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9399121c-1b6d-4df0-9538-77c0bfb0c301 | Initial amino acid in prokaryotic protein synthesis ? | Arginine | Methionine | Formyl-methionine | Alanine | 2c
| single | Ans. is 'c' i.e., Formyl-methionine | Biochemistry | null |
c502b189-722a-411f-8beb-0f0a4faa9896 | "Tear drop" sign on X-ray PNS is seen in | Blow out fracture of the floor of the orbit | Comminuted fracture of the maxilla | Fracture of the nasal bone | Fracture of the mandible | 0a
| single | Ans. a (Blow out fracture of the floor of the orbit) (Ref. Grainger Diagnostic Rad 4th/2527; Ref . Q. 159. Of MH-2207)BLOW-OUT FRACTURE is caused by fracturing of the orbital walls with herniation of orbital contents and subsequent tethering of the globe, resulting in pain and diplopia. It usually involves the orbital floor with 'trap-door deformity' on skull AP view or characteristic "Tear drop" sign on X-ray PNS.Also Know:# Tripod Fracture: zygomaticomaxillary fracture# "pyramidal" fracture = Le Fort II fracture (fracture medial orbital and lateral maxillary walls).# Bare orbit sign: Neurofibromatosis# Coke-bottle sign: thyroid ophthalmopathy# "Mushroom-shaped" posterior segment mass: choroidal melanoma# Calcification is pathognomonic of: Retinoblastoma# Most common intraorbital tumor in adults: Cavernous hemangioma. | ENT | Nose and PNS |
204d5328-da8f-4ae6-8e91-7b4cafa01289 | Which classification is used to divide the liver into segments? | Couinaud | Muhe | Starzl | Anatomical | 0a
| single | Ans. (a) Couinaud'sRef: Bailey and Love 26th edition page 1066* Couinaud divided the liver into multiple segments- 8 segments* He is a French Anatomist | Surgery | Liver |
8980a262-df85-4c2a-a508-c8975cb3dcdf | In a patient with compensated liver cirrhosis presented with history of variceal bleed. The treatment of choice in this patient is - | Propranolol | Liver transplantation | TIPS (Transjugular intrahepatic poal shunt) | Endoscopic sclerotherapy | 3d
| single | When a cirrhotic patient presents with upper GI bleed, the single most impoant diagnostic as well as therapeutic procedure to be performed is endoscopy (although after intravenous fluid resuscitation and correction of coagulation abnormalities) If varices are found they are treated by either Endoscopic variceal ligation or Endoscopic Sclerotherapy Endoscopic variceal ligation is now the t/t of choice (has replaced sclerotherapy) Ref : Schwaz 9/e p1113 | Anatomy | G.I.T |
c630a539-d29a-4e01-9a3f-19af15384684 | During an emergency thoracotomy, the incision is made > 1cm lateral to the sternal margin. This will preserve which of the following structures? | Intercostal aery | Superficial epigastric aery | Internal mammary aery | Intercostal vein | 2c
| single | In case of anterolateral thoracotomy, which is usually a transverse or a veical incision staing from fouh intercostal space, incision is made lateral to sternal in order to avoid injury to the adjacent vessels which include internal mammary aery. Superficial epigastric aery is the terminal branch of internal mammary aery and hence not at a risk in emergency thoracotomy. Intercostal vessels lie parallel to rib margin and hence not injured near sternal margin. Ref: General Thoracic Surgery, Volume 1 edited by Thomas W. Shields, Joseph LoCicero, Carolyn E. Reed, Richard H. Feins, Volume 1, Page 394 | Surgery | null |
c21b2211-2b4f-4cc3-a3c6-31817a867e4f | Causative organism of rheumatic fever - | Group A Streptococci | Staphylococci | Group B Streptococci | Group D Streptococci | 0a
| single | Ans. is 'a' i.e., Group A Streptococci Rheumatic fevero Rheumatic fever (RF) is an acute, inununologically mediated, multisystem inflammatory disease classically occurring a few weeks after an episode of group A streptococcal pharyngitis; occasionally, RF can follow streptococcal infections at other sites, such as the skin. | Pathology | Rheumatic Fever |
bda4eeca-8d5a-418c-90ba-9a3c90fc01ba | Kliiver-Bucy syndrome is associated with lesion in the following area of brain | Amygdala | Cerebral cortex | Hippocampus | Mammillary body | 0a
| single | (A) Amygdala # Kliiver-Bucy syndrome is a behavioral disorder that occurs when both the right and left medial temporal lobes of the brain malfunction. People with lesions in their temporal lobes show similar behaviors.> They may display oral or tactile exploratory behavior (socially inappropriate licking or touching); hypersexuality; bulimia; memory disorders; flattened emotions (placidity)-, and an inability to recognize objects or inability to recognize faces.> The full syndrome rarely, if ever, develops in humans. However, parts of it are often noted in patients with extensive bilateral temporal damage caused by herpes or other encephalitis and dementias of degenerative or post-traumatic etiologies.> This disorder may be caused by many conditions, including facial or cerebral trauma; infections; Alzheimer's disease; Niemann Pick disease of the brain; or cerebrovascular disease. | Medicine | Miscellaneous |
c3653ee1-d4b3-4bd3-962b-fe81aeab98b9 | Surest sign of brain stem death | Absent Doll's eye reflex | Fixed dilated pupil not reacting to light | Cheyne Stokes breathing | Decerebrate posture | 1b
| single | B i.e. Fixed dilated pupil not responding to light Cooling of body & rigor mois is a sign of molecular or cellular death. - Somatic (systemic, clinical or brain) death is cessation of spontaneous breathing, circulation and brain activity (as indicated by flat isoelectric EEG, deep unconsciousness with no response to external stimuli or internal need). Surest sign of brain stem death is fixed dilated pupil not constricting (responding) to light.Q | Forensic Medicine | null |
af90d178-d794-4bfa-b083-fb3fd86e900b | Stereoanesthesia is due to lesion ofa) Nucleus Gracilisb) Nucleus cuneatusc) Cerebral cortexd) Spinothalamic tract | abc | bc | acd | bcd | 0a
| single | Astereognosis/Stereoanaesthesia- Loss of ability to recognize size and shape of an object.
Seen in- lesion of somatosensory cortex, lesion of tractus cuneatus, lesion of tractus gracilis.
Somatosensory cortex lesion- proprioception and tactile sensations are lost while pain and temperature sensations are preserved.
Tractus cuneatus- formed by fasciculus cuneatus (spinal cord) and nucleus cuneatus (medulla). Pass through lateral portion of dorsal column. Carries sensations of dorsal column- proprioception and tactile sensations from upper part of the body.
Tractus gracilis- formed by fasciculus gracilis (spinal cord) and nucleus gracilis (medulla). Pass through medial portion of dorsal column. Carries sensations of dorsal column- proprioception and tactile sensations from lower part of the body. | Physiology | null |
f8ce8f8d-88a7-4003-9cb0-08f86e620ccc | A 70-years old male presented with asymptomatic white patch on oral cavity following application of the denture. Treatment of choice is | Low does radiotherapy | Biopsy of the all the tissues | Asceaining that denture is fitted properly | Antibiotics | 2c
| multi | Leukoplakia regress spontaneously after stopping alcohol or tobacco consumption or correction of underlying cause | Anatomy | All India exam |
ca7c9a11-c130-4b26-a754-d55e4f9a6b16 | Radiological hallmark of primary tuberculosis in childhood is- | Ghon's focus | Normal chest Xray | Lymphadenopathy | Pleural effusion | 2c
| multi | Ans. is 'c' i.e., Lymph adenopathy Primary tuberculosis in childhoodo Primary' tuberculosis in childhood can present in 4 major ways in addition to the normal chest radiography. These are:LymphadenopathyLobar or segmental parenchymal diseasePleural effusionMilitary involvemento Lymphadenopathy with or without parenchymal abnormality' is the radiological hallmark of primary tuberculosis in childhood. | Radiology | Imaging of Alveolar Lung Disease |
37995a81-8832-4afc-bd52-48359786c5e7 | Positive shick's test indicates that person is ? | Immune to diptheria | Hypersensitive to diptheria | Susceptible to diptheria | Carrier of diptheria | 2c
| single | Ans. is 'c' i.e., Susceptible to diphtheria Shick test . Shick test is no longer in use. It was used for the susceptibility of for diphtheria. . It was an intradermal test, in which after intradermal injections of diphtheria toxin in one forearm (usually left) and toxoid in other forearm two readings were taken one at 24-48 hrs and second at 5-7 days. . Interpretation of the test : - Reaction in control arm indicates hypersensitivity - Reaction in test arm : at 24 - 48 hrs --> Hypersensitivity at 5 - 7 days --> Susceptibility Type of reaction Observation inference Negative reaction No reaction on either arm, (toxin neutralized by circulating antitoxin) No susceptibility No hypersensitivity Positive reaction No reaction on control arm, Circumscribed erythematous reaction caused by toxin on the test arm that persists. No hypersensitivity Susceptibility present Pseudoreaction Diffuse erythematous reaction on both areas, appearing with in 24 hrs and fading by 4 days. Combined reaction Both areas initially show Hypersensitivity present pseudoreaction followed by positive reaction on test arm Susceptibility present | Microbiology | null |
dd55dfdf-bd63-4eb6-a39c-8480fc69cbb2 | Dependency' ratio includes - | Less than 15 years | Less than85 years | 30-50 years | None | 0a
| multi | Ans. is 'a' i.e.. Less than 15 years Dependency ratiooThe proportion of persons above 65 years of age and children below 15 years of age are considered to be dependent on the economically productive age group {15-64 years).o The ratio of combined age group 0-14 years plus 65 years and above to the 15-65 years age group is known as total dependency ratio.o It is also referred to as the societal dependency ratio and reflects the need for a society to provide for their younger and older population groups. | Social & Preventive Medicine | Demography |
3baba3af-86c3-4a17-a72f-315e4d88ba99 | All the following are indications for termination of pregnancy in APH patient except: | 37 weeks | IUD | Transverse lie | Continuous bleeding | 2c
| multi | Ans. is c, i.e. Transverse lieRef. Dutta Obs. 7/e, p 249In these questions, there is no confusion about any option except for 'lie of the fetus'.As far as lie is concerned:Friends, why would you terminate pregnancy just because of unstable lie or transverse lie, unless and until there is some other complication associated with it. Transverse lie/unstable lie in a patient of placenta previa simply means that whenever termination of pregnancy is considered cesarean section has to be done. | Gynaecology & Obstetrics | Antepartum Haemorrhage |
a0bd58d7-b1af-4e90-95fc-03e2f2b1d99d | An eight-month-old female infant presented with recurrent episodes of hypoglycemia, especially if time interval of feeding is increased. Dicarboxylic acid is present in the urine. Urine ketone bodies is negative. The child responded well to IV Glucose, less fat and more carbohydrate diet, frequent feeding. The child was diagnosed to be MCAD deficiency. What is the reason for hypoglycemia? | Increased dicarboxylic acid inhibit glycogenolysis | Lack of ATP to support gluconeogenesis | Lack of acetyl-CoA to favour glycogenolysis | Glycogen stores are inadequate in infants | 1b
| multi | Ans. B. Lack of ATP to support gluconeogenesis* This is a case of MCAD deficiency.* Identifying features are:* Recurrent episodes of hypoglycaemia is time interval of feeding increased* Dicarboxylic acids in urine* Absence of ketone bodies in urine* Reasons for hypoglycemia are:* Due to MCAD deficiency, beta oxidation is affected. This is the source of ATP for gluconeogenesis, when glycogen stores are depleted. So lack of ATP is one reason* Due to lack of acetyl-CoA, which is released by beta oxidation. Acetyl-CoA is the activator of pyruvate carboxylase, one of the key enzymes of gluconeogenesis | Biochemistry | Carbohydrates |
eac94128-0363-4e60-a93a-80f2a4cd952b | Hypersensitivity vasculitis usually involve | Aerioles | Post capillary venules | Capillaries | Medium sized aeries | 1b
| multi | Refer robbins 9/e p510, 8/e 515 Harrison 7/2128 Direct quote from Harrison 18th /2798; Postcapillary venules are most commonly involved vessels. Capillaries and aerioles are less frequent involved | Anatomy | Cardiovascular system |
5b7e48f0-5c0e-41aa-8dc3-325244f33bae | Amino acid absorption is by: | Facilitated transport | Passive transport | Active transport | Pinocytosis | 2c
| single | Ans. C. Active TransportFree amino acids are absorbed across the intestinal mucosa by sodium-dependent active transport. There are several different amino acid transporters, with specificity for the nature of the amino acid side-chain.Transporters of Amino AcidsFor Neutral Amino acidsFor Basic Amino acids and Cysteine.For Imino Acids and GlycineFor Acidic Amino acidsFor Beta Amino Acids (Beta-Alanine)Meister's CycleFor absorption of Neutral Amino acids from Intestines, Kidney tubules and brain.The main role is played by Glutathione (GSH).For transport of 1 amino acid and regeneration of GSH 3 ATPs are required.Disorders associated with Meister's Cycle Oxoprolinuria5 Oxoprolinase deficiency leads to OxoprolinuriaDisorders associated with absorption of amino acidsHartnup's DiseaseMalabsorption of neutral amino acids, including the essential amino acid tryptophan SLC6A19, which is the major luminal sodium-dependent neutral amino acid transporter of small intestine and renal tubules, has been identified as the defective proteinBlue Diaper Syndrome or Drummond Syndrome IndicanuriaTryptophan is specifically malabsorbed and the defect is expressed only in the intestine and not in the kidney. Intestinal bacteria convert the unabsorbed tryptophan to indican, which is responsible for the bluish discoloration of the urine after its hydrolysis and oxidationCystinuriaDibasic amino acids, including cystine, ornithine, lysine, and arginine are taken up by the Na-independent SLC3A1/ SLC7A9, in the apical membrane which is defective incystinuri(a).Most common disorder associated with Amino acid malabsorptionLysinuric Protein Intolerance(SLC7A7) carrier at the basolateral membrane of the intestinal and renal epithelium is affected, with failure to deliver cytosolic dibasic cationic amino acids into the paracellular space in exchange for Na+ and neutral amino acidsOasthouse Urine Disease (Smith Strang Disease)A methionine-preferring transporter in the small intestine was suggested to be affected. Cabbage-like odor, containing 2-hydroxybutyric acid, valine, and leucineIminoglycinuriaMalabsorption of proline, hydroxyproline, and glycine due to the proton amino acid transporter SLC36A2 defectDicarboxylic AciduriaExcitatory amino acid carrier SLC1A1 is affected.Associated with neurologic symptoms such as POLIP (polyneuropathy, ophthalmoplegia, leukoencephalopathy, intestinal pseudo-obstruction | Biochemistry | Proteins and Amino Acids |
cf2b651f-066f-4354-836f-1b5e10eb6f46 | Hyponatremia in multiple myeloma is - | TRUE | Relative | Absolute | Pseudo | 3d
| multi | • Patients with multiple myeloma also have a decreased anion gap because the M component is cationic, resulting in retention of chloride.
• This is often accompanied by hyponatremia that is felt to be artificial (Pseudohyponatremia) because each volume of serum has less water as a result of the increased protein. | Surgery | null |
be937085-bdc9-4487-aea6-4b5b2aa4cd96 | Index case is the - | First case in a community | Case getting infection from primary case | Case getting infection from secondary case | First case detected by investigator | 3d
| single | Ans. is 'd' i.e., First case defected by investigator [Ref: Park 22nd/e d. 92 & 21st/e p. 9/1o Primary caseo Index case--First case of communicable disease introduced into the population.First case to come to attention of the investigator.o It is not always necessary that primary case will be index case : -When the first case noticed by the investigator is also the first case of the population - Primary case and index case are the same.When the first case nociced by the investigator is not the first case of the population (primary case) - Index case and primary case are different.o Secondary cases - Cases those developing from contact with primary case. | Social & Preventive Medicine | Infectious Disease Epidemiology |
653e1924-a0e6-4c37-8671-d25d8832c02e | Gastrojejernostomy surgery belongs to | Clean surgery | Contaminated surgery | Clean contaminated surgery | Dirty surgery | 2c
| single | Clean contaminated surgery :
Wound is exposed to not only skin but also GI tract / Respiratory tract / Urinary tract organism in controlled enviroment.
Hence Gastrojejunostomy surjery belongs to this category. | Surgery | null |
ea9560ec-7791-4d43-8f27-b1389e1e9e16 | Hand and foot syndrome is due to ? | Vincristine | Cisplatin | 5 FU | Azathioprine | 2c
| single | Ans. is 'c' i.e., 5 FU | Pharmacology | null |
00d1d295-5998-4780-b5c8-3541ce055bd0 | Gaisbock syndrome is better known as? | Primary familial polycythemia | High-altitude erythrocytosis | Spurious polycythemia | Polycythemia vera | 2c
| single | Gaisbock syndrome is characterised by secondary polycythemia. It occurs mainly in male sedentary individuals, on a high-calorie diet. Prevalence is unknown. The clinical picture includes mild obesity, hypeension and decrease in plasma volume with relative increase in hematocrit, blood viscosity, serum cholesterol, triglycerides and uric acid. The reduction in plasma volume seems related to the elevation of the diastolic blood pressure. Prognosis is impaired by the development of cardiovascular complications. | Medicine | Haematology |
48d2615c-1348-4130-a284-488b5b5ce8f8 | After an incised wound, new collagen fibrils are seen along with a thick layer of growing epithelium. The approximate age of the wound is - | 12-24 hours | 24-72 hours | 4-5 days | About 1 week | 2c
| single | . 4-5 days | Pathology | null |
7acb1377-ee33-4ba0-96af-d6389e13e975 | Thyrotoxic periodic paralysis leads to extreme muscle weakness due to? | Hypokalemia | Hypocalcemia | Hypomagnesemia | Hyponatremia | 0a
| single | T3| T4| - Positive Na- K+ ATPase activity in the cells (3 Na outside 2 K+ inside) | K Influx | K| | Thyrotoxic Periodic Paralysis | Medicine | Diseases of Thyroid |
44fd2133-14eb-4365-845e-3b7739786c2f | vitamin involved in 1 carbon metabolism | Folic acid | Thiamine | biotin | niacin | 0a
| single | THFA is the carrier of One Carbon groups The folic acid is first reduced to 7,8-dihydrofolic acid and fuher reduced to 5,6,7,8-tetrahydrofolic acid (THFA) . Both reactions are catalyzed by NADPH dependent folate reductase. The THFA is the carrier of one-carbon groups. One carbon compound is an organic molecule that contains only a single carbon atom. The following groups are one carbon compounds: Formyl (-CHO) Formimino (-CH=NH) Methenyl (-CH=) Methylene (-CH2-) Hydroxymethyl (-CH2OH) Methyl (-CH3). One carbon groups bind to THF through N5 are Formyl, Formimino or methyl N10 are Formyl Both N5 and N10 are Methylene and Metheny Ref: DM Vasudevan - Textbook of Biochemistry, 8th edition, page no: 475 | Biochemistry | vitamins |
5719db2c-6692-4a88-8f7c-2bd05263ecba | Cauliflower ear is - | Keloid | Perchondritis in Boxers | Squamous cell carcinoma | Anaplastic cell carcinoma | 1b
| single | null | ENT | null |
58d4ffc2-c6bf-4c39-a61d-42edcdfbad08 | Which of the following diuretics is contraindicated in the presence of cardiac failure? | Mannitol | Spironolactone | Furosemide | Hydrochlorothiazide | 0a
| single | null | Pharmacology | null |
c58ae922-9ef2-42b4-96f7-4bf55d921817 | Snow blindness is caused by : | Ultravoilet rays | Infrarads | Microwaves | Defect in mirror | 0a
| single | A i.e. Ultra violet rays | Ophthalmology | null |
544ffd62-236b-4893-9a4d-7279e93ab84c | The most common neoplasm among HIV positive homosexual males: | Non-Hodgkin's lymphoma | Glomus tumor | Kaposi's sarcoma | None of the above | 2c
| multi | null | Medicine | null |
45e6c5a2-1420-48d3-b5fb-87667ce15e08 | Hyponatremia in multiple myeloma is | TRUE | Relative | Absolute | Pseudo | 3d
| multi | Pseudohyponatremia Patients with multiple myeloma also have a decreased anion gap because of the M component is cationic, resulting in retention of chloride This is often accompanied by hyponatremia that is felt to be aificial (pseudohyponatremia) because each volume of serum has less water as a result of the increased protein Ref: Harrison's 19th edition Pgno : 714 | Surgery | General surgery |
697b6579-7c0e-4b03-a149-96b25aa0d146 | Schiller-Duval bodies are seen in- | Teratoma | Seminoma | Yolk sac tumour | Chorio Carcinoma | 2c
| single | Yolk sac tumor of the testis: Raised a-fetoprotein level (AFP). Schiller-Duval bodies. Schiller-Duval body: It is the characteristic feature of the endodermal sinus tumor. This is a glomerulus-like structure composed of a central blood vessel enveloped by germ cells within a space lined by germ cells. Endodermal sinus tumor: 1. Schiller-Duval body 2. PAS-positive hyaline droplets Ref: RAM DAS NAYAK EXAM PREPARATORY MANUAL FOR UNDERGRADUATES 2nd ed. pg no: 684 | Pathology | Urinary tract |
01dab660-369d-42be-9871-53164591f758 | Which one of the following disorders is related to sense of unreality? | Depersonalization disorder | Derealization disorder | Delusion | Phobias | 0a
| single | Ans. A. Depersonalization disorderDepersonalization:Depersonalization is a sense of unreality or strangeness concerning the self, manifested by feeling detached from and being an outside observer of one's mental processes or body.A patient who experiences depersonalization may describe feeling like things "I have stepped outside of myself and am watching myself doing things".Derealization:Derealization refers to feeling detached from one's environment so that the sense of the reality of the external world is lost.E.g, I feel as if everything is unreal and those around me are actors in a play or two dimensional cardboard figures. | Psychiatry | null |
027b9811-e511-4d01-8c93-2099f4e39f7f | Floaters can be seen in following except | Vitreous haemorrhage | Retinal detachment | Uveitis | Acute congestive Glaucoma | 3d
| multi | Black spots or floaters in front of the eyes may appear singly or in clusters. They move with the movement of the eyes and become more apparent when viewed against a clear surface e.g., the sky. Common causes of black floaters are: Vitreous hemorrhage Vitreous degeneration e.g., - senile vitreous degeneration, vitreous degeneration in pathological myopia Exudates in vitreous Lenticular opacity Reference : AK KHURANA COMPREHENSIVE OPHTHALMOLOGY, E4, Page-463 | Ophthalmology | Anatomy, Development and clinical examination |
0a5e5d05-5d36-4eca-a464-cec53a160ea0 | Term psychoanalysis was coined by? | Eysenck | Freud | Jung | Adler | 1b
| single | Ans. is 'b' i.e., Freud * The credit for invention of psychoanalysis belong to Sigmund FreudImportant contributors in psychiatryTermCoined by* Demence precoce* Moral Emil* Dementia precox* Kraepelin* Catatonia, cyclotymia* Kahlbaum* Hebephrenia* Hecker* Schizophrenia* Eugen Bleuler* Ambivalence* Eugen Bleuler* Free association* Sigmund Freud* Psychoanalysis, Psychodynamics* Sigmunnd Freud* Id, ego, Superego* Sigmund Freud* Psychiatry* Johann christion Reil | Psychiatry | Psychoanalysis |
19de9e2f-472f-40ab-8530-767da4bb3910 | CSOM with Picket fence fever is seen in | Meningitis | Sigmoid Sinus Thrombosis | Brain Abscess | Extradural Abscess | 1b
| single | Sigmoid sinus thrombosis/lateral sinus thrombosis is an inflammation of inner wall of lateral venous sinus with formation of an intra sinus thrombus It occurs as a complication of chronic suppuration of middle ear or acute coalescent mastoiditis, and cholesteatoma Picket fence fever temperature never comes back to normal baseline. Remittent fever. Complications of CSOM - Intra temporal Intracranial Mastoiditis Meningitis - m/c Petrositis Brain abscess Facial paralysis Extradural abscess Labyrinthitis Subdural abscess Lateral sinus thrombophlebitis Otitic hydrocephalus | ENT | Complications of Chronic Otitis Media |
77ded5ec-a12d-469a-a16f-fd7871c27c98 | Which dietary deficiency of a vitamin can cause Pellagra. | Vitamin C | Niacin | Vitamin D | Biotin | 1b
| single | Some amino acids (isoleucine, tryptophan, phenylalanine, and tyrosine) are both glucogenic and ketogenic because their degradation pathway forms multiple products.a. Amino acids that are converted to pyruvate (see Figure I).(1). The amino acids that are synthesized from the intermediates of glycolysis (serine, glycine, cysteine, and alanine) are degraded to form pyruvate.(a). Serine is converted to 2-phosphoglycerate, an intermediate of glycolysis, or directly to pyruvate and NH4+ by serine dehydratase, an enzyme that requires PLP.(b). Glycine, in a reversal of the reaction utilized for its synthesis, reacts with methylene-FH4 to form serine.1. Glycine also reacts with FH4 and NAD+ to produce CO2 and NH4+ (glycine cleavage enzyme).2. Glycine can be converted to glyoxylate, which can be oxidized to CO2 and H2 O or converted to oxalate.(c). Cysteine forms pyruvate. Its sulfur, which was derived from methionine, is converted to H2 SO4 , which is excreted by the kidneys.(d). Alanine can be transaminated to pyruvate.b. Amino acids that are converted to intermediates of the TCA cycle (see Figure II).(1). The carbons from the four groups of amino acids form the TCA cycle intermediates: a-ketoglutarate, succinyl-CoA, fumarate, and oxaloacetate.(a). Amino acids that form a-ketoglutarate (see Figure III).1. Glutamate can be deaminated by glutamate dehydrogenase or transaminated to form a- ketoglutarate.2. Glutamine is converted by glutaminase to glutamate with the release of its amide nitrogen as NH4+ 3. Proline is oxidized so that its ring opens, forming glutamate semialdehyde, which is oxidized to glutamate.4. Arginine is cleaved by arginase in the liver to form urea and ornithine. Ornithine is transaminated to glutamate semialdehyde, which is oxidized to glutamate.5. Histidine is converted to formiminoglutamate (FIGLU). The formimino group is transferred to FH4, and the remaining five carbons form glutamate.(b). Amino acids that form succinyl-CoA (see Figure IV)1. Four amino acids are converted to propionyl-CoA, which is carboxylated in a biotin requiring reaction to form methylmalonyl-CoA, which is rearranged to form succinyl-CoA in a reaction that requires vitamin B12 (seen previously in the metabolism of odd-chain number fatty acids).a). Threonine is converted by a dehydratase to NH4+ and a-ketobutyrate, which is oxidatively decarboxylated to propionyl-CoA.In a different set of reactions, threonine is converted to glycine and acetyl-CoA.b). Methionine provides methyl groups for the synthesis of various compounds; its sulfur is incorporated into cysteine; and the remaining carbons form succinyl-CoA.i. Methionine and ATP form S-adenosylmethionine (SAM), which donates a methyl group and forms homocysteine.ii. Homocysteine is reconverted to methionine by accepting a methyl group from the FH4 pool via vitamin B12 .iii. Homocysteine can also react with serine to form cystathionine. The cleavage of cystathionine produces cysteine, NH4+ , and a-ketobutyrate, which is converted to propionyl-CoA.c). Valine and isoleucine, two of the three branched-chain amino acids, form succinyl-CoA (see Figure IV).i. The degradation of all the three branched-chain amino acids begins with a transamination followed by an oxidative decarboxylation catalysed by the branched-chain a-keto acid dehydrogenase complex (Figure V). This enzyme, like pyruvate dehydrogenase and a-ketoglutarate dehydrogenase, requires thiamine pyrophosphate, lipoic acid, CoA, flavin adenine dinucleotide (FAD), and NAD+.ii. Valine is eventually converted to succinyl-CoA via propionyl-CoA and methyl malonyl-CoA.iii. Isoleucine also forms succinyl-CoA after two of its carbons are released as acetyl-CoA.(c). Amino acids that form fumarate1. Three amino acids (phenylalanine, tyrosine, and aspartate) are converted to fumarate (see Figure II).a). Phenylalanine is converted to tyrosine by phenylalanine hydroxylase in a reaction requiring tetrahydrobiopterin and O2 (Figure VI).b). Tyrosine, obtained from the diet or by hydroxylation of phenylalanine, is converted to homogentisic acid. The aromatic ring is opened and cleaved, forming fumarate and acetoacetate.c). Aspartate is converted to fumarate via reactions of the urea cycle and the purine nucleotide cycle.d). Aspartate reacts with IMP to form AMP and fumarate in the purine nucleotide cycle.(d). Amino acids that form oxaloacetate (see Figure II)1. Aspartate is transaminated to form oxaloacetate.2. Asparagine loses its amide nitrogen as NH4+ , forming aspartate in a reaction catalyzed by asparaginase.c. Amino acids that are converted to acetyl-CoA or acetoacetate (see Figure VI).(1). Four amino acids (lysine, threonine, isoleucine, and tryptophan) can form acetyl-CoA, and phenylalanine and tyrosine form acetoacetate. Leucine is degraded to form both acetyl-CoA and acetoacetate.Pellagra is caused by a dietary deficiency of niacin, beriberi is caused by a lack of thiamine (vitamin B-,), scurvy caused by a lack of vitamin C, and rickets from a lack of vitamin D.I. Amino acids derived from the intermediates of glycolysis. These amino acids can be synthesized from glucose and can be reconverted to glucose in the liver.II. The degradation of amino acids. A. Amino acids that produce pyruvate or the intermediates of the TCA cycle. These amino acids are considered glucogenic because their carbons can produce glucose in the liver. B. Amino acids that produce acetyl-CoA or ketone bodies. These amino acids are considered ketogenic. CoA, coenzyme A; HMG-CoA, hydroxymethylglutaryl-CoA; TCA, tricarboxylic acid.III. Amino acids related through glutamate. These amino acids contain carbons that can be converted to glutamate, which can be converted to glucose in the liver. All of these amino acids except histidine can be synthesized from glucose.IV. Amino acids that can be converted to succinyl-CoA. The amino acids methionine, threonine, isoleucine, and valine, which form succinyl-CoA via methyl malonyl-CoA, are all essential. Because succinyl-CoA can form glucose, these amino acids are glucogenic. The carbons of serine are converted to cysteine and do not form succinyl-CoA by this pathway. A defect in cystathionine synthase causes homocystinuria. A defect in cystathionase causes cystathioninuria. B12-CH3, methyl cobalamin; N5-CH3-FH4, N 5- methyl tetrahydrofolate; PLP, pyridoxal phosphate; SAM, S-adenosylmethionine; TCA, tricarboxylic acid.V. The degradation of the branched-chain amino acids. Valine forms propionyl-CoA. Isoleucine forms propionyl-CoA and acetyl-CoA. Leucine forms acetoacetate and acetyl-CoA. CoA, coenzyme A; FAD, flavin adenine dinucleotide; HMG-CoA, hydroxymethylglutaryl-CoA.VI. A. Ketogenic amino acids. Some of these amino acids (tryptophan, phenylalanine, and tyrosine) also contain carbons that can form glucose. Leucine and lysine are strictly ketogenic; they do not form glucose. B. A deficiency in various steps leads to the diseases indicated. CoA, coenzyme A; NAD, nicotinamide adenine dinucleotide; NADP, nicotinamide adenine dinucleotide phosphate; PKU, phenylketonuria; PLP, pyridoxal phosphate; TCA, tricarboxylic acid cycle. | Biochemistry | Vitamins and Minerals |
1d939c71-c8f5-42a8-94a1-62b3f85c2445 | Good prognostic factor for schizophrenia is ? | Blunted affect | Early onset | Presence of depression | Male sex | 2c
| single | Ans. is 'c' i.e., Presence of depression Good prognostic factors :- Acute onset; late onset (onset after 35 years of age); Presence of precipitating stressor; Good premorbid adjustment; catatonic (best prognosis) & Paranoid (2nd best); sho duration (< 6 months); Married; Positive symptoms; Presence of depression; family history of mood disorder; first episode; pyknic (fat) physique; female sex; good treatment compliance & good response to treatment; good social suppo; presence of confusion or perplexity; normal brain CT Scan; outpatient treatment. | Psychiatry | null |
ce01e569-bf1c-40c5-bc57-bda928225325 | All drug inhibit bacterial cell wall synthesis EXCEPT | Spectinomycin | Vancomycin | Aztreonam | Cephalexin | 0a
| multi | Spectinomycin is an aminocyclitol antibiotic that inhibits bacterial protein synthesis. The other drugs all inhibit bacterial cell wall synthesis. Vancomycin and bacitracin inhibit early steps in the biosynthesis of the peptidoglycan component of the cell wall, whereas 3-- lactams such as aztreonam (a monobactam), penicillins, cephalosporins, and carbapenems inhibit the cross-linking (transpeptidation) of the cell wall peptidoglycan polymers. | Pharmacology | null |
a07737a9-2d74-4807-9182-aef521be32c1 | The most common cause of death in Kaposi's Sarcoma is - | Dissemination | AIDS | Massive pulmonary haemorrhage | Diabetes mellitus | 2c
| single | null | Medicine | null |
87ac2153-96e5-4df6-ba4d-389eaab02de1 | Longest and thinnest extrocular muscle - | SR | IR | SO | IO | 2c
| single | SO arises from the bone above and medial to the optic foramina. It runs forward and turns around a pulley- " the trochlea" and is inseed in the upper and outer pa of the sclera behind the equator. Ref;A.K.Khurana; 6th edition;Page no:336 | Ophthalmology | Ocular motility and squint |
863563ce-3fce-491b-92f6-3bc13d8a2d16 | Ribosomes has following enzymatic activity? | Peptidyl transferase | Peptidase | Aminoacyl tRNA synthetase | GTPase | 0a
| single | The formation of peptide bonds is catalysed by peptidyl transferase, an activity intrinsic to the 23 S r-RNA of 50 S subunit in prokaryotes and 28 S r-RNA of 60 S subunit in eukaryotes. So, it is referred to as ribozyme & indicates a direct role of r-RNA in protein synthesis. | Biochemistry | null |
eb09e278-8f3b-4e17-b853-54b536926b06 | Inhibin inhibits the secretion of which hormone : | FSH | LH | Estrogen | Prolactin | 0a
| single | FSH | Gynaecology & Obstetrics | null |
7324c16c-ec99-482b-9d83-16d5a8f9d6a8 | True regarding traumatic facial nerve palsy is all, except | Usually occurs with transverse petrous temporal bone fracture | Usually occurs with longitudinal petrous temporal bone fracture | Posttraumatic facial nerve palsy may be complete at the time of presentation | Decompression of the canal can be useful treatment | 1b
| multi | TRAUMA TIC FACIAL NERVE PARALYSIS 1. FRACTURES OF TEMPORAL BONE Fractures of temporal bone may be longitudinal, transverse or mixed. Facial palsy is seen more often in transverse fractures (50%). Paralysis is due to intraneural haematoma, compression by a bony spicule or transection of nerve. In these cases, it is impoant to know whether paralysis was of immediate or delayed onset. Delayed onset paralysis is treated conservatively like Bell palsy while immediate onset paralysis may require surgery in the form of decompression, re-anastomosis of cut ends or cable nerve graft. 2. EAR OR MASTOID SURGERY Facial nerve is injured during stapedectomy, tympanoplasty or mastoid surgery. Paralysis may be immediate or delayed and treatment is the same as in temporal bone trauma. Sometimes, nerve is paralyzed due to pressure of packing on the exposed nerve and this should be relieved first. Operative injuries to facial nerve can be avoided if attention is paid to the following: (a) Anatomical knowledge of the course of facial nerve, possible variations and anomalies and its surgical landmarks. Cadaver dissections should be an impoant pa of the training in ear surgery. (b) Always working along the course of nerve and never across it. (c) Constant irrigation when drilling to avoid thermal injury. Use diamond burr when working near the nerve. (d) Gentle handling of the nerve when it is exposed, avoiding any pressure of instruments on the nerve. (e) Not to remove any granulations that penetrate the nerve. (f) Using magnification; never to work on facial nerve without an operating microscope. 3. PAROTID SURGERY AND TRAUMA TO FACE Facial nerve may be injured in surgery of parotid tumours or deliberately excised in malignant tumours. Accidental injuries in the parotid region can also cause facial paralysis. Application of obstetrical forceps may also result in facial paralysis in the neonate due to pressure on the extratemporal pa of nerve. Ref : ENT textbook by Dhingra 6th edition Pgno : 96,97 | ENT | All India exam |
eef0905b-965f-4a6b-bd06-604bded9c566 | Mean Hb values in two population groups are compared by | Paired t test | Unpaired t test | Chi square test | Fischer test | 1b
| single | Ref:Park's Textbook of Preventive and Social Medicine 25th Ed | Social & Preventive Medicine | Biostatistics |
44951bf6-36b2-4283-b511-3075505c9e1b | A chest physician performs bronchoscopy in the procedure room of the out patient depament. To make the instrument safe for use in the next patient waiting outside, the most appropriate method to disinfect the endoscope is by - | 70 % alcohol for 5 min | 2% glutaraldehyde for 20 min | 2% formaldehyde for 10 min | 1% sodium hypochlorite for 15 min | 1b
| single | Glutaraldehyde is especially effective against the tubercle bacilli, fungi, and viruses. It is less toxic and irritant to eyes and skin than formaldehyde. It has no deleterious effects on the cement or lenses of instruments such as cystoscope and bronchoscopy It can be safely used to treat corrugated rubber,nanestheticubes, face masks, plastic endotracheal tubes, metal instruments a, d polythene tubings REF:Ananthanarayan and Panicker's Textbook ofMicrobiology 8th Edition pg no:36 | Microbiology | general microbiology |
47f7e154-421c-4628-bc72-a8edf7c3c33c | Most important amino acid for formation Neutrophilic extracellular trap (NET) is | Leucine | Methionine | Citrulline | Valine | 2c
| single | Conversion of arginine residues to Citrulline in the histones is an essential step in the formation of neutrophill extracillular traps. | Pathology | null |
b73f47f6-3b20-49ac-9207-544e3d53220d | All muscles of the pharynx are supplied by pharyngeal plexus, EXCEPT? | Inferior constrictors | Salpingopharyngeus | Stylopharyngeus | None of the above | 2c
| multi | With the exception of stylopharyngeus, which is supplied by the glossopharyngeal nerve, the muscles are supplied by the cranial pa of the accessory nerve the pharyngeal plexus. | Anatomy | null |
039be0b0-ecb7-47f0-be51-4e1ad708834e | On exertion urine stream increases in - | Prostate enlargement | Marion's disease | Post. urethral valves | Urethral stricture | 3d
| single | null | Surgery | null |
88224960-32ab-424f-8817-82cb0d84b1fd | Mauriac's syndrome is characterized by all except | Diabetes | Obesity | Dwarfism | Cardiomegaly | 3d
| multi | Ans. is 'd' i.e., Cardiomegaly Mauriac Sydrome Children with poorly controlled type I diabetes may develop Mauriac syndrome. It is characterized by : - Growth attenuation Delayed pubey Hepatomegaly Abnormal glycogen storage and steatosis Cushingoid features Rare in modern era of insuling therapy but is occasionlly repoed. | Medicine | null |
de228ccd-31cc-4308-aca2-6ff9b861bf41 | Which is not transmitted by arthropod - | Rickettsia prowazekii | Coxiella burnetii | Rickettsia akari | Rickettsia rickettsii | 1b
| single | null | Microbiology | null |
a08060f3-90a6-4a9e-a269-342a067a11ce | All of the following are true about Herpes group virus except- | Ether sensitive | May cause malignancy | HSV II involves below diaphragm | Burkitt's lymphoma involves Tcells | 3d
| multi | Herpes viruses are susceptible to fat solvents like alcohilic ether chlorofirm and bike salts. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO:466 | Microbiology | Virology |
86275511-77fc-43c3-a868-423d1cde049a | The diabetes control and complication trial (DCCT) provided definitive proof that reduction In chronic hyperglycemia helps to improve - | Microvascular complications of type 1 DM | Microvascular complications of type 1 DM | Microvascular complications of type 2 DM | Macro vascular complications of type 2 DM | 0a
| single | The Diabetes Control and Complications Trial (DCCT) found definitive proof that a reduction in chronic hyperglycemia can prevent many of the complications of type 1 diabetes mellitus (DM). This multicenter randomized trial enrolled over 1400 patients with type 1 DM to either intensive or conventional diabetes management and prospectively evaluated the development of retinopathy, nephropathy, and neuropathy. The intensive group received multiple administrations of insulin daily along with education and psychological counseling. The intensive group achieved a mean hemoglobin A1C of 7.3% versus 9.1% in the conventional group. Improvement in glycemic control resulted in a 47% reduction in retinopathy, a 54% reduction in nephropathy, and a 60% reduction in neuropathy. There was a nonsignificant trend toward improvement in macrovascular complications. The results of the DCCT showed that individuals in the intensive group would attain up to 7 more years of intact vision and up to 5 more years free from lower limb amputation. Later, the United Kingdom Prospective Diabetes Study (UKPDS) studied over 5000 individuals with type 2 DM. Individuals receiving intensive glycemic control had a reduction in microvascular events but no significant change in macrovascular complications. These two trials were pivotal in showing a benefit of glycemic control in reducing microvascular complications in patients with type 1 and type 2 DM, respectively. Another result from the UKPDS was that strict blood pressure control resulted in an improvement in macrovascular complications Ref - pubmed.com | Medicine | Endocrinology |
991e3b31-33bd-48f7-8ce3-29243c256121 | . True about polio is all except: | Sabin vaccine is attenuated, oral vaccine | Salk is a killed formalized vaccine used | Vaccine induced polio is usually due to Type 2 virus | Most common type of virus in epidemics is Type 1 | 2c
| multi | Vaccine induced polio" is usually due to Type 2 virus | Social & Preventive Medicine | null |
a413bd92-c958-482a-a848-aec3d592f395 | Strawberry gingivitis is seen in: | Wegener's Granulomatosis | Scorbutic Gingivitis | Plasma Cell Gingivitis | Leukemic Gingivitis | 0a
| single | null | Pathology | null |
4a02e1aa-2942-4fe9-87b5-cda43f5c2684 | Bleomycin toxicity is characterized by destruction of: | Endothelial cells | Type I pneumocytes | Type II pneumocytes | Alveolar macrophages | 1b
| single | Ans. b. Type I pneumocytes Bleomycin toxicity is characterized by destruction of Type I pneumocytes.Histopathotogy of Lung in Bleomycin Toxicity* Endothelial cell edema and blebbing* Necrosis of type 1 pneumocytes* Proliferation of fibroblast and fibrosis* Hyperplasia and metaplasia of type II pneumocytes* Inflammatory infiltrate with PMNBleomycin* Bleomycin is well known to cause pulmonary toxicity.* Incidence of bleomycin induced pulmonary toxicity is 5% for a total cumulative dose of 450 units and 15% for higher dosages.* Bleomycin is concentrated preferentially in the lung and is inactivated by hydrolase enzyme. This enzyme is relatively deficient in lung tissue. This may explain relative sensitivity of bleomycin to lung tissue.Type I pneumocytes are more vulnerable to bleomycin toxicity' and are destroyed by bleomycinPathological Features of Bleomycin Toxicity* Early endothelial cell damage* Destruction uf type 1 pneumocytes* Migration of type II pneumocytes into alveolar spaces inducing interstitial changesFollowing destruction of type I pneumocytes repair is characterized by hyperplasia and dysplasia of type II pneumocytes. Fibro- blast proliferation with subsequent pulmonary fibrosis is probably the basis for irreversible changes induced by Bleomycin. | Pharmacology | Anti-Neoplastic Agents |
42df5375-5026-4824-81fc-7c72d7a13f5a | A policemen foo..a a person ln ing unconscious in iglu lateral position on the road with superficial injury to the face, bruises on the right arm, and injury to the lateral aspect of right knee. Nerve most probably injured: | Femoral nerve | Radial nerve | Common peroneal nerve | Trigeminal nerve | 2c
| single | Ans. c. Common peroneal nerve Common peroneal nerve (L4, L5, Sl, S2) is the smaller terminal branch of sciatic nerve. The larger terminal branch of sciatic nerve is the tibial nerve. The common peroneal nerve is relatively unprotected as it traverses the lateral aspect of the head of fibula and is easily compressed at this site.' Common Peroneal Nerve Injury Common peroneal nerve (L4, L5, Sl, S2) is the smaller terminal branch of sciatic nerve. The larger terminal branch of sciatic nerve is the tibial nerve. The common peroneal nerve is relatively unprotected as it traverses the lateral aspect of the head of fibula and is easily compressed at this site. Common Modes of Injury Fracture of neck of fibula Plaster on the leg Lathi injury on the lateral side of knee joint Clinical Features: Injury to common peroneal nerve results in paralysis of all muscles in the anterior and lateral compament of the leg (dorsiflexors of the ankle and eveors of the foot) which results in: Loss of eversion of foot and dorsiflexion of the ankle causes foot drop Foot drop and toes drags on the floor while walking Foot comes down suddenly producing a distinctive plop Variable loss of sensation on the anterolateral aspect of the leg and dorsum of the foot Aicular loss the lateral side of the knee joint In common peroneal nerve injury, only eversion and dorsiflexion is lost, while inversion and plantar flexion remains normal, therefore ankle reflex is intact. | Surgery | null |
8ea90eae-eb18-4887-9d50-9892e4aa0479 | To which of the following events is 'good' outcome in neuroblastoma associated - | Diploidy | N-myc amplification | Chromosome 1 p deletion | Trk A expression | 3d
| single | null | Pathology | null |
833c680b-868a-47d2-a03b-7c9972141b05 | HLA B27 histocompatibility antigen is correlated With | Sjogren's disease | Ankylosing spondylitis | Felty's syndrome | Scleroderma | 1b
| single | REF:HARRISONS PRINCIPLE&;S OF INTERNAL MEDICINE 18TH EDITION | Medicine | Immune system |
5ac2cc09-7a22-477e-b98a-6d3c938893ed | Dileufloy's lesion is seen in - | Stomach | Jejunum | Oesophagus | Anus | 0a
| single | Ans. is 'a' i.e., Stomach Dieulafoy's lesion* Dieulafoy's lesion is a medical condition characterized by a large tortuous arteriole most commonly in the stomach wall (submucosal) that erodes and bleeds.* It can cause gastric hemorrhage but is relatively uncommon. It is thought to cause less than 5% of all gastrointestinal bleeds in adults* Dieulafoy's lesions are characterized by a single large tortuous small artery in the submucosa which does not undergo normal branching or a branch with caliber of 1-5 mm (more than 10 times the normal diameter of mucosal capillaries). The lesion bleeds into the gastrointestinal tract through a minute defect in the mucosa which is not a primary ulcer of the mucosa but an erosion likely caused in the submucosal surface by protrusion of the pulsatile arteriole.* Approximately 75% of Dieulafoy's lesions occur in the upper part of the stomach within 6 cm of the gastroesophageal junction, most commonly in the lesser curvature. | Anatomy | Abdomen & Pelvis |
4e6d7112-235c-455c-9c85-42b882282c27 | All the following are complications of streptokinase, except | Joint pain | Intracranial bleed | Anaphylaxis | Hypotension | 0a
| multi | Ref Harrison 19 th ed pg 1605 Allergic reactions to streptokinase occur in ~2% of patients who receive it. While a minor degree of hypotension occurs in 4-10% of patients given this agent, marked hypotension occurs, although rarely, in association with severe allergic reactions. | Medicine | C.V.S |
97597308-a57c-4395-a821-83903e96ee9c | Odontogenic tumors just 1cm away from lower border | Enbloc resection | Hemi mandibulectomy | Enucleation | None | 0a
| multi | null | Surgery | null |
4948ade6-689f-4089-88b0-84ad2c3e878b | A 40-year-old patient is suffering from carotid body tumor. Which of the following is the best treatment for him? | Excision of tumor | Radiotherapy | Chemotherapy | Carotid aery ligation both proximal and distal to the tumor | 0a
| multi | Best treatment for a 40-year-old patient who is suffering from carotid body tumor is excision of tumor. CAROTID BODY TUMOR TREATMENT Because these tumors rarely metastasizeQand their overall rate of growth is slow, the need for surgical removal must be considered carefully as complication of surgery are potentially serious. Operation is best avoided in elderly patientsQ. Preoperative embolization is performed for tumors >3 cm. Tumors >5 cm are associated with a need for concurrent carotid aery replacement. | Surgery | Neck |
1bfac5aa-b16b-41df-9688-d96e1c7b2270 | Following may be seen in the exit wound: DNB 10; NEET 14 | Di collar | Abrasion collar | Tattooing | Inveed edges | 1b
| single | Ans. Abrasion collar | Forensic Medicine | null |
af06c382-fa50-4f62-b9d4-bd722954415b | Substance which is not absorbed in the loop of Henle: March 2005 | K+ | Urea | CI? | Na+ | 1b
| single | Ans. B: Urea The descending pa of the thin segment of the loop of Henle is highly permeable to water and moderately permeable to most solutes and little or no active reabsorption. The thick ascending limb of the loop of Henle reabsorbs about 25% of the filtered loads of sodium, chloride and potassium as well as large amount of calcium, bicarbonate and magnesium. It also secretes hydrogen ions into the tubular lumen | Physiology | null |
4538d2e9-0987-488f-9dd4-91fdf628e56a | Frequency distribution is studied by - | Histogram | Line diagram | Pie diagram | Ski diagram | 0a
| single | null | Social & Preventive Medicine | null |
281a7260-b0ee-4e90-9e0b-88bd05fb693c | A 28 year old woman, suffers from emotional liability and depression, about 10 days prior to her menses. She repos that once she begins to bleed, she feels back to normal. She also gives a history of premenstrual fatigue, bloating and breast tenderness. What would be the best treatment for the patient? | Evening primrose oil | Vitamin B6 | Fluoxetine | Progesterone | 2c
| single | Fluoxetine is a selective serotonin Reuptake Inhibitor (SSRI) and SSRIs have shown the greatest efficiency in PMS treatment. Premenstrual syndrome (PMS), also called Premenstrual Tension (PMT), is a symptom complex, recognised primarily by cyclic changes, associated with ovulatory cycles. It occurs 7 to 14 days prior to menstruation and spontaneously resolves after menses. It always occurs in the luteal phase of the cycle. Symptoms include: Pain: Headache, breastpain, abdominal cramps, muscle stiffness, backache and generalise body ache. Water retention: Breast volume increase, bloating and weight gain. Behavioural changes: Low performance, difficulty in concentration, irritability, depression, forgetfulness, low judgement, anxiety, loneliness, feeling like crying, hostility, increased appetite and cravings and sleeplessness. Autonomic changes: Dizziness, faintness, nausea, vomiting and hot flushes Treatment: Psychosomatic symptoms: SSRIs, Vitamin B1, B6 and E Breast pain: Danazol, Bromocriptine and GnRH analogues Pelvic pain and bloatedness: OCP and Mirena IUCD General measures: Excercise, relaxation and hobbies like Meditation and Yoga Ref: Shaw&;s textbook of Gynaecology 17th edition PGno: 127 | Gynaecology & Obstetrics | Disorders of menstruation |
dc473812-45a6-4add-a49f-aeecc555e87c | Which of the following statements about 'Multiple Pregnancies' is TRUE? | Fetuses of same gender excludes dichorionicity | Twin Peak Sign is seen in dichorionicity | Thick separating membrane is a feature of monochorionic twins | Chorionicity can be reliably detected only after 16 weeks of gestation | 1b
| multi | Twin peak or Lambda sign is seen in dichorionic diamniotic twin gestation. In this the chorion and amnion for each twin reflect away from the fused placenta to form an inter twine membrane. A space that exist in the intewine membrane is filled by proliferating placental villi giving rise to twin peak sign. Twin peak sign appear as a triangle with the base at the chorionic surface and apex in the inter twin membrane. Ref: Textbook of Obstetrics By Dutta, 6th Edition, Page 207; Ultrasound in Obstetrics and Gynecology By Meyz, 2004, Page 422, 423; Ultrasound and Multifetal Pregnancy, 1998, Pages 74, 75, 73; Textbook of Perinatal Medicien By Kurjak, 2nd Edition, Page 499, 500, 501. | Gynaecology & Obstetrics | null |
bbcbba60-aa5d-44e9-b34f-5c4146e82733 | Protein secreted by odontoblast: | Chitin | Keratin | Collagen | Elastin | 2c
| single | null | Dental | null |
f9401c1c-b9cd-43d5-928a-0cf204326f7f | In hyponatremia following renal failure, serum sodium should be maintained at what levels ? | 120 mEq/L | 125 mEq/L | 130 mEq/L | 135 mEq/L | 0a
| single | Hyponatremia in CKD population is associated with increased moality, but the effect on renal outcome was unknown.. Hyponatremia (serum sodium <120 mEq/L) was associated with excessive volume and volume depletion, measured as total body water by bioimpedance analysis, in diuretic users, but not in diuretic non-users Ref Davidson 23rd edition pg 366 | Medicine | Fluid and electrolytes |
a0ba7c38-42ad-4c8a-8293-a146658bf3ca | True about VSD are all except – | Left to right shunt | Pansystolic mormor | Reverse spliting of S2 | Left atrial hypertrophy | 2c
| multi | Hemodynamics of VSD
A VSD results in shunting of oxygenated blood from left to right because left ventricle has more pressure than right → Left to right shunt.
Blood flow from left to right ventricle due to high pressure gradient → Pansystolic murmur and systolic thrill.
Because left ventricle starts contracting before Right ventricle, pansystolic murmur starts early → Masking of Si.
This pressure gradient is maintained throughout the systole pansystolic murmur lasts long → Masking of S2.
Towards the end of systole, the declining left ventricular pressure becomes lower than aortic → Early closure of A2.
Left to right shunt occurs during systole at a time when the right ventricle is also contracting, therefore left to right shunt streams to pulmonary artery more or less directly → No volume overload > Right ventricle size remains normal.
Increased blood flow through pulmonary valve → Pulmonary ejection systolic murmur and delay & accentuated P2.
Early closure of A2 and delayed closure of P2 cause → Widely split S2 (But this is usually masked by pansystolic murmur).
Larger volume reaches the left atrium → Left atrial hypertrophy
Increased blood flow through mitral valve → Accentuated S1 (But it is masked by pansystolic murmur) and delayed diastolic murmur.
Note :
Ejection systolic murmur of pulmonary valve can not be separated from pansystolic murmur.
The effect of ejection systolic murmur is a selective transmission of pansystolic murmur to the upper left sternal border (pulmonary valve area) → In this area ejection characteristic of this murmur can be recognized since it does not mask the aortic component of S2. For the same reason second heart sound (S2) can be heard in the pulmonary area where it is not masked by pansystolic murmur. | Pediatrics | null |
1d33a6f3-018f-4042-883f-3c1fd7ecd4cc | Rapid change of presbyopic glass is a feature of | Senile cataract | Retinal detatchment | Intumescent cataract | Open angle glaucoma | 3d
| single | D i.e. Open angle glaucoma Conditions associated with altered refraction Feature Found in Frequent change of presbyopic glasses Open angle glaucoma Q Second sight/ Myopic Shift/Improvement in near vision Senile immature nuclear cataract Fluctuation of refractory error Diabetic cataract Frequent change of glasses Coical or nuclear cataract Primary Open Angle Glaucoma/ Chronic Simple Glaucoma It is chronic, slowly progressive, bilateral disease characterized by - adult onset, 10P > 21 mmHg at some point in the course of disease, an open angle, glaucomatous optic nerve head damage and visual field loss. It presents with painless progressive loss of vision Q, frequent change in presbyopic glasses Q and difficulty in near work owing to accommodative failure. | Ophthalmology | null |
2c528ae4-9e61-4789-8d93-3c139d02998b | Alopecia areata is not associated with which of the folllowing condition? | Exclamation sign | Atopy | Pitting nails | Geographical tongue | 3d
| single | Alopecia areata may be associated with atopy, downs syndrome, vitiligo, pernicious anemia, myxedema , diabetes or hypeension in the family. Sho,1-2 mm fractured hairs can frequently be seen at the active margins of alopecia areata. These hairs are described as exclamation mark hairs because these characteristic hairs fracture at their distal end and taper proximally to a pencil point giving them appearance of an exclamation mark . nail pitting is a common finding in alopecia areata . Ref Harrison20th edition pg 1236 | Dental | Anatomy of skin |
e49161b3-15c9-4e3f-a90b-0d857f39c76c | Risk of mother to child HIV transmission in pregnant woman at the time of delivery, and after delivery in non breast feeding woman is | 5-10% | 15-30% | 10-15% | More than 50% | 1b
| single | HIV transmission in absence of intervention:
MTCT of HIV in developed countries: 20% (15-25%)
MTCT transmission of HIV in developing countries: 30% (25-35%) | Social & Preventive Medicine | null |
95e3a156-b0ae-4d62-a3dc-23c5864c0cfa | True about receptor potential is? | Due to difference in permability of receptors for different ions | Is propogated | Refractory period of 15-20 sec | Is a graded change | 3d
| multi | ANSWER: (D) Is a graded changeREF: Textbook of Medical Physiology by Khurana page 1032-1033, Physiology - Prep Manual for Undergraduates, 4th Edition by Vijaya D Joshi page 562, Ganongs 22nd ed p. 123-125When a stimulus excites the receptor, it changes the potential across the membrane of the receptors. This change in the potential is called receptor or generator potential.The change in membrane potential in a receptor is caused by a change in permeability of membrane of the unmylelinated terminals to Na+. The resultant influx of Na+ causes development of generator or receptor potential. Since the receptor potential may generate the action potential it is also called as generator potential.The larger the receptor potential, the greater the frequency of action potential generated in the afferent neuron. A larger receptor potential can not bring about a larger action potential (because of all or none phenomenon), but it can induce more rapid firing of action potential.DIFFERENCE BETWEEN RECEPTOR POTENTIAL AND ACTION POTENTIAL:Receptor potentialAction potentialReceptor potential is a graded response i.e. amplitude of receptor potential increases with increase velocity of stimulus application and increase strength of stimulusAction potential obeys all or none law i.e. further increase in stimulus above threshold do not bring any change in amplitudeCan be added together if second stimulus arrives before the first stimulus is overCan not be added togetherHas no refractory periodHas a refractory period of 1 msMostly it is local and can not be propagatedIt can be propagated without loss in the amplitude along the nerve fibreDuration is greater (approximately 5-10 ms)Duration is small (approximately 1-2 ms) | Physiology | Nerve Physiology |
0c4c9422-b509-440b-9ab9-389aaced86a2 | Condition required for autoclave is? | 121°C temperature for 20 min | 121°C temperature for 15 min | 100°C temperature for 60 min | 100°C temperature for 90 min | 1b
| single | Autoclave: Recommended condition- 121–124°C temperature for 15 min at 1.1 bar pressure
Alternate: 134–138°C temperature for 3 min at 2.2 bar pressure
Hot air oven: 160°C temperature for 120 min or 180°C temperature for 30 min | Microbiology | null |
84021fac-4a52-47bd-b87c-70201fc0f5e6 | An obese, diabetic patient with hypertension who is also a smoker, currently on anti-hypertensive and OHA drugs presents with complains of apnea during night. Polysomnography reveals 5 apneic episodes and 1 hypoapneic episode in one hour. What will be best next line of management is: (E. REPEAT 2007) | Nasal CPAP | Uvulopharyngopalatoplasty | Mandibular sling | Diet and weight reduction | 3d
| single | Ref: Harrison's Principles of Internal Medicine. 18th edition, Page 2188Explanation:OSAHS is defined as the coexistence of unexplained excessive daytime sleepiness with at least five obstructed breathing events (apnea or hypopnea) per hour of sleep.EPWORTH SLEEPINESS SCOREHow often are you likely to doze off or fail asleep in the following situations, in contrast to feeling just tired'* This refers to your usual way of life in recent times.Even if you have not done some of these things recently, fry to work out how they would have affected you.Use the following scale to choose the most appropriate number for each situation:= would never doze.= slight chance of dozing.= moderate chance of dozing.= high chance of dozing.* Sitting and reading--* Watching TV--* Sitting, inactive in a public place (e.g., a theater or a meeting)--* As a passenger in a car for an hour without a break--* Lying down to rest in the afternoon when circumstances permit--* Sitting and talking to someone--* Sitting quietly after lunch without alcohol--* In a car, while stopped for a few minutes in traffic--TOTAL--DiagnosisSleep history from the patient and partner, with both completing.Sleep questionnaires.Epworth Sleepiness Score.Assessment of:o Obesity.o Jaw structureo Upper airwayo Blood pressureo Hypothyroidismo Acromegaly.Polysomnography.The apnea-hypopnea index or apnoea-hypopnoea index (AHI)It is an index of sleep apnea severity that combines apneas and hvpopneas.The apneas (pauses in breathing) must last for at least 10 seconds and are associated with a decrease in blood oxygenation.Combining these gives an overall sleep apnea severity score that evaluates both number sleep disruptions and degree of oxygen desaturation (low blood level).The AHI is calculated by dividing the number of events by the number of hours of sleep.AHI values are typically categorized as:o Mild = 5-15/hro Moderate = 15-30/hro Severe = > 30/hTREATMENT: OBSTRUCTIVE SLEEP APNEAWhom to Treat-Indications for TreatmentGroup IPatients who have an:o Epworth Score >1Lo Troublesome sleepiness while driving or working.o >15 apneas + hypopneas per hour of sleep.Treatment is definitely indicated in this group- Maximum benefit.Treatment improves:o Symptomso Sleepinesso Drivingo Cognitiono Moodo Quality of lifeo Blood pressure.Group 2Patient who have:o Similar degrees of sleepiness as Group Io 5-15 events per hour of sleep.Treatment is indicated-But benefit is less than Group 1.Treatment improves:o Symptomso Subjective sleepiness.No significant improvement in cognition and quality of life.No improvements in Blood pressure.Group 3Patients who are/have:o Nonsleepy subjects.o Less than 5 events per hour of sleep.Treatment is not indicated.No benefit with treatment.Life style modifications advised.MANAGEMENT OPTIONSLifestyle ModificationsWeight loss.Alcohol Reduction-Alcohol acutely decreases URT dilating muscle tone.CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP)Blowing the airway open during sleep, usually with pressures of 5-20 mmllg.CPAP improves the following in patients with OSAHS:o Breathing during sleepo Sleep qualityo Sleepinesso Blood pressureo Vigilanceo Cognitiono Driving abilityo Moodo Quality of life.The main side effect of CPAP is airway drying (decreased by using heated humidifier).CPAP is effective for both Moderate and Severe disease.Most common treatment modality used in OS A.MANDIBULAR REPOSITIONING SPLINT (MRS)Also called oral devices.Holds lower jaw and tongue forward causing widening the pharyngeal airway.MRSs improve the follow ing in OSAHS patients:o Breathing during sleep.o Daytime somnolenceo Blood pressure.There are many devices with differing designs with unknown relative efficacy.Self-reports of the use of devices long-term suggest high dropout rates.SurgeryBariatric surgery can be curative in the morbidly obese.Tonsillectomy can be highly effective in children but rarely in adults.Tracheostomy is curative but rarely used because of the associated morbidity rate but should nor be overlooked in severe cases.Jaw advancement surgery--particularly maxillomandibular osteotomy--is effective in young and thin patients with retrognathia (posterior displacement of the mandible).There is no clear evidence that pharyngeal surgery , including uvulopalatopharyngoplasty (whether by scalpel, laser, or thermal techniques) helps OSAHS patients.DrugsNo drugs are clinically useful in the prevention or reduction of apneas and hypopneas.In CPAP refractory patients. Modafinil can be tried with limited success.Choice of TreatmentCPAP and MRS are the two most widely used and best evidence-based therapies.CPAP is the current treatment of choice.MRSs are evidence-based second-line therapy in those who fail CPAP.In younger. thinner patients, maxillomandibular advancement should be considered.Note:In the given case, patient has 5 events/hour of sleep. He is also obese, diabetic, smoker and hypertensive. So the next step in management is to advocate life style modifications to treat obesity advise smoking cessation and follow-up. | Medicine | Diabites & Inappropriate Antidiuretic Hormone |
e002aab4-2a95-4f63-bca4-bb7c054eb9c3 | Blue sclera is seen in - | Alkaptonuria | Osteogenesis imperfect | Down syndrome | Kawasaki syndrome | 1b
| single | Ans. is 'b' i.e., Osteogenesis imperfect * Blue scleral discoloration is caused by thinning or transparency with resultant visualization of the underlying uvea.* Causes of blue sclera are: Osteogenesis imperfecta, Marfan syndrome, Ehler - Danlos syndrome, Pseudoxanthoma elasticum. | Ophthalmology | Sclera |
9edee9c3-3343-4f76-821b-44edb74dacd5 | A 3 year graduate MBBS programme was suggested by which committee? | Sundar Committee | Expert Level Committee on Universal Health Coverage | Srivastava Committee | Krishnan Committee | 1b
| single | HLEG Recommendations
High Level Expert Group (HLEG, Planning Commission, GOI) on Universal health Coverage has suggested 3½ year MBBS course for serving rural population
HLEG was developed for XII Five Year Plan
Rural doctors will be called as ‘Community Health Officers’
3½ Degree given: B.Sc. Community Health | Social & Preventive Medicine | null |
4c00e498-9483-4d46-90e1-05db764595c1 | Quinidine exes action on hea by | Ca+ Channel blocker | Kt Channel blocker | Na+ Channel opener | Cl+ Channel opener | 1b
| single | Refer katzung 11e p 237 * Mechanism of action Like all other class I antiarrhythmic agents, quinidine primarily works by blocking the fast inward sodium current (INa). ... The effect of blocking the fast inward sodium current causes the phase 0 depolarization of the cardiac action potential to decrease (decreased Vmax). | Pharmacology | Cardiovascular system |
0ddd485d-1d97-49b3-8f1a-aceb36b938ba | In the beginning of resuscitation effos, 0.5 mg of epinephrine is administered subcutaneously. Which adrenergic receptors, in which tissues, are responsible for the beneficial effect of epinephrine in this patient? | Alpha-1 receptors in vascular smooth muscle, alpha-2 receptors in the hea, and beta-1 receptors in bronchial smooth muscle | Alpha-1 receptors in vascular smooth muscle, alpha-2 receptors at presynaptic nerve terminals, beta-1 receptors in bronchial smooth muscle | Alpha-1 receptors in vascular smooth muscle, beta-1 receptors in the hea, and beta-2 receptors in bronchial smooth muscle | Alpha-2 receptors in vascular smooth muscle and beta-2 receptors in vascular smooth muscle | 2c
| single | Epinephrine is a non selective adrenergic agonist and a valuable resuscitative drug because of its effects at multiple adrenergic receptor subtypes. In the treatment of anaphylaxis, epinephrine increases myocardial contractility, accelerates hea rate, causes constriction of vascular smooth muscle, and causes relaxation of bronchial smooth muscle. The principal pharmacologic effects of epinephrine that are beneficial in anaphylaxis are mediated : alpha-1 receptors in vascular smooth muscle, resulting in vasoconstriction, beta-1 receptors in the hea, resulting in increased contractility, and beta-2 receptors in bronchial smooth muscle, resulting in relaxation and relief of bronchoconstriction. (One simple mnemonic for the respective locations of beta1 and beta2 receptors is "one hea, two lungs.") Beta-2 receptors are also found, however, in vascular smooth muscle (especially in skeletal muscle beds), were, just as in bronchial smooth muscle, they promote relaxation. (Epinephrine dilates skeletal muscle vascular beds to maximize oxygen delivery for the "fight-or-flight" response.) The resulting vasodilation in skeletal muscle vascular beds would, by itself, tend to decrease blood pressure, which might tend to worsen the effects of anaphylactic shock, but this effect is mitigated by the intense alpha-1 receptor stimulation, causing vasoconstriction in multiple beds. The principal action of alpha-2 receptors is at the presynaptic nerve terminal, where receptor stimulation reduces the release of norepinephrine from the nerve terminal. Epinephrine does stimulate these receptors, but it does not really contribute to the beneficial actions of epinephrine in resuscitation. Alpha-2 receptors are not located in the hea (except at presynaptic nerve terminals), alpha-2 receptors do not have a significant beneficial effect in resuscitation, and beta-1 receptors are not located in bronchial smooth muscle, but are located in the hea. Beta-1 receptors are located in the hea, not in bronchial smooth muscle. The adrenergic receptor that produces bronchial smooth muscle relaxation is beta-2. Alpha-2 receptors are located primarily at presynaptic nerve terminals, and because the beta-2 receptors in vascular smooth muscle cause vasodilation, this not a helpful effect of epinephrine in this case. Also Know: Epinephrine is indicated for the treatment of anaphylactic reactions and acute asthma exacerbations. It is considered a first-line agent in the treatment of cardiac arrest (i.e., pulseless ventricular tachycardia/ventricular fibrillation, asystole, and pulseless electrical activity). Epinephrine also causes bronchodilation and antagonizes the effects of histamine. Epinephrine significantly increases myocardial oxygen consumption and thus can exacerbate ventricular irritability in the setting of myocardial ischemia. Extravasation causes necrosis and sloughing, and requires prompt infiltration of the affected area with phentolamine. Ref: Miller B.A., Clements E.A. (2011). Chapter 24. Pharmacology of Vasopressor Agents. In J.E. Tintinalli, J.S. Stapczynski, D.M. Cline, O.J. Ma, R.K. Cydulka, G.D. Meckler (Eds), Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e. | Pharmacology | null |
53863cc7-5dfe-4c90-be6a-b0cd962e04da | Residul lung volume increased in | Obesity | Emphysema | Bacterial pneumonia | Idiopatic pulmonary fibrosis | 1b
| single | (B) Emphysema# FACTORS AFFECTING FRC> FRC Increases with: Increased height Erect position (30% more than in supine) Decreased lung recoil (E.g. emphysema)> FRC Decreases with: Obesity, Muscle Paralysis (especially in supine) Restrictive lung disease (E.g. Fibrosis, Pregnancy) Anaesthesia FRC does not change with age> Emphysema is a condition of the lung characterized by abnormal permanent enlargement of the airspaces distal to the terminal bronchiole, accompanied by destruction of their walls and without obvious fibrosis.> Principal antielastase activity in serum and interstitial tissue is alpha 1 -AT (others are secretory leukoprotease inhibitor in bronchial mucus and serum alphal -macroglobulin), and the principal cellular elastase activity is derived from neutrophils (other elastases are formed by macrophages, mast cells, pancreas, and bacteria). Neutrophil elastase is capable of digesting human lung, and this digestion can be inhibited by alphal-antitrypsin.> The most plausible hypothesis to account for the destruction of alveolar walls is the protease-antiprotease mechanism. This hypothesis is based on two important observations, one clinical and one experimental. The first is that homozygous patients with a genetic deficiency of the protease inhibitor alphal -AT have a markedly enhanced tendency to develop pulmonary emphysema, which is compounded by smoking.# Emphysema is classified into distinct pathologic types:> The most important types being centriacinar and panacinar.# Centriacinar emphysema, the type most frequently associated with cigarette smoking, is characterized by enlarged airspaces found (initially) in association with respiratory bronchioles.> Centriacinar emphysema is most prominent in the upper lobes and superior segments of lower lobes and is often quite focal.# Panacinar emphysema refers to abnormally large airspaces evenly distributed within and across acinar units.> Panacinar emphysema is usually observed in patients with a1 AT deficiency.> Pulmonary function testing shows airflow obstruction with a reduction in FEV1 and FEV1/FVC With worsening disease severity, lung volumes may increase, resulting in an increase in total lung capacity, functional residual capacity, and residual volume.> In patients with emphysema, the diffusing capacity may be reduced, reflecting the parenchymal destruction characteristic of the disease. | Medicine | Miscellaneous |
912a667d-7314-4e2a-8c61-254829eae221 | What is the most probable diagnosis for on the x-ray of a 20 year old female who came with knee swelling | Osteosarcoma | Osteoclastoma | Osteochondroma | None of the above | 0a
| multi | Sunburst appearance of Osteosarcoma Sunburst appearance is a type of periosteal reaction giving the appearance of a sunburst secondary to an aggressive The sunburst appearance occurs when the lesion grows too fast and the periosteum does not have enough time to lay down a new layer and instead the It is frequently associated with or osteoblastic metastases Ref: Maheshwari 6e pg 239. | Orthopaedics | All India exam |
3279884b-f16a-455f-80ff-ffdac0268c3e | Which among the following is true about atrial myxoma? | Most common in right atrium | Rarely reoccurs after excision | Distant metastases are seen | More common in males | 3d
| multi | Atrial myxomas are the most common primary hea tumors, and 75-85% occurs in the left atrial cavity. The most common site of attachment is at the border of the fossa ovalis in the left atrium. Although atrial myxomas are typically benign, local recurrence due to inadequate resection or malignant change has been repoed. Two-dimensional echocardiography is the diagnostic procedure of choice. Most atrial myxomas are benign and can be removed by surgical resection. | Surgery | null |
26c725f5-13be-45fd-9f43-928281fb1d69 | For the following statements, select whether it is applicable to any or all of the below medications.Inhibition of angiotensin converting enzyme I (ACE I) | hydralazine | enalapril | spironolactone | metoprolol | 1b
| multi | Enalapril may exert its effect by inhibiting formation of angiotensin II. This lowers systemic vascular resistance. In addition, ACE inhibitors have a natriuretic effect by inhibition of aldosterone secretion. They have been shown to improve mortality and decrease hospitalization in patients with CHF. | Medicine | C.V.S. |
a1ae7e34-0cc1-4c25-832a-ad3e869b04bb | Lesion of optic tract causes? | Binasal hemianopia | Bitemporal hemianopia | Homonymous superior quadrantonopia | Homonymous hemianopia | 3d
| single | Ans. (d) Homonymous hemianopiaRef.: Harrison's 19th ed. /198-199* Unilateral optic nerve lesion: Unilateral blindness* Binasal hemianopia: Bitemporal optic chiasma lesion. Two different lesions compressing the chiasma from the lateral parts.* Bitemporal hemianopia: Binasal retinal damaged optic chiasmal lesion. Commonest lesion is pituitary adenoma.* Homonymous hemianopia: lesion at optic tract AND optic radiation* Homonymous superior quadrantonopia: All superior quadrantonopia goes to the temporal lobe (pie in the sky).* Homonymous inferior quadrantonopia: All inferior quadrantonopia goes to the parietal lobe (Pie on the floor).* Homonymous hemianopia w/ macular sparing: Lesion in occipital cortex les | Ophthalmology | Lesions of the Visual Pathway |
5a4d3e7d-5358-48ef-b7ac-57e7e7a5b3a8 | Who coined term anaesthesia | Moon | Holmes | Morgan | Priestly | 1b
| single | Oliver Wendell Holmes coined the term anesthesia. In 1846, Holmes coined the word anesthesia. In a letter to dentist William T. G. Moon, the first practitioner to publicly demonstrate the use of ether during surgery, he wrote: "Everybody wants to have a hand in a great discovery. All I will do is to give a hint or two as to names--or the name--to be applied to the state produced and the agent. The state should, I think, be called "Anaesthesia." This signifies insensibility--more paicularly ... to objects of touch." Ether was used for frivolous purposes ("ether frolics"), but not as an anesthetic agent in humans until 1842, when Crawford W. Long and William E. Clark independently used it on patients for surgery and dental extraction, respectively. However, neither Long nor Clark publicized his discovery. Four years later, in Boston, on October 16, 1846, William T.G. Moon conducted the first publicized demonstration of general anesthesia for surgical operation using ether. The dramatic success of that exhibition led the operating surgeon to exclaim to a skeptical audience: "Gentlemen, this is no humbug!" Joseph Priestley produced nitrous oxide in 1772, and Humphry Davy first noted its analgesic propeies in 1800. Gardner Colton and Horace Wells are credited with having first used nitrous oxide as an anesthetic for dental extractions in humans in 1844. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e | Anaesthesia | General anaesthesia |
5794f9a3-3751-4aaa-9a66-c8d595fb3029 | A 55-year-old man presents with recurrent epigastric pain. Upper GI endoscopy and gastric biopsy reveal a neoplastic, lymphocytic infiltrate invading glandular tissue. Giemsa staining is positive for Helicobacter pylori. Which of the following is the most likely diagnosis? | Burkitt lymphoma | Marginal zone lymphoma | Follicular lymphoma | Mantle cell lymphoma | 1b
| single | Diagnosis: Marginal zone lymphoma, MALT lymphoma Marginal Zone Lymphoma is an indolent tumor develop due to chronic B cell stimulation either by H.pylori or Auto immune disorders Translocation (11:18) involved | Pathology | Non Hodgkin Iymphoma |
389308bb-d6dc-408b-b364-15fe5627d57a | Maintenance of high urinary pH is important during methotrexate treatment because: | Bladder irritation is reduced | It decreases renal tubular secretion of methotrexate | Leucovorin toxicity is increased in a dehydrated patient | Methotrexate is a weak acid | 3d
| single | Methotrexate is a weak acid and is reabsorbed in acidic urinary pH. Higher plasma concentration may result in toxicity. Therefore, to decrease the reabsorption through renal tubules, high urinary pH must be maintained. | Pharmacology | null |
20c3f14f-2cf7-4952-ab36-08f6f761564a | Which of the following statement is true regarding Atazanavir:- | Effective against only HIV-1 | Resistance is due to mutation in codon 50 isoleucine to valine substitution | Decrease cholesterol and triglyceride levels | Combination with ritonavir do not have any advantage | 1b
| multi | Atazanavir is effective against both against HIV 1 and HIV 2 but NNI are effective only against HIV 1. They do not decrease cholesterol and triglyceride levels. Combination with ritonavir have an advantage due to the phenomenon of Ritonavir boosting. The resistance is due to mutation in codon 50 isoleucine to valine substitution. | Pharmacology | Anti-HIV Drugs |
34b433b0-90ba-447c-ae08-32c3b3aa43a1 | Cerebrosides consist mostly of this | Glucose | Galactose | Fructose | Arabinose | 1b
| single | Both glucocerebrosides and galacto cerebrosides are present however galactocerebrosides are most commonly seen on neural cells and are abundant | Biochemistry | miscellaneous |
a4da82ea-fb41-4064-b3d6-4400d4702165 | Bence Jone's Protein is: March 2005 | Monoclonal heavy chains | Monoclonal light chains | Both of above | None of the above | 1b
| multi | Ans. B: Monoclonal light chains A Bence Jones protein is a monoclonal globulin protein found in the blood or urine, with a molecular weight of 22-24 kDa. The proteins are immunoglobulin light chains (paraproteins) and are produced by neoplastic plasma cells. They can be kappa (most of the time) or lambda. The light chains can be immunoglobulin fragments or single homogeneous immunoglobulins. They are found in urine due to the kidneys' decreased filtration capabilities due to renal failure, often induced by hypercalcemia from the calcium released as the bones are destroyed. The light chains can be detected by heating or electrophoresis of concentrated urine. Light chains precipitate when heated to 50 - 60 degrees C and redisolve at 90 -100 degrees C. There are various rarer conditions that can produce Bence Jones proteins, such as Waldenstrom's macroglobulinemia. | Pathology | null |
2605426c-3123-4d74-83b1-1ffc00aa5543 | Risk factors for gonococcal infection is all except | Age > 25 year | Prior or current STDs | New or multiple sexual partners | Lack of barrier modes of protection | 0a
| multi | Age < 24 years is a risk factor. | Gynaecology & Obstetrics | null |
f894dd04-28d7-4d0d-adff-118cfc5cb70a | If a 5–year-old child suddenly develops stridor, which one of the following would be the most likely diagnosis – | Laryngomalacia | Acute laryngo–tracheobronchitis | Foreign body aspiration | Acute epiglottitis | 2c
| single | null | Pediatrics | null |
0d0c73ba-e981-4752-8f1f-8c753874534d | The ability of a screening test to detect "true positives" is known as - | Sensitivity | Specificity | Positive predictive value | Negative predictive value | 0a
| multi | null | Social & Preventive Medicine | null |
859927e4-cb26-4fc8-8245-c2e988870663 | Which of the following best defines the "Saccade"- | Voluntary slow eye movements | Involuntary slow eye movement | Abrupt, involuntary slow eye movements | Abrupt, involuntary rapid eye movements | 3d
| single | Saccades are sudden, jerky conjugate eye movements that occur as the gaze shifts from one object to another. Supranuclear eye movement systems include : Saccadic system Smooth pursuit system Vergence system Vestibular system Optokinetic sysytem Position maintenance system Ref;A.K.Khurana;6th edition; Page no: 341 | Ophthalmology | Ocular motility and squint |
5231c88b-72d2-458c-84c2-0054e526725b | Inclusion conjunctivitis is caused by- | Trachoma | Pneumococcus | Candida | Neisseria | 0a
| single | Ans. is 'a' i.e., Trachoma Adult inclusion conjunctivitiso It is a type offollicular conjunctivitis caused by serotypes D to K of chlamydia trachomatis-in sexually active young adults.o The primary source of infection is urethritis in males and cervicitis in females.o Transmission may occur either through contaminated fingers or through contaminated water of swimming pools (Swimmingpool granuloma).o Presentation is similar to other acute follicular conjunctivits with mucopurulent discharge,o The disease runs a benign course and often evolves into the chronic follicular conjunctivitis. | Ophthalmology | Inflammations of Conjunctiva - Infective |
0de41bd1-4c73-48eb-80b0-386daafdea24 | A 25 years old male smoker presents with high grade fever with chills and severe right sided pleuritic chest pain and cough with expectoration physical examination of the patient is likely to show | Increased percussion sounds | Decreased vocal fremitus | Bronchial breath sounds | Decreased vocal resonance | 2c
| single | This is the case of pneumonia shows signs of consolidation lung :
Reduced thoracic movements.
Increased vocal fremitus and vocal resonance.
Dull note on percussion.
Bronchial breath sounds. | Medicine | null |
784abd73-7587-4533-8793-502f594486d9 | All except one is continued prior to elective caesarean section in an hypertensive diabetic term gestation, obese female who is a case of chronic aorto iliac obstruction. | Labetalol | Statins | Magnesium sulphate | Heparin | 3d
| multi | Heparin is stopped 6 hours priorly. Rest all drugs need to be continued till day of surgery. | Anaesthesia | null |
38888c1e-f85f-4d38-ab27-3856cdb47cf3 | Triple bonds are found between which base pairs | A–T | C–G | A–G | C–T | 1b
| single | Adenine is always paired with thymine by the formation of two hydrogen bonds. Guanine is always paired with cytosine by the formation of three hydrogen bonds.
Thus, the C-G bonds are more resistant to denaturation. | Biochemistry | null |
d669b0d5-71b1-495f-9fa3-5c0d2651f676 | Which is not an effect of atropine? | Rise of body temperature | Decreased salivary secretion | Bradycardia | Increased A-V conduction | 2c
| single | ANSWER: (C) BradycardiaREF: KDT 4th Ed p. 94EFFECTS OF ATROPINE:CNS* Stimulates medullary , vasomotor and respiratory center* Depresses vestibular excitation , hence anti motion sickness* Suppresses cholinergic activity in basal ganglia, hence decreases tremor.* High doses may cause cortical excitation , restlessness , disorientation and hallucinationsCVS* Tachycardia* Abbreviates A-V refractory period* Facilitates A-V conduction* No consistent effect on BPEYE* Mydriaisis* Abolition of light reflexes* Cycloplegia* Rise of IOTSmooth musdes* All visceral smooth muscles are relaxed* Constipation* Bronchodilation* Urinary retention* Urinary bladder and ureter relaxation* Effect on uterus is minimal* Effect of biliary tract is less markedGlands* Decrease sweat, salivary , tracheobronchial and lachrymal secretions* Decreases secretion of acid and pepsinBody temperature* riseLocal anesthetic* effect present | Pharmacology | Anti Cholinergic |
Subsets and Splits