mehrdadgh/medmcqa · Datasets at Hugging Face

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23ef368c-b438-4589-8c71-8360bbf84ae5	Fundoscopy of a patient shows chalky white optic disc with well defined margins. Retinal vessels and surrounding retina appears normal. Which of the following is the most likely diagnosis:	Primary Optic Atrophy	Post-neuritic secondary optic atrophy	Glaucomatous optic atrophy	Consecutive optic atrophy	0a	single	A i.e. Primary Optic Atrophy	Ophthalmology	null
3659d893-cf23-4fa7-b16c-64fba02800ee	Root completion of primary maxillay Lateral incisor tooth occurs at an age of	2-2 ½ year	1-1 ½ year	3-4 year	None of the above	0a	multi	null	Dental	null
c5085fad-b97c-412c-b1da-6503711a324f	Test for RNA:-	Nohern blot	Southern blot	Immuno blot	South-Western blot	0a	single	Nohern Blotting detects RNA. Nohern blot - RNA Southern blot- DNA Western blot- Proteins See treasure for details	Biochemistry	Techniques in molecular biology
8910b07a-1055-4561-8a79-4cf9f20d7eb6	Medial boundary of anatomical snuffbox is formed by	Extensor pollicis longus	Extensorpollicis brevis	Abductor pollicis longus	Flexor carpi ulnaris	0a	single	ANATOMICAL SNUFF BOX:-Elongated triangular depression seen on the lateral side of the dorsum of hand when the thumb is hyperflexed. BOUNDARIES:1. Anterolaterally-tendon of abductor pollicis longus,tendon of extensor pollicis brevis.2. Posteromedially-tendon of extensor pollicis longus.3. Floor-scaphoid and trapezium.4. Roof-skin and superficial fascia.Contents:-1. Radial aery.Structures crossing the roof deep to skin:-1. Cephalic vein.2. Terminal branch of superficial radial nerve. Pulsations of radial aery felt here.Tenderness felt here indicates fracture of scaphoid bone.Cephaloc vein at this site can be used for giving iv fluids. {Reference: Vishram Singh , page no.171} Figure 9.33,page no:122 BD chaurasia	Anatomy	Upper limb
a385dc81-7224-49a8-a97b-88010d81b568	A drug that binds to the receptor at the same site as the agonist and produces an intrinsic effect opposite to the agonist is termed as:	Paial agonist	Inverse agonist	Competitive antagonist	Non-competitive Antagonist	1b	single	A drug that binds to the receptor at the same site as the agonist and produces an effo opposite to the agonist is termed as A reverse Agonist. Inverse/Reverse Agonist: is an agent that binds to the receptor as an agonist but induces an intrinsic response opposite to that of an agonist. A Competitive Antagonist: is an agent that binds to the same site as the agonist and induces no intrinsic response. (No intrinsic activity; does not activate). The antagonism is acheived because it blocks the action of the agonist. The antagonist effect is only observed if the agonist is also present (it cannot block the agonist effect if no agonist is present) Agonist Antagonist A drug that binds to and activates a receptor. Can be full, paial or Inverse. A Full Agonist has high efficacy, producing a full response while occupying a relatively low propoion of receptors A Paial Agonist has lower efficacy than a full agonist. It produces sub-maximal activation even when occupying the total receptor population, therefore cannot produce the maximal response, irrespective of the concentration applied. A paial antagonist antagonizes the action of a full agonist. An Inverse Agonist produces an effect opposite to that of an agonist, yet binds to the same receptor binding-site as an agonist. A drug that attenuates the effect of an agonist. Can be competitive or non-competitive, each of which can be reversible or irreversible A Competitive Antagonist binds to the same site as the agonist but does not activate it, thus blocks the agonist&;s action. A Non-competitive Antagonist binds to an allosteric (non-agonist) site on the receptor to prevent activation of the receptor. Any non-competitive inhibitor may thus also be termed as an Allosteric Inhibitor. A Reversible Antagonist binds non-covalently to the receptor, therefore can be "washed out" An Irreversible Antagonist binds covalently to the receptor and cannot be displaced by either completing ligands or washing Ref: KDT 7th edition	Pharmacology	General pharmacology
dcc7b916-2b93-4274-9d60-167f0709f4b0	Most common site of origin of pleomorphic adenoma is:	Parotid gland	Submandibular salivary gland	Minor salivary glands of soft and hard palate	Minor salivary glands of lip	0a	single	Pleomorphic adenoma most commonly arises from the parotid gland. Ninety per cent are located in the superficial lobe while 10% involve deep lobe and present as parapharyngeal tumours.	ENT	Oral Cavity
6f4f0463-fc9d-415c-be59-8106f2f65604	Management of infected pancreatic necrosis includes all of the following except: March 2010	Percutaneous drainage	Pancreatic necrosectomy	Manage conservatively with antibiotics alone	Nutritional suppo	2c	multi	Ans. C: Manage conservatively with antibiotics alone Infection complicating pancreatic necrosis leads to persisting sepsis, multiple organ dysfunction syndrome and accounts for about half the deaths that occur following acute pancreatitis. Severe cases due to gallstones require urgent endoscopic sphincterotomy. Patients with pancreatic necrosis should be followed with serial contrast enhanced computed tomography (CE-CT) and if infection is suspected fine needle aspiration of the necrotic area for bacteriology (FNAB) should be undeaken. If the aspirate is purulent, percutaneous drainage of the infected fluid should be carried out. In the presence of infection and worsening of sepsis despite percutaneous drainage, necrosectomy is indicated. Although traditionally this has been by open surgery, minimally invasive procedures are a promising new alternative. There are many unresolved issues in the management of pancreatic necrosis. These include, the use of antibiotic prophylaxis, the precise indications for and frequency of repeat CE-CT and FNAB and the role of enteral feeding. Nutritional suppo is essential	Surgery	null
ee2aa01a-8339-4e6b-88d0-e45080431869	Which of the following is a serious and characteristic adverse effect of Metformin	Lactic acidosis	Weight gain	Hypoglycemia	Dilutional hyponatremia	0a	single	Ans: A. Lactic acidosis [Ref: KDT 7h/e p. 453).Two impoant adverse effects of these agents are lactic acidosis (more with phenformin) and vitamin B12 deficiency (more common with metformin).More common side effects are abdominal pain, anorexia, metallic taste, mild diarrhea and tiredness.	Pharmacology	null
bda4eeca-8d5a-418c-90ba-9a3c90fc01ba	Kliiver-Bucy syndrome is associated with lesion in the following area of brain	Amygdala	Cerebral cortex	Hippocampus	Mammillary body	0a	single	(A) Amygdala # Kliiver-Bucy syndrome is a behavioral disorder that occurs when both the right and left medial temporal lobes of the brain malfunction. People with lesions in their temporal lobes show similar behaviors.> They may display oral or tactile exploratory behavior (socially inappropriate licking or touching); hypersexuality; bulimia; memory disorders; flattened emotions (placidity)-, and an inability to recognize objects or inability to recognize faces.> The full syndrome rarely, if ever, develops in humans. However, parts of it are often noted in patients with extensive bilateral temporal damage caused by herpes or other encephalitis and dementias of degenerative or post-traumatic etiologies.> This disorder may be caused by many conditions, including facial or cerebral trauma; infections; Alzheimer's disease; Niemann Pick disease of the brain; or cerebrovascular disease.	Medicine	Miscellaneous
20833593-4fdf-4f2c-b1d7-05528ac9c8f6	Dorsiflexion of ankle joint ?	Tibialis anterior	Peroneus longus	Tibialis posterior	Soleus	0a	single	Ans. is 'a' i.e., Tibialis anteriorActive movements permitted at ankle joint are dorsiflexion and plantar flexion.Dorsiflexion is the closed packed position with maximum congruence of the joint surfaces and ligaments tension.Thus talus fits snugly into the socket when foot is dorsiflexed and there are no chances of ankle dislocation in dorsiflexion.When foot is plantar flexed, talus is slightly loose and may allow slight lateral rotation with maximum chances of dislocation.Thus, Ankle is more stable in dorsiflexed position.Movements Principal muscles Accessory muscles DorsiflexionTibialis anterior Extensor digitorum longus, Extensor hallucis longus, Peroneus teius (Muscles of anterior compament of leg)Plantalexion Gastrocnemius Soleus Plantaris tibialis posteior, flexor hallucis longus, flexor digitourm longus (Muscles of posterior comapment of leg)	Anatomy	null
bf1fc3d4-98fd-4b84-b4c4-7568f41bbb02	Left Umbilical vein becomes?	Ligamentum teres	Ligamentum venosum	Medial umbilical ligament	Ligamentum aeriosum	0a	single	Ligamentum teres	Anatomy	null
b55385fc-8184-4651-9f6b-58a979ade5a8	Acute liver failure is caused by A/E-	Hepatitis A	Hepatitis B	Hepatitis E	Hepatitis C	3d	single	The imp pa of type C hepatitis is the chronic illness. REF:ANATHANARAYAN AND PANIKER'S TEXTBOOK OF PATHOLOGY 8TH EDITION PAGE NO-548	Microbiology	Virology
f325d660-3c74-4f4f-b09d-e49fe17b935c	A peptic ulcer is associated with all except one -	Cirrhosis	Zollinger Ellisons syndrome	Primary hyperparathyroidism	Pernicious anemia	3d	multi	You, don’t expect pernicious anemia to cause peptic ulcer. In pernicious anemia, there is autoimmune destruction of the parietal cells leading to hypochlorhydria which further progresses to achlorhydria Etiology. of peptic ulcer Acute Peptic Ulcer NSAIDS Ingestion Stress Cushing ulcer after cerebral trauma Curling ulcer* after burn injury, any kind of shock Sepsis — Undrained pus may be responsible for an acute ulcer. Steroids Chronic Gastric Ulcer NSAIDs Ingestion NSAIDs disrupt the prostaglandin driven support of the mucosal barrier. Prostaglandins are responsible for the prodn. of mucosal gel layer in the stomach, which provide a protective barrier to the gastric and duodenal lining. So disruption of this mucosal barrier allows even minimum amount of acid to cause ulceration. Helicobacter pylori H.Pylori is seen in almost 90% of cases of duodenal ulcer and 70% of cases of gastric ulcer. Pyloroduodenal reflux Regurgitate bile & other duodenal juices. Mucosal trauma by mechanical effect of food. Diet & smoking Irregular diet, spicy food excessive drinking of tea & coffee, alcohol, Cigarette smoking has a definite relation with both gastric & duodenal ulcers. Emotional factors Anxiety, Stress & strain. Liver disease Ulceration of both stomach and duodenum have co-existed with the disease of the liver, particularly cirrhosis. It may be due to increase in blood supply to the gastric mucosa and overproduction of histamine in the stomach wall to stimulate the parietal cell. Chronic Duodenal Ulcer Acid hypersecretion Genetic factors Persons of blood group 'O' who do not possess AB antigen are peculiarly apt to develop a duodenal ulcer. iii.Endocrinal disorders Zollinger Ellison syndrome Hyperparathyroidism Multiple adenoma syndromes (MEN-I) Cushing. syndrome (b/c of the high level of endogenous steroids) Chronic liver diseases Chronic lung disease Chronic pancreatitis Emotional factor Diet & smoking H.pylori The decrease in bicarbonate production The list may be exhaustive but questions have been repeatedly asked on etiology of peptic ulcers.	Surgery	null
07cb00a8-27aa-4917-a9b9-369c38b87aac	Ramachandran is on the surgical ward with non-seminomatous tumor of testis and more than 4 retroperitoneal lymph nodes involved. You are the resident who is making a decision about fuher management. The treatment include all of the following, except:	Retroperitoneal Lymph Node Dissection (RPLND)	Inguinal orchiectomy	Chemotherapy	Radiotherapy	3d	multi	Inguinal orchiectomy with high ligation of the cord at the internal ring is the initial management of testicular tumour. Multi Agent chemotherapy and followed by surgical resection is one modality of treatment. Ref: Bailey & Love, 25th Edition, Page 1269.	Surgery	null
652922f1-aace-4e4f-8134-e615ee163c1f	Fluconazole is more effective than itraconazole in the following systemic fungal disease:	Pulmonary histoplasmosis	Cryptococcal meningitis	Non-meningeal blastomycosis	Disseminated sprorotrichosis	1b	single	(Ref: KDT 6/e p763, 764) Fluconazole has maximum CNS penetration whereas itraconazole has limited entry in the brain. Therefore fluconazole is preferred over itraconazole for the treatment of cryptococcal meningitis. For all other conditions listed in the question, itraconazole is first choice drug.	Pharmacology	Other topics and Adverse effects
9107fbf1-ff2a-4d69-a65b-d3da742ddca1	Implantation occurs at -	2-3 days	6-7 days	15-20 days	20-25 days	1b	single	Ans. is 'b' i.e., 6-7 days Age (Days)SomitesCharacteristics0-1--Fertilized uncteaved zygote2-3--Segmentation=two cells to morula4-5--Unimplanted, free-floating blastocyst6-7--Implantation8-11--Progression into endometrium12-14--Embryonic disc, villi, and yolk sac appear15-16--Primitive streak appears17-18--Neural folds elevate19-201-3Head fold appears21-234-12Neural fold fusion begins, heart begins to beat23-2513-20Two branchial arches, foregut, hindgut, optic evagination21-2921-29Arm buds appear, neural tube closed, optic cup28-30 (complete no.)40Leg buds apear, heart chambers. lung buds, metanephric bud30-32--Lens invagination, septum primum, gonadal ridge32-34--Lens vesicle closed, external ears becoming recognizable35-36--Eye pigment appears, hand plate, hypophysis, liver37-40--Finger rays, foot plate, ear defined, somites less apparent superficially40-42--Eyelid, finger rays notched, toe rays, nerve plexuses42-44--Head more erect, limbs extend forward, muscles developing, duodenum closed45-46--Fingers, scalp plexus present, optic nerve, septum secundum4648--Hands meet over heart region, corpus striatum, thalamus, heart valves48-50--Fingers overlap those of opposite hand, duodenum reopened50-52--Head erect and rounded, scalp plexus reaching head vertex, ossification beginso Contact of blastocyst with endometrium occurs at the time of implantation,o Implantation occurs at around 6 -7 days.	Anatomy	Fertilization and Development of Embryo
c1e5b8b0-27c8-495a-8dc1-1536005badfc	Which of the following aminoglycoside antibiotic has the highest risk of causing Ototoxicity	Kanamycin	Amikacin	Neomycin	Natamycin	0a	single	Ototoxicity is the irreversible side effect of aminorglycosider. Auditory toxicity: Kanamycin > Amikasin > Neomycin Vestibular toxicity: Streptomycin. KAN → Ear.	Pharmacology	null
e1a6cfaf-36cd-465e-8d96-6cd4916b5345	When one strand of DNA isolated showed 20A, 25G, 30C, 22T. How many A, G, C, T will be there in both strands together	A=45 G=45, C=52, T=52	A=50, G=47, C=50, T=47	A=44, G=55, C=55, T=44	A=42, G=55, C=55, T=42	3d	multi	Chargaff's rule	Biochemistry	null
8d7aefb7-53b2-4e8a-a39e-a80c292657de	Vasa vasora are functionally analogous to ?	Valves	Basal lamina	Coronary aeries	Endothelial diaphragms	2c	multi	Vasa vasorum are small blood vessels that supply walls of large blood vessels. It was thought coronary aeries are analogous to vasa vasorum. "Because hea originates from the primitive endocardial tube (ventral aoa) embryologically, coronary aeries that supply this tube can be thought as "cardiac vasa vasorum" like aerial vasa vasorum that supply peripheral aeries".	Anatomy	General anatomy
654799d5-2a02-4908-94fe-1119512b6df9	All of the following are treatment modalities for gastric lymphoma except:	Chemotherapy for primary gastric lymphoma	Chemotherapy for secondary gastric lymphoma	Antibiotic treatment for H. pylori in low grade MALToma	Radical subtotal gastrectomy for locally advanced disease	3d	multi	Ans. (d) Radical subtotal gastrectomy for locally advanced diseaseRef: Sabiston 20th edition, Page 1228Treatment of lymphomas in stomach:* Most Lymphomas are treated with multimodality treatment* CHOP therapy is the chemotherapy commonly used* Chemotherapy alone is enough for early cases* Diffuse advanced cases are not amenable for surgery and palliative chemotherapy alone is given.* Indications for surgery in Lymphoma are:# Limited gastric disease# Recurrence# Complications like bleeding, obstruction and perforation	Surgery	Stomach & Duodenum
e086b206-96fe-45a6-8698-209fcbba16a1	All of the following are disorders of phagocyte function, except:	Chronic granulomatous disease	X-linked SCID	Chediak-Higashi syndrome	Myeloperoxidase deficiency	1b	multi	X-linked Severe Combined Immunodeficiency (SCID): most common form of SCID, mutation in the common g-chain (gc) subunit of cytokine receptors, defect in T-cell development, T-cell numbers are greatly reduced, B cells may be normal in number, antibody synthesis is impaired. Chronic granulomatous disease: Decreased oxidative burst due to defect in phagocyte oxidase, can be X-linked (majority) or autosomal recessive, macrophage-rich chronic inflammatory reaction seen due to inadequate neutrophil response. Chediak-Higashi syndrome: autosomal recessive, defect lies in fusion between phagosome and lysosome (impaired bacteriolysis), occurs due to mutation in LYST gene (defective transpo of materials into lysosomes), neutropenia, defective degranulation, and delayed microbial killing. Myeloperoxidase deficiency: Decreased microbial killing because of defective MPO-H2O2 system after phagocytosis of microbes.	Pathology	Oxygen dependent bacterial killing
47e4e692-98a5-4c42-8d5f-87917168c925	A 25 year old female presenting with amenorrhea and galactorrhea is suspected to have malignancy of the pituitary gland. Which of the following radiologic views is most useful for visualising the sella tursica?	Oblique view	Water's view	Cadwell's view	Lateral view of skull	3d	single	Lateral view of skull is best used to visualize sphenoid sinus and sella turcica, so this would be the most appropriate view in this patient. Cadwell's view is most useful for evaluating frontal and ethmoidal sinuses. Maxillary sinus is best visualised using Water's view. Reference: Imaging of the Head and Neck By Mahmood Mafee, 2e page 380.	Radiology	null

23ef368c-b438-4589-8c71-8360bbf84ae5

Fundoscopy of a patient shows chalky white optic disc with well defined margins. Retinal vessels and surrounding retina appears normal. Which of the following is the most likely diagnosis:

Primary Optic Atrophy

Post-neuritic secondary optic atrophy

Glaucomatous optic atrophy

Consecutive optic atrophy

0a

single

A i.e. Primary Optic Atrophy

Ophthalmology

null

3659d893-cf23-4fa7-b16c-64fba02800ee

Root completion of primary maxillay Lateral incisor tooth occurs at an age of

2-2 ½ year

1-1 ½ year

3-4 year

None of the above

0a

multi

null

Dental

null

c5085fad-b97c-412c-b1da-6503711a324f

Test for RNA:-

Nohern blot

Southern blot

Immuno blot

South-Western blot

0a

single

Nohern Blotting detects RNA. Nohern blot - RNA Southern blot- DNA Western blot- Proteins See treasure for details

Biochemistry

Techniques in molecular biology

8910b07a-1055-4561-8a79-4cf9f20d7eb6

Medial boundary of anatomical snuffbox is formed by

Extensor pollicis longus

Extensorpollicis brevis

Abductor pollicis longus

Flexor carpi ulnaris

0a

single

ANATOMICAL SNUFF BOX:-Elongated triangular depression seen on the lateral side of the dorsum of hand when the thumb is hyperflexed. BOUNDARIES:1. Anterolaterally-tendon of abductor pollicis longus,tendon of extensor pollicis brevis.2. Posteromedially-tendon of extensor pollicis longus.3. Floor-scaphoid and trapezium.4. Roof-skin and superficial fascia.Contents:-1. Radial aery.Structures crossing the roof deep to skin:-1. Cephalic vein.2. Terminal branch of superficial radial nerve. Pulsations of radial aery felt here.Tenderness felt here indicates fracture of scaphoid bone.Cephaloc vein at this site can be used for giving iv fluids. {Reference: Vishram Singh , page no.171} Figure 9.33,page no:122 BD chaurasia

Anatomy

Upper limb

a385dc81-7224-49a8-a97b-88010d81b568

A drug that binds to the receptor at the same site as the agonist and produces an intrinsic effect opposite to the agonist is termed as:

Paial agonist

Inverse agonist

Competitive antagonist

Non-competitive Antagonist

1b

single

A drug that binds to the receptor at the same site as the agonist and produces an effo opposite to the agonist is termed as A reverse Agonist. Inverse/Reverse Agonist: is an agent that binds to the receptor as an agonist but induces an intrinsic response opposite to that of an agonist. A Competitive Antagonist: is an agent that binds to the same site as the agonist and induces no intrinsic response. (No intrinsic activity; does not activate). The antagonism is acheived because it blocks the action of the agonist. The antagonist effect is only observed if the agonist is also present (it cannot block the agonist effect if no agonist is present) Agonist Antagonist A drug that binds to and activates a receptor. Can be full, paial or Inverse. A Full Agonist has high efficacy, producing a full response while occupying a relatively low propoion of receptors A Paial Agonist has lower efficacy than a full agonist. It produces sub-maximal activation even when occupying the total receptor population, therefore cannot produce the maximal response, irrespective of the concentration applied. A paial antagonist antagonizes the action of a full agonist. An Inverse Agonist produces an effect opposite to that of an agonist, yet binds to the same receptor binding-site as an agonist. A drug that attenuates the effect of an agonist. Can be competitive or non-competitive, each of which can be reversible or irreversible A Competitive Antagonist binds to the same site as the agonist but does not activate it, thus blocks the agonist&;s action. A Non-competitive Antagonist binds to an allosteric (non-agonist) site on the receptor to prevent activation of the receptor. Any non-competitive inhibitor may thus also be termed as an Allosteric Inhibitor. A Reversible Antagonist binds non-covalently to the receptor, therefore can be "washed out" An Irreversible Antagonist binds covalently to the receptor and cannot be displaced by either completing ligands or washing Ref: KDT 7th edition

Pharmacology

General pharmacology

dcc7b916-2b93-4274-9d60-167f0709f4b0

Most common site of origin of pleomorphic adenoma is:

Parotid gland

Submandibular salivary gland

Minor salivary glands of soft and hard palate

Minor salivary glands of lip

0a

single

Pleomorphic adenoma most commonly arises from the parotid gland. Ninety per cent are located in the superficial lobe while 10% involve deep lobe and present as parapharyngeal tumours.

ENT

Oral Cavity

6f4f0463-fc9d-415c-be59-8106f2f65604

Management of infected pancreatic necrosis includes all of the following except: March 2010

Percutaneous drainage

Pancreatic necrosectomy

Manage conservatively with antibiotics alone

Nutritional suppo

2c

multi

Ans. C: Manage conservatively with antibiotics alone Infection complicating pancreatic necrosis leads to persisting sepsis, multiple organ dysfunction syndrome and accounts for about half the deaths that occur following acute pancreatitis. Severe cases due to gallstones require urgent endoscopic sphincterotomy. Patients with pancreatic necrosis should be followed with serial contrast enhanced computed tomography (CE-CT) and if infection is suspected fine needle aspiration of the necrotic area for bacteriology (FNAB) should be undeaken. If the aspirate is purulent, percutaneous drainage of the infected fluid should be carried out. In the presence of infection and worsening of sepsis despite percutaneous drainage, necrosectomy is indicated. Although traditionally this has been by open surgery, minimally invasive procedures are a promising new alternative. There are many unresolved issues in the management of pancreatic necrosis. These include, the use of antibiotic prophylaxis, the precise indications for and frequency of repeat CE-CT and FNAB and the role of enteral feeding. Nutritional suppo is essential

Surgery

null

ee2aa01a-8339-4e6b-88d0-e45080431869

Which of the following is a serious and characteristic adverse effect of Metformin

Lactic acidosis

Weight gain

Hypoglycemia

Dilutional hyponatremia

0a

single

Ans: A. Lactic acidosis [Ref: KDT 7h/e p. 453).Two impoant adverse effects of these agents are lactic acidosis (more with phenformin) and vitamin B12 deficiency (more common with metformin).More common side effects are abdominal pain, anorexia, metallic taste, mild diarrhea and tiredness.

Pharmacology

null

bda4eeca-8d5a-418c-90ba-9a3c90fc01ba

Kliiver-Bucy syndrome is associated with lesion in the following area of brain

Amygdala

Cerebral cortex

Hippocampus

Mammillary body

0a

single

(A) Amygdala # Kliiver-Bucy syndrome is a behavioral disorder that occurs when both the right and left medial temporal lobes of the brain malfunction. People with lesions in their temporal lobes show similar behaviors.> They may display oral or tactile exploratory behavior (socially inappropriate licking or touching); hypersexuality; bulimia; memory disorders; flattened emotions (placidity)-, and an inability to recognize objects or inability to recognize faces.> The full syndrome rarely, if ever, develops in humans. However, parts of it are often noted in patients with extensive bilateral temporal damage caused by herpes or other encephalitis and dementias of degenerative or post-traumatic etiologies.> This disorder may be caused by many conditions, including facial or cerebral trauma; infections; Alzheimer's disease; Niemann Pick disease of the brain; or cerebrovascular disease.

Medicine

Miscellaneous

20833593-4fdf-4f2c-b1d7-05528ac9c8f6

Dorsiflexion of ankle joint ?

Tibialis anterior

Peroneus longus

Tibialis posterior

Soleus

0a

single

Ans. is 'a' i.e., Tibialis anteriorActive movements permitted at ankle joint are dorsiflexion and plantar flexion.Dorsiflexion is the closed packed position with maximum congruence of the joint surfaces and ligaments tension.Thus talus fits snugly into the socket when foot is dorsiflexed and there are no chances of ankle dislocation in dorsiflexion.When foot is plantar flexed, talus is slightly loose and may allow slight lateral rotation with maximum chances of dislocation.Thus, Ankle is more stable in dorsiflexed position.Movements Principal muscles Accessory muscles DorsiflexionTibialis anterior Extensor digitorum longus, Extensor hallucis longus, Peroneus teius (Muscles of anterior compament of leg)Plantalexion Gastrocnemius Soleus Plantaris tibialis posteior, flexor hallucis longus, flexor digitourm longus (Muscles of posterior comapment of leg)

Anatomy

null

bf1fc3d4-98fd-4b84-b4c4-7568f41bbb02

Left Umbilical vein becomes?

Ligamentum teres

Ligamentum venosum

Medial umbilical ligament

Ligamentum aeriosum

0a

single

Ligamentum teres

Anatomy

null

b55385fc-8184-4651-9f6b-58a979ade5a8

Acute liver failure is caused by A/E-

Hepatitis A

Hepatitis B

Hepatitis E

Hepatitis C

3d

single

The imp pa of type C hepatitis is the chronic illness. REF:ANATHANARAYAN AND PANIKER'S TEXTBOOK OF PATHOLOGY 8TH EDITION PAGE NO-548

Microbiology

Virology

f325d660-3c74-4f4f-b09d-e49fe17b935c

A peptic ulcer is associated with all except one -

Cirrhosis

Zollinger Ellisons syndrome

Primary hyperparathyroidism

Pernicious anemia

3d

multi

You, don’t expect pernicious anemia to cause peptic ulcer. In pernicious anemia, there is autoimmune destruction of the parietal cells leading to hypochlorhydria which further progresses to achlorhydria Etiology. of peptic ulcer Acute Peptic Ulcer NSAIDS Ingestion Stress Cushing ulcer after cerebral trauma Curling ulcer* after burn injury, any kind of shock Sepsis — Undrained pus may be responsible for an acute ulcer. Steroids Chronic Gastric Ulcer NSAIDs Ingestion NSAIDs disrupt the prostaglandin driven support of the mucosal barrier. Prostaglandins are responsible for the prodn. of mucosal gel layer in the stomach, which provide a protective barrier to the gastric and duodenal lining. So disruption of this mucosal barrier allows even minimum amount of acid to cause ulceration. Helicobacter pylori H.Pylori is seen in almost 90% of cases of duodenal ulcer and 70% of cases of gastric ulcer. Pyloroduodenal reflux Regurgitate bile & other duodenal juices. Mucosal trauma by mechanical effect of food. Diet & smoking Irregular diet, spicy food excessive drinking of tea & coffee, alcohol, Cigarette smoking has a definite relation with both gastric & duodenal ulcers. Emotional factors Anxiety, Stress & strain. Liver disease Ulceration of both stomach and duodenum have co-existed with the disease of the liver, particularly cirrhosis. It may be due to increase in blood supply to the gastric mucosa and overproduction of histamine in the stomach wall to stimulate the parietal cell. Chronic Duodenal Ulcer Acid hypersecretion Genetic factors Persons of blood group 'O' who do not possess AB antigen are peculiarly apt to develop a duodenal ulcer. iii.Endocrinal disorders Zollinger Ellison syndrome Hyperparathyroidism Multiple adenoma syndromes (MEN-I) Cushing. syndrome (b/c of the high level of endogenous steroids) Chronic liver diseases Chronic lung disease Chronic pancreatitis Emotional factor Diet & smoking H.pylori The decrease in bicarbonate production The list may be exhaustive but questions have been repeatedly asked on etiology of peptic ulcers.

Surgery

null

07cb00a8-27aa-4917-a9b9-369c38b87aac

Ramachandran is on the surgical ward with non-seminomatous tumor of testis and more than 4 retroperitoneal lymph nodes involved. You are the resident who is making a decision about fuher management. The treatment include all of the following, except:

Retroperitoneal Lymph Node Dissection (RPLND)

Inguinal orchiectomy

Chemotherapy

Radiotherapy

3d

multi

Inguinal orchiectomy with high ligation of the cord at the internal ring is the initial management of testicular tumour. Multi Agent chemotherapy and followed by surgical resection is one modality of treatment. Ref: Bailey & Love, 25th Edition, Page 1269.

Surgery

null

652922f1-aace-4e4f-8134-e615ee163c1f

Fluconazole is more effective than itraconazole in the following systemic fungal disease:

Pulmonary histoplasmosis

Cryptococcal meningitis

Non-meningeal blastomycosis

Disseminated sprorotrichosis

1b

single

(Ref: KDT 6/e p763, 764) Fluconazole has maximum CNS penetration whereas itraconazole has limited entry in the brain. Therefore fluconazole is preferred over itraconazole for the treatment of cryptococcal meningitis. For all other conditions listed in the question, itraconazole is first choice drug.

Pharmacology

Other topics and Adverse effects

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Implantation occurs at -

2-3 days

6-7 days

15-20 days

20-25 days

1b

single

Ans. is 'b' i.e., 6-7 days Age (Days)SomitesCharacteristics0-1--Fertilized uncteaved zygote2-3--Segmentation=two cells to morula4-5--Unimplanted, free-floating blastocyst6-7--Implantation8-11--Progression into endometrium12-14--Embryonic disc, villi, and yolk sac appear15-16--Primitive streak appears17-18--Neural folds elevate19-201-3Head fold appears21-234-12Neural fold fusion begins, heart begins to beat23-2513-20Two branchial arches, foregut, hindgut, optic evagination21-2921-29Arm buds appear, neural tube closed, optic cup28-30 (complete no.)40Leg buds apear, heart chambers. lung buds, metanephric bud30-32--Lens invagination, septum primum, gonadal ridge32-34--Lens vesicle closed, external ears becoming recognizable35-36--Eye pigment appears, hand plate, hypophysis, liver37-40--Finger rays, foot plate, ear defined, somites less apparent superficially40-42--Eyelid, finger rays notched, toe rays, nerve plexuses42-44--Head more erect, limbs extend forward, muscles developing, duodenum closed45-46--Fingers, scalp plexus present, optic nerve, septum secundum4648--Hands meet over heart region, corpus striatum, thalamus, heart valves48-50--Fingers overlap those of opposite hand, duodenum reopened50-52--Head erect and rounded, scalp plexus reaching head vertex, ossification beginso Contact of blastocyst with endometrium occurs at the time of implantation,o Implantation occurs at around 6 -7 days.

Anatomy

Fertilization and Development of Embryo

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Which of the following aminoglycoside antibiotic has the highest risk of causing Ototoxicity

Kanamycin

Amikacin

Neomycin

Natamycin

0a

single

Ototoxicity is the irreversible side effect of aminorglycosider. Auditory toxicity: Kanamycin > Amikasin > Neomycin Vestibular toxicity: Streptomycin. KAN → Ear.

Pharmacology

null

e1a6cfaf-36cd-465e-8d96-6cd4916b5345

When one strand of DNA isolated showed 20A, 25G, 30C, 22T. How many A, G, C, T will be there in both strands together

A=45 G=45, C=52, T=52

A=50, G=47, C=50, T=47

A=44, G=55, C=55, T=44

A=42, G=55, C=55, T=42

3d

multi

Chargaff's rule

Biochemistry

null

8d7aefb7-53b2-4e8a-a39e-a80c292657de

Vasa vasora are functionally analogous to ?

Valves

Basal lamina

Coronary aeries

Endothelial diaphragms

2c

multi

Vasa vasorum are small blood vessels that supply walls of large blood vessels. It was thought coronary aeries are analogous to vasa vasorum. "Because hea originates from the primitive endocardial tube (ventral aoa) embryologically, coronary aeries that supply this tube can be thought as "cardiac vasa vasorum" like aerial vasa vasorum that supply peripheral aeries".

Anatomy

General anatomy

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All of the following are treatment modalities for gastric lymphoma except:

Chemotherapy for primary gastric lymphoma

Chemotherapy for secondary gastric lymphoma

Antibiotic treatment for H. pylori in low grade MALToma

Radical subtotal gastrectomy for locally advanced disease

3d

multi

Ans. (d) Radical subtotal gastrectomy for locally advanced diseaseRef: Sabiston 20th edition, Page 1228Treatment of lymphomas in stomach:* Most Lymphomas are treated with multimodality treatment* CHOP therapy is the chemotherapy commonly used* Chemotherapy alone is enough for early cases* Diffuse advanced cases are not amenable for surgery and palliative chemotherapy alone is given.* Indications for surgery in Lymphoma are:# Limited gastric disease# Recurrence# Complications like bleeding, obstruction and perforation

Surgery

Stomach & Duodenum

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All of the following are disorders of phagocyte function, except:

Chronic granulomatous disease

X-linked SCID

Chediak-Higashi syndrome

Myeloperoxidase deficiency

1b

multi

X-linked Severe Combined Immunodeficiency (SCID): most common form of SCID, mutation in the common g-chain (gc) subunit of cytokine receptors, defect in T-cell development, T-cell numbers are greatly reduced, B cells may be normal in number, antibody synthesis is impaired. Chronic granulomatous disease: Decreased oxidative burst due to defect in phagocyte oxidase, can be X-linked (majority) or autosomal recessive, macrophage-rich chronic inflammatory reaction seen due to inadequate neutrophil response. Chediak-Higashi syndrome: autosomal recessive, defect lies in fusion between phagosome and lysosome (impaired bacteriolysis), occurs due to mutation in LYST gene (defective transpo of materials into lysosomes), neutropenia, defective degranulation, and delayed microbial killing. Myeloperoxidase deficiency: Decreased microbial killing because of defective MPO-H2O2 system after phagocytosis of microbes.

Pathology

Oxygen dependent bacterial killing

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A 25 year old female presenting with amenorrhea and galactorrhea is suspected to have malignancy of the pituitary gland. Which of the following radiologic views is most useful for visualising the sella tursica?

Oblique view

Water's view

Cadwell's view

Lateral view of skull

3d

single

Lateral view of skull is best used to visualize sphenoid sinus and sella turcica, so this would be the most appropriate view in this patient. Cadwell's view is most useful for evaluating frontal and ethmoidal sinuses. Maxillary sinus is best visualised using Water's view. Reference: Imaging of the Head and Neck By Mahmood Mafee, 2e page 380.

Radiology

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