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5f2cac99-9bb1-4273-ace9-bb53232d5f7d
Which of the positions best describes the location of celiac plexus
Anterior or anterolateral to Aoa
Posterolateral to Aoa
Anterolateral to sympathetic chain
Anteromedial to sympathetic chain
0a
single
A i.e. Anterior anterolateral to Aoa
Anatomy
null
cdbcfca8-0a8c-460f-aa9c-c972efcf837f
Drugs highly bound to albumin
NSAID'S
Lidocaine
Beta blockers
Verapamil
0a
single
null
Pharmacology
null
7ed9b448-a70f-4e1d-82dc-248dad43c615
Adverse effect of phenytoin include the following except-
Lymphadenopathy
Ataxia
Hypercalcemia
Hirsutism
2c
multi
Ans. is 'c' i.e., Hypercalcemia Phenytoin interferes with calcium metabolism by desensitizing target tissue to vit. D, this causes hypocalcemia (not hypercalcemia).
Pharmacology
null
9ef8c88a-4de3-4b89-b2a9-28586dd05628
Breast milk storage in a refrigerator is upto ?
4 hrs
8 hrs
12 hours
24 hrs
3d
single
Ans. is 'd' i.e., 24 hrs Breast milk o Can be stored at room temperature --> For 8-10 hours o In a refrigerator --> For 24 hours o In a freezer --> -20degc for 3 months
Pediatrics
null
1690c6d1-978e-4511-b77e-c2064e9fbb7b
Which of the following signs is not suggestive of a cervical spinal cord injury :
Flaccidity
Increased rectal sphincter tone
Diaphragmatic breathing
Priapism
1b
single
Answer is B (Increased Rectal Sphincter tone): Cervical spinal cord injury is associated with a decreased rectal sphincter tone (and not an increased rectal sphincter tone).
Medicine
null
faa40e91-a8c9-44c8-ad42-0824f37a0f5e
All are infraclavicular branches of brachial plexus except ?
Ulnar nerve
Long thoracic nerve
Axillary nerve
Thoracodorsal nerve
1b
multi
Ans. is `b' i.e., Long thoracic nerve
Anatomy
null
255935d9-d1c8-489d-ad2f-fc580c483729
Which of the following is used as inhibitor in the composition of composite?
Para-toluidine
Butylated hydroxy toluene
Methyl ether
Tertiary amine
1b
single
Butylated hydroxy toluene inhibits polymerization during storage.
Dental
null
375ec9c4-bfe1-460c-8c54-5d4f1cdb81c0
Tuberculin test positivity indicates
Good humoral immunity
Infection with mycobacteriam
Good cell mediated immunity
None
2c
multi
Tuberculin (Mantoux) skin test. This test is done by intradermal injection of 0.1 ml of tuberculin protein, purifiedprotein derivative (PPD). Delayed-type of hypersensitivity develops in individuals who are having or have beenpreviously infected with the tuberculous infection which is identified as an indurated area of more than 15 mm in 72hours. However, patients having disseminated tuberculosis may show negative test due to the release of a large amount of tuberculin proteins from the endogenous lesions masking the hypersensitivity test. A positive test is indicative of cell mediated hypersensitivity to tubercular antigens but doesnot distinguish between infection and disease. The test may be false positive in atypical mycobacterial infection and falsenegative in sarcoidosis, some viral infections, Hodgkin's disease, and fulminant tuberculosis. Ref: Harsh Mohan - Textbook of Pathology, 6th Edition.page no.152
Pathology
dermatology and infectious disease
fe1e6282-4663-4616-8fe5-b31217fca5e3
Presence of Epstein Barr virus in hairy Leukoplakia can be demonstrated using following methods EXCEPT -
Tzanck smear
Polymerase chain reaction
In situ hybridization
Electron microscopy
0a
multi
null
Pathology
null
d41e8a6b-1dc4-4cd7-8586-4960983fccfc
An inexpensive and efficient method of sewage disposal for a small community is –
River outfall
Oxidation pond
Trickling filter
Activated sludge
1b
multi
null
Social & Preventive Medicine
null
3392e6e4-b16b-46ed-9532-a1bf939b431e
Following is/are the causes of a chronic cough with noncontributory chest radiograph?
Asthma
Post nasal drip
GERD
All the above
3d
multi
90% of patients who have a chronic cough and a normal or noncontributory chest radiograph belong to one of the following causes:Use of an angiotensin-conveing enzyme inhibitor;Post -nasal drainage;Gastroesophageal reflux; andAsthmaRef: PL Dhingra, Diseases of Ear, Nose & Throat, 7th edition
ENT
Larynx
f0df3dc4-a8cd-42a7-8771-7a8de582186f
Anagen effluvium is induced by all except -
Radiation
PEM
Anticancer drug
Prolonged Iabor
3d
multi
Causes of anagen effluvium drugs: antimitotics- cyclophosphamide, methotrexate, actinomycin, doxorubicin, 5 fluorouracil,azathioprine, busulphan anticoagulants-heparin, warfarin,dextran metallic slats- thallium, arsenic,gold,bismuth others-levodopa, colchicine ionising radiation Ref Harrison20th edition pg 1236
Dental
Anatomy of skin
cb39be95-5d11-49dd-bf0b-6ad749807520
All the following familial syndromes are associated with development of pheochromocytomas except ?
Sturge-Weber syndrome
Von Recklinghausen disease
MEN Type II
Prader-Willi syndrome
3d
multi
Ans. is 'd' i.e., Prader willi syndrome Pheochromocytoma is associated with the following familial syndromes. MEN syndrome type 2A & type 2B 3. Von Recklinghausen (Neurofibromatosis type I) Von Hippel lindau syndrome 4. Sturge weber Syndrome Familial paraganliomas 1,2, & 3 are also associated with Pheochromocytoma (Has been added in 8th/e of Robbin's)
Pathology
null
41c6f497-7e0b-4be1-9855-15668b2a99ed
A child presents with respiratory distress. A vascular ring is suspected. Investigation of choice is:
PET
CT
MR1
Angiography
2c
single
MRI Sabiston writes-"Initially, diagnosis is made by a high index of suspicion, and the barium swallow is the first investigation. Echocardiography can document an abnormal head and neck vessel branching pattern, excluding intracardiac abnormalities. MRI provides complete anatomic detail." A vascular ring is a condition in which an anomalous configuration of the arch and/or its associated vessels completely or incompletely surrounds the trachea and oesophagus causing compression of these structures. Neonates present with respiratory distress, older children present with stridor or dysphagia. The two most common types of complete vascular rings, which account for 85-95% of cases, are double aoic arch and right aoic arch with left ligamentum aeriosum. Tracheomalacia results from compression of the trachea by vascular rings. Surgical division of a vascular ring is the only definitive treatment.
Radiology
null
e3f66971-984f-4ea4-a552-297e8f84c42f
The purines salvage pathway is for:
Hypoxanthine & Xanthine
Hypoxanthine & Thymine
Adenine & Guanine
Xanthine & Guanine
2c
single
The purines salvage pathway is for Adenine Guanine Hypoxanthine Adenosine is the only purine nucleoside which can be salvaged i.e. Adenosine gets conveed to AMP by Adenosine Kinase.
Biochemistry
Nucleotides
6022af1f-be7a-4b78-8cda-43e0bac536e5
A 28 year old labourer, 3 yrs back presented with penile ulcer which was not treated. Later he presented with neurological symptoms for which he got treated. Which is the test to monitor response to treatment?
VDRL
FTA ABS
TPI
RPR
0a
single
This is a case of neurosyphilis. A positive nontreponemal CSF serologic test result (CSF VDRL) establishes the diagnosis of neurosyphilis (and an increased cell count in response to the spirochete documents the presence of active disease). In VDRL test, the inactivated serum is mixed with cardiolipin antigen on a special slide & rotated for 4 minutes. Cardiolipin remains as uniform crystals in normal serum but it forms visible clumps on combining with regain antibody. The reaction is read under low power microscope. By testing serial dilutions, the antibody titre can be estimated. The results are repoed as reactive, weak by reactive / not reactive. The VDRL test can be used for testing CSF also, but not plasma. A number of modification of VDRL test have been developed, of which the Rapid Plasma Reagin (RPR) is the most popular. In RPR test. VDRL antigen containing carbon paicles which make the result more clear cut & evident to the naked eye The RPR test is done with unheated serum / plasma but is not suitable for testing CSF. Ref: Ananthanarayanan & Paniker's textbook of microbiology Ed 8 Pg - 375; Klausner J.D., Hook III E.W. (2007). Chapter 20. Neurosyphilis. In J.D. Klausner, E.W. Hook III (Eds), CURRENT Diagnosis & Treatment of Sexually Transmitted Diseases.
Microbiology
null
26551f44-091b-40f2-a57f-7c8a257b181b
Preaxial border of limb is ?
Ulnar border of forearm
Fibular border of leg
Radial border of forearm
None of the above
2c
multi
Ans. is 'c' i.e., Radial border of forearm Preaxial pa is derived from anterior segments of limb bud and postaxial pa is derived from posterior segments of limb bud.Upper limbPreaxial border : Lateral epicondyle of humerus radius, thumb Postaxial border : Medial epicondyle of humerus, ulna, little fingerLower limbPreaxial border : Medial epicondyle of femur, tibia, great toe Postaxial border : Lateral epicndyle of femur, fibula, little toe
Anatomy
null
ec0dca57-b9d0-439c-a518-381739a6487a
Abnormalities of copper metabolism are implicated in the pathogenesis of all the following except -
Wilson's disease
Monkes' Kinky-hair syndrome
Indian childhood cirrhosis
Keshan disease
3d
multi
Ans. is 'd' i.e., Keshan disease o Keshan disease is a disorder of selenium metabolismo Following diseases are related to copper metabolism:-i) Wilson's diseaseii) Menkes kinky hair syndromeiii) Indian childhood cirrhosis (increased hepatic, urinary and serum copper concentration are characteristic of ICC).
Pediatrics
Micronutrient Mineral Deficiencies
e9c85bb3-b362-48fc-b3b1-586db05b1861
Common bile duct stones will manifest all except -
Distended gall bladder
Jaundice
Itching
Clay coloured stools
0a
multi
null
Surgery
null
c0c00f25-1d14-4a18-be06-4e84f3fdc126
One gray of radiation is equal to –
1 rad
10 rad
100 rad
1000 rad
2c
single
null
Social & Preventive Medicine
null
2f61fd48-8583-4faa-a374-29964f1dfc4c
Saddleback/ biphasic fever is seen in: September 2004
Typhoid
Dengue
Brucellosis
Trench fever
1b
single
Ans. B i.e. Dengue
Social & Preventive Medicine
null
2b41ea99-bd94-4992-8a61-bd23561ec0f9
Savlon contains
Cetrimide + Chlorhexidine
Cetrimide + Chlorhexidine + butyl alcohol
Cetrimide + butyl alcohol
Cetrimide + cetavlon
0a
single
Savlon is a combination of cetavlon and hibitane. Plastic appliances can be disinfected by keeping them in normal strength savlon for 20 minutes. Savlon 1 in 6 spirit is more effective than savlon in 1 in 20 aquous solution Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 141
Social & Preventive Medicine
Epidemiology
229e1f82-e51c-4718-81af-ccacb11a6117
In congenital adrenal hyperplasia precocious puberty in male is due to -
21 alpha hydroxylase deficiency
11 Beta hydroxylase deficiency
Both
None
2c
multi
Ans. is 'c' i.e., Both Etiology of precocious puberty in boys Central - cause: GonadoGonadotropindent Idiopathic CNS tumor - Harmartoma, craniopharyngioma. CNS Infection - TBM, Meningitis CNS Injury - Trauma, surgery, radiation. CNS malformation- Arachnoid cyst, hydrocephalus Peripheral cause : Gonadotropin independent Congenital adrenal hyperplasia 21-hydroxylase deficiency - Most common 11 b hydroxylase def Adrenal tumor - Adenoma, carcinoma Testicular tumor - Seminoma, germinoma Activation of LH receptor HCG secreting tumor - Germinoma, hepatoblastoma Testosterone cream
Pediatrics
Adrenal Gland
27a1ae35-7c36-4f7a-8e9f-14ae79a23a03
A boy is suffering from acute pyelonephritis. Most specific urinary finnding will be:
WBC cast
Leucocyte esterase test
Nitrite test
Bacteria in Gram stain
2c
single
Sensitivity and Specificity of Urinanalysis in UTI: Tests Sensitivity (%) Specificity (%) Esterase 83 (67-94) 78(64-92) Nitrite 53(15-82) 98(90-100) Esterase or NItrite 93(90-100) 72(58-91) White blood cells 73(32-100) 81(45-98) Bacteria 81(16-99) 83(11-100) Any above 99.8 (99-100) 70(60-92) Ref: Smith 18th edition Pgno: 200
Surgery
Urology
97e1844a-8d0b-4330-ae96-56fa2bdbaea0
Trousseau's syndrome is classically seen with:
Carcinoma stomach
MEN type II
Neuroendocrine tumors
Carcinoma pancreas
3d
multi
Paraneoplastic Thrombophlebitis Deep venous thrombosis is the most common thrombotic condition in patients with cancer.It may be associated with pulmonary embolism (15% of patients who develop deep venous thrombosis or pulmonary embolism have cancer) (Chap. 117). Trousseau's syndrome The coexistence of peripheral venous thrombosis with internal malignancy, paicularly pancreatic cancer. Ref: Harrison,E-18,P-831
Medicine
null
13a40a30-a18b-4300-ba3d-f191b6df3993
Bite test is used for detection of
Cracked tooth
Pulp vitality
Bite force measurement
occlusal discrepancy
0a
single
null
Dental
null
23f93efc-0a86-4f19-a735-465ef995b4e6
A pt. presents with hematuria of several days and dysmorphic RBC casts in urine. The site of origin is :
Kidney
Ureter
Bladder
Urethra
0a
single
Ans. is 'a' ie kidney " Isolated microscopic hematuria can be a manifestation of glomerular disease. The RBCs of glomerular origin are often dysmorphic."" Hematuria with dysmorphic RBCs, RBC casts and protein excretion > 500 mg/day is virtually diagnostic of glomerulonephritis."SoDysmorphic RBCs - origin is kidney*RBCs cast - origin is kidney *Broad cast - Seen in chronic renal diseases.Granular cast - ARF*Waxy casts - seen in chronic renal disease.WBC casts - pyelonephritis*.Also rememberHematuria is defined as two to five RBCs per high power fieldNormal RBCs excretion is upto 2 million RBCs/day
Surgery
Kidney & Ureturs
a10015a6-55b8-40be-9d9c-42e4abad1561
All is true about Fibrous dysplasia except
Benign
Trabeculae mimic Chinese characters
Can be polyostotic
Extramedullary
3d
multi
Fibrous dysplasia is a disorder where normal bone and marrow is replaced with fibrous tissue, resulting in formation of bone that is weak and prone to expansion. As a result, most complications result from fracture, deformity, functional impairment and pain.Morphology Fibrous dysplasia is characterized by well circumscribed intramedullary lesions of varying sizes, large masses expand and disto the bone. Robbins basic pathology 9th edition page no 780,box=
Pathology
Breast
a1419f9e-d598-45ba-b406-39f2a2224009
In an incised wound, all of the following are true, except:
It has clean-cut margins
Bleeding is generally less than in lacerations
Tailing is often present
Length of injury does not correspond with length of blade
1b
multi
Incised wound/ cut/ slash/ slice Margins clean cut & regular Blood vessels are clean cut, profuse bleeding present. Gaping is present & eversion of margins Tailing is present, suggesting the direction. Bevellingis seen if the blade cuts obliquely. POINTS TO REMEMBER :- CHARACTERS LACERATION INCISED WOUND Margins Irregular, edges contused Clean cut, regular Tissue bridges Present Absent Tailing Absent Present Bleeding Less (due to crushing of vessels) More (due to cutting of vessels)
Forensic Medicine
Mechanical Injuries
a47a3015-0cbc-483f-a7f1-96ba927f04b4
Group of 4-8 expes talking in front of a large group of audience is known as: September 2011
Symposium
Workshop
Seminar
Panel discussion
3d
single
Ans. D: Panel Discussion In a panel discussion, 4-8 persons who are qualified to talk about the topic sit and discuss a given problem, or the topic, in front of a large group of audience Panel Discussion A panel consists of a small group of four or eight persons, who carry on a guided and informal discussion before an audience as if the panel were meeting alone. The proceedings of the panel should be the same as those described for informal discussion: volunteering of facts, asking questions, stating opinions-all expressed with geniality, with respect for the contributions of other members, without speech making, and without making invidious personal references. This primary function should occupy approximately two-thirds of the allotted time-say foy minutes of an hour's meeting. The secondary function of the panel is to answer questions from the audience. This discussion method is suitable for use when a relatively large audience is anticipated. The disadvantage of the method is that it confines most of the discussion to the panel itself. The audience listens and is given a chance to ask questions, but for the most pa is passive and receptive. Panel discussions, if well conducted, are usually more interesting to the audience than is the single-speaker forum. They provide sufficiently varied clash of opinion and presentation of facts to give even the quiet members of the audience a feeling of vicarious paicipation. Quality and tasks of leadership in panel discussion are similar to those described for informal discussion. The leader must in addition take special care to select panel members who can think and speak effectively. He must also be sure that they prepare themselves to discuss the subject. During the discussion by the panel the leader has substantially the same duties as in informal discussion except that he should keep himself more in the background as chairman of the panel. He can do so because each member of the panel is in reality an assistant to the leader and is responsible for specific contributions to the proceedings. When the subject is thrown open to the house, it is the leader's job to recognize appropriate questions and to reject those not bearing on the subject or involving personalities. Some questions he may answer himself, but usually he should repeat the question and call upon one of the panel to answer it. By preliminary announcement the leader may also tell the audience that they may direct questions at paicular members of the panel if they choose. In any case, during the question period the leader needs to maintain strict control.On many occasions this may be the toughest pa of his assignment to carry off efficiently and with good humor. While it is customary to confine audience questions to a specific period, some leaders permit questions from the floor at any time. Unless very carefully limited by the leader, this practice may interfere with effective discussion by the panel. Arranging the panel properly will lend effectiveness to this form of discussion.The members should face the audience.It is impoant that each panel member adjust his chair so that he can see every other member without effo the chairman will also find that the best places for his readiest speakers are at the extreme ends of the table.He should keep the more reticent members close to, him so that he can readily draw them out with direct questions. If the quieter ones sit on the fringes of the panel, the more voluble members are quite likely to monopolize the discussion.
Social & Preventive Medicine
null
86498971-86b3-4ca5-94a6-c5a7fc8b777d
Medial longitudinal arch is supported by-
Plantar fascia
Sustentaculum tali
Peroneus longus
Peroneus brevis
0a
single
Ans. is 'a' i.e., Plantar fascia Arches of the foot* The arches of the foot are well known features of the foot. There are two longitudinal arches, i.e. medial longitudinal arch and lateral longitudinal arch.* In addition there are two transverse arches, i.e. posterior transverse arch and an anterior transverse arch.* The medial longitudinal arch is the most important and is primarily affected in pes planus and pes cavus.# This arch is formed by the calcaneus, talus, navicular, three cuneiforms and medial three metatarsals.# Flattening of the arch is common and is assessed clinically.# The medial arch is supported byi) Spring ligament which supports the head of the talus.ii) Plantar fascia: Both these act as a tie beam.iii) Abductor hallucis and flexor digitorum brevis which act as spring ties.iv) Tibialis anterior which lifts the centre of the arch. This muscle also forms a stirrup like support with the help of peroneus longus muscle.v) Tibialis posterior adducts the mid-tarsal joint and supports the spring ligament.vi) Flexor hallucis longus extending between the anterior and posterior ends also supports the head of talus.vii) Flexor hallucis longus* The lateral longitudinal arch is formed by calcaneum, cuboid, 4th and 5th metatarsals. It is rather shallow and gets flattened on weight bearing.# This arch is supported by long plantar ligament, short plantar ligament. Plantar fascia acts as a tie beam.# Flexor digitorum brevis, flexor digiti minimi and abductor digiti minimi act as tie beam.# Peroneus longus, peroneus brevis and peroneus tertius support this arch.* Posterior transverse arch is formed by three cuneiforms and cuboid. This arch extends across the sole in a coronal plane. It is only a half arch, the other half gets completed by the other foot. This arch is supported by the ligaments binding the bones. It gets specific support form the tendon of peroneus longus as it extends form the lateral side to the medial side of the sole.* Anteior transverse arch also lies in coronal plane. It is formed by the heads of five metatarsals. During weight bearing, the metatarsal heads flatten out.# This arch is supported by intermetatarsal ligaments and the intrinsic muscles of the sole. The transverse head of adductor hallucis holds the heads of metatarsals together.
Anatomy
Lower Extremity
1ea84daf-d8a5-4550-89d7-6499fba9f09a
Onion peel appearance of splenic capsule is seen in:
SLE
Scleroderma
RA
Sjogrens
0a
single
SLE
Pathology
null
b15b6c95-a13b-4d95-9f0d-cb28060144b4
Which of the following will have the highest magnitude of the increased Alveolar aeriolar gradient at rest?
Interstitial lung disease
Massive Pulmonary embolism
Acute severe asthma
FB leading to upper airway obstruction
1b
single
Normal alveolar aeriolar gradient is 5-15 mm Hg. In interstitial lung disease, diffusion effect is present but PO2 can be normal and decreases in exercise. Hence in ILD A-a gradient is normal at rest and increases in exercise Massive pulmonary embolism, the increased dead space leads to very low PO2 and an increase of A-a gradient. Choice C and D are easily ruled out as both leads to hypoventilation leading to normal A-a gradient.
Medicine
COPD and Asthma
1f7b062c-a2a3-4e02-b746-7dec2aefadf4
Figure of 8 configuration on chest x-ray is seen in ?
TOF
ASD
TAPVC
VSD
2c
single
Ans. is 'c' i.e., TAPVC X-ray findings of TAPVC o Cardiomegaly o Plethoric lung fields o Snowman or figure of '8' configuration --> In supracardiac TAPVC. o Ground glass appearance of lung In obstructive TAPVC. Clinical manifestations of TAPVC 1)Nonobstructive TAPVC --> Patients presents with mild cyanosis and CHF at 6-8 weeks. 2)Obstructive TAPVC Paients presents with severe cyanosis and CHF within first week. EGG o Right axis detion with right ventricular hyperophy. o In obstructive TAPVC pulmonale.
Pediatrics
null
a9102f14-30ab-4d5d-909b-c9cd971f56d4
Total ATP generated by oxidation of stearic acid is
114
131
148
None
2c
multi
Fatty acidCycles in0-oxidationSource of ATPTotal ATPs (recent calculations)Total ATPs (older calculations)Myristic acid (14-C)6 Cycles7 acetyl Cok(7x10)+(6x1.5)+(6x2-5) = 94 ATPs(7x12)+(6x2)-1-(6x3) = 114 ATPs 6 FADH NA92 ATPs)gain ' ATPs)Palmitic acid (16-C)7 Cycles8 acetyl CoA,7 FADH , 6 NADH= 108 ATPs(6, i2)+(7x2) - 131 ATPs(Net gain = 131-2 = 129 ATPs)(Net gain = 108-2 = 106 ATPs)Stearic acid (18-C)8 Cycle.9 acetyl(9x10)+(8x1.5)+(8x2-5)= 122 ATPs(9x12)+( +(8x3)= 148 ATPs 8 FADH2, 8 NADH(Net gain = 122-2 = 120 ATPs)(Net gain = 148-2 = 146 ATPs)
Biochemistry
null
43d6cc32-88f0-48cd-a6cb-b94ee00f5941
What is the finding seen earliest in USG :
Yolk sac
Fetal hea
Chorion
Placenta
0a
single
Ans. is a i.e. Yolk sac Fetal structure Detected by TVS Detected by TAS Gestational sac 4 weeks 5 weeks Yolk sac 5 weeks 7 weeks Cardiac activity 5.1 - 6.5 weeks 8 weeks Embryonic movement 7 weeks
Gynaecology & Obstetrics
null
abaf958a-b608-47e2-8935-ee56ab75fe67
What is the common cause of labial fusion in an adult female?
Congenital adrenal hyperplasia
Fetal exogenous androgen exposure
Abdominal wall defects
All of the above
0a
multi
Labial fusion in adult women is most commonly due to classical congenital adrenal hyperplasia. Other causes include, Fetal exogenous androgen exposure Abdominal wall defects Ref: (2010). Chapter 40. Reproductive Tract Abnormalities. In Cunningham F, Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (Eds), Williams Obstetrics, 23e.
Gynaecology & Obstetrics
null
1c9c04a1-2a35-445c-b92c-489f8bbdd48d
Which ONE of the following is TRUE about a competitive antagonism ?
Antagonism cannot be completely reversed by increased dose of the agonist
An agonist cannot displace an antagonists from the receptor
Agonists and antagonists bind to the same receptor
Dose–response curve of an agonists shifts to the left in the presence of an antagonist
2c
multi
null
Pharmacology
null
7a1584e4-5978-450a-9a23-8df97df816fc
Muscle that causes flexion at elbow joint when forearm is semi - pronated
Biceps brachii
Brachialis
Coracobrachialis
Brachioradialis
3d
single
Brachioradialis causes flexion at elbow joint when forearm is semi - pronated.
Anatomy
null
dcc0209d-3521-46eb-8daf-c28cf8e9b229
An elderly male presented with uncontrolled hypertension and sign of renal failure on biopsy shows medial thickening of arteries with onion skin appearance is diagnostic of?
Thrombo-angioobliterans
Arteriosclerosis obliterans
Hyperplastic arteriosclerosis
Hyaline arteriosclerosis
2c
single
null
Medicine
null
9e2c9834-8d37-46a3-bee6-14c379dfcbfa
Which one of the following disorder is not x-linked recessive
Fragile-x syndrome
Lesch-Nyhan syndrome
Hunter syndrome
Charcot marie tooth disease
3d
single
Charcot marie tooth disease : X-linked dominant
Medicine
null
090a4816-c3f1-48ca-bc32-acf9749a2022
Best antagonist of morphine is
Nalorphine
Naloxone
Buprenorphine
Pentazocine
1b
single
B i.e. Naloxone
Anaesthesia
null
776e0fa9-478e-494a-99d6-3fb6734ef7b9
Nerve commonly involved in fracture distal shaft of the Humerus is:
Radial
Medial
Ulnar
Circumflex brachial nerve
0a
single
Ref: Shao YC, Harwood P. Grotz MR, Limb D, Giannoudis PV. Radial nerve palsy associated with fractures of the shaft of the humerus: a systematic review.Pone Joint Surg Br. 2005 Dec;87(12):1647-52. & Wheeless' Textbook of Orthopaedics.Explanation:"Fractures of the middle and middle-distal pans of the shaft had a significantly higher association with radial nerve palsy"Palsy Associated with Distal Third Fracture of humerusRadial nerve may be injured by fractures is at junction of mid and distal thirds of humeral shaft, esp if there is lateral displacement of distal fragmentThe radial nerve emerges from spiral groove at this location & is tethered as it pierces the intermuscular septumNerve cannot yield to lateral displacement of distal fragment and therefore may be subject to neuropraxia.
Orthopaedics
Humerus Fractures
06acf535-195e-483b-a09b-f5bd8380a066
Serotonin is mainly secreted by?
Mast cells
Platelets
Neutrophills
Macrophages
1b
single
o Serotonin (5-hydroxy tryptamine) is present in platelets and enterochromaffin cells. o It is also present in mast cells of rodents, but not humans.
Pathology
null
fa1dac98-aacc-4a5f-b513-b0b8cb84c7e1
Which among these has a moderately increased risk to develop into invasive breast carcinoma?
Apocrine metaplasia
Ductal papillomatosis
Atypical ductal hyperplasia
Sclerosing adenosis
2c
single
Cancer risk associated with Benign breast disease and carcinoma in situ Abnormality Relative risk Non proliferative lesions No increased risk Sclerosing adenosis No increased risk Duct papilloma No increased risk Florid hyperplasia 1.5- 2 X Atypical ductal hyperplasia 4 X Atypical lobular hyperplasia 4 X Ductal involvement by cells of Atypical ductal hyperplasia 7 X LCIS 10 X DCIS 10 X
Surgery
Breast
a808bf6b-8d1e-4555-9fe3-666ec1150eba
Commonest cause of non traumatic subarachnoid hemorrhage
Idiopathic
Berry aneurysm rupture
Hypertension
AV malformation
1b
single
Ans. (b) Berry aneurysm ruptureRef: Bailey 26th 320 Schwartz 10th 1730* Most common cause of SAH - TRAUMA* Most common cause of non traumatic subarachnoid hemorrhage - BERRY ANEURYSM RUPTURE
Surgery
Nervous System
7857f05e-aadb-4aff-8a04-d8abcfc26240
Preferred insulin regimen during pregnancy?
Insulin Regular + NPH
Insulin NPH + Lispro
Insulin Degludec
Insulin Lispro + Insulin regular
1b
single
For basalinsulincoverage, intermediate-acting neutralprotamineHagedorn (NPH)insulinhas historically been considered first-line therapy and has been widely studied in this patient population. For postprandial glycemic control, rapid-actinginsulinanalogues, such asinsulinlispro andinsulin aspa, do not cross the placenta and have been safely used in pregnancy.
Medicine
JIPMER 2019
6d1d5ef2-e5b4-4481-8cd6-a4247728b01b
Most common feature of essential hypeension: September 2005
Visual disturbances
Headache
Palpitations
Dizziness
1b
single
Ans. B: Headache Many patients with essential hypeension repo that they can determine when their blood pressure is elevated. Often, their perception of experiencing high blood pressure is accompanied by vague complaints of headache, fatigue, dizziness, sweating, a pounding hea, or nose-bleeds. - Of all these symptoms, headache is the commonest complaint.lt is localized to the occipital region and occurs in the morning.
Medicine
null
398cd50d-f92e-44d8-858c-58caa0ee9f9e
A patient on therapy for his CNS illness develops the following abnormality what is the possible cause ?
Anti depressants
Anti psychotics
Antiepileptics
Anti Parkinsonian drugs
1b
single
Extrapyramidal symptoms due to D2 blockade in the limbic system are closely related to antipsychotic potency of typical antipsychotic drugs. Acute Muscular dystonia: It is the earliest appearing symptom(within hours)and may manifest as Toicollis, locked jaw, oculogyric crisis or spasm of other muscles. Central anticholinergics are useful in the treatment. Note : Oculogyric crisis is thespasm of the extraocular muscles, causing upward and outward detion of the eyes which is treated by Central anticholinergic agents.
Pharmacology
CNS
4e12570f-6786-4f77-b8c6-5578e29dde85
The conjugation of bilirubin to glucuronic acid in the liver;
Converts a hydrophilic compound to a hydrophobic one
Converts a hydrophobic compound to a hydrophilic one
Enables the bilirubin molecule to cross the cell membrane
Is increased during neonatal jaundice
1b
single
Ans. is 'b' i.e. converts a hydrophobic compound to a hydrophilic one.Ref: Harrison 16th/e p 239 (15th/e p 255)Bilirubin is produced in the reticuloendothelial cells of spleen and liver. This unconjugated bilirubin is not soluble in water so is bound to albumin for its transfer in plasma.Liver uptakes this unconjugated bilirubin and conjugates it with glucuronic acid generating bilirubin glucuronide which is water soluble.For more on this topic see Question no. 12 Nov. 1999
Biochemistry
Proteins and Amino Acids
d678676d-73ca-4443-88d8-39b0bcdcfa99
An emergent hernia repair is scheduled. As the attending physician is driving to the hospital, the medical student assisting on the case quickly reviews his anatomy atlas and is trying to commit to memory that the internal oblique abdominis muscle contributes to the formation of which of the following structures?
Inguinal ligament
Deep inguinal ring
Falx inguinalis (conjoint tendon)
Internal spermatic fascia
2c
single
The falx inguinalis (conjoint tendon) is formed by the aponeuroses of the internal oblique and transverse muscles of the abdomen. The inguinal ligament is formed by aponeurosis of the external oblique abdominal muscle, and the reflected inguinal ligament is formed by ceain fibers of the inguinal ligament reflected from the pubic tubercle upward toward the linea alba. The deep inguinal ring lies in the transversalis fascia, and the internal spermatic fascia is formed by the transversalis fascia.
Anatomy
Abdomen, Pelvis and Perineum
9660d60e-7da6-4373-8de8-5d7a3d341d34
Which of the following statemnets is FALSE about the drug treatment with Memantine?
It is neuroprotective
It has a long half life
It is used in treatment of moderate dementia
It is a NMDA receptor agonist
3d
multi
Memamntine is a NMDA (N-methyl D-aspaate) antagonist (not agonist) used in the treatment of Alzheimer's disease. Memantine 5-10mg per day is used in the treatment of moderate dementia. It is theoretically neuroprotective and has a half life of 100 hours. It also has 5HT3 (serotonin receptor) antogonistic propeies as well. Ref: A Sho Text Book of Psychiatry by Niraj Ahuja, 2006, Page 27
Psychiatry
null
786efe0b-4ef6-4853-b08d-0317cf308c3c
metaclopromide:
inhibit cholinergic smooth.muscle stimulation in the gastrointestinal tract
decrease lower esophageal spinchter pressure
stimulate D2 receptor
enhance colonic activity
3d
single
metaclopromide is aD2 receptor antagonist that increases cholinergic activity by inhibiting presynapyic D2 receptors in GIT . it increases LES tone that is also responsible for anti emetic action. it does not significantly increase colonic motility
Pharmacology
Gastrointestinal tract
40f81fbf-ecf2-4284-978d-48557ba4a8ba
A-23-Year-old female presented with burning pain during micturition. On investigations, she is found to be suffering from co-infection with chlamydia and gonococcus. Drug of choice for treatment of this female is: -
Azithromycin
Ceftriaxone
Fluconazole
Clindamycin
0a
single
Doc for gonococcal urethritis => ceftriaxone Doc for gonococcal and nongonococcal urethritis => Azithromycin Doc for candidiasis (fungal infection) => fluconazole DOC for Anaerobic bacterial infections=> Metronidazole and Clindamycin
Pharmacology
Protein Synthesis Inhibitors
12d8c100-791c-4537-b5df-370e1799c652
False about branchial cyst is:
it develops from the remnants of 2nd branchial cleft
Usually line by squamous epithelium
Found at the anterior border of lower third of Sternocleidomastoid muscle
Treatment involves complete excision
2c
multi
Branchial cyst is found at the junction of upper third & middle third of Sternocleidomastoid over anterior border.
Surgery
null
921bc072-8443-4453-acfc-4696c90588ae
Which one of the following is the description used for the term allodynia during pain management?
Absence of pain perception
Complete lack of pain sensation
Unpleasant sensation with or without a stimulus
Perception of an ordinarily nonnoxious sitmulus as severe pain.
3d
multi
Ans. is 'd' i.e. Perception of an ordinarily nonnoxious stimuli as severe pain Terms used in pain managementAllodyniaPerception of an ordinarily nonnoxious stimulus as painAnalgesiaAbsence of pain perceptionAnaesthesiaAbsence of all sensationsDysesthesiaUnpleasant or abnormal sensation with or without a stimulusHypalgesiaDiminished response to noxious stimulationHyperalgesiaIncreased response to noxious stimulationHyperaesthesiaIncreased response to mild stimulationHyperpathiaPresence of hyperaesthesia, allodynia and hyperalgesia usually associated with overreaction and persistence of sensation after the stimulusHypoaesthesiaReduced cutaneous sensation (e.g. light touch, pressure or temperature)NeuralgiaPain in the distribution of a nerve or a group of nerves.ParesthesiaAbnormal sensation perceived without an apparent stimulusRadiculopathyFunctional abnormality of one or more roots
Anaesthesia
Muscle Relaxant
60b905fe-9756-432c-985c-d5591d600c24
Pleomorphic adenoma is most commonly found in:
Parotid gland.
Sublingual gland.
Submandibular gland.
lacrimal gland.
0a
single
null
Pathology
null
c1cd3816-2e6e-4f24-ac76-ffc0f1c54495
Which is not true about thoracic outlet syndrome ?
Radial Nerve is commonly affected
Neurological features are most common
Resection of Pt rib relieves symptom
Positive Adson's test
0a
multi
Ans is 'a' ie Radial Nerve is commonly affected Not the Radial nerve, but Ulnar nerve is most commonly affected in thoracic outlet syndrome.
Surgery
null
13078679-a34d-4ce4-9e5a-7bee20537509
A 2-day-old newborn is brought to the physician because of vomiting. Physical examination shows a small mass about the size of an olive in the epigastric area. Which of the following conditions is this child likely to exhibit?
Biliary stenosis
Duodenal atresia
Non-bilious vomiting
Pancreas divisum
2c
multi
null
Medicine
null
f086b917-0634-42fc-b854-d644496d1a0a
charecterstic feuture of anorexia nervosa is
redtricting food
dyslipedima
overweght
hypeension
0a
single
Anorexia nervosa Anorexia nervosa is a eating disorder where the patient has decreased weight and altered body image and persistent desire to maintain thinness * Gender==== more common in females * Age=======adolescence * Comorbidity=== depression and social phobia * Duration====3 months * Criteria= * Intense fear of becoming fat * Restriction of food intake * Restricting type * Binge eating and purging type * Amenorrhea is not needed for diagnosis, previously amenorrhea is considered as a diagnostic criteria for diagnosis, in recent DSM 5 amenorrhea is considered for a diagnosis * Association= * OCD and depression * Decreased interest in sex * Complication * 7-14% moality * ECG changes * Hypokalemic alkalosis because of induced vomiting * Gastric dilation * Drugs * Cypro hepatidine * SSRI * Management * Admit in severe cases * Prevent vomiting by making restroom inaccessible for 2 hours after food intake * Avoid laxatives * Small frequent meals * Avoid refeeding syndrome Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 509
Anatomy
Sleep disorders and eating disorders
6c19f02d-c74a-4633-a178-071a9f9ed3f9
False about Kerley's A lines
Lines are 2-6 cm in length
These are found in mid and upper zones
These are due to thick interlobar septa
Transverse lines at lung base perpendicular to pleura
3d
multi
Kerley's A lines are thin, non-branching lines radiating from hilum.
Radiology
null
c341048f-7d22-49cd-9400-857c7258224a
All of the following are common cause of post splenectomy infections except: September 2009
H.influenza
Ecoli
Klebsiella
Streptococcus
2c
multi
Ans. C: Klebsiella The first description of overwhelming post-splenectomy infection was published by King and Schumaker in 1952. The disease may begin as a minor flu-like illness that rapidly escalates into a fulminant infection. It is most common in the first two years after splenectomy but may occur decades later. Splenectomy may be followed by severe systemic infection because such surgery removes the splenic macrophages that filter and phagocytose bacteria and other bloodborne pathogens. Overwhelming post-splenectomy infection (OPSI) is uncommon but has high moality. Overwhelming post-splenectomy infection is usually caused by the encapsulated bacteria Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis and more than half of those infected die. Other pathogens in such infection may include bacteria such as Escherichia coli and Pseudomonas aeruginosa, Capnocytophagia canimorsus, group B streptococci, Enterococcus spp, Ehrlichia spp, and protozoa such as the Plasmodium spp. leading to malaria.
Surgery
null
72a2198f-98eb-4249-932d-bfd47efdc4cf
Acetic acid staining of cervix shows the following EXCEPT:
Squamous metaplasia
Cervical carcinoma in situ
Cervical polyp
Cervical dysplasia
2c
multi
Ans. is 'c' ie Cervical polyp While performing a colposcopy, after visualization with naked eyes, acetic acid is applied for better visualization.The application of acetic acid coagulates the proteins of the nucleus and cytoplasm and makes the protein opaque and white.The acetic acid does not affect mature, glycogen producing epithelium.The cells which contain a large amount of protein are most affected.So dysplastic cells and cancerous cells which contains a large amount of protein (chromatin) are most affected.Metaplastic cells are also somewhat affected because the metaplastic epithelium is thin, it does not turn white or opaque but instead appears grey.
Unknown
null
807c3ed7-dec7-43fc-8810-64059ed3d589
If a chromosome divides in an axis perpendicular to usual axis of division it is going to form:
Ring chromosome
Isochromosome
Acrocentric chromosome
Subtelocentric chromosome
1b
single
Isochromosome Chromosome dividing in an axis perpendicular to usual axis of division Results when one arm of a chromosome is lost and the remaining arm is duplicated, resulting in a chromosome consisting of two sho arms only or of two long arms. Morphologically identical genetic information in both arms. The most common present in live bihs involves the long arm of the X and is designated as i(X)(q10). The Xq isochromosome is associated with monosomy for genes on the sho arm of X and trisomy for genes on the long arm of X. Associated with tumors - 17q. High chance of development of testicular cancer- 12p.
Pathology
Miscellaneous
a83ea158-6b46-4f41-be24-5c2e86c17cb8
All known effects of cyclic AMP in eukaryotic cells results from:
Activation of the catalytic unit of adenylate cyclase
Activation of synthetase
Activation of protein kinase
Phosphorylation of G protein
2c
multi
Cyclic AMP exerts most of its effects by stimulating cAMP-dependent protein kinases. These phosphorylate enzymes resulting in their activation or inhibition.
Pharmacology
null
3d424928-fa62-4625-9c1f-46af1cd272b4
Causes of chronic tropical pancreatitis is
Parasitic infection
Cassava Ingestion
Idiopathic
Genetic
1b
single
Tropical (Nutritional) Pancreatitis Associated with mutations of PSTI or SPINK1 gene Protein calorie malnutrition and toxic products of some indigenous foodstuff may contribute to the disease Cassava root contains toxic glycosides, increases susceptibility to free radical injury to pancreas Ref: Sabiston 20th edition Pgno : 1530
Anatomy
G.I.T
d9644739-717b-4853-8e82-eb6e7e1dca55
If life style factor is causing infeility in a young male is identified. Which of the following life style modification will have no effect on feility:
more exercise
meditation
Vegetarian diet
Weight loss
2c
single
Obesity increases peripheral conversion of androgen to oestrogen and affects feility. Hence life style modification to reduce obesity will help in the treatment of infeility. Vegetarian diet is not impoant in the management. Reference: Shaw's Textbook of Gynaecology 16th edition page no 241.
Gynaecology & Obstetrics
Infertility
55d5095a-8408-4731-b870-e71d8ae00cde
The killing range of a military rifle is about -
100 yards
600 yards
1000 yards
300 yards
1b
single
It is 600 yards
Forensic Medicine
null
c404c501-5de7-40b4-b170-035c7fd9933f
Toxin is produced by all except:
C. diphtheriae
C. ulcerans
C. hofmanni
C. pseudotuberculosis
2c
multi
Ans. is 'c' i.e., Corynebacterium hofmannii(Ref: Ananthanarayan, 9th/e, p. 242 and 8th/e, p. 239; Harrison, 17th/e, p. 893-941; Greenwood)Among the Corynebacterium species, three Corynebacterium produce diphtheria toxin: C. diphtheriae, C. pseudotuberculosis and C. ulcerans. "Like C. diphtheriae, C. pseudotuberculosis and C. ulcerans can produce toxin and cause clinically resembling Diphtheria."
Microbiology
Bacteria
59bf0d7a-e20c-4658-a84d-dc4031bc7a6b
Sorafenib is used in
Multiple myeloma
CLL
AML
ALL
2c
multi
Sorafenib is used in the treatment of FLT3 acute myeloid leukemia it is also used in hepatocellular carcinoma REF KD Tripathi 8th ed
Pharmacology
Immunomodulators
63effd28-7735-4bfb-bc6f-401c7bb29b09
Enzyme which is not regulated by phosphorylation dephosphorylation ?
Glycogen synthase
Glycogen phosphorylase
Aspaate transcarboxylase
HMG CoA reductase
2c
single
Ans. is 'c' i.e., Aspaate transcarboxylase
Biochemistry
null
a5b2e089-3e8a-490a-9387-74687302149f
ACE inhibitor contraindicated in which of the following condition:
Bilateral renal artery stenosis
Chronic kidney disease
Post myocardial infarction
Diabetes mellitus
0a
single
Ans. (a) Bilateral renal artery stenosisRef. Katzung's pharmacology 10th ed. Ch 11* ACEI inhibits the converting enzyme peptidyl dipeptidase that hydrolyzes angiotensin I to angiotensin II and (under the name plasma kininase) inactivates bradykinin, a potent vasodilator, which works at least in part by stimulating release of nitric oxide and prostacyclin.* Drugs under this class are: Captopril, Enalapril, Lisinopril, Benazepril, fosinopril, moexipril, perindopril, quinapril, ramipril, and trandolapril.* ACE inhibitors have a particularly useful role in treating patients with chronic kidney disease because they diminish proteinuria and stabilize renal function (even in the absence of lowering of blood pressure).* ACE inhibitors have also proved to be extremely useful in the treatment of heart failure, and after myocardial infarction, and* There is recent evidence that ACE inhibitors reduce the incidence of diabetes in patients with high cardiovascular risk.
Pharmacology
ACE Inhibitors
e244a146-a1bb-4334-9b97-898df8dddaba
Glycemic index is defined as:
Glucose control in last 3 months
Measure of the change in the blood glucose following ingestion of proteins
Measure of the change in the blood glucose following ingestion of carbohydrate
Measure of the change in the blood glucose following ingestion of fats.
2c
single
The Glycemic index (GI) of a carbohydrate containing food is a measure of the change in the blood glucose following its ingestion
Biochemistry
null
07d9a04b-f5ba-485c-b5ea-cadec3e13eb3
Spiral aery is a branch of
Uterine aery
Arcuate aery
Vesical aery
Ovarian aery
1b
single
Spiral aery are small aeries which temporarly supply blood to endometrium of the uterus during the leteal phase of the menstrual cycle.The spiral aries are conveed for uteroplacental blood flow during pregnancy. imageRef - Semantischolar.org
Anatomy
Abdomen and pelvis
97405e42-2d1f-4f7f-9671-256967a19a1f
A 60-year-old patient presents with recurrent TIA episodes. Echocardiography shows candle flame sign. The probable etiology of the disease is?
Senile calcification of hea valve
Rheumatic fever when he was a youth
Long-standing undiagnosed hypeension
Undiagnosed congenital condition
1b
single
The clue is candle flame sign on echo which is a feature of mitral stenosis. Hence the answer is B. In longstanding mitral stenosis, left atria appendage clots can develop. This can explain the neurological presentation of this patient. Most common valvular cause of RHD is mitral stenosis at young age .
Medicine
Rheumatic Hea disease & infective endocarditis
0a39ee5d-48e4-496c-95cf-7661e8e19b68
What is the longest duration of function of primary teeth
6 yr
8 yr
10 yr
12 yr
2c
single
null
Dental
null
e17958c9-6ed7-42ff-a9cb-81b8b8c4e73e
Antigen antibody precipitation is maximally seen in which of the following?
Excess of antibody
Excess of antigen
Equivalence of antibody and antigen
Antigen Hapten interaction
2c
multi
Ans. is 'c' i.e., Equivalence of antibody and antigen Precipitation reactionIt is a type of antigen antibody reactionWhen a soluble antigen combines with its antibody in the presence of electrolytes (NaCl) at a suitable temperature and pH, the antigen antibody complex forms an insoluble precipitate.The amount of precipitate formed is greatly influenced by the relative proportions of antigens and antibodies.Precipitation occurs most rapidly and abundantly in the zone of equivalence in which the antigen and antibody are present in optimal proportions.If increasing quantities of antigens are added to the same amount of antiserum in different tubes and the amounts of precipitate in different tubes are plotted on a graph, the resulting curve will have three phases:
Microbiology
Immunology
b5d9155f-0a4a-41e6-a185-e5bce97c3a86
Fracture of lateral condyle of humerus is seen in age group of?
2-3 years
5-15 years
15-25 years
35- 45 years
1b
single
The lateral condylar (or capitular) epiphysis begins to ossify during the first year of life and fuses with shaft at 12-16 years. Between these ages it may be shared off or avulsed by forceful traction. The maximum chances of injury is between 5-15 years. Ref: Apley's 8/e, Page 596-609; Rockwood and Green's Fractures in Adults 6/e, Page 990-92.
Surgery
null
a420caf6-8835-4145-8d7b-7ec0dc6f6b40
All of the following are true about development EXCEPT?
Development is a continuous process
Depends on functional maturation of nervous system
Ceain primitive reflexes have to be lost before relevant milestones attained
Limb control precedes trunk and head control
3d
multi
Development progresses in a cephalocaudal direction; So head control preceds trunk control, which precedes limb control.
Pediatrics
Impoant Motor Milestones
23772c9f-953f-4a70-8106-699d9506bcd7
A 45-year-old man who is a heavy smoker complains of sudden onset of high fever and chills, nonproductive cough, and chest pain. An X-ray film of the chest shows bilateral, diffuse, patchy infiltrates. The patient reports that a number of similar cases have occurred recently in the building where he works. He responds to antibiotics and recovers. Which of the following is the most likely a reservoir for the microorganism that is responsible for this patient's respiratory tract infection?
Cooling towers
Elevator shafts
Floor cleaners
Heat pumps
0a
single
Legionella pneumophila causes a pneumonia that ranges from mild to a severe life-threatening, necrotizing pneumonia referred to as "Legionnaire disease." The bacterium is found in natural bodies of fresh water and survives chlorination, allowing it to proliferate in cooling towers, water heaters, humidifiers, and ventilation systems. Legionella pneumonia begins when microorganisms enter alveoli, where they are phagocytized by resident macrophages. Bacteria multiply within macrophages and are released to infect new macrophages. The disease presents as an acute bronchopneumonia, with a diffuse and patchy pattern of infiltration. None of the other situations creates suitable conditions for bacteria to multiply.Diagnosis: Legionnaire disease
Pathology
Infectious Disease
842de55e-2c2b-4abe-9450-0a5a52edbbb3
Small for date baby has bih weight -
<10 percentile
<50 percentile
<60 percentile
None
0a
multi
They weigh kess than 10th percentile for the gestational age.REF.PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE.Editon-21.Page no.-494
Social & Preventive Medicine
obstetrics,pediatrics and geriatrics
0a6705fa-7157-425b-b09e-62c393fd6b9a
Drug not given in pregnancy -
ACE inhibitors
Penicillin
Methyldopa
Labetalol
0a
single
Ans. is 'a' i.e., ACE inhibitors Important drugs contraindicated pregnancyo Domperidoneo Lansoprazoleo Cisaprideo Morphineo Tetracyclineso Chloramphenicalo Aminoglycosideso Astemizoleo Diethylcarbamazineo Albendazole, mebendazoleo Warfarino Radioactive iodineo Lithiumo Cyclophosphamideo ACE inhibitorso AT-II antagonists
Pharmacology
Pregnancy
879b3a36-2ef2-4d69-b019-69f64be7bb12
The increase in the threshold of a receptor when a series of stimuli of subthreshold intensity are applied in succession is called
Adaptation
Accomodation
Initiation
Resistance
1b
multi
Accommodation - Slow rising subthreshold stimulus failing to produce action potential even when the normal threshold levels are reached. This occurs because of inactivation of voltage-gated Na+ channels. Adaptation- Persistent application of suprathreshold stimulus fails to generate repetitive firing.
Physiology
null
b7a644dd-cff6-45ac-9b95-af948ea20dad
Among Bipyridyl herbicides, 1) Diquat is only half as toxic as paraquat 2) Diquat doesnot produce pulmonary toxicity
Both are true
Both are false
1 is true, 2 is false
2 is true, 1 is false
0a
multi
Diquat is only half as toxic as paraquat Diquat doesnot produce pulmonary toxicity
Forensic Medicine
Toxicology - 1
10dd91d4-bdc1-448a-9278-53052b22aaf3
Decreased level of serum Vit B6 is seen in
CRF
INH therapy
CHF
Alcohol
1b
single
null
Social & Preventive Medicine
null
46276e23-069d-490c-8926-4aa4735397ab
The main drawback of a saddle pontic is:
It is unhygienic
It is unaesthetic
It is bulky
It does not restore the tooth contours
0a
single
null
Dental
null
a21b7844-9dae-4ab5-a61e-ab3da03efa83
A 57-year-old man presents with hemoptysis and generalized weakness. His symptoms began with small-volume hemoptysis 4 weeks ago. Over the past 2 weeks, he has become weak and feels "out of it." His appetite has diminished, and he has lost 10 lb of weight. He has a 45-pack-year history of cigarette smoking. Physical examination is unremarkable. Laboratory studies reveal a mild anemia and a serum sodium value of 118 mEq/L. Chest x-ray shows a 5-cm left, mid-lung field mass with widening of the mediastinum suggesting mediastinal lymphadenopathy. MR scan of the brain is unremarkable. What is the most likely cause of his symptoms?
Bronchial carcinoid
Adenocarcinoma of the lung
Small cell carcinoma of the lung
Lung abscess
2c
multi
Hyponatremia in association with a lung mass usually indicates small cell lung cancer (SCLC) with inappropriate antidiuretic hormone (ADH) production by the tumor. About 10% of lung cancers present with a paraneoplastic syndrome. Tumors producing ADH or adrenocorticotropic hormone (ACTH) are overwhelmingly SCLCs, which arise from hormonally active neuroendocrine cells. SCLC is a rapidly growing neoplasm; early mediastinal involvement, as in this case, is common. Tumor staging for SCLC differs from non-small cell cancers. SCLCs are simply classified as limited (confined to one hemithorax) or extensive. Limited tumors are usually managed with combination radiation and chemotherapy, with approximately 20% cure rate. Extensive tumors are treated with palliative chemotherapy alone; durable remissions are rare. Surgery is not curative in SCLC.Bronchial carcinoids are usually benign. Although they can produce ACTH, mediastinal involvement and hyponatremia would not be expected. Adenocarcinoma of the lung, although common, rarely causes a paraneoplastic syndrome. Localized benign lung infections (especially lung abscess) can cause syndrome of inappropriate antidiuretic hormone (SIADH) but would not account for this patient's mediastinal adenopathy. Lung abscess usually causes fever and fetid sputum. Pulmonary aspergilloma (a fungus ball growing in an old cavitary lesion) can cause hemoptysis but not this patient's hyponatremia or mediastinal lymphadenopathy.
Medicine
Respiratory
1bd7b61a-a3d4-4f87-85bd-9bdc6be9d29f
Aminopeptidase is elevated in obstruction of ?
Ureter
Urethra
CBD
Bladder
2c
single
Ans. is 'c' i.e., CBD
Surgery
null
8b98625b-a75a-45fe-b005-b39645ca8706
Apoptosis is associated with all the following features Except
Cell shrinkage
Intact cellular contents
Inflammation
Nucleosome size fragmentation of nucleus
2c
multi
The following morphologic features, some best seen with the electron microscope, characterize cells undergoing apoptosisCell shrinkageChromatin condensationFormation of cytoplasmic blebs and apoptotic bodiesPhagocytosis of apoptotic cells or cell bodies, usually by macrophages. The plasma membrane of the apoptotic cell remains intact, but the membrane is altered in such a way that the cell and its fragments become avid targets for phagocytes. The dead cell and its fragments are rapidly cleared before cellular contents have leaked out, so apoptotic cell death does not elicit an inflammatory reaction in the host. Apoptosis differs in this respect from necrosis, which is characterized by loss of membrane integrity, enzymatic digestion of cells, leakage of cellular contents, and frequently a host reaction( Robbins Basic Pathology, 9th edition, page 18 )
Pathology
General pathology
cdfc030e-91bb-49e0-91d3-80538686d529
Oral evidence is more important than written testimony as-
Oral evidence cannot be cross examined
Oral evidence can be cross examined
Documentary evidence requires no proof
None
1b
multi
Ans. is 'b' i.e., Oral evidence can be cross examined [Ref: Reddy 30th/e p. 9-10/}Oral evidenceo It includes all statements which the court permits, or which are required to be made before it by the witness, in relation to matters of fact under inquiry.o It is more important than documentary evidence, as it permits cross-examination.o Written evidence is accepted by the court only on oral testimony by the person concerned,o All facts, except the contents of documents, may be proved by it.o Exceptions to oral evidence:o Dying declaration; statements made by a person who is dead is admissibe as evidence.Expert opinion expressed in a treatise.Evidence of doctor recorded in a lower court is accepted in higher courtEvidence given by a witness in a previous judicial hearingEvidence of Mint officers or an officer of the India Security pressReports of certain Government scientific experts.Public records
Forensic Medicine
Introduction to Forensic Medicine and Medical Jurisprudence
d45cc001-9b28-40ac-ac7c-cad6596fdb11
Kassowitz law is related to:
Gonorrhoea
Herpes genitals
Donovanosis
Syphilis
3d
single
Kassowitz law states that as the stages of syphilis progress in a pregnant females outcome of  pregnancy is better. Pregnancy during primary syphilis can lead to abortion. Pregnancy in secondary syphilis can lead to still births. Whereas a pregnant females in tertiary syphilis is more likely to have a live birth.
Dental
null
ab09abbd-d026-47a9-b064-725d8e07545d
&;V&; wave in jugular venous pulse is due to
Ventricular filling
Ventricular contraction
Atrial contraction
Atrial filling
3d
single
&;V&; wave in jugular venous pressure corresponds to right atrial filling during ventricular systole when the tricuspid valve is closed. The JVP has a biphasic waveform. * The "a" wave: First positive presystolic wave. * Right Atrial contraction. * Precedes the upstroke of carotid pulse, syn follows P wave of ECG. J. * * Peak of the &;a&; wave demarcates (\c the end of atrial systole. * Dominant wave in JVP during inspiration. * Larger than "v" wave. s, * The "x" descent: (Systolic collapse) * Follows the &;a&; wave * Corresponds to atrial relaXation and rapid atrial filling pressure. * Most prominent motion of normal JVP. * Begins during systole and ends just before S2. * Larger than "y" descent. * The " x&; " (x prime) descent * Follows the &;c&; wave * Occurs as a result of the right ventricle pulling the tricuspid valve downward during ventricular systole. * As stroke volume is ejected, the ventricle takes up less space in pericardium, allowing relaXed atrium to enlarge. * Can be used as a measure of right ventricle contractility. * The "c" wave * and positive venous wave. * Right ventricular (isovolumic) Contraction 4 tricuspid valve to bulge towards the right atrium. The "v" wave * 3rd positive wave. * Begins in late systole and ends in early diastole. * Corresponds to Venous filling when the tricuspid valve is closed and venous pressure increases from venous return. * Occurs during and following the carotid pulse and peaks after S2. * The "y" descent: * Downslope of v wave. * Decline in RA pressure -rapid emptYing of the RA into the RV following the opening of the tricuspid valve in early diastole. Reference : Harrison 20th edition, pg 1421
Medicine
C.V.S
eedb9591-24b8-40dc-a350-62ae424d1257
Colposcopy is used to visualize all except: March 2005
Upper 2/3rd endocervix
Lower 1/3rd endoCervix
Lateral fornix
Vault of vagina
0a
multi
Ans. A: Upper 2/3rd endocervix Colposcopy is used to identify or rule out the existence of any precancerous conditions in the cervical tissue. If a Pap test shows abnormal cell growth, colposcopy is usually the first follow-up test performed. Colposcopy may also be performed if the cervix looks abnormal during a routine examination. It may be suggested for women with genital was and for diethylstilbestrol (DES) daughters (women whose mothers took the anti-miscarriage drug DES when pregnant with them). Colposcopy is used in the emergency depament to examine victims of sexual assault and abuse and document any physical evidence of vaginal injury.
Gynaecology & Obstetrics
null
ee2177a3-0257-4a24-8fb2-42e55fa2bba6
Which nerve is involved in this deformity:
Musculocutaneous nerve
Long thoracic nerve
Radial nerve
Thoracodorsal nerve
1b
single
Ans. B. Long thoracic nerveThe deformity shown is Winging of scapula due to Paralysis of serratus anterior.The paralysis of serratus anterior muscle following an injury to long thoracic nerve by stab injury or during removal of the breast tumor leads to the following effects:(a) Protraction of scapula is weakened.(b) Inferior angle and medial border of scapula become unduly prominent particularly when patient pushes his hands against the wall, producing a clinical condition called winging of the scapula.
Anatomy
Upper Extremity
d5dcb8da-0810-4edf-9e8b-bb29bebc6205
Haemopoietic malignancy is seen in
HTLV -1
EBV
Parvo B19
HHV - 8
0a
single
Human T-cell leukemia virus type 1 (HTLV-1) is a causative agent of a malignant disease of peripheral CD4+ T cells called adult T-cell leukemia-lymphoma (ATL) and several inflammatory diseases such as HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Ref Davidson 23rd edition pg 1091
Medicine
Miscellaneous
fe8cf830-b85a-4291-951e-f5c65acac929
Which of the following is not an application of screw feed technique
80% volume reduction
Pathological wastes are removed
Weight is decreased by 20-30%
Based on non-burn thermal treatment
1b
single
SCREW-FEED Technology: Principle: Non-burn dry thermal process Process:  - Shredding of waste -  Heating in a rotating auger Reduction in waste: - Reduction in weight: 20-35% - Reduction in volume: 80% Useful for wastes: - Infectious waste - Sharps Not useful for wastes: - Pathological waste - Cytotoxic waste - Radioactive waste
Dental
null
841a6c4b-dea9-455e-9d0a-f3fe938ec85e
In OCD treatment is based on -
Serotonergic receptor
Dopaminergic receptor
NA receptor
Glutamate receptor
0a
single
null
Psychiatry
null
072d5cbf-0ba1-4223-95be-dd9a5e043715
Which of the following sensations is most affected by coical lesions?
Proprioception
Temperature
Itch
Crude touch
0a
single
The position senses are frequently also called proprio- ceptive senses. They can be divided into two subtypes: (1) static position sense, which means conscious percep- tion of the orientation of the different pas of the body with respect to one another, and (2) rate of movement sense, also called kinesthesia or dynamic proprioception. Proprioception is most effected by the coical lesion Ref: guyton and hall textbook of medical physiology 12 edition page number:580,581
Physiology
Nervous system
91927e80-4c74-47de-bf4c-46dc049710ea
Not True about Pinna of the Ear
Develops from HILLOCK's of HIS
Tragus formed from 1st Hillock
Costal Rib Cartilage used as graft in treatment of Anotia
Reconstruction of pinna in Anotia is done as soon as possible within 1 year of age
3d
multi
Reconstruction of pinna done at 6 years of age.
ENT
null
8e8d7404-c439-4746-8616-bd680815b09c
All the following causes QT prolongation except
Cisapride
Quinidine
Terfenadine
Cetrizine
3d
multi
Drugs producing QT prolongation- class 1a, class 3 antiarrhythmic agents terfinadine, tricyclic antidepressants, neuroleptics, prokinetics Ref: KD tripathi 8th ed
Pharmacology
Cardiovascular system