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|---|---|---|---|---|---|---|---|---|---|---|
a1de3ffb-08f9-4abe-9b32-dfddbc9ced2f
|
False about eukaryotic protein synthesis is
|
N formyl Met is the first t-RNA to come into action
|
mRNA read from 5' to 3'
|
Ef2 shifts between GDP to GTP
|
Capping helps in attachment of mRNA to 40 S ribosome
| 0a
|
multi
|
The first amino acid incorporated is methionine But in prokaryotes, the same codon stands for N -formyl methionine which is the firstRef: DM Vasudevan, 7th edition, page no: 600
|
Biochemistry
|
Metabolism of nucleic acids
|
9d04431c-ef19-43c0-8dd0-46ae83ad5bfe
|
Onion skin thickening of aeriolar wall is seen in
|
Atherosclerosis
|
Median calcific sclerosis
|
Hyaline aeriosclerosis
|
Hyperplastic aeriosclerosis
| 3d
|
multi
|
Hyperplastic aeriolosclerosis is more typical of severe hypeension. Vessel exhibit onion skin , concentric laminated thickening of aeriolar walls and luminal narrowing Robbins 9 th edition page no. 334
|
Pathology
|
Cardiovascular system
|
08c2400a-af6a-4b33-ab17-167e55637ec2
|
In carcinoma bas of tongue pain is refered to the ear through-
|
Hypoglossal nerve
|
Vagus nerve
|
Glossopharyngeal nerve
|
Lingual nerve
| 2c
|
single
|
C i.e. Glossopharyngeal nerve
|
Anatomy
| null |
120c6bbd-a322-477f-ad68-8f4e10f1aba1
|
Mikulicz cells & Russell bodies are characteristic of:
|
Rhinoscleroma
|
Rhinosprodiosis
|
Plasma cell disorder
|
Lethal midline granuloma
| 0a
|
single
|
Rhinoscleroma (RS) is a chronic specific granulomatous disease of the upper respiratory tract. Clinically, RS is a slowly progressive disease with insidious onset and indolent course affecting primarily the nasal cavity in 95 to 100% of cases with or without involvement of the nasopharynx, nasal sinuses, pharynx, larynx, trachea and bronchi. The presenting features and imaging techniques provide a presumptive diagnosis of RS but histopathological examination remains the mainstay for final definitive diagnosis. Catarrhal stage shows a nonspecific sub-epithelial infiltrate of polymorphonuclear leukocytes with granulation tissue. The diagnostic histological changes of RS are only seen during granulomatous phase. These include dense infiltration by lymphocytes, plasma cells, Russell bodies and the pathognomonic large Mikulicz cells; foamy macrophages with numerous cytoplasmic vacuoles containing ble and nonble Klebsiella bacilli. Mickulicz cells are sparse or absent in the initial catarrhal and final sclerotic stages and most abundant during the second proliferative phase.
|
ENT
| null |
f4eabb5c-5e61-4785-96ed-92f209599fde
|
Natural history of disease can be studied from
|
Community trials
|
Quasi-controlled trials
|
Cross-sectional studies
|
Longitudinal studies
| 3d
|
single
|
Longitudinal studies There is an increasing emphasis on the value of longitudinal studies in which observations are repeated in the same population over a prolonged period of time by means of follow-up examinations. Cross-sectional studieshave been likened to a photograph, and longitudinal studies to a cine film. Longitudinal studies are useful (i) to study the natural history of disease and its future outcome {ii) for identifying risk factors of disease, (iii) for finding out incidence rate or rate of occurrence of new cases of disease in the community. Longitudinal studies provide valuable information which the cross-sectional studies may not provide, but longitudinal studies are difficult to organize and more time-consuming than cross-sectional studies. Measurement can also be extended to health states and events. For example, the study of blood pressure levels in a population will reveal the normal values, rather than abnormal ones related to disease. Ref : Park 23rd edition Pgno : 69
|
Social & Preventive Medicine
|
Epidemiology
|
9960ae22-7843-4cb4-af88-13a75fc8bd6e
|
A child with mental retardation and skin rash on cheeks underwent a CT scan. The diagnosis of the child is?
|
Tuberous sclerosis
|
Von Hippel Lindau
|
Sturge Weber syndrome
|
Ataxia telangiectasia
| 0a
|
single
|
In the image on the left adenoma sebaceum is present, which looks like extensive acne in a butterfly distribution. The CT scan head shows a big lesion obliterating the ventricular system. It is a sub-ependymal nodule seen in tuberous sclerosis. A point against Sturge Weber is the absence of cutaneous lesion of Po wine stain. VHL is associated with cerebellar hemangioblastoma.
|
Medicine
|
Epilepsy and EEG
|
5d975ad8-b9cb-4629-9462-8bfdc64020cd
|
Mifepristone - misoprostol sequential oral administration is safe & effective method for termination of pregnancy up to what gestational age?
|
12 weeks
|
10 weeks
|
9 weeks
|
7 weeks
| 3d
|
single
|
Ans. D 7 weeks . (Ref. Text book of Obstetrics by DC Dutta 7th/pg. 174; KDT 6th/pg. 310) MIFEPRISTONE (RU 486) # It is a steroid with an affinity for progesterone receptors. # Single dose 600 mg or 25 mg bd for 4 days if amenorrhea is of > 48 hours. # Mifepristone (RU 486/progesterone receptor antagonist) is effective in inducing therapeutic abortion upto 63 days of gestation, but is most effective when used within 49 days of gestation. # It does not prevent fertilization, but by blocking action of progesterone on endomertium, causes sloughing and shedding of deciduas and brings about abortion. # However, emptying is incomplete and surgical evacuation is needed. # Adding PG (Misoprostol) on last day improves the rate of complete abortion Uses of Mifepristone (anti-progestin): A Postcoital contraceptive Mifepristone 600 mg given within 72 hrs of intercourse interferes with implantation and is highly effective method of emergency contraception. The menstrual cycle is however disturbed. B. Termination of pregnancy * Up to 7 weeks: 600 mg as single dose causes complete abortion in 60-85% cases. * To improve the success rate, current recommendation is to follow up 48 hrs later by a single 400 mg oral dose of misoprostol. This achieves > 90% success rate and is the accepted nonsurgical method of early first trimester abortion. * In place of oral Misoprostol, a 1 mg geneprost pessary can be inserted intravaginally. Mifepristone administered within 10 days of missed period results in an apparent late heavy period in upto 90% cases. * Anorexia, nausea, tiredness, abdominal discomfort, uterine crapms, loose motions are the side effects, apart from problems like prolonged bleeding and failed abortion in some cases. C. Cervical ripening 24-30 hrs before attempting surgical abortion or induction of labour, mifepristone 600 mg results in softening of cervix. D. Once a month contraceptive A single 200 mg dose of mifepristone given 2 days after the midcycle each month prevents conception on most occasions. E. Induction of labour By blocking the relaxant action of progesterone on uterus of late pregnancy, mifepristone can induce labour. It may be tried in cases with IUD and to deliver abnormal fetuses. F. Cushing's syndrome Mifepristone has palliative effect due to glucocorticoid receptor blocking property. May be used for inoperable cases.
|
Gynaecology & Obstetrics
|
Miscellaneous (Gynae)
|
f833623c-71bb-4d4c-8e57-1d7b9c129521
|
True about Posttraumatic fat embolism syndrome -a) Fracture mobility is a risk factor b) Associated diabetes pose a riskc) Bradycardia occursd) Thrombocytopeniae) On ABG PaO2 < 60 mm Hg on FIO2 < 0.4
|
abcd
|
bcde
|
abde
|
ade
| 2c
|
multi
|
Mobility at fracture site and associated DM increase the risk of development of fat embolism syndrome.
|
Orthopaedics
| null |
d4de8a06-fc99-4587-a8bc-d3a184ff8ea7
|
X-rays are modified -
|
Protons
|
Electrons
|
Neutrons
|
Positrons
| 1b
|
single
|
X rays are the modified electrons from cathode striking the anode both are made up of tungsten which has a high melting point and low vapourisation pressure
|
Radiology
|
Fundamentals in Radiology
|
94e8cbab-22f7-43da-9b5c-f900b6b90ab6
|
MC affected valve in RHD: March 2013
|
Mitral
|
Tricuspid
|
Aoic
|
Pulmonary
| 0a
|
single
|
Ans. A i.e. Mitral In rheumatic fever, the mitral valve is involved most frequently followed by the aoic valve
|
Medicine
| null |
d49b4503-37f2-4851-8d8f-62204eb78114
|
Prevalence of a disease depends upon the following-
|
Incidence
|
Duration
|
Both of the above
|
None of the above
| 2c
|
multi
|
.prevalence of a disease can be calculated as prevalence is the product of incidence and the mean duration of the illness. ref:parks textbook ,22nd edition,pg no 59
|
Social & Preventive Medicine
|
Epidemiology
|
c6e47e76-a339-40d4-a6b7-1d11a8999eb1
|
In valvular hea disease complicating pregnancy the following statements are true except :
|
A closed mitral valvotomy can be carried out if symptoms of mitral stenosis are severe
|
Open hea surgery is associated with a reduction in fetal loss
|
Mitral regurgitation is usually well tolerated
|
A maternal moality of 15% has been repoed in women with critical aoic stenosis
| 1b
|
multi
|
Open hea surgery is associated with a reduction in fetal loss
|
Gynaecology & Obstetrics
| null |
64518f58-c14f-4908-bedf-cdc7ffc2ccb9
|
Mcburney's point tenderness is indicative of signifies -
|
Acute appendicitis
|
Acute pancreatitis
|
Acute hepatitis
|
Acute nephritis
| 0a
|
single
|
Ans. 'a' i.e., Acute appendicitis * McBurney's point is the name given to the point over the right side of the abdomen that is one-third of the distance from the anterior superior iliac spine to the umbilicus (navel).* This point roughly corresponds to the most common location of the base of the appendix where it is attached to the cecum.* Deep tenderness at McBurney's point, known as McBurney's sign, is a sign of acute appendicitis.
|
Surgery
|
Vermiform Appendix
|
57b5af64-0c74-44ae-8307-b0c1efbc5d84
|
Characteristic skin lesion in Peutz-Jeghers syndrome is
|
Freckles
|
Lentigines
|
Cafe au lait spots
|
Adenoma sebaceum
| 1b
|
single
|
Lentigines in patients with Peutz-Jeghers syndrome are located primarily around the nose and mouth, on the hands and feet, and within the oral cavity. Ref - Harrison 20thedition pg 223t , 573t
|
Medicine
|
All India exam
|
dbacb9cb-3205-444c-804b-21ae62c28472
|
All are symptoms of hyperglycaemia in a diabetic patient except
|
Polyuria
|
Weight gain
|
Fatigue
|
Recurrent skin infections
| 1b
|
multi
|
Symptoms of hyperglycemia include polyuria, polydipsia, weight loss, fatigue, weakness, blurry vision, frequent superficial infections (vaginitis, fungal skin infections), and slow healing of skin lesions after minor trauma. Metabolic derangements relate mostly to hyperglycemia (osmotic diuresis) and to the catabolic state of the patient (urinary loss of glucose and calories, muscle breakdown due to protein degradation and decreased protein synthesis). Blurred vision results from changes in the water content of the lens and resolves as the hyperglycemia is controlled.Ref: Harrison 19e pg: 2406
|
Medicine
|
Endocrinology
|
a4dab156-b547-47c3-aa70-e89821931589
|
Pegvaliase was approved by FDA in 2018 for
|
Phenylketonuria
|
Pancreatic tumours
|
Crohn's disease
|
Glycogen storage disorders
| 0a
|
single
|
Pegvaliase is a drug approved for the treatment of phenylketonuria. Chemically, it is a pegylated derivative of the enzyme phenylalanine ammonia-lyase that metabolizes phenylalanine to reduce its blood levels.
|
Pharmacology
|
All India exam
|
f3441675-7592-4dbc-b073-c61d6d227956
|
Lipid soluble plasma membrane associated antioxidant?
|
Ubiquitin
|
Vitamin E
|
Vitamin C
|
Glutathione
| 1b
|
single
|
Ans. is 'b' i.e., Vitamin E"Alpha-tocopherol is the only lipid soluble, chainbreaking antioxidant present in biological membranes".
|
Biochemistry
| null |
9428bb5e-e8d0-4c0d-b41f-f85f7f5bbd8f
|
Specific stain for myeloblasts -
|
Sudan black
|
PAS
|
Myeloperoxidase
|
LAP
| 2c
|
single
|
The specific stain for myeloblast is myeloperoxidase And the specific stain for erythroblasts is periodic acid schiff Reference :textbook of Pathology 6th edition Author Harsha Mohan page number 362
|
Pathology
|
Haematology
|
b3ed22cc-f880-4088-92e3-1428ae0c964c
|
Which is true about Klebsiella infections?
|
Most clinical isolates are obtained from the respiratory tract.
|
Predisposing factors for Klebsiella pneumonia include alcoholism, diabetes mellitus
|
Klebsiella is closely related to Pseudomonas.
|
Detecting Klebsiella growth from a sputum culture obtained from an intubated patient mandates treat ment with an aminoglycoside or a third-generation cephalosporin.
| 1b
|
multi
|
Predisposing factors for Klebsiella .............. Klebsiella and the related Serratia and Enterobacter are the most impoant enteric organisms other than E. coli to infect humans. Although respiratory disease is impoant (Klebsiella accounts for 1 % or less of community-acquired pneumonia), most clinical isolates now come from the urinary tract. All three genera are impoant pulmonary nosocomial pathogens. However, merely finding these organisms growing in the sputum of a very ill hospitalized patient does not necessarily implicate the bacteria as pathogenic in that paicular circumstance and may indicate colonization rather than infection. Clinical context and procurement of the sample in a sterile fashion (transtracheal aspiration, bronchoscopy) will aid in the diagnosis Chronic alcoholics, diabetics, and those with chronic lung disease are at increased risk for Klebsiella pneumonia, a difficult disease to treat because of the frequency of suppurative complications (empyema and abscess) with the associated requirement for prolonged (>2 weeks) therapy.
|
Surgery
| null |
52698e5d-2007-433e-801a-ee9b1e2e6cd1
|
Which of the following infestation leads to malabsorption?
|
Giardia lamblia
|
Ascaris lumbricoides
|
Necater Americana
|
Ancylostoma duodenale
| 0a
|
single
|
Ans. (a)(Ref: Parasitology-Protozoology and Helminthology by K.D. Chatterjee, 13th edition)Giardia lamblia is a cosmopolitan parasite, more prevalent in children than adults and more common in warm than in cool climates. It inhabits the deudenum and upper part of the jejunum. The presence of G. lamblia in the glandular crypts of duodenal-jejunal mucosa may not cause any pathology. These flagellates do not invade the tissues, but feed on mucous secretions. With the sucking disc it attaches to the surface of the epithelial cells. Patient may compiain of dull epigastric pain, flatulence and chronic diarrhea of steatorrhoea type. The stool is voluminous, foul smelling and contains large amount of mucus and fat but no blood. This is due to malabsorption since the parasites are coated on the mucosa, thus absorption suffers. Patient loses weight due to the malabsorption.
|
Microbiology
|
Parasitology
|
1902c092-9b0d-411a-8787-171ee9ce003b
|
In plasmodium falciparum infection, the number of cycles in which the parasite undergoes in the liver is:
|
0
|
1
|
2
|
3
| 1b
|
single
|
Sexual cycle of falciparum consists of gametogony (production of gametes) in humans and sporogony (production of sporozoites) in mosquitoes; asexual cycle (schizogony) occurs in humans. Sporozoites in saliva of female Anopheles mosquito enter the human bloodstream and rapidly invade hepatocytes (exoerythrocytic phase). There they multiply and form merozoites (Plasmodium vivax and Plasmodium ovale also form hypnozoites, a latent form). Merozoites leave the hepatocytes and infect red cells (erythrocytic phase). There they form schizonts that release more merozoites, which infect other red cells in a synchronous pattern (3 days for Plasmodium malariae; 2 days for the others). Ref: Levinson W. (2012). Pa IX. Brief Summaries of Medically Impoant Organisms. In W. Levinson (Ed), Review of Medical Microbiology & Immunology, 12e.
|
Microbiology
| null |
d2c07e5a-012d-4660-ba81-c729ce25d3c6
|
Following is not a possible effect of a dentigerous cyst on surrounding tissue:
|
Resorption of cortex
|
Resorption of adjacent teeth
|
Displacement of floor of the maxillary antrum
|
Expansion of outer cortical boundary of involved jaw
| 0a
|
single
|
Effects on Surrounding Structures
A dentigerous cyst has a propensity to displace and resorb adjacent teeth. It commonly displaces the associated tooth in an apical direction. The degree of displacement may be considerable. For instance, maxillary third molars or cuspids may be pushed to the floor of the orbit, and mandibular third molars may be moved to the condylar or coronoid regions or to the inferior cortex of the mandible. The floor of the maxillary antrum may be displaced as the cyst invaginates the antrum, or a cyst may displace the inferior alveolar nerve canal in an inferior direction. This slow-growing cyst often expands the outer cortical boundary of the involved jaw. As in the case with radicular cysts, dentigerous cysts that invaginate the sinus can drain and collapse with new bone formation at the periphery.
Ref: Oral radiology White and Pharaoh; 7th ed. Page no 338
|
Radiology
| null |
526a36fb-4b01-41ed-b7df-d216702131f0
|
Increased tendency to fall asleep at night without causing CNS depression is a property exhibited by
|
Pyridoxine
|
Diphenhydramine
|
Melatonin
|
Ethanol
| 2c
|
multi
| null |
Pharmacology
| null |
0dc936d9-ff42-4d2c-b0ac-ab49564b9220
|
Which is the vitamin deficiency disorder, in people who take the given cereals as their staple diet?
|
Scurvy
|
Beriberi
|
Pellagra
|
Pyridoxine deficiency
| 2c
|
single
|
Ans. C. PellagraPicture given are of maize and Jowar* Maize-Niacin present in unavailable form Niacytin* Sorghum vulgare (Jowar)-High Leucine content inhibit QPRTase, rate limiting enzyme in Niacin synthesis.
|
Biochemistry
|
Vitamins and Minerals
|
f55769b8-0887-4ec1-97e6-af47b07e8ae5
|
Nerve not damaged in breast surgery is?
|
Median nerve
|
Median pectoral nerve
|
Nerve to latissimus dorsi
|
Nerve to serratus anterior
| 0a
|
single
|
ANSWER: (A) Median nerveREF: Breast surgery by William G. Cance page 95Following nerves get injured during breast surgeries:Axillary motor nervesThe long thoracicThoracodorsalMedial pectoralnerves
|
Surgery
|
Breast Cancer - Treatments
|
2b914563-e45e-4c5b-a956-898049c68022
|
"Pseudopalisading" arrangement of malignant cells is characteristic of:
|
Glioblastoma
|
Ependymoma
|
Oligodendroglioma
|
Medulloblastoma
| 0a
|
single
|
"The highest grade tumor of astrocytoma, known as glioblastoma, has a histologic appearance similar to anaplastic astrocytoma with the additional features of necrosis and vascular or endothelial cell proliferation and pseudo-palisading nuclei."
Glioblastoma is type of infiltrating astrocytoma (Classified as Grade 4).
Necrosis in glioblastoma often results in a SERPENTINE pattern in areas of hyper-cellularity.
Tumor cells collect along the edges of the necrotic regions, producing histologic pattern referred to as pseudopalisading pattern.
GLIOMAS
Gliomas are tumors of the brain parenchyma that histologically resemble different types of glial cells. The major types of tumor in this category are:
a. Astrocytomas
b. Oligodendrogliomas
c. Ependymomas.
ASTROCYTOMAS
Two major categories of astrocytoma, infiltrating and non-infiltrating types.
Infiltrating astrocytomas account for about 80% of adult primary brain tumors.
They are most frequent in the fourth through sixth decades.
They are usually found in the cerebral hemispheres.
The most common presenting signs and symptoms are seizures, headaches and focal neurologic deficits related to the anatomic site of involvement.
Infiltrating astrocytomas show a spectrum of histologic differentiation that correlates well with clinical course and outcome.
Based on the degree of differentiation, they are classified into four groups:
Pilocytic astrocytoma - Grade I - Most common
Astrocytoma - Grade 2
Anaplastic astrocytoma - Grade 3
Glioblastoma multiforme - Grade 4 - Least differentiated
PILOCYTIC ASTROCYTOMA
Pilocytic astrocytomas are relatively benign tumors, often cystic, that typically occur in children and young adults.
They are usually located in the cerebellum; also in the floor and walls of the third ventricle, the optic nerves, and occasionally the cerebral hemispheres.
A pilocytic astrocytoma is often cystic, with a mural nodule in the wall of the cyst; if solid, it is usually well circumscribed.
The tumor is composed of areas with bipolar cells with long, thin “'hairlike” processes that are GFAP positive: Rosenthal fibers, eosinophilic granular bodies, and microcysts are often present.
Necrosis and mitoses are absent.
OLIGODENDROGLIOMAS
These tumors constitute about 5% to 15% of gliomas and are most common in the fourth and fifth decades.
Patients may have had several years of neurologic complaints, often including seizures. The lesions are found mostly in the cerebral hemispheres, with a predilection for white matter.
Oligodendrogliomas are infiltrative tumors that form gelatinous, gray masses, and may show cysts, focal hemorrhage and calcification.
On microscopic examination, the tumor is composed of sheets of regular cells with spherical nuclei containing finely granular chromatin (similar to normal oligodendrocytes) surrounded by a clear halo of cytoplasm.
The tumor typically contains a delicate network of anastomosing capillaries. Calcification, present in as many as 90% of these tumors, ranges from microscopic foci to massive depositions.
With increasing cell density, nuclear anaplasia, increased mitotic activity and necrosis, the tumor becomes higher grade (anaplastic oligodendroglioma.)
Patients with oligodendrogliomas have a better prognosis than do patients with astrocytomas.
Current treatment with surgery, chemotherapy, and radiotherapy yields an average survival of 5 to 10 years.
Patients with anaplastic oligodendroglioma have a worse prognosis.
EPENDYMOMAS
Ependymomas most often arise next to the ependyma-lined ventricular system, including the central canal of the spinal cord.
In the first two decades of life, they typically occur near the fourth ventricle and constitute 5% to 10% of the primary brain tumors in this age group.
In adults, the spinal cord is their most common location; tumors in this site are particularly frequent in the setting of neurofibromatosis type 2.
Because ependymomas usually grow within the ventricles. CSF dissemination is a common occurrence.
In the fourth ventricle, ependymomas are typically solid or papillary masses extending from the floor of the ventricle.
These tumors are composed of cells with regular, round to oval nuclei with abundant granular chromatin.
Between the nuclei there is a variably dense fibrillary background.
Tumor cells may form round or elongated structures (rosettes, canals) that resemble the embryologic ependymal canal, with long, delicate processes extending into a lumen. More frequently present are perivascular pseudo-rosettes in which tumor cells are arranged around vessels with an intervening zone consisting of thin ependymal processes directed toward the wall of the vessel.
Anaplastic ependymomas show increased cell density, high mitotic rates, necrosis and less evident ependymal differentiation.
The clinical outcome for completely resected supratentorial and spinal ependymomas is better than for those in the posterior fossa.
|
Pathology
| null |
f7b98d5c-d1b6-4655-9578-e469f14ca54f
|
A patient presents with respiratory distress, hypotension and dilated bulging neck veins after chest trauma, most likely cause is-
|
Hemothorax
|
Tension Pneumothorax
|
Cardiac tamponade
|
Flail chest
| 1b
|
single
| null |
Medicine
| null |
db0f17bc-c137-4334-98ca-6fc7dae6de09
|
Linear coefficient of thermal expansion of metal used for metal ceramic restoration range from:
|
11.5-12.5 x 10-6/°C
|
10.5-11.5 x 10-6/°C
|
13.5-14.5 x 10-6/°C
|
16.5-17.5 x 10-6/°C
| 2c
|
single
|
Most porcelains have coefficients of thermal expansion between 13.0 and 14.0 × 10 −6 /°C, and metals between 13.5 and 14.5 × 10 −6 /°C. The difference of 0.5 × 10 −6 /°C in thermal contraction between metal and porcelain causes the metal to contract slightly more than does the ceramic during cooling. This condition places the porcelain under slight residual compression, which makes it less sensitive to the tensile stresses induced by mechanical loading.
Craig’s Restorative dentistry 14 ed page 222
|
Dental
| null |
17f6ff22-51d8-470a-81d1-1a0e070048f9
|
Peak growth velocity in adolescent girl is indicated by –
|
Breast enlargment
|
Axillary hair
|
Public hair
|
Just before commensement of menarche
| 3d
|
single
|
Mensus typically appears around the peak in height velocity -Nelson
Menarche usually occurs after peak velocity has been attained and as the growth rate begins to decline.
Remember:
Growth acceleration begins in early adolescence, but peak growth velocities are not reached until middle adolescence.
|
Pediatrics
| null |
a55ccc4d-893b-4bd7-a7c9-61a1a4ec6ac3
|
Lichen sclerosus lesions are limited by
|
Vagina
|
Cervix
|
Labia minora
|
Labia majora
| 3d
|
single
|
Lesions of lichen sclerosus are always limited by labia majora.
|
Gynaecology & Obstetrics
| null |
ae4758b9-da05-4030-9f23-d6857bf0a85e
|
A circular bullet wound, erythema seen around the margin, blackening & tattooing present. What is the range?
|
Close shot entry wound
|
Close shot exit wound
|
Distant shot entry wound
|
Distant shot exit wound
| 0a
|
single
|
Ans. (A). Close shot entry wound(Ref: Essentials of Forensic medicine, Dr KS narayana Reddy, 33th Edition, P: 216)Presence of erythema, blackening & tattooing around the wound indicates that it is close shot.
|
Forensic Medicine
|
Injuries
|
7cb6b5e4-7f02-4468-a563-5add6baecc28
|
MPTP (2'-methyl-l, 2, 3, 4'- tetrahydro-carbolines) is a causative factor for
|
Parkinsons disease
|
Schizophrenia
|
Alzheimer's disease
|
Huntingtons chorea
| 0a
|
single
|
(A) Parkinson's # MPTP induces parkinsonism in humans and animal models, whereas the b-carbolines were postulated as possible toxins involved in neurodegeneration.> A so-called 'activation' to toxic pyridinium or b-carbolineum species is required for toxicity, whereas an 'inactivation' may influence the fate of these protoxins in the body potential involvement of peroxidases in neurodegeneration and Parkinson's disease has been already suggested.> Myeloperoxidase occurs at sites of degenerative diseases and neuroinflammation and increases in Alzheimer's disease, and its ablation mitigated PD produced by MPTP neurotoxin in animals.
|
Medicine
|
Miscellaneous
|
5f5fbc6f-a9ec-45a2-9a7e-fbb4569f1496
|
treatment of tardive dyskinesia is
|
dantrolene sodium
|
clonazepam and vitamin E
|
pacitine
|
propanolol
| 1b
|
single
|
TARDIVE DYSKINESIA Involuntary Choreo athetoid movements Involving the face, trunks and limbs M.C SITE-=========== peri oral movements Exacerbated by stress Relieved by rest TREATMENT Benztropine Benzodiazepine Vitamin E Ondansean clozapine Ref. kaplon and Sadock, synopsis of psychiatry, 11 th edition, pg no. 925
|
Anatomy
|
Pharmacotherapy in psychiatry
|
3312cf8d-7a3a-47d6-af99-f9e9583b437d
|
Hodkin lymphoma treatment -
|
ABVD is more commonly used regimen
|
Sterility is common in ABVD regimen
|
WBC > 16 * 109\/L is good prognostic factor
|
None
| 0a
|
multi
|
The ABVD(doxorubicin,bleomycin,vinbalstine, & dacarbazine)is widely used in the treatment of Hodgkin&;s disease .Ihe incidence of sterility is low with this regime. According to Hasenclever prognostic index for Hodgkin&;s disease ,WBC more than 15x10^9/L is a risk factor. Davidson&;s principles & practice of medicine 22nd edition pg no 1043.
|
Medicine
|
Haematology
|
b4403de4-5b4c-4cfb-8138-e10a62b88f95
|
Which of the following is the cut-off value of cervical length at 24 weeks of gestation for prediction of preterm delivery?
|
0.5 cm
|
1.5 cm
|
2.5 cm
|
3.5 cm
| 2c
|
single
|
Factors required for the prediction of preterm labour includes: presence of symptoms of preterm labour, uterine contraction of >= 4 per hour, cervical length <=2.5cm, presence of fibronectin in cervicovaginal discharge between 24-34 weeks, Bishop score >=4, cervical dilation >2cm and effacement of 80%, vaginal bleeding and prior preterm bih. Ref: Textbook of Obstetrics By D.C. Dutta 6th Edition, Pages 314-315
|
Gynaecology & Obstetrics
| null |
c2140877-e454-4e8c-b938-2d30b1839f63
|
True about lucid interval is?
|
Seen in extradural hemorrhage
|
Valid will can be made
|
Can give evidence
|
All of the above
| 3d
|
multi
|
Ans is 'd' i.e. All of the aboveLucid interval* Lucid interval is a state of consciousness between two episodes of unconsciousness in subacute/chronic epidural haemorrhage. It is significant that during this period (lucid interval), the person can:i) Make a valid will,ii) Can give valid evidence, andiii) Is legally responsible for act done (civil/criminal).* Lucid interval is also seen in insanity, i.e. the period of sanity between two phases of insanity.* Lucid intervals may also occur in conditions other than traumatic brain injury, such as heat stroke, mania, melancholia and the postictal phase after a seizure in epileptic patients.
|
Forensic Medicine
|
Law & Medicine, Identification, Autopsy & Burn
|
879b0509-b213-489d-8c6f-c02a7ba862b4
|
Cell mediated immunity is markedly depressed in
|
Tuberculoid leprosy
|
Lepromatous leprosy
|
Polyneuritic form of leprosy
|
Indeterminate leprosy
| 1b
|
single
|
(B) Lepromatous leprosy# In untreated LL patients, lymphocytes regularly fail to recognize either M. leprae or its protein constituents, and lepromin skin tests are negative.> This loss of protective cellular immunity appears to be antigen-specific, as patients are not unusually susceptible to opportunistic infections, cancer, or AIDS and maintain delayed-type hypersensitivity to Candida, Trichophyton, mumps, tetanus toxoid, and even purified protein derivative of tuberculin.> Lepromatous leprosy, has the greatest number of bacilli and is characterized by early, widespread, ill-defined, erythematous or hypopigmented papules and plaques. Later findings include facial infiltration (leonine facies), ocular effects, neurologic involvement, and hypogonadism.
|
Microbiology
|
Misc.
|
746e3587-00d2-4dd6-83e6-ccb6ccfa0d66
|
Schneider's first rank symptom is ?
|
Depresonalization
|
Derealization
|
Audible thoughts
|
Insomnia
| 0a
|
single
|
Ans. is 'c' i.e., Audible thoughts Schneider's first rank symptoms Hallucinations :- Audible thoughts, voices commenting on one's action, voices heard arguing two or more hallucinatory voices discussing the subject in third person (third person hallucination). Thought attention phenomena :- Thought inseion, thought withdrawal, thought broadcasting. Passivity phenomena :- Made feeling (affect), made impulse, mode volition (acts), somatic passivity. Delusional perceptions (Primary delusions).
|
Psychiatry
| null |
7733a36b-0245-4c14-9f3f-34b50409641c
|
Parathyroid Gland accidentally removed and found after surgery is implanted in
|
Sartorius
|
Biceps
|
Brachioradialis
|
Triceps
| 2c
|
multi
|
Ans. (c) BrachioradialisRef: Surgery Sixer 3rd Edition Page 235* Accidentally removed Parathyroid Gland found after surgery in Specimen is kept in non Dominant hand Brachioradialis muscle* If the parathyroid is identified during Surgery it must be inserted in the Sternocleidomastoid muscle pocket.
|
Surgery
|
Pancreas
|
f761a825-3db5-4e0b-954f-3d84762fd1e3
|
Mechanism of action of Triazoles
|
Inhibits cell wall synthesis
|
Inhibits ergosterol biosynthesis
|
Inhibits glucan synthesis
|
Inhibits tubulin
| 1b
|
multi
|
* Triazole antifungals (Fluconazole, Itraconazole, Voriconazole, Posaconazole) inhibit 14-sterol demethylase --> impair the biosynthesis of ergosterol--> resulting in depletion of membrane ergosterol along with accumulation of the toxic product 14-methyl-3,6- diol --> leading to fungal growth arrest. Ref:- Goodman & Gilman Pharmacological Basis of Therapeutics 13th Ed; Pg num:- 1091
|
Pharmacology
|
Chemotherapy
|
6c15dec0-75c5-4d8d-b82a-dfed443ed75e
|
Vasoconstricting mediator is?
|
Prostacyclin
|
Thromboxane-A2
|
PG D2
|
Lipoxins
| 1b
|
single
|
Ans. is 'b' i.e., Thromboxane-A2 Thromboxane-A2 causes vasoconstriction. Other three mediators (given in question) cause vasodilatation.
|
Pathology
| null |
b3d4f9eb-404f-4c7e-a338-d643deae6fc1
|
Diagnostic criteria for SIRS include all except:
|
Hypotension
|
Tachycardia
|
Tachypnoea
|
Leucocytosis
| 0a
|
multi
|
Systemic inflammatory response syndrome (SIRS):Two or more of the following conditionsFever (oral temperature >38 deg C) or hypothermia (<36 deg C)Tachypnea (>24 breaths/min)Tachycardia (hea rate >90/min)Leukocytosis (>12000/micro L), leucopenia (<4000/micro L), or >10% bands(ref:Harrison's 18/e p2223, table 271-1)
|
Medicine
|
All India exam
|
e4162cdb-e542-431e-b457-0bf8793ff80c
|
DNS may be associated with all the following except:
|
Recurrent sphenoiditis
|
Acute otitis media
|
Hyperophy of the inferior turbinate
|
Recurrent maxillary sinusitis
| 0a
|
multi
|
In deted nasal septum, the nasal chamber on the concave side of the nasal septum is wide and shows compensatory hyperophy of turbinates and not atrophy. The sphenoid sinus opens in the sphenoethmoid recess near the roof of nasal cavity and this opening is not affected by DNS.
|
ENT
| null |
d25dcc8e-767d-40e3-a4d6-bc4e405e3161
|
Which of the following is not administered by intradermal route
|
BCG
|
Insulin
|
Mantoux
|
Drug sensitivity injection
| 1b
|
single
|
Refer KDT 6/e p259 Insulin is admistered by s,.c route Insulin is a peptide hormone produced by beta cells of the pancreatic islets; it is considered to be the main anabolic hormone of the body.
|
Pharmacology
|
Kidney
|
5ee1ca8d-7376-4d1d-9516-137351f12b9a
|
All are X-ray findings of retinoblastoma except –
|
Widening of optic canal
|
Intra cerebral calcification
|
Intraocular calcification
|
Secondaries in cranial bones
| 1b
|
multi
|
Retinoblastoma is the most common cause of orbital calcification (nodular or punctate calcification & is favourable prognostic sign).
Enlargement of orbit & orbital canal occurs d/t involvement of optic nerve & intracranial extension.
Metastasizes to meninges, cranial bones, bone marrow, lung, liver, lymph node.
|
Radiology
| null |
ccb3c752-cd27-484a-bb40-d9b5c2e523bc
|
Which amongst the following biological agents has the highest potential for use as a biological weapon for microbial bioterrorism -
|
Plague (Yersinia pestis)
|
Small pox (variola major)
|
Botulism (Cl. botulinum)
|
Brucellosis (Brucella sp)
| 0a
|
multi
|
Plague, smallpox and Botulinum all belong to category 'A' agents of microbial bioterrorism as classified by U.S. Centre for Disease Control and Prevention (CDC). All these agents represent 'high' risk to national security and represent potentially dangerous agents as biological weapons.
‘The highly contagious nature and high mortality of plague make it a close to an ideal agent of bioterrorism, particularly if delivered in a weaponized form.'
|
Microbiology
| null |
c04b0ed6-6291-48fc-82f4-0412f29961fb
|
Donor Breast milk is known to transmit all EXCEPT: September 2012
|
Tuberculosis
|
CMV
|
HIV
|
Rubella
| 3d
|
multi
|
Ans. D i.e. Rubella
|
Gynaecology & Obstetrics
| null |
8ae92537-5a84-44d9-b536-29d7dc534360
|
Gastric motility decreases in A/E:
|
Diabetes
|
Upper abdominal surgery
|
Stroke
|
Hypehyroidism
| 3d
|
single
|
Answer is D (Hypehyroidism): Hypehyroidism is associated with increased gastric and intestinal motility while Hypothyroidism is associated with decreased gastric and intestinal motility. Hypehyroidism Hyperrnotilitv: diarrhea or steatorrhea Hypothyroidism Decreased motility: reflux, bezoars, ileus, constipation
|
Medicine
| null |
ab08b548-3783-468c-9522-70c94d5470c6
|
A child having H/0 profuse watery diarrhoea not taking oraly and not passed urine since 2 days, what to be given
|
Milk
|
ORS
|
I.V. fluid
|
I.V. antibiotic
| 2c
|
single
|
Ans. is 'c' i.e., I.V. fluid Child having history of profuse watery diarrhoea with poor oral intake and not passed urine since 2 days is suffering from diarrhoea with dehydration and probably acute renal failure of pre renal types. Here best choice is intravenous I.V. fluid If I.V. access not possible, then you can give feed through Ryle's tube or intra osseous fluid.
|
Pediatrics
| null |
4cdb02b9-c590-43c1-bd29-98b3f5974d9a
|
Which is not a biological derivative of tyrosine?
|
Melanin
|
Melatonin
|
Epinephrine
|
Dopamine
| 1b
|
single
|
Uses of tyrosine: =Melatonin is formed from tryptophan not from tyrosine Tip to remember:- Tyrosine (smaller name) - Melanin (smaller name) Tryptophan (bigger name) - Melatonin (bigger name) Extra information:- Phenylalanine is conveed to tyrosine by enzyme Phenylalanine Hydroxylase. Therefore tyrosine is non-essential as it can be synthesized in body from phenylalanine. Other uses of tryptophan are- Synthesis of vitamin B3 and serotonin
|
Biochemistry
|
Classification and metabolism of amino acids
|
23de5102-3514-44e6-ab21-a6eea2a5ff38
|
All of the following syndromes are associated with AML except -
|
Down's syndrome
|
Klinefelter's syndrome
|
Patau syndrome
|
Turner's syndrome
| 3d
|
multi
|
Ans. is 'D' i.e., Turner's syndrome Risk Factors of AML: Genetic disorders :Down syndrome ,Klinefelter syndrome ,Patau syndrome ,Ataxia telangiectasia, Shwachman syndrome ,Kostman syndrome, Neurofibromatosis ,Fanconi anemia ,Li-Fraumeni syndrome Physical and chemical exposures: Benzene Drugs such as pipobroman, Pesticides ,Cigarette smoking, Embalming fluids. Herbicides. Radiation exposure :Nontherapeutic, therapeutic radiation Chemotherapy :Alkylating agents ,Topoisomerase-II inhibitors, Anthracyclines, Taxanes
|
Pediatrics
| null |
fa771dfa-b8c5-4275-9929-690fe2947f7f
|
La belle indifference is seen in -
|
Conversion reaction
|
Schizophrenia
|
Mania
|
Depression
| 0a
|
single
|
In conversion (dissociative) disorder, inspite of the severity of symptoms many patients are indifferent to their presence. It is referred to as la belle indifference.
|
Psychiatry
| null |
8327c781-7947-42ca-833c-6e87a68b4203
|
'Telephone Handle' long bones are seen in:
|
Achondroplasia
|
Thanatophoric dwarfism
|
Mucopolysaccharidosis
|
Acromegaly
| 0a
|
single
|
Ans. Thanatophoric dwarfism
|
Radiology
| null |
38a92459-2d58-4217-aa74-db4b5d89b26b
|
In acoustic neuroma, the earliest ocular finding is -
|
Diplopia
|
Ptosis
|
Loss of pupillary reflex
|
Loss of corneal reflex
| 3d
|
single
|
Earliest nerve involved by acoustic neuroma - Vth nerve/trigeminal nerve.
The earliest manifestation of Vth nerve involvement is decreased corneal sensitivity leading to loss of corneal reflex.
|
ENT
| null |
6ef7f690-c913-48b9-b84b-bb60565f78e9
|
Gingival fluid from diabetics contain a reduce level of cyclic adenosine monophosphate which may lead to
|
Increased severity of gingival inflammation
|
Decreased severity of gingival inflammation
|
No response on gingiva
|
Epithelial desquamation
| 0a
|
single
| null |
Dental
| null |
bf796a51-fd7a-49d4-9324-233692eae28d
|
More than 50% of Poly Unsaturated Fatty Acid is seen in all, except:
|
Mustard oil
|
Soybean oil
|
Safflower oil
|
Corn oil
| 0a
|
multi
|
>50% PUFA Soybean oil Safflower oil Corn oil Palm oil Ref: Park, 20th Edition, Page 528
|
Social & Preventive Medicine
| null |
63d0a3b7-0bef-4f10-a8d0-8007c335ef1e
|
All are true about brown sequard syndrome except
|
Contralateral loss of joint sensation
|
Ipsilateral loss of pain & temperature
|
Segmental sign are bilateral
|
All of the above
| 3d
|
multi
|
Brown-Sequard syndrome is an incomplete spinal cord lesion characterized by a clinical picture reflecting hemisection injury of the spinal cord, often in the cervical cord region. The effects of hemisection of the spinal cord can be described in two-stage: - immediate effects Immediate effects following hemisection of the spinal cord are those of 'spinal shock'. - late effects If the patient survives, typical motor and sensory changes develop after recovery from the spinal shock. These changes constitute the Brown-Sequard syndrome and can be described as ~ changes at the level of section, ~ changes below the level of section, ~ changes above the level of section Ref: guyton and hall textbook of medical physiology 12 edition page number:691,692,693
|
Physiology
|
Nervous system
|
f6afdd95-1282-483f-9b44-4fecaff1d4de
|
Tumour marker of endodermal sinus tumour of ovary :
|
a feto proteins
|
CA 125
|
HCG
|
CEA
| 0a
|
single
|
a feto proteins
|
Gynaecology & Obstetrics
| null |
5f52d5cc-3afa-4ff2-aae4-c69189140039
|
Peripheral neuropathy as a side effect is caused by which of the following anti cancer drugs :
|
Vincristine
|
Cyclophosphamide
|
Etoposide
|
Irinotecan
| 0a
|
single
| null |
Pharmacology
| null |
713b14f0-f0bf-4363-b319-de71883959af
|
Which of the structure in central nervous system where the major autonomic reflex centers are found?
|
Cerebellum
|
Medulla oblongata
|
Hypothalamus
|
Thalamus
| 1b
|
single
|
The medulla oblongata, commonly called the medulla, is located at the level of the foramen magnum. It serves as the major autonomic reflex center that relays visceral motor control to the hea, blood vessels, respiratory system, and gastrointestinal tract. It possesses the nuclei for the glossopharyngeal, vagal, accessory, and hypoglossal nerves (CNN IX, X, XI, and XII, respectively). Ref: Moon D.A., Foreman K.B., Albeine K.H. (2011). Chapter 16. Brain. In D.A. Moon, K.B. Foreman, K.H. Albeine (Eds), The Big Picture: Gross Anatomy.
|
Anatomy
| null |
44089053-e052-49d6-abde-58cc2b389bee
|
A 70-year-old man presents with h/o prosopagnosia, loss of memory, 3rd person hallucinations since 1 month. On examination deep tendon reflexes are increased, mini-mental examination score is 20/30. What is most likely diagnosis?
|
Dissociative amnesia
|
Schizophrenia
|
Alzheimer's disease
|
Psychotic disorder
| 2c
|
multi
|
The presence of loss of memory, prosopagnosia (difficulty in identifying face) in a 70 year old man is quite suggestive of Alzheimer's disease. Third person auditory hallucinations are usually seen in schizophrenia; however they can be present in Alzheimer's disease too. Fuher on examination, deep tendon reflexes are increased, which again can be seen in late stage of Alzheimer's disease. Finally MMSE score below 24 seals the diagnosis.
|
Psychiatry
|
Organic Mental Disorders
|
21a80d42-ec74-45d7-9024-d9985f7c898d
|
If a claw hand develops in a patient with Leprosy, the deformity is –
|
Grade 0
|
Grade I
|
Grade II
|
Grade III
| 2c
|
single
|
Deformities in leprosy
The findings of the examination are first noted in the disability assessment form separately for right and left eyes, hands and feet. Thereafter each eye, each hand and each foot is given its own grade. Deformities are classified into three grades. The criteria are as follows :
|
Dental
| null |
a9c80a19-451c-4750-941c-6190bd562b11
|
Histological appearance of scleroderma include all except
|
Extensive fibrosis of upper 1/3 of the dermis
|
Decreased adnexal structure.
|
Homogenization of collagen
|
Increased dermis thickness
| 0a
|
multi
|
Ans: A Extensive fibrosis of upper 1/3 of the dermis Mucin deposition is a feature of metabolic diseases like pretibial myxedema, scleroderma and lichen myxedematosis. Microscopy appearance of scleroderma- Thinning of epidermis, extensive fibrosis of lower 2/3 of dermis, replacement of subcutaneous fat, homogenization of collagen and decreased adnexal structure.
|
Unknown
| null |
c9a5da49-d82a-4fa2-b110-d9bb14dc6ee3
|
The posterior palatal seal for a maxillary complete denture:
|
Is placed immediately posterior to the vibrating Line
|
placed immediately anterior to the vibrating tine
|
Is not necessary if a metal base is made
|
Will vary in outline and depth according to the palatal form
| 3d
|
single
| null |
Dental
| null |
d6a3097a-3b46-471f-90b9-ae778c56a3f7
|
C in CRP stands for-
|
Concanavalin A
|
Chondrotin sulfate in series with ARP, BRP
|
Capsular polysaccharide of pneumococcus
|
Cellular
| 2c
|
single
|
CRP is an acute phase reactant synthesized primarily by the liver. C in CRP stands for Capsular polysaccharide of pneumococcus pneumococcus is a causative agent of pneumonia, meningitis and otitis media in sera of patients with acute inflammation, a beta-globin appears that precipitates with pneumococcal C-antigen ref apurba sankar sastry microbiology page 232
|
Pathology
|
General pathology
|
5f28a057-9075-4c8b-9cd0-8da4edce0b2f
|
Zinc dose in 8 months infants -
|
10 mg/kg x 10 days
|
20 mg/kg x 10 days
|
10 mg/kg x 14 days
|
20 mg/kg x 14 days
| 3d
|
single
|
Ans. is 'd' l.e., 20 mg/kg x 14 days
|
Pediatrics
|
Micronutrient Mineral Deficiencies
|
f19e20a7-8ef4-44f9-9c22-f6ea6ef2dd80
|
Treatment of mooren's ulcer is?
|
Topical steroids
|
Corneal graft
|
Immunosuppressives
|
All of the above
| 3d
|
multi
|
Ans. (d) All of the aboveRef : A.K. Khurana 6th ed. /116, 4th Ed./109-110MOOREN'S ULCER* Moorens Ulcer/ chronic serpiginous or rodent ulcer is a severe inflammatory peripheral ulcerative keratitis.* Treatment:# Topical corticosteroids# Immunosuppressives with systemic steroids, e.g. cyclosporine# Soft contact lens# Lamellar or full thickness corneal grafting.
|
Ophthalmology
|
Inflammations of the Cornea
|
3f2f00c9-aa59-4fd0-bc58-f7e95bbfb1e6
|
Most common cause of chronic retropharyngeal abscess
|
Infective foreign body
|
Caries teeth
|
Caries of cervical spine
|
Suppuration of retropharyngeal lymph node
| 2c
|
single
|
CHRONIC RETROPHARYNGEAL ABSCESS (PREVEEBRAL ABSCESS) AETIOLOGY :- It is tubercular in nature and is the result of (i) caries of cervical spine or (ii) tuberculous infection of retropharyngeal lymph nodes secondary to tuberculosis of deep cervical nodes. Ref:- Dhingra; pg num:-266,267
|
ENT
|
Pharynx
|
80743579-7b0b-4df2-a10a-04e4f2311aa7
|
A thirty year man presented with nausea, fever and jaundice of 5 days duration. The biochemical tests revealed a bilirubin of 6.7 mg/dl (conjugated 5.0 mg/dl) with SGOT/SGPT (AST/ALT) of 1230/ 900 IU/ml. The serological tests showed presence of HBsAg, IgM anti HBc and HBe Ag. The most likely diagnosis -
|
Chronic hepatitis B infection with high infectivity
|
Acute hepatitis B infection with high infectivity
|
Chronic hepatitis B infection with low infectivity
|
Acute hepatitis B infection with low infectivity
| 1b
|
single
| null |
Microbiology
| null |
6e0f3164-bdf3-4de8-b9b7-32f5b4a82867
|
Drug inhibiting release of Ach at myoneural junction is
|
Botulinum toxin
|
Hemicholinum
|
Atropine
|
Vesamicol
| 0a
|
single
|
Ans) a ( Botulinum toxin) Ref Goodman & Gilman 11th ed, KDT 5th ed page 76Two toxins interfere with cholinergic transmission by affecting release. Boutilinum toxin inhibit release, while black widow spider toxin induces massive release and depletion. The site on the presynaptic nerve terminal for block of ACh release by botulinum toxin; death usually results from respiratory paralysis unless patients with respiratory failure receive artificial ventilation.Injected locally, botulinum toxin type A is used in the treatment of certain ophthalmological conditions associated with spasms of ocular muscles (e.g., strabismus and blepharospasm) and for a wide variety of unlabeled uses ranging from treatment of muscle dystonias and palsy to cosmetic erasure of facial lines and wrinklesHemicholinium, a synthetic compound, blocks the transport system by which choline accumulates in the terminals of cholinergic fibers, thus limiting the synthesis of the ACh store available for release.Vesamicol blocks the transport of ACh into its storage vesicles, preventing its release.
|
Pharmacology
|
A.N.S.
|
f0518b79-bef3-480d-93cd-38156c7b0dc6
|
The point of intersection of dorsal contours of Mandibular processes
|
Supramentale
|
Articulare
|
Condylion
|
Pterygomaxillary point
| 1b
|
single
| null |
Dental
| null |
f3433ee1-7bcb-4eec-8f06-1e9ebeae68df
|
In - vitro feilisation is indicated in :
|
Anovulatory cycles
|
Tubal block
|
Azoospermia
|
Uterine anomalies
| 1b
|
single
|
Tubal block
|
Gynaecology & Obstetrics
| null |
3cbc68e7-f27c-4339-aa66-0e9fbb8db491
|
Near double stranded DNA among the following
|
Hepatitis A
|
Hepatitis B
|
Hepatitis C
|
Hepatitis D
| 1b
|
single
|
(B) Hepatitis B # Genome of HBV is made of circular DNA, but it is unusual because the DNA is not fully double-stranded.> One end of the full length strand is linked to the viral DNA polymerase.> The genome is 3020-3320 nucleotides long.
|
Microbiology
|
Misc.
|
731cfb8a-bccb-4508-900c-0a5023ba7f5f
|
Drug containing two sulfhydryl groups in a molecule?
|
BAL
|
EDTA
|
Pencillamine
|
None of the above
| 0a
|
multi
|
Ans. is 'a' i.e., BAL o Dimercaprol (British Anti-Lewisite, BAL) contains two sulfahydryl groups. Note - Penicillamine has one SH group.
|
Pharmacology
| null |
a85a5ab1-e2f6-4f89-8d94-f56e6d4a6ccd
|
Unilateral middle ear serous effusion in an adult, most common cause ?
|
TB
|
Foreign body
|
Nasopharyngeal carcinoma
|
CSOM
| 2c
|
single
|
Ans. is 'c' i.e., Nasopharyngeal carcinoma "In adults presenting with a unilateral middle ear effusion the possibility of a nasopharyngeal carcinoma should be considered-- Current otolaryngology 2"d/e p. 659 "A high incidence of NPC (Nasopharyngeal carcinoma) in South East Asia and Southern China correlates with the high incidence of OME (otitis Media with Effusion) in adults in these regions". - Scott Brown 7"d/e Vol III p. 3389
|
ENT
| null |
98284bc3-e30f-472c-80f2-677290760962
|
True about Stein-Leventhal syndrome is/are:a) Oligomenorrhea & amenorrheab) Seen in post - menopausal womenc) Innumerate cysts in ovary d) BRCA -1 is associatede) Theca cell hypertrophy
|
acd
|
ace
|
cde
|
ade
| 1b
|
multi
|
• There is no doubt that PCOD causes oligomenorrhea/amenorrhea, i.e. option ‘a’ is correct.
• PCOS is seen in young females. Most common age affected is 15–25 years. and not postmenopausal, so option ‘b’ is incorrect.
• Pathologically – Ovaries are enlarged (2–5 times the normal size). Tunical albuginea is thickened. There is Theca cell hypertrophy (stromal hyperthecosis) and multiple follicular cysts are localized along the surface of ovary (i.e. options ‘c’ and ‘e’ are correct).
• BRCA - 1 is not associated with PCOD.Q (i.e. options ‘d’ is incorrect)
• BRCA - 1 gene has been located at the chromosomal locus 17q21; women who inherit a mutated allele of this gene from either parent have an approx. 60-80% lifetime chance of developing Breast Ca and about 33% chance of developing Ovarian Ca.
• Men who carry a mutant allele of the gene of BRCA-1 have an increased incidence of Prostate Ca, but not usually of Breast Ca.
• BRCA - 2 gene which has been located to chromosome 11, is associated with an increased incidence of Breast Ca in both men and women.
|
Gynaecology & Obstetrics
| null |
a5708b45-9627-493e-a03f-050f91132865
|
Which of the following is not an absolute contraindication for corneal transplantation?
|
TB meningitis
|
Rabies
|
Death due to unknown cause
|
SSPE
| 0a
|
single
|
Ans. a. TB meningitis
|
Ophthalmology
| null |
439aeb9e-157f-487c-adc2-da8d74876b73
|
Sociology is
|
Study of human relationship
|
Study of human behavior
|
Both
|
None of the above
| 2c
|
multi
|
Sociology deals with the study of human relationships and of human behavior for a better understanding of the pattern of human life. It is also concerned with the effects on the individual of the ways in which other individuals think and act.Ref: Park; 23rd ed; Pg 670
|
Social & Preventive Medicine
|
Social science, Mental health & Genetics
|
cc8a975c-9995-41fe-a5c6-d16ce0a04d4f
|
The most common underlying anomaly in a child with recurrent urinary tract infections is:
|
Posterior urethral valves
|
Vesicoureteric reflux
|
Neurogenic bladder
|
Renal calculi
| 1b
|
single
|
Ans. is 'b' i.e. Vesicoureteric refluxRef. O.P. Ghai 6th/e p457 (5th/e 374, 375), Nelson 17th/e, p 1790-1794 (16th/e page 1624, 1636)According to Nelson "the most common abnormality seen in a child with UTI in a voiding cystourethrogram is vesicoureteric reflux. It is identified in approximately 40% of patients".Some students were in favour of posterior urethral valves. Make it clear that the chief complain of posterior urethral valve is not UTI but poor urinary stream. Posterior urethral valve mainly presents with obstructive uropathy.Also rememberGrade I: reflux into a nondilated ureter.Grade II: reflux into the upper collecting system without dilatation.Grade III: reflux into dilated ureter and/or blunting of calyceal Fornices.Grade IV: reflux into a grossly dilated ureter.Grade V: massive reflux, with significant ureteral dilatation and tortuosity and loss of the papillary impression.Grading of Vesico ureteral reflux
|
Pediatrics
|
Urinary Tract Infections
|
b9f3c15b-bf15-45a3-a2a6-07c137e80d3a
|
Which of the following type of aneurysm is associated with adult polycystic kidney disease?
|
Berry aneurysms in Circle of Willis
|
Saccular aneurysms of aoa
|
Fusiform aneurysms of aoa
|
Luetic aneurysms
| 0a
|
single
|
Patients with ADPKD have a 2-4 fold increased risk subarachnoid or cerebral hemorrhage from ruptured berry aneurysm in the circle of Willis. Saccular aneurysms of the anterior cerebral circulation may be detected in up to 10% of asymptomatic patients on magnetic resonance angiography (MRA) screening. Patients at risk for hemorrhage are: Age more than 50 Family history of intracranial hemorrhage Aneurysms more than 10mm Uncontrolled hypeension Other extrarenal manifestations of ADPKD are: Mitral valve prolapse and aoic regurgitation Hepatic cysts Colonic diveicula Abdominal wall and inguinal hernias Ref: Harrison's Principles of Internal Medicine 18e chapter 284.
|
Pathology
| null |
8e15e1af-1fd1-4be8-aa64-af0cd7748572
|
The Earliest sign of male pubey is
|
Pubic hair
|
Axillary hair
|
Hoarseness of voice
|
Testicular enlargement
| 3d
|
single
|
In boys, the first visible sign of pubey and hallmark of SMR2 is testicular enlargement, beginning as early as 9 1/2 years. This is followed by penile growth during SMR3. Peak growth occurs when testis volumes reach approximately 9-10 cm3 during SMR4. Under the influence of LH and testosterone, and prostate enlarges. The left testis normally is lower than the right. Some degree of breast hyperophy, typically bilateral, occurs in 40-65% of boys during SMR2-3 due to a relative excess of estrogenic stimulationIn girls, the first visible sign of pubey and the hallmark of SMR2 is the appearance of breast buds, between 8 and 12 years of age. Menses typically begins 2-2 1/2 years later, during SMR3-4 (median age, 12 years; normal range, 9-16 years), around the peak height velocity. Less obvious changes include enlargement of the ovaries, uterus, labia, and clitoris, and thickening of the endometrium and vaginal mucosa
|
Microbiology
|
All India exam
|
c4b1e706-479d-4b53-aeb3-97af4806a631
|
A patient of 45 yrs old Having ahritis with involvolvement of PIP 4 DIP and 9 MCP and sparing of wrist and ankle diagnosis ?
|
osteoahritis
|
Rheumatoid Ahritis
|
Psoriatic ahritis
|
GouT
| 0a
|
single
|
# Osteoahritis is a non-inflammatory, degenerative condition of joints Characterized by degeneration of aicular cailage and formation of new bone is. osteophytes. Primary OA # More common than secondary OA # Cause --Unknown # Common-in elders where there is no previous pathology. # Its mainly due to wear and tear changes occuring in old ages mainly in weight bearing joints. SECONDAY OA : # Due to a predisposing cause such as: linjury to the joint 2.Previous infection 3. RA 4.CD 5. Deformity 6.Obesity 7.hypehyriodism Clinical features * Pain and tenderness -- Usually slow onset of discomfo, with gradual and intermittent increase -- Pain is more on wt. bearing due to stress on the synol membrane & later on due to bone surface,which r rich in nerve endings coming in contact. -initially relieved by rest but later on disturb sleep. -Diffuse/ sharp and stabbing local pain * Movement abnormalities - &;Gelling&;: stiffness after periods of inactivity, passes over within minutes (approx 15min.) of using joint again -- Coarse crepitus: palpate/hear (due to flaked cailage & eburnated bone ends) -- Reduced ROM: capsular thickening and bony changes in joint,ms. Spasm or soft tissue contracture. REF : MAHESWARI 9TH ED
|
Orthopaedics
|
All India exam
|
88583589-3126-49ce-b502-07c7fd8f5c63
|
In a subclan aery block at outer border of 1st rib, all of the following aeries help in maintaining the circulation to upper limb, EXCEPT?
|
Subscapular aery
|
Superior thoracic aery
|
Thyrocervical trunk
|
Suprascapular aery
| 1b
|
multi
|
A rich anastomosis exists around the scapula between branches of subclan aery (first pa) and the axillary aery (third pa). This anastomosis provides a collateral circulation through which blood can flow to the limb when the distal pa of subclan aery or the proximal pa of axillary aery is blocked. Scapular anastomoses occur between the following branches of proximal subclan and distal axillary aery: Branches of Subclan aery: Thyrocervical trunk, Suprascapular and Deep branch of transverse cervical.Branches of Axillary aery: Subscapular, Posterior circumflex humeral and Thoracoacromial aeires.
|
Anatomy
| null |
8a3c2f7e-7873-46c5-9a17-db3131bb6f87
|
A 30-year-old woman with a history of intravenous drug abuse is admitted to a hospital for rapidly progressive malaise, fever, and chills. On physical examination, subungual splinter hemorrhages and a systolic murmur are detected. Blood cultures are positive for Staphylococcus aureus. She died of myocardial infarction on her third hospital day. Which of the following was the underlying condition leading to the patient's demise?
|
Acute infective endocarditis
|
Carcinoid hea disease
|
Libman-Sacks endocarditis
|
Nonbacterial thrombotic endocarditis
| 0a
|
single
|
Infective endocarditis leads to formation of bulky and friable vegetations on the valvular leaflets. The vegetations are composed of fibrin, neutrophils, and colonies of bacteria that cause erosion of underlying cardiac structures. Fragments of infected vegetations may detach and cause pulmonary or systemic septic embolism. Splinter hemorrhages in the nail bed and petechiae in skin and mucosae are also due to microscopic septic emboli. In this case, myocardial infarction was probably due to a septic embolus in the coronary circulation. If infective endocarditis is due to a virulent organism such as Staphylococcus aureus (a common cause of endocarditis in intravenous drug abusers), a tumultuous clinical course ensues, associated with high moality. With less virulent organisms, such as Streptococci viridans, Subacute infective endocarditis is the resultant clinical picture. Subacute endocarditis arises in patients with previously malformed or damaged valves and is associated with a slower course and a better prognosis. Also Know: Carcinoid hea disease is caused by serotonin-producing carcinoids in the liver or lungs. Fibrosis of the endocardium ensues, affecting the right hea in the case of hepatic carcinoids and the left hea for pulmonary carcinoids. Thickening and rigidity of valvular leaflets are characteristic gross findings. Libman-Sacks endocarditis is a non-infective form of endocarditis associated with systemic lupus erythematosus (SLE). The vegetations are small and regularly aligned along the valvular margins. Nonbacterial thrombotic endocarditis was previously known as marantic endocarditis, being associated with debilitating conditions such as disseminated neoplasms. Increased coagulability is probably the underlying pathogenesis. The lesions are small vegetations similar to Libman-Sacks endocarditis. Clinical and Laboratory Features of Infective Endocarditis (Frequency,%) Fever 80-90 Chills and sweats 40-75 Anorexia, weight loss, malaise 25-50 Myalgias, ahralgias 15-30 Back pain 7-15 Hea murmur 80-85 New/worsened regurgitant murmur 20-50 Aerial emboli 20-50 Splenomegaly 15-50 Clubbing 10-20 Neurologic manifestations 20-40 Peripheral manifestations (Osler's nodes, subungual hemorrhages, Janeway lesions, Roth's spots) 2-15 Petechiae 10-40 Anemia 70-90 Leukocytosis 20-30 Microscopic hematuria 30-50 Elevated erythrocyte sedimentation rate 60-90 Elevated C Reactive protein level >90 Rheumatoid factor 50 Circulating immune complexes 65-100 Ref: Karchmer A.W. (2012). Chapter 124. Infective Endocarditis. 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.
|
Pathology
| null |
92cf3158-85fc-492b-b064-b03f1f70d773
|
A patient of acute leukemia is admitted with febrile neutropenia. On day four of being treated with broad spectrum antibiotics, his fever increases. X-ray chest shows bilateral fluffy infiltrates. Which of the following should be the most appropriate next step in the management?
|
Add antiviral therapy
|
Add antifungal therapy
|
Add cotrimoxazole
|
Continue chemotherapy
| 2c
|
multi
|
The Patient's history of acute leukemia with febrile neutropenia is suggestive of Immunocompromised state The clue to the diagnosis here is fluffy chest infiltrate which are seen in Pneumocystis carinii pneumonia. The treatment of choice for Pneumocystis carinii pneumonia is Cotrimoxazole
|
Microbiology
|
Mycology
|
ff5155b6-1d41-41b6-993f-653526884b94
|
Retractile mesenteris may be seen in:
|
Ormond's disease
|
Gardner's disease
|
Turner's syndrome
|
Down's syndrome
| 0a
|
single
|
Retractile Mesenteritis Retroperitoneal fibrosis has been associated with a variety of sclerosis disease, among these is a variant known as retractile mesenteritis Involve predominantly the mesentry of small intestine and associated vessels, involvement of mesocolon and colon is less frequent. Ref: Schwaz 10th edition Pgno: 1458
|
Surgery
|
G.I.T
|
791cff6e-e457-485e-b180-78c267764091
|
False about acute aluminum phosphide poisoning
|
Subendocardial infarct
|
Produce phosphine gas
|
Inhibit mitochondrial cytochrome oxidase
|
Esophageal stricture
| 3d
|
multi
|
Aluminum (zinc) phosphide or celphos poisoning liberates phosphine gas which inhibits mitochondrial cytochrome oxidase, respiratory chain enzymes and electron transport system. It is a systemic poison and kills most of patients with in 24 hours secondary to cardiovascular collapse due to direct myocardial toxic effect.
Esophageal strictures and fistula occur in few survivors (which are already very few) in late stages. So this is late complication of least occurrence (among other options).
|
Forensic Medicine
| null |
d65ade7a-0f33-40a8-a229-e945717f69ee
|
Drug used for Buerger's disease:
|
Xanthinol nicotinate
|
Propranolol
|
CCBs
|
All of the above
| 0a
|
multi
|
Xanthinol Nicotinate Xanthinol nicotinate (or xanthinol niacinate or complamina) is a vasodilatorQ. It is a combination of xanthinol and niacin (nicotinic acid) This vasodilator is used in the treatment of Raynaud's phenomenon and Buerger's disease. All other forms of pharmacologic treatment have been generally ineffective in the treatment of Buerger's disease, including, steroids, calcium channel blockers, reserpine, vasodilators, antiplatelet drugs.
|
Surgery
|
Aerial disorders
|
59c271a3-d6d7-44a8-b4b8-23510e08b0fd
|
All are features of ileocecal tuberculosis except?
|
Pulled Up Cecum
|
Fleischner Sign
|
Goose Neck Deformity
|
Wind-Sock Appearance of duodenum
| 3d
|
multi
|
* Wind Sock Appearance of Duodenum is seen with intraluminal diveiculum of duodenum. Goose neck deformity occurs due to contracted, cicatrized, and pulled-up cecum as well as straightening of the terminal ileum seen in ileocecal tb . The 'Fleischner sign'(also known as the 'inveed umbrella sign'), refers to a widely gaping, thickened, patulous ileocaecal valve and a narrowed, ulcerated terminal ileum associated with tuberculous involvement of the ileocaecum.
|
Radiology
|
Gastrointestinal Radiology
|
c6213c2f-c03f-46a1-8e7a-2f431e09784a
|
Trismus in oral cancer patients is severe in those treated with -
|
Surgery and Radiotherapy
|
Chemotherapy alone
|
Surgery alone
|
Not related to treatment
| 0a
|
single
|
Restriction to mouth opening, including restrictions caused by trauma, surgery or radiation.
Implications : Reduced nutrition due to impaired mastication, difficulty in speaking, and compromised oral hygiene.
Often observed in persons who have received radiation to the head and neck, in conjunction with difficulty in swallowing.
Limited jaw mobility can result from trauma, surgery, radiation treatment, or even TMJ problems.
Radiation that affects the temporomandibular joint, the pterygoid muscles, or the masseter muscle, is most likely to result in trismus.
Some patients who have not received radiation treatment may develop trismus secondary to scarring and edema after surgery.
|
Surgery
| null |
cabffc0c-6fa2-4a8f-9f83-95058c72490d
|
What do you understand by the term secular trend-
|
Long term changes
|
Sho long term changes
|
Seasonal Changes
|
Periodical changes
| 0a
|
single
|
The term secular trend implies changes in the occurrence of disease(i.e. A progressive increase or decrease)over a long period of time, generally several years or decade. (refer pg no:66 park textbook 23 rd edition)
|
Social & Preventive Medicine
|
Epidemiology
|
748dac85-411d-4783-bb6f-9ce171ef0a17
|
True about Intercalated Disc is :-
|
Appear as straight bands
|
Shows Gap Junctions
|
Stain dark to Hematoxilin
|
All of above
| 3d
|
multi
|
The Cardiac Muscle develops by joining the cells end to end through anchoring cell junctions called the Intercalated Discs that form the distinguishing feature of Cardiac Muscles. These Dark Staining discs found at irregular intervals and represent the specialized junctional complexes between the cardiac muscles. They appear as Straight bands or Staggered across individual fibers. Inter-digitating intercalated discs are composed of Fascia adherens, Desmosomes, and Gap Junctions.
|
Anatomy
|
Cailage tissue & cell junctions
|
1dc514da-3246-40f3-b343-3d6aa403078c
|
All is exempted from oral testimony except-
|
Dying declaration
|
Medical evidence of injury as witness
|
Chemical examination report
|
Evidence of medical expert in lower court
| 1b
|
multi
|
Oral testimony is not required in:-
Dying declaration.
Deposition of medical witness taken in lower court.
Evidence given by a witness in a previous judicial proceedings.
Expert opinion expressed in a treatise (ex. book).
Report of a certain government scientific experts eg. chemical examiner, assistant chemical examiner, chief inspector of explosive, director of finger print bureau.
Statement by persons who cannot be called as witness (the person is either dead, untraceable or has become incapable of giving evidence or cannot be called without unreasonable delay or expense to the court).
|
Forensic Medicine
| null |
90d3f27a-e4f6-4cef-a858-3e03c9dabd90
|
Which activity will be difficult to perform for a patient with an anterior cruciate deficient knee joint-
|
Walk downhill
|
Walk uphill
|
Sit cross leg
|
Getting up from sitting
| 0a
|
single
|
It has been explained that ACL is taut in extension, and prevent anterior gliding of tibia an femur. When one walks downhill, he tries to keep the knee in extension to maintain the balance and In extension, ACL is required to prevent anterior gliding of tibia. Therefore a person with ACL deficient knee will have difficulty in going downhill.
Opposite is true for PCL. When one climbs upstairs, he keeps the knee in flexion most of the time. PCL is taut in flexion and prevent posterior gliding of tibia. Therefore PCL deficient knee will have difficulty in climbing upstairs.
|
Orthopaedics
| null |
8ddf6b5d-9461-4a72-be80-61299e00707b
|
Turban epiglottitis is a clinical finding in -
|
Tubercular laryngitis
|
Tubercular pharyngitis
|
Polypoid degeneration of vocal cord
|
Subglottic hemangioma
| 0a
|
single
|
Ans. is 4a' i.e.. Tubercular laryngitis Laryngeal examination in TB lary ngitiso Hyperaemia of the vocal cord in its whole extent or confined to posterior part with impairment of adduction is the first sign.o Swelling in the interarytenoid region giving a mammilated appearance,o Ulceration of vocal cord giving mouse-nibbled appearance.o Superficial ragged ulceration on the arytenoids and interarytenoid region,o Granulation tissue in interarvtenoid region or vocal process of arytenoid,o Pseudoedema of the epiglottis 'Turban epiglottis",o Swelling of ventricular bands and aryepiglottic folds,o Marked pallor of surrounding mucosa.
|
ENT
|
Infections and Inflammatory Conditions
|
1bb82f31-3305-4601-9dc3-9f856858454b
|
Which organ does not move with respiration
|
Kidney
|
Liver
|
Stomach
|
Pancreas
| 3d
|
single
|
Pancreas is a retroperitoneal organ and is immobile on respiration.
|
Medicine
| null |
5eb499d7-071c-4830-83e1-a5f66da75d7c
|
True regarding child labor act-
|
True regarding child labor act-
|
does not include children in wool cleaning
|
Does not include children in cashew descalding and processing
|
Excludes school based activities
| 3d
|
multi
|
Ans. is 'd' i.e., Excludes school based activities Child labour act (1986) o Except in the process of family-based work or recognized school-based activities, children are not permitted to work in occupations concerned with :- Li Passenger, goods mail transpo by railways q Carpet weaving Cinder picking, cleaning of ash-pits Cement manufacturing Building construction operations Cloth printing a Dyeing, weaving Manufacturing of matches, explosives, fire-works Beedi making Mica cutting, splitting Abattoirs Wool cleaning Printing Cashew descalding and processing Soldering process in electronic industries o This act includes children less than 15 years of age
|
Social & Preventive Medicine
| null |
368f3bfa-87b2-4e7c-b853-9cd7f7710c03
|
Alcoholic paranoia is associated with:
|
Fixed delusions
|
Hallucinations
|
Drowsiness
|
Impulsivity
| 0a
|
multi
|
Alcoholic paranoia usually presents with delusion of infidelity (also known as morbid jealousy). Patient with delusion of infidelity has a false belief that his paner/spouse is having an affair.
|
Psychiatry
|
Schizophrenia Spectrum and Other Psychotic Disorders
|
2c088222-33e6-41a8-8220-98193594e0a7
|
Post coital test detects all of the following. Except:
|
Fallopian tube block
|
Cervical factor abnormality
|
Sperm count
|
Sperm abnormality
| 0a
|
multi
|
Ans. is 'a' fallopian tube block. (Shaws, 13/e, p 202, 210 (12/e, p. 158, 164))Postcoital test can be used to study the properties of cervical mucus i.e.,. its capability to allow sperm penetration and presence of antisperm antibodies and also about ovulation.Study of cervical mucus has nothing to do with fallopian tube patency.Fallopian tube patency is checked by -Hysterosalpingography*CO2 - insufflation test*Laparoscopic chromotubationSalpingographyHysteroscopyTranscervical fallo scopyAmpullary and fimbrial salpingoscopy
|
Gynaecology & Obstetrics
|
Pathology of Conception
|
63ec7712-977c-45b4-a470-bccc08a90cc3
|
Nocardia is stained by all except -
|
Acid fast stain
|
Kiram's stain
|
Alcian blue stain
|
Mucin stain
| 1b
|
multi
| null |
Microbiology
| null |
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