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|---|---|---|---|---|---|---|---|---|---|---|
cecb808d-11f6-46b8-bf19-a2e295acc9c3
|
Which of the following is true about right principal bronchus
|
Short and thin
|
Short and broad
|
Long and broad
|
Long and thin
| 1b
|
multi
|
The right main bronchus (or right primary bronchus, or right principal bronchus), wider, shorter, and more vertical in direction than the left, is about 2.5 cm. long, and enters the right lung nearly opposite the fifth thoracic vertebra.
The azygos vein arches over it from behind; and the right pulmonary artery lies at first below and then in front of it
|
Unknown
| null |
ff5c5e25-3707-41f7-9c95-d70e6ed70343
|
What constitutes a spinal motion segment?
|
A disc and the facet joints at that level.
|
A disc and the vertebrae above and below, including their interlocking facet joints.
|
A section of the spine involved in a physiological curve with the similar function (i.e. thoracic kyphosis).
|
A vertebral body and the disc above.
| 1b
|
multi
|
Ans. B. A disc and the vertebrae above and below, including their interlocking facet joints.A spinal motion segment is made up of a disc with its adjacent vertebrae and their interlocking facet joints devoid of musculature
|
Orthopaedics
|
Spinal Injuries
|
788047e9-3a3d-4b0c-9e4b-004d496c4ce6
|
Closure of coronal sutures starts at age of -
|
20 years
|
25 years
|
30-35 years
|
50-60 years
| 1b
|
single
|
This question is tricky one. Most of the guides have given option c is the answer. Which is incorrect.
Coronal suture is completely obliterated at 35-40 years. But, read the question carefully, examiner is asking when the closure starts (not completes).
Closure of coronal, lambdoid and sagittal sutures starts at inner side at 25 years. And it is complete on outer side :-
Sagittal suture → 30-35 years.
Coronal suture → 35-40 years.
Lambdoid suture → 45-50 years.
|
Forensic Medicine
| null |
3fef645f-e543-44e0-9e20-4bca2af5f7aa
|
Epithelial mesenchymal interaction in tooth development is an example of:
|
Cell signaling
|
Calcification
|
Histodifferentiation
|
Morphodifferentiation
| 0a
|
single
|
Cells interact through a system of effectors, modulators, and receptors called cell signaling. An example of such a system is epithelial-mesenchymal interaction in tooth development. The precursor cells, odontoblast and ameloblast, establish a positional relationship by means of effectors and receptors that are on the cell surface.
|
Dental
| null |
614007a1-93dd-45a4-8bf5-53379bda96e0
|
A 23-year-old male developed an excruciating chest pain and palpitations after drinking 4 cans of energy drink at night while revising for final year exams. He was brought to ED, and his ECG showed sinus tachycardia but no ST change. Pulse was 90/min and BP was 130 /90 mm Hg. The pain subsided after a sho while. His physical examination was normal. He gave a history that last year his father had a myocardial infarction at the age of 60. All his lab findings were in a normal range. Troponin and D-dimer tests came out to be negative. What shall be the next step in management?
|
Closely observe and monitor
|
Put him on exercise treadmill test
|
Do a Stress echocardiogram
|
No fuher investigation is required
| 3d
|
multi
|
The symptoms of chest pain and palpitations has developed in the patient due rapid adrenaline gush in his system due to energy drink. As ECG shows, no ST elevation, it rules out STEMI. This patient currently has a very low risk of coronary disease and so no fuher ischaemic stratification is necessary. In view of family history, primary prevention is of utmost impoance.
|
Medicine
|
Acute coronary syndrome
|
708505d4-4b0f-4318-8357-b98f309b06ef
|
An example of a preventive antioxidant is:
|
Catalase
|
Tocopherol
|
Superoxide dismutase
|
Urate
| 0a
|
single
|
Antioxidants fall into two classes:
Preventive antioxidants, which reduce the rate of chain initiation. ex: Catalase and other peroxidases such as glutathione peroxidase.
Chain-breaking antioxidants, which interfere with chain propagation. ex: Superoxide Dismutase, Uric Acid, Vitamin E (Most powerful).
Key Concept:
Catalase falls into preventive anti-oxidants which reduce the rate of chain initiation.
Ref : Harper’s illustrated biochemistry, 31st edition.
|
Biochemistry
| null |
78b3e2d3-cc6d-43bf-988a-40e8fe87fc91
|
Grayish white membrane in throat may be seen in all of the following infections except:
|
Streptococcal tonsilitis
|
Diphtheria
|
Adenovirus
|
Ludwig's angina
| 3d
|
multi
|
Membrane in Throat is Caused by Pyogenic organisms viz. Streptococci, Staphylococci causing membranous tonsillitis Diphtheria Vincent's angina (Caused by fusiform bacilli and spirochetes: Borrelia vincentii) Candidiasis/monoliasis/oral thrush Infectious mononucleosis Agranulocytosis Leukemia Aphthous ulcers Traumatic ulcers
|
ENT
| null |
5d2bfa02-b76f-44b6-909b-4d1198adff83
|
Injection of muscarinic agonist in conjunctival sac will lead to all of the following except-
|
Conjunctival and uveal hyperaemia
|
Ciliary spasm
|
Miosis
|
Decreased secretion from ciliary epithelium
| 3d
|
multi
|
Effects of muscarinic agents 1) Blood vessel dilation causing conjunctival and uveal hyperaemia 2) Ciliary spasm 3) Miosis 4) Increased aqueous outflow due to opening of trabecular meshwork due to ciliary muscle contraction. Ref: Yanoff & Duker 2nd/e p.1121
|
Ophthalmology
|
Miscellaneous
|
261ca07d-24e0-40ac-b2cc-1eae4c606418
|
A 7 year old boy with boggy swelling of the scalp with multiple discharging sinuses with cervical lymphadenopathy with easily pluckable hair. What would be done for diagnosis?
|
Pus for culture
|
KOH mount
|
Biopsy
|
None of the above
| 1b
|
multi
|
KOH mount The patient gives classic presentation of Kerion (Tinea capitis). Tinea capitis It is an infection caused by dermatophyte fungi usually species of the genera (microsporum and Trichophyton)) of scalp hair follicles and the surrounding skin. It is predominantly a disease of preadolescent children. The main pathogens are anthrophilic organisms with Trichophyton Tonsurans accounting for > 90% cases. There are two patterns of the disease : Endothrix --> Spores (anthroconidia) within the hair shaft Ectothrix --> Hyphae and anthrocondia outside the hair shaft Investigation needed in cases of Tinea capitis Microscopy Potassium hydroxide (KOH) wet mounts Microscopy provides the most rapid diagnosis. Samples are taken from the site of infection and are demonstrated using 10% (KOH). - KOH dissolves the keratin and the fungus is easily demonstrated using the low power objective. - The slide is examined for fungal hyphae and spores Cultures - Cultures need to be done when KOH mount is negative or when it is necessary to identify the .fungal species. - Fungi are cultured on sabroud's dextrose agar. - Culture is more sensitive than microscopy and the result may be positive even when microscopy is negative. Wood's ultraviolet light - When wood's ultraviolet light is shown on hairs they produce green fluorescence with microspora infection but will .fail to identify Trichophyton tonsurans.
|
Skin
| null |
bf0aac42-006d-4011-8c61-dd7cc6168f59
|
A 50 year old male with type 2 diabetes mellitus is found to have 24-hr urinary albumin of 250 mg. Which of thefollowing drugs may be used to retard progression of renal disease -
|
Hydrochlohiazide
|
Enalapril
|
Amiloride
|
Aspirin
| 1b
|
single
|
Answer is option 2 - Enalapril ACE inhibitors and angiotensin receptor blockers are specifically indicated to reduce progression of renal disease. Drug specific benefit in patients in diabetic nephropathy independent of blood pressure control has been shown only for ACE inhibitors and ARB&;s in patients with DM. Ref Harrison 19 /2428
|
Medicine
|
Endocrinology
|
7e2108a8-ee1e-4857-a533-649df5b80f08
|
Which one of the following is of most serious prognostic significance in a patient of essential hypertension -
|
Diastolic blood pressure greater than 130 mmHg
|
Transient ischaemic attacks
|
Left ventricular hypertrophy
|
Papilloedema and progressive renal failure
| 3d
|
single
| null |
Medicine
| null |
b5beb38a-e567-4bdc-89ab-8d2e2558affd
|
An 8-year-old boy presents with Intellectual deterioration and myoclonus. The diagnosis is
|
GSS
|
SSPE
|
Kuru
|
C-J disease
| 1b
|
single
|
(B) SSPE # SUBACUTE SCLEROSING PANENCEPHALITIS (SSPE) is a rare progressive demyelinating disease of the CNS associated with a chronic infection of brain tissue with measles virus.> Most patients give a history of primary measles infection at an early age (2 years), which is followed after a latent interval of 6 to 8 years by the development of insidious intellectual decline and mood and personality changes.> Typical signs of a CNS viral infection, including fever and headache, do not occur. Focal and/or generalized seizures, myoclonus, ataxia, and visual disturbances occur as the disease progresses. The EEG shows a characteristic periodic pattern with bursts every 3 to 8 s of high-voltage, sharp slow waves, followed by periods of attenuated ("flat") background.> The CSF is acellular with a normal or mildly elevated protein level and a markedly elevated globulin level (>20% of total CSF protein). CSF antimeasles antibody levels are invariably elevated, and oligoclonal antimeasles antibodies are often present.> CT and MRI show evidence of multifocal white matter lesions and generalized atrophy. Measles virus can be cultured from Drain tissue, and viral genome can be detected by in situ hybridization or PCR amplification.> Treatment with isoprinosine (Inosiplex) (100 mg/kg per day), alone or in combination with intrathecal or intraventricular interferon has been reported to prolong survival and produce clinical improvement in some patients but has never been subjected to a controlled clinical trial.
|
Medicine
|
Miscellaneous
|
d9e8e6cd-8542-4548-9f5a-84f344587e21
|
Organs first to be injured in the blast-
|
Ear, lung
|
Kidney, spleen
|
Pancreas, duodenum
|
Liver, muscle
| 0a
|
single
|
Tympanic membrane is most sensitive & most commonly injured.
Lung is second most sensitive. The lung is the most common cause of life-threatening injury.
|
Forensic Medicine
| null |
65a8461e-5015-4faf-95d0-ded1e3d46065
|
Surgical excision of parotid gland endangers which of the following structures:
|
Hypoglossal nerve
|
Motor nerve of the muscles of mastication
|
External carotid artery, auriculotemporal nerve, facial nerve
|
Lesser occipital nerve and spinal accessory nerve
| 2c
|
single
| null |
Anatomy
| null |
312d84a2-9555-46d5-8cda-231abc57d706
|
A 30 year old male bhuvan,fish handler by profession came to OPD with multiple skin nodules and discharging sinuses over the right hand as show below.Which of the following organism can likely cause this condition?
|
Mycobacterium.burudi
|
Parapox virus
|
Mycobacterium marinum
|
Actinomyces israeli
| 2c
|
single
|
The nodules and discharging sinuses along the lymphatics are typically sporotrichoid in appearance.The history reveals he is a fish handler which suggests the diagnosis of "fish tank granuloma or swimming pool granuloma" caused by Mycobacteria.marinum commonly seen in fish tank handlers and swimmers.
|
Dental
| null |
b9207386-d389-484b-b29d-5e0403db0593
|
Which of the following is nucleotide reverse transcriptase inhibitor ?
|
Indinavir
|
Nelfinavir
|
Tenofovir
|
Lopinavir
| 2c
|
single
|
Ans. is 'c' i.e., Tenofovir Antiretroviral drugs Nucleoside reverse transcriptase inhibitors (NIs) ? Zidovudin, Didanosine, Zalcitabine, Stavudine, Lamivudine, Abacavir. Nucleotide reverse transcriptase inhibitor- Tenofovir (Katzung 10th/e) Nonucleoside reverse transcriptase inhibitors (NNIS) - Nevirapine, Eirenz, Delavirdine, Etravirine. d)Protease inhibitors - Ritonavir, Indinavir, Nelfinavir, Saquinavir, amprenavir, Lopinavir, Fosamprenavir, Atazanavir, Darunavir, Tipranavir. Fusion inhibitor - Enfuviide, Maraviroc. Integrase inhibitors - Roltegravir, Elvitegravir.
|
Pharmacology
| null |
87fd0e9d-3036-4740-a9e7-693ede4e8398
|
Orally administered anti kala-azar drug is?
|
Paromomycin
|
Miltefosine
|
Amphotericin
|
Sodium stibogluconate
| 1b
|
multi
|
ANSWER: (B) MiltefosineREF: Harrison's 18th ed ch: 212Drugs for lieshmeniasis and their route of administration:DrugDose and routeRemarksPentavalent Antimonial CompoundsTwo pentavalent antmonial (Sb) preparations are available: sodium stibogluconate (100 mg of SbVmL) and meglumine antimonate (85 mg of Sb/mL).The daily dose is 20 mg/kg by rapid IV infusion or IM injection, and therapy continues for 28-30 daysAdverse reactions to Sb treatment are common and include arthralgia, myalgia, and elevated serum levels of aminotransferases. Electrocardiographic changes are common. Concave ST segment elevation is not significant, but prolongation of QT to >0.5 s may herald ventricular arrhythmia and sudden death. Chemical pancreatitis is common but usually does not require discontinuation of treatment; severe clinical pancreatitis occurs in im- munosuppressed patients.Conventional Amphotericin B deoxycholate0.75-1.0 mg/kg on alternate days for a total of 15 infusions.Fever with chills is an almost universal adverse reaction to AmB infusions. Nausea and vomiting are also common, as is thrombophlebitis in the infused veins. AmB can cause renal dysfunction and hypokalemia and in rare instances elicits hypersensitivity reactions, bone marrow suppression, and myocarditis, all of which can be fatal.The several lipid formulations of AmB3 mg/kg daily on days 1-5,14, and 21 (total dose, 21 mg/kg). However, the total dose requirement for different regions of the world varies widely. In a study in India, a single dose of 10 mg,'leg cured infection in 96% of patients.Adverse effects of liposomal AmB are usually mild and include infusion reactions, backache, and occasional reversible nephrotoxicity.Because very little free drug is available to cause toxicity, a large amount of drug can be delivered over a short period.Paromomycin (aminosi- dine)IM dose of 11 mg of base/kg daily for 21 daysParomomycin is a relatively safe drug, but some patients develop hepatotoxicity, reversible ototoxicity, and (in rare instances) nephrotoxicity' and tetany.MiitefosineFirst oral compound approved for the treatment of leishmaniasis.Daily dose of 50 mg for 28 days for patients weighing <25 kg, a twice-daily dose of 50 mg for 28 days for patients weighing >25 kg, and 2.5 mg/kg for 28 days for children 2-11 years of age.Its adverse effects include mild to moderate vomiting and diarrhea in 40% and 20% of patients, respectively; these reactions usually clear spontaneously after a few days. Rare cases of severe allergic dermatitis, hepatotoxicity, and nephrotoxicity have been reported.best administered as directly observed therapy to ensure completion of treatment and to minimize the risk of resistance induction c/I in pregnancy
|
Pharmacology
|
D.O.C
|
4e6461df-d8f5-4081-8726-5804963cc926
|
A clinical study is undertaken with subjects from families in which complications of atherosclerotic cardiovascular disease and tendinous xanthomas occurred before age 30 years. Some of the children in these families are observed to have early atheroma formation. These affected individuals benefit from treatment with pharmacologic agents that inhibit HMG-CoA reductase. Affected individuals in these families are most likely to have a mutation in a gene encoding a cell surface receptor for which of the following?
|
Cortisol
|
Insulin
|
LDL cholesterol
|
Leptin
| 2c
|
single
|
Familial hypercholesterolemia results from mutations in the LDL receptor gene, causing plasma LDL cholesterol to increase because it is not catabolized or taken up by the liver. It is an autosomal dominant disorder with a carrier rate of 1 in 500, so the frequency of homozygosity is 1 in 1 million. Heterozygotes have total serum cholesterol levels twice normal; homozygotes have levels even higher, with death from myocardial infarction by the second decade. The statin drugs inhibit the HMG-CoA reductase and reduce cholesterol levels in heterozygotes. Steroid hormone receptors, such as those for cortisol, are located in the cell nucleus. Insulin receptors play a role in glucose metabolism and glycemic control that may be part of diabetes mellitus with risk for atherosclerosis; statin drugs have no effect on diabetes mellitus. Abnormal leptin receptors may play a role in some forms of obesity. TGF-a is a growth factor with a role in inflammation, cell proliferation, and repair.
|
Pathology
|
Genetics
|
65319b70-54dd-40c1-a7de-f6f31c8b9086
|
Which Substance does not cross the blood-brain barrier?
|
Insulin
|
Urea
|
Testosterone
|
Glucose
| 0a
|
single
|
Substances cross the blood-brain barrier (BBB) by a variety of mechanisms. These include transmembrane diffusion, saturable transpoers, adsorptive endocytosis, and the extracellular pathways. ... Most drugs in clinical use to date are small, lipid soluble molecules that cross the BBB by transmembrane diffusion Ref: guyton and hall textbook of medical physiology 12 edition page number: 671,672,673
|
Physiology
|
G.I.T
|
41729105-2e4b-4944-903c-6181a9749aec
|
A 73-year-old woman presents with increasing weakness, most noticeable in the legs. She has noticed some cramping and weakness in the upper extremities as well. She has more difficulty removing the lids from jars than before. She has noticed some stiffness in the neck but denies back pain or injury. There is no bowel or bladder incontinence. She takes naproxen for osteoarthritis and is on alendronate for osteoporosis. She smokes one pack of cigarettes daily. The general physical examination reveals decreased range of motion in the cervical spine. On neurological examination, the patient has 4/5 strength in the hands with mild atrophy of the interosseous muscles. She also has 4/5 strength in the feet; the weakness is more prominent in the distal musculature. She has difficulty with both heel walking and toe walking. Reflexes are hyperactive in the lower extremities. Sustained clonus is demonstrated at the ankles. What is the best next step in her management?
|
Obtain MRI scan of the head
|
Begin riluzole
|
Obtain MRI scan of the cervical spine
|
Check muscle enzymes including creatine kinase and aldolase
| 2c
|
multi
|
Cervical spondylosis (arthritis) or midline disc protrusion can cause cervical myelopathy, which can mimic amyotrophic lateral sclerosis. The neck pain and stiffness can be mild. The patient can have both lower motor neuron signs such as atrophy, reflex loss, and even fasciculations in the arms and upper motor neuron signs such as hyperreflexia and clonus (from cord compression) in the legs. Therefore, the diagnosis of ALS is never made without imaging studies of the cervical cord, as compressive cervical myelopathy is a remediable condition. Starting riluzole to slow the progression of ALS would, therefore, be inappropriate at this point. Disease in the cortex would never cause this combination of bilateral upper and lower neuron disease, so an MRI scan of the brain would be superfluous. Myopathies such as polymyositis or metabolic myopathy cause more proximal than distal weakness and would not be associated with hyperreflexia. You should think of disease of the neuromuscular junction (e.g., myasthenia gravis) or muscle when the neurological examination is normal except for weakness. Simply referring the patient for physical or occupational therapy would leave her potentially treatable cervical spine disease undiagnosed. Decompressive surgery can improve symptoms and halt progressive loss of function in cervical myelopathy.
|
Medicine
|
C.N.S.
|
5754b3ee-b5c8-4c06-a4d7-a835b23a3e05
|
Regarding the use of halothane in obsteric surgery,which is true –
|
There is increased risk of PPH
|
It has no effect on uterine musculature
|
Best used in caesarean section
|
None is true
| 0a
|
multi
|
As halothane causes uterine relaxation, post-partum hemorrhage can occur.
|
Anaesthesia
| null |
cc46b8ca-ae8e-4dd5-9493-956fcd7a8d51
|
Commonest among diseases with Mendelian inheritance is –
|
Autosomal dominant
|
Autosomal recessive
|
X–linked recessive
|
X–dominant
| 0a
|
single
|
It is estimated that the combined incidence of mendelian inheritance (autosomal dominant, autosomal recessive, x-linked) in man is about 1% of all live born individuals.
As many as 793 autosornal dominant phenotypes, 629 autosomal recessive traits and 123 sex linked diseases have been catalogued to date.
|
Social & Preventive Medicine
| null |
1516ccb0-ae26-43aa-92d4-a3f5f4d4a8a9
|
Regarding isoflurane all are true except
|
Is a respiratory depressant
|
Causes tachycardia
|
Is metabolised to inorganic fluoride ions
|
Implicated in causing seizures
| 3d
|
multi
|
Isoflurane is not epileptogenic.
|
Anaesthesia
| null |
295e3b58-d546-4e87-866f-491d71e9e21a
|
Bone resorption markers are all except
|
Taarate resistant acid phosphatase
|
Osteocalcin
|
Cross linked-N-telopeptides
|
Urine total free deoxypyridiflolone
| 1b
|
multi
|
Tarate-resistant acid phosphatase (TRACP) is an enzyme that is expressed in high amounts by bone resorbing osteoclasts, inflammatory macrophages and dendritic cells. Two forms of TRACP circulate in human blood, TRACP 5a derived from macrophages and dendritic cells, and TRACP 5b derived from osteoclasts. Recent data have demonstrated the utility of TRACP 5b as a marker of osteoclast number and bone resorption, and serum TRACP 5a as a marker of inflammatory conditions. Cross-linked N-telopeptide of type-I collagen (NTx) is one of the biochemical markers of bone resorption, and is widely used in clinical situations to evaluate the indication and efficacy of treatments for osteoporosis. Deoxypyridinoline (DPD) in urine, which reflects systemic bone resorption, is considered useful for assessing the effects of osteoporosis treatment. Refer robbins 9/e p774
|
Pathology
|
Breast
|
4f29a09a-927a-4319-b8e1-0be7a6e7c30a
|
Most serious complication of myelogram is
|
Allergy
|
Transient neurological deficit
|
Headache
|
Arachnoiditis
| 3d
|
multi
|
Ans. Arachnoiditis
|
Radiology
| null |
a0b7720b-0f0d-40f0-94c2-b3c22807bfaf
|
TROTTER'S TRIAD is seen in-
|
Juvenile nasal angiofibroma
|
Acoustic neuroma
|
Nasopharyngeal carcinoma
|
Glomus tumour
| 2c
|
single
|
Ans. is 'c' i.e., Nasopharyngeal carcinoma Trotter's triado Trotter's triad occurs in nasopharyngeal carcinoma. It includes :-i) Conductive deafness (due to Eustachian tube blockage)ii) Temporo - parietal neuralgia (due to involvement of ipsilateral Vth cranial nerveiii) Palatal paralysis (due to involvement of Xth cranial nerve)
|
ENT
|
Tumors
|
deed20e5-f47a-4ab0-836c-003232c65802
|
Branches of coeliac axis are all except:
|
Splenic aery
|
Left gastric aery
|
Hepatic aery
|
Inferior phrenic aery
| 3d
|
multi
|
D. i.e. Inferior Phrenic aery
|
Anatomy
| null |
8e327cbe-2bdf-46d6-96bd-2e7532f8bae8
|
Non-gonococcal vaginal discharge, dysuria and frequency of urine may be due to infection with: March 2003
|
Trichomonas vaginalis
|
Trichomonas vaginalis
|
Candida albicans
|
Chlamydia trachomatis
| 3d
|
single
|
Ans. D i.e. Chlamydia trachomatis
|
Gynaecology & Obstetrics
| null |
71ae477d-513a-433a-a1fc-274ef84cb05b
|
Organic mental disease is indicated by:
|
Incoherence
|
Delusion
|
Flight of idea
|
Perseveration of speech
| 3d
|
single
|
Perseveration of speech is suggestive of organic mental disorders. Few books are giving the answer as delusion which is completely wrong. Flight of ideas is seen in case of mania. Incoherence is formal thought disorder characteristic of Schizophrenia.
|
Psychiatry
|
Organic Mental Disorders
|
dd3a4270-e757-4783-9eee-9a5bb5b6d3da
|
Commonest source of extradural hemorrhage: UP 09
|
Middle meningeal aery
|
Basilar aery
|
Charcot's aery
|
Middle cerebral aery
| 0a
|
single
|
Ans. Middle meningeal aery
|
Forensic Medicine
| null |
f489590c-7a81-44d0-b7fb-aca02bbf4ee6
|
Which causes antral gastrin release?
|
Antral distension
|
Acid
|
Secretin
|
Calcitonin
| 0a
|
single
|
Gastrin is produced by cells called G cells in the antral poion of the gastric mucosa.G cells are flask-shaped, with a broad base containing many gastrin granules and a narrow apex that reaches the mucosal surface. Microvilli project from the apical end into the lumen. Receptors mediating gastrin responses to changes in gastric contents are present on the microvilli. Other cells in the gastrointestinal tract that secrete hormones have a similar morphology. Gastrin is typical of a number of polypeptide hormones in that it shows both microheterogeneity and microheterogeneity. Microheterogeneity refers to the occurrence in tissues and body fluids of peptide chains of various lengths; microheterogeneity refers to differences in molecular structure due to derivatization of single amino acid residues. preprogastrin is processed into fragments of various sizes. Three main fragments contain 34, 17, and 14 amino acid residues. All have the same carboxyl terminal configuration. In large doses, gastrin has a variety of actions, but its principal physiologic actions are stimulation of gastric acid and pepsin secretion and stimulation of the growth of the mucosa of the stomach and small and large intestines (trophic action). Gastrin secretion is affected by the contents of the stomach, the rate of discharge of the vagus nerves, and bloodborne factors. Atropine does not inhibit the gastrin response to a test meal in humans, because the transmitter secreted by the postganglionic vagal fibers that innervate the G cells is gastrin-releasing polypeptide rather than acetylcholine. Gastrin secretion is also increased by the presence of the products of protein digestion in the stomach, paicularly amino acids, which act directly on the G cells. Phenylalanine and tryptophan are paicularly effective. The acid in the antrum inhibits gastrin secretion, paly by a direct action on G cells and paly by release of somatostatin, a relatively potent inhibitor of gastric secretion. The effect of acid is the basis of a negative feedback loop regulating gastrin secretion. Increased secretion of the hormone increases acid secretion, but the acid then feeds back to inhibit fuher gastrin secretion. In conditions such as pernicious anemia in which the acid-secreting cells of the stomach are damaged, gastrin secretion is chronically elevated.REF: GANONG&;S REVIEW OF MEDICAL PHYSIOLOGY, KIM BARRETT, HEDDWEN BROOKS, SCOTT BOITANO, SUSAN BARMANTWENTY THIRD EDITIONPAGE NO:443
|
Physiology
|
G.I.T
|
8e39f5e0-cf2c-49c3-bc7d-87cba6dac53f
|
Which of the following acts as defence against E.coli?
|
Lactoglobulin
|
Lactalbumin
|
Lactoferrin
|
None of the above
| 2c
|
multi
|
Lactoferrin binds to iron and makes it unavailable for E.coli and acts a defence mechanism against infections. Ref: Nutrition and Child Development, K.E. Elizabeth, 4th edition pg: 17
|
Social & Preventive Medicine
| null |
9c527738-289e-490f-a0cb-95fb0790c2ea
|
Which of following Culture media combination is/are true except:
|
Thayer-Main media: Gonorrhoea
|
Chocolate agar-: enriched media
|
Lowenstein-Jensen Medium: Mycobacterium tuberculosis
|
Muller-Hinton agar: Corynebacterium diphtheriae
| 3d
|
multi
|
Ans: d. Muller-Hinton...Thayer-Main is a useful selective media for Neisseria gonorrhoeae''.Mueller-Hinton is enriched media for Neisseria.C diphtheriae and other corynebacteria grow aerobically on most ordinary laboratory media. On Loeffler's serum medium, corynebacteria grow much more readily than other respiratory organisms, and the morphology of organisms is typical in smears.Lowenstein-Jensen Medium. It is used to culture tubercle bacilli. It contains egg, malachite green and glycerol.Chocolate Agar or Heated Blood agar: Prepared by heating blood agar. It is used for culture of pneumococcus, gonococcus, meningococcus and Haemophilus. Heating the blood inactivates inhibitor of growths.
|
Microbiology
| null |
b5737b8a-025c-41b3-a2bb-da816234266c
|
Most impoant factor which decides the results of a randomized controlled trial is: March 2005
|
Inclusion of all age groups
|
50% treated with placebo and 50% with drugs
|
100% follow up
|
Effective randomization
| 3d
|
multi
|
Ans. D: Effective randomization It is a procedure by which the paicipants are allocated into groups usually called 'study' and 'control' groups. Randomization is the hea of control trials. It eliminates selection bias
|
Social & Preventive Medicine
| null |
44ce4c2b-4da1-4239-97dd-6274dd69289c
|
All of the following are true about Primary Sjogren's syndrome, except:
|
May be seen in children
|
Sensation of sand or gravel in eyes
|
Associated with rheumatoid ahritis
|
Salivary gland enlargement
| 2c
|
multi
|
Answer is C (Associated with Rheumatoid Ahritis): Kelly's Rheumatoid ahritis is associated with Secondary Sjogren's Syndrome and not Primary Sjogren's Syndrome. Primary Sjogren's Syndrome No Connective Tissue /Chronic inflammatory disorder Secondary Sjogren's Syndrome Underlying Connective Tissue / Chronic inflammatory disorder Keratoconjunctivitis Sicca (Sensation of sand or gravel in eyes) and salivary gland enlargement are typical symptoms of Sjogren's syndrome (Both Primary and Secondary). Primary Sjogren's syndrome typically affects women in their middle age (Female to male ratio = 9:1) but it may occur at any age including childhood. Primary Sjogren's syndrome has been repoed infrequently in children with onset as early as 5 years of age. The presence of symptoms and signs of Sjogren's 's syndrome (Dry eyes; Dry mouth; Salivary Gland Enlargement) in the setting of another connective tissue disease or chronic inflammatory pathology like Rheumatoid Ahritis, SLE, Systemic Sclerosis by definition is termed as Secondary Sjogren's Syndrome.
|
Medicine
| null |
5ddbaad6-17a3-4aac-b91f-8fe5b4eecfcf
|
Creatinine is formed from all except -
|
Glycine
|
Arginine
|
Methionine
|
Asparagine
| 3d
|
multi
|
Ans. is 'd' i.e., Asparagine * The three aminoacids used for the synthesis of creatine are Glycine, Arginine and Methionine* In Kidney, Glycine reacts with Arginine in the presence of Arginine Glycine Amido Transferase to for Guanidoacetate and Ornithine* Guanidoacetate through circulation is taken to liver. In liver Guanidoacetate undergoes transmethylation reaction with S- Adenosyl Methionine in the presence of Guanidoacetate Methyl Transferase to form Creatine.* The creatine through circulation reaches tissues.* 90% of creatine is taken up by skeletal muscles and is phosphorylated by creatine Kinase to form creatine Phosphate.* This creatine phosphate acts as the immediate source of energy for skeletal muscle.
|
Biochemistry
|
Proteins and Amino Acids
|
ed6e716c-9ff2-48ef-a242-e8d60dcd46f2
|
A 67 year male smoker presents with haemoptysis and cough. Bronchoscopic biopsy revealed undifferentiated tumour. The immunohistochemical marker that can be most helpful is:
|
Calretinin
|
Vimentin
|
Cytokeratin
|
GGT
| 2c
|
single
|
Immunohistochemistry is used in conjunction with light microscopy to distinguish between primary and metastatic adenocarcinoma, determine neuroendocrine features, diagnose mesotheliomas. Pulmonary adenocarcinomas usually stain positive for cytokeratin 7, thyroid transcription factor 1 (TTF-1), and surfactant apoprotein A and are negative for cytokeratin 20. Metastatic adenocarcinomas from other sites except the thyroid stain negative for TTF-1. All carcinoids and most SCLCs stain positive for chromogranin and synaptophysin, whereas NSCLC is usually negative for these two markers. Mesothelioma is distinguished from adenocarcinoma by the presence of calretinin and cytokeratin 5/6 and the absence of carcinoembryonic antigen (CEA), B72.3, Ber-EP4, and MOC-31. Ref: Gibbons D., Pisters K.M., Johnson F., Eapen G.A. (2011). Chapter 15. Non-Small Cell Lung Cancer. In H.M. Kantarjian, R.A. Wolff, C.A. Koller (Eds), The MD Anderson Manual of Medical Oncology, 2e.
|
Biochemistry
| null |
5052bf32-3b33-460d-8368-f9e846c1546b
|
Differential diagnosis in a case of fever with vesicular rash for two days are all except
|
Candida-albicans
|
Infectious monocleosis
|
Klabsiella pneumonia
|
Influenza
| 0a
|
multi
|
Cutaneous candidosis is caused by candida albicans. - it may be interiginous or paronychial -the former is an erythematous, scaling or moist lesions with sharply demarcated borders, where papular lesions are most prominent. - paronychia is seen in occupations that lead to frequent immersion of hands in water. * In infectious mononucleosis a maculopapular rash is seen . *Vesicular rash is also seen in varicella ,HSV ,HFMD ,papulonecrotic TB . Reference : Anathanarayan & paniker&;s 9th edition, pg no: 611 op ghai pg 208 9th edition
|
Pediatrics
|
Infectious disease
|
cea7ac5a-dc7b-40e6-b333-01faa0645124
|
Which is the most common site of feilization in the female reproductive tract?
|
Cervix
|
Ampulla
|
Fimbriae
|
Uterus
| 1b
|
single
|
The middle segment of fallopian tube called the ampulla is the widest and longest segment. It contains extensive branched mucosal folds and is the commonest site of feilization.
|
Physiology
| null |
86e902e9-a0b1-4730-85d1-a2e6832d3cec
|
Principle of pole dilatation is:
|
Dilatation of alveolus.
|
Expansion of bony socket.
|
Both of the above.
|
None.
| 2c
|
multi
| null |
Surgery
| null |
e913a6c7-6d6a-4f3c-8f8c-84cfa68a7edd
|
True about vitiligo are all except:
|
Surgical treatment is indicated if medical treatment fails
|
Leucotrichia is associated with good prognosis
|
Autoimmune condition
|
Skin biopsy specimen shows abscence of melanocytes.
| 1b
|
multi
|
VITILIGO -Autoimmune disorder -Skin biopsy specimen shows absence of melanocytes. Poor prognostic factors: Leucotrichia Long standing type Lesions over bony prominences Acrofacial -Surgical treatment is indicated if medical treatment fails and disease is stable for >1 year. - Modalities : Skin grafting Non-cultured autologous melanocytic transfer Cultured autologous melanocytic transfer.
|
Dental
|
Hypo Pigmentary Disorders
|
40d23aa4-7e6b-4ec0-99f1-488c2dc9a3ff
|
General fertility rate:
|
Average number of children born to a women in her reproductive life span
|
Annual number of live births per 1000 married women during reproductive age
|
Total number of girl child born to a female
|
Total number of boy child born to a female
| 1b
|
single
|
Ans. (b) Annual number of live births per 1000 married women during reproductive ageRef: Park's 21sted. /451* General fertility rate is the annual number of live births per 1000 married women of child bearing age (15-49 years).* Total fertility rate average number of children born to a women in her reproductive life span.* Gross reproduction rate is total number of girl children born to a female. It is half of the TFR.* Net reproduction rate is total number of girl children born to a female, taking into account their mortality.
|
Social & Preventive Medicine
|
Epidemiology
|
0777d993-2d4e-43ed-8d35-6dfb6ac49b64
|
A child 14 years of age come to emergency depament with a history of blunt trauma abdomen. On examination Ballance's sign is found to be positive, otherwise the child is stable. Which of the following is not true statement?
|
A palpable tender mass can be felt in the left upper quadrant with persistent dullness
|
It is due to extracapsular or subcapsular hematoma ( of spleen )
|
Managed with Conservative treatment
|
Splenectomy is required
| 3d
|
multi
|
As the child is stable, conservative management should be done. " 70% to 90% of children with splenic injury are successfully treated without operation, and 40% to 50% of adult patients with splenic injury nonoperatively in large volume trauma centres". "Splenectomy may be safer option, especially in the unstable patients with multiple potential sites of bleeding. In ceain situations, selective angio embolism of the spleen can play a role''. Splenic injuries are treated nonoperatively, by splenic repair (splenorrhaphy), paial splenectomy, or resection, depending on the extent of the injury and the condition of the patient. Enthusiasm for splenic salvage has been driven by the evolving trend toward nonoperative management of solid organ injury and the rare but often fatal complication of overwhelming postsplenectomy infection (OPSI ). It is uncommon in otherwise healthy adults. For this reason attempts to salvage the spleen are more vigorous. Splenectomy is also indicated for lesser splenic injuries in patients who have developed a coagulopathy and have multiple abdominal injuries, and it is usually necessary in patients with failed splenic salvage attempts. Paial splenectomy can be used in patients in whom only a poion of the spleen has been destroyed, usually the superior or inferior half. Splenic trauma: The spleen is the most commonly injured organ in cases of blunt abdominal trauma. Nonoperative management is the treatment of choice Splenic injuries in children have been managed traditionally without surgery. Until recently, most splenic injuries in the adults were managed with splenorrhaphy or splenectomy. Currently., 50-80% of adults with blunt splenic injuries are managed non operatively. Stable patients who have high-grade splenic injuries on CT or have evidence of ongoing bleeding on CT may be candidate for angiographic embolisation. Unstable patients with splenic injuries should undergo splenectomy or attempts at splenic repair if appropriate. "Ballance's sign: A palpable tender mass can be felt in the left upper quardant with persistent dullness. It is due to extracapsular or subcapsular hematoma (of spleen ) " Splenectomy is usually indicated under the following circumstances: Patient is unstable Other injuries require prompt attention Spleen is extensively injured with continuous bleeding Bleeding is associated with hilar injuries Ref: L & B 25/e, page 348 ; CSDT 11/e, page 253
|
Surgery
| null |
1ea643b9-4b60-45e7-bfa8-e822c3efb05d
|
Common oral change seen with nutritional anemia is:
|
Enlarged tongue
|
Atrophic glossitis
|
Generalized osteolysis
|
Focal marrow expansion
| 1b
|
single
| null |
Pathology
| null |
7e7ba40d-d0c6-426d-b0b7-a4303a0ee8c8
|
Following drugs are known to contribute to urinary Incontinence except
|
Nicardipine
|
Haloperidol
|
Metoprolol
|
Prazosin
| 2c
|
multi
|
Medications that may cause urinary incontinence include:
Alcohol
α agonist and blockers
ACE Inhibitors
Calcium channel blockers
Diuretics
Narcotics
Thiaxolidinediones.
|
Gynaecology & Obstetrics
| null |
f1ded941-94e3-4106-868d-6cbd46fa9d24
|
A synthetic “cocktail” vaccine SPf66 has shown potential for the protection against
|
Dengue/ DHF
|
Japanese encephalitis
|
Lymphatic filariasis
|
Falciparum Malaria
| 3d
|
single
|
SPf 66: A synthetic ‘Lytic Cocktail vaccine’ developed for P. Falciparum has been extensively tested –
Formulated as peptide-alum combination.
– Safe, effective and reduces risk of developing clinics malaria by 30%.
|
Social & Preventive Medicine
| null |
baea121c-53c9-4bd2-964d-b7b730b5253f
|
which of the following is charecterstic of type D disorder
|
odd and excentric
|
self pessimism
|
reward dependent
|
acheivemnt oriented
| 1b
|
single
|
there are two types of personality disorders TYPE A PERONALITY PEOPLE are called' BORN WARRIORS' who are workaholics end up having hea disease TYPE D PERSONALITY PEOPLE are called 'BORN WORRIERS' who ruminate and have high risk of hea disease Ref. kaplon and Sadock synopsis of psychiatry, 11 th edition, pg no.746
|
Psychiatry
|
Personality disorders
|
e7ad8c11-1e80-4a22-b607-c9d15f078ad0
|
Scaphoid fracture which area has maximum chances of Avascular Necrosis?
|
Proximal 1/3
|
Middle 1/3
|
Distal 1/3
|
Scaphoid Tubercle Fracture
| 0a
|
single
|
(a) Proximal 1/3* Most of the blood supply to the scaphoid enters distally, so blood supply of scaphoid diminishes proximally. This accounts for the fact that 1% of distal third, 20% of middle third, 40% of proximal third and 100% of proximal pole fractures result in avascular necrosis or non-union of the proximal fragment.Scaphoid blood supplyAVN scaphoid
|
Orthopaedics
|
Fractures of Metacarpals, Phalanges, Metacarpo-Phalangeal Joints
|
0ae5dc6a-3f8c-4953-91fe-06da78fea732
|
Potassium-sparing diuretics are all except:
|
Spironolactone
|
Triamterene
|
Amiloride
|
Ethacrynic acid
| 3d
|
multi
|
classification: High efficacy diuretics - Furosemide, Bumetanide, Torasemide Medium efficacy( inhibit Na-Cl sympo ) - Thiazides ( Hydrochlorothiazide, Benzthiazide, Hydroflumethiazide, Clopamide ), Thiazide-like (Indapamide, Xipamide, Metolazone) Carbonic anhydrase inhibitors - Acetazolamide Potassium-sparing - Spironolactone( Aldosterone antagonist), Amiloride, Triamterene ( inhibit renal epithelial Na channel ) Osmotic diuretics - Mannitol, Isosorbide, Glycerol ( Essentials of Medical Pharmacology, K.D Tripathi,6th edition, page 561 )
|
Pharmacology
|
Kidney
|
5c4b8d64-d3e7-4563-b587-4959991417f5
|
Of the following the most significant risk factor for developing breast cancer is-
|
The presence of sclerosing adenosis
|
Nullipartiy
|
Atypical lobular hyperplasia
|
Atypical ductal hyperplasia
| 3d
|
single
| null |
Surgery
| null |
8ef667f8-b58d-48b0-817d-71d18b3f7f6a
|
All are true for maxillary fracture except:
|
Geriatric maxillary fracture is difficult to treat
|
Pediatric maxillary fracture is more comminuted
|
Midpalatal fracture has 8% incidence
|
All 4 buttresses are seldom fracture
| 1b
|
multi
| null |
Surgery
| null |
42108baf-dccf-41ae-968d-ce101d7f1fed
|
Mandibular nerve passes through ?
|
Formanen rotundum
|
Foramen lacerum
|
Stylomastoid foramen
|
Foramen ovale
| 3d
|
single
|
Foramen ovale
|
Anatomy
| null |
5d940ffb-1176-48d3-a931-92b4a20e9e52
|
Pneumococcal resistance to penicillin G is mainly acquired by :
|
Conjugation
|
Transduction
|
Transformation
|
All of the above
| 2c
|
multi
|
Acquisition of antibiotic resistance by Transduction is common in Staphylococcal and that of by Transformation in Pneumococcus and Neisseria.
Vancomycin resistance in enterococci and Staphylococcus is mediated by the conjugative plasmid.
|
Pharmacology
| null |
2d568d89-d617-49cf-8c04-4af012d661c2
|
Commonest cause of epistaxis in children is -
|
Trauma
|
Foreign body
|
Nasal diphtheria
|
Enlarged adenosis
| 0a
|
single
| null |
ENT
| null |
ee0344be-5ffe-44f4-a4a1-ad7dbac16727
|
Metabolic complications of subtotal gastrectomy with Billroth I or Billroth II reconstruction include:
|
Anemia
|
Reactive hypoglycemia
|
Dumping syndrome
|
All of the above
| 3d
|
multi
|
Anemia develops in as many as 30% of patients within 15 years of surgery. The cause is multifactorial and includes malabsorption of iron, folate, and vitamin B 12. A metabolic bone disease occurs in as many as 33% of patients, is similar to osteomalacia, and is probably a result of malabsorption of calcium and vitamin D. Reactive hypoglycemia occurs with rapid gastric emptying, resulting in increased glucose absorption immediately after a meal. Initially there is hyperglycemia, leading to hyperinsulinemia and subsequent rapid glucose clearance and symptomatic hypoglycemia. Dumping syndrome varies from very mild symptoms to significantly disabling ones. The severe syndrome occurs in fewer than 5% of patients. Small, frequent, dry meals of low osmolality reduces symptoms and somatostatin analog has been of some clinical use.
|
Surgery
|
Stomach & Duodenum
|
655fe558-80a0-43c5-8886-2d92fe5de62c
|
Conjugated hyperbilirubinemia in infancy seen in –a) Choledochal cystb) Extra hepatic biliary atresiac) Crigler – Najjar diseased) Gilbert disease
|
ac
|
a
|
ad
|
ab
| 3d
|
single
| null |
Pediatrics
| null |
327bc019-7109-4162-b765-f961785143da
|
Middle 1.5 cm of anal canal is lined by
|
Keratinized stratified squamous epithelium
|
Non keratinized stratified squamous epithelium
|
Columnar epithelium
|
Psudocolumnar epithelium
| 1b
|
single
|
The anal canal is divided into three pas. The zona columnaris is the upper half of the canal and is lined by simple columnar epithelium. The lower half of the anal canal, below the pectinate line, is divided into two zones separated by Hilton's white line. The two pas are the zona hemorrhagic and zona cutanea, lined by atratified squamous non keratinized and stratified squamous keratinized. ref - BDC vol2 pg416
|
Anatomy
|
Abdomen and pelvis
|
2a506297-aea0-4323-afb9-81de3d576b40
|
In a 35 year old man which is most likely organism causing infection of epididymis-
|
E.coli
|
Gonococci
|
Chlamydia
|
Ureaplasma ureolyticum
| 2c
|
single
|
Chlamydial urethritis may be followed by acute epididymitis, but this condition is rare, generally occurring in sexually active patients <35 years of age; in older men, epididymitis is usually associated with gram-negative bacterial infection and/or instrumentation procedures. It is estimated that 50-70% of cases of acute epididymitis are caused by C. trachomatis . The condition usually presents as unilateral scrotal pain with tenderness, swelling, and fever in a young man, often occurring in association with chlamydial urethritis. The illness may be mild enough to treat with oral antibiotics. (Harrison's Principles of internal medicine,20 th edition, page 1423)
|
Medicine
|
Infection
|
e95c5896-f989-4e5c-a7bf-bed216fd2b23
|
The organism most commonly implicated in the causation of subacute bacterial endocarditis is:
|
S. albus
|
S. Aureus
|
S. typhi
|
S. Viridans
| 3d
|
single
| null |
Medicine
| null |
1b9973bd-32fa-4033-83c7-d02322e837ec
|
Adverse effects of insulin include all of the following except:
|
Edema
|
weight loss
|
Lipodystrophy
|
hypoglycemia
| 1b
|
multi
|
Hypoglycemia is the most frequent and potentially the most serious relationship of insulin therapy. Some patients develop sho lived dependent edema. Lipodystrophy occur at the site of injection after a long time. weight gain can occur due to insulin not weight loss (REF.Essential of medical pharmacology K D TRIPATHI 6 Edition, Page No - 262)
|
Pharmacology
|
Endocrinology
|
6ad43210-4f47-46e0-9336-3f713731bab5
|
Most specific enzyme for mi is:
|
Cpk-MM
|
Cpk-MB
|
Cpk-BB
|
LDH
| 1b
|
single
|
Ans: bRef: Harrison, 16thed, p. 1450
|
Medicine
|
C.V.S.
|
0dc3ee67-d6d2-46f9-b265-44a6c716829c
|
Staphylococcus aureus differs from staphylococcus epidermidis by -
|
Is coagulase positive
|
Forms white colonies
|
A common cause of UTI
|
Causes endocarditis in drug addicts
| 0a
|
single
| null |
Microbiology
| null |
d8a3e98a-f538-4c97-a4df-43f950d0de47
|
Putrefaction is
|
Perimoem sign of death
|
Immediate sign of death
|
Early sign of death
|
Late sign of death
| 3d
|
single
|
CHANGES AFTER DEATH 1.Immediate changes a) cessation of respiration b) cessation of circulation c) insensibility d) loss of voluntary power e) dilatation of pupil 2. Early changes a) primary flaccidity of muscles b) algor mois c) livor mois d) rigor mois e) retinal changes and changes in vitreous humor. 3. Late changes a) putrefaction b) adipocere formation c) mummification Ref: FORENSIC MEDICINE AND TOXICOLOGY DR PC IGNATIUS THIRD EDITION PAGE 19
|
Forensic Medicine
|
Death and postmortem changes
|
0414746a-af4a-4c7b-8115-345ed67fc1fd
|
All of the following are habbit disorders, except:
|
Thumb sucking
|
Tics
|
Temper tantrums
|
Nail biting
| 1b
|
multi
|
Tics are rapid and reccurent moments for brief duration and it is not included under habbit disorders.
|
Psychiatry
| null |
52fc5a8e-4f07-4e05-89dd-fee56cfeb715
|
In a highly selective vagotomy, the vagal supply is severed to
|
Proximal two-thirds of stomach
|
Antrum
|
Pylorus
|
Whole of stomach
| 1b
|
single
|
Done in cases of uncomplicated duodenal ulcer wherein the fibres entering the stomach is divided both anteriorly as well as posteriorly, Nerve of Latarjet is retained to supply the tantrum. Reference: SRB 5th edition page no. 861
|
Surgery
|
G.I.T
|
c924dafd-2309-44d3-8f48-12c9996efa84
|
Which of the following is the most appropriate method for collecting urine for culture in a case of vesicovaginal fistula?
|
Sterile speculum
|
Foley's catheter
|
Midstream clean catch
|
Suprapubic needle aspiration
| 1b
|
single
|
Ureteric catheterisation is the best method of collecting urine for culture in a case of vesico-vaginal fistula. Second best method of collection of urine is supra pubic aspiration, which needs a full bladder and is not possible in this case. Collection of urine sterile speculum and midstream clean catch leads to contamination of urine. So by exclusion, the best answer is collection of urine using a foley's catheter. Ref: Textbook of Gynecology By DC Dutta, 4th Edition, Pages 386-8
|
Gynaecology & Obstetrics
| null |
74e6c4f2-ccb8-44bc-a548-e7668d09d489
|
A 6-month infant presented with multiple papules and exudative lesions on the face, scalp, trunk and few vesicles on the palms and soles for 2 weeks. His mother had H/O itchy lesions. Most likely diagnosis:
|
Scabies
|
Infantile eczema
|
Infantile seborrheic dermatitis
|
Impetigo contagiosa
| 0a
|
single
|
Ans. A. ScabiesScabies is due to infestation with human scabies mite, which is an obligate parasite and has no separate existence outside the human body. The disorder is notorious for the intensity of itch that it causes, even in the presence of relatively minor physical signs. Physical signs are essentially those of eczema and the effects of scratching vesicle are seen, but excoriations and prurigo-like papules are more common.
|
Skin
|
Erythmato-Squamous and Lichenoid Eruption
|
f318a0ef-01f6-43e7-beff-de29694040ea
|
Symptoms of narcolepsy are all except
|
Cataplexy
|
Catalepsy
|
Daytime sleepiness
|
hypnagogic hallucinations
| 1b
|
multi
|
NarcolepsyThe classic tetrad of symptoms is:i. Sleep attacks (most common): ii. Cataplexy: iii. Hypnagogic hallucinations: iv. Sleep paralysis (least common): Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 138
|
Psychiatry
|
Sleep disorders and eating disorders
|
203dc3a8-f9ec-4cc3-9ec0-88a9a8a06fdd
|
After staing your patient on imipramine, his hea rate rises to 120/min and he has blurred vision. These effects can be explained by the fact imipramine:
|
Is a muscarinic antagonist
|
Potentiates epinephrine
|
Is a ganglionic blocker
|
Is a potent a-adrenergic blocker
| 0a
|
single
|
(Ref: KDT 6/e p444) These symptoms are of anticholinergic drugs. Tricyclic antidepressants have powerful anticholinergic propeies and can lead to these symptoms.
|
Anatomy
|
Other topics and Adverse effects
|
d337d21f-f500-4a61-b045-4ee005e4b5e2
|
Commonest cause of lung abscess is
|
Aspiration
|
Hematogenous spread from distant date
|
Direct contact
|
Lymphatic spread
| 2c
|
single
|
Lung abscess Lung abscess refers to a microbial infection of the lung that results in necrosis of the pulmonary parenchyma MC cause of primary lung abscess : Anaerobic bacteria Etiology of anaerobic lung abscess : Aspiration Routes of infection Aspiration of organisms that colonize oropharynx (MC) Inhalation of infection or aerosols Hematogenous dissemination from extrapulmonary site Direct inoculation (as in tracheal intubation or stab wounds) Contiguous spread from an adjacent site of infection Ref: schwaz's principle of surgery 10th edition Pgno : 650
|
Surgery
|
Cardio thoracic surgery
|
8fcc2b40-b388-42ca-b3af-f167e389d289
|
An adult old man gets burn injury to his hands. Over few weeks, the burned skin heals without the need for skin grafting. The most critical factor responsible for the rapid healing in this case is ?
|
Remnant skin appendages
|
Underlying connective tissues
|
Minimal edema and erythema
|
Granulation tissue
| 0a
|
single
|
Ans. is 'a' i.e., Remnant skin appendagesSkin consists of two layers1. Epidermis Most superficial layer of the skin. It is constantly replaced from the basal layer.2. Dermis It is thicker than epidermis and supplies the strength and integrity to the skin It has rich blood supply It contains adnexal structures i.e. --> Hair follicles, Sebaceous glands, Sweat glands.o The impoance of these adnexal structures is that they contain epithelial cells that can proliferate and can heal a paial thickness wound by epithelialisation.o Superficial burns Involve only epidermis and superficial dermis The adnexal structures are left intact so they can heal by epithelialisation.o Deep burnsIn deep burns all the adnexal structures are lost so they can only heal by secondary intention with scarring. o Presence of granulations simply indicate healing, one cannot tell whether it is healing by primary intention or by secondary intention.
|
Pathology
| null |
da4942d2-5db5-4f1e-a4df-14705da209f4
|
Meniere's disease is manifested by all of the symptoms except:
|
Tinnitus
|
Deafness
|
Vertigo
|
Otorrhoea
| 3d
|
multi
|
(d) Otorrhoea(Ref. Scott Brown, 8th ed., Vol 2, 819)Meniere is manifested as vertigo followed by deafness (SN), tinnitus and a sensation of fullness in the ear but no discharge.
|
ENT
|
Ear
|
864ccf14-cbe3-409b-b669-5ffa39674bad
|
Both oral and Nasal intubation are C/I – a) Laryngeal edemab) CSF–Rhinorrhoeac) Comatose patientd) Acute Tracheo–Laryngo-bronchitis
|
b
|
c
|
ac
|
ad
| 3d
|
multi
|
Both nasal and oral intubation are contraindicated in Laryngeal edema, epiglotitis, and Laryngotracheobronchitis.
|
Anaesthesia
| null |
ce4c6730-9236-4ba4-869f-5d781f774166
|
All are true about Ewing's sarcoma except
|
Low grade tumor has good prognosis
|
Pain is most common symptom
|
Onion peel appearance
|
Associated with t(11,22)
| 0a
|
multi
|
All cases of Ewing's sarcoma are considered as high grade.
Histological grading has no prognostic significance.
|
Orthopaedics
| null |
589106a2-db31-423a-9cb8-657f73e4009b
|
False about caffey's disease
|
Usually occurs in infants < 6 months
|
Jaw Osteomyelitis
|
Cortical hyperostosis
|
Caused by salmonella
| 3d
|
multi
| null |
Orthopaedics
| null |
96ccb70c-2ed3-471d-84b2-111da155ac9a
|
True about the H+ secretion by the PCT is:
|
It is for acidification of urine
|
It occurs against the concentration gradient for H+
|
It is meant for reabsorption of the filtered bicarbonate
|
It is an example of diffusion trapping
| 2c
|
multi
|
(C) It is meant for reabsorption of filtered bicarbonate (A) Acidification of urine is done by collecting ducts. H+ secretion in PCT occurs along the concentration gradient. In collecting ducts H+ secretion is against concentration gradient Diffusion trapping occurs in collecting ducts not in PCT. H+ secretion in PCT is meant for reabsorption of bicarbonate. Amount of filtered is calculated by (per unit time) Px x GFRPx = plasma concentration of substance. How much bicarbonate is filtered per unit time is 24meq/lit X 180L/day =4320meq/day Most of this is reabsorbed in PCT HCO3- is ionic. Ionic substances are less diffusible. So, first it is conveed to non-ionic form. For this H+ is secreted by PCT. H+ is secreted in equal amounts of HCO3- (i.e 4320 meq/day) In addition, PCT secretes 80meq/day of H+(: 4320 + 80 =4400meq/day) .This is net acid output.
|
Physiology
|
Excretory System (Kidney, Bladder) Acid-Base Balance
|
64be329d-5aff-43b9-ba93-f8336fdf178b
|
After how many days of ovulation, embryo implantation occurs?
|
3-5 days
|
6-9 days
|
10-12 days
|
13-15 days
| 1b
|
single
|
After the feilization process, embryo is formed in the ampulla and it reaches the uterine cavity on 3rd - 4th day and the implantation occur between 6th to 9th day of ovulation
|
Gynaecology & Obstetrics
|
Maternal Anatomy and Physiology
|
ee738a89-7e09-4f97-a381-571bf0828d8d
|
Percentage of gold in high noble alloy is
|
< 25%
|
25%
|
>40%
|
0%
| 2c
|
multi
| null |
Dental
| null |
465c4eaa-001a-4443-9721-43f16e193a55
|
Hypersensitivity vasculitis affects
|
Post-capillary venules
|
Aerioles
|
Veins
|
Medium-sized aeries
| 0a
|
single
|
. Post-capillary venules
|
Pathology
| null |
9ec12699-fe6d-40a1-965b-db246ee5ad11
|
Mechanism of action of sulfonamide is?
|
Inhibit bacterial cell wall synthesis
|
Inhibits translocation of mRNA
|
Inhibits folate synthesis
|
Inhibits bacterial respiration
| 2c
|
multi
|
Ans. is 'c' i.e., Inhibits folate synthesis Sulfonamides are bacteriostatic and act by inhibiting folic acid synthesis by inhibiting enzyme folate synthatase.
|
Pharmacology
| null |
ab3168ed-54c1-4075-9dcb-7fdf1bc2b2d9
|
In a patient with gouty ahritis, synol fluid aspiration will show-
|
Needle shaped crystals
|
Rhomboid shaped crystals
|
Mononuclear leucocytosis
|
Polymorphonuclear leukocytosis
| 0a
|
single
|
During acute gouty attacks, needle-shaped MSU crystals typically are seen both intracellularly and extracellularly . With compensated polarized light, these crystals are brightly birefringent with negative elongation. Ref - Harrisons 20e p2632
|
Medicine
|
Immune system
|
d68095f3-82cf-498b-88cb-b97df293242e
|
Most important triad of symptoms in portal hypertension is:
|
Splenomegaly, Hepatomegaly and Ascites
|
Splenomegaly, Oesophageal varices and Ascites
|
Piles, splenomegaly and general Anasarca
|
Oesophageal varices, piles and General Anasarca
| 1b
|
single
| null |
Medicine
| null |
14347448-3936-4be8-ae15-95d97797f996
|
A female treatment for depression took a massive dose of amitriptyline for suicide. Which of the following is wrong regarding management for her?
|
Gastric lavage was done
|
Sedium bicarbonate was administered to treat acidosis
|
Atropine sulphate was administered as an antidote
|
Diazepam was injected to control seizures.
| 2c
|
single
|
Ans. c. Atropine sulphate was administered as an antidote (Ref: Reddy 28/e p524: Goodman Gilman 11/448)Tricyclic antidepressants (amitriptyline) cause anticholinergic effects such as dry skin, ileus, urinary retention etc., administration of atropine would further worsen these symptoms. Atropine is better avoided in poisoning or overdose of cyclic antidepressants.Poisoning/Overdose of Cyclic AntidepressantsMechanism of Action:Inhibition of neurotransmitter uptake leading to cholinergic and alpha-adrenergic blockadeDirect myocardial depressant effectSystemic SymptomsCNS SymptomsCVS SymptomsParasympathetic* Depression of mental state* Coma, Delirium* Altered sensorium* Generalized brief and self-limited convulsions* Myoclonus, NystagmusQ* Dysarthria, AtaxiaQ* Sinus tachycardiaQ* Conduction delays* Ventricular arrhythmias* Negative inotropic action* HypotensionQ* Dry skin and mucosaQ* IleusQ* Urinary retentionQ* MydriasisQ* HypothermiaQPoisoning/Overdose of Cyclic AntidepressantsTreatment:Gastric lavage to remove the unabsorbed drugEmesis should be avoided; Activated charcoal can be usedSymptomatic treatment:Sodium bicarbonate to treat acidosisQAnti-convulsants to treat seizures
|
Pharmacology
|
Anti Depressant
|
cc33ce39-de28-4f18-9abe-95f247ac85f8
|
Tumour marker for a highly vascular tumour
|
Desmin
|
Keratin
|
Sa 200
|
Alpha-feto protein
| 1b
|
single
|
Ans. is 'b' i.e., Keratin o Mesotheloma is highly vascular and keratin is a marker of mesotheloma.
|
Pathology
| null |
f11e4916-a8f7-4d3c-865d-cf2d1d8cf673
|
All are true of police inquest, except:
|
Senior head constable can investigate
|
Most common inquest
|
Panchnama has to be signed by IO
|
IO cannot summon
| 3d
|
multi
|
Police inquest is held by a police officer (Investigation Officer--IO) not below the rank of senior head constable in all cases of unnatural deaths with the exceptions mentioned under Magistrate inquest. Police inquest (174 CrPC) : Most common type of inquest. Minimum cadre of police for conducting inquest is station officer( senior Head Constable) Panchanama - enquiry repo Can summon
|
Forensic Medicine
|
FMT Q Bank
|
5b266891-196b-4551-8776-012904d0e097
|
Which of the following features is more suggestive of organic conditions?
|
Primary delusions
|
Visual hallucinations
|
Made phenomena
|
Third person auditory hallucinations
| 1b
|
multi
|
Visual hallucinations are characteristic of organic conditions. The other choices mentioned in the question - Primary delusions, Made phenomena and third person auditory hallucinations are all examples of First rank symptoms, hence more characteristic of Schizophrenia.
|
Psychiatry
|
Basics of Psychiatry
|
a0438e94-5181-4210-96b3-f72664182bcd
|
Shoest pa of male urethra is :
|
Prostatic
|
Membranous
|
Bulbar
|
Penile
| 1b
|
single
|
B i.e. Membranous - Membranous urethra is shoest & Penile urethra is longest pa.Prostatic urethra is widest & most dilatable poion & Urethral orifice f/19 membranous urethra is narrowest & least dilatable pa
|
Anatomy
| null |
c1cb9416-3bc8-44b2-8c1c-1433b8891fe2
|
Which of the following is an analgesic which does not inhibit prostaglandin synthesis?
|
Nefopam
|
Tenoxicam
|
Ketorolac
|
Piroxicam
| 0a
|
single
|
Nefopam is nonopioid analgesic and does not inhibit prostaglandin synthesis relieves traumatic, postoperative, sho lasting musculoskeletal pain produce anticholinergic and sympathomimetic side effects Ref: KD Tripathi 8th ed ESSENTIALS OF MEDICAL PHARMACOLOGY;7TH EDITION;KD TRIPATHI;PAGE NO 208
|
Pharmacology
|
Autacoids
|
1f89bc1b-b2e7-497a-aeba-a55037edd851
|
Which of the following lifestyle modifications you should not advise to a GERD patient
|
Avoiding fatty, spicy, chocolate
|
Small frequent meals
|
Last meal should be within 2 hours of going to bed
|
Head end elevation of the bed
| 2c
|
multi
|
Last meal should be no less than 2 hours before going to bed
|
Surgery
| null |
63e9ea8f-ffe4-4674-bc05-8e9c1f77b006
|
In transposition of great vessels, all are true except –a) Aorta arises from the right ventricleb) Mitral valve is continuous with the aortic valvec) Causes jaundice immediately after birthd) None of the above
|
bc
|
c
|
ac
|
ad
| 0a
|
multi
|
Mitral valve is continous with pulmonary valve.
|
Pediatrics
| null |
08c1b5d8-c285-4777-9df5-11513d805177
|
Perifascicular atropy of muscle fibres is seen in?
|
Steroid myopathy
|
Dermatomyositis
|
Inclusion body myositis
|
Nemaline myopathy
| 1b
|
single
|
Ans. is 'b' i.e., Dermatomyositis Dermatomyositis is a connective-tissue disease related to polymyositis that is characterized by inflammation of the muscles and the skin. It is a systemic disorder that may also affect the joints, the esophagus, the lungs, and, less commonly, the hea. On the muscle biopsy, there are two classic microscopic findings of dermatomyositis. They are : mixed B- & T-cell perivascular inflammatory infiltrate and perifascicular muscle fiber atrophy. It is associated with autoantibodies, especially anti-Jol antibody.
|
Pathology
| null |
06ef8522-8d36-4248-8c4b-c75a0929cc21
|
Disinfection of sputum is done by -a) Boilingb) Autoclavingc) Sunlightd) Burninge) Airing
|
ae
|
edb
|
abd
|
bd
| 2c
|
single
| null |
Social & Preventive Medicine
| null |
8881e1f7-163a-4b20-b8ec-6e15ac879448
|
Raxiobacumab is used in:-
|
Anthrax
|
Pontiac fever
|
Listeria
|
Clostridium
| 0a
|
single
|
Raxibacumab is used for Anthrax It is a monoclonal antibody and it contains 'bac' in its name so effective against bacillus and contains 'ax' so effective for anthrax.
|
Pharmacology
|
Targeted Anticancer Drugs and Immunosuppressants
|
940bb138-a015-4c5e-a76e-4ea9363b0376
|
All of the following therapies may be required in a 1–hour-old infant with severe birth asphyxia except –
|
Glucose
|
Dexamethasone
|
Calcium gluconate
|
Normal saline
| 1b
|
multi
|
Corticosteroids should not be used' - Paediatrics for doctors - Frankshann & John Vince
Management Protocol
The management protocol of babies with asphyxia :
Oxygen. In the absence of continuous oxygen saturation monitoring, it is reasonable to give nasopharyngeal oxygen (0.5 litre/min) until the baby recovers. If monitoring is available, oxygen is given as appropriate.
Thermal control. Baby's body temperature should be kept in the normal range of 36.5-37.2°C (sometimes the babies become hyperpyrexic).
Correction of shock, If peripheral perfusion is poor, it is reasonable to give 20 ml/kg of normal saline initially. If perfusion remains poor, the use of dopamine should be considered.
Fluid balance. Give IV fluids at 2/3 maintenance. Use 10% dextrose.
Monitor blood glucose with dextrostix and do not let it fall below 2.2 mmol (explains glucose administration)
Prevent/control convulsions. In less severely affected babies, phenobarbitone should be given when there is anyuspicion of actual or impending convulsions (phenobarbitone loading dose 20 mg/kg IM or 10mg/kg slowly IV, then 5 mg/kg daily orally).
Treat hvpocalcaemia if it occurs (or more practically, if the baby has uncontrollable fitting with anormal dextrostix).
(explains calcium gluconate administration)
Notes:
Corticosteroids should not be used, and although many paediatricians use mannitol, there is no evidence for its effectiveness.
Babies with severe asphyxia may appear to settle relatively quickly after the resuscitation - but there is likely to be a deterioration after 6-12 hours or so as cerebral oedema develops.
|
Pediatrics
| null |
53a04775-54ca-415c-a1c4-0a44b9a1cfc7
|
Fast breathing in a 3 year old child is?
|
> 60
|
>50
|
>40
|
>30
| 2c
|
single
|
ANSWER: (C) > 40REF: OP Ghai 7th ed p. 356According to WHO fast respiratory rate:>60/ min< 2 months> 50/min2-12 months>40/min12-60 months
|
Pediatrics
|
Disorders of the Respiratory Tract
|
825a0237-5f25-4aca-9791-1e8921316b01
|
Reffered pain to Inferior angle of right scapula in acute cholecystitis is known as
|
Murphy's sign
|
Naunyn's sign
|
Boa's sign
|
Cullen's sign
| 2c
|
single
|
It is seen in acute cholecystitis Boa's sign - Hyperaesthesia below the right scapula Murphy's sign- Inspiratory arrest with deep palpation in the RUQ in acute cholecystitis (also known as Naunyn's sign) Cullen's Sign- Periumbilical ecchymosis. Seen in retro peritoneal bleeding associated with severe Pancreatitis Ref: Sabiston 20th edition Pgno : 1526, 1494
|
Anatomy
|
G.I.T
|
85617db2-cbb6-4de7-9ed6-ebc2bd541755
|
Following delivery, uterine fundus lies about:
|
10 1/2 " above pubic symphysis
|
8 1/2 " above pubic symphysis
|
5 1/2 " above pubic symphysis
|
2 1/2 " above pubic symphysis
| 2c
|
multi
|
Ans. C. 5 1/2 above pubic symphysisFollowing delivery, the fundus lies about 13.5cm(51/2) above the pubic symphysis. During the first 24 hrs the level remains constant, thereafter there is steady decrease in height by 1.25cm in 24 hours so that by the end of 2nd week the uterus becomes a pelvic organ. These measurements are clinically significant to know the process of involution. If the height is more than the period of puerperium, it may be because of subinvolution.
|
Gynaecology & Obstetrics
|
Fetal Skull and Maternal Pelvis
|
6c52938b-5ee9-437a-81e7-62d0cacd2512
|
A 35-year-old man presents to his physician with a 18Kg weight loss over the preceeding 4 months. The man has not been dieting, but has been having abdominal pain, nausea, and diarrhea. He also had a chronic cough. Sputum studies demonstrate Pneumocystis carinii, and esophagogastroduodenoscopy with biopsy demonstrates Candida and Herpes in the esophagus.The pathogen which causes this patient's underlying disease is a member of which of the following groups of viruses?
|
Caliciviridae
|
Coronaviridae
|
Flaviviridae
|
Retroviridae
| 3d
|
single
|
This man with multiple infections probably has AIDS, in which "wasting" due to infection and weight loss is common. All three of this patient's secondary infections (Pneumocystis pneumonia, Candida esophagitis, and Herpes esophagitis) are considered to be "AIDS-defining illnesses," that indicate that the patient's HIV infection has progressed to the point of producing profound immunosuppression. HIV is a member of the Lentivirus subgroup of retroviruses. This viral family is characterized by prolonged infections, often with a latent period. These viruses are usually inadequately opposed by the host immune response, and often can infect the nervous system. The Retroviridae also include the oncovirus group that includes the human T-cell Leukemia/Lymphotropic virus. The family Retroviridae includes seven subfamilies members, of which two of the families infect humans with pathologic consequences: the delta retroviruses, of which human T cell lymphotropic virus (HTLV) type I is the most impoant in humans; and lentiviruses, of which HIV is the most impoant in humans. Also Know: The Caliciviridae includes the Norwalk virus and the virus that causes Hepatitis E. Coronaviruses cause upper respiratory illnesses. Flaviviruses include the Hepatitis C virus, yellow fever virus, dengue virus, and several encephalitis viruses. Ref: Longo D.L., Fauci A.S. (2012). Chapter 188. The Human Retroviruses. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds),Harrison's Principles of Internal Medicine, 18e.
|
Microbiology
| null |
71633b48-bdac-4ddc-8dec-62eeb330c8af
|
KLB is another name for
|
Corynebacterium diphtheria
|
Corynebacterium pseudodiphtheriae
|
Corynebacterium tetani
|
Anthrax
| 0a
|
single
|
Diphtheria bacilli were first observed and described by Klebs in 1883 and first cultivated by Loeffler in 1884 - hence called Klebs- Loeffler's bacilli or KLB. Reference: Textbook of Microbiology; Anathanarayan and panicker's; 10th edition; Page no: 239
|
Microbiology
|
Bacteriology
|
418c2fb1-85f8-4dcc-b5ab-9c1d07419b7a
|
A woman with infertility receives an ovary transplant from her sister who is an identical twin. What type of graft it is?
|
Xenograf
|
Autograft
|
Allograft
|
Isograft
| 3d
|
multi
|
Ans. is 'd' i.e., Isograft (Ref: Ananthanarayan, 9th/e)
|
Microbiology
|
Immunology
|
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