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|---|---|---|---|---|---|---|---|---|---|---|
994c46cc-0c57-4f89-a3f8-bade16b8f0f6
|
Which of the following is the best indication for propofol as an intravenous induction agent?
|
Neurosurgery
|
Day care surgery
|
Patients with coronary artery disease
|
In neonates
| 1b
|
single
|
Smooth induction and rapid recovery with antiemetic property of propofol makes it an ideal agent for day care surgery.
|
Anaesthesia
| null |
9855bc43-dda7-4e28-a64d-e49ecfbd384b
|
All are components of saint's traid except
|
Renal stones
|
Hiatus hernia
|
Diveiculitis of colon
|
Gall stones
| 0a
|
multi
|
Saint's triad is a medical condition of concurrence of the following: Cholelithiasis (gallstones) Hiatal hernia Diveicular disease (diveiculosis of colon) Ref: Bailey and love 27th edition Pgno: 1124
|
Anatomy
|
G.I.T
|
c9156ed9-aec3-41b9-9520-6b523cc7e19c
|
Von-Rosen's sign is positive in -
|
Perthe'sdisease
|
SCFE
|
DDH
|
CTEV
| 2c
|
single
|
Ans. is 'c' i.e., DDHRadiological features of DDH/CPHo In Von Rosen's view following parameters should be notedPerkin's line : Vertical line drawn at the outer border of acetabulumHilgenreiner's line : Horizontal line drawn at the level of tri-radiate cartilageShenton's line : Smooth curve formed by inferior border of neck of femur with superior margin of obturator foramen.Acetabular index: Normally is < 30degCE angle of Wiberg: Normal value is 15-30dego Normally the head lies in the lower and inner quadrant formed by two lines (Perkin's & Hilgenreiner's). In DDH the head lies in outer & upper quadranto Shenton's line is brokeno Delayed appearance & retarded development of ossification of head of femuro Sloping acetabulumo Superior & lateral displacement of femoral headVon-Rosen's lineo This is a line, which helps in the diagnosis of DDH in infants less than 6 months.o For this AP view of pelvis is taken with both lower limb in 45deg abduction and full internal rotation,o Upward prolongation of long axis of shaft of the femur points towards the lateral margin of the acetabulum and crosses the pelvis in the region of sacroiliac joint.o In CDH, upward prolongation of this line points towards anterior superior iliac spine and crosses the midline in the lower lumber region - Positive Von-Rosen's sign.
|
Orthopaedics
|
Congenital Dislocation of Hip (C.D.H.)
|
9d9fba02-426f-4d4c-9d08-5257fa2b56ac
|
The striated vertebra is seen in -
|
TB spine
|
Haemangioma
|
Chordoma
|
Metastasis
| 1b
|
single
|
In hemangioma there is a loss of horizontal striation and prominence of vertical striation giving vertebra a typical striated appearance on radiography.
|
Orthopaedics
| null |
81243669-d04d-4a68-aa00-ae5ef0a82340
|
Thyroid storm can be treated by all the following drugs except-
|
Propylthiouracil
|
Dexamethasone
|
Propranolol
|
Aspirin
| 3d
|
multi
|
Thyrotoxic crisis, or thyroid storm, is rare and presents as a life-threatening exacerbation of hypehyroidism, accompanied by fever, delirium, seizures, coma, vomiting, diarrhea, and jaundice. It is usually precipitated by acute illness (e.g., stroke, infection, trauma, diabetic ketoacidosis), surgery (especially on the thyroid), or radioiodine treatment of a patient with paially treated or untreated hypehyroidism.Management requires intensive monitoring and suppoive care, identification and treatment of the precipitating cause, and measures that reduce thyroid hormone synthesis : * Propylthiouracil - 500-1000 mg loading dose and 250 mg every 4 h) orally or by nasogastric tube or per rectum; reduces hormone synthesis as well as peripheral T4 to T3 conversion. * One hour after the first dose of propylthiouracil, stable iodide is given to block thyroid hormone synthesis the Wolff-Chaikoff effect. A saturated solution of potassium iodide (5 drops SSKI every 6 h) or, where available, ipodate or iopanoic acid (500 mg per 12 h) may be given orally. * Propranolol should be given to reduce tachycardia and other adrenergic manifestations (60-80 mg PO every 4 h; or 2 mg IV every 4 h). In addition they reduce peripheral T4 to T3 conversion. * Glucocoicoids (e.g., hydrocoisone 300 mg IV bolus, then 100 mg every 8 h) help to tide over the crisis, cover any adrenal insufficiency and inhibit peripheral T4 to T3 conversion. * Antibiotics if infection is present, cooling, oxygen, and IV fluids. Reference : page 2297 Harrison's Principles of Internal Medicine 19th edition
|
Medicine
|
Endocrinology
|
535d0a0b-35c0-405d-b4f1-b895b5ebe51d
|
Best level of anesthesia for LSCS:
|
T8
|
T10
|
T6
|
T4
| 3d
|
single
|
Ans. is d, i.e. T4Ref Dutta Obs. 7/e, p 519Spinal anesthesia:Spinal anesthesia is done by injection of local anesthetic agent into the subarachnoid space. It has less procedure time and high success rate. Spinal anesthesia can be employed to alleviate the pain of delivery and during the third stage of labor. For normal delivery or for outlet forceps with episiotomy, ventouse delivery, block should extend from T10 (umbilicus) to S1. For cesarean delivery, level of sensory block should be up to T4 dermatome. Hyperbaric bupivacaine (10-12 mg) or lignocaine (50-70 mg) is used.
|
Gynaecology & Obstetrics
|
Operative Obs
|
33450f50-0fb3-4a7d-831f-f20aa30c74d7
|
Genital tubercle forms which pa in females ?
|
Labia major
|
Labia minora
|
Clitoris
|
None
| 2c
|
multi
|
Ans. is 'c' i.e., Clitoris
|
Anatomy
| null |
11dd76a2-8af9-4326-856a-011d7f06529e
|
True about Brenner tumor:a) Usually bilateralb) Resembles fibromac) Accounts for 20% of all ovarian tumorsd) Common in postmenopausal age group
|
c
|
bd
|
ab
|
ac
| 1b
|
multi
|
Brenner tumour is also called as Transitional cell tumour:
• It is a rare epithelial neoplasm of ovary resembling fibroma.
• It is an essentially benign tumour.
• Tumour is generally seen in women around menopause and is generally unilateral.
• Cause menopausal bleeding and Pseudomeig syndrome (ascites and hydrothorax).
• Malignant change is very rare.
• Histologically it shows walthard cell rests of transitional cellsQ, cells have coffee bean nuclei, cut section is gritty.
|
Gynaecology & Obstetrics
| null |
b9c2ea5f-8b14-485f-805e-a9e5b04fc1fd
|
Buccolingual positioning of mandibular Canal can be assessed by:
|
Horizontal 0 and -20 degree.
|
Horizontal 0 and -15 degree.
|
Vertical 0 and -20 degree.
|
Vertical 0 and -15 degree.
| 2c
|
single
|
“Periapical radiographs taken from two vertical angulations, 0° (parallel technique) and – (Minus) 20°, determine the buccolingual position of the canal”.
“Periapical radiographs taken from two Horizontal angulations, 0° (parallel technique) and – (Minus) 20°, may differentiate between buccal and lingual roots”.
|
Dental
| null |
e599ca58-6b43-4598-aaeb-d1ef948105b4
|
Palpable purpura could occur in the following conditions, except -
|
Thrombocytopenia
|
Small-vessel vasculitis
|
Disseminated gonococcal infection
|
Acute meningococcemia
| 0a
|
multi
|
Ref - Semantischolar.org
|
Medicine
|
Miscellaneous
|
9a75423a-a1b9-43c5-bacc-f5f6b5e3df89
|
Boucher's method of relining is a
|
Open mouth technique
|
Chair side relining technique
|
Functional relining method
|
Closed mouth relining technique
| 0a
|
single
| null |
Dental
| null |
22a55be6-ca87-4267-a2e3-c70c365ccb61
|
The progestogenic emergency contraceptive pills act by -
|
Altered cervical secretion
|
Inhibition of ovulation
|
Anti-implantation effect
|
Inhibition of LH secretion
| 2c
|
single
|
Ans. is 'c' i.e., Anti-implantation effect o If ovulation and feilization occur, the blastocyte fails to implant (anti-implantation effect) because endometrium is either hyperproliferativer or hypersecretory; not suitable for nidation. o This is the mechanism of action of postcoital (emergency) contraceptive pills.
|
Pharmacology
| null |
ba76018f-02df-41f2-bc05-1ca44203231e
|
The most common side effect of IUD insertion is -
|
Bleeding
|
Pain
|
Pelvic
|
Ectopic pregnancy
| 0a
|
single
|
Most common side effect → Bleeding
Most common side effect requiring removal of the device → Pain
|
Social & Preventive Medicine
| null |
20c819d9-e220-4637-b234-ea20bb6ff6f7
|
Duffy blood group antigen negativity confers protection against infection by: September 2012
|
Plasmodium falciparum
|
Plasmodium vivax
|
Plasmodium ovate
|
Plasmodium malariae
| 1b
|
single
|
Ans. B i.e. Plasmodium vivax Duffy antigen/Chemokine receptor (DARC)/ Fy glycoprotein (FY) or CD234 (Cluster of Differentiation 234) It is a protein that in humans is encoded by the DARC gene. The Duffy antigen is located on the surface of red blood cells, and is named after the patient in which it was discovered. The protein encoded by this gene is a glycosylated membrane protein and a non-specific receptor for several chemokines. The protein is also the receptor for the human malarial parasites Plasmodium vivax and Plasmodium knowlesi. Duffy negative individuals whose erythrocytes do not express the receptor are believed to be resistant to merozoite invasion
|
Pathology
| null |
89ea7bc0-a427-41a7-bb49-b51844ed15df
|
Each milliliter of red cells contains ....... mg of elemental iron:
|
1 mg
|
2 mg
|
3 mg
|
4 mg
| 0a
|
single
|
Each milliliter of red cells contains 1 mg of elemental iron. Reference: Harrisons Principles of Internal Medicine, 18th Edition, Page 845
|
Medicine
| null |
d28a0160-2376-4ef7-b689-c64acaa8917c
|
Bence jones proteins are -
|
Heavy chain IgG
|
Present in bone marrow
|
Seen in lymphoma
|
Light chain IgG
| 3d
|
single
|
About two-third cases of multiple myeloma excrete Bence Jones peotein i.e, light chain Ig G in the urine. Bence Jones proteins are paraproteins or abnormal immunoglobulins or their pas circulating in plasma & excreted in urine.Reference :Harsh mohan textbook of pathology sixth edition pg no 383.
|
Medicine
|
Haematology
|
ee401c6b-f93d-4812-810e-28a473daf48a
|
Mutation in which of the following chromosome is associated with meningioma ?
|
Chromosome 1
|
Chromosome 19
|
Chromosome 22
|
Chromosome 9q
| 2c
|
single
|
Meningioma is a CNS tumor arising from arachnoid cap cells associated with chromosome 22 mutation.
|
Surgery
| null |
80b07c1a-cdb8-44c3-a05c-4382da127d8d
|
Hyoglossus muscle inserts into
|
Tip of the tongue
|
Base of the tongue
|
Lateral part of the tongue
|
Hyoid bone
| 2c
|
single
|
Key Concept:
Hyoglossus muscle inserts into lateral part of tongue.
|
Anatomy
| null |
365c603d-4570-4612-bb74-5f113dd90033
|
1st evidence of calcification of Primary mandibular central incisor is seen in
|
14 wk IU
|
16 wk IU
|
17 wk IU
|
15 wk IU
| 0a
|
single
| null |
Dental
| null |
5fcd9cfc-67ff-40ba-aae0-ec9c5eebdbd9
|
If C5 ,C6 nerve root is injured, sensations of which pa of upper limb will be lost ?
|
Thumb and index finger
|
Little finger
|
Upper medial pa of arm
|
Upper medial side of forearm
| 0a
|
single
|
The palmar pad of thumb is innervated by C6 The pad of index finger is innervated by C7. Pad of little finger - C8 Skin on medial aspect of elbow - T1. Ref : Gray's Anatomy The Anatomical Basics of Clinical Practice 41 e pg 786.
|
Anatomy
|
Upper limb
|
21c59e2e-aa57-4aaa-8a46-3e7d36b919c0
|
All are steroids except ?
|
Testosterone
|
Vitamin D
|
Cholesterol
|
Thyroxine
| 3d
|
multi
|
Ans. is 'd' i.e., Thyroxine Steroids Steroids are complex molecules consisting of four fused carbon rings. There is a phenanthrene nucleus made of three six-membered rings (A,B,C, rings), and a cyclopentane which forms D ring. The fully saturated parent compound (steroid) is known as cyclopentanoperhydrophenathrene. The alcohol derivatives of steroids, in which one or more OH groups are present in the steroids nucleus, are termed sterols, i.e. sterols are a class of steroids containing hydroxy (OH) group. Cholesterol, ergosterol, coprosterol and sitosterol are some impoant sterols.In animal tissues, Cholesterol is the major sterol. Functionally, cholesterol is a very impoant molecule being precursor of a variety of steroids -Steroid hormones :- Progesterone, estrogen, androgens (Testosterone), glucocoicoids, mineralocoicoids.Bile acids:- Cholic acid, Chenodeoxycholic acid.Vitamin DSo, all above mentioned compounds have cyclopentanoperhydrophenanthrene nucleus.
|
Biochemistry
| null |
61192d44-d5e2-4c27-86eb-2d19f7d8939c
|
All of the following drugs are metabolised by acetylation except
|
INH
|
Sulfonamides
|
Ketoconazole
|
Hydralazine
| 2c
|
multi
|
Ans. is 'c' i.e. Ketoconazole Drugs undergoing Acetylation-SulfonamidesIsoniazidPASHydralazineProcainamideAlso knowDrugs undergoing glucuronide conjugationChloramphenicolAspirinPhenacetinMorphineMetronidazoleDrugs undergoing Glycine conjugationSalicylates andOther drugs with Carboxyl groupDrugs undergoing Glutathione conjugationParacetamol.
|
Pharmacology
|
Pharmacokinetics
|
11ae0d36-09b4-422b-8291-6bcfdf3ac826
|
Nail's involvement is NOT a feature of: March 2003
|
Psoriasis
|
DLE
|
Dermatomyositis
|
Lichen planus
| 1b
|
single
|
Ans. B i.e. DLE Discoid lupus is a benign variant of SLE in which only the skin is involved.
|
Skin
| null |
0e569539-64b2-4703-ac64-afa61834971a
|
Iopanoic acid is used in -
|
Myelography
|
Bronchography
|
Hysterosalpingography
|
Cholecystography
| 3d
|
single
|
Iopanoic acid : iodine containing contrast agent Hepatic excretion potent inhibitor of thyroid hormone release and also peripheral conversion. used in cholecystography and also in hypehyroidism as adjuvant therapy
|
Radiology
|
Fundamentals in Radiology
|
a64628e7-d6bd-44eb-8841-9297b532d935
|
Primary atypical pneumonia is caused by
|
Legionella
|
Streptococcus
|
Mycoplasma
|
Listeria
| 2c
|
single
|
Ans. c (Mycoplasma). (Textbook of Microbiology by Anantanarayan 6th/365)MYCOPLASMA# Bacteria devoid of cell walls# Highly pleomorphic# Eaton agent# Pleuropneumonia like organisms. Smallest free living micro-organisms.# Do not produce spores, flagella or fibria.# Gliding motility present.# 'Fried egg' appearance of colonies positive.# Colonies best studied by staining with Diene's method.# Cold agglutination test (streptococcus MG).# Pathogenicity- M. pneumonia -Primary atypical pneumonia.- Ureaplasma urealyticum and M.hominis -genital infection# Treatment--tetracycline & erythromycin.
|
Microbiology
|
Mycoplasma
|
ac492fd0-7fd3-43a3-9ae2-5d84ee8c1f65
|
A 32-year-old woman has had a chronic cough with fever for the past month. On physical examination, her temperature is 37.5deg C. A chest radiograph shows many small, ill-defined nodular opacities in all lung fields. A transbronchial biopsy specimen shows interstitial infiltrates with lymphocytes, plasma cells, and epithelioid macrophages. Which of the following infectious agents is the most likely cause of this appearance?
|
Candida albicans
|
Cytomegalovirus
|
Enterobacter aerogenes
|
Mycobacterium tuberculosis
| 3d
|
multi
|
These findings suggest a granulomatous inflammation, and tuberculosis is a common cause. Candida is often a commensal organism in the oropharyngeal region and rarely causes pneumonia in healthy (non-immunosuppressed) individuals. Viral infections tend to produce a mononuclear interstitial inflammatory cell response. Bacteria such as Enterobacter and Staphylococcus are more likely to produce acute inflammation. Plasmodium produces malaria, a parasitic infection without a significant degree of lung involvement.
|
Pathology
|
Inflammation & Repair
|
16523d06-95db-40a0-8f39-924d846f46f2
|
20-year-old female present with features of anemia. Blood tests: Hb-5g/dL, MCV - 52 fL, MCH-22 pg, PCV - 15%. Diagnosis?
|
Phenytoin toxicity
|
Fish tapeworm infection
|
Hookworm infection
|
Blind loop syndrome
| 2c
|
single
|
The findings in the question are suggestive of iron deficiency anemia. Among given options, Hookworm infection can cause iron deficiency anemia due to chronic blood loss. Associated with megaloblastic anemia (vitamin B12/folate Deficiency): Phenytoin toxicity, Blind loop syndrome and Fish tapeworm (D. latum) infection.
|
Pathology
|
Iron deficiency anemia
|
5d78c3c2-8ca1-4c17-8bf6-96ed7f64bd43
|
Ruffled membrane is seen in -
|
White fibrous cailage
|
Osteoblast
|
Osteoclast
|
Elastic cailage
| 2c
|
single
|
Membrane ruffling (also known as cell ruffling) is the formation of a motile cell surface that contains a meshwork of newly polymerized actin filaments. It can also be regarded as one of the earliest structural changes observed in the cell. The GTP-binding protein Rac is the regulator of this membrane ruffling. Changes in the Polyphosphoinositide metabolism and changes in the Ca2+ level of the cell may also play an impoant role. A number of actin-binding and organizing proteins localize to membrane ruffles and potentially target to transducing molecules. The characteristic feature of migrating cells Membrane Ruffling is a characteristic feature of many actively migrating cells. When the membrane is unable to attach to the substrate, the membrane protrusion is recycled back into the cell. The ruffling of membranes is thought to be controlled by a group of enzymes known as Rho GTPases, specifically RhoA, Rac1, and cdc42. Robbins 9th edition page no. 29
|
Pathology
|
General pathology
|
19946d44-57cd-4d51-a55a-d6cdeac33e6c
|
Which color plastic bag is used for noninfectious waste?
|
White
|
Yellow
|
Red
|
Black
| 3d
|
single
|
Black is used for noninfectious waste Red-plastic bag -sharps Blue-non chlorinated plastic bag Ref: Textbook of Microbiology Baveja 5th ed Pg 641
|
Microbiology
|
general microbiology
|
f8ba2e1f-b541-44d0-96eb-86220255a736
|
A 55-year-old man with recent onset of atrial fibrillation presents with a cold, pulseless left lower extremity. He complains of left leg paresthesia and is unable to dorsiflex his toes. Following a successful popliteal embolectomy, with restoration of palpable pedal pulses, the patient is still unable to dorsi- flex his toes. The next step in management should be
|
Electromyography (EMG)
|
Measurement of anterior compartment pressure
|
Elevation of the left leg
|
Immediate fasciotomy
| 3d
|
multi
|
This case illustrates two (among many) conditions that lead to the anterior compartment syndrome, namely, acute arterial occlusion without collateral inflow and rapid reperfusion of ischemic muscle. Treatment for a compartment syndrome is prompt fasciotomy Assessing a compartment syndrome and proceeding with fasciotomy are generally based on clinical judgment. Inability to dorsiflex the toes is a grave sign of anterior compartment ischemia. EMG studies and compartment pressure measurements would probably be abnormal but are unnecessary in view of the known findings and would delay treatment. Mere elevation of the leg would be an ineffective means of relieving compartment pressure, although elevation should accompany fasciotomy. Application of a splint has no role in the acute management of this problem.
|
Surgery
|
Arterial Disorders
|
64c6385d-cf87-4ed7-98fb-02d485010535
|
All of these are derivative of neural crest except
|
Melanocyte
|
Adrenal medulla
|
Sympathetic ganglia
|
Cauda equina
| 3d
|
multi
|
D. i.e. Cauda Equina
|
Anatomy
| null |
9aa19ddd-14db-451a-9396-f183e58a8369
|
Substrate level phosphorylation is catalysed by :
|
Succinate dehydrogenase
|
Thiokinase
|
Malate dehydrogenase
|
Hexokinase
| 1b
|
single
|
Ans is 'b' i.e. Thiokinase/7te/i Chatterjee Shinde, 4/e, p 264]* There are two types of phosphorylation of ADP to ATP: -Oxidative phosphorylation at the respiratory chain levelSubstrate level phosphorylation.Substrate level phosphorylation :Is production of ATP 'at the substrate level' without the participation of the electron transport chain.Examples of substrate level phosphorylation :2 in glycolytic pathway &1 in Citric acid (TCA) cycle.
|
Biochemistry
|
Respiratory Chain
|
84b19255-3121-471c-ad86-c9ae99b02bf1
|
mood stabilizer used in the tretament of rapid cycling
|
vaproate
|
lithium
|
carbamezepine
|
lamotrigine
| 0a
|
single
|
Lamotrigine is a mood stabilizer which works best in BIPOLAR DEPRESSION Lithium is a mood stabilizer which works best in BIPOLAR MANIA valproate is a mood stabilizer which works best in RAPID CYCLING ref. kaplon and sadock, synopsis of psychiatry, 11 thedition, pg no.935
|
Anatomy
|
Pharmacotherapy in psychiatry
|
abdfd4ec-fac2-47d3-b0f3-cbf11582070f
|
LCAT is induced by ?
|
Apo A-I
|
Apo B-48
|
Apo B-100
|
Apo C-II
| 0a
|
single
|
Ans. is 'a' i.e., Apo A-I
|
Biochemistry
| null |
409e633a-5c76-4998-8de4-1771f8aed8ae
|
Musculocutaneous nerve is injured at the lateral cord of brachial plexus, positive clinical findings would be:
|
Loss of flexion at shoulder
|
Sensory loss on the radial side of the forearm
|
Loss of extension of forearm
|
Loss of extension of the wrist
| 1b
|
single
|
B i.e. Sensory loss on the radial side of forearm
|
Anatomy
| null |
cca8ff34-dfeb-4d7c-bf24-5ba4082a560f
|
Conversion of Pyruvate to Acetyl CoA does not require
|
Thiamine
|
TPP
|
Pyridoxine
|
FAD
| 2c
|
single
|
Pyruvate is conveed to acetyl CoA by oxidative decarboxylation catalysed by a multienzyme complex, known as pyruvate dehydrogenase complex (PDH) The enzyme PDH requires five cofactors (coenzymes), namely--TPP(thiamine pyrophosphate), lipoamide, FAD, coenzyme A and NAD+ ref Satyanarayana biochemistry 4th ed page 252
|
Biochemistry
|
vitamins
|
8326fd9c-018a-4bc7-8922-2e700120b7f4
|
Roseola infantum is caused by (most commonly)-
|
HHV - 2
|
HHV - 6
|
HHV - 7
|
HHV - 8
| 1b
|
single
|
Roseola infantum is caused most commonly by HHV - 6 less commonly by HHV - 7 C/F: fever 3-4 days + Rash (maculopapular) appear after cessation of fever
|
Pediatrics
|
Impoant Viral Diseases in Children
|
89e26485-c1cd-4a5b-bfb5-708e8ba69139
|
A patient presents with symptoms of Hypoglycemia. Investigations reveal decreased blood glucose and increased Insulin levels. C-peptide assay is done which shows normal levels of C-peptide. The most likely diagnosis is:
|
Insulinoma
|
Accidental sulfonylurea ingestion
|
Accidental exogenous Insulin administration
|
Accidental Metformin ingestion
| 2c
|
single
|
For the production of insulin enzymes in the pancreatic beta cells cleave the proinsulin molecule into insulin and C peptide, which are both present in insulin granules and are released in equimolar amounts when insulin is secreted into blood stream. In accidental exogenous Insulin administration, beta cell function is normal, and the release of endogenous insulin as well as C peptide is suppressed by the low circulating glucose level. Ref: Joslin's diabetes mellitus By Elliott Proctor Joslin, C. Ronald Kahn page1160; Clinical endocrinology By Ashley Grossman page 534; Problem solving in clinical medicine: from data to diagnosis By Paul Cutler page 204; Criminal poisoning: clinical and forensic perspectives By Christopher P. Holstege page 94
|
Medicine
| null |
1d22bdbb-b4d2-4273-a5c6-5c143c65f583
|
Most accurate test among the following:
|
Heat
|
Cold
|
EPT.
|
All of the above.
| 1b
|
multi
| null |
Dental
| null |
7c1fd59f-ce0e-4a79-85bb-8d531cfec0c2
|
Recommended daily dose of Iodine in a child is:-
|
120-200 ug
|
90-120 ug
|
30-60 ug
|
500 ug
| 1b
|
single
|
Recommended dietary allowance of iodine: - For children <10 yrs - 40-120 mg/day For children > 10 yrs - 150 mg/day Additional 25mg & 50mg during pregnancy & lactation respectively
|
Pediatrics
|
FMGE 2018
|
6264b65a-e92e-4a0e-baf0-cac7fd3f0eb5
|
Which index is used to score the outcome of treatment in patients with cleft lip and palate?
|
Index of Orthodontic Treatment Complexity (IOTC)
|
Summer’s Index
|
Index of Complexity Outcome and Need (ICON)
|
Goslon Yardstick
| 3d
|
single
|
Goslon Yardstick Index was given by Mars et al (1987) is an acronymn for Great Ormond Street, London and Oslo.
The Goslon (Great Ormond Street, London and Oslo) Yardstick is a clinical tool that allows categorization of the dental relationships in the late mixed and or early permanent dentition stage into five discrete categories. Cases are allocated to these categories on a value judgment basis by reference to the anchor groups of the Goslon Yardstick. The categorization was sufficiently sensitive to distinguish the treatment results at different centers. It is proposed that the Goslon Yardstick should facilitate cross-center studies.
Clinical tool that allows the categorization of dental relationships in late mixed dentition and early permanent dentition into five discrete categories.
Group 1: Excellent - No treatment
Group 2: Good - Simple orthodontic treatment/no treatment.
Group 3: Fair - Complex orthodontic treatment, good result anticipated.
Group 4: Poor - Limited orthodontic treatment without orthognathic surgery, if growth is favorable.
Group 5: Very poor - Orthognathic surgery, categorizes malocclusion in cleft lip & palate.
The orthodontics: basic aspects and clinical considerations
Page. No 302.
|
Dental
| null |
0a1a710a-899b-4372-b417-e0aeb868faa2
|
All are true for transplanted kidney except -
|
Humoral antibody responsible for rejection
|
CMI is responsible for rejection
|
Previous blood transfusion
|
HLA identity similarity seen in 1:100 people
| 3d
|
multi
|
Ans. is 'd' i.e., HLA identity similarity seen in 1:100 people transplant immunobiology and rejection -o Antigen which is responsible for transplantation mechanism is glycoprotein surface antigen (HLA).o Every indivudual has a unique set of inherited transplant antigens the human leucocyte antigen (HLA) - Which are genetically encoded on chromosome 6.o The purpose of these antigens is to help the body recognize what is self and what is not.o When an organ is transplanted between HLA mismatched people, that organ is recognized as nonself because of unrecognized HLA, and can be destroyed."Within any particular family, sibling 'v have a 1:4 chance of being HLA identical In contrast among unrelated people, the probabilities of HLA identity is in several thousand depending upon phenotype involved. It is due to the fact that HLA complex is inherited intact as two haplotypes".THREE TYPES OF REJECTION MAY TAKE PLACE IN RENAL TRANSPLANT PATIENTS :Hyperacute -o This reiection is analogous to a blood transfustion reaction as it is a humoral response mediated bv preformed recipient antibodies against the HLA expressed on the donor renal vascular endothelium.o To have these preformed antibodies the recipient must have been sensitized by a previous blood transfusion, a previous pregnancy or a previous transplant.o All potential recipients are screened for these antibodies preoperatively by placement of donor lymphocytes with recipient serum.o If this cross match is positive, that is antibodies are present in the recipient serum against the donor HLA, transplant surgery is contraindicated.o Clinically hyperacute rejection is seen as soon as blood flow to the donor kidney is established.Acute reiection -o This occurs in first week to month after transplant.o Cell mediated immunity is involved in this process and T lymphocytes play a major role in this.Chronic rejection -o It is defined as a process of gradual progressive decrease in renal function that cannot be attributed to another cause.o Unlike the causes of hyperacute and acute rejection, the underlying immune mechanism of chronic rejection is not understood.
|
Medicine
|
Renal Transplantation
|
ff229087-4728-4f86-a1ec-524e14de7bdc
|
Drug of choice for the treatment of negative symptoms of schizophrenia is -
|
Chlorpromazine
|
Haloperidol
|
Clozapine
|
Doxepin
| 2c
|
single
|
Ans. is 'c' i.e., Clozapine o Drugs for negative symptoms Clozapine Olanzapine Risperidone Aripiprazole Ziprazidone
|
Pharmacology
| null |
7dd6bfb1-85df-474a-9770-6044a19f9376
|
Isolated hyperbilirubinemia is classically seen as an adverse effect of:
|
INH
|
Rifampin
|
Pyrazinamide
|
Capreomycin
| 1b
|
multi
|
Hepatotoxicity due to rifampin alone is uncommon and often consists of isolated hyperbilirubinemia. Ref: Harrisons Principles of Internal Medicine, 18th Edition, Page 1375
|
Medicine
| null |
f93f0e5c-99ae-49ca-a2fa-7fdea733668a
|
Which of the following is a prokinetic drug?
|
Domperidone
|
Cimetidine
|
Ondansetron
|
Hyoscine
| 0a
|
single
|
Ans. is 'a' i.e., Domperidone Gastrokinetic (prokinetic drugs) These are the drugs which promote gastrointestinal transit and speed gastric emptying by enhancing coordinated propulsive motility. Prokinetic drugs are - Metoclopramide, Domperidone, Cisapride, Mosapride, Tegaserod, renzapride, prucalopride. Prokinetic drugs can act by ? 5HT4 agonistic activity D2 and 5-HT3 antagonistic activity Both these actions will increase the release of Ach and thereby motility of GIT.
|
Pharmacology
| null |
ea9cb464-73f9-46b6-9a85-b27187702b69
|
All are seen in VKH syndrome except -
|
Vitiligo
|
Veigo
|
Granulomatous uveitis
|
Iris heterochromia
| 3d
|
multi
|
Clinical features of VKH syndrome Cutaneous lesion:alopecia, poliosis and vitiligo Neurological lesions:meningism and encephalopathy Auditory features:tinnitus, veigo and deafness Ocular features :granulomatous uveitis Ref:A K Khurana 6th edition pg:169
|
Ophthalmology
|
Uveal tract
|
0bfaf7bb-6369-4a4f-861a-5b1c4d425839
|
Plasma half life of carbimazole -
|
4 hours
|
8 hours
|
16 hours
|
24 hours
| 1b
|
single
|
Ans. is 'b' i.e., 8 hours o Half life of propylthiouracil : 1-2 hours o Half life of carbimazole : 6-10 hours
|
Pharmacology
| null |
11601b5d-7dc2-4b03-bb82-faeb3dd6fcb6
|
Testamentary capacity refers to
|
Ability to make a valid will
|
Criminal liability
|
Right to vote
|
Ability to give evidence
| 0a
|
single
|
Ans. (A). Ability to make a valid will(Ref: KSN Reddy, Essentials of Forensic Medicine & Toxicology, 33rd Ed., P. 493)Testamentary capacityQMental Ability of a person to make a valid willHolograph willQWritten by the testator in his own hand writingSomnambulismSleep walkingSomnolentiaSleep - drunkenness - midway between sleep and walking, he may commit some crime due to confusion of the mind
|
Forensic Medicine
|
Forensic Psychiatry
|
9f33ee46-603f-4d3f-afc3-94aa7c484384
|
Sjogren syndrome is characterized by all except
|
Keratoconjunctivitis sicca
|
Excessive salivation
|
Splenomegaly
|
Lymphoma
| 1b
|
multi
|
Answer- B. Excessive salivationSjogren syndrome is a chronic disease characterized by dry eyes (keratoconjuctivitis sicca) and dry mouth (xerostomia) resulting from immunological mediated destruction of the lactimal and salivary gland.ExtraglandularRaynaud's phenomenonVasculititisAhralgia/AhritisLymphadenopathylymphomaSplenomegalyLung involvementKidney involvementPeripheral neuropathyMyositisLiver involvement
|
Pathology
| null |
42610528-218f-47aa-8a06-f26c8240ab4f
|
Neurovascular plane in the anterior abdominal wall is between
|
External and internal oblique
|
Internal oblique and transversus abdominis
|
Peritoneum and transversalis fascia
|
Skin and external oblique aponeurosis
| 1b
|
multi
|
.
|
Anatomy
|
All India exam
|
5f3e04e0-604c-4e70-b34d-de41f7ae1382
|
Most common cause of Mediastinitis is:
|
Tracheal rupture
|
Esophageal rupture
|
Drugs
|
Idiopathic
| 1b
|
single
|
Answer is B (Esophageal rupture): Most cases of acute mediastinitis are due to esophageal perforation or occur after median sternotomy for cardiac surgery- Harrison Acute Mediastinitis Chronic Mediastinitis 1. 2. Esophageal rupture Q Median sternotomy for cardiac surgery 1. 2. 3. Tuberculosis / Histoplasmosis (most cases) Q Sarcoidosis, silicosis Q Other fungal diseases
|
Medicine
| null |
3f7a9bc3-7c1b-490d-903d-3fff141798fe
|
Tension band wiring is done in following except?
|
Fracture patella
|
Fracture olecranon
|
Colie's Fracture
|
Fracture medial malleolus
| 2c
|
multi
|
Ans. C. Colle's Fracture. (Ref Maheshwari orthopaedics 3rd/pg. 24 & 139)Maheshwari orthopaedics 3rd/pg. 24 mentions........................|||Tension-band wiringTension-band plateTension-band fixation|||iUsed for producing dynamic compression in Patella, Olecranon & transverse malleolus .Used for Humerus & Tibia .Used for Tibia .RECENT ADVANCES IN Rx OF FRACTURES:# A.O. method# Cast (functional) bracing# Ilizarov's techniqueA.O. method:In this method the following principles are used to achieve stable fixation:# A. Inter-fragmentary compression i.e., achieving compression between different fragments.# B. Splinting (splinting fracture fragments internally or extrenally)# C. Combination of A and B.A. Inter-fragmentary compression i.e., achieving compression between different fragments.a. Static compressionb. Dynamic compression# Methods of producing static compression:- a). Lag screw- b). Compression plating- c). External fixator# Methods of producing dynamic compression:- a). Tension-band wiring e.g. Patella & Olecranon - b). Tension-band plate e.g. Humerus & Tibia - c). Tension-band fixation e.g. Tibia .B. Splinting.a. IM splinting: e.g. Kuntscher's nailing for+shaft of femur.b. EM splinting: e.g. plating without compression (neutralising plate), or plate supporting the without fixing it (buttress plate) sometimes used for tibial condyle .c. Outside the body e.g. external fixators used merely to hold the fragments.C. Combination of A and B.e.g. for Spiral of shaft of femur.Cast (functional) bracing# Popularized by Sarmiento (1973)# Done if fracture reduction is satisfactory, and once the swelling subsides - usually 2-3 weeks after injury.# Most commonly used for of the shaft tibia. It is also used for femoral/humerus shaft, and other fractures.Ilizarov's technique# * Infected non-union of long bones is a problem in the developing countries.# * Persistent infection, deformity, shortening, bone loss, joint stiffness and disability complicate the non-union.# * Secondary procedures are often required for correction of bone defects and deformity.# * Ilizarov method deals with all the above problems simultaneously and offers a kind of universal remedy for infected non-unions.# *The stability of the fixation and provision for bone transport allows bridging of bone defects, limb lengthening, early weight bearing ambulation and joint mobilization.# The basic principle of Ilizarov's technique is that Osteogenesis requires dynamic state, which causes dormant mesenchymal cells at the non-union gap to differentiate into functioning osteoblasts.# Distraction or compression is carried out at lmm/day.# This is done is four settings i.e. l/4th mm four times a day.# It is useful in management of:- Limb lengthening- Non-union especially resistant to conventional methods of Rx or those associated with deformity or shortening.- Deformity correction, which may be congenital or acquired.- Osteomyelitis can be treated as this technique offers possibility of excision of necrotic bone - creating a gap, which can be made up by transporting a segment of bone from either end.- Arthrodesis can be performed by crushing articular surfaces against each other, and thus stimulating union between opposite bones.# Advantages:- Immediate load bearing- Healthy viable bone in place of de-vascularized bone- Correction of more than one problems by one-stage operation.# Disadvantages:- Inconvenience- Long duration Rx- Pin-tract infection- Nerve palsy by pin insertion or traction- Joint stiffness of the soft tissues by external fixator.
|
Orthopaedics
|
Injuries Around the Thigh & Knee
|
81faaa8f-7103-4964-90b8-b54b1fbcf34b
|
% of O2 inhaled-
|
5%
|
20%
|
50%
|
78%
| 1b
|
single
|
Ans. is 'b' i.e., 20% Atmospheric (inspired) airAlveolar airExpired air %PP mm Hg%PP mm Hg%PP mm HgO220.8415813.410016116CO20.040.35.340432Nitrogen78.6259675.157374.1565H2O (vapour)0.505.76.2476.247 100760100760100760
|
Physiology
|
Principles of Gas Exchange - Respiratory Membrane
|
ce7c2678-f90c-46e2-98c1-a874adc83346
|
True about inspiration; the intrapleural pressure becomes:
|
More - ye
|
More +ve
|
Same
|
Initially positive, then negative
| 0a
|
multi
|
A i.e. More - ve
|
Physiology
| null |
c1767a45-36d7-456a-81f4-c57778ff0327
|
All the following are true of de Quervain's Thyroiditis except -
|
Pain
|
Increased ESR
|
Increased radioactive iodine uptake
|
Fever
| 2c
|
multi
| null |
Surgery
| null |
2b636249-b815-4842-b951-29f20353966e
|
In which condition intensity of systolic murmur is incre ased-
|
Hyperophic cardiomathy
|
Severe AS
|
MS
|
AR
| 1b
|
single
|
The intensity of functional systolic ejection murmurs varies, but generally ranges from grades 1 to 3. The intensity typically increases during phase 3 (release phase) of the Valsalva maneuver, following a post-extrasystolic pause and after inhalation of amyl nitriteand AS conditions Ref Davidson 23rd edition pg 455
|
Medicine
|
C.V.S
|
4b1181d3-d9b9-460d-b60a-bd8896dda4fd
|
At 30 days of intrauterine life
|
Hea stas beating
|
Cerebellum develops
|
Optical vesicle appears
|
Pinna appears
| 2c
|
single
|
*Optical vesicle come in contact with surface ectoderm and lens place is forming by the 4th week of IUL - the eyes begin to develop as a pair of diveicula from the lateral aspects of the forebrain. These diveicula make their appearance before the closure of the anterior end of the neural tube; after the closure of the tube, they are known as the optic vesicles. *Ear pinna or auricle stas forming by the 5th week of IUL *Cerebellum stas forming by the 8th week of IUL *The baby's heabeat stas as the blood flow begins by 22nd day of IUL (Reference: I B Singh's Embryology, 10th edition, pg 374, 281)
|
Anatomy
|
General anatomy
|
0aae3a43-3d54-4f1f-9005-9dbf7c3d48f2
|
Vogt-Koyanagi-Harada (VKH) syndrome is:
|
Chronic granulomatous uveitis
|
Chronic non-granulomatous uveitis
|
Acute purulent uveitis
|
None
| 0a
|
multi
|
Ans. Chronic granulomatous uveitis
|
Ophthalmology
| null |
9bb63a91-eb4e-463d-b74c-2adbd5e91616
|
A 36-year-old diabetic woman develops metabolic changes following salpingo-oophorectomy. Serum osmolality of the blood can be calculated from serum values of which of the following?
|
Sodium, potassium, chloride, and bicarbonate
|
Sodium, potassium, urea, and hemoglobin
|
Sodium, potassium, glucose, and urea
|
Sodium, albumin, urea, and glucose
| 2c
|
single
|
Serum osmolality is calculated from serum values of sodium, potassium, glucose, and BUN by using the formula 2(Na+K)+BUN/2.8+glucose/18.
|
Surgery
|
Wounds, Tissue Repair & Scars
|
c2b38fd4-caf0-4f14-b185-50e042ef9df2
|
The cause of oedema in Nephritic syndrome is
|
Decreased in plasma protein concentration
|
Increased in plasma protein concentration
|
Reduced plasma osmotic pressure
|
Sodium and water retension
| 3d
|
single
|
(Sodium and water retension) (80, 522 - R) (100, 683 - HM) (554- Basic pathology 8th)Patho Physiologic categories of EDEMAIncreased Hydrostatic pressureReduced plasma Osmotic pressure(Hypo proteinemia)Increased venous return* CHF* Constrictive pericarditis* Ascites (liver cirrhosis)* Venous obstruction or compression* Thrombosis* External pressure (e.g. mass)* Lower extremity inactivity with prolong dependancy* Arterioler dilation- Heat- Neuro humoral dysregulation- Protein losing glomerulopathies (Nephroticsyndrome)- Liver cirrhoses (ascitis)- Malnutrition- Protein losing gastro enteropathySODIUM RETENSION* Excessive salt intake with renal insufficiency* Increased tubular reabsorption of sodium- Renal hypoperfusion- Increased renin - angio tension aldosterone secretion* Reduced plasma osmotic pressure can result from excessive loss or reduced synthesis of albumin, the serum protein most responsible for maintaining colloid osmotic pressure. An important cause of albumin loss is the NEPHROTIC SYNDROME characterized by a leak glomerular capillary wall and generalized edema* Nephritic syndrome - oedema is due to excessive reabsorption of sodium and water in the renal tubules via renin angiotensin - aldosterone mechanism
|
Pathology
|
Kidney
|
6e218e5c-2a3c-4b0e-b164-b0a21756f009
|
An infant present with bilateral white pupillary reflex. On slit lamp examination a zone of opacity is observed arround the fetal nucleus with spoke like radial opacities. The most likely diagnosis is-
|
Cataracta Centralis Pulverulenta
|
Lamellar cataract
|
Coronary cataract
|
Posterior polar cataract
| 1b
|
single
|
lamellar cataract - opacities in the foetal nucleus and which are small linear like spokes of a wheel towards the equator. Cataracta centralis pulverulenta - small rounded opacity lying exactly in the centre of the lens. Coronary cataract - opacities are often many hundreds in number and have a regular radial distribution in the periphery of lens encircling the central axis. posterior polar cataract - small circular circumscribed opacity involving the posterior pole.
|
Ophthalmology
|
Lens
|
a60b59c9-c053-4fd4-a02d-13ea52320d66
|
What type of hypersensitivity reaction is seen in myasthenia gravis?
|
Type 1 hypersensitivty reaction
|
Type 2 hypersensitivty reaction
|
Type 3 hypersensitivty reaction
|
Type 4 hypersensitivty reaction
| 1b
|
single
|
Type 2 hypersensitivity reactions: My - Myasthenia gravisBlood - blood transfusion reactionsGroup- Goodpasture syndrome and Graves diseaseIs - Insulin resistant DM, ITPR - Rheumatic feverH - hyperacute graft rejectionPositive - pernicious anaemia & pemphigus vulgaris Ref : Ananthanarayana textbook of Microbiology 9th edition Pgno : 162,165
|
Microbiology
|
Immunology
|
9f21fc0b-e389-4b03-b3ec-0e9ad6335ca3
|
Aery to bleed in duodenal ulcer haemorrhage -
|
Splenic aery
|
Gastroduodenal aery
|
Left gastric aery
|
Sup. mesenteric aery
| 1b
|
single
|
Gastro duodenal aery is the most common aery involved in duodenal ulcer hemorrhage. Also, remember A peptic ulcer is the most common cause of massive upper gastrointestinal bleed (Duodenal ulcers > Gastric ulcers) Bleeding ulcers in the duodenum are usually located on the posterior surface of the duodenal bulb. Ref : Bailey & Love 25/e p1045
|
Anatomy
|
G.I.T
|
9f1ec281-951d-4abf-8b6d-cceaac626717
|
Gustilo Anderson classification is used for ?
|
Compound fractures
|
Closed fractures
|
Distal end radius fractures
|
Femur head fractures
| 0a
|
single
|
Ans. is 'a' i.e., Compound fractures Compound fracture Compound fracture, also called open fracture, in which fracture communicates with external environment, i.e., overlying soft tissue coverage (skin and muscles) is breached. Open fractures are typically caused by high energy injuries such as car crashes, falls, or spos injuries. Gustila and Andersion classified open fracture into following types.
|
Surgery
| null |
f7665cb0-4047-4cb6-9166-fc8e742b87aa
|
Day 3 serum Estrogen levels to diagnose premature ovarian failure:
|
<10-20 pg/ ml
|
<20-40 pg/ ml
|
<60-80 pg /ml
|
<40-60 pg /ml
| 2c
|
single
|
Diagnosis of premature ovarian failure: History of amenorrhea in less than 35 years, Day 3 Serum FSH>10-15 miu/ml,LH < 10 IU/L, Day 3 serum estrogen 60-80 pg/ml or less. Anti-mullerian hormone is low, Inhibin is low, Antral follicular count measuring 2-9mm in both the ovariess and number of follicles and size,count less than 4-5 on day 2-5 denotes poor response to hormones,Usg ovarian volume is low and progesterone on 21/22 day is >15ng/ml. SHAW'S TEXTBOOK OF GYNAECOLOGY, 16TH edition,Pg no:257
|
Gynaecology & Obstetrics
|
Menopause and HRT
|
019f722e-2b58-4cbd-ae88-a38c1a7efd34
|
Which antineoplastic agent is an antifolate drug ?
|
Methotrexate
|
Adriamycin
|
Vincristine
|
Cyclophosphamide
| 0a
|
single
|
Ans. is 'a' i.e., Methotrexate
|
Pharmacology
| null |
a9c9fafc-35d0-491a-868f-49701d2876e5
|
An early systolic murmur may be caused by all of the following, EXCEPT:
|
Small ventricular septal defect
|
Papillary muscle dysfunction
|
Tricuspid regurgitation
|
Aoic stenosis
| 3d
|
multi
|
In Aoic stenosis, murmur is ejection systolic ie: murmur stas after the isovolumic or isometric contraction phase. So the murmur stas only after the opening of the semilunar valve. In all the other conditions murmur stas in the isometric contraction phase itself, so its early systolic.
|
Medicine
| null |
20332b65-71b9-4175-9215-220298aada34
|
Gold standard diagnostic test for babeiosis is:
|
Peripheral blood smear examination
|
Blood Culture
|
PCR
|
ELISA
| 0a
|
single
|
Ans: a. Peripheral blood smear ...,Microscopic examination of stained blood smear is gold standard test for babesiosis"A specific diagnosis usually is established by microscopic examination of Giemsa-stained thin blood smears. Babesia trophozoites appear round, pear-shaped, or ameboid.The ring form is most common and lacks the central brownish deposit (hemozoin) typical of Plasmodium falciparum trophozoites. Other distinguishing features are the absence of schizonts and gametocytes and the occasional presence of tetrads ("Maltese cross").If parasites cannot be identified by microscopy and the disease is still suspected, amplification of the babesial 18S rRNA gene by polymerase chain reaction (PCR) is recommended. Quantitative PCR has greatly lowered the threshold for detection of B. microti DNA
|
Microbiology
| null |
d4207813-064a-451a-a03b-59cb63b6d9f1
|
Three years back a woman had exposure to an eahquake and she was successfully saved. After recovery she has nightmares about the episode and she also gets up in the night and feels terrified. The MOST probable diagnosis is :
|
Major depression
|
Post-traumatic stress disorder
|
Mania
|
Schizophrenia
| 1b
|
single
|
This woman was exposed to a traumatic event following which she is getting flashbacks about the event and is having difficulty in sleeping. All of these symptoms indicates a diagnosis of post traumatic stress disorder. Post traumatic stress disorder is an anxiety disorder characterized by re experiencing a traumatic event and decreased responsiveness and avoidance of current events associated with the trauma. They experience illusions, sleep problems, nightmares, difficulties in concentration, and hyperaleness. Patients with acute stress disorder develops similar symptoms sholy after the traumatic event but they lasts between 2 and 28 days. Ref: CURRENT Medical Diagnosis & Treatment 2014 chapter 25 By Stua J. Eisendrath, MD.
|
Psychiatry
| null |
492eefa5-964c-43d0-877a-4afc64c811bb
|
Single lesion leprosy treatment
|
Dapsone and rifampicin
|
Dapsone and clofazamine and ofloxacin
|
Rifampicin ,ofloxacin and dapsone
|
Rifampicin , olfoxacin and minocycline
| 3d
|
single
|
ROM Regimen is used in single lesion leprosy.Now a days singlw lesion leprosy is also treated as paucibacillary leprosy and standared MDT of leprosy is given for 6 months- 1 yr. Ref: Harrison 17thed/1127
|
Pharmacology
|
All India exam
|
af6bb29e-269c-4ad2-8b4e-7e55b9b22ec5
|
Which polyp has maximum malignant potential ?
|
Sessile
|
Pedunculated
|
Superficial spreading
|
Any of the above
| 0a
|
multi
|
Ans. is 'a' i.e., Sessile Polyp --> Polyp is a grossly visible protrusion from the mucosal surface and it is classified pathologically as. a) Adenomatous polyp b) Juvenile polyp (hamaomatous polyps) c) Inflammatory polyp d) Hyper plastic polyp (hyperplastic mucosal proliferation) Adenomatous polyps These are premalignant lesions. The risk of malignant degeneration is related to both the size and type of polyp. Majority of colorectal carcinomas evolve from adenomatous polyps; this sequence of events is the adenoma-carcinoma sequence. Hamaomatous Polyps (Juvenile Polyps) In contrast to adenomatous polyps, hamaomatous polyps (juvenile polyps) are not usually premalignant. These lesions are the characteristic polyps of childhood but may occur at any age. Inflammatory Polyps (Pseudopolyps) Inflammatory polyps occur most commonly in the context of inflammatory bowel disease, but may also occur after amebic colitis, ischemic colitis, and schistosomal colitis. These lesions are not premalignant. Hyperplastic Polyps Hyperplastic polyps are the most common colonic polyps, but they are usually quite small (Ninety percent of these polyps are less than 3 mm in size) These lesions are not premalignant. Adenomatous polyps have special clinical significance because only adenomatous polyps are clearly premalignant, and only a minority of these adenomatous lesions ever develop into a cancer. Clinically, the probability of an adenomatous polyp becoming a cancer depends on three factors 1) Gross appearance of the lesion --> on gross appearance polyps are of two types a) Pedunculated (stalked) b) Sessile (flat based) Cancer develops more frequently in sessile polyps. 2) Histologically --> Histologically polyps are of 3 types a) Tubular b) Villous (papillary) c) Tubulovillous Out of these histological types villous adenomas which are usually sessile become malignant more than 3 times as often as tubular adenomas.
|
Surgery
| null |
5c595626-3af1-4949-b552-494cde6cfa4f
|
All of the following are contraindications to use diaphragm except :
|
Multiple sex paners
|
Recurrent infections
|
Uterine prolapse
|
Herpes vaginitis
| 0a
|
multi
|
Contraindications to use of diaphragm are: (i) prolapse, cystocele, rectocele because accurate fitting is not possible; (ii) recurrent infection and (iii) allergy to rubber or spermicidal agent. Reference: Shaw's Textbook of Gynaecology 16th edition page no 267
|
Gynaecology & Obstetrics
|
Contraception
|
6125acc0-1459-4c04-a31c-ededbcaa99f7
|
Cholinergic drugs are used in all the following conditions except
|
Cobra Bite
|
Post operative paralytic ileus
|
Glaucoma
|
Bradycardia
| 3d
|
multi
|
Cholinergic drugs produce bradycardia by acting on M2 receptors on hea Ref: KDT 7th ed pg 101
|
Pharmacology
|
Autonomic nervous system
|
cd5f94c1-b8f1-499a-b52c-4fdd96f66469
|
Undulant fever is caused by
|
Salmonella typhi
|
Staphylococcus aureus
|
Brucella melitensis
|
Coxiella burnetti
| 2c
|
single
|
Acute brucellosis is mostly due to B.melitensis. It is usually known as undulent fever, but this is misleading as only some cases show the undulent pattern. It is associated with prolonged bacteremia and irregular fever. Ref: Textbook of microbiology; Ananthanarayan and paniker's; 10th edition; Pg:347
|
Microbiology
|
Bacteriology
|
20d19644-70f9-49da-bdf0-a75ff2f47bbb
|
All are true about hyperophic cardiomyopathy, except?
|
Systolic dysfunction
|
Dynamic left ventricular outflow tract obstruction
|
Diastolic dysfunction
|
Double apical impulse
| 0a
|
multi
|
HOCM- AD ( b- myosin gene defect, ch-14 )- Asymmetrical septal hyperophy- L-VOTO (Left ventricular outflow tract obstruction)- characterized by predominant diastolic dysfunction. On Examination :1. Pulsus Bisfiriens (aka) "Jerky Pulse"* Fast rise initially* LVOTO contribution to sudden dip in pressure2. Apex beat- Displaced impulse- Double apical impulse (5 + 6th I/C space)3. S2: Narrow split/ single S2 / Reverse Split S2- Splitting is best Heard Best in phase of inspiration- Heard at ERB'S Point - 3rd left parasternal I/C Space.4. S4 is heard due to out flow obstruction, left atrial hyperophy occurs.5. Ejection systolic murmur* CRESENDO- DECRESENDO MURMUR* ALL Murmur | in intensity with Valsava, Standing, amyl nitrate Except - HOCM = Louder SYSTOLIC ANTERIOR MOTION(SAM) of valve seen in ECHO.
|
Medicine
|
Cardiomyopathies
|
971ac47c-fa9a-4db2-8f2b-5dcb6bb8dd98
|
The following regarding colostomy are true except?
|
A colostomy is an aificial opening made in large Bowel to dive the faeces to the exterior
|
Temporary colostomy is established to defunction an anastomosi
|
Permanent colostomy is formed after the resection of Rectum by the abdominoperinea technique
|
Double barreled colostomy is commonly done nowadays
| 3d
|
multi
|
Ans. is 'd' i.e., Double barreled colostomy is commonly done nowadays
|
Surgery
| null |
6914ba19-8620-457d-9a52-e302a4ad8d7e
|
Dysthyroid ophthalmopathy all are true except-
|
Proptosis
|
Myopathy
|
Exophthalmos
|
Optic neuritis
| 3d
|
multi
|
*Three chacteristic Clinical features of dysthyroid ophthalmopathy are retraction if upper lid, proptosis and restrictive extraocular myopathy. Ref: Head &Neck Surgery 2nd/e p.1513
|
Ophthalmology
|
Diseases of orbit, Lids and lacrimal apparatus
|
b945cdd5-2e89-4289-9e3f-805476ff0c09
|
In which of the following conditions fluid levels are NOT seen?
|
Meconium ileus
|
Intussusception
|
Colon pouch
|
Duodenal obstruction
| 0a
|
single
|
"In meconium ileus, meconium is so thick that it is unable to form air fluid level despite complete small intestinal obstruction". Ref: Bailey & love 25/e, Page 1199; schwaz 9/e, Page 1429.
|
Surgery
| null |
fb40ed7d-c09e-457f-a922-2ab364eae4b2
|
Among the given options ; iodinated compound present in maximum concentration in thyroid is
|
Monoiodotyrosine (MIT).
|
Diiodotyrosine (DIT).
|
T3.
|
Reverse T3.
| 1b
|
multi
|
THYROID HORMONE SYNTHESIS AND SECRETION
§ Thyroid hormones are synthesized in the colloid, near the apical cell membrane of the follicular cells. Catalyzed by the enzyme thyroidal peroxidase, iodide in the thyroid cell is oxidized to iodine.
|
Unknown
| null |
b7317867-92f2-4ae1-bab7-23b87fec96bc
|
Calcific hepatic metastasis are seen in
|
Adenocarcinoma of the colon
|
Carcinoid tumors
|
Renal cell carcinoma
|
Lymphoma
| 0a
|
single
|
Calcified hepatic metastases Clacified hepatic metastases are most frequently associated with mucin-producing neoplasm such as colon carcinoma or less likely ovarian carcinoma
|
Anatomy
|
G.I.T
|
ed0bf5d4-ea4c-4f1a-9f78-df7d6bdb1840
|
Which waves is predominantly seen in EEG with eyes closed in normal alert adult?
|
Alpha waves
|
Beta waves
|
Theta waves
|
Delta waves
| 0a
|
single
|
Ans. A. Alpha wavesBandFrequency (Hz)Location NormallyDelta<4frontally in adults, posteriorly in children; high-amplitude waves* adult slow-wave sleep* in babiesTheta4-7Found in locations not related to task at hand* higher in young children* drowsiness in adults and teensAlpha8-15posterior regions of head, both sides, higher in amplitude on dominant side.* relaxed/reflecting* closing the eyesBeta16-31both sides, symmetrical distribution, most evident frontally; low-amplitude waves* range span: active calm - intense - stressed - mild obsessive* active thinking, focus, high alert, anxiousGamma>32Somatosensory cortex* Displays during cross-modal sensory processing (perception that combines two different senses, such as sound and sight)* Also is shown during short-term memory matching of recognized objects, sounds, or tactile sensations
|
Psychiatry
|
Sleep Disorders
|
c8540558-7ff9-45eb-8256-aaaa731d168c
|
A 63-year-old woman develops skin lesions, and difficulty getting out of a chair. A clinical diagnosis of dermatomyositis is made. What might the findings include?For the above patient, select the associated skin and clinical findings.
|
rarely involves border of scalp
|
discoloration of upper eyelids
|
never a permanent effect on skin
|
potentially aggravated by contact with the skin
| 1b
|
multi
|
In dermatomyositis, the dermatitis may be the most striking feature of the illness or so minor as to be easily overlooked. The classic manifestation is a purplish-red heliotrope erythema of the eyelids, upper cheeks, forehead, and temples, often with edema of the eyelids and of the periorbital tissue. Telangiectasia and skin atrophy can also occur. The typical hand changes involve scaly, bluish-red plaques around the base of the nails and backs of the joints of the fingers. These are most frequently found in elderly patients and are called Gottron papules. There is an association with malignancy in those over 55 years of age.
|
Medicine
|
Skin
|
19a10560-18b3-4fa1-af56-f993b6408ad4
|
Which among the following is the MOST common site of salivary gland calculi formation?
|
Parotid
|
Submandibular
|
Sublingual
|
Minor salivary glands
| 1b
|
single
|
Submandibular salivary glands are the most common site for calculus formation. followed in frequency by parotid gland. Sublingual glands and minor salivary glands are rarely affected. Physiologic factors which contribute to stone formation are: Alkaline pH High calcium concentration Mucin content of saliva Submandibular salivary glands are the most common site for calculus formation. followed in frequency by parotid gland. Sublingual glands and minor salivary glands are rarely affected. Physiologic factors which contribute to stone formation are: Alkaline pH High calcium concentration Mucin content of saliva
|
Surgery
| null |
c6660f96-8c46-476b-aba8-262ef797dc1a
|
A 5-month old infant is brought in for routine visit. What is the probable cause for the following findings?
|
Benign skin lesion
|
Sepsis
|
Hemophilia
|
Child abuse
| 0a
|
single
|
The image shows congenitsl dermal melanocytes (Mongolian spot) It is the most frequent encountered pigmented lesion in newborns Mongolian spots are completely benign Congenital dermal melanocytosis typically appears as blue-gray pigmented macule with indefinite borders, although it also can be greenish-blue or brown The diameter of the lesion may be 10cm or more The most common location is the sacral-gluteal region, homogenous gray-blue patches is usually diagnostic, paicularly when located in classic sites, there are repos of false accusations of child abuse resulting from misinterpretation of congenital dermal melanocytosis as bruises (which tend to change color and resolve more quickly) Ref: Nelson textbook of pediatrics 21st edition Pgno: 868
|
Pediatrics
|
New born infants
|
0fc3769e-0210-4076-86ad-a595dbcef431
|
Tumor appears at the earliest after birth.
|
Cystic hygroma
|
Branchial cyst
|
Lymphoma
|
Sternomastoid tumor
| 0a
|
single
|
Ans. (a) Cystic hygromaRef: Bailey and Love 26th edition, Page700* Earliest swelling one can note in human beings in Cystic Hygroma.* It can present as obstructed labor
|
Surgery
|
Neck
|
f3330e45-4d2f-401d-894f-31cbba4526a8
|
Sensory supply of middle ear is provided by
|
Facial
|
Glossopharyngeal
|
Vagus
|
Trigeminal
| 1b
|
single
|
Tympanic plexus provide the nerve supply It is formed by Tympanic branch of glossopharyngeal nerve Sympathetic fibres from plexus around the internal carotid aery Reference-Dhingra 6/e, p 8.
|
ENT
|
Ear
|
bacaf1e7-eb14-40ae-968b-5b454cafc672
|
As per 'Rule of Nine', each lower limb accounts for how much % of total body surface area:
|
1%
|
9%
|
18%
|
27%
| 2c
|
single
|
Ans. C i.e. 18%
|
Surgery
| null |
9534a5b0-bdfa-48fa-8ed7-ddbe0f05920a
|
Patient with massive hemorrhage presents to the ER after A. What's not to be done?
|
Massive transfusion of fluid challenge
|
IV crystalloid 2L, within few minutes
|
Early tranexamic acid recommended
|
Check coagulation with thromboelastography, if available
| 1b
|
multi
|
- ATLS updates (2018): Give only 1 liter of warm isotonic crystalloids for adults (old edition recommended 1-2 liters of warm crystalloid solution) - ATLS updates (2018): In children <40kg, give 20ml/kg of warm isotonic crystalloids The initial resucitation with crystalloid fluid still begins with a 1 litre bolus of warmed isotonic fluid.Early control of external hemorrhage is pivotal to the management of the injured patient. Thromboelastography and rotational thromboelastometry are helpful when available to pinpoint the precise ocagulation deficiency." CRASH-2 Trial (ATLS updates 2018 ) - Use of tranexamic acid in hypotensive trauma patients
|
Surgery
|
Trauma
|
cf9e7460-3d38-48c8-b5b8-4421540bf144
|
A client is undergoing peritoneal dialysis. The dialysate dwell time is completed, and the dwell clamp is opened to allow the dialysate to drain. The nurse notes that the drainage has stopped and only 500 ml has drained; the amount the dialysate instilled was 1,500 ml. Which of the following interventions would be done first?
|
Change the client’s position.
|
Call the physician
|
Check the catheter for kinks or obstruction.
|
Clamp the catheter and instill more dialysate at the next exchange time
| 2c
|
multi
|
The first intervention should be to check for kinks and obstructions because that could be preventing drainage. After checking for kinks, have the client change position to promote drainage. Don’t give the next scheduled exchange until the dialysate is drained because abdominal distention will occur, unless the output is within parameters set by the physician. If unable to get more output despite checking for kinks and changing the client’s position, the nurse should then call the physician to determine the proper intervention.
|
Pathology
| null |
6813ae69-9583-4571-85ae-e760665f935b
|
Hirustism may be found in any of these disorders, except-
|
Cushing's syndrome
|
Hypothyroidism
|
Congenital adrenal hyperplasia
|
Polycystic ovarian syndrome
| 1b
|
multi
|
Hirsutism refers to the excessive growth of thick terminal hair in an androgen-dependent distribution in women (upper lip, chin, chest, back, lower abdomen, thigh, forearm).It is due to androgen excess and is seen in the follwing conditions: *Idiopathic *Polycystic ovarian syndrome *Congenital adrenal hyperplasia (95% 21- hydroxylase deficiency) *Exogenous androgen administration *Androgen- secreting tumour of ovary or adrenal coex *Cushing's syndrome Reference : page 763 Davidson's Principles and practice of Medicine 22nd edition
|
Medicine
|
Endocrinology
|
00f27455-3e70-4889-ab91-ae4fabdf140f
|
Trachoma is caused by which serotype of chlamydia trachomatis?
|
D to K
|
A, B, C
|
L1 L2 L3
|
All of the above
| 1b
|
multi
|
Ans. is. 'b' i. e., A, B, C
|
Microbiology
| null |
89f6db99-50f4-49fd-b7a1-1b506b469f5e
|
Which hormone inhibits FSH secretion in feedback-
|
Testosterone
|
Progesterone
|
Inhibin
|
None
| 2c
|
multi
|
Ans. is 'c' i.e., Inhibin * LH is tropic for lyedig cells and the secretion of testosterone is under the control of LH. FSH is tropic for sertoli cells and stimulates sertoli cells to secrete inhibin and androgen binding protein (ABP). ABP binds testosterone, increasing its local concentration in the testes and thereby stimulating spermatogenesis.* Consistent with the phenomenon that the secretion of the target hormone inhibits is tropic hormone (negative feedback), testosterone inhibits LH secretion while estrogen (estradiol) and inhibin inhibit FSH secretion. Testosterone and estrogen have negative feedback at both pituitary and hypothalamic levels (GnRH), whereas inhibin exert negative feedback at pituitary level only.
|
Physiology
|
Endocrinology and Reproduction
|
6c8224d8-3801-4e4e-8111-2174b899aa92
|
Metrifonate is effective against -
|
Amoebiasis
|
Leishmaniosis
|
Schistosomiasis
|
Giardiasis
| 2c
|
single
|
Ans. is 'c' i.e., Schistosomiasis Infecting Organism Roundworms (nematodes) Drug of Choice Alternative Drugs Ascaris lumbricoides (roundworm) Albendazole's or pyrantel pamoate or membendazole Piperazine Trichuris trichiura (whipworm) Mebendazole or albendazole Oxantel/pyrantel pamoate Necator americanus (hookworm) Pyrantel pamoate or mebendazole or albendazole Ancylostoma duodenale (hookworm) Ivermectin Thiabendazole, albendazole Strongyloides stercoralis (threadworm) Mebendazole or pyrantel pamoate Albendazole Enterobius vermicularis (pinworm) Mebendazole; add coicosteroids Albendazole; add coicosteroids Trichinella spiralis (trichinosis) for severe infection for severe infection Trichostrongylus species Pyrantel pamoate or mebendazole Albendazole Cutaneous larva migrans (creeping eruption) Albendazole or ivermectin Thiabendazole (topical) Visceral larva migrans Albendazole Mebendazole Angiostrongylus contonensis Thiabendazole Albendazole or mebendazole Wuchereria bancrofti (filariasis); Brugia malayi Diethylcarbamazine<!--> <w:LsdException Locked="false" Priority="64" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 2 Accent
|
Pharmacology
| null |
17359cd6-5677-4bf2-85a7-ea2cc5258aa5
|
Failure of rupture of bucconasal membrane leads to?
|
Choanal atresia
|
Rhinophyma
|
Crooked nose
|
Epistaxis
| 0a
|
single
|
Ans. is 'a' i.e., Choanal atresia Choanal atresia Choana, also called posterior nares, is an opening in the posterior pa of each nasal cavity, through which nasal cavity communicates with nasopharynx. Choanal atresia is a congenital anomaly characterized by closure of one or both posterior nasal cavities (i.e., choana). It is due to persistence of bucconasal membrane. Approximately 6070% of cases are unilateral and are more common on right side. Bilateral cases occurs in 20-30% of patients and 50% of these patients are associated with other congenital anomaly, i.e., CHARGE syndrome - Coloboma, Hea defects, Choanal atresia, Retraded growth, Genitourinary abnormalities and Ear defects. Diagnosis Unilateral lesions go unnoticed until the child presents with persistent unilateral nasal discharge. There is absence of air bubbles in nasal discharge. A simple test for unilateral choanal atresia is to have the child attempt nose blowing with opposite nostril occluded by external pressure. Failure to detect any air movement is suspicious for complete obstruction. Bilateral choanal atresia presents as respiratory distress in newborn and requires suppo immediately after bih.
|
ENT
| null |
b1df7c40-b994-448d-97d8-26eda12b7471
|
AML is characterized by -
|
Philadelphia chromosome
|
Auer rods
|
Hemolytic anemia
|
Dohle bodies
| 1b
|
single
|
The diagnosis of AML is based on the presence of atleast 20% myeloblasts in the bone marrow.Myeloblasts have delicate nuclear chromatin, 2-4 nucleoli and more voluminous cytoplasm than lymphoblasts.Cytoplasm often contains fine peroxidase positive azurophilic granules. Auer rods,distinct needle like azurophilic granules are present Philadelphia chromosome is seen in CML Hemolytic anaemia is seen in CLL. Due to auto antibodies made by non neoplastic B cells. Dohle bodies are seen in leukocytosis.They are patches of dilated endoplasmic reticulum that appear as sky blue endoplasmic puddles Ref: Robbins and Cotran Pathologic basis of disease.South Asia Edition volume 1.page no583,594,613,617
|
Pathology
|
Haematology
|
e5715690-ed6e-4f36-9e39-f7a06e116133
|
Changes in the gingiva during pregnancy are attributed to
|
Changes in the hormonal level
|
Altered microorganisms
|
Altered immunological responses level
|
All the above
| 0a
|
multi
| null |
Dental
| null |
df2e1633-15bf-48f9-baf6-29b34bb646a7
|
Level V cervical nodes includes:
|
Upper jugular nodes
|
Middle jugular nodes
|
Lower jugular nodes
|
Posterior triangle nodes
| 3d
|
single
|
Level V cervical nodes includes posterior triangle nodes. CERVICAL LYMPH NODES Level Lymph Node IA SubmentalQ IB SubmandibularQ II UpperQ jugular III MiddleQ jugular IV LowerQ jugular V Posterior triangularQ VI Anterior compamental or centralQ VII Superior mediastinalQ
|
Surgery
|
Neck
|
4cad07c4-3d1c-47f0-b3f3-fce0cb2b5241
|
Tuberculosis verrucosa cutis is a form of –
|
Tuberculid
|
Primary tuberculosis
|
Postprimary tuberculosis with good resistance
|
Post primary tuberculosis with poor resistance
| 2c
|
single
|
Tuberculosis vernicosa cutis is a variant of cutaneous tuberculosis in patients with good cell mediated immunity to M. tuberculosis.
|
Dental
| null |
525d597e-352e-4958-84d2-874549c11181
|
Non-proliferative Glomerulonephritis include all of the following, except
|
Focal Segmental glomerulonephritis (FSGS)
|
Mesangiocapillary glomerulonephritis
|
Membranous glomerulonephritis
|
Amyloidosis
| 1b
|
multi
|
Among the 4 options, Mesangiocapillary Glomerulonephritis is a proliferative glomerulonephritisMembranoproliferative Glomerulonephritis(MPGN):Immune-mediated glomerulonephritis characterized by thickening of the GBM with mesangioproliferative changes. Because the proliferation is predominantly in the mesangium but also may involve the capillary loops, a frequently used synonym is mesangiocapillary glomerulonephritis also known as lobar glomerulonephritis.Ref: Harrison's 18/e p2334-35
|
Medicine
|
All India exam
|
4254246d-9c89-436b-832d-d0bdef1cc8cd
|
Causes of conjugated hyperbilirubinemia is –
|
Rotor syndrome
|
Breast millcjaundice
|
Crigler najjar
|
Gilbert syndrome
| 0a
|
single
| null |
Pediatrics
| null |
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