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|---|---|---|---|---|---|---|---|---|---|---|
e9c61495-29b3-47c2-961d-2d096bbf22af
|
Irreversible injury in myocardium occurs at -
|
2 minutes
|
30 minutes
|
2 hours
|
5 hours
| 1b
|
single
|
Ans-Bo Myocardial function is more sensitive to ischemia(loss of contractility occurs within 60 seconds) than myocardial structure (irreversible injury occurs in 20-40 minutes, thus myocardial necrosis begins at approximately 30 minutes after coronary occlusion.FeatureTimeo Onset of ATP depletiono Loss of contractilityo ATP reduced to 50%o ATP reduced to 10%o Irrversible injuryo Microvascular injurySeconds< 2 minutes10 minutes40 minutes20-40 min> 1 hr
|
Unknown
| null |
e0e5e2b7-32fc-4762-8317-3f61f4d72701
|
Which of the following is a minor criteria for diagnosis of Rheumatic fever (RP) according to modified Jones criteria –
|
ASO titre
|
Past history of Rheumatic fever
|
Fever
|
Subcutaneous nodules
| 2c
|
single
|
Fever is a minor criteria
|
Pediatrics
| null |
c059ab34-cba9-4ea7-aef9-48bb6f2fe660
|
Sparfloxacin and astemizole can cause :
|
Ventricular arrhythmia
|
Myopathy
|
Electrolyte imbalance
|
Nephropathy
| 0a
|
single
| null |
Pharmacology
| null |
eff108fd-8d29-4585-a821-2cd493bb8f80
|
All of the following are true about fetal circulation EXCEPT?
|
Pulmonary vascular resistance is low
|
Umbilical aeries carry deoxygenated blood
|
Lungs are collapsed and filled with fluid
|
source of oxygen in fetal circulation is placenta
| 0a
|
multi
|
Components of Fetal circulation: - placenta --> source of oxygen As placenta provides gas exchange for fetus, lungs are collapsed & filled with fluid exhibiting high pulmonary vascular resistance Thus, very little blood flows to lungs - Ductus venosus --> provide low resistance bypass for umbilical venous blood to reach Inferior Vena Cava - Ductus aeriosus --> Allow right ventricular blood to reach descending aoa, since lungs are non-functioning - Foramen ovale --> Enables oxygenated blood to reach left atrium & ventricles for distribution to hea & brain. - Umbilical vein--> carry oxygenated blood from placenta towards fetus - umbilical aeries --> carry deoxygenated blood from fetus to placenta Fetal circulation:
|
Pediatrics
|
Fetal circulation
|
b122d570-73e1-4e9e-bb91-87a310c7069a
|
Deficiency of enzyme in Tay–Sack disease –
|
Galactosidase
|
Hexosaminidase
|
Acid lipase
|
Glucosidase
| 1b
|
single
| null |
Pediatrics
| null |
a6874576-93ac-4764-bb54-41ded09bf90f
|
A young female presented with halo's abdominal pain and amnesia she is likely to be suffering from
|
Conversion disorder
|
Dissociative disorder
|
Depresonalization disorder
|
Mania
| 1b
|
single
|
B i.e. Dissociative disorderAmnesia is seen in dissociative disorders and Conversion disorder presents with anesthesia (sensory dysfunction) voluntary motor dysfunction or hysterical fits.Q.Autonomic system is characteristically not involved in conversion disorderQDisorder PresentationDissociative disorder****AmnesiaQFugueQ (wandering away from home)Trance & Possession disorderGanser syndrome (hysterical Pseudodementia)QConversion disorder*Hysterical fits - usually occur in safe place & infront of people - never occur during sleep - injury, incontinence & tongue bite usually absent *Motor symptoms - paralysis - abnormal movements - gait disturbance (Atasia abasia) *Sensory symptoms - blindness but walks well & does not injure himself - tubular vision, deafness - Glove stocking anesthesia Loss of all sensation Abrupt boundary Not according to dermatomes - Hemianesthesia i.e. Loss of vibration sense maintains a strict midline seperation inspite of fact that vibrationcan be perceived on other side through bone conduction.
|
Psychiatry
| null |
4b80f35e-7ca5-40c6-8af2-2081174bbdc9
|
Treatment with fracture neck of humerus in a lady will be:
|
Triangular sling
|
Hemiahropalsty
|
Chest arm bandage
|
Internal fixation
| 0a
|
single
|
A i.e. Triangular sling
|
Surgery
| null |
1e61fe91-1677-42e3-9417-fbdf2ae1b694
|
Puscher retinopathy is seen in patients with ?
|
Complication of chronic pancreatitis
|
Occlusion of anterior retinal aery
|
Head trauma
|
Diabetes mellitus
| 2c
|
single
|
Ans. is 'c' i.e., Head trauma Puscher retinopathv Occurrence of bilateral patches of retinal whitening and hemorrhage around the optic disc in patients who suffered massive head trauma was first described by Puscher and is called Puscher retinopathy.
|
Ophthalmology
| null |
bba3fffa-09db-4f76-8fdf-cb9ab74a5398
|
The movement of the leukocytes across the endothelium is called as:
|
Emigration
|
Transmigration
|
Margination
|
Pavementing
| 1b
|
multi
| null |
Pathology
| null |
c2d0e192-6165-4d2a-a7df-58f37001b78a
|
Spastic paraplegia can be caused by the following except -
|
Motor neuron disease
|
Chronic lead poisoning
|
Vitamin B12deficiency
|
Cervical spondylosis
| 1b
|
multi
| null |
Medicine
| null |
ed690132-6284-4456-b21c-a5c2657a1cee
|
False about Keshan's disease
|
Due to excess of selenium
|
Endemic cardiomyopathy in China
|
Due to increased diet of maize
|
Most common in children and women of child bearing age
| 0a
|
multi
|
KESHAN'S DISEASE :- Due to DEFICIENCY of selenium Endemic cardiomyopathy in China Due to increased diet of maize Most common in children and women of child bearing age
|
Forensic Medicine
|
Toxicology - 1
|
5dca7e7b-24ae-4256-b18d-7e23fe677ce2
|
Minocycline is not used in the 3 mix antibiotic paste because of only one adverse effect
|
Discolouration of crown
|
Roots become brittle
|
It reaches out readily
|
It has least antimicrobial effect
| 0a
|
single
| null |
Dental
| null |
2bd36249-e417-460d-b9e9-d52dbfed459e
|
AV node is situated in
|
Opening of SVC
|
Interventricular septum
|
Koch's triangle
|
Interatrial septum
| 2c
|
single
|
Koch's triangle is an anatomical area located within right atrium, defined by Ostium of coronary sinus, posteriorly The anterior-septal leaflet commissure Tendon of Todaro ( a tendinous structure connecting the valve of the inferior venacava ostium to the central fibrous body posteriorly) Used as anatomical landmark for location of AV node during electrophysiology procedures such as pacing or ablation. Ref - researchgate.net
|
Anatomy
|
Thorax
|
b4aac6fa-96dc-449c-a779-154b655703b1
|
'Row of tombstones' appearance is seen in:
|
Irritant dermatitis
|
Pemphigus
|
Pemphigoid
|
Herpes zoster
| 1b
|
single
|
Ans. (b) Pemphigus(Ref: Robbins 9th/pg 1167)DiseaseBiopsy featuresDIFPemphigus vulgaris* Suprabasal acantholytic vesicle (tombstone pattern) Q* Mixed perivascular infiltrate with eosinophils QIgG within suprabasal intercellular spaces-fishnet pattern Q
|
Pathology
|
Skin
|
5bacdfff-a9e5-42be-8152-3b2aa8a4db74
|
In PCR:
|
Thermostable enzyme is needed
|
211 copies formed after 'n' numbers of multiple
|
Non specific
|
Thermolabile enzyme
| 0a
|
single
|
A i.e. Thermostable enzyme is needed
|
Medicine
| null |
5f6e36bd-7b87-4ad6-9baa-31feb2877b85
|
A 21 year old college student presents with hot potato voice and trismus. Throat examination was done. Clinical Diagnosis is?
|
Quinsy
|
Epiglottitis
|
Infectious mononucleosis
|
Chronic Tonsillitis
| 0a
|
single
|
Ans. (a) QuinsyThe image shows a deviated uvula indicating a Peri-tonsillar abscess and clinical history of hot potato voice confirms the diagnosis of quinsy
|
ENT
|
Head & Neck Infections
|
6d306e2e-b133-484f-b095-2d812af5c102
|
Retropulsion is the event seen in:
|
Stomach
|
Duodenum
|
Jejunum
|
Ileum
| 0a
|
single
|
Retropulsion is the event seen at the pylorus. As the pyloric wall contracts, some amount of food (chyme) moves into the duodenum whereas the remaining food rebounds from the pyloric sphincter. This is retropulsion. It will again move forward. This back and foh movement allows a thorough mixing of foodstuffs with the gastric juice, helping formation of chyme.
|
Physiology
|
Gastrointestinal System
|
20b2aee9-b8e3-4acb-a0fd-5716c016273d
|
All of the following statements about congenital rubella are true, EXCEPT:
|
IgG persists for more than 6 months
|
IgM antibody is present at bih
|
Most common anomalies are hearing and hea defects
|
Increased risk of congenital malformation if infection occur after 16 weeks
| 3d
|
multi
|
Rubella is ateratogenic virus, can be transmitted from fetus to mother. The risk of congenital manifestations is maximum when a women is infected during the first trimester. After 12 weeks' gestation, the risk of congenital malformation decreases markedly. Features of congenital rubella syndrome include microcephaly and encephalitis, cardiac defects (patent ductus aeriosus, pulmonary aerial stenosis, aerial hypoplasia) cataracts, retinopathy, and microphthalmia, growth restriction, hepatosplenomegaly, thrombocytopenia, and purpura and deafness. Presence of IgM antibody in the serum of infant indicates recent infection as IgM does not cross the placenta from the mother as IgG. In an infant with congenital infection, serum IgM antibodies may be present for up to 1 year after bih. A rubella serum IgG titer persisting beyond the time expected after passive transfer of maternal IgG antibodyis another serologic criterion used to confirm CRS.
|
Pediatrics
| null |
3eb94c24-f91a-4a0a-a389-81714f046f9c
|
A 25 year old primigravide with mitral stenosis and mitral regurgitation is under labor. She wants normal delivery which would be the best way to provide analgesia in this lady
|
Inhalational analgesia
|
Intravenous opioids
|
Spinal anesthesia
|
Neuraxialblockde analgesia
| 3d
|
single
|
D i.e. Neuraxialblockde analgesia Epidural (neuraxial) analgesia is the most effective and least depressant method of intrapaum pain relief and is often viewed as technique choice for relief of labor painQ. It blunts the hemodynamic effects of contractions and associated pain response, which is desirable for patients with hypeensive disorders, asthma, diabetes, and cardiac and intracardiac neurovascular diseaseQ
|
Anaesthesia
| null |
743b74e8-6d72-42b2-8c5f-053c4da6621c
|
Uncoupler of oxidative phosphorylation is
|
2, 4-DNP
|
BAL
|
TTFA
|
Rotenone
| 0a
|
multi
|
Mechanism of Action of DNP as uncoupler Dinitrophenol (DNP) a potent uncoupler is amphipathic and increase the permeability of the lipoid inner mitochondrial membrane to protons (H+), thus reducing the electrochemical potential and sho-circuiting the ATP synthase. In this way, oxidation can proceed without phosphorylation. Note: DNP was used for weight loss. But it was discontinued due to hypehermia and other side effects Inhibitors of ETC Site-I (Complex-I) * Rotenone: A fish poison and also insecticide. Inhibits transfer of electrons through complex-I-NADH-Q-reductase. * Amobarbital (Amytal) and Secobarbital: Inhibits electron transfer through NADH-Q reductase. * Piericidin A: An antibiotic. Blocks electron transfer by competing with CoQ. * Drugs: Chlorpromazine and hypotensive drug like guanethidine. Site-II (Complex III) * Antimycin A * BAL (dimercaprol) * Hypoglycaemic drugs: like Phenformin Site-III (Complex IV) * Cyanide Blocks electron transfer from cyt b to c1 Inhibits terminal * H2S * Azide transfer of electrons to molecular O2 * Co (Carbon monoxide): Inhibits Cyt. oxidase by combining with O2 binding site. It can be reversed by illumination with light. Complex II: Succinate dehydrogenase FAD * Carboxin * TTFA Specifically inhibit transfer of reducing equivalent from succinate dehydrogenase * Malonate: A competitive inhibitor of succinate dehydrogenase.Ref: MN Chatterjea Textbook of Medical Biochemistry, 8th edition, page no: 143 & 146
|
Biochemistry
|
Respiratory chain
|
423e37d8-3918-4584-92e3-ee33804408e2
|
A child on b2 agonists for treatment of bronchial asthma may exhibit all of the following features except:
|
Tremors
|
Hypoglycemia
|
Hypokalemia
|
Bronchodilation
| 1b
|
multi
|
Ans. (B) Hypoglycemia(Ref: KDT 8th/e p149)b2 agonists are the inhaled bronchodilators used for the management of bronchial asthma.Tremor is the dose related adverse effect of these drugs.Brief hyperkalemia followed by hypokalemia is an important adverse effect of these agents.b2 agonists do not cause hypoglycemia.
|
Pharmacology
|
Adrenergic System
|
3b17dcd9-ebf9-4bb4-9859-f46e2ec016ac
|
Which of the following factor regulates CSF pressure?
|
Rate of CSF formation
|
Rate of CSF absorption
|
Cerebral blood flow
|
Blood pressure
| 1b
|
single
|
Rate of CSF formation normally remains constant and is independent of CSF pressure. CSF absorption by arachnoid villi is propoionate to CSF pressure. Ref: Barrett K.E., Barman S.M., Boitano S., Brooks H.L. (2012). Chapter 33. Circulation through Special Regions. In K.E. Barrett, S.M. Barman, S. Boitano, H.L. Brooks (Eds), Ganong's Review of Medical Physiology, 24e.
|
Physiology
| null |
5bb5c41c-b38c-445d-ad1a-c6b5b57de448
|
In which of the following cancer screening is least useful?
|
Breast
|
Cervix
|
Colo rectal cancer
|
Lung
| 3d
|
single
|
Screening for Ca Lungs require chest X rays every 6 months and sputum cytology. It is not recommended or practical. According to the U.S. Preventive Services Task Force (USPSTF), there is insufficient evidence to recommend for or against screening for lung cancer and prostate cancer in men under 75. There is insufficient evidence to recommend for or against screening for skin cancer and oral cancer. Routine screening is not recommended for bladder cancer, testicular cancer, ovarian cancer and pancreatic cancer.
|
Social & Preventive Medicine
| null |
54383845-a4fa-42e8-a0be-8507f5067469
|
How long should a palatal crib should be worn by a patient being extracted for thumb sucking habit
|
One week
|
One month
|
Three months
|
Six months or longer
| 3d
|
single
| null |
Dental
| null |
57b4dce1-869c-4b08-bd0a-d5f0b451ffa8
|
Drug of choice for myoclonic epilepsy in pregnancy is :
|
Carbamazepine
|
Sodium valproate
|
Phenobarbitone
|
Phenytoin
| 1b
|
single
| null |
Pharmacology
| null |
e47f5679-1d9c-44cc-ba87-0321d6c1eb28
|
All are feature(s) of sarcoidosis except:
|
High CD4: CD8 ratio
|
Hypercalciuria and hypercalcimia maybe present
|
f Serum levels of angiotensin-conveing enzyme (ACE)
|
Schauman and asteroid bodies are pathognomic
| 3d
|
multi
|
Answer- D. Schauman and asteroid bodies are pathognomicHypercalcemia and/or Hypercalciuria occurs in about 10% of sarcoidosis patients.Bronchoalveolar lavage fluid ln sarcoidosis is usually characterized by an increase in lymphocyte and a high CD4/ CD8 ratio."Schauman and asteroid bodies- although characteristic, these cells are not pathognomic of sarcoidosis because they may be encountered in other granulomatous diseases.The granuloma is the pathologic hallmark of sarcoidosis."Serum levels of anglotensin-conveing enzyme (ACE) can be helpful in the diagnosls of sarcoidosis.
|
Medicine
| null |
4cab36cd-e0ab-4325-81e8-a92db52c6433
|
Of all the following, incineration is done for -
|
Mercury
|
Radiological waste
|
Halogen containing plastics
|
Human anatomical waste
| 3d
|
multi
|
- wastes types not to be incinerated are; pressurized gas container or radiographic wastes. plastics sealed ampules wastes with mercury or cadmium content. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no:791 <\p>
|
Social & Preventive Medicine
|
Hospital waste and disaster management, Occupational health
|
79f64650-e068-47ea-bae7-1ea901eb2e46
|
Cobra head appearance is seen in:
|
Ureterocele
|
Wilm's Tumor
|
Horse shoe kidney
|
Vesicoureteral reflux
| 0a
|
single
|
Ans: A (Ureterocele) Ref: Harrison is online. 18th edExplanation:Some Important Features in ContrastRadiographsSpider leg appearance -- Polycystic kidneyCobra head appearance -- UreteroceleFlower vase appearance of ureters -- Horse shoe kidneySandy patches -- Schistosomiasis of bladderSoap bubble appearance -- HydronephrosisApple core lesion on barium -- Ca colonClaw appearance on barium enema -- IntussusceptionSaw tooth appearance -- Diverticula of colonBirds beak appearance of esophagus on barium meal -- AchalasiaCork screw appearance of esophagus on barium meal -- Diffuse esophageal spasmString sign of kantor -- Crohn's disseaseThumb printing sign -- Ischemic colitisEGG SHELL CALCIFICATION------ Silicosis, Sarcoidosis. Scleroderma, Histoplasmosis, Amyloidosis, lymphoma following radiotherapy
|
Radiology
|
CT and MRI of the Kidney
|
78d81ffb-afc6-43cd-8667-0b4dbce5fa7c
|
The concentration of hydrocioinone for treating cholasma should be-
|
1%
|
lto 2 %
|
2 to 5 %
|
10%
| 2c
|
multi
|
C i.e. 2-5% - Light brown butterfly rash without systemic involvement in pregnancy and on OCPQ is seen in chloasma. Whereas erythematous (red) phostosensitive butterfly rash with multisystem (multi organ) involvement like ahritis, nephritis, Raynaud's phenomenon etcQ is seen in SLE. - Hydroquinone, the most effective topical bleaching agent is used in 2-4% concentration in chloasma. Chloasma/Melasma/Mask of SLE pregnancy - Dusky red (erythematous) - Light brown macules (rash or photosensitive pigmentationQ. pigmentation)Q - Associated with multi-organ - Associated with pregnancy (most involvement like common), OCPQ, menstrual ahritis/ahralgia, nephritis, disturbance in unmarried girls & raynaud's phenomenon etcQ. persistent anemia - More common in females - More common in females on bridge involving bridge of nose & of nose & cheeks (malar eminence). cheeks i.e. malar eminence Linear area just above eyebrows is (malar butterfly rash) usually involved and area between nose & upper lip and skin around eyes as a rule spared. Photodermatitis - In farmers, sailors, labourer (in professions, which keep them in sun for prolonged periods) - Scally read lesionsQ in sun exposed areas Rosacea Recurrent episodes of bright red erythema and hot flushes on face, mostly in females nearing their menopause, triggered by emotional tension, hot spicy food & beverages. Later on erythema becomes persistant and telengectasia appears on nose, cheeks and chin.
|
Skin
| null |
fe50f378-6a8d-4b6a-8ad2-e11792760d77
|
A 27 year old man with epilepsy presents with complaints of persistent lethargy and occasional feelings of intoxication, although he does not consume alcohol. The patient is currently taking phenobarbital for the long-term management of tonic-clonic seizures. In addition, he was recently staed on a medication for the treatment of gastroesophageal reflux disease. Which of the following agents was he most likely prescribed?
|
Cimetidine
|
Famotidine
|
Lansoprazole
|
Ranitidine
| 0a
|
single
|
Cimetidine is an H2-receptor antagonist indicated for the sho-term and maintenance treatment of duodenal and gastric ulceration, as well as gastroesophageal reflux disease. One of the primary disadvantages of using this agent, with respect to other H2-receptor antagonists famotidine and ranitidine, is that it is a relatively potent hepatic enzyme inhibitor. Therefore, this medication is likely to decrease the metabolism of other hepatically metabolized medications, such as phenobarbital. When the metabolism of a medication is decreased, the blood levels will increase, leading to an extension of the therapeutic effect and/or toxicity. Phenobarbital is a barbiturate indicated for the treatment of tonic-clonic seizures and status epilepticus. When the blood concentration of this medication increases, lethargy and feelings of intoxication may occur. Lansoprazole is a gastric acid proton-pump inhibitor indicated for the sho-term and maintenance treatment of duodenal and gastric ulceration, as well as gastroesophageal reflux disease. This agent does not affect hepatic enzymes. Ref: McQuaid K.R. (2012). Chapter 62. Drugs Used in the Treatment of Gastrointestinal Diseases. In B.G. Katzung, S.B. Masters, A.J. Trevor (Eds),Basic & Clinical Pharmacology, 12e.
|
Pharmacology
| null |
ef778d2c-c68e-439a-8b2e-eb2ccf844d2b
|
H202 is breaked or formed by which of the following enzyme:
|
Oxidase
|
Oxygenase
|
Hydrolase
|
All
| 0a
|
multi
|
A i.e. OxidaseOxidase & superoxide dismutase generate H202, where as catalase and peroxidase are associated with breakdown of 11202Q.
|
Biochemistry
| null |
c2060916-5c91-4ba4-bc55-b32d7bb71520
|
All of the following cells are present in cerebellar cortex EXCEPT:
|
Granular cell
|
Purkinje cell
|
Golgi cell
|
Bipolar cell
| 3d
|
multi
|
Ans. (d) Bipolar cell* Cerebellar cortex contain 5 types of neuron cells. They are:1. Golgi cells2. Purkinje cells3. Basket cells4. Granule cells5. Stellate cells
|
Physiology
|
Cerebellum and Brainstem
|
e23c2bca-2462-488b-8c6f-5ccec6992864
|
Traveller's diarrhoea is caused by -
|
Enteropathogenic E. coli
|
Enterohaemorrhagic E. coli
|
Enterotoxigenic E. coli
|
Enteroinvasive E. coli
| 2c
|
single
| null |
Microbiology
| null |
bbaa3319-4153-4835-b064-6460b5ab0aea
|
A biopsy from a mass in front of the neck revealed parafollicular cells. How do you follow up?
|
Calcitonin
|
T4
|
Thyroxine
|
Thyroglobulin
| 0a
|
single
|
Biopsy from the mass in front of the neck revealed parafollicular cells indicating that it's a case of Medullary carcinoma of the thyroid. Medullary carcinoma of the thyroid (MTC): It is a distinct thyroid carcinoma that originates in the parafollicular C cells of the thyroid gland. These C cells produce calcitonin. Hence it is used for follow up of these patients
|
Surgery
|
JIPMER 2017
|
233302a3-bdc3-41b8-b1f5-0d076b8b85c7
|
The deficit in weight for height in a 3-year-old child indicates –
|
Acute malnutrition
|
Chronic malnutrition
|
Concomittant acute and chronic
|
Under weight
| 0a
|
single
|
SURVEILLANCE OF GROWTH AND DEVELOPMENT
Surveillance of growth and development is an important component of the routine anticipatory care of children.
The main purpose of growth surveillance is to identify those children who are not growing normally. Surveillance for physical growth can be done in the following ways.
1) Weight for age
Measurement of weight and rate of gain in weight are the best single parameters for assessing physical growth. The weight should be carefully repeated at intervals:
Birth -1 year → Monthly
The second-year → Every two months
2-5 years → Every 3 months
These measurements when compared with the reference standards of the weight of children of the same age, the trend of growth becomes obvious.
Weight for age can be used to classify malnutrition and determine its prevalence.
80 % of the median weight for age of the reference is cut off point below which children should be considered malnourished.
2) Weight for age
Height is a stable measurement of growth as opposed to body weight.
Whereas weight reflects only the present health status of the child, height indicates the events in the past also.
Low height for age :
This is also known as nutritional stunting or dwarfing.
It reflects past or chronic malnutrition.
The cutoff point commonly taken for the diagnosis of stunting is 90 percent of the united states NCHS height for age.
3) Weight for height
Weight in relation to height is now considered more important than weight alone.
It helps to determine whether a child is within range of normal weight for his height.
Low weight for height
This is also known as nutritional wasting or emaciation (Acute malnutrition).
It is associated with an increased risk of mortality and morbidity.
A child who is less than 70% of the expected weight for height is classed as severely wasted.
4) Head and chest circumference
Chest circumference
At birth → Less than 2 cm from head circumference
6-9 months →Two measurements become equal
> 6-9 months → Overtakes head circumference
In severely malnourished children this overtaking may be delayed by 3 to 4 years.
|
Pediatrics
| null |
dcb5e3a4-6967-40b3-8a46-3a91e243f1e5
|
Thomsen Friedenreich phenomenon is -
|
Red cells infection by CMV
|
Red cell agglutination by all blood group sera
|
Hemolysis of transfused blood
|
Due to B antigen
| 1b
|
multi
| null |
Microbiology
| null |
698368b6-a0ac-4336-a139-c1829b689b2a
|
All of the following statements about WPW syndrome are true, Except:
|
More common in females
|
Rt ventricular aberrant is commonly seen
|
Incidence | with age
|
Hea is structurally normal
| 0a
|
multi
|
Answer is A (More common in females) WPW syndrome is more common in males and the incidence varies from 0.1 to 3/1000 in apparently healthy subjects (Le 0.01 to 0.3 percent) WPW syndrome : Accessory AV Pathways WPW syndrome or `Prexcitation syndrome' is charachterized by the presence of tachyarrvthmiasQ due to an accessory conducting pathwaye between atrium and ventricle WPW abnormality occurs when an impulse reaches the atria or ventricles earlier than would be expected if the impulse traveled by way of normal specialized conducting tissue (Pre excitation)Q - When atrial impulse activates the entire or some pa of ventricle - When ventricular impulse activates the entire or some pa of the atrium Epidemiology Incidence varies from 0.1 to 3.0/1000 in apparently healthy subjects (Average = 1.5/1000) It may be found in all ages (Neonates to Elderly) Prevalence decreases with age apparently because of loss of preexcitation It is more common in Males Most adults with WPW syndrome have normal hea (However various acquired and congenital defects may be associated specially Ebstein's anomaly, MVP and cardiomyopathics) Electrocardiographic features Three basic features typify the ECG abnormalities with usual form of WPW syndrome Sho PR interval (PR interval <120 ms during sinus rhythm)e Wide QRS complex (>120 ms) with a slurred slowly rising upstroke (delta wave) Q The terminal poion of QRS complex is usually normal as conduction through bundle of His usually catches up with preexcitation Secondary ST-T changese that are generally directed to an opposite direction to the major Delta/ QRS vectors Note : Fusion beats: e If the accessory pathway is capable of anteprade conduction, the typical QRS complex represents a `Fusion beat' as a result of depolarization of the ventricle in pa by the wave travelling from the accessory pathway and in pa by wave travelling from normal AV nodal pathway Normal p waveQ - Since the atrial activation is normal, the P wave is usually normal
|
Medicine
| null |
866c2893-9e80-4dbe-9c6b-f074a2e83fb2
|
Dryopithecus pattern is the characteristic feature of:
|
Permanent mandibular 1st molar.
|
Permanent mandibular 3rd molar.
|
Permanent maxillary 2nd molar.
|
Permanent maxillary canine.
| 0a
|
single
|
In a mandibular first molar mesiolingual cusp joins the distobuccal cusp along the floor of the central fossa, this is known as dryopethicus pattern.
|
Dental
| null |
7cf76e31-6e6c-411c-8e99-1995e7a22d25
|
Shortest diameter of pelvic outlet:
|
Antero-posterior
|
Inter tuberous
|
Oblique
|
Inter-spinous
| 1b
|
single
|
Ans- B Inter tuberousRef.: D.C. Dutta 8th ed. / 94-97; William's 23rd ed. Chapter 2, Maternal Pelvic Anatomy* Most of the students answer interspinous for this question. Obviously interspinous is having the least diameter (10cm)y but it belongs to mid pelvis.* The question is asking about the shortest diameter of pelvic outlet, which is inter-tuberous (diameter between ischial tuberosity) diameter ~ 11cm.PLANES AND DIAMETERS OF THE PELVISThe pelvis is described as having four imaginary planes:* The plane of the pelvic inlet--the superior strait* The plane of the mid pelvis--the least pelvic dimensions* The plane of the pelvic outlet--the inferior strait* The plane of greatest pelvic dimension--of no obstetrical significance.Summarized data of maternal Pelvis planes and diameters (all the numerical data are derived from standard reference i.e. William's 23rd ed.)PlaneDiameterMeasured BetweenSizeTransverseGreatest distance between the linea terminalis on either side~ 13 cmA-P diameter aka true conjugateExtends from the uppermost margin of the symphysis pubis to the sacral promontory11cmOblique diameterExtends from one of the sacroiliac synchondroses to the iliopectineal eminence on the opposite side.12 cmInterspinous diameterBetween the ischial spines10cmAnteroposteriorAt the level of ischial spine11.5cmAntero-posteriorCoccyx to symphysis pubis11.5 cmTransverseBetween ischial tuberosities11 cmPosterior sagittalSacro-Coccygeal angle to the midline imaginary line at base11.5/2 cmObstetrical conjugateShortest distance between the sacral promontory and the symphysis pubis10 cm. the obstetrical conjugate is estimated indirectly by subtracting 1.5 to 2 cm from the diagonal conjugateDiagonal conjugatefrom the lower margin of the symphysis to the sacral promontory11.5-12 cm
|
Unknown
| null |
d518d93d-6d27-499d-bdd9-68814eeef581
|
Not a metabolic product of urea cycle-
|
Citrulline
|
Ornithine
|
Alanine
|
Arginine
| 2c
|
single
|
Biosynthesis of urea occurs in five steps.
1) Carbamoyl phosphate synthase-I (CPS-I), a mitochondrial enzyme, catalyzes the formation of carbamoyl phosphate by condensation of CO2 and ammonia.
Two molecules of ATP are required for the reaction. CPS-I is the rate-limiting enzyme of the urea cycle. It is an allosteric enzyme and allosterically activated by N-acetyl glutamate.
2) Ornithine transcarbamylase catalyzes the formation of citrulline from carbamoyl phosphate and ornithine.
3) Argininosuccinate synthase catalyzes the formation of argininosuccinate from citrulline and aspartate.
This reaction requires 1ATP, but 2 high energy phosphate bonds are consumed as ATP is converted to AMP + PPi.
The amino group of aspartate provides one of the two nitrogen atoms that appear in urea (The other one is provided by ammonia NH4).
4) Argininosuccinate lyase (argininosuccinase) catalyzes the cleavage of argininosuccinate into arginine and fumarate.
Fumarate enters in TCA cycle.
5) Arginase catalyzes the formation of urea from arginine by hydrolytic cleavage of arginine to yield urea and ornithine.
Ornithine is thus regenerated and can enter mitochondria to initiate another round of the urea cycle.
|
Biochemistry
| null |
afb7b584-42ad-4891-8461-c3658c91edb3
|
In spinal anaesthesia the drug is deposited between-
|
Dura and arachnoid
|
Pia and arachnoid
|
Dura and vertebra
|
Into the cord substance
| 1b
|
single
|
Ans. is 'b' i.e., Pia and arachnoid matter Spinal anaesthesiao In spinal anaesthesia LA is injected into subarachnoid space (space between pia matter and arachnoid matter),o Structure pierced during SA (from outside in) - Skin - Subcutaneous tissue - Supraspinous & intraspinous ligament - Ligamentum falvum - Duramater - Arachnoidmater.o Site of spinal anaesthesiaL2.3 or L3-4 intervertebral space in adult (In adult spinal cord ends at lower border of L1 vertebrae).L4.5 intervertebral space in children (spinal cord ends at lower border of L3 vertebrae in children).o Spinal anaesthesia leads to creation of a zone of differential blockade, ie motor fibres are blocked two levels tower and autonomic fibres are blocked two levels higher than the sensory blockade due to different sensitivity of different fibres.
|
Anaesthesia
|
Fundamental Concepts
|
36fca4ec-e72f-4b12-bc05-73fdafdccf71
|
All are the pharmacologic therapeutic options for achalasia, EXCEPT:
|
Nitrates
|
Beta blockers
|
Botulinum toxin
|
Sildenafil
| 1b
|
multi
|
Pharmacologicals therapies are usually ineffective. They can be used as a temporary measures. The agents used are: 1. Nitrates 2. Calcium channel blockers 3. Botulinum toxin 4. Sildenafil- phosphodiesterase inhibitors, effectively decrease LES pressure. Botulinum toxin, injected into the LES under endoscopic guidance, inhibits acetylcholine release from nerve endings and improves dysphagia in about 66% of cases for at least 6 months Ref: Harrison, Edition-18, Page-2432
|
Medicine
| null |
315ab04d-95e5-4f94-83fd-48266b7ed082
|
All the following statement about clozapine are true except -
|
It is used in schizophrenia
|
May precipitate seizure
|
May cause agranulocytosis
|
Extrapyramidal side effects are seen
| 3d
|
multi
|
Clozapine
It blocks D4, 5-HT, and α-adrenergic receptors.
Despite of anticholinergic property, it causes hypersalivation.
It also blocks H1-histaminic receptors.
The important side effects are agranulocytosis & myocarditis.
It can induce seizures even in nonepileptics.
It causes weight gain and precipitation of diabetes.
It does not produce extrapyramidal side effects.
|
Psychiatry
| null |
b298e72b-57ea-4375-8a69-612b50bc8d3a
|
Pegvisomant is approved for the treatment of?
|
Parkinsonism
|
Hyperprolactinemia
|
Amenorrhoea
|
Acromegaly
| 3d
|
single
|
Pegvisomant is a mutant growth hormone. It is used for the treatment of acromegaly caused by small pituitary adenoma. Ref: Sharma and Sharma 2nd e/pg 547
|
Pharmacology
|
Central Nervous system
|
cebedd08-5ffd-47b6-ba96-fc80f73fe93d
|
Posterior relation of neck of pancreas ?
|
IVC
|
Origin of postal vein
|
Aoa
|
Common bile duct
| 1b
|
single
|
Ans. is 'b' i.e., Origin of poal vein
|
Anatomy
| null |
4407e573-5d23-43c5-9dbe-b036e129313d
|
Most virulent variety of shigellosis is caused by:
|
S. dysentriae
|
S. sonnei
|
S. flexneri
|
S. boydii
| 0a
|
single
|
Ans. is 'a' i.e., Shigella dysenteriae(Ref: Ananthanarayan, 8th/e, p. 286 and 9th/e, p. 2851)Complications are most often seen in infection with Sh. dysenteriae type I and include arthritis, toxic neuritis, conjunctivitis, parotitis and in children, intussusception. HUS may occur in severe cases.
|
Microbiology
|
Bacteria
|
78dae398-d167-44b7-b0cc-acf62218b6c9
|
IFN-a and IFN-b are produced by the virus-infected cell due to the interaction of virus nucleic acid with which of the following?
|
C3 (third component of complement)
|
Defensins
|
TLR pathway
|
IL-12
| 2c
|
single
|
Following virus entry into a cell, the virus initiates replication and the viral nucleic acid interacts with specific microbial sensors (TLR3, TLR7, TLR 9, RIG-1, and MDA-5). This interaction triggers cellular production of IFN that is secreted from the infected cell.Jawetz 27e pg: 130
|
Microbiology
|
Immunology
|
9e20c9be-9b47-486a-954e-ce450d464ccb
|
True regarding 'Damage control surgery is:
|
Done during damage control surgery
|
Done during triage
|
Minimal intervention to stabilize patient so that definitive surgery can be done later on
|
Maximum possible surgical intervention considering the event
| 2c
|
multi
|
Ref: Charles M. Court-Brown et al. Trauma. Lippincott, 2006, Page 16. Washington Manual of Surgery 2012. 6th edition, Page 514Explanation:DAMAGE CONTROL SURGERY (DCS)It is a form of surgery utilized in severe unstable injuries typically by trauma surgeons.This form of surgery puts more emphasis on preventing the trauma triad (Hypothermia, Coagulopathy and Acidosis) of death, rather than correcting the anatomy.DCS is about minimal intervention done to stabilize the patient and the definitive surgery later.DCS includes abbreviated laparotomy, temporary packing and closure of the abdomen in an effort to blunt the physiologic response to prolonged shock and massive hemorrhage.DC'S centers on coordinating staged operative interventions with periods of aggressive resuscitation to salvage trauma patients sustaining major injuries.These patients are often at limits of their physiological reserve when they present to operating room and persistent operative efforts results in exacerbation of their underlying hypothermia, coagulopathy and acidosis, initiating a vicious cycle that culminates in death.PHASES OF DAMAGE CONTROL SURGERYPhase 1 - Initial ExplorationTo attain rapid control of active hemorrhage and contamination.The abdomen is entered via a midline incision and if exsanguinating hemorrhage is encountered four quadrant packing should be performed.Any violations of GI tract should be treated w ith suture closure or segmental stapled resection.External drains are placed to control any major pancreatic or biliary injuries.Phase 2 - Secondary ResuscitationFollowing completion of the initial exploration, the critically ill patient is transferred to the ICU.Invasive monitoring and complete ventilator support needed.This phase focuses on secondary resuscitation to correct hypothermia, coagulopathy and acidosis.Phase 3 - Definitive OperationIt consists of planned re-exploration and definitive repair of injuries.Occurs 48 - 72 hours following initial and after successful secondary resuscitation.The abdomen should be closed primarily if possible.Risky GI anastomoses or complex reconstruction should be avoided.INDICATIONS FOR DAMAGE CONTROL SURGERYPolytrauma and thoracic trauma.Polytrauma with severe abdominal/pelvic trauma and hemodynamic shock (BP < 90 mm Hg).Bilateral lung contusions.Initial mean pulmonary artery pressure > 24 mmHg.Pulmonary artery pressure increase > 6 mm Hg during long bone intramedullary nailing.
|
Surgery
|
Initial Assessment
|
414a36e6-2dc9-4dea-9b13-413e3b504a26
|
Growth Hormone may be beneficial in the following, except:
|
In children with constitutional growth delay.
|
In treatment of osteoporosis.
|
Laron type dwarfism.
|
Panhypopituitarism.
| 2c
|
multi
|
Growth hormone is effective in accelerating the growth rate in children with constitutional growth delay. It increases the calcium absorption in the gastrointestinal tract and has a positive effect on osteogenesis; it may be of use in treatment of osteoporosis and non-healing fractures. In panhypopituitarism, there is deficiency of all the anterior pituitary hormones. Before starting growth hormone, replacement with other hormones (thyroid hormone, glucocorticoids) must be done. Laron type dwarfism is due to mutation of the growth hormone receptor gene, which prevents binding of the growth hormone to its receptor and exerting its effect. Administration of growth hormone proves ineffective It is treated with insulin like growth factor-1.
|
Pharmacology
| null |
ad44cd21-17c3-4a44-88ab-dfeba035a4ee
|
A patient presents with cheek ca of 2.5 cm size close to and involving the alveolus with a single mobile cervical lymph node of 6 cm size. What is the TNM staging -
|
T3N2
|
T3N3
|
T4N2
|
T4N3
| 3d
|
single
|
Ans. is 'd' i.e., T4N3 [Ref: Schwartz 9th/e p491; Here's the TNM staging for Oral cavity carcinoma (according to TNM ?h edition) Primary tumor staging of oral cavity carcinoma T0 No evidence of primary tumor T1 Tumor is <2 cm in greatest dimension T2 Tumor is > 2 cm and < 4 cm in greatest dimension T3 Tumor > 4 cm in greatest dimension T4a (lip) Primary tumor invading cortical bone, inferior alveolar nerve, floor of mouth, or skin of face (e.g., nose or chin) T4a (oral cavity) Tumor invades adjacent structures (e.g., cortical bone, into deep tongue musculature, maxillary sinus) or skin of face T4b (lip & oral) Tumor invades masticator space, pterygoid plates, or skull base and/or encases the interna carotid artery Regional lymphadenopathv NX Unable to assess regional lymph nodes N0 No evidence of regional metastasis N1 Metastasis in a single ipsilateral lymph node, 3 cm or less in greatest dimension N2a Metastasis in single ipsilaeral lymph node, > 3 cm and < 6 cm N2b Metastasis in midtiple N2c Metastasis in bilateral or contralateral lymph nodes, all nodes < 6 cm N3 Metastasis in a lymph node > 6 cm in greatest dimension Note: midline nodes are considered ipsilateral nodes.
|
Surgery
|
Oral Cavity
|
dc7a3d21-7dc7-49e4-a8a9-970f93d2e89c
|
Sumatriptan is used in -
|
Glaucoma
|
Migraine
|
Hypeension
|
Opioid withdraw
| 1b
|
single
|
Ans. is 'b' i.e., Migraine o Administered at the onset of an attack sumatriptan is as effective and better tolerated than ergotamine. o It tends to suppress nausea and vomiting of migraine, while ergotamine accentuates these symptoms. o Mechanism of action : 1. In migraine, there is throbbing headache due to dilatation of pain sensitive aeries outside the brain (extracerebral) Sumatriptan provides relief by 5-HT 1D/1B receptor mediated constriction of dilated cranial extracerebral vessels. 2. In migraine, there is perivascular neurogenic inflammation occurs due to realease of endogenous neurotransmitter -->sumitriptan inhibit neurotransmitter release.
|
Pharmacology
| null |
9bc471d0-4472-4d4b-8a29-3d1f7f37a7da
|
Ideally immunization against poliomyelitis should be staed at: September 2004
|
Bih
|
6 weeks
|
12 weeks
|
9 months
| 0a
|
multi
|
Ans. A i.e. Bih
|
Social & Preventive Medicine
| null |
98576ce6-8bdf-4cd2-b11a-75cd9e229c95
|
Renal threshold for glucose is:
|
80 mg%
|
100 mg%
|
180 mg/dl
|
200 mg%
| 2c
|
single
| null |
Biochemistry
| null |
0c34b767-5900-4f84-89d7-68e8b99396ea
|
Burns present as all the following EXCEPT
|
Sepsis
|
Shock
|
Acute kidney injury
|
Air embolism
| 3d
|
multi
|
Ans. (d) Air embolismRef : Schwartz 10th ed. 1233The following Complications in burns may occur* Infections being the most common* Pneumonia, cellulitis, urinary tract infections* Anemia secondary to full thickness burns of greater than 10% TBSA is common.* Electrical burns may lead to compartment syndrome or rhabdomyolysis* Deep vein thrombosisLong term morbidity with burns* The hypermetabolic state result in a decrease in bone density and a loss of muscle mass.* Keloids may form subsequent to a burn* Significant psychological trauma* Social isolation, extreme poverty and child abandonment.
|
Surgery
|
Pathophysiology of Burn and Inhalation Injury
|
bf9d48bb-6b54-4b26-afcf-8dbc4a48310b
|
All of the following disease may be acquired by ingestion except -
|
Taeniasis
|
Guinea worm
|
Toxoplasmosis
|
Leishmaniasis
| 3d
|
multi
| null |
Microbiology
| null |
9ea96050-fd7c-4e45-8dca-41f82d3d7b8e
|
Conventional cytogenetics are difficult in solid tumors especially in case of Ca Cx due to aEUR'
|
High mitotic rate
|
Bacterial contamination of the specimen
|
Good metaphase activity
|
Inadequate biopsy specimen
| 1b
|
multi
|
Bacterial contamination of the specimen Ideally, the answer should be "lack of good metaphase activity". However, if that option is not mentioned, bacterial contamination is the closest. Although we are not sure how bacterial contamination would hamper cytogenetics. But the other options are not correct. Cytogenetics is the study of chromosomal structure. - It can be done by conventional technique like karyotyping or molecular techniques like FISH, sky, multiplex fish, comparative genomic hybridization. "Conventional cytogenetics needs good metaphase activity" -If metaphase is distinct cytogenetics is easy About the option, High mitotic rate If mitotic rate is high, cytogenetics would definitely be easy. Technical difficulties that can affect cytogenetics - Overgrowth of neoplastic cells by reactive nonneoplastic cells - Unpredictable growth of neoplastic cells in tissue culture - Predominance of nonble tumour (necrotic sample) - Contamination of tumour by bacteria or fungi
|
Pathology
| null |
d6426c57-6b09-41a5-ba5c-3b16adacc4e0
|
The most common cause of ambiguous genitalia in a newborn is –
|
21 hydroxylase deficinece
|
11 β – hydroxylase deficiency
|
17 α – hydroxyalse deficiency
|
3 β – hydroxysteroid deficiency
| 0a
|
single
|
Congenital adrenal hyperplasia due to classic 21-Hydroxylase deficiency is the most common cause of ambiguous genitalia in the newborn. Virilization is apparent at birth in the female and within the first 2-3 years of life in the male.
|
Pediatrics
| null |
f5f479c1-e6be-4e52-bd86-9427216fb5e3
|
A 45 years male presents with hypeension. He has sudden abnormal flinging movements in right upper and lower limbs. Most likely site of haemorrahge is:
|
Substantia nigra
|
Caudate nuclei
|
Pons
|
Subthallmic nuclei
| 3d
|
multi
|
This patients abnormal movements is termed 'Hemiballismus'. Hemiballismus is a manifestation of sudden, violent movement of a proximal limb usually an arm. It develops due to a lesion in the subthalamic nucleus. Ref: The Brain and Behaviour: An Introduction to Behavioural Neuroanatomy By David L.Clark, Page 125 ; Harrison's Principle of Internal Medicine, 16th Edition, Page 139
|
Medicine
| null |
d456a161-f581-418e-8a4a-44f533a4ee81
|
Which of the following anaesthetic agent causes adrenal suppression –
|
Etomidate
|
Thiopentone
|
Ketamine
|
Propofol
| 0a
|
single
| null |
Anaesthesia
| null |
7ecb7fe0-520b-4ff1-a8b8-e744e3ac11c0
|
A 15-year-old female was referred to an oral surgeon for extraction of an impacted tooth 23, which is located in area apical to teeth 22 and 24, which was found on routine X-rays. How would the oral surgeon decide as to where the impacted tooth lay with respect to being either buccal or palatal to teeth 22 and 24?
|
Waters view
|
Use of panoramic radiograph
|
Application of the SLOB rule
|
Lateral head radiograph
| 2c
|
single
|
The application of this principle can be easily remembered by the acronym SLOB: same lingual, opposite buccal. Thus, if the object in question appears to move in the same direction with respect to the reference structures as does the X-ray tube, it is on the lingual aspect of the reference object; if it appears to move in the opposite direction as the X-ray tube, it is on the buccal aspect. If it does not move with respect to the reference object, it lies at the same depth (in the same vertical plane) as the reference object. The application of this method works equally well when the X-ray tube is moved vertically, instead of horizontally. In this case, the movement of the object’s image in the vertical plane (superior or inferior to the reference structure) is evaluated.
Reference: ORAL RADIOLOGY PRINCIPLES AND INTERPRETATION,8th EDITION, Stuart C. White, Michael J. Pharoah
|
Radiology
| null |
16d9bbdb-831f-4962-a9b2-4c4ba5e4638f
|
Arousal is most difficult in which stage of sleep -
|
Stage 1 NREM
|
Stage 2 NREM
|
Stage 3,4 NREM
|
REM
| 2c
|
single
|
Ans is 'c' i.e., Stage 3,4 NREM'In general, the ease of arousal from sleep parallels the ordering of the sleep stages, with NEM and stage 1 being the easiest for arousal and stage 4 the most difficult.
|
Physiology
| null |
d8001d87-2c27-4c8d-ba00-f655a44f9af4
|
You are called to a maternity ward to see a 23 year old primi patient who had delivered a 2.7 kg baby boy 2 days back.She had a normal vaginal delivery and placenta delivered spontaneously. Now she complains of bloody vaginal discharge with no other signs. 0/E you notice a sweetish odour bloody discharge on the vaginal walls and introitus.Sterile pelvic examination shoes a soft non tender uterus.Her P/R-78/min, B/P-110/76 mm of hg, temp-37°C,R/R-16/min. Her WBC count =10,000 with predominant granulocytes. What is the most appropriate step:
|
Currettage
|
Oral antibiotics
|
Reassurance
|
Order urinalysis
| 2c
|
multi
|
This patient is a purperal female who is complaining of bloody vaginal discharge with no other significant abnormal signs. On examination there is a sweetish odour bloody discharge on the vaginal walls and introitus.Her vitals are normal suggesting that this cannot be PPH (The most common cause of secondary PPH is retained bits of placenta for which curettage is done, but here it is not required).
Slight amount of bloody discharge called as lochia is absolutely normal for the first 15 days after delivery and doesnot require any treatment, so we will reassure the patient and do nothing.
Donot get confused with the finding of WBC count, 10,000 with predominant granulocytes as this is a normal finding in the puerperal period Note- leucocytes can rise to as high as 25000 during puerperium probably as a response to the stress of labor). Since lochia has no foul smell it means no infection and so no need for culture or antibiotics.
|
Gynaecology & Obstetrics
| null |
f9088846-889e-47c9-a1e7-54ec4903e524
|
A young female on antidepressants presents to the emergency with altered sensorium and hypotension, ECG reveals wide QRS complexes and right axis deviation. Next best step for the management of this patient:
|
Sodium bicarbonate
|
Hemodialysis
|
Fomepizole
|
Flumazenil
| 0a
|
multi
|
Ans. a. Sodium bicarbonate (Ref: Harrison 19/e p172)A young female on antidepressants presents to the emergency with altered sensorium and hypotension. ECG reveals wide QRS complexes and right axis deviation. The clinical features and ECG findings typically suggest a diagnosis of tricyclic antidepressant poisoning. Antidote for TCA poisoning is sodium bicarbonate administered IV100 mEq (1--2 mEq/kg), and repeated every few minutes until BP improves and QRS complexes begin to narrow. Hemodialysis should not be used since TCAs are highly protein-bound with large volume of distribution.Tricyclic Antidepressant OverdoseTCA overdose is caused by excessive use or overdose of a TCA drug.It is a commonly used antidepressant & in children prescribed for bed-wettingQPathophzysiology:Most of the toxic effects of TCAs are caused by four major pharmacological effects:Anticholinergic effectsQExcessive blockade of norepinephrine reuptake at the preganglionic synapseQDirect alpha adrenergic blockadeQBlock sodium membrane channels with slowing of membrane depolarization, thus having quinidine-like effects on the myocardiumSigns and Symptoms:Peripheral ANS, CNS & heart are the main systems that are affected following overdose.Initial or mild symptoms typically develop within 2 hours and include tachycardia, drowsiness, a dry mouth, nausea & vomiting, urinary retention, confusion, agitation & headacheQ.More severe complications include hypotension, cardiac rhythm disturbances, hallucinations & seizuresQ.CCG abnormalities are frequent: MC is sinus tachycardia & intraventricular conduction delay resulting in prolongation of the QRS complex & PR/QT intervalsQ.Seizures, cardiac dysrhythmias & apnea are the most important life-threatening complicationsQ.TreatmentInitial treatment: Gastric decontaminationQ of the patient.This is achieved by administering activated charcoal lavage, which adsorbs the drug in the GIT either orally or via a nasogastric tube. Activated charcoal is most useful if given within 1-2 hours of ingestionQ.Other decontamination methods, such as stomach pumps, ipecac- induced emesis, or whole bowel irrigation are not recommended in TCA poisoningQ.Supportive therapy is given if necessary, including respiratory assistance, maintenance of body temperature, etc.Administration of IV sodium bicarbonateQ as an antidote has been shown to be an effective treatment for resolving the metabolic acidosis and cardiovascular complications of TCA poisoning.If sodium bicarbonate therapy fails to improve cardiac symptoms, conventional antiarrhythmic drugs, such as phenytoin & magnesium can be used to reverse any cardiac abnormalities.Hypotension is initially treated with fluids along with bicarbonate to reverse metabolic acidosis (if present).If the patient remains hypotensive despite fluids, then further measures, such as the administration of epinephrine, norepinephrine, or dopamine can be used to increase blood pressure.Seizures often resolve without treatment but administration of a benzodiazepine or other anticonvulsive may be required for persistent muscular over activity.There is no role for physostigmine in the treatment of tricyclic toxicity as it may increase cardiac toxicity and cause seizuresQ.In cases of severe TCA overdoses that are refractory to conventional therapy, intravenous lipid emulsion therapy has been reported to improve signs & symptoms in moribund patients suffering from toxicities involving several types of lipophilic substances. Therefore, lipids may have a role in treating severe cases of refractory TCA overdose.Tricyclic antidepressants are highly protein-bound and have a large volume of distribution. Therefore, removal of these compounds from the blood with hemodialysis, hemoperfusion or other techniques is unlikely to be of any significant benefitQ.
|
Psychiatry
|
Pharmacotherapy Management of Children and Adolescents
|
80340d8a-c1cc-487e-b049-ef0abbd17515
|
Ehlers Danlos syndrome is?
|
Autosomal Dominant
|
Autosornal recessive
|
X-Linked Dominant
|
X-Linked recessive
| 0a
|
single
|
Ehler-Danlos syndrome is classified into 8 types and more than 5 types show autosomal dominant transmission.
|
Pathology
| null |
ac0a2d84-4ee2-490e-b511-259d01995bee
|
The band which disappears on muscular contraction is?
|
A
|
H
|
I
|
M or CM
| 1b
|
single
|
B i.e. H
|
Physiology
| null |
df11b5d8-ada9-4a3d-b1f2-edbc00ab6826
|
Characteristic of type II lepra reaction ?
|
Erythema & edema
|
ENL
|
Lymphadenopathy
|
All
| 3d
|
multi
|
. Ans. is 'a' i.e., Erythema & edema; 'b' i.e., ENL; 'c' i.e., Lymphadenopathy 1) Lepra 1 reaction Type 1 lepra reaction is a type IV hypersensitivity. There are classical signs of inflammation (Redness, pain & Tenderness) within previously involved macule, papules or plaque. Systemic features do not occur (in contrast to type 2 reaction). Neuritis is common and ulnar nerve is involved most commonly. 2) Lepra 2 reaction (Erythema nodosum leproticum : ENL) The presenting symptoms include :0 Crops of fresh painful erythematous papules or nodules are most common presenting feature. ii) Systemic features :- Fever, malaise, ahritis, neuritis, dactylitis, orchitis, uveitis (iridocyclitis), lymphadenitis, glomerulonephritis, periostitis, hepatitis.
|
Microbiology
| null |
403f9f93-7dfb-496c-ba59-e459cea88ec1
|
All are true regarding cryptococcal infection except -
|
Occurs in immune-deficient states
|
Capsular Ag in CSF is a rapid method of detection
|
Anticapsular Abs is protective
|
Urease test +ve
| 2c
|
multi
|
1. Capsular antigen detection from CSF or serum by latex agglutination test is a rapid and sensitive (95%). 2. Cryptococcus gives Urease test positive. 3. Anticapsular Abs is not protective 4. Predisposing factors: Patients with advanced HIV infection with CD4 T-cell counts < 200/ml is the most impoant risk factor for C.neoformans. However, C.gattii is not associated with HIV. It usually causes infection in immunocompetent individuals. Patients with hematologic malignancies. Transplant recipients Patients on immunosuppressive or steroid therapy.
|
Microbiology
|
Mycology
|
dc289ecb-337b-4b35-ae21-efb2ebb94f0a
|
All of the following are mediators of acute inflammation except:
|
Angiotensin
|
Prostaglandin E2
|
Kallikrein
|
C3a
| 0a
|
multi
|
Kallikreins like:- Bradykinin PGs Complement components are mediators of acute inflammation.
|
Pathology
|
Basic Concepts and Vascular changes of Acute Inflammation
|
3734fd2a-551c-4104-9b17-c00db6643b41
|
Maximum protein among pulses is found in-
|
Green gram
|
Red gram
|
Soyabean
|
Black gram
| 2c
|
single
|
Ans. is 'c' i.e., Soyabean Amongst Pulses o Highest calories-Soyabeano Highest protein-Soyabeano Highest fat-Soyabeano Highest iron-Soyabeano Highest thiamine-Soyabeano Highest riboflavin-Soyabeano Highest calcium-Horse gramo Highest Niacin-Peas dryo Highest vit C-Bengal gram
|
Social & Preventive Medicine
|
Nutrition and Health
|
7c896a1f-7024-43ff-a82a-e86700f71ac9
|
A 4-year-old male child presents with fever, anemia and azotemia after an episode of dysentery 9 days earlier. The commonest organism responsible for this condition is?
|
Meningococcus
|
E.coli
|
E. histolytica
|
Staphylococcus
| 1b
|
single
|
b. E. coli(Ref: Nelson's 20/e p 2540-2543, Ghai 8/e p 487-491)The given condition is most likely HUS for which the most common organism is E. coli, among the given options
|
Pediatrics
|
Kidney
|
1145ffe0-9446-4a6b-b0b4-6b3c5beb8513
|
A 22 year old athlete had twisting injury to his right ankle. A lot of swelling around the medial malleolus was observed . An X-ray which did not show any fracture. Most probable structur to be injured is :
|
Tendo Achilles
|
Spring ligament
|
Anterior talofibular ligament
|
Deltoid ligament
| 3d
|
multi
|
The structure injured here is Deltoid Ligament. Mechanism of Injury : Forced eversion combined with external rotation. Deltoid ligament Forms medial pa of the ankle joint. It attaches the medial malleolus to multiple tarsal bones.
|
Orthopaedics
|
Spos Injury
|
f4eade2a-0ba4-4200-a256-978bfa35e4c7
|
Theory of contagion was first enunciated by
|
Paracelsus
|
Fracastorius
|
Vesalius
|
Pare
| 1b
|
single
|
Revival of medicine encompasses period from 1453 -1600. Fracastorius an Italian physician enunciated &;theory of contagion&;. He envisaged transmission of infection minute invisible paicles and explained cause of epidemics. He recognised syphilis was transmitted from person to person during sexual relationss. He is founder of epidemiology. Ref: Park&;s textbook of preventive and social medicine; 23rd edition; Pg no: 5
|
Social & Preventive Medicine
|
Concept of health and disease
|
379c03f7-98f8-4103-9b24-d6156d077f63
|
Which is not Glucogenic ?
|
Arginine
|
Histidine
|
Glycine
|
Lysine
| 3d
|
single
|
Ans. is 'd' i.e., Lysine
|
Biochemistry
| null |
2ce38c05-4e0d-4fc1-aec2-c1ac061ec76b
|
APGAR score - include all except ?
|
Hea rate
|
Respiratory rate
|
Muscle tone
|
Color
| 1b
|
multi
|
Ans. is 'b' i.e., Respiratory rate
|
Pediatrics
| null |
4545ae5c-d0e4-4f49-8206-b2d6aa577006
|
Safest method of Airway maneuver is:
|
Head tilt.
|
Chin lift.
|
Jaw thrust.
|
All of the above.
| 2c
|
multi
| null |
Surgery
| null |
39e7f659-489e-4737-bbe2-563881a4b33f
|
All of the following may cause Traumatic Asphyxia, except
|
Railway Accident
|
Road Traffic Accident
|
Accidental strangulation
|
Stampede in crowd
| 2c
|
multi
|
Traumatic asphyxia results from respiratory arrest due to mechanical fixation of the chest so that the normal movements of the chest wall are prevented. Here all options other than accidental strangulation can result in fixation or compression of chest wall. But in accidental strangulation there will be compression of the neck by a ligature without suspending the body i.e. there is no fixation of the chest wall. Hence it is not a type of traumatic asphyxia. Ref: The synopsis of forensic medicine & Toxicology 28th edition pg: 190
|
Forensic Medicine
|
Asphyxia
|
f151dab7-7520-459c-bffe-796c19f5c155
|
Which of the following is a pure histological landmark for termination of cleaning and shaping of root canal?
|
CDJ
|
CEJ
|
DEJ
|
None
| 0a
|
multi
|
Cementodentinal junction is considered as a pure histological landmark for termination of cleaning/shaping and obturation.
|
Dental
| null |
c8d34a52-7343-469d-b6b9-28dc4bfd9025
|
The principle component of surfactant that reduces surface tension in the alveoli and keeps them inflated and non-collapsed?
|
Dipalmitoyl phosphatidylcholine
|
Phosphatidylglycerol
|
Carbohydrate component
|
Lipopolysaccharide
| 0a
|
single
|
Ans. a (Dipalmitoyl phosphatidylcholine); (Ref. Ganong, Physiology, 21st ed., 657)SURFACTANT-- produced by type II pneumocytes,# Role--- | Alveolar surface tension,- | Compliance,- | work of inspirationApproximate Composition Of Surfactant: ComponentComposition1.Dipalmitoyl phosphatidylcholine62%2.Phosphatidylglycerol05%3.Other phospholipids10%4.Neutral lipids13%5Proteins08%6Carbohydrate02%Note: Phosphatidylcholine appears in 24th week of intrauterine life.
|
Physiology
|
Respiratory System
|
0b50a50b-d45f-4999-a86f-ff32798a40bc
|
Likely cause of this manifestation is:
|
Candida
|
Pseudomonas
|
Staphylococcus aureus
|
Fusarium
| 1b
|
single
|
Diagnosis of this image is green nail syndrome. Paronychial infection that can develop in individuals whose hands are frequently submerged in water. Cause- Pseudomonas aeruginosa
|
Microbiology
|
Systemic Bacteriology (Gram Positive Bacilli, Gram Negative Bacilli)
|
79cbf81a-3cc4-4c51-8aec-4e1939e7f674
|
Which of the following is a characteristic post moem finding of drowning?
|
Dribbling of saliva
|
Cherry red discolouration
|
Paltauf's haemorrhages
|
Pugilistic attitude
| 2c
|
single
|
Paltauf's haemorrhages are postmoem changes of drowning. The alveolar walls may rupture due to increased pressure during forced expirations, and produce hemorrhages, which when present subpleurally are called 'Paltauf's hemorrhages'. Paltauf' s haemorrhages are shining, pale bluish-red, and may be minute or 3-5 cm. in diameter. They are usually present in about 50% of cases in the lower lobes of the lungs, but may be seen on the anterior surfaces of the lungs, and the interlobar surfaces. Ref: The Essentials of Forensic Medicine and Toxicology by KS Narayan Reddy, 27th edition, Page 327.
|
Forensic Medicine
| null |
1d780d10-b70d-4c29-a007-25a947980516
|
Which among the following is the culture media of leptospira?
|
Kohof
|
Perkin
|
Tinsdale
|
Bakers
| 0a
|
single
|
Leptospira is a fastidious organism and can be grown on Kohof Babudeiri, Stua's medium and Fletcher's semisolid medium. EMJH media is the most successful medium for its growth. Tinsdale medium is used for the isolation of Corynebacterium diphtheriae. Other culture medium used for C. diphtheriae are Loffler's medium and dorset egg medium, tellurite agar. Ref: Molecular Detection of Human Bacterial Pathogens edited by Dongyou Liu, page 1175
|
Microbiology
| null |
df6c9d3c-4d28-4e42-98cf-6adf5d0bfcc5
|
Least likely associated with SLE -
|
Anti ds DNA
|
Anti Sm
|
Anti topoisomerase
|
Anti histone
| 2c
|
single
|
Ans. is 'c' i.e., Anti topoisomerase Best screening test for SLE is demonstration of antinuclear antibodies :o Most sensitive test for SLE- Anti nuclear antibodies (ANA).o Most specific test for SLE- Anti ds DNA, Anti Sm.
|
Pathology
|
Autoimmune Diseases
|
c0e4d44a-e570-4e15-b85f-9082eee3e57e
|
All are used for monitoring of air pollution except-
|
Haze coefficient
|
Air pollution index
|
Smoke index
|
Kanawati index
| 3d
|
multi
|
Ans. is 'd' i.e., Kanawati index Monitoring of air pollutiono Monitoring of air pollution is done by : -Sulphur dioxide.Gritt and dust measurement.Co-efficient of haze.Air pollution index.Smoke or soiling index
|
Social & Preventive Medicine
|
Environment and Health
|
9503ef96-fed4-4ec6-bca9-fea54738e0cc
|
Decerebrate rigidity is characterised by all except
|
Abnormal extensor response
|
Wrists and fingers flexed
|
Arms flexed at elbow
|
Plantar flexion of foot
| 2c
|
multi
|
Decerebrate rigidity is characterised by adducted arms and extended elbow
|
Medicine
| null |
d48354e8-afe7-4473-86cd-3a2ff26cb395
|
Exclusive breast feeding is advised till what age-
|
3 months
|
6 months
|
9 months
|
10 months
| 1b
|
single
|
Ans. is 'b' i.e., 6 month
|
Pediatrics
|
Newborn Infant - Parent-Infant Bonding
|
66e61a7b-da49-448d-b495-28eb20fe689f
|
Which of the following drug(s) is/are mainly metabolized extra hepatically in plasma?
|
Halothane
|
Propofol
|
Lignocaine
|
Atracurium
| 3d
|
multi
|
Ans. is 'd' i.e., AtracuriumoThe principal site for the metabolism of propofol is the liver.oHalothane is metabolized in the liver primarily by CYP2E1, and to a lesser extent by CYP3A4 and CYP2A6oLidocaine is about 95% metabolized (dealkylated) in the liver mainly by CYP3A4oThe unique feature of atracurium is inactivation in plasma by spontaneous nonenzymatic degradation (Hofman elimination) in addition to that by alkaline ester hydrolysis.PropofoloThe principal site for the metabolism of propofol is the liver. However, the total body clearance of propofol is greater than the generally accepted hepatic blood flow and significant extrahepatic metabolism also occur in lungs, and excreted via kidney. Metabolic clearance of propofol by the kidneys accounts for almost one-third of total body clearance and may be the major contributor to the extra-hepatic elimination of this drug.HalothaneoHalothane is an inhalational anesthetic. Most of the inhaled anesthetics are eliminated from lung, though some metabolism in liver may occur. In terms of extent of hepatic metabolism, the rank of order is methoxyflurane (>50%) > Halothane (20%)> Ether (10-15%)> enflurane (3-5%)> Sevoflurane (3%)> Isoflurane (0.2%)> desflurane (<0.1%)>N2 O(0%). N2 O does not have any metabolism in the body.oHalothane is metabolized in the liver primarily by CYP2E1, and to a lesser extent by CYP3A4 and CYP2A6 LignocaineoLidocaine is about 95% metabolized (dealkylated) in the liver mainly by CYP3A4 to the pharmacologically active metabolites monoethylglycinexylidide (MEGX) and then subsequently to the inactive glycine xylidide. Lignocaine clearance is reduced in patients with liver disease and appears to be a sensitive index of liver dysfunction.AtracuriumoThe unique feature of atracurium is inactivation in plasma by spontaneous non-enzymatic degradation (Hoffman elimination) in addition to that by alkaline ester hydrolysis. Consequently its duration of action is not altered in patients with hepatic/renal insufficiency or hypodynamic circulation - Preferred muscle relaxant for such patients as well as for neonates and the elderlyoThe major degradation product is laudanosine. Metabolites can be considered as pharmacologically inactive with the usual doses of atracurium. Because of spontaneous degradation of atracurium in plasma, its kinetics is theoretically independent of renal and liver functions.
|
Anaesthesia
|
General Anesthesia
|
2439f79f-4894-47ea-9dda-e3abd7f2d343
|
All of the following may be seen with Neuroleptic malignant syndrome except -
|
Hypothermia
|
Altered consciousness
|
Muscle rigidity
|
Involuntary movements
| 0a
|
multi
|
Ans. is 'a' i.e., Hypothermia Features of Neuroleptic malignant syndrome o Marked muscle rigidity o Semiunconciousness o High fever (not hypotermia) o Extrapyramidal effects (involuntary movement) o Autonomic instability (Fluctuating BP & Hea rate) o Increased CPK.
|
Pharmacology
| null |
bd326d17-d993-4078-8922-b5db25c9f84f
|
Which organelle is involved in the case of sphinghomyelin deficiency:
|
Lysosome
|
Nucleus
|
Mitochondria
|
Cell membrane
| 0a
|
single
|
Ans. (a) LysosomeRef: Harper's Biochemistry, 30th ed. pg. 251* Sphinghomyelin is a major neural tissue component, the core structure of which is formed by ceramide.* It is the only sphingholipid without sugar.* The common sphinghomyelin deficiency is Neiman-Pick disease. The organelle which is involved is the lysosomes which allow accumulation of sphinghomyelin.* Signs & symptoms of Niemen pick's: Hepatosplenomegaly, decreased appetite, unsteady gait, ataxia, slurring of speech (due to accumulation of sphingholipids in neural tissue).
|
Biochemistry
|
Lipids
|
b4363433-36ec-4f99-b257-b892c0447502
|
Which of the following most commonly cause intraorbital metastasis in female :
|
Breast cancer
|
Cervical cancer
|
Ovarian cancer
|
Endometrial cancer
| 0a
|
single
|
Carcinoma breast cause metastasis in both bone and soft tissues. Brain secondaries may leads to intraorbital metastasis. For more information refer page no 558 of SRB'S manual of surgery ,5 th edition.
|
Gynaecology & Obstetrics
|
Gynaecological oncology
|
02cc6c53-430f-4db9-93b2-b248cb047b70
|
Uterine-cervix ratio up to 10 years of age:
|
3:02
|
2:01
|
3:01
|
1:02
| 3d
|
single
|
The relationship of the length of the cervix and that of the body of uterus varies with age.
|
Gynaecology & Obstetrics
| null |
52e5c3be-7eb7-4cff-9edf-74c8a4ae671d
|
The main action of muscle "GameIlius" is:
|
Medial rotation of thigh
|
Lateral rotation of thigh
|
Flexion of hip
|
Extension of hip
| 1b
|
single
|
Lateral rotation of thigh
|
Anatomy
| null |
6bfe94ee-1568-4ea6-bd6e-9f55bd073bef
|
drug with teratogenic potential is
|
carbamezepine
|
clonazepam
|
risperidone
|
olanzapine
| 0a
|
single
|
- SIDE EFFECTS OF THE DRUG - APLASTIC ANEMIA - AGRANULOCYTOSIS - Hyponatremia - Steven Johnson's syndrome - Liver enzyme elevation - It has teratogenic potential ref. kaplon and sadock, synopsis of psychiatry, 11 th edition,pg no.935
|
Anatomy
|
Pharmacotherapy in psychiatry
|
29d61a90-f241-45ac-92bb-133f761ba5f1
|
The most important aspect in treating Disseminated Intravascular Coagulation (DIC) is to:
|
Administer heparin
|
Administer platelets
|
Treat the underlying disease process
|
Achieve normal levels of fibrinogen
| 2c
|
single
| null |
Medicine
| null |
aa2ef8ff-fb08-42ca-a410-744e91765594
|
In the management of toxicity caused by ingestion of methanol in wood spirits, which one of the following statements is most accurate?
|
Treatment should involve the administration of disulfiram in the ER.
|
Naltrexone is a suitable antidote in poisoning due to alcohols.
|
Ethanol will prevent formation of formaldehyde in methanol poisoning.
|
Hemodialysis will not remove methanol from the blood.
| 2c
|
multi
|
Ethanol saturates alcohol dehydrogenase (ADH) at very low blood levels (zero- order elimination), preventing the conversion of methanol to formaldehyde, a toxic compound that can result in blindness. Ethanol (IV) continues to be used as an antidote in poisoning due to the ingestion of liquids containing methanol or ethylene glycol (antifreeze). Hemodialysis is also employed in management of methanol intoxication. Disulfiram (Antabuse) is an inhibitor of aldehyde dehydrogenase used in some alcohol rehabilitation programs, and naltrexone (an opioid antagonist) is approved for use in alcoholism because it decreases "craving." Delirium tremens is a characteristic of the withdrawal or abstinence syndrome in patients who have become physically dependent on ethanol.
|
Pharmacology
|
C.N.S
|
8e290d6c-1039-4262-8b97-d28d24bede8b
|
For age determination of 21 year old female , site for X-ray done
|
Elbow and shoulder
|
Wrist
|
Hip and knee
|
Iliac crest and clavicle
| 3d
|
single
|
D i.e. Iliac crest & clavicle The following data is used for radiologically age determination. Region selected for X Ray Age Girls Boys ElbowQ 13 -14 15 -17 WristQ 16 - 17 18 - 19 Shoulder 17-18 19-20 Crest of IliumQ 18 -19 20 - 21 Ischial Tuberosity 21 - 220 23 - 24Q Inner end of clavicle * Way of remembering : By radiological examination of wrist we can determine age of 16, 17, 18, 19; From shoulder 17, 18, 19, 20 & from crest of ilium examination 18, 19, 20, 21. These all are 4 continuous numbers staing from 16 from wrist, 17 for shoulder & 18 for crest of ilium. Also remember that Pt two years are for girls & last two for boys. Radiological examination of elbow is done for age determination before this i.e. 13 - 16 yrs. & R.E. of Ischial tuberosity & Clavicle inner end is done for 21, 22, 23, 24 age group (Ist 2 years for girls & last 2 years for boys).
|
Forensic Medicine
| null |
466bb3f8-cd0f-429d-9ba0-6641bbe1ed73
|
A 35 year old woman complains of severe lower abdominal pain, which is worst during menstruation. Laparoscopic examination of the pelvis demonstrates multiple small brown spots on the surface of pelvic structures. Most of these lesions are cauterized, but biopsy of one of the remaining lesions reveals glandular tissue resembling normal endometrium. No cytologic atypia or abnormally shaped glands are seen. Which of the following is the most likely diagnosis?
|
Acute endometritis
|
Adenomyosis
|
Chronic endometritis
|
Endometriosis
| 3d
|
multi
|
This benign condition is endometriosis, rather than metastatic endometrial cancer. Endometriosis is defined as a benign growth of endometrium at sites at which it does not normally occur (excluding the myometrium, at which site it is called adenomyosis). Endometriosis is common and is a significant cause of both pain and pelvic scarring. Most of the problems occur because the abnormally located endometrium responds to hormonal control and may menstruate, producing a very irritating fluid. Endometriosis may apparently be staed either by seeding of menstrual cells in the pelvis (entering through the open end of the fallopian tubes) or by metaplasia of mesothelial or other cells (accounting for rare, well-documented cases of endometriosis of bizarre sites such as nasal mucosa or lungs). Acute endometritis is acute inflammation of the endometrium. Adenomyosis is characterized by foci of endometrium deep in the myometrium. Chronic endometritis is chronic inflammation of the endometrium. Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 10. Endometriosis. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e.
|
Gynaecology & Obstetrics
| null |
cff8853e-242a-4354-aa09-b10d22ecc5d8
|
False about folic acid
|
It is present in all the green leafy vegetables
|
It is proven to decrease the occurrence of neural tube defects when taken pre-natal
|
Wheat flour in India is foified with folate as in USA
|
Methyl folate trap is because of methionine synthase defect
| 2c
|
multi
|
Folic acid : Folic acid acts as a carrier of one-carbon units. The active form of folic acid (pteroyl glutamate) is tetrahydrofolate. Sources: Leafy Green Vegetables, Legumes, Seeds, Liver, The folates in foods may have up to seven additional glutamate residues linked by -peptide bonds. In addition, all of the one-carbon substituted folates may also be present in foods The extent to which the different forms of folate can be absorbed varies, and folate intakes are calculated as dietary folate equivalents--the sum of g food folates + 1.7 x g of folic acid (used in food enrichment). Prevents NTD in fetus, and Lowers homocysteine. Metabolism: The one-carbon fragment of methylene-tetrahydrofolate is reduced to a methyl group with release of dihydrofolate, which is then reduced back to tetrahydrofolate by dihydrofolate reductase.
|
Pharmacology
|
All India exam
|
8363bddd-5025-4199-99a1-3baccc77b080
|
Retinoblastoma gene regulates?
|
G1-s phase
|
G2 to M phase
|
G0 to G 1 Phase
|
S-G2 Phase
| 0a
|
single
|
harshmohan textbook of pathology 7th edition. *active form of RB gene :it blocks cell division by binding to the transcription factor E2F and this inhibits the cell from transcription of cell cycle related gene there by inhibiting the cell cycle at G1.
|
Pathology
|
General pathology
|
6a6f4f76-6710-4e41-a693-d578f9e8b832
|
Which of the following is a cause for autoimmune hemolytic anemia?
|
CLL
|
IMN
|
Sickle cell anemia
|
Both CLL & IMN
| 3d
|
multi
|
In sickle cell anemia the hemolysis is due to structural defect in the B chain causing increased stickiness. It is not immune related.
|
Medicine
| null |
b0500326-7315-42c7-b50f-bfb80696691d
|
A 10-year-old boy was admitted to the ward with complaints of fever for 2 weeks duration. After admission his fever pattern is recorded (shown below). In addition, he has ahritis and hepatosplenomegaly. What is the likely diagnosis?
|
Systemic onset JIA
|
Acute Leukemia
|
Enteric fever
|
Measles
| 0a
|
single
|
The depicted fever pattern is suggestive of Quotidian fever. Quotidian fever means the presence of daily fever spikes with temperature touching and going below baseline (37oC ) on occasions. Among the given options, this fever pattern is suggestive of Systemic onset JIA. In Systemic onset JIA, in addition to ahritis, Systemic features such as fever, evanescent rash, enlarged liver and spleen, lymphadenopathy, serositis and pericardial effusions can be seen
|
Pediatrics
|
Other disorders of bone
|
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