribef into the mRNA nucleotide sequence and then translated to the amino acid sequence of the polypeptide chain. The mRNA encodes the information,tge tRNA transposthe aminoacids and ribosomes provide the platform for the protein synthesizing machinery .Transfer RNA and ribosomal RBA are transcribed from specific genes on DNA by RNA polymerases Reference:FM.VASUDEVAN Textbook SEVENTH EDITION ,Page no: 597
Biochemistry
Structure and function of protein
60c1bc25-7c92-4508-824b-05c52f3fc569
Psychosurgery is used in
Phobia
Generalized anxiety
OCD
Depression
2c
single
Psychosurgery can be used in the treatment of OCD that has become intractable and is not responding to other methods of treatment. The best responders are usually those who have significantly associated depression, although pure obsessives also respond. The main benefit is the marked reduction in associated distress and severe anxiety. (Ref: a sho textbook of psychiatry, Niraj Ahuja, 7th edition, pg no.98)
Psychiatry
Treatment in psychiatry
7d016384-20b8-4e8b-a107-32589c7d1168
Gluteus maximus is inserted on -
Lesser trochanter
Greater trochanter
Spiral line
iliotibial tract
3d
single
Gluteus maximus -        Origin    Iliac crest    Posterior gluteal line of ileum and area behind and above it    Sacrum    Coccyx    Sacrotuberous ligament -        Insertion    Gluteal tuberosity    Iliotibial tract
Anatomy
null
00464bea-c068-4cdd-a203-22fbb736351b
Amniocentesis is done at what intrauterine age?
12-Oct
20-Dec
20-25
25-30
1b
single
ANSWER: (B) 12-20REF: Current OB./GYN 10th edition chapter 13.Repeat from December 2011 & June 2008Amniocentesis is often performed between 15 and 20 weeks' gestation. Chorionic villus sampling (CVS) is an alternative to amniocentesis. It is performed between 10 and 12 weeks' gestation and can be performed either transcervically or transabdominally.
Gynaecology & Obstetrics
Diagnosis in Obstetrics
4be59c8a-aa48-4173-a485-721f95e7fd31
Crossed aphasia means-
Right hemispherical lesion in right handed person
Right hemispherical lesion in left handed person
Left hemispherical lesion in left handed person
Left handed lesion in right handed person
0a
single
null
Medicine
null
df4f3280-2c8f-4a70-a9e2-607fe67cd7d5
'Whip-lash' injury is caused due to: AIIMS 06; Karnataka 07; BHU 12; NEET 15
Fall from a height
Acute hyperextension of the spine
Blow on top to head
Acute hyperflexion of the spine
1b
multi
Ans. Acute hyperextension of the spine
Forensic Medicine
null
8cfdd1af-eb0f-4978-b299-42060f5d3ff6
Splicing is a process of
Activation of protein
Removal of introns
Synthesis of protein
Replication of DNA
1b
single
Removal of Introns : The primary transcripts are very long ;they have molecular weights more than 10 power of 7.Molecular weight of mature mRNA is about 1-2 x 10 power of 6.This means large poion of hnRNA are cleaved off. The primary transcript contains coding regions (exons)interspersed with non-coding regions (introns). These intron sequences are cleaved and the exons are spliced (combined together ) to orm the mature mRNA molecule.This processing is done in the nucleus.Splicing is an energy requiring process. REF :DM VASUDEVAN TEXTBOOK ;7th EDITION ; Page no :591.
Biochemistry
Metabolism of nucleic acids
f8e1ee0b-e167-44e8-bd63-98169dd86be7
Supernumerary teeth common location -
Upper incisor
Canine
Molar
Lower incisor
0a
single
Supernumerary teeth are those which are additional or in excess of the normal number. The most common site is upper incisor. Ref: K.S.Narayan Reddy's synopsis of Forensic Medicine and Toxicology 29 th edition Chapter 4,page- 59.
Forensic Medicine
Identification
e15c578c-c586-4a56-8f43-62e97f49b891
Which one of the following tumors involving the female genital tract has the WORST prognosis?
Dysgerminoma in a 35-year-old
Uterine choriocarcinoma in a 25-year-old with a recent history of molar pregnancy
Granulosa cell tumor in a 40-year-old
Serous cystadenocarcinoma of the ovary in a 45-year- old
3d
single
Ans. D. Serous cystadenocarcinoma of the ovary in' a 45-year-oldAround 75% of serous cystadenocarcinoma of the ovary are in an advanced stage at the time of diagnosis.These tumors have a worse prognosis than any of the other tumors listed.
Gynaecology & Obstetrics
Gynaecological Disorders in Obs.
42a5b0f8-da08-457f-872a-99c364b489d0
Most common site of disc prolapse in lumbar spine is
L2-3
L3-4
L4-5
L5-S1
2c
single
Ans. is 'c' i.e., L4-5 Prolapsed intervertebral disc:* Herniation of intervertebral disc is a common cause of combined back pain and sciatica (Pain in back with radiation to lower limb). Prolapsed intervertebral disc is often precipitated by injury, but it may also occur in the absence of any remembered injury.* The site of exit of the nucleus is usually posterolateralon one or the other side.Occasionally, it can be central (posterior-midline)disc prolapse.* The type of nuclear protrusion maybe: a protrusion, an extrusion or a sequestration.* A dissecting extrusion, (an extrusion with discmaterial between the body of the vertebra andposterior longitudinal ligament, stripping the latteroff the body), may occur.* The commonest level of discprolapse is between L4-L5 in the lumbar spine and C5-C6 in the cervical spine.
Orthopaedics
Spinal Injuries
f9a7a931-09d6-4393-8d55-42949b233f5f
Painless Breast lump in a young female
Fibroadenoma
Fibroadenosis
Cancer
Mastalgia
0a
single
Ans. (a) Fibroadenoma(Ref. Bailey and Love 27th edition Page 870)* Fibroadenoma (Breast mouse) is mc in young females, painless and freely mobile with Firm Indian rubbery consistency
Surgery
Breast
fe70baca-5733-467f-a0cb-669b35bf2d70
Keratomalacia
Occurs due to Vitamin A deficiency
Relative Benign condition
First feature of Vitamin A deficiency
Also seen in retinitis pigmentosa
0a
single
Night blindness is a first feature of Vitamin A deficiency and is also a feature of retinitis pigmentosa Refer: Khurana 6th edition page number 468
Ophthalmology
Conjunctiva
a49ba38c-2090-4bbe-9d63-bd56e4d74024
Anticipation is seen in?
Translocation
Chromosome breaking
Trinucleotide - repeat expansion
Mitochondrial mutation
2c
single
Ans- (c) Trinucleotide - repeat expansionRef: Robbin's pathology 9th ed. /168* Anticipation is a phenomenon where by the symptoms of a genetic disorder become apparent at an earlier age as it is passed to next generation. In most cases, an increased severity of symptoms is also noted.* In triplet nucleotide repeat mutation, the DNA fragment is unstable and tends to expand further during cell division.So, in successive generations the expanded repeat increases and the manifestations of disease may worsen or may be observed at an earlier age; this phenomenon is referred to as anticipation.
Pathology
Cytogenetic Disorders
4498b3cf-9730-4da6-bbf1-9b5154fbc0b6
Hearing loss of 65dB, what is the grade of deafness-
Mild
Moderate
Severe
Moderately severe
3d
single
Ans. is 'd' i.e., Moderately severe o WHO recommended the following classification on the basis of pure tone audiogram.Hearing threshold in better ear (average of 500,1000,2000Hz)Degree of impairment (WHO classification)Ability to understand speech0-25Not significantNo significant difficulty with faint speech2640MildDifficulty with faint speech.41-55ModerateFrequent difficulty with normal speech.56-70Moderately severeFrequent difficulty even with loud speech71-91SevereCan understand only shouted or amplified speechAbove 91ProfoundUsually cannot understand even amplified speech
ENT
Ear
afad3bfc-429c-47ac-89a9-11c4f2ce5bbb
False about Varicocele is?
Dilated pampiniform plexus veins
More common on right side
Doppler USG is best investigation
Abnormality increases on Valsalva
1b
multi
Ans BVaricocele - The left testicle is affected much more commonly ([?]85%) than the right. This may be due to the shorter course of the right testicular vein and its oblique insertion into the IVC which creates less backpressure. Isolated right varicoceles are rare and should prompt evaluation for a secondary varicocele.
Radiology
Genito Urinary System
cec8fbfd-5c22-44a1-bcee-a932e3896429
All of the following are true about incidence of retinoblastoma except:
Is the most common intraocular tumour of childhood
Occurs in 1 in 14000-34000 live bihs
No sex predisposition
More common in negroes than whites
3d
multi
Ans. More common in negroes than whites
Ophthalmology
null
8972a2fc-e874-4d27-ac8a-3b3346b005e1
The structural proteins are involved in maintaining the shape of a cell or in the formation of matrices in the body. The shape of these protein is:
Globular
Fibrous
Stretch of beads
Planar
1b
single
Ans. B. FibrousBased on the shape of protein are classified into:Fibrous Protein#Elongated or Needle shaped or long cylindrical or rodlike a Minimum Solubility in water#Regular Secondary Structure#Axial Ratio >10#They are Structural Proteins, e.g. Collagen, Elastin, KeratinGlobular Proteins#Spherical or oval or Spheroidal in shape#Easily Soluble#Axial Ratio <3#They perform dynamic functions, e.g. Albumin, Globulin, most enzymes
Biochemistry
Proteins and Amino Acids
2e69a244-26c7-439e-83a2-5a1e550a3f46
A sewage worker presnets to the Emergency depament with fever and jaundice. Laboratory findings reveal an elevated BUN and serum craetinine suggestive of renal failure. Which of the following antibiotics is recommended?
Coctrimaxozole
Erythromycin
Ciprofloxacin
Penicillin G
3d
single
<p> It is a case of leptospirosis and the drug of choice is penicillin. Reference:Park&;s textbook of preventive and social medicine,K.Park,23rd edition,page no:292. <\p>
Social & Preventive Medicine
Communicable diseases
c0c80d82-6b8a-453c-9e7f-944003f7f930
Which of the following is seen in iridodialysis: September 2009
Biocular diplopia
Degenerative condition
Iris is torn away from its ciliary attachment
Normal pupil
2c
single
Ans. C: Iris is torn away from its ciliary attachment In iridodialysis there is rupture of the iris at its iris root and it frequently occurs following blunt trauma or penetrating injuries to the globe. Clinical features: A. Symptoms: Minimal with small iridodialyses With larger iridodyalises, patients may experience double pupil effect, monocular diplopia, glare and phophobia B. Signs: Commonly associated with hyphema and an irregular pupil (D-shaped pupil) May be single or multiple, small or extensive radially Damage of the trabecular meshwork and peripheral anterior synechiae may cause 10P elevation C. Management: Bed rest and observation. Sunglasses, tinted contact lenses or those with aificial pupil may help reduce the symptoms. Surgical repair may be considered in cases of large dialyses or persistent monocular diplopia
Ophthalmology
null
44f4aa0b-21a2-4b26-9801-20593f9b3893
Hernia not related to abdominal wall:-
Amyand's hernia
Richter's hernia
Little's hernia
Peterson hernia
3d
multi
Amyand's hernia - content is appendix Little's hernia - content is Meckel's diveiculum Richter's hernia - Herniation of pa of circumference of bowel - Mimics acute gastro enteritis Peterson hernia - Type of internal hernia - Hernia behind Roux - LIMB, After Roux-en-y gastrojejunostomy
Surgery
JIPMER 2019
cc0c14a0-269d-4616-97fb-faf9a159926b
Lingual bar is:
Maxillary major connector
Direct retainer
Indirect retainer
None of the above
3d
multi
null
Dental
null
b379aa86-a5f0-4ce4-8585-7df217c612d4
Which among the following causes staining of burnt area
Sulfamylon
Povidone iodine
Silver nitrate
Mafenide
2c
single
Silver nitrate causes staining of burnt area.
Surgery
null
e38361f7-417a-4e72-b6c5-dac78df8b09e
Most common type of emphysema is-
Centriacinar
Obstructed
Distalacinar
Panacinar
0a
single
Ans. is A Centriacinar Types of emphysema 1) Centriacinar (centrilobular) emphysema o Centriacinar emphysema is the most common type of emphysema seen clinically. It is chracterized by involvement of respiratory bronchioles, i.e. central (proximal) part of the acinus. Occurs predominantly in heavy smokers and usually coexists with chronic bronchitis. 2) Panacinar (Panlobular) emphysema o The acini are uniformly enlarged from the level of the respiratory bronchiole to the terminal blind alveoli. This type of emphysema is associated with al-antitrypsin deficiency. 3) Distal acinar (Paraseptal) emphysema o This type of emphysema involves distal part of the acinus, while proximal part is normal.This type of emphysema is a common cause of spontaneous pneumothorax in young adults 4) Irregular emphysema (Para-cicatricial emphysema) o The acinus is involved irregularly and is almost invariably associated with scarring. It is the most common type of emphysema histologically Remember o Most common type of emphysema is irregular emphysema, but it is not clinically significant as most patients are asymptomatic and it is only an autopsy finding. Most common type of emphysema seen clinically is centracinar emphysema.
Pathology
Obstructive Lung Diseases
2311efff-2902-4915-b252-0344041bf077
Egg yields about ________K cal of energy -
50
60
70
80
2c
single
<p> EGG Contain all the nutrients except carbohydrates and vitamin C. An egg weighing 60g contains 6g of protein, 6g of fat , 30 mg of calcium and 1.5 mg of iron, and supplies about 70 kcal of energy. Egg proteins have all the nine essential aminoacids needed by body in right propoions. Egg protein is the standard against which the quality of other proteins is compared. Except for vitamin C, egg contains all the fat soluble and water soluble vitamins in appreciable amounts. Impoant minerals such as calcium, phosphorous, iron, zinc, and other trace elements. NPU (Net protein Utilization) is 100 for egg . Boiling destroys avidin , a substance which prevents the body from obtaining biotin . {Reference: Park&;s textbook of community medicine 23 rd edition}
Social & Preventive Medicine
Nutrition and health
aa26906f-4243-46fa-b7f4-1d6c9b6dc2a9
In ca ovary inguinal lymph nodes are involved in stage
Stage II
Stage III a
Stage IIIc
Stage IVb
3d
single
FIGO revised the staging of carcinoma ovary in January 2014 and according to the new staging inguinal LN involvement is stage IV b.
Unknown
null
e330d0c7-278b-4cfc-ab77-8528947d02ef
Which of the following is calcivirus?
HEV
HBV
HCV
HAV
0a
single
Ans. (a) HEV According to Ananthanarayan 9/e, p 550 "HEV has been classified in genus hepesvirus under family calciviridae." But according to Harrison 18/e 2543 "HEV although resembling calicivirus is sufficiently distinct from any known agent to merit a new classification of its own as a unique genus; Hepevirus with in the family Hepeviridae."
Microbiology
null
90d55422-6805-4138-8797-a067a745729b
A 54-year-old man is brought to the emergency after experiencing several syncopal episodes. The patient states that he is currently taking erythromycin for treatment of bronchitis and another medication for treatment of gastroesophageal reflux disease (GERD). If an electrocardiogram reveals torsades de pointes, the patient is most likely taking which of the following medications for treatment of his reflux disease?
Cisapride
Famotidine
Lansoprazole
Metoclopramide
0a
single
This question is about an impoant drug interaction occurring between erythromycin and cisapride (used for gastroesophageal reflux disease- GERD). Serious cardiac arrhythmias, including torsades de pointes, QT interval prolongation, ventricular tachycardia, and ventricular fibrillation, have been repoed in patients taking cisapride with medications that inhibit cytochrome P450 3A4. Examples of medications other than cisapride that have a similar interaction with erythromycin include ketoconazole, fluconazole, clarithromycin, nefazodone, and indinavir. It is impoant to note that QT prolongation, torsades de pointes, cardiac arrest, and sudden death have occurred in patients taking only cisapride. None of the other agents listed interact with erythromycin to produce these proarrhythmic effects. Famotidine is an H2 receptor antagonist used in the treatment of GERD and gastric ulcers; this agent is generally well tolerated with very little incidence of drug interactions. Lansoprazole is a proton pump inhibitor indicated for the treatment of gastric ulcerations and GERD. When this agent is administered with phenytoin, the clearance of phenytoin is decreased by 15%, leading to an extension of the therapeutic effect. Metoclopramide is a prokinetic agent indicated for the treatment of GERD and diabetic gastroparesis. When given with cyclosporine, the toxic effects of cyclosporine are more pronounced. Fuhermore, when metoclopramide is administered with levodopa, it decreases the effectiveness of levodopa.
Pharmacology
null
a2c6d442-01c4-4961-b88e-fb2ee891405e
Critical temperature of oxygen is?
20
118
36.5
400C
1b
single
Ans. is 'b' i.e., -118
Anaesthesia
null
863ce436-7513-470c-8b4e-bb4f4e9f5708
Cause of U/L secretory otitis media in an adult is -
CSOM
Nasopharyngeal carcinoma
Mastoiditis
Foreign body of external ear
1b
single
Unilateral serous otitis media in an adult should always raise the suspicion of a benign / malignant tumor of nasopharynx “In adults presenting with a unilateral middle ear effusion the possibility of a nasopharyngeal carcinoma should be considered”. Ref. Dhingra 5/e, p 72, 6/e, p 251; Current Laryngology 2/e, p 659
ENT
null
e4ba25b1-2be8-4d30-b095-c3ddc931cc4c
A 26 year old third_gravida mother delivered a male baby weighing 4-2 kg at 37 weeks of gestation through an emergency caesarean section, for obstructed labour. The child developed respiratory distress one hour after bih. He was kept nil per orally (NPO) and given intravenous fluids. He maintained oxygen saturation on room air. No antibiotics were given. Chest radiograph revealed fluid in interlobar fissure. Respiratory distress settled by 24 hours of life. What is the most likely diagnosis ?
Transient tachypnea of the newborn
Meconium aspiration syndrome
Persistent fetal circulation
Hyaline membrane disease
0a
multi
Ans. is 'a' i.e., Transient tachypnea of newborn o Respiratory distress, which resolves within 24 hours without any respiratory suppo and fluid in interlobar fissure on chest X-ray suggest the diagnosis of TTN.
Pediatrics
null
359f22bf-fbd2-4397-8aa1-66b48b707ab6
Five-day self subsiding pain is diagnostic of -
Anal fissure
Fistul-in-ano
Thrombosed external hemorrhoids
Thrombosed internal hemorrhoids
2c
single
null
Surgery
null
51918895-86df-47fc-93cc-07dc4f70cf86
Vagal stimulation of hea causes? (irrelevant to pharmacology)
Increased hea rate
Increased RR interval in ECG
Increased cardiac output
Increased force of contraction
1b
single
Increased RR interval is seen in ECG on vagal stimulation. Normal values for waves and intervals are as follows: RR interval: 0.6-1.2 seconds. P wave: 80 milliseconds. ... QT interval: 420 milliseconds or less if the hea rate is 60 beats per minute (bpm) Ref: KD Tripathi 8th ed.
Pharmacology
Cardiovascular system
c30fb439-41ee-41f0-9afa-ebf6c59fd1a6
A patient of CSOM has choleastatoma and presents with vertigo. Treatment of choice would be -
Antibiotics and labyrinthine sedative
Myringoplasty
Immediate mastoid exploration
Labyrinthectomy
2c
single
The patient is presenting with CSOM and vertigo which means cholesteatoma has led to fistula formation involving semicircular canals which in turn has caused vertigo. So the management is immediate mastoid exploration to remove the cholesteatoma.
ENT
null
2de5f736-1fad-496b-95b4-3bab1e062206
Metabolically most active layer of cornea is:
Endothelium
Stroma
Descemet's membrane
Epithelium
3d
multi
Ans. Epithelium
Ophthalmology
null
c4cb3b32-9f33-4805-a082-60b973cb93f3
Octreotide is used in all except:
Insulinoma
Glucagonoma
Glioma
Carcinoids
2c
multi
Ans. c. GliomaOctreotide is a synthetic analogue of somatostatin and its pharmacological actions are similar to somatostatin, used in insulinoma, glucagonoma and carcinoid tumors but not in glioma."Somatostatin is a hypothalamic peptide that regulates the function of several endocrine and exocrine glands.Somatostatin acts primarily as a negative regulator of a variety of different types of cells blocking processes such as cell secretion, cell growth and smooth muscle contraction. It is secreted from the hypothalamus into the portal circulation and travels to the anterior pituitary gland where it inhibits the production and release of both growth hormone and thyroid stimulating hormone: Somatostatin is present in many tissues other than hypothalamus. It is also secreted by the cells in the pancreas and in the intestine where it inhibits the secretin of variety of hormones. " Action of Somatostatin BrainGITPancreasInhibits the release of:* Growth hormone* Thyroid stimulating hormoneInhibits the release of:* Gastrin* Chofecystokinin* Secretin* Motilin* Vasoactive intestinal polypeptide* Gastric inhibitory polypeptideInhibits the release of:* Insulin* Glucagon"By virtue of its pharmacological actions. Octreotide has been used to treat the symptoms associated with metastatic carcinoid tumors (flushing and diarrhea) and vasoactive intestinal peptide (VIP) secreting adenomas."Octreotide* Most widely used somatostatin analogue* Preferentially binds to SSTR-2 and SSTR-5 receptors* Administered subcutaneously; Peak effects within 30 minutes* Half life: 90 minutes; Duration of action: 12 hours* Adverse reactions: Nausea, abdominal pain and gall stones0Indications* Decreases GH secretion (indicated in acromegaly)* Decreases TSH secretion (indicated in thyrotrope adenomas)* Decreases insulin (indicated in insulinoma)* Decreases glucagon (indicated in glucagonoma)* Secretory diarrhea* Variceal bleeding* Pancreatitis* Intestinal dysmotilityBy virtue of its pharmacological actions, Octreotide has been used to treat the symptoms associated with metastatic carcinoid tumors (flushing and diarrhea) and vasoactive intestinal peptide (VIP) secreting adenomas.
Pharmacology
Endocrinology
4272d3d3-fa0b-4062-a778-259c34e3ba3d
The periodontal pocket principally contains
Living and degenerated leucocytes
Microorganisms, their products and debris
Gingival fluids and salivary mucin
Desquamated epithelial cells
1b
multi
null
Dental
null
e48f5735-1d19-4692-a97a-1146afed10b9
Sensitivity means the ability to detect -
True negative
True positive
False negative
False positive
1b
multi
For easy to remember : Sensitivity → "I know my patient has the disease. What is the chance that the test will show that my patient has it". Specificity → "I know my patient doesn't have the disease. What is the chance that the test will show that my patient doesn't have it".
Social & Preventive Medicine
null
7e7bbed8-5541-4413-be69-f57d069f422a
The following deformity is seen characteristically in
Osteoahiritis
Rheumatoid ahiritis
Ankylosing spondylitis
Psoriatric ahiritis
1b
multi
Deformities of Rheumatoid ahritis Swan-neck deformity: flexion posture of the DIP and hyperextension posture of the PIP joints. Buttonhole or Boutonniere Deformity: PIP in flexion, DIP in hyperextension. Wind sweep deformity: hallux valgus on one side & hallux varus on another side- produce deformity which is parallel to each other. Intrinsic plus deformity: caused by tightness and contracture of the intrinsic muscles, seen in RA, Cerebral palsy etc. Here the IP joints are in extension & MCP joints are in flexion. Z deformity: Radial detion of the wrist joint with ulnar detion of MCP joints. Pannus may form in RA, with underlying cailage destruction. With time, synol fibrosis occurs, resulting in joint stiffness Ref : Maheshwari 6e pg 282.
Orthopaedics
All India exam
80073c6e-5af6-42c0-894f-d4530305f982
Alpha feto protein is elevated in what percentage of children with hepatoblastoma:
10%
50%
90%
100%
2c
single
Most liver function test results are normal. Alpha-fetoprotein levels are increased in 90% of children with hepatoblastomas but are elevated much less commonly in children with other liver malignancies. Ref: Schwaz's principle of surgery 9th edition, chapter 39.
Surgery
null
22794b57-95eb-4390-afea-f3491a4e9a91
All of the following statements about Phenytoin are true, Except:
Follows saturation kinetics
Is teratogenic
Is highly protein bound
Stimulates Insulin secretion
3d
multi
Phenytoin inhibits the release of insulin and cause hyperglycemia. Ref: Essentials of Medical Pharmacology By KD Tripathi, 5th Edition, Page 372, 373.
Pharmacology
null
8d2df97c-8957-4663-aa35-db5f27a7103c
A 72-year-old man is newly diagnosed with bullous pemphigoid. Which of the following is the most appropriate next step in the management?
plasmapheresis
low-dose prednisone (10-20 mg/day)
high-dose prednisone (50-100 mg/day)
azathioprine (150 mg/day)
2c
multi
Severe cases require systemic steroids, often with the addition of azathioprine. Dapsone is useful in mild cases, and occasionally in very mild cases (or for local recurrences) topical glucocorticoid therapy will suffice.
Medicine
Skin
2887fff7-b273-44d5-b569-d57636acc1bb
Phantom limp sensation are best described by
Weber Fechner law
Power law
Bell-Magendie law
Law of projection
3d
single
Ans. (d) Law of projection(Ref: Ganong, 25th ed/p.171)Law of projection:This law states that "No matter where a particular sensory pathway is stimulated along its course to the cortex, the conscious sensation produced is referred to the location of the receptor"This law explains phantom pain wherein Some of these patients may complain of pain and proprioceptive sensations in the absent limb following amputation
Physiology
Nervous System
3c64c493-7bd7-4f55-a87f-f6a416ca58c9
Fusion inhibitor is-
Enfuvirtide
Ritonavir
Efavirenz
Didanosine
0a
single
Ans. is 'a' i.e., Enfuvirtide New drugs in HIV infection o Etravirine is recently approved NNRTI. This is the second generation NNRTI and is effective against HIV resistant to first generation NNRTI (Efavirenz, Delavirdine. Nevirapine). Fusion inhibitors (Entry inhibitors) o Enfuvirtide binds to Gp41 subunit of HIV envelop protein and inhibits the fusion of viral and host cell membrane. o Maraviroc is a CCR5 Co-receptor antagonist and is only active against "CCR - 5 - tropic virus" which tends to predominate early in infection. Integrase inhibitors o Raltegravir and Elvitegravir act by inhibiting enzyme integrase.
Unknown
null
98a1d642-fe07-4eab-9878-927f41499308
Complication of Rheumatoid arthritis of condyle is
Fibrous ankylosis
Subluxation
Dislocation
None of above
0a
multi
null
Pathology
null
8da3e39f-7fe3-45b8-931a-9f9e035e846b
All of the following are Water Borne Diseases except ?
Scabies
Salmonella
Cholera
Hepatitis - A
0a
multi
Public Health Classification of Water Borne Diseases: Water borne diseases - Illnesses caused by micro-organisms, d/t drinking of untreated or contaminated water Typhoid Cholera Hepatitis- A E.coli Salmonella Water washed diseases - Infections that are caused by poor personal hygiene resulting from inadequate water availability. Conjunctivitis Trachoma Shigellosis, Scabies Typhus Water based diseases - Caused by parasites that spend pa of their life cycle in water. Dracunculiasis or Guinea worm disease Water breeding diseases - Insect related diseases which breed in water Malaria Dengue Filariasis (Mansonia) Trypanosomiasis Yellow fever
Social & Preventive Medicine
Water
b0a19de2-f676-4ad3-a279-7b4ad27fbd55
ADH is released from: March 2013
Anterior pituitary
Posterior pituitary
Hypothalamus
Intermediate pituitary
1b
single
Ans. B i.e. Posterior pituitaryArginine vasopressin (AVP)/Vasopressin/Argipressin/Antidiuretic hormone (ADH)It is a neurohypophysial hormone.It is derived from a preprohormone precursor that is synthesized in the hypothalamus and stored in vesicles at theposterior pituitary.Its two primary functions are to retain water in the body and to constrict blood vessels.Vasopressin regulates the body's retention of water by acting to increase water absorption in the collecting ducts of the kidney nephron
Physiology
null
3720c5c5-f7c6-4820-bbd6-8583ce7ceaa1
Case control study is-
Prospective
Retrospective
Cross sectional
None of the above
1b
multi
.<p>case control studies are usually retrospective studies that proceed from an effect to a cause.</p><p>ref:park&;s textbook of preventive and social medicine,22 nd edition ,pg no 131</p>
Social & Preventive Medicine
Epidemiology
0ee68dcf-42a7-4c5f-9b24-e86776afec5f
Cystitis is most commonly caused by
E. coli
Pseudomonas
Proteus mirabilis
Neisseria gonorrhea
0a
single
(E. coli): Ref: 173-S* The organisms found in urine in cystitis are the E. coli, streptococci, staphylococci and B. proteus, the tubercle bacillus, and occasionally pseudomonas pyocyanea, Gonococcal cystitis is relatively rare, and almost invariably follows instrumentation.* The organism which is found most frequently is the E. coli* As the result of antibiotic treatments Pseudomonas, pyocyanea sometimes become the dominant infecting organism because of its resistance to antibiotics relative to the other infecting organisms.
Gynaecology & Obstetrics
Miscellaneous (Gynae)
5bc91493-e1f5-4919-8b64-1933fa23a5fa
The facial muscle responsible for frowning:
Zygomaticus major
Corrugator supercilii and procerus
Dilator naris and depressor septi
Depressor anguli oris
1b
single
null
Anatomy
null
bdac0e9e-9d4e-49aa-90bf-2c1554e13c9f
Inversion & Eversion of foot occurs at which joint?
Subtalar joint
Tibiotalar joint
Inferior tibiofibular joint
Tarso-metatarsal joint
0a
single
#NAME?
Anatomy
Bones and Joints
1d509422-d76b-46a0-a43d-875b932f738d
The head quaers of UNESCO is located in
New Delhi
Geneva
Paris
New York
2c
single
The United Nations Educational, Scientific and Cultural Organization (UNESCO is a specialized agency of the United nations (UN) based in Paris , France. Its declared purpose is to contribute to promoting international collaboration in education, sciences, and culture in order to increase universal respect for justice, the rule of law , and human rights .
Social & Preventive Medicine
All India exam
83af0f7b-253a-4e27-8754-0685707c6ea1
A young pregnant mother at 32 weeks gestation presents in preterm labor. Antenatal steroid to induce fetal lung maturity is indicated in all of the following conditions, EXCEPT:
Prolonged rupture of membranes for more than 24 hrs
Pregnancy induced hypeension
Diabetes mellitus
Chorioamnionitis
3d
multi
Patient in the clinical scenario is in preterm labour. For patients in 32 weeks of gestation, steroids are given to induce lung maturity. But if the patient is having chorioamnionitis, steroids are contraindicated, as steroids can accelerate the infection. Chorioamnionitis can be diagnosed clinically by the presence of maternal fever, tachycardia and uterine tenderness. When this is diagnosed, fetal and maternal morbidities increase and delivery is indicated, regardless of the fetal gestational age. Ampicillin is the drug of choice to treat group B streptococcal infection. Ref: Williams Obstetrics, 22nd Edition, Pages 864-5 ; Textbook of Obstetrics By DC Dutta, 6th Education, Pages 317-8
Gynaecology & Obstetrics
null
444b4571-c88a-447e-b066-4103d7fea143
Trochlear nerve all true except
Longest intracranial course
Arises from dorsum of brainstem
Supplies ipsilateral superior oblique muscles
Enter orbit though sup orbital fissure outside annulus of Zinn.
2c
multi
Trochlear nerve is thinnest nerve. It is the only nerve to emerge from dorsum of brain stem has longest intracranial course. It enters orbit through outer part of superior orbital fissure (ie lateral to annulus of Zinn) and supplies superior oblique muscle. Because it's a crossed cranial nerve (with decussation in mid brain), the trochlear nerve nucleus supplied contralateral superior oblique muscle.
Anatomy
null
7655f703-3028-4ffb-8da9-c37bf1aeed4d
Gardener&;s syndrome is a rare hereditary disorder involving the colon. It is characterized by
Polyposis colon, Cancer thyroid, skin tumours
Polyposis is jejunum, pituaitary adenoma and skin tumours
Polyposis colon, osteomas, epidermal inclusion cysts and fibrous tumours in the skin
Polyposis of gastrointestinal tract, cholangiocarcinoma and skin tumours
2c
single
.GARDNER'S SYNDROME * It is commonly associated with FAP - 10%. * Presents with bone, skin, soft tissue and dental abnormalities. Jaw osteomas are very common. Other features are epidermoid cysts (50%), exostoses, fibromas, lipomas. * Associated with desmoid tumours seen in the scar, abdomen, intraabdominal region and mesenteric fibromatosis. * Congenital hyperophy of pigment layer of retina (seen as pigment spots)--commonly seen. * Often associated with MEN IIb syndrome. ref:SRB&;s manual of surgery,ed 3,pg no 834
Surgery
G.I.T
734a8e8e-f6e2-44b2-aacd-5d0e8e69a926
Surgical alteration or suturing of gunshot wounds may create problems in distinguishing entry from exit. This is called as: AIIMS 13
Formication phenomenon
Gordon phenomenon
Cookie cutter phenomenon
Kennedy phenomenon
3d
multi
Ans. Kennedy phenomenon
Forensic Medicine
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235b711f-50d6-4ebe-bc77-15f5ebf19b58
Treatment of choice for annular pancrease is
Division of pancreas
Duodenoduodenostomy
Duodenojejunostomy
Roux-en-Y loop
1b
single
Pancreatic ring surrounds the second or third pa of duodenum. The usual treatment is duodenoduodenostomy. Bailey & Love ,26th,1125
Surgery
G.I.T
313427b1-7ec6-437b-9fd4-b4cc5a70972a
An old lady was brought to the ER in an unconscious state. She has a history of previous such attacks in the past months. An ECG was done and the graph obtained is given below. Which of the following is most probable cause?
PSVT
Atrial flutter
Ventricular bigeminy
2 :1 block
3d
single
Ans. D. 2:1 blockElectrocardiography and Electrophysiology of AV conduction blockAV conduction block typically is diagnosed electrocardiographically, which characterizes the severity of the conduction disturbances and allows one to draw inferences about the location of the block. AV conduction block manifests as slow conduction in its mildest forms and failure to conduct, either intermittent of persistently, in more severe varieties.a. First degree AV block (PR interval >200ms) is a slowing of conduction through the AV junction. The site of delay is typically in the AV node but may be in the atria, bundle of his, or his Purkinje system. A wide QRS is suggestive of delay in the AV node proper or less commonly in the bundle of His. In second degree AV block there is an intermittent failure of electrical impulse conduction from atrium to ventricle.b. Second degree AV block is sub classified as Mobitz type I (Wenckebach) or Mobitz type II. The periodic failure of conduction in Mobitz, type I block is characterized by a progressively lengthening PR interval, shortening of the RR interval, and a pause that is less than the two times the immediately preceding RR interval on the electrocardiogram (ECG). The ECG complex after the pause exhibits a shorter PR interval than that immediately preceding the pause. This ECG pattern most often arises because of decremental conduction of electrical impulses in the AV node.
Medicine
C.V.S.
bddcce3a-b518-403c-aad1-7255451bc2be
Syndrome of apparent mineralocoicoid excess is due to?
Increased aldosterone production
Lack of inactivation of aldosterone
Increased coisol production
Lack of Inactivation of coisol to coisone
3d
single
Coisol can stimulate mineralocoicoid receptors. But renal inactivation of coisol occurs to form coisone and thereby BP remains normal. SAME (Syndrome of Apparent Mineralocoicoid Excess) leads to lack of this inactivation. The resultant increase in coisol leads to excess activation of mineralocoicoid receptor and results in hypeension.
Medicine
Disorders of Adrenal Gland
cd7841f9-7f5e-484e-bb4f-95d249a1c5e9
First sign of compament syndrome is ?
Pain
Tingling
Loss of pulse
Loss of movement
0a
single
Ans. is 'a' i.e., Pain Clinical features of compament syndrome Four signs are reliable in diagnosing a compament syndrome :- Paresthesia or hypesthesia in nerves traversing the compament Pain with passive stretching of the involved muscles (stretch pain) Pain with active flexion of the muscles Tenderness over the compament Amongst these, stretch pain is the earliest sign of impending compament syndrome. The ischemic muscles, when stretched, give rise to pain. Passive extension of fingers (streching the fingers) produce pain in flexor compament of forearm. Other features are Pulselessness, paralysis, Pallor and pain out of propoion to physical findings. Peripheral pulses, are present initially and disappear later. Therefore, pulse is not a reliable indicator for compament syndrome.
Surgery
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8b726796-16b2-4778-9185-89e74f04bf8b
Apa from T & B lymphocytes, the other class of lymphocytes is -
Macrophages
Astrocytes
NK cells
Langerhans cells
2c
single
Lymphocytes include natural killer cells (NK cells) (which function in cell-mediated, cytotoxic innate immunity), T cells (for cell-mediated, cytotoxic adaptive immunity), and B cells (for humoral, antibody-driven adaptive immunity). Reff: Ananthanarayanan & panikers textbook of microbiology 9th edition pg:132
Microbiology
Immunology
5d63da57-3ddf-46da-b984-556b7d0627ac
Damage to median nerv e produces -
Claw hand
Winging ofscapule
Ape thumb
Wrist drop
2c
single
Ans. is 'c' i.e., Ape thumbDeformity' or disorderNerve involvedo Wrist dropo Radial nerveo Foot dropo Common peroneal nerve (Lateral popliteal)o Claw hand (complete)o Ulnar + Median nerveo Ulnar claw hando Ulnar nerveo Ape thumb deformityo Median nerveo Pointing indexo Median nerveo Policeman tip deformity'o Erb's Palsy (Brachial plexus)o Winging of scapulao Long thoracic nerve (nerve to SA)o Meralgia parestheticao Lateral cutaneous nerve of thigh
Orthopaedics
Peripheral Nerve Injuries
1595eb3e-d189-4dec-b037-d6ddea724c48
A 31-year-old patient complains of sensory loss over the anterior and posterior surfaces of the medial third of the hand and the medial one and one-half fingers. He is diagnosed by a physician as having "funny bone" symptoms. Which of the following nerves is injured?
Axillary
Radial
Median
Ulnar
3d
single
Ulnar nerve supplies sensory fibers to the skin over the palmar and dorsal surfaces of the medial third of the hand and the medial one and one-half fingers. Funny bone sensation is irritation of a nerve at the elbow that causes numbness and tingling of the inner elbow, forearm as well as little and ring fingers Median nerve innervates the skin of the lateral side of the palm; the palmar side of the lateral three and one-half fingers; and the dorsal side of the index finger, the middle finger, and one-half of the ring finger. Radial nerve innervates the skin of the radial side of the hand and the radial two and one-half digits over the proximal phalanx.
Anatomy
Nerve supply, Nerve Lesions
2ca21986-5f8c-4ba9-93ce-bf2b8df85882
A 6 year old female patient complains of pain due to a decayed lower right 2nd molar. She has a history of unpleasant dental extraction with the lower left second molar. On seeing the dentist, the child immediately cries and withdraws. Which theory of child psychology best explains the reaction of the patient?
Operant conditioning by Skinner (1938)
Classical conditioning by Pavlov (1972)
Classical conditioning by Pavlov (1927)
Operant conditioning by Skinner (1952)
2c
single
Classical conditioning (1927) occurs readily with young children and can have a considerable impact on a young child's behavior on the first visit to a dental office. By the time a child is brought for the first visit to a dentist, even if that visit is at an early age, it is highly likely that he or she will have had many experiences with pediatricians and medical personnel. When a child experiences pain, the reflex reaction is crying and withdrawal. In Pavlovian terms, the infliction of pain is an unconditioned stimulus, but a number of aspects of the setting in which the pain occurs can come to be associated with this unconditioned stimulus. For instance, it is unusual for a child to encounter people who are dressed entirely in white uniforms or long white coats. If the unconditioned stimulus of painful treatment comes to be associated with the conditioned stimulus of white coats, a child may cry and withdraw immediately at the first sight of a white-coated dentist or dental assistant. In this case, the child has learned to associate the conditioned stimulus of pain and the unconditioned stimulus of a white-coated adult, and the mere sight of the white coat is enough to produce the reflex behavior initially associated with pain Note: A) Acquisition – learning a new experience (fear of dentist/whitecoat/needles)            B) Generalization – generalizing all similar stimuli (all those wearing white coat cause pain)            C) Discrimination – differentiating individual stimuli ( not everyone who wears white coat causes pain)            D) Extinction - disappearance of the acquired experience ( loss of fear of dental procedures)            E) Spontaneous recovery – reappearance of extinct response ( fear of dental procedure reappears due to poor management behaviour strategies).
Dental
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