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|---|---|---|---|---|---|---|---|---|---|---|
4b091257-dfdb-4c79-b40b-a09968829053
|
Secondary deposits from prostatic carcinoma is commonest in -
|
Bone
|
Kidney
|
Liver
|
Brain
| 0a
|
single
|
Ans. is 'a' i.e., Bone
|
Surgery
| null |
4ddf1e71-a9e3-4b21-98d1-ee3c30b337f3
|
Predisposing factors for gastric ca are -
|
Atrophic gastritis
|
Hyperplastic polyp
|
Adenomatous polyp
|
All
| 3d
|
multi
|
Answer 'a' i.e. Atrophic gastritis; 'b' i.e. Hyperplastic Polyp; 'c' i.e. Adenomatous Polyp Achlorhydria associated with pernicious anemia, chronic H. pylori infection, gastrectomies are assoicated with increased risk of gastric cancer probably because reduced acid secretion ours bacterial growth and perpetuation of chronic inflammation with mucosal epithelial cell proliferation and hence increased risk of genomic mutation. Bacterial growth also conves nitrates into nitrites which are a proven carcinogen.
|
Surgery
| null |
9187293b-a7e6-4395-9ba6-3cb269ac5f5f
|
A child can withhold and postpone his/her bowel movements at _______
|
1 year
|
2 years
|
3 years
|
4 years
| 2c
|
single
|
Encopresis is defined as passage of stools in clothes beyond an age when bowel control should have been achieved (usually 4 years). It may be retentive (associated with constipation) or non-retentive, primary (never achieved bowel control) or secondary (loss of control after an initial phase of control for at least 6 months). Primary encopresis is usually associated with constipation, while secondary is associated with significant psychological stressors. Behavioral therapy with positive reinforcement and treatment of constipation are necessary. Ref : Nelson paediatrics chapter : Groth and de
|
Pediatrics
|
Growth and development
|
3296028d-945e-471c-887f-86bc2c51c7b4
|
Babu is brought to the emergency as a case of road-traffic accident. He is hypotensive. Most likely ruptured organ is:
|
Spleen
|
Mesentry
|
Kidney
|
Rectum
| 0a
|
single
|
Most common abdominal organ to rupture following blunt trauma is spleen. Splenic ruptures should be suspected after any trauma paicularly if there has been direct injury to the left upper quadrant from any angle. Ref: Sabiston Textbook Of Surgery, 17th Edition, Pages 514, 523; Bailey and Love's Sho Practice of Surgery, 23rd Edition, Page 955; Clinical Surgery By S. Das, Page 896.
|
Surgery
| null |
5c2270d7-538c-41ec-8b39-84dde9199342
|
On X-ray of the abdomen, soap bubble appearance is seen in:
|
Multiple cystic kidney
|
Meconium ileus
|
Cystic lymphangiectasis
|
Volvulus
| 1b
|
single
|
Ans. Meconium ileus
|
Radiology
| null |
de681be3-1600-4c59-ab60-38910aab3c6f
|
Economic blindness is defined as:
|
Vision < 6/60 to 3/60
|
Vision < 3/60 to 1/60
|
Vision < 1/60 to Finger counting
|
No PL
| 0a
|
single
|
Economic Blindness: Vision < 6/60 to 3/60 Definitions:- * Economic Blindness: < 6/60-3/60 * Social Blindness < 3/60- 1/60 * Legal Blindness < 1/60 to perception of light
|
Ophthalmology
|
Community Ophthalmology
|
4312cb15-405b-48f9-8679-8b78e621ffea
|
Which of the following is not a ototoxic drug -
|
Paracetamol
|
Cisplatin
|
Quinine
|
Erythromycin
| 0a
|
single
|
Ans. is 'a' i.e., Paracetamol Important ototoxic drugso Aminoglycosideso Cisplatino Furosemideo Deferoxamineo Quinineo Chloroquineo Interferonso Eiythromycino Bleomycino Aspirin
|
Pharmacology
|
Adverse Drug Effect
|
f9cbb739-e4ce-4be5-a850-1f1184b6db93
|
Effect of ultraviolet radiation on DNA is formation of
|
Purine dimers
|
Pyrimidine dimers
|
DNA-DNA cros linking
|
All of the above
| 1b
|
multi
|
UV light causes the formation of thymine dimers, where covalent bonds are formed between adjacent thymine residuesSince repair mechanism is not operating these mutations are accumulated, leading to cancerRef: DM Vasudevan, 7th edition, page no: 584
|
Biochemistry
|
Metabolism of nucleic acids
|
674d900e-9652-4bf7-a2ce-8fb83201518b
|
The influence of maternal smoking and LBW incidence is studied. Detailed smoking history is taken at first AN visit and smoking history and bih weight were studied later. The type of study is-
|
Retrospective coho study
|
Cross sectinal study
|
Clinical trial
|
Prospective coho study
| 3d
|
single
|
prospective coho studies is one which the outcome has not yet occurred at the time the investigation begins.most prospective studies begin in the present and continue into future. ref:park&;s textbook,ed 22,pg no 73
|
Social & Preventive Medicine
|
Epidemiology
|
159d55d9-1e01-404a-b3bc-b38256b17a6f
|
Which of the following statements is true regarding menorrhagia?
|
Heavy and regularly timed episodes of bleeding
|
Heavy and irregularly timed episodes of bleeding
|
Amount of bleeding greater than 50 ml
|
Duration of bleeding greater than 3 days
| 0a
|
multi
|
Menorrhagia is defined as heavy but regular menstrual bleeding. Menorrhagia denotes regularly timed episodes of bleeding that are excessive in amount (>80mL) and/or duration of flow (>7 days) According to the recent update, the term heavy menstrual bleeding has replaced menorrhagia. Hemoglobin concentration below 12 g/dL increase the chance of identifying women with heavy menstrual bleeding. A normal level, however, doesnot exclude heavy menstrual bleeding, as many women with clinically significant bleeding have normal values. All patients should undergo a pelvic examination and, if the menstrual pattern has changed substantially or if anemia is present, a vaginal sonography should be carried out as the most impoant supplemental examination. Vaginal sonography combined with an endometrial biopsy is a reliable method for diagnosing endometrial hyperplasia or carcinoma, but it is insufficient for diagnosing endometrial polyps and fibroids; these can be diagnosed more reliably by sonohysterography or hysteroscopy. Appropriate treatment considerably improves the quality of life of the patients. Non-steroidal anti-inflammatory drugs and tranexamic acid reduce menstrual blood loss by 20-60% Drug treatment should be used and evaluated before surgical interventions are considered. Ref: Shaw&;s textbook of Gynaecology 17th edition Pgno: 122
|
Gynaecology & Obstetrics
|
Disorders of menstruation
|
f8f3b174-eebc-4b9b-bd01-2fbb350b69ab
|
If serum osmolality 300 musm/ivg & urine osmolaUty is 1200 mOsm/kg, what is the diagnosis.
|
SIADH
|
Central DI
|
Nephrogenic Di
|
Water deprivation
| 0a
|
single
|
The syndrome of inappropriate antidiuretic hormone secretion (SIADH) involves the continued secretion or action of arginine vasopressin (AVP) despite normal or increased plasma volume. The resulting impairment of water secretion and consequent water retention produces the hyponatremia (ie, serum Na+ < 135 mmol/L) with concomitant hypo-osmolality (serum osmolality < 280 mOsm/kg) and high urine osmolality that are the hallmark of SIADH. The key to understanding the pathophysiology, signs, symptoms, and treatment of SIADH is the awareness that the hyponatremia results from an excess of water rather than a deficiency of sodium. Depending on the magnitude and rate of development, hyponatremia may or may not cause symptoms. The history should take into account the following considerations: In general, slowly progressive hyponatremia is associated with fewer symptoms than is a rapid drop of serum sodium to the same value Signs and symptoms of acute hyponatremia do not precisely correlate with the severity or the acuity of the hyponatremia Patients may have symptoms that suggest increased secretion of AVP, such as chronic pain, symptoms from central nervous system or pulmonary tumors or head injury, or drug use Sources of excessive fluid intake should be evaluated The chronicity of the condition should be considered Ref Harrison20th edition pg 288
|
Medicine
|
Kidney
|
a0faf7bf-751b-43ce-a54d-a90259c376b2
|
A 60-year-old woman noticed an enlarging "bump" beneath her tongue for the past year. She does not smoke or use alcohol. On physical examination, there is a 2.5-cm, movable, submucosal mass arising in the minor salivary glands on the buccal mucosa beneath the tongue on the right. Histologic examination of the excised mass shows that it is malignant and locally invasive. The tumor recurs within 1 year. Which of the following is the most likely diagnosis?
|
Non-Hodgkin lymphoma
|
Mucoepidermoid carcinoma
|
Primitive neuroectodermal tumor
|
Pleomorphic adenoma
| 1b
|
multi
|
Mucoepidermoid carcinomas can arise in major and minor salivary glands. They account for most neoplasms that arise within minor salivary glands, particularly malignant neoplasms. Low-grade mucoepidermoid carcinomas may be invasive, but the prognosis is usually good, with a 5-year survival of 90%. High-grade mucoepidermoid carcinomas can metastasize and have a 5-year survival of only 50%. Non- Hodgkin lymphomas are found in adjacent cervical lymph nodes or in the Waldeyer ring of lymphoid tissue. A primitive neuroectodermal tumor, also known as an olfactory neuroblastoma, is a small, round, blue cell tumor of childhood; it is likely to arise in the nasopharyngeal region. Pleomorphic adenomas are more common in the major salivary glands than are mucoepidermoid tumors, and they are more likely to be indolent. Squamous cell carcinomas are invasive and arise in the buccal mucosa. Warthin tumors are uncommon and indolent.
|
Pathology
|
Head & Neck
|
c23d27c6-2b05-452f-999a-70a5e39fd450
|
Which of the following is NOT a content of medial wall of middle ear:
|
Oval window
|
Round window
|
Processus cochleariformis
|
Aditus ad antrum
| 3d
|
multi
|
Ans. (d) Aditus ad antrumReft Dhingra's ENT 6th edj 5-6* Aditus ad antrum is located on posterior wall. It is a doorway to antrum of mastoid.* Antrum is largest mastoid air cell.
|
ENT
|
Ear
|
df59ab2f-9b7e-4059-9ab8-c76f468ce293
|
Tripod fracture is
|
Displaced fracture of calcaneum
|
Zygomatiomaxillary fracture
|
Sphenoid Wing Fracture
|
Coronal shear pilon Fracture
| 1b
|
single
|
Zygomaticomaxillary complex (ZMC) fractures, also known as a tripod, tetrapod, quadripod, malar or trimalar fractus, are seen in the setting of traumatic injury to the face. They comprise fractures of the:Zygomatic archInferior orbital rim, and anterior and posterior maxillary sinus wallsLateral orbital rim(Refer: Mohindra's Fundamentals of Ohopedics, 2nd edition, pg no. 109)
|
Orthopaedics
|
All India exam
|
c46d5adb-e785-4cb7-88e6-f3e065b319ca
|
pH for acidifier used in fixer should be:
|
3.2 - 4.2
|
4 - 4.5
|
4.5 - 5
|
5.2 - 5.5
| 1b
|
single
|
The fixing solution contains an acetic acid buffer system (pH 4 to 4.5) to keep the fixer pH constant. The acidic pH is required to promote good diffusion of thiosulfate into the emulsion and of silver thiosulfate complex out of the emulsion. The acid-fixing solution also inactivates any residual developing agents in the film emulsion, blocking continued development of any unexposed crystals while the film is in the fixing tank.
White and Pharoah's Oral Radiology Principles and Interpretation 8th edition
|
Radiology
| null |
964d590c-2eb3-4282-a448-74e97a4467f6
|
IUCD is made up of -
|
Nickel
|
Strontium
|
Copper
|
Polyethylane
| 3d
|
single
|
park's textbook of preventive and social medicine 23rd edition. *The 1st generation IUD comprises the ine or non medicated devices usually made up of poly ethylene or other polymer.They appear in different shapes loops ,spirals,coils and rings .lippes loop is most commonly used.2nd generation IUDs are made by adding copper to the IUDs.
|
Social & Preventive Medicine
|
Non communicable diseases
|
00ea642f-47b0-4b13-b9b5-c78188895e89
|
Succinylcholine causes?
|
Severe hyperkalemia
|
Paraplegia
|
Liver failure
|
Renal failure
| 0a
|
single
|
Ans. (a) Severe hyperkalemiaRef: Miller 4thedCh: 9
|
Anaesthesia
|
Depolarising Neuromuscular Blocking Agents
|
6eedba1a-12ab-4f05-93f2-4551f80d7de3
|
The triad of diabetes, gallstones and steatorrhea is associated with -
|
Gastrinoma
|
Somatostatinoma
|
VlPoma
|
Glucagonoma
| 1b
|
multi
|
The somatostatinoma syndrome is due to an neuroendocrine tumour (NET) that secretes excessive amounts of somatostatin, which causes a distinct syndrome characterized by diabetes mellitus, gallbladder disease, diarrhea, and steatorrhea. The mean age is 51 years. Somatostatinomas occur primarily in the pancreas and small intestine. Reference : page 570 Harrison's Principles of Internal Medicine 19th edition
|
Medicine
|
Endocrinology
|
eb981c10-33e5-4760-ac07-a28218bb2574
|
Direct pulp capping has a favourable prognosis if the exposure is around
|
1 mm
|
1.5 mm
|
0.5 mm
|
2 mm
| 2c
|
single
| null |
Dental
| null |
9531bb3b-8b5c-4529-9f1e-abecf25185ac
|
Functional technique of relining and rebasing utilizes
|
Functional wax
|
Tissue conditioner
|
ZOE
|
Alginate
| 1b
|
single
| null |
Dental
| null |
f54dd825-32ae-48f8-a0d2-75fb49e15f72
|
What is the rate of BER in the stomach?
|
About 1.5/min in the stomach.
|
About 15/min in the stomach.
|
About 4/min in the stomach.
|
About 0.4/min in the stomach.
| 2c
|
single
|
About 4/min in the stomach. Basic Electrical Rhythm (BER): Smooth muscle cells of the gastrointestinal tract have spontaneous rhythmic fluctuations in membrane potential between about -65 and -45 mV. BER initiated by Pacemaker cells called "Interstitial cells of Cajal" Metrics: The threshold for the action potential is -50 mV. The rate of BER: About 4/min in the stomach. About 12/min in duodenum About 8/min - distal ileum (falls down) In Colon: Rate rises from about 2/min at Cecum -----------> about 6 min at the Sigmoid colon.
|
Physiology
| null |
c2dffdc2-9c48-46d5-8090-a8665c6ed1d6
|
All of the following are class Ic anti-arrhythmic drugs except?
|
Propafenone
|
Tocainide
|
Enacainide
|
Flecainide
| 1b
|
multi
|
CLASS I ANTI-ARRHYTHMICS Class Mechanism Drugs Ia Na+ and K+ channel blocker Quinidine Procainamide Ib Na+ channel blocker K+ channel opener Lignocaine Phenytoin Tocainide Ic Na+ Channel blocker Enacainide Flecainide Propafenone Tocainide: Class Ib anti-arrhythmic.
|
Pharmacology
|
Hypeension, Arrhythmias, Dyslipidemia
|
6f23d61a-4dd9-4481-abcc-4df0c97f460d
|
Which of the following drugs has a high surface activity and vasoconstrictor actions that reduce bleeding in mucus membranes?
|
Bupivacaine
|
Cocaine
|
Lidocaine
|
Procaine
| 1b
|
single
|
(Ref: KDT 6/e p356, 357) All LAs are vasodilators except cocaine. It possesses vasoconstrictor activity. Cocaine also has good surface activity.
|
Pharmacology
|
Other topics and Adverse effects
|
710e517c-1491-48ce-81fd-8f61a5e8f3fe
|
Common differential diagnosis of verucous carcinoma is -
|
Condylomata lata
|
Condylomata acuminata
|
Adenocarcinoma
|
Tuberculosis
| 1b
|
single
|
Ans. is 'b' Condyloma accuminata (Ref Chandrasoma Taylor, 3/e, p 797).Both verrucous carcinoma and condyloma acuminata presents with verrucous growth on vulva and differentiation between these 2 is very difficult.Chandrasoma Taylor states "Verrucous carcinoma is a variant of well differentiated squamous carcinoma, characterised by a polypoid growth pattern with little infiltrative tendency. Distinction from condyloma acuminata very difficult
|
Gynaecology & Obstetrics
|
Symptoms Associated with Genital Infections
|
8992e3d7-b7c3-451a-8c2c-ddc251796155
|
Most common reason for failure of rest seat in RPD is
|
Improper rest seat preparation
|
Contaminated metal
|
Distorted occlusal rest
|
Excessive occlusal forces
| 0a
|
single
| null |
Dental
| null |
b40ad981-f721-423c-b20a-8709c0d9fd58
|
Soiling index used for -
|
Water pollution
|
Air pollution
|
Sound pollution
|
Faecal pollution
| 1b
|
single
|
(B) (Soiling index) (683 - Park 22nd)Smoke or Soiling Index:A known volume of air is filtered through a white filter paper under specified conditions and the stain is measured by photoelectric meter smoke concentration is estimated and expressed as micrograms/cubic meter of air as an average level over a period of time.* Best indicators of air pollution are sulphurdioxide, smoke and suspended particle**** Source of carbon monoxide indoor air pollution is combustion equipment, stove, Gas heaters.AIR POLLUTION INDEX* It is an arbitary index which takes into account one or more pollutants as a measure of the severity of pollution.* For example, the following index has been used in USA: 10 times the sulphur dio-oxide concentration plus twice the carbon mono oxide concentration (both in ppm by volume) plus twice the coefficient of haze.* It was considered to be a cause for alarm when the value of this index rose from its value of about 12 - 50 or more.
|
Social & Preventive Medicine
|
Environment and Health
|
01ddc7d4-8bd8-4ab5-85a8-2ea6498a9ac4
|
A 40-year-old female patient presented with dysphagia to both liquids and solids and regurgitation for 3 months. The dysphagia was non-progressive. What is the most likely diagnosis?
|
Caricnoma of the esophagus
|
Lower oesophageal mucosal ring
|
Achalasia cardia
|
Reflux esophagitis with esophageal stricture
| 2c
|
multi
|
Dysphagia equal for both solids and liquids from the very onset of disease suggests motor disorder like
Achalasia
Diffuse esophageal spasm
Dysphagia more for solids than liquids implies mechanical obstruction
Ca esophagus
Strictures
Webs
Note that dysphagia in achalasia cardia is slowly progressive. But 'nonprogressive' dysphagia in this pt. does not rule out the diagnosis of achalasia
|
Surgery
| null |
cbc35b03-62e5-4709-bdda-3fc4d5aac58b
|
Antibody found in patients with myasthenia gravis is directed against
|
Acetylcholine
|
Acetylcholine receptor
|
Acetylcholine vesicles in nerve terminals
|
Actin myosin complex of the muscle
| 1b
|
single
|
Ref Robbins 9/e p195 Myasthenia gravis Acetylcholine receptor Antibody inhibits acetylcholine binding, downmodulates receptors Muscle weakness, paralysis
|
Anatomy
|
General anatomy
|
0c4a8fcb-5245-4d3d-bdc8-c6c35987ac3d
|
All the following antimicrobial agents are used topically except -
|
Clotrimazole
|
Griseofulvin
|
Nystatin
|
Miconazole
| 1b
|
multi
|
Ans. is 'b' i.e., Griseofulvin o Griseofulvin is used systemically for dermatophytosis. It is ineffective topically.
|
Pharmacology
| null |
9bd3e43d-688e-4fd3-9d05-d087e997aeaf
|
Bone marrow involvement is maximum in which type of lymphoma?
|
B cell chronic lymphocytic lymphoma
|
Follicular lymphoma
|
Diffuse large B cell lymphoma
|
Burkitt's lymphoma
| 0a
|
single
|
Bone marrow involvement is seen in 72% of B cell chronic lymphocytic lymphoma. Ref: Harrisons principles of internal medicine, 18th edition, Page: 926
|
Medicine
| null |
454367c2-4260-40c4-9a04-707e993d2145
|
Biotin is a Co-enzyme for ?
|
Transketolase
|
Dehydrogenase
|
Oxidase
|
Carboxylase
| 3d
|
single
|
Ans. is 'd i.e., Carboxylase
|
Biochemistry
| null |
3e673561-4f10-4380-9659-9d05bca99ff2
|
Middle meningeal aery courses along which of the following opening in the base of the skull?
|
Foramen ovale
|
Foramen lacerum
|
Foramen spinosum
|
Foramen rotundum
| 2c
|
single
|
Middle meningeal aery and vein travels through foramen spinosum. Structures passing through openings in the skull base are: ForamenStructuresCribriform plate of ethmoidOlfactory nervesOptic foramenOptic nerve, ophthalmic aery, meningesSuperior orbital fissureOculomotor, trochlear, and abducens nerves; ophthalmic division of trigeminal nerve; superior ophthalmic veinForamen rotundumMaxillary division of trigeminal nerve, small aery and veinForamen ovaleMandibular division of trigeminal nerve, veinForamen lacerumInternal carotid aery, sympathetic plexusForamen spinosumMiddle meningeal aery and veinInternal acoustic meatusFacial and vestibulocochlear nerves, internal auditory aeryJugular foramenGlossopharyngeal, vagus, and spinal accessory nerves; sigmoid sinusHypoglossal canalHypoglossal nerveForamen magnumMedulla and meninges, spinal accessory nerve, veebral aeries, anterior and posterior spinal aeries
|
Anatomy
| null |
e30c1766-b972-42f7-9812-041a94739629
|
Most radiosensitive tissue of body among the following is –
|
Bone marrow
|
Spleen
|
Kidney
|
Brain
| 0a
|
single
|
Bone & cartilage are radioresistant.
Ewing's sarcoma, seminoma and GI epithelium are highly radiosensitive.
|
Radiology
| null |
604c8857-39b6-43da-adee-7f2c81f6906f
|
A 20-year-old male patient presented to the ER with complaints of abdominal pain, nausea and vomiting. The pain was initially peri-umbilical in nature, however, with time, the pain worsened and shifted to right lower quadrant. On palpating the abdomen, tenderness is present over right lower quadrant with guarding. Patient is febrile and lab repos show leukocytosis. Emergency laparotomy is planned and the inflamed organ is identified by the confluence of taenia coli. Which position of the above-mentioned organ is considered to be the most dangerous position?
|
D
|
A
|
C
|
B
| 3d
|
multi
|
A- Post ileal B- Pre ileal C- Retro-cecal D- Pelvic The patient is suffering from acute appendicitis. During laparotomy, the appendix is identified by confluence of taenia coli. Pre-ileal variety of splenic position is considered to be the most dangerous position because it is associated with higher chances of spread to general peritoneal cavity. Retrocecal variety is the most common and Pelvic is the 2nd most common anatomical position of the appendix.
|
Unknown
|
Integrated QBank
|
e0fd449d-b73c-498c-9c2e-86348cd41d45
|
All of the following are true about Heparin except
|
Argatroban is the drug of choice for Heparin induced thrombocytopenia
|
Unfractionized Heparin induce antibodies against PF - 4 and lead to platelet aggregation
|
Heparin can lead to arterial thrombosis more than venous thrombosis
|
Unfractionized Heparin is safer in renal failure
| 2c
|
multi
|
Heparin causes venous thrombosis more commonly than arterial thrombosis.
|
Pharmacology
| null |
f0d6d149-d505-4b53-b288-31b8fe4b2be1
|
Which of the following method of protein separation is not dependent on molecular size?
|
Gel filtration chromatography
|
Ultracentrifugation
|
Ion-exchange chromatography
|
SDS-PAGE
| 2c
|
single
|
The nucleoside Inosine, Xanthosine, Guanosine is conveed into Hypoxanthine, Xanthine, and Guanine. This reaction is catalyzed by "Purine nucleoside phosphorylase". ... The hypoxanthine is conveed into Xanthine. The Xanthine is conveed into Uric acid Ref-Harpers illustrated biochemistry 30/e p684
|
Biochemistry
|
Metabolism of nucleic acids
|
9b65f0d4-2a55-413a-b8b5-cc7d33316175
|
Scarring alopecia is seen in –
|
T. Capitis
|
Androgenic alopecia
|
Alopecia areata
|
Lichen planus
| 3d
|
single
| null |
Dental
| null |
b8c01233-de58-4d4b-9943-3acb43c2b77e
|
Triad of glomerulonephritis, pulmonary hemorrhages,and antibody to basement membrane is called?
|
Goodpasture syndrome
|
Systemic Necrotising Vasculitis
|
Mixed connective tissue disease
|
Diabetic nephropathy
| 0a
|
multi
|
* Goodpasture syndrome- autoimmune disease in which antibodies attack the lungs and kidneys, leading to bleeding from the lungs and to kidney failure. * It may quickly result in permanent lung and kidney damage, often leading to death. * It is treated with immunosuppressant drugs such as coicosteroids and cyclophosphamide, and with plasmapheresis, in which the antibodies are removed from the blood.
|
Medicine
|
Nephrotic and Nephritic syndrome
|
29a60e26-c392-4259-ab54-af25df7df3b1
|
Paprika sign during debridement is crucial in management which of the following condition?
|
Chronic osteomyelitis
|
Osteosarcoma
|
Osteoid osteoma
|
Brodies abscess
| 0a
|
single
|
Ans. is 'a' i.e., Chronic osteomyelitis Sequestrectomy and curettage for chronic osteomyelitis* Sequestrectomy and curettage require more time toperform and result in considerably more blood loss than aninexperienced surgeon would anticipate. Consequently,appropriate preparation should be made before surgery.Sinus tracks can be injected with methylene blue 24 hoursbefore surgery to make them easier to locate and exciseTechnique:* Expose the infected area of bone, and excise all sinus tracts completely.* Incise the indurated periosteum, and elevate it 1.3 to2.5 cm on each side.* Use a drill to outline an oval cortical window at the appropriate site, and remove it with an osteotome.* Remove all sequestra, purulent material, and scarred and necrotic tissue. If sclerotic bone sealsoff a cavity within the medullary canal, open it into thecanal in both directions to allow blood vessels to growinto the cavity. Use a high-speed burr to debride necrotic or ischemic bone until the "paprika sign" (active punctate bleeding bone) is achieved, indicating healthy tissue.Tissue obtained at surgical debridement should be sentfor culture and pathology studies.* After removing all suspicious matter, carefully excise the overhanging edges of bone. Subsequent dead space can be filled with antibiotic PMMA beads. A soft tissue, a localmuscle flap, or a free tissue transfer can be performed atthe time of bead removal.* If there is nonunion with any bony instability, the bonemust be stabilized, preferably with an Ilizarov-type external frame.* If possible, close the skin loosely over drains and ensurethat no excessive skin tension is present. If closure isimpossible, pack the wound open loosely or apply an antibiotic bead pouch and plan for delayed closure or skingrafting at a later time.* Appropriate antibiotics should be used before, during, and after the operation.
|
Orthopaedics
|
Infection of Bones & Joints
|
a1db7a8f-9534-4730-85da-5fea92e96d38
|
Which one of the following drugs exacerbate reflux esophagitis
|
Cisapride
|
Chlorpropamide
|
Theophylline
|
Metoclopramide
| 2c
|
single
|
Drugs that can increase acid reflux and worsen GERD include: Anticholinergics Tricyclic antidepressants Calcium channel blockers Nitrates Opioids Progesterone Quinidine Benzodiazepines Theophylline ref - Harrisons internal medicine 20e pg2215,2219
|
Medicine
|
C.V.S
|
f3dc4a7b-c44f-4264-b46f-7c1baaca2aa1
|
Most common congenital malformation seen in a diabetic pregnant woman amongst the following are:
|
Cardiac defect
|
Renal defect
|
Liver defect
|
Lung defect
| 0a
|
single
|
Ans. is a, i.e. Cardiac defectRef. Williams Obs. 24/e, p 1128; Fernando Arias 2/e, p 289; COGDT 10/e, p 312; Sheila Balakrishnan, p 288,Cardiac anomalies are the most common single organ anomalies in case of diabetes. --Williams 21/e, p 1369This is supported by 24/e Williams which specifically mention, that cardiovascular anomalies are much common that CNS anomalies in babies of diabetic mothers (p 1128)Most common cardiac anomalies seen are:Ventricular septal defect QAtrial septal defect QTransposition of the great vessels QAortic coarctation Q
|
Gynaecology & Obstetrics
|
Medical & Surgical Illness Complication Pregnancy
|
c80324a1-dc52-47dd-8feb-0e45abcf6c20
|
Most common nephropathy in world is?
|
IgA nephropathy
|
FSGS
|
Minimal Change ds
|
Adult PSGN
| 0a
|
single
|
a. IgA nephropathy(Ref: Nelson's 20/e p 2496)High Yield Points:IgA nephropathy is the most common type of glomerulonephritis worldwideIgA nephropathy is the most common cause of gross hematuria
|
Pediatrics
|
Kidney
|
3e1405a9-2b1f-48de-b49a-358a1796f108
|
All are TRUE regarding health planning, except –
|
Resource planning and implementation
|
Eliminating wasteful expenditure
|
Creating demands for needs
|
To develop best course of action for best results
| 2c
|
multi
|
Health planning
Health planning has been defined as the orderly process which involves (in order) -
Defining community health problems and identifying the unmet needs.
Surveying the resources to meet unmet needs to eliminate wasteful expenditure.
Establishing priority goals that are realistic and feasible
Projecting administrative action to accomplish the goals
" The purpose of planning is :
To match the limited resources with many problems
To eliminate the wasteful expenditure
|
Social & Preventive Medicine
| null |
8c009aea-a31e-4878-af52-af6093108add
|
Which is the most common malignant tumour seen in parotid gland ?
|
Adenoid Cystic
|
Warthin tumour
|
Mucoepidermoid carcinoma
|
Adenocarcinoma
| 2c
|
single
|
Ans. is 'c' i.e., Mucoepidermoid carcinoma Salivary and .tumorso Most common salivary gland tumor-Pleomorphic adenoma (mixed tumor)o Most Common benign Salivary gland tumor-Pleomorphic adenoma (mixed tumor)o Most Common malignant tumor of salivary gland-Mucoepidermod Carcinomao Most Common site of pleomorphic adenoma-Parotid glando Most common parotid tumor-Pleomorphic adenomao Most Common site of mucoepidermoid Carcinoma-Parotid glando Most Common site for acinic cell ca-Parotid glando Most Common site for adenoid cytic Carcinoma-Minor salivary glandso Multifocal and bilateral Salivary gland tumor-Warthin tumor and acinic cell tumoro Salivary gland tumor with tendency to invade perineural space-Adenoid cystic carcinomao Salivary gland tumor with worst prognosis-Adenoid cystic carcinomao Most malignant salivary gland tumor-Adenoid cystic carcinomao Most common salivary gland tumor in children-Hemangiomao Most common malignant salivary gland tumor in children-Mucoepidermoid carcinoma
|
Surgery
|
Salivary Gland Neoplasms
|
3d8643fc-f09c-42c2-8f1f-53914a64ebff
|
Which is the main component of soda-lime in closed circuit
|
Sodium hydroxide
|
Barium hydroxide
|
Calcium hydroxide
|
Potassium hydroxide
| 2c
|
single
|
Sodalime constitutes a mixture of 95% Ca(OH)2, 5% NaOH and 1%KOH.
|
Anaesthesia
|
Anaesthetic equipments
|
ec453a28-5439-4a03-ba82-7ff82488e622
|
In firearm injury, entry-wound blackening is due to -
|
Flame
|
Hot gases
|
Smoke
|
Unburned powder
| 2c
|
single
| null |
Forensic Medicine
| null |
58270b50-3303-483d-a9de-ef326bcf6876
|
A patient complains of pain in the upper poion of his neck on swallowing. He occasionally regurgitates undigested food sholy after eating. Which of the following is the most likely etiology of his problems?
|
Mallory-Weiss tear
|
Zenker's diveiculum
|
Schatzki rings
|
Traction diveicula
| 1b
|
multi
|
Zenker's diveiculum False diveiculum Formed by herniation of mucosa at junction of pharynx & esophagus in posterior hypopharyngeal wall. Features Halitosis Regurgitation of previous day food If diveiculum fills completely with food,can cause dysphagia or obstruction of esophagus. Mallory-Weiss tear (option A) - Mucosal tear below gastroesophageal junction secondary to repeated, forceful vomiting; often seen in alcoholics. Schatzki rings (option C) are mucosal rings found in distal esophagus at squamocolumnar junction. Traction diveicula (option D)- In contrast to a Zenker's diveiculum, this is usually asymptomatic & are true diveicula involving all of layers of esophagus. They are typically caused by adherence of esophagus to scarred mediastinal structure.
|
Pathology
|
Esophageal disorders
|
860346c6-a7f6-44da-b938-c8043bb515d6
|
17 hydroxylase dificiency causes - increase production of
|
Aldosterone
|
Coisol
|
Androstene
|
All of above
| 0a
|
multi
|
Deficiency of 17 alpha hydroxylase leads to increased production of aldosterone. Progesterone synthesised from cholestrole is normally acted upon by 21 alpha hydroxylase which is fuher conveed to coicosterone and aldosterone . Some amount of progesterone is channeled to production of coisol and estradiol by the action of 17 alpha hydroxylase through a separate pathway. So in the absence of 17 alpha hydroxylase progesterone is entirely channeled to the production of aldosterone by the action of 21 alpha hydroxylase Reference: Ghai TB of pediatrics 8th edition pg 527 fig 17.11
|
Pediatrics
|
Genetic and genetic disorders
|
d1c1c7b9-4b2d-4701-a94b-459554eddbb7
|
Non-depolarising Muscle relaxant Contraindicated in Person shown is -
|
Pancuronium
|
Vecuronium
|
Rocuronium
|
Gallamine
| 3d
|
multi
|
Ans-DGallamine
|
Unknown
| null |
4e6d71ea-f60d-4d3e-a8c8-23ddf5ddaa7b
|
Patch test is done to document:
|
Type I hypersensitivity
|
Delayed type hypersensitivity
|
Autoimmune disease
|
Immunocomplex deposition
| 1b
|
single
|
Delayed type hypersensitivity
|
Skin
| null |
abf3545e-b5ca-4b80-812c-3e81f469bfac
|
In a population of 100000, 100 people have pulmonary tuberculosis. Out of 100 people, 10 died . What is the case fatality rate of TB-
|
5%
|
10%
|
0.50%
|
1%
| 0a
|
single
|
Ans. is 'a' i.e., 5% CFR =Total no. of deaths due to a disease--------------------------------Total no. of cases of the same diseasex 100 CFR due to TB =5------100x 100 = 5%.
|
Social & Preventive Medicine
|
Epidemiology
|
39663904-1b93-40a3-904a-6152ff0e6b0f
|
Strabismic amblyopia is more common in patients with:
|
Intermittent squint
|
Alternate squint
|
Constant squint
|
Latent squint
| 2c
|
single
|
Paralytic Squint (Incomitant): * Due to complete or paial palsy of one of the nerves t at supp y * . * Here, the angle of direction of gaze, being maximal in the direction of action of the weak muscle. Eg.: - Oculomotor Palsy -> - Abducens Palsy - Trochlear Palsy Latent Strabismus / tga.Ua o It is a condition in which the tendency of the eyes to dete is kept latent by fusion. Therefore, when the influence of fusion is removed the visual axis of one eye detes away. L Types L 1. Esophoria- It is a tendency to converge. L 2. Exophoria- It is a tendency to diverge. L 3. Hyperphoria- It is a tendency to dete upwards, while hypophoria is a tendency to dete downwards. L 4. Cyclophoria- It is a tendency to rotate around the anteroposterior axis. When the 12 O&;clock meridian of cornea rotates nasally, it is called incyclophoria and when it rotates temporally it is called excyclophoria. Constant squint Least common - alternate squint. Ref: AK khurana 7th ed.
|
Ophthalmology
|
All India exam
|
e912320b-0b7f-4a78-981b-1381655673ea
|
Which of the following is not true of caloric test?
|
Induction of nystagmus by thermal stimulation
|
Normally, cold water induces nystatmus to opposite side and warm water to same side
|
In canal paresis, the test is inconclusive
|
None
| 2c
|
multi
|
Nystagmus can be induced both by cold as well as thermal stimulationCold stimulation causes nystagmus towards opposite side while thermal stimulation causes Nystagmus towards same side. (COWS)In canal paresis either there is a reduced or absent response (causes of U/L canal paresis are-U/L vestibular Schwannoma or vestibular neuritis).B/L absence of caloric nystagmus is seen in case of amminoglycoside ototoxicity or postmeningitis
|
ENT
| null |
d299c07f-ac10-4a43-8656-9c3fec183f12
|
Which of the following has the lowest risk of causing nausea & vomiting?
|
Semaglutide
|
Lixisenatide
|
Albiglutide
|
Liraglutide
| 2c
|
single
|
Nausea & vomiting is the most common side effect of all GLP-1 analogues, but Albiglutide has the lowest risk of causing nausea & vomiting.
|
Pharmacology
| null |
03b2e197-fa45-44ad-b689-bcc4a62def88
|
Gastric Lavage is contraindicated in poisoining with: (PGI Dec 2008)
|
Kerosene
|
Organophosphorus
|
Arsenic
|
Morphine
| 0a
|
single
|
Ans: A ( Kerosene) Gastric lavage Is C/l in kerosene poisoningGastric evacuation for pure petroleum distillate or turpentine ingestion is not recommended" - Reddy 27th/522Gastric Lavage (G. L) - C/l or Precautions# The only absolute C/l for G. L. is corrosive poison ingQ (except carbolic acidiy}, owring to the danger of perforation# In following conditions - stomach wash can be done by taking proper precautionsi. Convulsant poisonsQ - As itmay lead to convulsion, lavage should be done after controlling convulsionii. Comatose patientQ - There is risk of aspiration of fluid into the air passage. The airway should be sealed by cuffed endotracheal tube(8 to 9 no.) & then lavage doneiii. Volatile poison' - Which may be inhalediv. Upper alimentaryfi disease - Like oesophageal variesv. In patient with marked hypothermia & haemorrhagic diastbesisGastric LavageIt is useful any time within 3hr after ingestion of poison (Reddy)It is life saving if undertaken within 4-6 hr after ingestion of poison {ParikhjGL most effective if done within 2-3 hr after ingestion of poison (modi)In case of irritent poison, the stomach should be passed with caution (modi),As poisoning - "Stomach should be repeatedly washed by warm water & milk" (Reddy 27th/473)Morphine poisoning - Wash stomach with 1:5000 solution of KMnOf" (Reddy 27th/516)Datura poisoning - "Wash stomach repeatedly with a weak solution of tannic acid"(Reddy 27th/533)Organophosphorus poisoning - "Stomach should be %vashed with 1 : 5000 KMn04 solution"(Reddy 27th/459)C/I of Emetics# Same as for stomach wash &Severe heart & lung diseaseAdvanced pregnancy'After ingestion of a CNS stimulant, because further stimulation associated with vomiting may produce convulsion.
|
Forensic Medicine
|
Forensic Toxicology - Concepts, Statutes, Evidence, and Techniques
|
cdee9e88-6f08-40e2-92cb-d8bb67e68faf
|
A baby is hypotonic and shows increased ratio of Pyruvate to Acetyl CoA. Pyruvate cannot form Acetyl CoA in fibroblast. He also shows features of lactic acidosis. Which of the following can revert the situation?
|
Biotin
|
Pyridoxine
|
Free fatty acid
|
Thiamin
| 3d
|
single
|
Ans. D. ThiaminIncreased Pyruvate to Acetyl-CoA, with lactic acidosis, inability to convert Pyruvate to Acetyl-CoA are all suggestive of a Pyruvate Dehydrogenase deficiency. Thiamine Pyrophosphate is one of the coenzymes of PDH. Hence Thiamine is the answer.
|
Biochemistry
|
Carbohydrates
|
f4543693-45f3-4c29-9671-c2fd0cc8e348
|
False about Toxic Amblyopia
|
Tobacco - alchol amblyopia is characterized by foggy vision associated with B/L centroceacal Scotomas
|
Methyl alchol amblyopia results from degeneration of ganglion cells of retina
|
Quinine amblyopia - Visual loss may be associated with deafness and tinnitus
|
Ethambutol amblyopia progresses even after cessation of the drug
| 3d
|
multi
|
Ethambutol amlyopia recovers completely in most of the cases after immediate cessation of the drug.
|
Ophthalmology
| null |
ea51acab-3541-427f-951d-b75501c76044
|
Cause of methaemoglobinemia are all except :
|
Nitrites
|
Phenacetin
|
Sulfonamide
|
Phenytoin
| 3d
|
multi
|
D i.e. Phenytoin
|
Physiology
| null |
845e8e98-b88c-4086-bbc9-c9cf28d827d6
|
a female patient of age 53yrs is known case of osteoahritis & diabetic using METFORMIN 500mg , sitagliptin , glimipride 1mg since 10years. patient was recently diagnosed with CKD due to vigrous nsaid usage , now regarding her management what is the next step ?
|
Stop sitagliptin and sta linagliptin
|
stop metaformin and change her to subcutaneous insulin
|
nsaids are stoped and opiods are used for ahritis pain
|
all of the above
| 3d
|
multi
|
sitagliptin and metaformin are excreated by kidneys and so they are stopped and linagliptin and humaninsulin is staed. opiods like tramadol have least renal toxicity . ref : kd tripathi 8th ed
|
Pharmacology
|
All India exam
|
b9c58936-9576-49b8-bc44-5ccf0f1d340c
|
Plasma cells are derived from -
|
B lymphocytes
|
T lymphocytes
|
NK cells
|
Monocytes
| 0a
|
single
|
Ans. is 'a' i.e., B lymphocytes o B-cells are able to make a specific antibody against a specific antigen. It is due to present of specific receptor on B-cells - B-cell receptor (BCR), that is usually an immunoglobulin Ig M or Ig D. An antigen interacts with B-cell that shows best fit by virtue of its BCR. The antigen binds to this receptor, and the B-cell is stimulated to divide and form a clone (clonal selection). This clone of cells will become plasma cells that will secretes antibody of a particular specificity and same class.o Although, B-cells are the major source of antibodies (after their conversion into plasma cells). Helper - T cells are also important. Helper T-cells activate B-cells by secreting cytokines (lymphokines). These lvmphokines than stimulate the specific clone of B-cells to differentiate into plasma cells (clonal selection)Antigen exposure|Antigen presenting cells present this antigen to helper T cells|T cells are activated|Secretion of lymphokine by T-cells|B-cells that carrv BCR specific to that antigen are. stimulated (clonal selection)|B-cells proliferate and differentiate in to plasma cells|Plasma cells synthesize an immunoglobulin of same specificity as that carried by the B-cell precursors
|
Pathology
|
Cells and Tissues of Immune System
|
72e4dc6b-ed06-4e06-88d5-6146c4e30a19
|
What is the diagnosis in this patient who had abdominal pain?
|
Familial Mediterranean fever
|
Henoch-Schonlein purpura
|
Meningococcemia
|
Polyarteritis nodosa
| 1b
|
single
|
Answer B. Henoch-Schonlein purpuraSkin biopsies revealed leukocytoclastic vasculitis with IgA deposition, which is consistent with IgA vasculitis (Henoch-Schonlein purpura). The patient was treated with high-dose glucocorticoids including pulse therapy, which were tapered successfully after cyclosporine was added to the treatment. Henoch-Schonlein purpura, a systemic small-vessel vasculitis, causes palpable purpura in the lower extremities, abdominal pain, arthralgia, and glomerulonephritis.
|
Medicine
|
Immunology and Rheumatology
|
42087134-0225-44aa-b469-e7b5d52343af
|
Multiple rain drop osteolytic lesions are seen in
|
Lead poisoning
|
Littere siwe disease
|
Intracranial lesion
|
Multiple fractures
| 1b
|
single
|
Multiple lytic lesions are seen in Acute disseminated langerhans cell histiocytosis (aka Letterer-Siwe disease)
|
Radiology
|
Skeletal system
|
9a625a08-cdf4-49e7-ad7f-7def3f41b6fa
|
who gave the structural theory of mind
|
jean piaget
|
freud
|
mary ainswoh
|
alfred adler
| 1b
|
single
|
CONTRIBUTIONS OF FREUD o Father of psychoanalysis He founded a type of psychotherapy called psychoanalysis. It is nothing but analyzing the psych(MIND) o Interpretation of dreams According to Freud dreams are royal road to unconscious In dreams several conflicts that are present in the unconscious comes to the consciousness in the form of dreams Thus by analyzing ones dreams we could understand the unconscious conflicts o Psychosexual stages of life o Freud divided development into 5 stages namely psycho sexual development o It is divivded namely oral , anal , phallic, latent, genital phase. o Conversion disorders conversion disorder is conveing a psychological pain to physical symptoms present physical symptoms which has some connection with unconscious conflict is called SYMBOLIZATION present physical symptoms which has some resemblance with illness in family members, which is called MODELLING patient has illness like neurological deficit but they have apparent in concern towards their own illness which is known as LA BELLE INDIFFERENCE main defense mechanism in conversion disorder is REPRESSION o Repression defence mechanism * REPRESSION is called QUEEN of defense mechanisms o COUCH and FREE ASSOSIATION * He introduced a technique called as a couch technique where he makes the patient lie on the couch, he asks the patient to speak from 'cabbages to kings. This method is called FREE ASSOSIATION. By allowing the patient to speak whatever that comes to their mind randomly so that by analyzing their thoughts we could understand the conflict in the unconscious. o Topographical theory of mind Freud gave topographical theory mind It is divided into pre conscious, unconscious, conscious Later he disregarded topographical theory of mind and gave structural theory of mind o Structural theory of mind It is divided into id, ego, super ego Id= instinctual desires like anger, hunger, sexual instinct Ego= function of mind to work based on ego to avoid guilt from super ego Super ego= based on moral principle, obtained from family members and relatives, teachers Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition pg no. 845
|
Anatomy
|
Treatment in psychiatry
|
ec0bac66-c996-49c2-bed0-f855536fc322
|
Hypocalcemia is characterized by all except
|
Numbness and tingling of circumoral region
|
Hyperactive tendon reflexes
|
Shoening of Q-T interval in ECG
|
Carpopedal spasm
| 2c
|
multi
|
Widening of Q-T interval in ECG is seen in hypocalcemia.Perioral numbness, Carpopedal spasm, tetany and hyperactive tendon reflexes are noted.Trousseau sign, Chovstek&;s sign elicit latent tetany.
|
Physiology
|
General physiology
|
673efb91-ea61-4ecc-998d-2e16e47ff30b
|
Which of the follow ing drugs is contraindicated in liver dysfunction?
|
Pefloxacin
|
Vancomycin
|
Amikacin
|
Hydralazine
| 0a
|
single
|
Ans. is 'a' i.e., Pefloxacin In liver dysfunctionDrugs contraindicatedDrugs require dose adjustmento Erthromycin estolaleo Tetracyclineso Pyrazinamideo Pefloxacino Chloremphenicalo Methotrexateo INHo Rifampicino Tacrineo Talcaponeo Clindamycin
|
Pharmacology
|
Adverse Drug Effect
|
921d977a-d97c-4d83-bc98-4af81a8c4d68
|
Germ cell tumor(s) of paediatric includes all except
|
Pure yolk sac tumor
|
Leydig cell tumor
|
Choriocarcinoma
|
Embryonal cell carcinoma
| 1b
|
multi
|
Germ cell tumors in males(95%) include embryonal carcinoma(40%),yolk sac tumor(5%),Choriocarcinoma(rare),Seminoma(45%) and teratomas.Leydig cell tumor is a sex cord-stromal tumor(5%).Other sex cord -stromal tumors in males are seoli cell tumor,granulosa cell tumor. In females,germ cell tumors(15-20%) include embryonal carcinoma(40%),yolk sac tumor,choriocarcinoma(rare), teratomas(95%) ,dysgerminoma(2%).Sex cord-stromal tumors (5-10%) include granulosa-theca cell tumor,seoli-leydig cell tumor,gynandroblastoma. Reference:Textbook of pathology-Harsh Mohan,6th edition,page no:708,745.
|
Pediatrics
|
Childhood tumors
|
bf5e1ec8-8904-4de0-bde2-e54527381db0
|
All of the following are minor criteria for multiple Myeloma, Except
|
Plasmacytosis 20%
|
Multiple lytic lesions
|
Plasmacytoma on tissue biopsy
|
Monoclonal Ig spike < 2g/dl for IgA and < 3.5 for IgG
| 2c
|
multi
|
Answer is C (Plasmacytoma on tissue biopsy) Plasmacytoma or tissue biopsy is a major criterion for diagnosis of multiple myeloma (and not a minor criterion)
|
Medicine
| null |
fcf76f62-3851-4ebd-894d-4fb529b5056c
|
Satiety centre is located at
|
Ventromedial nucleus of hypothalamus
|
Dorsomedial nucleus of hypothalamus
|
Peritrigonal area
|
Lateral nucleus
| 0a
|
single
|
Satiety centre is situated in ventromedial, arcuate, and paraventricular nuclei; lateral hypothalamus. Ref: Ganong&;s Review of medical physiology;25th edition; pg: 309; table 17-1.
|
Physiology
|
Nervous system
|
5ce6a458-c485-4a77-8e89-c9ca779947ec
|
GH secretion is
|
Greater in early morning
|
Greater in evening
|
Increases on preolonged fasting
|
Stimulates B-cells of pancreases directly
| 2c
|
single
|
Peptide hormones. ... Sex hormones. ... Clonidine and L-DOPA by stimulating GHRH release. a4b2 nicotinic agonists, including nicotine, which also act synergistically with clonidine. Hypoglycemia, arginine and propranolol by inhibiting somatostatin release. Deep sleep. Insulin. Ref: guyton and hall textbook of medical physiology 12 edition page number: 550,551,552
|
Physiology
|
Endocrinology
|
d261f7b7-5e31-46f3-8627-35d4b6f4cdf8
|
Emphysema aquosum is found in -
|
Dry drowning
|
Wet drowning
|
Immersion syndrome
|
Secondary drowning
| 1b
|
single
| null |
Forensic Medicine
| null |
c39be99e-ef08-46b6-adc8-8bb311b52cc8
|
The antidote of choice in paracetamol poisoning is:
|
Flumazenil
|
Siodium bicarbonate
|
N-acetylcysteine
|
Methylene Blue
| 2c
|
single
|
Cytochromes P450 conve approximately 5% of paracetamol to a highly reactive intermediary metabolite, N-acetyl-p-benzoquinone imine (NAPQI). Under normal conditions, NAPQI is detoxified by conjugation with glutathione to form cysteine and mercapturic acid conjugates N-acetylcysteine works to reduce paracetamol toxicity by replenishing body stores of the antioxidant glutathione. Glutathione reacts with the toxic NAPQI metabolite so that it does not damage cells and can be safely excreted DOC Injection - N acetylcysteine DOC Oral- methionine Ref: KD Tripathi 8th ed
|
Pharmacology
|
Autacoids
|
ca14d5ab-1e57-4d1d-9be6-39589afed227
|
Parietal peritonium is lined by ?
|
Simple squamous
|
Stratified squamous
|
Cuboidal
|
Columnar
| 0a
|
single
|
A i.e. Simple squamousTransitional epithelium is a multilayered (4 - 6) stretchable epithelium, which has extra reserve of cell layers Q i.e. as tension increases the epithelial sheet is expanded & number of observable cell layers decrease & cell shape change from cuboid to squamous.The deepest layer of transitional epithelium is columnar or cuboidal; middle layer is polyhedral or pear shaped & surface layer is umbrella shaped.It differs from stratified squamous epithelium in that the cells at surface are not squamous.Membranous and most of penile urethraQ (in males) is lined by pseudostratified or stratified columnar epitheliumAnsa nephroni (renal loop of Henle) and mesothelium (i.e. serous/outer/parietal layer of peritoneum, pericardium & pleura) is lined by simple squamous epitheliumQ and distal convulated tubule (DCT) is lined by simple cuboidal epithelium without brush borderQ
|
Anatomy
| null |
68e7d988-ab8d-446d-967a-1379a4cf077c
|
Primary dentition is complete by: UPSC 08
|
1.5 years
|
2.5 years
|
3.5 years
|
4.5 years
| 1b
|
single
|
Ans. 2.5 years
|
Forensic Medicine
| null |
c7a654a2-8e55-4bd5-8560-65da0139a3b6
|
If a drug is active against pre erythrocytic stage of the malaria parasite it will be useful as
|
Suppressive prophylactic
|
Causal prophylactic
|
Clinical curative
|
Radical curative
| 1b
|
single
|
(Ref KDT 6/e p782) Stage ---clinical use Preerythrocytic- Causal prophylaxis Erythrocytic-Clinical cure -Suppressive prophylaxis Exo-Erythrocytic: Radical cure Gametocytic Pevention of transmission
|
Anatomy
|
Other topics and Adverse effects
|
57d15b6e-cb57-497e-9623-8e04b12d1592
|
All are true for sickle cell anemia, except -
|
Pulmonary arterial hypertension
|
Fish vertebra
|
Leukopenia
|
Increased size of heart
| 2c
|
multi
| null |
Medicine
| null |
baf7257f-8ace-4d74-81e8-d91a2f7c2667
|
Which of the following is the most common pure. malignant germ cell tumor of the ovary?
|
Choriocarcinoma
|
Gonadoblastoma
|
Dysgerminoma
|
Malignant teratoma
| 2c
|
single
| null |
Gynaecology & Obstetrics
| null |
ac7038f4-eeb4-4cfc-bd9b-8719630a4db4
|
The test having the fastest lab processing time for karyo type assessment is
|
Amniocentesis
|
Cordocentesis
|
Chorionic villus sampling (CVS)
|
Doppler flow ultrasound
| 2c
|
single
|
Amniocentesis, cordocentesis, cystic hygroma aspiration, and chorionic villus samplingare techniques of obtaining fetal tissues that are amenable to cytogenetic analysis.
Amniotic fluid cellsrequire tissue culture to obtain adequate cell numbers for analysis.
Chorionic villi can be harvested directlyfor extremely rapid diagnosis or can be cultured for higher banding (increased detail).
|
Unknown
| null |
c25aa1bc-32fd-4bf7-93fa-c3fe65034669
|
In low ovarian reserve,anti mullerian hormone level will be:
|
<1
|
4-Jan
|
>7
|
>10
| 0a
|
single
|
Ans. A. <1AMH and ovarian reserveAMH of 1.0 has very poor ovarian reserveThe central concept for the measurement of blood levels of AMH to determine ovarian reserve is this: women with lower AMH levels have a lower ovarian reserve than women with high AMH levels. AMH is currently being used by feility specialists to help predict women who may respond poorly to feility medications and in general, couples who are less likely to be successful with feility treatment.
|
Gynaecology & Obstetrics
| null |
1d1f7a02-e8c5-4826-90e4-9361493c67b1
|
A 78-year-old man underwent surgical repair of an abdominal aoic aneurysm. Postoperatively he developed left lower quadrant pain along with urgency to defecate and had frequent episodes of passage of bright red blood per rectum. He has a history of prostate cancer for which he had received radiation therapy several years ago. Colonoscopy findings of the patient are shown below.X ray abdomen was also done. What is the most likely cause of his symptoms?
|
Radiation proctitis
|
Clostridium difficile colitis
|
Ischemic colitis
|
Acute diveiculitis
| 2c
|
single
|
1st image shows ischemic colitis with patchy mucosal edema, subepithelial hemorrhage, and cyanosis. 2nd image shows the classical thumb printing sign. Most impoant precipitating factor - Surgery in an old individual Most common surgery leading to it - Repair of abdominal aoic aneurysm Colonoscopy findings show haemorrhagic ulcers with sharp demarcation between normal and ischemic mucosa.
|
Unknown
|
Integrated QBank
|
c096c16f-b0ca-4d47-9cfc-ccf609007f0b
|
Exsanguination is one of the first steps before application of a tourniquet preoperatively. All the following are contraindications for exsanguination except
|
Deep vein thrombosis
|
Underlying fracture
|
Presence of infection
|
Tumour
| 1b
|
multi
|
Presence of underlying infection or tumor is an absolute contra indication for exsanguination since that can cause dissemination. Fatal pulmonary embolism may result if exsanguination is done over underlying deep vein thrombosis
|
Pathology
|
All India exam
|
48655c03-9511-40ff-8463-3681a26fb3e3
|
Effect of increased vertical dimension is/are
|
Muscular fatigue
|
Trauma
|
TMJ problem
|
All of the above
| 3d
|
multi
| null |
Dental
| null |
7ff13484-3f3d-4fd6-ba74-7f9f30f315d1
|
All of the following are characteristic features of Kwashiorkar, except -
|
High blood osmolarity
|
Hypoalbuminemia
|
Edema
|
Fatty liver
| 0a
|
multi
|
Ans. is 'a' i.e., High blood osmolarity
|
Pediatrics
| null |
66dd5657-da79-40fd-b160-9b5a71f57765
|
All are true regarding DIC, EXCEPT:
|
Decreased fibrinogen
|
Decreased PTT
|
Thrombocytopenia
|
Increased PT
| 1b
|
multi
|
Common laboratory findings in DIC include the prolongation of PT and/or aPTT; platelet counts 100,000/L3, or a rapid decline in platelet numbers, the presence of schistocytes (fragmented red cells) in the blood smear and elevated levels of FDP (fibrin degradation products ). The most sensitive test for DIC is the FDP level. Ref: Harrison's Internal Medicine, 18th Edition, Pages 978-80
|
Medicine
| null |
97ae6006-6ae2-4e50-8c75-77c206498104
|
Postnatally when is the growth velocity maximum?
|
In the first year of life
|
In the second year of life
|
In the seventh year of life
|
In adolescence
| 0a
|
multi
|
Postnatally there are 2 periods of accelerated growth: first year of life and growth spu during pubey.
|
Pediatrics
|
Growth
|
cb15e48e-4197-458d-8b83-d8f3e16d4824
|
Drug of choice for Herpes simplex encephalitis is:
|
5-Hydroxy deoxyuridine (5-HU)
|
Acyclovir
|
Gancyclovir
|
None of the above
| 1b
|
multi
|
Acyclovir is active only against herpes group of viruses; H. simplex type I is most sensitive followed by H. simplex type II > varicella-zoster virus= Epstein-Barr virus; while cytomegalovirus (CMV) is practically not affected. Both H. simplex and varicella-zoster virus have been found to develop resistance to acyclovir during therapy; the former primarily due to mutants deficient in thymidine kinase activity and the latter primarily by change in specificity of virus directed enzyme so that its affinity for acyclovir is decreased. Use Acyclovir is effective in patients with normal as well as deficient immune status. 1 . Genital Herpes simplex Generally caused by type II virus; can be treated by topical, oral or parenteral acyclovir depending on stage and severity of disease. 2. Mucocutaneous H. simplex is a type I virus disease, remains localized to lips and gums; does not usually require specific treatment, but acyclovir skin cream may provide some relief 3. H. simplex encephalitis (type I virus): Acyclovir 10 to 20 mg/kg/8 hr i.v. for ;?.10 days is the drug of choice. Treatment is effective only if staed early: delay precludes salutary effect on moality and neurological complications. 4. H. simplex (type I) keratitis: Acyclovir is equally effective as idoxuridine in superficial dendritic corneal ulcer, and may be better for deep stromal infections because of good corneal penetration. Though acyclovir eye ointment acts slower than idoxuridine eye drops, blindness can be prevented. The eye ointment should be applied 5 times daily till 3 days after healing. 5. Herpes zoster: The varicella-zoster virus is less susceptible to acyclovir. As such, higher doses are needed and it should be used only in immunodeficient individuals or in severe cases: 10 mg/ kg/8 hr i.v. for 7 days. 6. Chickenpox: in patients with immunodeficiency and in neonates only calls for specific therapy. Acyclovir (15 mg/kg/day i.v. x 7 days) is the drug of choice: reduces fever, eruptions, hastens healing and prevents visceral complications ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:768,769
|
Pharmacology
|
Chemotherapy
|
6cd6111b-3af2-4fd5-8373-e6a9e1f465a3
|
IUGR is caused by all except :
|
Rh incompatibility
|
Smoking
|
DM
|
CRF
| 0a
|
multi
|
Rh incompatibility
|
Gynaecology & Obstetrics
| null |
66fc37f0-6717-48a9-8471-b07743986196
|
A 5 year old child presents with perivascular IgA deposition and neutrophilic collection. There is erythematous rash on the lower limb and nonblanching purpura. Probable diagnosis is
|
Henoch-Schonlein purpura
|
Wegener's granulomatosis
|
Vasculitis
|
Kawasaki's disease
| 0a
|
single
|
Henoch schonlein purpura : It is one of the most common vasculitic disorder of childhood. Characterised by the presence of nonthrombocytopenic , palpable purpura, transient ahralgia and abdominal symptoms. The illness begins with a rash more prominent over the extensor aspects of lower extremities and buttocks. It may be macular, maculopapular or even uicarial to begin with . Glomerulonephritis seen in one third of cases. Gastrointestinal manifestations usually occur in first 7-10 days if illness. Abdominal pain is intermittent, colicky and periumbilical.vomitingseen , whereas melena and hemetemesis are less common. Rare manifestations include CNS vasculitis, coma, Guillain Barre syndrome, pulmonary hemorrhage, carditis and orchitis. Criteria for childhood HSP:- Palpable purpura in the presence of at least one of the following 4 features: 1. Diffuse abdominal pain. 2. Any deposit showing IgA deposition. 3. Ahritis/Ahralgia. 4. Renal involvement. Investigation: Nonspecific rise in total serum IgA levels. Skin biopsy shows leukocytoclastic vasculitis. On indirect immunofluorescence there are mesangial deposits of IgA andC3 in skin and renal biopsy. Reference: GHAI essential Paediatrics
|
Pediatrics
|
Urinary tract
|
9e1ac2ed-b9d0-42d1-99dc-1fa01f6fcecf
|
Pisiform is which type of bone:
|
Pneumatic bone
|
Sesamoid bone
|
Accessory bone
|
Long bone
| 1b
|
single
|
The pisiform is a sesamoid bone, with no covering membrane of periosteum. It is the last carpal bone to ossify.
The pisiform bone is a small bone found in the proximal row of the wrist (carpus).
It is situated where the ulna joins the wrist, within the tendon of the flexor carpi ulnaris muscle.
|
Anatomy
| null |
7d54cc6b-b074-44e6-82e8-af6d05e94e36
|
Which of the following is not a component of the crush syndrome.
|
Myohemoglobinuria
|
Massive crushing of muscles
|
Acute tubular necrosis
|
Bleeding diathesis
| 3d
|
single
|
Ans. is 'd' i.e., Bleeding diathesis Crush syndrome results from massive crushing of muscles. Crushing of muscles leads to release of large amounts of my haemoglobin into the circulation. which is excreted in urine (Myohaemoglobinuria).Myohemoglobin is an endogenous nephrotoxin. It can cause acute tubular necrosis particularly in hypovolemic or acidotic pts.
|
Orthopaedics
|
Injuries to the Leg, Ankle & Foot
|
0f6a50b6-c73d-4522-b6fb-e0ffacdd3525
|
Palpatory thud, audible slap is seen in -
|
Tracheal foreign body
|
Bronchial foreign body
|
Laryngeal foreign body
|
None
| 0a
|
multi
|
Ans. is 'a' i.e., Tracheal foreign body o A foreign body in trachea may move up and down the trachea between the carina andd the undersurface of the vocal cords causing "audible slap" and "palpatory thud". o Symptoms and signs of foreign bodies at different levels :# Larynx# Trachea
|
Medicine
|
C.V.S.
|
7cd71d0e-e5ea-48a4-bd2c-0ae2e7390c0e
|
A fungicidal drug that can be used orally for the treatment of onychomycosis is:
|
Griseofulvin
|
Amphotericin B
|
Clotrimazole
|
Terbinafine
| 3d
|
multi
|
Fungicidal drugs are amphotericin B and terbinafine. Out of these, amphotericin B cannot be given orally. Thus, the answer is terbinafine.
|
Pharmacology
|
Anti-Fungal Drugs
|
1d99d3b5-bbb3-4bfd-aeb1-1fd23f4e0c00
|
10 month old child cannot do _____
|
Change cube from one hand to another
|
Can build a cube of six
|
Can pull and stand
|
Waves bye bye
| 1b
|
single
|
Developmental milestones:- GROSS MOTOR DEVELOPMENT: 2 months: Holds head in plane of rest of the body when held in ventral suspension. In prone position in bed, the chin lifts momentarily. 3 months:lift head above the plane of the body. Head control stas by 3 months and fully developed by 5 months. 4 months:Remain on forearm suppo if put in prone position, lifting the upper pa of the body off the bed. 5 months: Rolls over. 6 months:sit in tripod fashion. 8 months: sits without suppo., crawling 9 months: Takes a few steps with one hand held. Pulls to standing and cruises holding on to furniture by 10 months. 10 months: creeps 12 months:creeps well, walk but falls, stand without suppo. 15 months: walks well, walks backward/ sideways pulling a toy. May crawl upstairs. 18 months: Runs, walks upstair with one hand held. Explores drawers 2 years: walk up and downstairs, jumps. 3 years : rides tricycle, alternate feet going upstairs. 4 years: hops on one foot, alternate feet going downstairs. 5 years:skips FINE MOTOR DEVELOPMENT:- 2 months- eyes follow objects to 180 deg. 3 months-Grasp reflex disappears and hand is open most of the time. 4 months- Bidextrous approach( reaching out for objects with both hands). 6 months- Unidextrous approach( Reach for an object with one hand). 8 months- radial grasp sta to develop. Turns to sound above the level of ear. 9 months- immature pincer grasp, probes with forefinger. 12 months-Unassisted pincer grasp. Releases object on request.Uses objects predominantly for playing, not for mouthing. Holds block on each hand and bang them together. 15 months- imitate scribbling , tower of two blocks 18 months- scribbles, tower of 3 blocks.turn pages of a book, 2-3 at a time. 2 years- tower of 6 blocks, veical and circular stroke. 3 years-Tower of 9 blocks, dressing and undressing with some help, can do buttoning. 4 years- copies cross, bridge with blocks 5 years- copies triangle, gate with blocks. SOCIAL AND ADAPTIVE MILESTONES: 2 months: social smile(smile after being talked to).watches mother when spoken to and may smile. 3 months:Recognizes mother, anticipates feeds. 4 months: Holds rattle when placed in hand and regards it . Laughs aloud. Excited at the sight of food. 6 months:recognizes strangers, stranger anxiety . Enjoy watching own image in mirror, shows displeasure when toy pulled off. 9 months:waves bye bye 12 months:comes when called, plays simple ball game.kisses the parent on request. Makes postural adjustments for dressing. 15 months:jargon, stas imitating mother. 18 months: copies parents in tasking, dry by day, calls mother when he wants potty, points to three pas of body on request. 2 years: ask for food, drink, toilet, pulls people to show toys. 3 years:shares toys, know fullname and gender, dry by night. 4 years:Plays cooperatively in a group, goes to toilet alone, washes face, brushes teeth. Role play . 5 years:helps in household task , dresses and undresses. LANGUAGE MILESTONES: 1 month: Ales to sound. 2 month:respond to sound by stale or quitening to a smooth voice. 3 months: babbles when spoken to. Makes sounds (ahh,coos, ) laughs. 4 months: laughs aloud. 6 months: monosyllables 9 months: understands spoken words, bisyllables. 12 months: 1-2 words with meaning. 15months : vocabulary of 6 words 18 months: vocabulary of 10 words. Can name one pa of body. 2 years: 3 word simple sentences 3 years:asks questions, knows full name and gender. 4 years: says songs or poem, tells story, knows three colours. 5 years: ask meaning of words. Reference: GHAI Essential pediatrics, 8th edition
|
Pediatrics
|
Growth and development
|
7af0c8d9-7b75-4741-b249-c3bad7dd971d
|
True about polio vaccination is all EXCEPT -
|
Follow up of AFP for 30 dyas
|
Salk contains three types of polio virus
|
Pulse polio doses are extra and supplemental
|
Oral polio vaccine provides intestinal immunity also
| 0a
|
multi
|
<p> Follow up in 60 days. Reference:Park&;s textbook of preventive and social medicine,K.Park,23rd edition,page no:203. <\p>
|
Social & Preventive Medicine
|
Communicable diseases
|
44335f99-941d-42bf-a8cb-93258db0eec0
|
A patient with ptosis presents with retraction of ptotic eye lid on chewing. This represents:
|
Marcus gunn Jaw winking syndrome
|
Third nerve misdirection syndrome
|
Abducent palsy
|
Occulomotor palsy
| 0a
|
single
|
Ans. Marcus gunn Jaw winking syndrome
|
Ophthalmology
| null |
29521497-9a7a-46b3-a295-bdf4dcfc7963
|
Blowout injury refers to what?
|
Fracture of orbit
|
Fracture of maxillary antrum
|
Fracture of nasal septum
|
Fracture of mandible
| 0a
|
single
|
Ref: Basok Essentials of Ophthalmology 5th edition, pg no 421: Kanski: Clinical Ophthalmology; 7th edition, pg no 873- 874Explanation:Blow out fracture of orbit:Caused by a sudden increase in the orbital pressure by an impacting object of size > 5cm like tennis ball or fist.The fracture usually involves the floor of the orbit, along the thin bone covering the infra orbital canal.Two types:Pure Blow Out fracture does not involve the orbital rim or the other bones.Impure Form involves other bones.Symptoms:Diplopia - due to the entrapment of muscle into the fracture, intraorbital hemorrhage or injury to the muscle itself.Double Diplopia - Diplopia in both upgaze & downgaze due to entrapment of both Inferior rectus (Depression) & inferior oblique (Elevation).Periocular ecchymosis & edema.Enophthalmos.Infraorbital nerve ana esthesia.Investigations: X-ray (WATER'S view) - 'Tear Drop Sign' because of the protruding orbital tissue from the floor if the orbit into the maxillary antrum.Management:Conservative management with antibiotics & anti inflammatory drugs.Orbital floor repair with bone graft, silicone plate within 2 weeks.Indications:Fracture involving > one third of the floorPersisting diplopiaEnophthalmos > 2mmBlow-In Fracture:Sudden rise of pressure in the maxillary antrum due to trauma to the face with subsequent elevation of bone fragments into the orbit.
|
Ophthalmology
|
Ocular Trauma
|
ebc05d6b-24de-4a60-a2a1-f1081224987e
|
The term schizophrenia means
|
Free mind
|
Euphoric mind
|
Split mind
|
Confused mind
| 2c
|
single
|
the term SCHOZPHRENIA means SPLIT MIND this was given by Eugene Bleuler it means that there is a split in the components of the mind the split is between the thoughts, cognition and behavior. Reference: Kaplon and sadock, 11 th edition, synopsis of psychiatry, 11 th edition, pg no. 301
|
Psychiatry
|
All India exam
|
1085eb55-6581-435c-8f63-060e8d7d65b1
|
Cerebral blood supply
|
55 ml/100 gm/min
|
400 ml/100 gm/min
|
100 ml/100 gm/min
|
200 ml/100 gm/min
| 0a
|
single
|
The average cerebral blood flow in young adults is 54 mL/100 g/minRef: Ganong's Review of Medical Physiology Twenty-Third Edition Page No: 575
|
Physiology
|
Cardiovascular system
|
5dd7fc2d-eeee-4ab2-9a72-3ac6fd02b366
|
All of the following are associated with increased risk of atherosclerotic plaque formation except
|
Apo E mutation
|
Oxidized LDL
|
Increased homocysteine
|
Increased Alpha 2 macroglobulin
| 3d
|
multi
|
Risk Factors for Cardiovascular Disease Class 1: Modifiable risk factors, Interventions have been proved to lower CAD risk. 1. Cigarette smoking 2. High total cholesterol 3. High LDL cholesterol 4. Low HDL cholesterol 5. High fat/cholesterol diet 6. Left ventricular hyperophy (LVH) 7. Thrombogenic factors Class 2: Modifiable risk factors, Interventions are likely to lower CAD risk. 8. Lipoprotein (a) or Lp(a) 9. Diabetes mellitus 10. Hypeension 11. Physical inactivity 12. Obesity 13. High triglycerides 14. High homocysteine 15. Increased high-sensitivity-CRP (hs-CRP) 16. Stress Class 3: Nonmodifiable risk factors. 17. Age 18. Male gender 19. Family history of CAD Alpha-2-Macroglobulin (AMG) AMG is a tetrameric protein with a molecular weight of 725 kD. It is the major component of alpha-2 globulins. It is synthesized by hepatocytes and macrophages. AMG inactivates all proteases and is impoant in vivo anti-coagulant. AMG is the carrier of many growth factors such as platelet-derived growth factor (PDGF). Normal serum level is 130-300 mg/dl. Its concentration is markedly increased (up to 2-3 g/dl) in Nephrotic syndrome, where other proteins are lost through urine.Ref: DM Vasudevan - Textbook of Biochemistry, 8th edition, page no: 294, 335
|
Biochemistry
|
Metabolism of lipid
|
8d073c1c-b1d7-4fa1-bcff-e092753a575b
|
Category A bioterrorism agents are-a) Ebolab) Yersiniac) Clostridium botulinumd) Rickettsiae) Cholera
|
abc
|
bcd
|
abe
|
acd
| 0a
|
single
| null |
Microbiology
| null |
388212e3-d15e-4dcc-8847-c4ff09e7f82d
|
True about minoxidil is:(1995)
|
Increases hair growth
|
Antihypertensive
|
Both
|
None
| 2c
|
multi
|
cRef: KDT, 5th ed, p. 512 & 4th ed, p. 549
|
Pharmacology
|
C.V.S
|
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