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|---|---|---|---|---|---|---|---|---|---|---|
d18a3ba2-275b-4e19-8ae2-2c8b9272eff0
|
Testicular tumour which responds best to radiation is:
|
Teratoma
|
Seminoma
|
Embryonal cell carcinoma
|
None of the above
| 1b
|
multi
|
Ans. Seminoma
|
Radiology
| null |
7be251cc-3af9-4b2f-8ded-21f55c0fecf1
|
Most radiosensitive tumor of the following is?
|
Dysgerminoma
|
Renal cell carcinoma
|
Melanoma
|
Thyroid carcinoma
| 0a
|
single
|
ANSWER: (A) DysgerminomaREF: Rozer's radiotherapy 3rd e table 11.3RADIOSENSITIVITY OF DIFFERENT TUMORSHighly radiosensitive* Ewings* Seminoma* Lymphoma* Wilms* Multiple myelomaModerately* Nasopharyngeal* Dysgerminoma* Medulloblastoma* Small cell ca* Teratoma* Breast ca* Ovarian ca* Basal cell caRelatively resistant* Renal cell ca* Rectal ca* Colonic ca* Ca cxHighly resistant* Hepatoma* Pancreatic ca* Osteosarcoma* Melanoma
|
Radiology
|
Neoplasia
|
c1abb2c8-e631-4a18-b5b6-97c8d964e485
|
Allergic reactions in patients who receive amide-type local anesthetics for dental procedures are most likely caused by reaction of
|
Methylparaben
|
Contaminants
|
Lignocaine hydrochloride
|
Epinephrine
| 0a
|
multi
| null |
Surgery
| null |
09ff664b-1c49-48cf-87a4-18c366058e82
|
Mania is a
|
Mood disorder
|
Psychological Disorder
|
Obsessive disorder
|
Neurotic disorder
| 0a
|
single
|
According to ICD-10 mood disorders are classified as Manic episodes Depressive episodes Bipolar mood disorder Recurrent depressive disorder Persistent mood disorder Other mood disorders (including mixed effective episodes and recurrent brief depressive disorder) (Ref: a sho textbook of psychiatry, Niraj Ahuja, 7th edition, pg no.69)
|
Psychiatry
|
Mood disorders
|
23b60f93-db87-4085-9360-831f985e458e
|
NRHM (National Rural Health Mission) done in
|
2002
|
2005
|
2006
|
2011
| 1b
|
single
| null |
Dental
| null |
51a5991c-d1a0-431a-b864-ba96a113e107
|
First investigation for solitary thyroid nodules is: (Or) Investigation of choice in discrete thyroid swelling is
|
Thyroid scan
|
CT scan
|
MRI
|
FNAC
| 3d
|
single
| null |
Surgery
| null |
be5073d3-5757-4648-b7c8-140abe6e259a
|
The persistent suppression of bacterial growth that may occur after limited exposure to some antimicrobial drug is called :
|
Time dependent killing
|
Post antibiotic effect
|
Concentration dependent killing
|
Sequential blockade
| 1b
|
multi
|
Time dependent killing kinetics is shown by aminoglycosides. Here, the killing activity depends upon the length of time, plasma concentration is above MIC.
Concentration dependent killing is shown by β lactam drugs. Here, killing activity depends upon the ratio of plasma concentration to MIC.
Post-antibiotic effect is the suppression of bacterial growth after limited exposure to the antibiotic.
|
Pharmacology
| null |
ab993794-1b17-4f2e-82cd-d0df1e11736c
|
NOT an etiology for Myopia is
|
Increased axial length
|
Increased curvature of Cornea
|
Increased radius of curvature of Cornea
|
Increased accommodative effort
| 2c
|
single
|
Decreased radius of curvature of Cornea is an etiology for myopia, not increased radius of curvature.
|
Ophthalmology
| null |
2dc39fab-a599-48b6-894d-56b312fa111e
|
For each mol of substrate oxidized Complexes I, III, and IV in the respiratory chain NADH, --- mol of ATP are formed?
|
1
|
1.5
|
2
|
2.5
| 3d
|
single
|
For each mol of substrate oxidized Complexes I, III, and IV in the respiratory chain (ie, NADH), 2.5 mol of ATP are formed per 0.5 mol of O2 consumed; ie, the P:O ratio = 2.5. On the other hand, when 1 mol of the substrate (eg, succinate or 3-phosphoglycerate) is oxidized Complexes II, III, and IV, only 1.5 mol of ATP are formed; that is, P:O = 1.5. These reactions are known as oxidative phosphorylation at the respiratory chain level. Reference: Harper; 30th edition; Page no: 131
|
Biochemistry
|
Respiratory chain
|
3bb3c474-2873-4fe8-8ca8-5a2db4cef0a5
|
Period of cornmunicability of measles is-
|
3 days before and 10 days after appearance of rashes
|
3 weeks after appearance of rashes
|
I week before appearance of rashes
|
4 days before and 5 days after appearance of rashes
| 3d
|
single
|
Ans. is 'd' i.e., 4 days before and 5 days after appearance of rashes t Ref: Park 24th/e p. 157; Community Medicine with Recent by Suryakantha 4th/e p. 328]Chicken pox : 1 - 2 days before to 4 - 5 days after appearance of rash.Measles : 4 days before to 5 days after appearance of rash.Rubella : 7 days before symptoms to 7 days after appearance of rash.Mumps : 4 - 6 days before symptoms to 7 days thereafter.Influenza : 1 - 2 days before to 1 - 2 days after onset of symptoms.Diphtheria : 14 - 28 days from disease onset.Peussis : 7 days after exposure to 3 weeks after paroxysmal stage.
|
Social & Preventive Medicine
| null |
6f0be715-83f0-453f-875d-8e917dad96c8
|
An 80 year old man has a history of progressive gait disturbance and incontinence which had been attributed to old age and prostatism. For the past 4 months he has been forgetful and confused. He has a history of head trauma 25 years ago. His head CT is shown below .The most likely diagnosis
|
Alzheimer’s disease
|
Creutzfeldt – jakob disease
|
Normal pressure hydrocephalu
|
Pelizaeus-merzbacher disease
| 2c
|
single
|
Normal pressure hydrocephalus triad:
Dementia
Ataxia
Incontinence
CT or MRI brain in these patients shows enlarged frontal and temporal horns of lateral ventricles out of proportion to degree of cortical atrophy.
|
Medicine
| null |
4b211276-a663-4681-9376-b72b4dcb5c71
|
Anti cancer drug causing nephrotoxicity ?
|
Cyclophosphamide
|
Busulfan
|
Cisplatin
|
Procarbazine
| 2c
|
single
|
Ans. is 'c' i.e., Cisplatin Platinum compound These are alkylating agents and act by similar mechanism. Drugs are - First generation -9 - Cisplatin Second generation - Carboplatin Third generation - Oxaliplatin Side effects of Cisplatin Vomiting Ototoxicity Hyperuricemia Nephrotoxicity Neuropathy Note ? Cisplatin is most nephrotoxic where as carboplatin is more hematotoxic (bone marrow suppression). Carboplatin has less nephrotoxic, neurotoxic and ototoxic effects. Dose limiting toxicity of oxaliplatin is neurotoxicity (Peripheral neuropathy). Drugs causing nephrotoxicity: Chemotherapy and Immunosuppressants drugs causing nephrotoxicity: - Cisplatin - Methotrexate - Mitomycin - Cyclosporine - Ifosphamide (Causes Fanconi's Syndrome) Antibiotics: - Aminoglycoside - Sulfonamides Amphotericin B - Foscarnet Quinolones (e.g. Ciprofloxacin, Levofloxacin) - Rifampin - Tetracycline - Acyclovir (only nephrotoxic in intravenous form) - Pentamidine - Vancomycin Heavy Metals: Mercury Poisoning - Lead Poisoning - Arsenic Poisoning Bismuth - Lithium related kidney disorders AntiHyperlipidemics: - Statin Drugs (Rhabdomyolysis) Gemfibrozil-Associated with Acute Renal Failure due to Rhabdomyolysis Miscellaneous Drugs: - Chronic Stimulant Laxative use-Resulting in chronic volume depletion and Hypokalemia causes nephropathy - Radiographic contrast - ACE Inhibitor- NSA ID - Aspirin - Mesalamine
|
Pharmacology
| null |
2d952c60-26e9-47dc-8ad5-dc2c7d2d8f51
|
In a case of diarrhea with histopathological evidence of intestinal mucosal clefts studded with copious thick secretions and inflammatory cells is characteristic of pseudomembranous colitis. The likely cause is?
|
Ischemic colitis
|
Clostridium defficile
|
E. coli
|
All of1 the above
| 1b
|
multi
|
Ans. b (Clostridium defficile). (Ref. Harrison's, Internal medicine, 16th ed., 760)PSEUDOMEMBRANOUS OR CLOSTRIDIUM COLITIS# Inflammation of colon by C. defficile and its toxin, A and B (Cytotoxic and enterotoxic effect)# Most common symptom--watery diarrhea and acute abdomen.# Diagnosis made by stool assay of cytotoxin, takes 48 hours.# Elderly are at higher risk than young.# Drugs causing it is ampicillin, vancomycin,etc# HPE:Mildfocal necrosis of surface epithelial cells in glandular crypts with neutrophilic infiltration and fibrin plugging of capillaries in lamina propria and copious thick mucus hypersecretions in adjacent crypts.ModerateCrypt abscessesSevereNecrosis and denudation of mucosa with thrombosis of submucosal venules.# Accordion sign is diagnostic on CECT.# Treatment:- Stop the culprit drug- Metronidazole (DOC) and vancomycin. Q
|
Pathology
|
G.I.T.
|
679c75ae-24c7-4d0a-a363-0c842282bf3e
|
The peri-orbital view is carried out for ?
|
Petrous apex
|
Mastoid process
|
Bilateral mastoid pathologies
|
Internal auditory meatus
| 3d
|
single
|
Ans. is 'd' i.e., Internal auditory meatus The posteroanterior periorbital projection enables the best evaluation of the internal auditory canal in its full length.
|
ENT
| null |
13b887f0-f8fa-40b5-a3eb-5c65e5411f73
|
Mechanism of action/properties of Sod. Hypochlorite is explained as
|
Saponification
|
Hypochlorous acid formation
|
Deamination
|
All of the above
| 3d
|
multi
| null |
Dental
| null |
d28f9925-ea63-4563-ae60-a14c0f851f17
|
Mycobacterium causing lung infection are a) Mycobacterium Tuberculosis b) Mycobacterium Kansasii c) Mycobacterium Fortuitum d) Mycobacterium avium intracellularae e) Mycobacterium Scrofuloceuml
|
abd
|
abc
|
acd
|
bcd
| 0a
|
single
| null |
Medicine
| null |
5d1906d8-a774-425a-8b79-d8d426ba2809
|
Which of the following subtance is toxic to neurons?
|
Unconjugated bilirubin
|
Bile salt
|
Haemoglobin
|
Melanin
| 0a
|
single
|
Ans. is 'a' i.e., Unconjugated bilirubin
|
Pediatrics
| null |
15a7a4b6-245d-40d7-8cac-e79c73b44bd5
|
A patient with recent–onset primary generalized epilepsy develops drug reaction and skin rash due to phenytoin sodium. The most appropriate course of action is :
|
Shift to clonazepam
|
Restart phenytoin sodium after 2 weeks
|
Shift to sodium valproate
|
Shift to ethosuximide
| 2c
|
single
| null |
Pharmacology
| null |
16ec43a7-ad03-4d0a-a156-4b7ff45e3f61
|
Hyaline membrane disease is associated with:
|
Respiratory distress syndrome
|
Bronchopulmonary dysplasia
|
Sudden infant death syndrome
|
Bronchiolitis obliterans
| 0a
|
single
|
(Respiratory distress syndrome): Ref: 470-HM, 48J-83-R (257- Basic pathology 8th)* The fundamental defect in RDS is a deficiency of pulmonary surfactant* Surfactant synthesis is modulated by a variety of hormones and growth factors, including cortisol, insulin, prolactin, thyroxin, and TGF b45. The role of glucocorticoid is particularly important* Increased risk for developing complications are1. Patent ductus arteriosus2. Intraventricular hemorrhage3. Necrotizing enterocolities
|
Pathology
|
Respiration
|
9f7e5b6d-44e4-4efe-b58a-1b61066caaef
|
A 6-year-old boy presents with painful sores on his upper lip. He was seen for a flu 1 week ago. The lesion appears as 0.2- to 0.4-cm vesicles with focal ulceration. Which of the following is the most likely histologic feature of this skin lesion?
|
Acute arteritis
|
Caseating granulomas
|
Fungal hyphae
|
Multinucleated epithelial cells
| 3d
|
single
|
Herpes labialis (cold sores, fever blisters) and herpetic stomatitis are caused by herpes virus type 1. They are among the most common viral infections of the lips and oral mucosa in both children and young adults. The disease starts with painful inflammation of the affected mucosa, followed shortly by the formation of vesicles. These vesicles rupture and form shallow, painful ulcers. Microscopically, the herpetic vesicle forms as a result of "ballooning degeneration" of the epithelial cells. Some epithelial cells show intranuclear inclusion bodies. At the edge of the ulcer are large, multinucleated, epithelial cells with "ground glass" homogenized nuclei, often exhibiting nuclear molding. The ulcers heal spontaneously without scar formation. Acute arteritis (choice A) does not cause the described lesions. Choices B, C, and E do not represent acute vesicular lesions.Diagnosis: Herpes labialis
|
Pathology
|
Head & Neck
|
f7a7bf29-dcf5-45c5-b1e2-f12495066614
|
A punch biopsy shows carcinoma rectum with fixed mass. X-ray chest normal, which of the following is LEAST useful investigation
|
Rigid protoscope
|
Barium enema
|
CT chest
|
MRI-abdomen and pelvis
| 0a
|
single
|
Rigid protoscope is of least significance in carcinoma rectum with fixed mass
|
Surgery
|
G.I.T
|
95658a39-3e66-484f-b531-3270a186e3eb
|
Following are complications of chicken pox except
|
Meningitis
|
Pneumonia
|
Enteritis
|
Reyes Syndrome
| 2c
|
multi
|
Chicken pox is caused by varicella zoster virus ,a DNA virus of Herpes virus family . It is present in respiratory secretions and skin lesions of an affected child . The poal of entry is the respiratory tract. Secondary bacterial infections of skin lesions is fairly common and occasionally result in necrotising fascitis . Neurologic complications include meningoencephalitis,acute cerebellar ataxia,tranvserse myelitis,landry-guillain-barre syndrome and optic neuritis.other complications include purpura fulminans,cns vasculitis leading to stroke, Auto immune thrombocytopenic purpura and reye syndrome, progressive varicella syndrome is a dreaded complication of pox characterised by continued development of lesions,hemorhagic lesions, coagulopathy and visceral organ involvement including hepatitis,pneumonia and encephalitis. Reference: Essential paediatrics,op ghai, 9 th edition, pg no: 210 & 211
|
Pediatrics
|
Infectious disease
|
e8e04920-a245-4092-bade-ceb3ab4383fe
|
Which of the following most often causes cholestatic jaundice:
|
INH
|
Erythromycin estolate
|
Pyrazinamide
|
Ethionamide
| 1b
|
single
|
Erythromycin estolate
|
Pharmacology
| null |
baa1b925-809f-4469-848d-5c3a26de0d6f
|
Which is not included in modified child pugh score?
|
S. bilirubin
|
INR
|
Encaphalopathv
|
Nutritional status
| 3d
|
single
|
Ans. is 'd' i.e., Nutitional status Child pugh score - Ask child turcotte pugh score :o This score is/as originally developed to evaluate the risk of portacaval shunt for portal hvpertention in cirrhotic patients. It has been shown to be useful in predicting surgical risks of other intrabdominal operations performed on cirrhotic patients.Variable1 points2 points3 points1. Bilirubin level2. Albumin level3. INR4. Encephalopathy5. Ascitis< 2 mg/dl>3.5 mg/dl<1.7NoneNone2-3 mg/di2.8-3.5 mg/di1.7-2.2ControlledControlled>3 mg/di<2.8 mg/di>2.2UncontrolledUncontrolled
|
Surgery
|
End-Stage Liver Disease and Liver Transplantation
|
d3ca173c-f2e2-486b-8226-c355875c2989
|
Morula is how many celled -
|
4
|
8
|
12
|
16
| 3d
|
single
|
Ans. is 'd' i.e., 16At about 16 cells stage the blastomeres tightly align by the process of compaction to form a compact ball of cells called morula (mulberry).This process of compaction leads to segregation of cells into two groups :Inner cells (inner cell mass) Outer cells (outer cell mass)Morula enters uterine cavity 4 days after feilization.
|
Anatomy
| null |
213891b8-9743-4614-b7d2-bee7d7684f83
|
The antibiotic of choice of pertussis is –
|
Ampicillin
|
Gentamicin
|
Erythromycin
|
Penicillin
| 2c
|
single
|
Treatment of pertussis
DOC → Macrolides (Erythromycin, Azithromycin, Clarithromycin)
Alternative → Cotrimoxazole
|
Pediatrics
| null |
f652bc48-f4ac-417c-9b0b-7b1d1d8a2c04
|
Gold standard investigation for renovascular hypeension in a patient showing asymmetrical kidneys on Ultrasound?
|
Captopril radionuclide scan
|
Spiral CT
|
MRI
|
Angiography
| 3d
|
single
|
Asymmetrical kidneys on usg in a pt of Renovascular hypeension suggests Renal Aery stenosis and Gold standard is renal Angiography. Perfusion Studies to Assess Differential Renal Blood Flow Captoril-renograpy with technetium 99m Tc meiatide (99mTcMAG3) Captopril -mediated fall in filtration pressure amplifies differences in renal perfusion Normal study excludes renovascular hypeension Multiple limitations in patients with advanced atherosclerosis or creatinine >2.0 mg/dL C/I In bilateral RAS Vascular Studies to Evaluate the Renal Aeries Duplex Ultrasonography Shows the renal aeries and measures flow velocity as a means of assessing the severity of stenosis Inexpensive and good screening test Heaviy dependent on operator's experience; Less useful than invasive angiography for the diagnosis of fibromuscular dysplasia and Magnetic resonance Angiography Shows the renal aeries and perirenal aoa Not nephrotoxic, but concerns for gadolinium toxicity exclude use in GFR<30/mL/min/1.73 m2 Expensive; Gadolinium excluded in renal failure, Unable to visualize stented vessels Computed tomographic Angiography Shows the renal aeries and perirenal aoa Provides excellent image Moderate volume of contrast required, Potentially nephrotoxic Intraaerial angiograhy Shows location and severity to vascular lesion Gold standard" for dx of large-vessel disease, Expensive,associated hazard of atheroembolism Contrast toxicity, Procedure-related complications
|
Radiology
|
Genitourinary radiology
|
c9b80c25-1dc8-482a-b1a9-b7706c583b53
|
Most common nerve to be damaged in CSOM is -
|
III
|
VII
|
III
|
VI
| 1b
|
single
|
Ans. is 'b' i.e., VII o Facial nerve is the most commonly involved cranial nerve as a complication of CSOM.Complications of otitis mediaa. Extracranial complicationsb. Intracranial complicationso Mastoiditiso Meningitiso Petrositis/Gradenigo syndromeo Extradural abscesso Facial paralysiso Subdural abscesso Labyrinthitiso Otogenic Brain Abscesso Osteomyelitis of temporal boneo Lateral sinus thrombophlebitiso Septicaemia or pyaemiao Otitic hydrocephalus
|
ENT
|
Ear
|
71bad158-b7f2-4c22-b616-29f817245b9d
|
Koplik spots are pathognomic of ?
|
Measles
|
Diphtheria
|
Donovanosis
|
Gonorrhoea
| 0a
|
single
|
Ans. is 'a' i.e., Measles Koplik spots Koplik spots, the pathognomonic enanthem of measles, begin as small, bright red macules that have a 1-2-mm blue- white speck within them. They are typically seen on the buccal mucosa near the second molars in 1-2 days before and lasting 2 days after the onset of the rash.
|
Skin
| null |
66fa5045-ab71-4e3f-9829-66fd6247cd3e
|
Commonest complication of chronic gastric ulcer is which of the following?
|
Adenocarcinoma
|
Perforation
|
Lymphoma
|
Haematenesis
| 3d
|
single
|
GI bleed is the commonest complication of acute or chronic gastric ulcer. Outlet obstruction is the least commonest complication.
|
Surgery
| null |
b3852421-1221-4df6-8ba9-f341e48df286
|
In unilateral Afferent pupillary defect, when light in moved from normal to affected eye, there is:
|
Dilatation in affected side and constriction in normal eye
|
Dilatation in normal eye and constriction in affected side
|
Dilatation in both pupils
|
Constriction in both pupils
| 2c
|
multi
|
C i.e. Dilation in both pupils
|
Ophthalmology
| null |
62b581e1-c4b5-4b58-928d-fe63653fcd80
|
The malignancy of most common occurance in children is which of the following?
|
Leukemia
|
Lymphoma
|
Wilm's tumor
|
Neuroblastoma
| 0a
|
single
|
The most common tumors found in children are leukemias (30%) followed by brain tumors (22%), lymphomas (11%), neuroblastoma (8%), soft tissue sarcoma (7%), Wilm's tumor (6%), bone tumors (5%) and others (11%). Ref: Nelson 11th Edition, Page 1694: 17th Edition, Page 1694; Essentials of Pediatric Radiology: A Multimodality Approach, By Heike E. Daldrup-Link, Charles A. Gooding Cambridge University Press, 02-Sep-2010 - Pg 187 3. Cancer in Children and Adolescents, By William L. Carroll, William Larkin Carroll, Jonathan Finlay.
|
Pediatrics
| null |
0e042a37-4779-4192-bc4b-e816ad05171f
|
Crescent formation is seen in?
|
FSGS
|
MGN
|
RPGN
|
PSGN
| 2c
|
single
|
TypeClinical featuresPathogenesisPathologyLMEMAcute GNAcute nephrotic syndromeImmune complex disease (local or circulating)Diffuse proliferation, leucocytic infiltrationSubepithelial deposits (humps)RPGNAcute renal failure(i) Type I: anti GBM type(ii) Type II: Immune complex type(iii) Type III: Pauci-immune RPGNProliferationCrescentsQ(i) Linear deposits along GBM(ii) Subepithelial deposits(iii) No depositsMinimal change diseaseNephrotic syndrome (higher selective proteinuria)Reduction of normal negative charge on GBM Cell-mediated mechanismNormal glomeruli, lipid vacuolation in tubulesLoss of foot processes, no depositsMembranous GNNephrotic syndromeImmune complex disease (local)Diffuse thickening of capillary wallSubepithelial deposits (Spikes)Membrano- Proliferative GNNephrotic syndromeType I: immune complex diseaseType II: Dense deposit disease (alternate pathway activation)Type III: Rare, with systemic disease and drugsLobular proliferation of mesangial cells increased mesangial matrix, double contour of GBMType I: subendothelial depositsType II: Dense intramembranous depositsType III: Subendothelial and subepithelial deposits
|
Pathology
|
Kidney
|
c437e0bf-2281-47b0-9f22-c1d3f3f28e9c
|
Cremasteric muscle is supplied by
|
Ilioinguinal nerve
|
Genital branch of genitofemoral
|
Femoral nerve
|
Obturator nerve
| 1b
|
single
|
CREMASTER MUSCLE:-Consists of muscle fasciculi embedded in cremasteric fascia. The fasciculi forms superficial loops from middle one-third of upper surface of inguinal ligament and deep loops from pubic tubercle, pubic crest and conjoint tendon. Fully developed in males.In females only few fibres.Muscle along with the intervening connective tissue forms a sac-like cremasteric fascia around spermatic cord and testis. Nerve supply:- genital branch of genitofemoral nerve. Action: suspend the testis and elevate it.Cremasteric reflex:-Stroking the upper pa of the medial side of the thigh there is reflex contraction of the cremaster muscle, as is evidenced by elevation and retraction of the testis. In UMN lesions above segment L1 reflex is lost. <img src=" /> {Reference: BDC 6E vol2 pg 206}
|
Anatomy
|
Lower limb
|
f5ad4886-ad4b-48c0-a50c-adbdbc2502ae
|
True about dentition are all except
|
Hypothyroidism causes delayed dentition
|
Premolar is not seen in primary dentition
|
Third molar is last to appear in secondary dentition
|
Canine is the first in primary dentition
| 3d
|
multi
|
The first tooth to erupt in primary dentition is the lower central incisor at 6-10 yrs of age, and in upper jaw at the age of 8-12 yrs. Whilst the canine in primary dentition appears at the age of 16-22 yrs, in the upper jaw. Ref: Ghai, 9th edition, Table 2.2.
|
Anatomy
|
General anatomy
|
a1cf2781-81d8-4dfc-ad24-ac9ce371363c
|
A 55-year-old female was admitted to ICU 8 days ago after suffering burns \ Currently she is febrile with 102 degree F. Blood cultures were obtained with following finding. The Doctor on duty is worried about a blood infection and plans to sta with empiric combination therapy containing aminoglycosides directed against Pseudomonas aeruginosa. Old usg record of the patient is shown below: The patient could not come for follow up due to lockdown. The doctor, currently is concerned about nephrotoxicity profile of the drugs. Which of the following drug is most safe?
|
Gentamycin
|
Tobramycin
|
Neomycin
|
NONE
| 3d
|
multi
|
Usg shows raised renal coical echogenecity suggestive of renal parenchymal disease and therefore should avoid aminoglycosides. All aminoglycosides have complication of being ototoxic and nephrotoxic. Ototoxicity and nephrotoxicity are more likely : when therapy is continued for > 5 days at higher doses Elderly renal insufficiency. Concurrent use with loop diuretics or other nephrotoxic antimicrobial agents (eg, vancomycin or amphotericin. Ototoxicity is most likely seen with: Neomycin Kanamycin amikacin vestibulotoxic agent- Streptomycin gentamicin nephrotoxic agents: Neomycin Tobramycin gentamicin
|
Anatomy
|
Integrated QBank
|
a23b7fec-8666-45dd-8888-a9ce2b0e9efe
|
Pyknolepsy is seen in
|
Lennox gastout syndrome
|
Absence seizures
|
Marcolepsy
|
Adrenoleukodystrophy
| 1b
|
single
|
Pyknolepsy refers to a syndrome of typical absence seizures (both simple and complex) in otherwise normal, prepubeal children older than about 3 to 5 years. There is a strong genetic predisposition, and girls are more frequently affected. The absences are very frequent (occurring at least several times daily), and tend to cluster. The absences may remit during adolescence, but generalized tonic-clonic seizures may develop. The EEG reveals a bilateral, synchronous, symmetric 3-Hz spike-and-wave discharge with normal interictal background activity. No distinct clinical or EEG features completely differentiate childhood absence epilepsy from juvenile absent epilepsy Ref Harrison20th edition pg 2234
|
Medicine
|
C.N.S
|
6efdc7a2-7cd8-40f1-99d3-3bb18d1ea09e
|
in rectal atresia -
|
Anus is normal
|
Rectovesical fistula present
|
It is low type of anorectal malformation
|
Rectovesical fistula is most common in males
| 0a
|
single
|
Ans. is 'a' i.e., Anus is normal o Rectal atresia is classified as high type of anorectal malformation. In this defect, anal canal is normal but, ends proximally just below the level of pelvic floor whereas rectum ends below blindly above pelvic floor. This anomaly is rare and usually not associated with fistulous connection.Classification of Anorectal malformationsI HIGHAnorectal agenesis +- rectovaginal/rectoprostatic urethral fistula Rectal Atresia.II INTERMEDIATEAnorectal agenesis +- rectovaginal/recfobulbar urethral fistula Anal Agenesis.III LOWAnovestibular/Anocutaneous fistula (anteriorly displaced fistula) Anal stenosis.IV CLOACA
|
Surgery
|
Rectum
|
ba7d18f5-fc57-4f7b-a169-2154f0908fe1
|
A 27-year-old woman complains of double vision and fatigue at the end of the day. Further history reveals difficulty in chewing food, and some weakness in climbing stairs. She has stopped running because of easy leg fatigue and leg weakness. The symptoms improve with resting. On examination, there is weakness of the eyelids, masticatory muscles, and thigh flexors. Her handgrip decreases with repetitive action. There is no sensory abnormality, and reflexes are normal. Which of the following is the most likely diagnosis?
|
hypercalcemia
|
myasthenia gravis
|
multiple sclerosis
|
thyroid storm
| 1b
|
single
|
The most common presenting symptoms relate to weakness of eye muscles, causing ptosis or diplopia. Difficulty in chewing, dysarthria, and dysphagia are also common. The differential diagnosis includes all diseases that cause weakness of oropharyngeal or limb muscles. These include the muscular dystrophies, ALS, and progressive bulbar palsies, among others. Most other conditions do not improve after injection of edrophonium or neostigmine.
|
Medicine
|
C.N.S.
|
cd394cfd-f689-4bb8-a660-fc7330490474
|
A patient complains of muscle weakness. It was reversed on administration of neostigmine,because ?
|
It blocks action of acetylcholine
|
It interferes with the action of amine oxidase
|
It interferes with the action of carbonic anhydrase
|
It interferes with the action of acetylcholine esterase
| 3d
|
single
|
Ans. is 'd' i.e., It interferes with the action of acetyl cholinesterase o Neostigmine acts by inhibiting the enzyme acetylcholinesterase. This enzyme is involved in degradation of ACh, consequently neostigmine increases the synaptic level of ACh. Muscle weakness can be improved by stimulation of NM receptor at muscle end plate due to increased ACh.
|
Pharmacology
| null |
8f5628d2-a76a-4ab8-bd3e-804c3613fefb
|
Cheiloscopy is the study of prints of-
|
Foot
|
Fingers
|
Palate
|
Lips
| 3d
|
single
|
Cheiloscopy (queiloscopy) is the study of lip prints.
|
Forensic Medicine
| null |
505fac60-9a23-4f16-879a-16ed490009c3
|
A 56-year-old man with a history of cigarette smoking presents with difficulty swallowing and a muffled voice. Laryngoscopy reveals a 2-cm laryngeal mass. If this mass is a malignant neoplasm, which of the following is the most likely histologic diagnosis?
|
Adenocarcinoma
|
Leiomyosarcoma
|
Small cell carcinoma
|
Squamous cell carcinoma
| 3d
|
multi
|
Squamous cell carcinoma. The vast majority of laryngeal cancers are squamous cell carcinomas and occur principally in smokers. Adenocarcinoma (choice A), leiomyosarcoma (choice B), and small cell carcinoma (choice C) are rarely encountered in the larynx.Diagnosis: Laryngeal cancer
|
Pathology
|
Respiration
|
88935015-14eb-405c-8075-2fc61ed6751e
|
Fat-soluble vitamins, compared with their water soluble counterpas. generally have a greater potential toxicity for because they are
|
Administeicd in larger doses
|
Avidly stored by the body
|
Capable ot dissolving membrane phospholinids
|
Involved in more essential metabolic pathways
| 1b
|
multi
|
Fat soluble vitamins, especially A and D, can be stored in massive amounts and hence, have a potential for serious toxicities. Water soluble vitamins are easily excreted by the kidney and accumulation to toxic levels is much less common. Conversely, inadequate dietary intake will lead to manifestations of deficiency relatively faster.
|
Surgery
| null |
dfc4b748-12cb-41bc-8651-dd36f3f84500
|
Not a feature of HELLP syndrome:
|
Raised liver enzymes
|
Eosinophilia
|
Thrombocytopenia
|
Hemolytic anemia
| 1b
|
single
|
HELLP is an acronym derived from the first letters of the terms that describe the following laboratory findings: Hemolytic anemia, Elevated Liver enzymes, and Low Platelet count. HELLP syndrome is seen in severe pre-eclampsia.
|
Gynaecology & Obstetrics
|
Pregnancy induced Hypeension
|
d8728480-17f9-46c6-a91e-32785a1fce6e
|
The most common systemic association of scleritis is:
|
Ehlers - Danlos syndrome
|
Disseminated systemic sclerosis
|
Rheumatiod ahritis
|
Giant cell aeritis
| 2c
|
single
|
C i.e. Rheumatiod ahritis Scleritis is a rare chronic granulomatous disorder characterised by fibrinoid necrosis, destruction of collagen, infiltration by inflammtory cells and vascular remodelling. It is usually a B/ L disease affecting females more than males.
|
Ophthalmology
| null |
4110f345-7c23-42e8-bb3a-1e0b12410457
|
Wound contraction is mediated by –
|
Epithelial cells
|
Collagen
|
Myofibroblasts
|
Elastin
| 2c
|
single
|
"Perhaps the feature that most clearly differentiates primary from secondary healing is the phenomenon of wound contraction, which occurs in large surface wounds. Permanent wound contraction requires the action of myofibroblasts— altered fibroblasts that have the ultrastructural characteristics of smooth muscle cells. Contraction of these cells at the wound site decreases the gap between the dermal edges of the wound"- Robbins 7th/113
Healing By First Intention (Wounds With Opposed Edges) Robbins 7th/all-113
□ The least complicated example of wound repair is the healing of a clean, uninfected surgical incision approximated by surgical sutures. Such healing is referred to as primary union or healing by the first intention.
□ The narrow incisional space immediately fills with clotted blood containing fibrin and blood cells; dehydration of the surface clot forms the well-known scab that covers the wound.
□ Within 24 hours, neutrophils (Polymorphonuclear leukocytes) appear at the margins of the incision, moving toward the fibrin clot.
□ In 24 to 48 hours, spurs of epithelial cells move from the wound edges (with little cell proliferation) along the cut margins of the dermis, depositing basement membrane components as they move.
□ By day 3, the neutrophils have been largely replaced by macrophages. Granulation tissue progressively invades the incision space.
□ By day 5, the incisional space is filled with granulation tissue. Neovascularization is maximal
□ During the second week, there is continued accumulation of collagen and proliferation of fibroblasts The leukocytic infiltrate, edema, and increased vascularity have largely disappeared.
□ By the end of the first month, the scar is made up of a cellular connective tissue devoid of inflammatory infiltrate, covered now by the intact epidermis.
|
Pathology
| null |
e3a1fd4b-0635-4ed0-9eff-b12dfd3c9f3a
|
The latent period of muscle twitch is 10ms and the contraction period is 40ms. What is the tetanizing frequency (Hz)?
|
25
|
50
|
100
|
75
| 0a
|
single
|
Tetanizing frequency = 1/Contraction period = 1/40ms = 25Hz Tetanizing Frequency As the contractile mechanism does not have a refractory period, on rapid stimulation of a muscle, each new contraction occurs before the preceeding one is over. As a result, the second contraction is added paially to the first, and thus the total strength of contraction rises progressively with increasing frequency . Such a response is called a tetanus (tetanic contraction). It is a complete tetanus when no relaxation occurs between stimuli. Tetany occurs because enough calcium ions are maintained in the muscle sarcoplasm throughout the period of stimulation. Ref: Ganong's Review of Medical Physiology 26th edition Pgno: 107
|
Physiology
|
General physiology
|
dc589c03-354c-49ff-9761-4af7b6144981
|
Which is more appropriate in a case of schizophrenia-a) Low socioeconomic groupb) Seen in adolescentsc) Common in primitive societiesd) Affluent society influences the incidence
|
ac
|
a
|
ab
|
bc
| 2c
|
single
|
Schizophrenia starts in late adolescents and early adulthood.
"Schizophrenia is more prevalent in patients having a lower socioeconomic status". —Namboodiri
|
Psychiatry
| null |
8465c8ce-5212-4652-99ed-57992cf8079d
|
All of the following statements regarding subendocardinal infarction are true, except -
|
These are multifocal in nature
|
These often result from hypotension or shock
|
Epicarditis is not seen
|
These may result in aneurysm
| 3d
|
multi
| null |
Pathology
| null |
7360692d-f4d6-42f0-870b-536251efb410
|
A 10 year old child develops hematuria after 2 days of diarrhoea. Blood film shows fragmented RBCs & thrombocytopenia. Ultrasound shows marked enlargement of both kidneys. The likely diagnosis is -
|
Acute pyelonephritis
|
Disseminated intravascular coagulopathy
|
Haemolytic uremic syndrome
|
Renal vein thrombosis
| 3d
|
multi
| null |
Medicine
| null |
5b0287fc-7e96-444f-9686-c9ea4407b98a
|
Cysticercosis cellulosae causes infection with
|
Taenia saginata
|
Echinococcus granulosus
|
Taenia solium
|
Diphyllobothrium latum
| 2c
|
multi
| null |
Social & Preventive Medicine
| null |
e57550c9-12d6-42d0-8608-3f5176771d50
|
A 31-year-old woman has had a persistent fever for the past 2 months. Her temperature has ranged from 38.3degC to 38.6degC on multiple occasions. On physical examination, she has diffuse abdominal pain and mild splenomegaly, but no hepatomegaly or lymphadenopathy. Laboratory studies show Hgb, 13.2 g/dL; Hct, 39.8%; MCV, 930 mm3; platelet count, 242,000/ mm3; and WBC count, 12,290/ mm3 with 71% segmented neutrophils, 19% lymphocytes, and 10% monocytes. CT imaging of her abdomen shows an ill-defined pelvic soft- tissue density mass with a mottled lucent center and a small, square, radiopaque area. Review of her medical record reveals that a salpingo-oophorectomy for ectopic pregnancy was performed on the left side 3 months ago. Which of the following is the most likely cause of her persistent fever?
|
Abscess
|
Non-Hodgkin lymphoma
|
Ovarian cystadenocarcinoma
|
Sarcoidosis
| 0a
|
multi
|
She has fever of unknown origin (FUO), at least until a record review correlated with the CT imaging suggests that the mass is a residual hemostatic sponge placed at the time of surgery. Radiopaque markers or radio-frequency identification (RFID) chips can be incorporated into such objects for identification. The mild splenomegaly is consistent with intra-abdominal abscess. There is a long differential diagnosis list for FUO. A mass could represent a neoplasm, but lymphomas do not tend to have significant necrosis and a lucent center. Sarcoidosis tends to involve multiple organs, but lymph node enlargement is likely, although central caseation is not. At the prior surgery, an ovarian neoplasm should have been identified, as would pelvic inflammatory disease that may produce a tubo-ovarian abscess.
|
Pathology
|
Misc.
|
33ee8fd0-3e07-4e36-a48f-b1ca4feed8e9
|
Delayed hypersensitivity involves -
|
Neutrophils
|
Monocytes
|
Eosinophils
|
Lymphocytes
| 3d
|
single
|
Delayed or cell-mediated hypersensitivity is a cell-mediated response. The antigen activates specifically ssensitizedCD4 & CD8 T lymphocytes leading to the secretion of lymphokines and phagocyte accumulation. Reference:nathanarayan & paniker's 9th edition, pg no: 162 <\p>
|
Microbiology
|
Immunology
|
89cbdb6f-7e0c-4f15-aaf5-9c579f551fff
|
Cause of exudative retinal detachment are all except
|
Scleritis
|
Toxaemia of pregnancy
|
Dysthyroid eye disease
|
Central serous retinopathy
| 2c
|
multi
|
C i.e. Dysthyroid eye disease
|
Ophthalmology
| null |
8f336d72-cadb-4443-bb42-597dba38d156
|
The following are Components of Brown sequard syndrome except
|
Ipsilateral extensor plantar response
|
Ipsilateral pyramidal tract involvement
|
Contralateral spmothalamic tract involvement
|
Contralateral posterior column involvement
| 3d
|
multi
|
. *The sensations that are transmitted only in dorsal and dorsolateral columns-kinesthetic and position sensations,vibration sensation, discrete localization and 2 point discrimination are lost on the side of transection because fibers in this column do not cross to opposite side until they reach medulla Brown-Sequard syndrome is characterized by loss of motor function (i.e. hemiparaplegia), loss of vibration sense and fine touch, loss of proprioception (position sense), loss of two-point discrimination, and signs of weakness on the ipsilateral (same side) of the spinal injury. ref Harrison20th edition pg 2700
|
Medicine
|
C.N.S
|
3786e81f-cb56-4d3b-a942-bab67af0a45c
|
Degeneracy of codon means:
|
More than one codon for a single amino acid
|
More than one amino acid for a single codon
|
No punctuation in codons
|
Termination of protein synthesis
| 0a
|
single
|
More than one codon for a single amino aci
|
Biochemistry
| null |
a0aa0863-6022-4475-9714-1ddfa1281594
|
A patient presents with recurrent swelling of the lips as shown. He has no itching. Family history is positive. Which of the following is deficient in this patient?
|
C1,C2,C4
|
C1 inhibitor
|
C3b inactivator
|
C5-C8
| 1b
|
single
|
This boy presents with features of hereditary angioneurotic edema, which is due to deficiency of C1 inhibitor. C1 inhibitor deficiency - Hereditary angioedema. C1, C2, C4 deficiency - Collagen vascular disorders C5-C8 deficiency - Recurrent bacteremia with Neisseria. Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition
|
Microbiology
|
Immunology
|
ed1d2a48-af4e-4ca8-bcde-76685a8dcc6d
|
Primary Dentition begins to show teeth eruption by __________
|
6 weeks
|
12 weeks
|
6 months
|
12 months
| 2c
|
single
|
Primary dentition to appear first is the lower central incisors at 6-10 months of age. Ref- Ghai , 9th edition , Table 2.2
|
Pediatrics
|
Growth and development
|
1170d16e-3bf4-4082-a67e-de3fd02fe77c
|
All are true about thiopentone except
|
Na2CO3 is a preservative
|
contraindicated in porphyria
|
Agent of choice in shock
|
Has cerebroprotective action
| 2c
|
multi
|
In situations where the baroreceptor response will be blunted or absent (eg, hypovolemia, congestive hea failure, b-adrenergic blockade), cardiac output and aerial blood pressure may fall dramatically due to uncompensated peripheral pooling of blood and direct myocardial depression. So, sodium thiopental is contraindicated in shock. Ref: Morgan & Mikhail's clinical anesthesiology 6e
|
Anaesthesia
|
General anaesthesia
|
be933adc-1c1a-4898-9057-3f88155639bb
|
Which of the following is a characteristic radiological finding in neonatal necrotizing enterocolitis –
|
Gas in the portal system
|
Gas in the intestinal wall
|
Pneumoperitonium
|
Air fluid levels
| 1b
|
multi
| null |
Pediatrics
| null |
b2fa10d0-c38f-405e-92cb-664e282ce762
|
'Shepherd's crook' deformity of the proximal femur seen in
|
Fibrous dysplasia
|
Chondroblastoma
|
Osteochondroma
|
Aneurysmal bonecyst
| 0a
|
single
|
(Fibrous dysplasia) (227-M) (174-75-Abley 8th)FIBROUS DYSPLASIA is a developmental disorder in which areas of trabecular bone are replaced by cellular Fibrous tissue containing flecks of osteoid and woven bone* ** Occasionally the bone disorders is associated with "cafe-au-lait " patches on the skin and (in girls) precocious sexual development (Albright's syndrome)* * Malignant transformation to fibrosarcoma occurs in 5-10% of patients with polystotic lesions, but only rarely in monostotic lesionsX ray shows radiolucent 'cystic ' areas in the metaphysis or shaft because they contain fibrous tissue with diffuse spots of immature bone, the lucent patches typically have a slightly hazy or 'ground glass' appearanceThe weight bearing bones may be bent and one of the classic features is the 'shepherd's crook' deformity of the proximal femur
|
Orthopaedics
|
Bone Tumour
|
8d7482e4-4e96-427c-9bb6-d87a819e3e97
|
Treatment of choice choriocarcinoma is:
|
Chemotherapy
|
External beam radiotherapy
|
Hysterectomy
|
Intracavitary brachytherapy
| 0a
|
single
|
Ans. A. Chemotherapy* The treatment of choice of choriocarcinoma is mainly chemotherapy both for local and distal metastasis. The drug of choice for the same is methotrexate. It is given orally 5mg five times a day for 5 days. Side effects of Methotrexate are ulcerative stomatitis, gastric hemorrhage, skin reaction, alopecia, bone marrow suppression, Liver and Kidney damage.
|
Gynaecology & Obstetrics
|
Gestational Trophoblastic Disease
|
861a5317-24d9-465a-8534-1d3079e7985b
|
Collagen 7 is present in which layer of Basement membrane zone
|
Hemi-desmosomes
|
Salt split layer
|
Lamina Densa
|
Sublamina Densa
| 3d
|
single
|
SUBLAMINA DENSA * Contains anchoring fibrils, anchoring plaques, elastic microfibrils (without elastin), and linkin . Anchoring Fibril :- * Primary constituent is type VII collagen; appears larger than anchoring filaments and emanates perpendicularly down from lamina densa into papillary dermis. * Connects lamina densa to anchoring plaques (type IV collagen) in dermal matrix . * Intercalation with banded collagen fibrils of papillary dermis: forms fan-shaped clumps. Ref:- Sima Jain; pg num:- 8
|
Dental
|
Anatomy of skin
|
c6752ef2-0006-4ce8-a607-0ef0eaef1775
|
Which of the following show splaying of carina in retro cardiac shadow
|
Left atrium enlargement
|
Left ventricle enlargement
|
Right atrium enlargement
|
Right ventricle enlargement
| 0a
|
single
|
ANSWER: (A) Left atrium enlargementREF: Sutton s textbook of radiology, 7th edition, volume 1 page 284Left atrial enlargement in 5 directions:(out of all 6 directions, inferior enlargement is not seen)It is believed left atrial appendage enlargement occur early. Left atrial Appendage enlargement is seen as fullness beneath the pulmonary artery shadow. It may be the earliest finding of Left atrial enlargement in X-ray. (This may appear as straight left heart border, as in classical mitral stenosis). The Left atrial appendage enlargementis not necessarily in proportion with left atrial enlargement.Left atrium could also enlarge posteriorly by pushing the esophagus towards the spine. This is visible only in barium swallow.Then LA can enlarge either to left or right (Usually towards right) and reach the right heart border or over shoot it and form the right heart border by itself. This occurs very late in the course.The other direction LA goes on to enlarge is superiorly. When LA enlarges superiorly it hits on the left main bronchus and lifts it. This is measured by the widened subcarinal angle which is normally less than 75 degrees.LA can enlarge anteriorly sometimes, but it is resisted by right ventricle but rarely right ventricle yields to the LA push and produces a left parasternal lift which could be mistaken for RV enlargement.Inferior enlargement cannot happen in a significant way as it is limited by the AV groove and strong fibrous skeleton. The upper limit of normal LA size is around 4.5cm.
|
Radiology
|
Cardiac and Pericardiac Imaging
|
07dee588-f5b6-428b-840d-dd61225c1fdf
|
Spinal nerve roots are supplied by ?
|
Anterior spinal aery
|
Posterior spinal aery
|
Ascending cervical aery
|
All of the above
| 2c
|
multi
|
Ans. is 'c' i.e., Ascending cervical aeryAnterior and posterior spinal aeries supply spinal cord, but not spinal nerve roots.Spinal nerve roots are supplied by radicular aeries which are segmental branches of veebral, ascending cervical, deep cervical, intercostal and sacral aeries.Blood supply of spinal cord1. The spinal cord receives its blood supply from :The anterior spinal aeryTwo posterior spinal aeriesIn addition to these channels the pia mater covering the spinal cord has an aerial plexus (called the aerial vasocorona) which also sends branches into the substance of the cord.2. The main source of blood to the spinal cord is from the veebral aeries (form which the anterior and posterior spinal aeries take origin)However, the blood from the veebral aery reaches only up the cervical segments of the cord.Lower down the spinal cord receive blood through radicular aeries that .These arise form spinal branches of the veebral, ascending cervical, deep cervical, intecostal, lumbar and sacral aeries
|
Anatomy
| null |
dee6ef5f-b9ac-476c-bff1-2c103c005d9e
|
DIC is common in which AML -
|
Nonocytic (M5)
|
Promyelo cytic (M3)
|
Erythrocytic (M6)
|
Megakaryocytic (M7)
| 1b
|
single
|
Ans. is 'b' i.e., Promyelocytic Tumor cells in acute promyelocytic leukemia (M3) release procoagulant and fibrinolytic factors that cause disseminated intravascular coagulation (DIC).
|
Pathology
| null |
f182f677-7242-4a22-8c2d-2657c73824e8
|
Transitional epithelium is seen in
|
Esophagus
|
Vagina
|
Urinary bladder
|
Trachea
| 2c
|
single
|
INDERBIR SINGH&;S TEXTBOOK OF HUMAN HISTOLOGY-PAGE NO:320
|
Anatomy
|
General anatomy
|
7472e4c6-6ee5-4497-9cbd-bb2ae1ca1914
|
Which one of the following serum levels would help in distinguishing an acute liver disease from chronic liver disease
|
Aminotransaminase
|
Alkaline phosphatase
|
Bilirubin
|
Albumin
| 3d
|
single
|
Answer- D. AlbuminSerum albumin has a long half life 15-20 days with approximately 4% degraded per day
|
Medicine
| null |
b32f6351-bbfd-4c71-93eb-1e3eff7f1af5
|
In sickle cell crisis bone pain is due to:-
|
Bone infarction
|
Osteroporosis
|
Osteomalacia
|
Periosteal reaction
| 0a
|
single
|
- Abnormal shape of RBC - Occlusion of small vessels of bone - bone infarction - resulting in pain If bones of hand & feet are involved - Hand foot syndrome Long bones - Avascular necrosis of femur veebral column - 'H' shaped veebra/ cod fish veebra/ fish mouth veebra -X ray skull - crew cut appearance (Hair on end appearance)
|
Pathology
|
Hemoglobinopathies: Sickle cell anemia
|
1a0c8aeb-3581-4fe3-9f60-8f8df8b1fb39
|
A dental instrument which creates aerosols containing large number of microorganisms is the:
|
Evacuator
|
Ultrasonic scaler
|
Amalgam condenser
|
Endodontic reamer
| 1b
|
single
| null |
Dental
| null |
1e158a03-95c9-493e-b8b2-967acb062eee
|
The following statements are true regarding botulism except -
|
Infant botulism is caused by ingestion of preformed toxin
|
Clostridium botulinum A, B, C and F cause human disease
|
The gene for botulinum toxin is encoded by a bacteriophage
|
Clostridium baratti may cause botulism
| 0a
|
multi
|
Ans. is 'a' i.e., Infant botulism is caused by ingestion of preformed toxin . Infant botulism is caused by ingestion of spores. Spores are ingested in food, get established in the gut and there produce the toxin. "Seven main types of C. botulinum, designated A - G, produce antigenically distinct toxins with pharmacologically identical action. All types can cause human disease, but type A, B and E are most common". (In Harrison & Ananthanarayan, eight types of C. botulinum A, B, CI, C2, D, E, F, G have been mentioned). . Toxin production in clostridium botulinum appears to be determined by presence of bacteriophage (at least in type C & D). . "Clostridium butyricum and clostridium baratti have also been found to produce toxin". - Harrison 16th/e 843 - Any strain producing toxin will obviously cause botulism.
|
Microbiology
| null |
2ba3239b-631b-43f3-8325-b1ca724fcfba
|
All the following are included in the Rotterdam criteria for Polycystic ovarian syndrome (PCOS) diagnosis except
|
Hyperandrogenism
|
Amenorrhea or oligomenorrhea
|
Polycystic ovaries by USG
|
Weight of the patient
| 3d
|
multi
|
PCOS is a medical condition associated with hyperandrogenism, ovulatory dysfunction, and polycystic ovaries.The Rotterdam 2003 criteria required two of three of the following for PCOS diagnosis: hyperandrogenism, oligomenorrhea or amenorrhea, polycystic ovaries by ultrasound Reference: Berek and Novak's gynecology; 14th edition; Chapter 30; Amenorrhea
|
Gynaecology & Obstetrics
|
Sexuality and intersexuality
|
28c1bdbe-eb5d-4a0d-bac4-7f0bba82c162
|
Central precocious puberty in a girl is defined as breast development before the age of?
|
6 years
|
8 years
|
12 years
|
10 years
| 1b
|
single
|
b. 8 years(Ref: Nelson's 20/e p2656, Ghai 8/e p 534)Central precocious puberty is defined by onset of breast development before the age of 8 yrs in girls and by onset of testicular development (vol 4mL) before the age of 9 yrs in boys, as a result of early activation of hypothalamic-pituitary-gonadal axis.
|
Pediatrics
|
Endocrinology
|
09e17233-d63c-4399-bf4e-1350747da141
|
All are true about pathogenesis of Ovarian Hyperstimulation Syndrome, EXCEPT?
|
Due to ovarian enlargement and fragility
|
Increase in intravascular volume
|
Role of VEGF and inflammatory cytokines
|
Secondary to infeility treatment
| 1b
|
multi
|
Symptoms of OHSS are the result of ovarian enlargement and fragility, extravascular fluid accumulation, and intravascular volume depletion (and not increase as stated in option b). Fluid shifts that accompany OHSS are due to increased protein-rich fluid secretion from the stimulated ovaries, increased renin and prorenin within follicular fluid, increased capillary permeability and VEGF
|
Gynaecology & Obstetrics
|
Ovarian Hyperstimulation Syndrome (OHSS)
|
8b80d0f4-6728-4ebd-96d4-5ff0fd5c6ad7
|
Auto-splenectomy is associated with -
|
Systemic lupus erythematosus
|
Trauma
|
Sarcoidosis
|
ITP
| 0a
|
single
|
Answer- A. Systemic lupus erythematosusSLE patients with thrombocytosis anil antiphospholipid sytdrome are at risk of developing autosplenectomy.
|
Medicine
| null |
c47a6145-31da-40dd-995d-1622f1f8f472
|
Thomas test is used for testing
|
Knee flexion
|
Knee extension
|
Hip flexion
|
Hip extension
| 2c
|
single
|
Hip flexion
|
Surgery
| null |
7568cf7b-c0d5-4647-9dc4-fe988b315f75
|
Not true about vancomycin is :
|
95% oral bioavailability
|
Inhibits cells wall synthesis
|
Can be used parenterally as well as orally
|
Indicated for MRSA infections
| 0a
|
multi
| null |
Pharmacology
| null |
3e83eed3-086f-4c7b-8e3f-462a00d79c0a
|
Mass immunization is indicated in the following, except -
|
Leprosy
|
Cholera
|
Influenza
|
Tuberculosis
| 0a
|
multi
|
.
|
Social & Preventive Medicine
|
Epidemiology
|
5eda62f8-6c5f-4bfc-ac52-61f8311b185a
|
Which of the following carcinoma most frequently metastasizes to brain -
|
Small cell carcinoma lung
|
Prostate cancer
|
Rectal carcinoma
|
Endometrial cancer
| 0a
|
multi
|
Ans. is 'a' i.e., Small cell carcinoma of lung Frequency of Nervous system metastasis by common primary tumour. Site of primary tumourBrain %MetastasesLeptomeningeal % MetastasisSpinal cord % CompressionLung402418Breast194124Melanoma10124Gastrointestinal tract7136Genitourinary tract7-18Others171030
|
Pathology
|
Clinical Aspects of Neoplasia
|
e39b6f2d-279d-4f19-97ff-a6ec38594e15
|
Neuroblastomas - good prognositc factor is
|
N-myc amplification
|
RAS oncogene
|
Hyperdiploidy
|
Translocations
| 2c
|
single
|
Ref : Sabiston 20th edition Pgno : 1887-1888 Neuroblastoma prognostic factors Favorable prognosis Unourable Prognosis Age <1 year Thoracic primary lesion Shimada index showing well differentiated stromal rich tumor Increased ratio of VMA/HVA Normal serum ferritin Hyperdiploid or near triploid High level of expression of Trk-A gene N-myc amplification (>10) Deletion of 1p(most characteristic cytogenetics abnormality) and gain of 17q Expression of multidrug resistance protein Over expression of telomerase Increased serum ferritin Diploid Older patients of stages III and IV
|
Anatomy
|
Endocrinology and breast
|
b554854b-5bd4-42bc-b773-9611a465d1c7
|
OC pills are C/I in pts receiving :
|
Rifampicin
|
Ethambutol
|
Streptomycin
|
Pyrazinamide
| 0a
|
single
|
Ans. is a i.e. Rifampicin
|
Gynaecology & Obstetrics
| null |
3647db32-f6dc-4978-ad0f-47e96b03f81a
|
Lactobacilli are numerous in carious lesions because they
|
Are the main causative agent
|
Can produce insoluble extracellular polysaccharides
|
Can attach to smooth enamel surfaces
|
Are secondary invaders
| 3d
|
single
| null |
Pathology
| null |
9437b7e8-5a39-4cae-976f-317b698241ae
|
The lack of ability of an individual to do his routine activity is -
|
Disease
|
Impairement
|
Disability
|
Handicap
| 2c
|
single
|
Disability defined as lack of ability of an individual to do his routine activity Disease defined as a condition in which body health is impaired, a depaure from a state of health, an alteration of human body interupting the performance of vital functions Impairment is defined as any loss or abnormality of psychological, physiological,or anatomical structure or function Handicap defined as a disadvantage for a given individual,resulting from an impairment or disability , that limits or prevents the fulfilement of a role that is normal for that individual ref ;(page no;44) 23rd edition of PARK&;s textbook of Preventive and Social medicine
|
Social & Preventive Medicine
|
Social science, Mental health & Genetics
|
f99e92c2-0243-4372-b8a9-3c025fc15c37
|
Regarding Xenon anesthesia all are true accept
|
Slow induction and recovery
|
Non explosive
|
Minimal cardiovascular side-effects
|
Low blood solubility
| 0a
|
multi
|
Xenon Advantages of Xenon Anesthesia 1. Ine (probably nontoxic to liver and kidney with no metabolism) 2. Minimal effect on CVS function 3. Lowest blood solubility (Lowest blood gas paition coefficient) therefore rapid induction and recovery. 4. Does not trigger malignant hypehermia 5. Environmental friendly 6. Non-explosive Disadvantages of Xenon Anesthesia 1. High cost 2. Low potency (MAC = 70%) 3. No commercially available anaesthesia equipment.
|
Pharmacology
|
Miscellaneous
|
75fe458d-6caa-4863-a66e-ca288716104a
|
Fluctuating deafness is seen in:
|
Otosclerosis
|
Meniere's disease
|
Acute otitis media
|
Benign paroxysmal positional vertigo
| 1b
|
single
|
(b) Meniere's disease(Ref. Cummings, 6th ed., 2331)In otosclerosis there occurs progressive deafness. AOM shows temporary deafness. There is no deafness in BPPV.
|
ENT
|
Ear
|
06812b3f-9599-4370-bb1a-a8a3f33285d2
|
Treatment of choice in a perimenopausal woman with bleeding PV due to multiple fibroids Is :
|
TAH with BSO
|
TAH
|
Vaginal hystrectomy
|
Enucleation of fibroids
| 1b
|
single
|
TAH
|
Gynaecology & Obstetrics
| null |
e47dffb5-4b43-4458-96cd-8f10b4604fda
|
Antidote of paracetamol poisoning
|
Flumazenil
|
N-acetyl cysteine
|
Nalexone
|
Sodium bicarbonate
| 1b
|
single
|
i.e. (N- acetyl cysteine): (680 - Ghai 7th)Overdosage of PCM is treated with N-acetyl cysteine used orally within 16 hour after ingestion at a loading dose of 140 mg/ Kg diluted to 5% solution orally. Followed by 70 mg /Kg q 4hr for another 2 daysPCM is the most common analgesic, antipyretic used in childrenParacetamol produces a hghly reactive toxic minor metabolites - N-acetyl benzoquinone amine. Normally this metabolite is detoxified by conjugation with glutathione - when a very large doses of paracetamol is taken glucuronidation capacity is saturated and this metabolite is not detoxified (Hepatic glutathione is depleted)|Excess metabolite N acetyl benzoquinone** binds to protein in liver cells (and renal tubules)|Centrilobular hepatic necrosis**This single most important laboratory test in patient who present after acetaminophen is the acetaminophen level in the serum.Antidotes for common poisoningPoison Antidote* Acetaminophen (PCM)N- acetyl cysteine* AnticholinergicsPhysostigmine* BenzodiazepinesFlumazenil* DigoxinDigoxin immune antibody* MethemoglobinemiaFragnent* OpioidsMethylene blue* OrganophosphatesNaloxone* SalicylatesAtropine* Ethylene glycolSodium bicarbonates* MethanolFomepizole
|
Pediatrics
|
Miscellaneous
|
801121d9-d317-471f-a2f8-b79d3cd92632
|
In which of the following disease the given appearance of calves is seen?
|
Spinal muscular dystrophy
|
Muscular dystrophy
|
Myopathy
|
Peripheral neuropathy
| 1b
|
single
|
Ans. B. Muscular dystrophy* The given image shows Pseudohypertrophy of the calves. This is characteristic of Duchenne Muscular dystrophy.* In DMD due to the weakness of proximal thigh muscles there is compensatory hypertrophy of the distal calf muscle.* This is pseudo hypertrophy as there is only a deposition of fat and connective tissue and not true hypertrophy of muscles.
|
Pediatrics
|
Musculo Skeletal Disorders
|
94713c6d-2bd3-4a07-83ed-0f751f9aca29
|
Vitamin C deficiency results in which of the following?
|
Decreased degradation of collagen
|
Stimulation of poly hydroxylase
|
Formation of unstable collagen helices
|
Excessive callus formation in healing fractures
| 2c
|
multi
|
Scurvy, or vitamin C deficiency, results in an inability to form normal collagen triple helices. In scurvy, the resulting collagen is less stable and is subject to denaturation and proteolytic breakdown. That results partially from slower secretion of collagen from fibroblasts. The collagen formed is not normally hydroxylated at proline and lysine residues because of the absence of vitamin C, which is a specific cofactor for hydroxylation of proline and lysine. Bone growth, development of the dentition, and wound and fracture healing as well as the general stability of adult organs are inhibited because of the importance of collagen in the maintenance of structural support. Periodontal bleeding and ulceration are also common symptoms in scurvy.
|
Unknown
| null |
09133289-b389-4d65-bc77-65ac205e7e89
|
Bilateral hydroureteronephrosis is usually the result of
|
Posterior urethral valves
|
Urethral stricture
|
Benign prostatic hyperplasia
|
Bilateral renal calculi
| 3d
|
multi
|
Only bilateral ureteric calculi cause hydroureteronephrosis
|
Physiology
|
All India exam
|
ac861780-9be1-4afc-8307-0967b5b7b854
|
Suicidal risk is common with which type of depression -a) Reactive depressionb) Endogenous depressionc) Childhood depressiond) Depression in involution
|
c
|
d
|
bd
|
ac
| 2c
|
single
| null |
Psychiatry
| null |
591c8b0e-f497-44d6-b46d-fcc4897b0f34
|
Gonococci has affinity for :
|
Columnar epithelium
|
Glandular epithelium
|
Stratified sqamous epithelium
|
Squamous epithelium
| 0a
|
single
|
Columnar epithelium
|
Gynaecology & Obstetrics
| null |
dc294862-c8a8-4e29-a7d7-a130a7a66381
|
Group B fibers are present in:
|
Intrafusal fibers of the muscle spindle
|
Golgi tendon apparatus
|
Autonomic preganglionic fibers
|
Spinothalamic tracts
| 2c
|
single
| null |
Physiology
| null |
757ad506-4f62-489d-8eb4-56b4501326e5
|
Rhinophyma occurs as complication of
|
Acne vulgais
|
Acne rosacea
|
Psoriasis
|
Plicinphigus
| 1b
|
single
|
Rosacea:-Chronic skin infection characterised by symptoms of facial flushing and a spectrum of signs including erythema, telangiectasia,coarseness of skin and inflammatory papulopustular lesion.Features:-1. Red papules and pustules on nose ,forehead,cheeks and chin.2. Frequent flushing 3. Aggravated by sun exposure,foods , alcolhol, spicy foods, hot tea or coffeeextreme temperatures,vasodilator drugs,, h.pylori infection There are 4 subtypes of rosacea erythematotelengieatatic rosacea- flushing,central facial erythema, telengiectasia papulopustular rosacea- persistent central facial erythema with transient papules , pustules, in central facial distribution phymatous rosacea: thick skin with modularity most common over nose-rhinophyma ocular rosacea watery eyes, foreign body sensation, burning/stinging, dryness, itching blepharitis. iadvltextbook of dermatology, page page 856
|
Dental
|
Photosensitive disorders
|
9d5114ca-0e9e-488b-be7b-c5c0ade537a2
|
Which of the following drug produce analogous action on dilator pupillae as is produced by pilocarpine on sphincter pupillae?
|
Epinephrine
|
Hydroxyamphetamine
|
Cocaine
|
Timolol
| 0a
|
single
|
Ans. (A) Epinephrine(Ref: KDT 8th/e p114, 144)Pilocarpine is a parasympathomimetic drug. It causes contraction of sphincter pupillae and result in miosis. Epinephrine results in contraction of dilator pupillae and result in mydriasis.
|
Pharmacology
|
Adrenergic System
|
d043a81d-0e43-4d69-9768-76634bf4f035
|
Which of the following is a not member of HACEK group-
|
Hemophilus aphrophilus
|
Acinetobacter
|
Cardiobacterium
|
Kingella
| 1b
|
single
|
The HACEK groupinclude -Hemophilus parainfluenzae, Hemophilus aphrophilus, Actinobacillus (now Aggregatibacter) actinomycecomitans, Cardiobacterium hominis, Eikinella corrodens and Kingella kingae. These are gram negative pleomorphic bacilli which are capnophilic and have fastidious growth requirements. They do not grow on MacConkey and on blood agar, their colonies appear in 2-3 days. They are normal commensals of the oral cavity which can cause endocarditis following dental manipulations.
|
Microbiology
|
Systemic Bacteriology (Haemophilus, Yersinia, Spirochaetes, Ricketssia, Chlamydia, Mycoplasma and Miscellaneous Bacteria)
|
1a5999cb-c97f-4283-9e33-10a8e559d904
|
Which one of the following is characteristic of mitral valve prolapse syndrome -
|
Rough mid diatolic murmur
|
Collapsing pulse
|
Lound first hea sound
|
Mid systolic click
| 0a
|
single
|
Early diastolic murmurs sta at the same time as S2 with the close of the semilunar (aoic & pulmonary) valves and typically end before S1. Common causes include aoic or pulmonary regurgitation and left anterior descending aery stenosis. Mid-diastolic murmurs sta after S2 and end before S1. They are due to turbulent flow across the atrioventricular (mitral & tricuspid) valves during the rapid filling phase from mitral or tricuspid stenosis.characteristcs of mitral valve prolapse Late diastolic (presystolic) murmurs sta after S2 and extend up to S1 and have a crescendo configuration. They can be associated with AV valve narrowing.They include mitral stenosis, tricuspid stenosis, myxoma, and complete hea block Ref Davidson 23rd edition pg 435
|
Medicine
|
C.V.S
|
6c085df7-8518-42da-9789-9e4ad3d0e296
|
Endogenous Depression is characterized by A/E
|
Loss of Self esteem
|
Guilt psychosis
|
Third person hallucination
|
Paranoid feeling
| 2c
|
multi
|
C i.e. Third person hallucination
|
Psychiatry
| null |
81f3ce8d-ce5d-4da1-a6b3-b8228d4856ce
|
GABA is produced from:
|
Alanine
|
Glycine
|
Glutamate
|
Glutamine
| 2c
|
single
|
Glutamate
|
Physiology
| null |
08f8032e-01cd-4799-b05c-99d1cc75f844
|
Toxicity of leigonella is due to:
|
Capsule
|
Toxin
|
Phage
|
Plasmid
| 1b
|
single
|
Toxin
|
Microbiology
| null |
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